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[2026] ACAT 27
ACT Civil and Administrative Tribunal
2026-06-09
Original judgment source is linked above.
Source: the ACT Civil and Administrative Tribunal (www.acat.act.gov.au). Converted to plain text by ZoeLaw. Not the official version.
ACT CIVIL & ADMINISTRATIVE TRIBUNAL
NURSING AND MIDWIFERY BOARD OF AUSTRALIA v GOURZIS (Occupational Discipline) [2026] ACAT 27 OR 13/2025 Catchwords: OCCUPATIONAL DISCIPLINE – HEALTH PROFESSIONAL – professional misconduct – non-compliance with registration conditions relating to alcohol breath testing and workplace supervision – prior disciplinary history – interstate service – failure to participate in proceedings – ex parte hearing
Legislation cited: ACT Civil and Administrative Tribunal Act 2008 s 47A(2) Health Practitioner Regulation National Law (ACT) ss 3A, 5, 120, 193, 195, 196 Service and Execution of Process Act 1992 (Cth) Subordinate legislation cited: ACT Civil and Administrative Tribunal Procedures Rules 2024 rr 19, 20, 25, 134 Nursing and Midwifery Board of Australia, ‘Code of Conduct for Nurses’ Cases cited: Briginshaw v Briginshaw (1938) 60 CLR 366 Chinese Medical Board of Australia v Zhou [2020] SACAT 23 GLJ v The trustees of the Roman Catholic Church for the Diocese of Lismore [2023] HCA 32 Health Care Complaints Commission v Neale [2024] NSWCATOD 16 Health Care Complaints Commission v Philipiah [2013] NSWCA 342 Health Ombudsman v HSK [2018] QCAT 419 Health Ombudsman v Joy [2020] QCAT 202 Lee v Health Care Complaints Commission [2012] NSWCA 80 Medical Board of Australia v Al-Naser (No. 3) [2024] ACAT 9 Medical Board of Australia v CQW [2021] VCAT 346 Medical Board of Australia v Griffiths [2017] VCAT 822 Medical Board of Australia v Hocking [2015] ACAT 44 Medical Board of Australia v Jansz [2011] VCAT 1026 Medical Board of Australia v QLX [2023] QCAT 60 Medical Board of Australia v Singh [2017] WASAT 33 Medical Board of Australia v Stone [2023] ACAT 38 Nursing and Midwifery Board of Australia v Crivici [2026] ACAT 7 Nursing and Midwifery Board of Australia v Gourzis, (NTCAT, Members Meier, Perry and Luppino, 22 October 2025) Nursing & Midwifery Board v Hogan [2018] TasHPT 3 Nursing and Midwifery Board of Australia v Nurse DZ [2015] ACAT 93 Nursing and Midwifery Board of Australia v Stokes [2021] VCAT 1319 Nursing and Midwifery Board of Australia v Szkup [2022] SACAT 18 Osteopathy Board of Australia v Caminiti [2024] ACAT 72 Osteopathy Board of Australia v Canagasabai [2024] VCAT 358 Perpetual Trustees Australia Ltd v Heperu Pty Ltd (No 2) [2009] NSWCA 387 Prakash v Health Care Complaints Commission [2006] NSWCA 153 Williams v Medical Practitioners Board of Victoria [2008] VCAT 1784 Texts/Papers cited: Australian College of Midwives, The Role of Midwifery in the First 2000 Days (9 November 2023) Tribunal: Senior Member E Morrison
Date of Orders: 2 June 2026 Date of Reasons for Decision: 2 June 2026 Date of Publication: 9 June 2026 AUSTRALIAN CAPITAL TERRITORY ) CIVIL & ADMINISTRATIVE TRIBUNAL ) OR 13/2025
BETWEEN: NURSING AND MIDWIFERY BOARD OF AUSTRALIA Applicant AND: REBECCA GOURZIS Respondent TRIBUNAL: Senior Member E Morrison
DATE: 2 June 2026 ORDER Ex parte the respondent: The Tribunal being satisfied that the respondent has behaved in a way that constitutes professional misconduct within the meaning of paragraphs (a) and (b) of the definition of ‘professional misconduct’ in section 5 of the Health Practitioner Regulation National Law (ACT) (the National Law), and noting that the respondent has not held registration as a midwife since 12 June 2023, the Tribunal orders:
The respondent is reprimanded.
The respondent is disqualified from applying for re-registration as a health practitioner for a period of twelve months from the date of this order.
The respondent is prohibited from providing any health service for a period of twelve months from the date of this order. The Tribunal further orders that:
Pursuant to section 195 of the National Law, the respondent is to pay the applicant’s costs of these proceedings for a fixed amount of $10,750 (GST inclusive).
………………………….. Senior Member E Morrison REASONS FOR DECISION
The Nursing and Midwifery Board of Australia (the Board) seeks orders for occupational discipline against the respondent under section 196 of the Health Practitioner Regulation National Law (ACT) (the National Law).
The Board alleges the respondent failed to comply with conditions imposed on her registration as a midwife while working at Calvary John James Hospital, Canberra (Calvary Hospital) in April and May 2023.
The conditions related to breath alcohol testing, general workplace supervision, and oversight by a ‘senior person’ who could monitor the respondent’s compliance with her registration conditions and report to the Australian Health 1 Practitioner Regulation Agency (Ahpra).
The respondent has a prior disciplinary background. Her registration as a midwife was suspended in 2014 and 2023, for different reasons. The respondent surrendered her midwifery registration in June 2023.
In November 2025, the Northern Territory Civil and Administrative Tribunal (the NTCAT) found the respondent engaged in professional misconduct when she worked as a registered nurse without the relevant qualification or nursing registration. The NTCAT made disciplinary orders that included a three-year prohibition on applying for re-registration.
For the reasons below, I have determined that: (a) the key facts constituting the alleged conduct are established; (b) the respondent’s conduct warrants a finding of professional misconduct as defined in paragraphs (a) and (b) of the definition in section 5 of the National Law; and
1 Ahpra is the regulator responsible for administering the national regulation and health accreditation scheme for health practitioners in Australia (c) disciplinary orders in the form of a reprimand, and a twelve-month disqualification and prohibition period is warranted to protect the public and maintain confidence in the health profession.
The respondent’s failure to participate in these proceedings
Natural justice requires that all parties to a proceeding are on notice of the key issues to be determined and have a reasonable opportunity to respond.
The ACT Civil and Administrative Tribunal Procedures Rules 2024 (the ACAT Rules) prescribe specific service requirements in disciplinary proceedings. Rule 134(3) requires that the applicant (in this case, the Board) must personally serve 2 a sealed copy of the application on the respondent. This is different to other ACAT proceedings where the Registrar generally serves the application and there is more flexibility with how service can be effected (such as by post, email or text 3 message in limited circumstances).
Additional service requirements apply where an application is served interstate. The Service and Execution of Process Act 1992 (Cth) requires a ‘Form 4’ to be attached to the application. The Form 4 ensures that the ‘legal power’ of the claim is recognised when legal proceedings are commenced against a party located in another Australian jurisdiction.
The respondent to these proceedings now lives in South Australia but the Board was unable confirm her physical address. A process server could not locate her personally and documents sent by post were returned to sender.
To overcome this challenge, the Tribunal made substituted service orders under rule 25 of the ACAT Rules. The Board was directed to serve the application on the respondent using her last known email address with a corresponding 4 notification to her Facebook account advising that the email had been sent. The
2 Or otherwise by giving it to the respondent in an agreed way or by service on the respondent’s solicitor if they are instructed to accept service 3 See ACAT Rules, rr 19-20 4 For discussion of substituted service, see Osteopathy Board of Australia v Caminiti [2024] ACAT 72 and Nursing and Midwifery Board of Australia v Crivici [2026] ACAT 7 (Crivici) Tribunal was satisfied, when making those orders, that the respondent’s email and Facebook accounts were currently active.
The Tribunal also made orders requiring the Board to serve all other documents relevant to these proceedings on the respondent in the same way. This included the respondent’s bundle of evidence and supporting material (called the Book of Documents), a copy of the Tribunal’s previous orders (which included orders for the respondent to file a response and material in reply to the application), and the listing notice for the final hearing.
In making these orders, the Tribunal formed the view that sending the documents in that way was reasonably likely to bring them to the respondent’s attention.
The Board provided proof of service in the form of affidavits, copies of sent emails and screenshots of the Facebook notifications. There was no suggestion that email delivery had failed or that the respondent’s Facebook account had been deactivated since the substituted service orders had been made.
The respondent did not provide any response or supporting documents, nor did she attend any of the directions or final hearings.
At the beginning of the final hearing, I determined that the respondent had been properly served with the application and Book of Documents, and been afforded a reasonable opportunity to respond to the Board’s allegations and orders sought. I was also satisfied the respondent was on notice of the time, date and location of the hearing. I proceeded to hear the application in the respondent’s absence pursuant to section 47A(2) of the ACT Civil and Administrative Tribunal Act 2008 (the ACAT Act).
That said, despite proceeding ex parte, before making disciplinary orders, I still needed to be satisfied that the underlying facts were established and the proposed disciplinary orders were appropriate for achieving the purpose of protecting the public, maintaining proper professional standards and upholding the public’s 5 confidence in the profession.
5 Perpetual Trustees Australia Ltd v Heperu Pty Ltd (No 2) [2009] NSWCA 387
The Board must prove its case to the civil standard: on the balance of probabilities. In disciplinary proceedings, the standard is to be applied having regard to the Briginshaw principle that the gravity of the facts to be proved calls 6 for a higher degree of satisfaction. As the Tribunal stated in Nursing and 7 Midwifery Board of Australia v Crivici (Crivici): Findings of fact must be proved to the reasonable satisfaction of the Tribunal having regard to the seriousness of the allegations, the inherent unlikelihood of an occurrence of a given description, or the gravity of the consequences flowing from a particular finding. The Tribunal must be 8 “comfortably satisfied” of those facts, on proper evidence.
I reserved my decision at the end of the hearing and made directions for each party to file a submission in relation to costs.
Relevant background and findings of fact
Work and disciplinary background prior to 2020
The respondent was first registered as a midwife on 31 January 2007. Her registration with the Board was national — it entitled her to practice as a midwife anywhere in Australia, subject to any conditions imposed on her registration.
Between April 2001 and November 2012, the respondent was convicted of criminal offences on four occasions. Three convictions related to driving under 9 the influence or with excess blood alcohol.
6 Briginshaw v Briginshaw (1938) 60 CLR 366 at 361-362 per Dixon J; GLJ v The Trustees of the Roman Catholic Church for the Diocese of Lismore [2023] HCA 32 at [57] 7 [2026] ACAT 7 8 At [41] 9 Book of Documents at 14-15
Between May 2008 and October 2013, the respondent was employed as a midwife at Burnside Hospital in South Australia. During that time, she commenced, but 10 discontinued, studying a Bachelor of Nursing degree.
Between 2010 and 2013, allegations were made that the respondent had reported to work affected by alcohol.
In March 2014, the respondent gave the Board a signed undertaking that she would, among other things, submit to alcohol breathalyser testing and maintain a log of test results. The Board accepted the undertaking and removed conditions 11 that had been imposed on her registration.
On 5 September 2014, the Board suspended the respondent’s midwifery registration due to non-compliance with her undertaking. The suspension ended 12 on 2 April 2015.
On 2 July 2015, the respondent allowed her midwifery registration to lapse. She 13 did not reapply for registration until 2020.
Grant of conditional registration as a midwife in 2021
In 2020, the respondent applied for re-registration as a midwife. 14
On 8 April 2021, the Board granted registration subject to 11 conditions. At the time of her re-registration, the respondent had been out of practice for five years and eight months.
The registration conditions can be summarised as follows: (a) Alcohol breath testing must occur within 30 minutes before and after each period of practice, and otherwise as directed (Condition 1). Breath testing must be administered by an approved supervisor (the breath test supervisor). Respondent’s nomination of the breath test supervisor to
10 Nursing and Midwifery Board of Australia v Gourzis (NTCAT, Members Meier, Perry and Luppino, 22 October 2025) (Gourzis), at [5]-[7] 11 Gourzis at [8] 12 Gourzis at [9] 13 Gourzis at [9] – [10] 14 Book of Documents at 16-22 Ahpra must be accompanied by written confirmation from that person (on the approved form) (Condition 3). (b) Prohibited from practice following a positive breath test result, and obligation to notify Ahpra (Condition 2). (c) Prohibited from practice unless supervised by another registered health practitioner (the supervisor), who must be approved by Ahpra (Conditions 5 and 7). (d) Must cease practice where an approved supervisor is not willing or able to provide the required supervision, and must not resume practice until Ahpra has approved a new supervisor (Condition 7). (e) Within 14 days of receiving notice of the conditions, the respondent must give to Ahpra (using the approved forms): (i) Details of her nominated primary supervisor and at least one alternate supervisor, to be approved by Ahpra (i.e. the supervisor). The nomination form must be accompanied by the person’s acknowledgement that they are willing to undertake the role and understand that Ahpra may seek reports from them (Condition 6). (ii) Confirmation that the respondent understands the drug and alcohol testing protocol and monitoring requirements of breath test analysis (Condition 4(a)). (iii) An acknowledgement that Ahpra may obtain information from relevant authorities, and monthly reports from the respondent’s approved supervisor and/or a senior person at each workplace (Condition 8). The senior person must be the Director of Nursing, Senior Practice Manager or a Senior Manager. (iv) Written confirmation by the senior person at each place of practice that Ahpra may contact them for the purpose of monitoring compliance with the conditions (Condition 4(b). (v) Written confirmation by the senior person at each place of practice that Ahpra may contact them for the purpose of obtaining reports (Condition 9). (f) Within 21 days of receiving notice of the conditions, and within seven days of commencing practice at each subsequent place of practice, the respondent must give to Ahpra (using the approved forms): (i) Contact details of a senior person at each current place of practice. By providing the contact details, the respondent acknowledges that Ahpra will contact the senior person and provide them with a copy of her registration conditions or confirm they have received a copy from the respondent (Condition 10). (g) If and when the registration conditions are changed, respondent must provide the senior person information to Aphra within seven days of that change (Condition 10). (h) The respondent must bear all costs associated with compliance of her registration conditions (Condition 11).
Correspondence about registration conditions and partial compliance
On 15 April 2021, Ahpra sent the respondent an email about her conditional 15 registration and compliance monitoring. The email noted that the respondent’s conditions required her to give Ahpra several forms, with the first bundle due on 22 April 2021. The email also stated: I take this opportunity to advise that you are unable to start practising as a midwife until you have at least one breath testing administrator and supervisor nominated and approved by the Board & have provided to Ahpra evidence of an approved breath testing device.
Attached to the email was a letter providing further information about compliance monitoring, a further copy of her registration conditions, a Monitoring Plan setting out the due date for each form, the Drug and Alcohol Screening Protocol, 16 and the required forms.
15 Book of Documents at 23 16 Book of Documents at 24-57
On 19 April 2021, the respondent replied by email confirming she had received 17 the notification and Monitoring Plan. Her email advised Ahpra that: I am not currently working as a midwife and do not ever intend to do the wrong thing by AHPRA. I am assuming it may take me a bit of time to secure a position as a midwife and don’t think me returning all of the completed forms to you is completely achievable.
On 22 April 2021, the respondent exchanged emails with Ahpra about the forms, given she was not then working as a midwife. The respondent sent two forms to Ahpra — the breath testing practitioner acknowledgement form and the supervised practice acknowledgement form. In doing so, the respondent complied with Conditions 4(a) and 8.
Work as a registered nurse between 2021 and 2023
Between 2021 and 2023, the respondent obtained employment and practised as a 18 registered nurse as follows: (a) September 2021 to April 2023 — with Calvary Health Care’s Virtual Call Centre, initially in the position of team leader and then casually. (b) December 2022 to January 2023 — with Central Australian Aboriginal Congress (CAAC) in the Northern Territory.
The Board later commenced disciplinary proceedings against the respondent in relation to those positions, which is referred to below.
Application to review conditions and midwifery work at Calvary Hospital in 2023
On 9 January 2023, the respondent’s employment at CAAC ceased after an 19 internal investigation. At that time, she was still employed at Calvary’s virtual call centre.
On 11 January 2023, the respondent applied to the Board for review and removal 20 of the conditions on her midwifery registration. In her application, the
17 Book of Documents at 58 18 Book of Documents at 166-167 19 Book of Documents at 138 20 Book of Documents at 65-70 respondent stated she was working as a manager and not as a midwife, had made significant changes to her employment, place of practice and practice setting, had won a national award, and had complied with Ahpra’s directions for the past two years.
On 24 February 2023, the respondent sent Ahpra an email following up on her application. She stated that her practise conditions: … [had] no bearing on my current situation and I would like to move forward and pursue a career in Health Management with a Midwifery focus 21 WITHOUT having conditions on my Registration.
On 11 April 2023, the respondent commenced work at Calvary Hospital as a 22 midwife. At that time, she had not received any notification from the Board about whether it had agreed or refused to remove her registration conditions.
On 26 April 2023, the Board decided to refuse the respondent’s application to 23 remove her registration conditions. The Board’s reasons included that the respondent had not practised as a midwife since she was granted conditional registration, there was no ‘tangible’ evidence to support her claim of a continued stable relationship with alcohol and the conditions were put in place as safety measures.
On 29 April 2023, the respondent emailed Ahpra to advise that she was commencing employment at Calvary Hospital as a midwife and provided the 24 names and contact details for two direct supervisors. At that time, the respondent had been working as a midwife at Calvary Hospital for 18 days, and had not yet received notice of the Board’s refusal decision.
On 2 May 2023, the respondent was notified of the Board’s decision to refuse her 25 application to remove her registration conditions.
21 Book of Documents at 71 22 Book of Documents at 127-128 23 Book of Documents at 72-75; the respondent was notified of the decision by email on 2 May 2023 24 Book of Documents at 76 25 Book of Documents at 79-83
On the same day, Ahpra contacted the respondent by telephone and advised she had not obtained the required approvals to work at Calvary Hospital as a midwife 26 and should immediately cease practice.
On 2 and 3 May 2023, the respondent exchanged several emails with Ahpra. Ahpra provided a further copy of the registration conditions and relevant forms. The respondent provided proof of purchase of a breath alcohol testing device, advised she would commence breath testing before and after each shift, and 27 provided details of her nominated supervisors. 28
On 8 May 2023, the respondent emailed a bundle of forms to Ahpra. The bundle contained her acknowledgement of the requirement to undertake breath testing, nominated a senior person, nominated a primary supervisor, nominated a breath test supervisor, and contained a signed acknowledgement from her nominated primary supervisor and breath test supervisor. The respondent also provided a copy of her conditions with a signed acknowledgement that she had given the document to her nursing unit managers. The senior person acknowledgement form was unsigned.
On 14 May 2023, the respondent sent a second bundle of forms to Ahpra by 29 email. The bundle contained signed acknowledgement forms from a second nominated supervisor, a second nominated breath test supervisor and the senior person.
On 19 May 2023, the respondent ceased practice as a midwife at Calvary Hospital 30 but continued to work as a ward clerk until 16 June 2023.
26 Book of Documents at 84 27 Book of Documents at 85-97 28 Book of Documents at 97-114 29 Book of Documents at 115-118 30 Book of Documents at 131-132 Suspension and surrender of midwifery registration, and NTCAT disciplinary proceedings
On 7 June 2023, Ahpra advised the respondent the Board proposed to take suspend her registration following a notification by CAAC about her work in the Northern Territory as a registered nurse. 31
On 12 June 2023, the respondent surrendered her registration as a midwife.
On 15 June 2023, Ahpra notified the respondent that the Board had decided to take immediate action to suspend her midwifery registration while it investigated 32 the notification by CAAC.
On 13 July 2023, Ahpra advised the respondent that the Board had decided to commence a separate investigation relating to her compliance with the conditions imposed on her midwifery registration. The respondent replied by email asking 33 Ahpra not to contact her.
On 24 August 2023, Ahpra sent the respondent a formal request for her response to its investigation relating to her midwifery registration. Later that day, the 34 respondent replied by email asking Ahpra not to contact her.
NTCAT decision to make disciplinary orders
31 Book of Documents at 133-134 32 Book of Documents at 138-148 33 Book of Documents at 149 34 Book of Documents at 150-155 (b) held herself out to be, and purported to practice as, a registered nurse in the course of her employment with Calvary Health Care and CACC without holding a Bachelor of Nursing or registration as a registered nurse; (c) claimed that she held a Bachelor of Nursing degree, was a registered nurse, and had previously practised extensively as a registered nurse, when she 35 was not entitled to do so; and (d) ‘repeatedly’ failed to disclose her criminal history to Ahpra in 2010, 2011, 2012 and 2013 when applying for annual renewal of her midwifery 36 registration.
ACAT disciplinary proceedings 37
The Board filed its ACAT application on 27 June 2025. The application is made pursuant to section 193(1)(a) of the National Law.
The Board alleged that between 11 April 2023 and 19 May 2023, the respondent failed to comply with the conditions on her registration while practising as a midwife at Calvary Hospital, Canberra (now called North Canberra Hospital). In particular, the Board alleged breaches of Conditions 1, 3, and 5 – 10.
The Board submitted that the respondent’s conduct contravened: (a) clause 1.1(b) of the Nursing and Midwifery Board of Australia: Code of 38 Conduct for Midwives (Code of Conduct) which requires practitioners to inform their employers if a regulatory entity has imposed restrictions on their practice including conditions and recognise that a breach of any
35 Gourzis at [14]-[20] 36 Gourzis at [26] 37 Book of Documents at 1-13 38 Effective from 1 March 2018; Book of Documents at 173-193 restriction would place the public at risk and may constitute unprofessional conduct or professional misconduct; (b) clause 4.2(b) of the Code of Conduct to provide only accurate, honest and verifiable information about their registration, experience and qualifications, including any conditions that might apply to their registration; and (c) section 120(1) of the National Law which states that a registered health practitioner who is registered on conditions must not knowingly or recklessly claim, or hold themselves out, to be registered without the conditions or any conditions.
The Board further submitted that the respondent’s conduct constitutes professional misconduct as defined in section 5 of the National Law, and at 39 common law.
The Board sought disciplinary orders against the respondent under section 196(1) 40 of the National Law, being a reprimand and six-month disqualification period.
Did the respond fail to comply with her registration conditions? Practitioner acknowledgement forms — Conditions 4(a) and 8
On 22 April 2021, the respondent sent two forms to Ahpra — her breath testing practitioner acknowledgement form and the supervised practice acknowledgement form. These forms were provided 14 days after the Board’s decision to grant conditional registration. In doing so, the respondent complied with Conditions 4(a) and 8.
The respondent was not working as a midwife at that time, and so was unable to provide the other forms. This was not disputed by the Board at the hearing.
39 Application for Disciplinary Action at [13]; Notice of Allegations, para 4; Applicant Submissions, dated 23 January 2026 at [23] – [29] 40 Applicant Submissions, dated 23 January 2026 at [51]-[56] Nomination of supervisors, senior person — Conditions 4(b), 6, 9 and 10
On 8 and 14 May 2023, the respondent provided two bundles of forms to Ahpra for approval.
The first bundle contained: (a) a further signed version of the respondent’s acknowledgement forms; (b) the respondent’s signed nomination forms for two breath test supervisors, two primary/alternate supervisors, and two senior persons; (c) signed forms from one nominated breath test supervisor and one primary supervisor; (d) the signed acknowledgment form from one senior person (in which they acknowledged they had seen a copy of the respondent’s registration conditions and was aware that Ahpra may require reports from them); and (e) a copy of the respondent’s conditions containing a signed handwritten statement that she had emailed the conditions to her nursing unit managers (who were also her nominated breath test supervisors).
The second bundle contained: (a) signed forms from the respondent’s second nominated supervisor, a second nominated breath test supervisor and a second senior person.
By providing these forms to Ahpra, the respondent had attempted to comply with Conditions 4(a), 6, 9 and 10.
However, they were not provided within the required timeframe. By the time the first bundle was sent to Ahpra, the respondent had been working at Calvary Hospital as a midwife for approximately 27 days, which is well outside the seven and 14-day timeframes required under her conditions.
By failing to provide the forms within time, and practising as a midwife during that period, the respondent contravened Conditions 4(a), 6, 9 and 10. Supervised breath testing, general supervision — Conditions 1, 3, 5 and 7
During the Ahpra investigation, Calvary Hospital and the respondent’s nominated supervisors/senior persons advised Ahpra that: (a) When the respondent was introduced to the ‘senior person’ at Calvary Hospital on 20 March 2023, she: … advised of conditions on her registration … [and] that due to not working in a hospital setting with midwifery for the last few years, she was required to work along-side another midwife to regain currency of practice. Rebecca advised she did not have any specific guidelines or a work book outlining any particular aspects of 41 midwifery care that required supervision or formal assessment. (Emphasis added) (b) At that conversation on 20 March 2023, the respondent did not advise that 42 she was required to undergo breath testing. (c) The respondent commenced breath testing using her own device on 3 May 2023 and breath tests were witnessed until she ceased work as a 43 midwife on 19 May 2023. (d) Calvary Hospital did not maintain logbooks of the respondent’s breath testing results and was not advised by the respondent that this was a condition of her registration. The breath test results were sighted by the 44 Nurse Unit Manager or After Hours Coordinator on duty. (e) The respondent did not complete a work journal sighted or signed by her 45 supervisor. (f) The senior person was not aware the respondent was not allowed to practise 46 as a midwife until her supervisors had been approved.
41 Book of Documents at 127 42 Book of Documents at 159 43 Book of Documents at 127, 160 44 Book of Documents at 160 45 Book of Documents at 162 46 Book of Documents at 119
The respondent’s work roster showed she worked 28 shifts at Calvary Hospital 47 as a midwife between 11 April 2023 and 19 May 2023.
At the hearing, the Board acknowledged that the respondent attempted to comply with her conditions after Ahpra contacted her on 2 May 2023. However, it was too late: the respondent had been practising in breach of her conditions since commencing work at Calvary Hospital and she continued to do so despite being advised she must stop work until her supervisors were approved. The Board submitted that the respondent’s application to remove her conditions, along with her later correspondence with Ahpra, showed she knew about the conditions on her registration. I accept that submission and further find that the respondent understood what she needed to do to comply with those conditions.
Having considered the material filed by the Board, and in the absence of a different account provided by the respondent, I am comfortably satisfied the respondent failed to comply with her registration conditions as follows: (a) Between 11 April 2023 and 2 May 2023, the respondent practised midwifery without breath alcohol testing before and after each practice period — this contravened Condition 1. (b) Between 3 May 2023 and 19 May 2023, the respondent did undertake breath alcohol testing but this was not administered by an approved breath testing supervisor — this contravened Conditions 1 and 3. (c) Between 11 April 2023 and 19 May 2023, whilst the respondent may have been supervised by another registered health practitioner, that supervisor was not approved by Ahpra and the respondent continued to work after being notified that no approval had been granted — this contravened Conditions 5 and 7.
47 Book of Documents at 160-161 Characterisation of conduct
‘Professional misconduct’ is defined in section 5 of the National Law as follows: professional misconduct, of a registered health practitioner, includes- (a) unprofessional conduct by the practitioner that amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and (b) more than one instance of unprofessional conduct that, when considered together, amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and (c) conduct of the practitioner, whether occurring in connection with the practice of the health practitioner’s profession or not, that is inconsistent with the practitioner being a fit and proper person to hold registration in the profession.
It is generally accepted that the common law meaning of professional misconduct subsists alongside the three limbs comprising the statutory definition. At common law, professional misconduct includes conduct that would reasonably be regarded as disgraceful or dishonest by members of the relevant profession of good 48 reputation and competency.
‘Unprofessional conduct’ is defined in section 5 of the National Law to mean, relevantly: professional conduct that is of a lesser standard than that which might reasonably be expected of the health practitioner by the public or the practitioner’s professional peers, and includes — … (b) a contravention by the practitioner of — (i) a condition to which the practitioner’s registration was subject; …
Between 11 April 2023 and 19 May 2023, the respondent worked 28 shifts as a midwife, contravening multiple registration conditions on each occasion. The respondent’s request to remove the conditions, and her follow-up communications with Aphra about that request, are clear indicators that she
48 Nursing & Midwifery Board v Hogan [2018] TasHPT 3 at [22]; Medical Board of Australia v Hocking [2015] ACAT 44 at [16]-[19]; Nursing and Midwifery Board of Australia v Nurse DZ [2015] ACAT 93 at [49]-[51] understood what was required of her before commencing employment as a midwife but proceeded anyway.
Further, the respondent continued to practise midwifery in contravention of those conditions despite being advised that she was not authorised to do so, and Aphra’s direction to cease work until her supervisors were approved. This demonstrates a blatant disregard for Aphra’s authority as the professional regulator.
The evidence also raises a concern that the respondent provided incomplete, incorrect and/or misleading information to Calvary Hospital at her pre-employment meeting.
Calvary Hospital nursing managers recalled the respondent telling them that she held conditional registration, but that her conditions involved working “along- 49 side another midwife to regain currency of practice” after a period of absence from work. They recalled being advised there were no specific guidelines or aspects of the respondent’s work that required formal supervision or assessment.
According to the evidence, the respondent’s supervisors were unaware of her breath testing obligations until early May 2023, by which time she had been working as a midwife for approximately three weeks. It further appears they were unaware that she was not permitted to practise pending approval of her supervisors, until Aphra contacted them on 22 May 2023. This prevented Calvary Hospital from identifying and managing the risks to the public that the conditions were intended to mitigate.
In this respect, I agree with the Board’s submission that the respondent’s conduct contravened: (a) section 120(1) of the National Law, which states that a registered health practitioner who is registered on conditions must not knowingly or recklessly claim, or hold herself out, to be registered without the conditions or any conditions;
49 Book of Documents at 127 (b) clause 1.1(b) of the Code of Conduct, which requires practitioners to inform their employers if a regulatory entity has imposed restrictions on their practice including conditions and recognise that a breach of restriction would place the public at risk and may constitute unprofessional conduct or professional misconduct; and (c) clause 4.2(b) of the Code of Conduct, which requires practitioners to provide accurate, honest and verifiable information about their registration, experience and qualifications, including any conditions that apply to their registration.
With seven years of post-qualification experience, the respondent was reasonably expected to understand and adhere to all relevant standards of practice, including the limitations of her registration and her disclosure obligations.
The short duration of the respondent’s conduct does not diminish its seriousness. 50 As the tribunal stated in Szkup : ‘[t]he failure to comply with…conditions is a serious matter. Conditions should be scrupulously observed. They are there for the protection of the 51 public’.
On that basis, I have determined the respondent’s conduct constitutes professional misconduct as defined in section 5(a) and (b) of the National Law, being conduct that: (a) falls substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and (b) constitutes multiple instances of ‘unprofessional conduct’ which, when considered together, amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience.
Whilst each case turns on its own facts, a characterisation of professional misconduct within limbs (a) and (b) is consistent with other disciplinary matters
50 Nursing and Midwifery Board of Australia v Szkup [2022] SACAT 18 51 At [3], citing Prakash v Health Care Complaints [2006] NSWCA 153 at [74]; also see Nursing and Midwifery Board of Australia v Stokes [2021] VCAT 1319 (Stokes) at [1] involving breaches of registration conditions relating to drug and alcohol 52 screening occurring over period of less than 12 months.
What disciplinary orders are appropriate? Guiding principles
It is well established that the purpose of making disciplinary orders is to protect the public, maintain proper professional standards with the profession and to 53 uphold the public’s confidence in the profession.
A non-exhaustive list of principles guiding the determination of disciplinary orders for health practitioners were set out in Medical Board of Australia v 54 Singh as follows:
(a) The need to protect the public against further misconduct by the respondent (specific deterrence). (b) The need to protect the public, through general deterrence, of other practitioners from similar conduct. (c) The need to protect the public and maintain public confidence in the profession by reinforcing high professional standards and denouncing transgressions. (d) Whether the practitioner has breached any Act, Regulations, Guidelines or Code of Conduct issued by the relevant professional body and if so, was this done knowingly. (e) Whether or not the incident was isolated such that the tribunal can be satisfied of the respondent’s reliability in the future. (f) The respondent’s disciplinary history. (g) Any remorse or insight shown by the practitioner.
52 See for example: Osteopathy Board of Australia v Canagasabai 2024] VCAT 358; Stokes; Medical Board of Australia v QLX [2023] QCAT 60 53 National Law s 3A(1); see Medical Board of Australia v Jansz [2011] VCAT 1026 [366]–[367]; Crivici at [66] 54 [2017] WASAT 33 (h) The Respondent’s personal circumstances at the time of the conduct and at the time of imposing the sanction. However, the weight to be given to personal circumstances cannot override the fundamental obligation of the Tribunal to provide appropriate protection of the public interest in the honesty and integrity of practitioners. (i) Any other matters relevant to the Respondent’s fitness to practise and other matters which may be regarded as aggravating the conduct or mitigating its 55 seriousness.
The Tribunal may also consider the need or otherwise for specific deterrence, evidence of character, evidence of rehabilitation, any delay between the start of the investigation until the completion of the Tribunal hearing and other mitigating 56 factors.
The Board submitted that an appropriate sanction would be a reprimand and disqualification from applying for registration as a registered health practitioner for a period of six months from the date of the Tribunal’s orders, pursuant to 57 sections 196(2) and 196(4)(a) of the National Law.
Specific deterrence, assessment of future risk, insight and remorse
Specific deterrence involves an assessment of the risk of further misconduct by the respondent.
The respondent surrendered her registration in June 2023 and the NTCAT has made orders to disqualify and prohibit the respondent from practising as a midwife or providing any health service until 22 October 2028. Arguably, the NTCAT’s orders should protect the public from further misconduct by the respondent during that period. However, there is also a need for specific deterrence in these proceedings.
The evidence indicates the respondent had a long-standing vulnerability related to alcohol use. The breath testing and supervision conditions were designed to
55 At [30]; applied in Medical Board of Australia v Al-Naser (No. 3) [2024] ACAT 9 at [18] 56 Medical Board of Australia v Griffiths [2017] VCAT 822 at [43] 57 Applicant Submissions, dated 23 January 2026 at [36] provide workplace supports and protections that would enable her to practise 58 competently and safely as a midwife while providing protection to the public.
On 10 June 2023, the respondent emailed the Board saying: Every day I live with physical scars from the time in my life when I was in an abusive relationship. I also live every day with many emotional scars. Thankfully though, I am one of the lucky ones who is still alive and all I have left from that time are scars ....... I turned my life around and got out of the abusive relationship, got on with my life, protected my family and about five years ago decided to commence the process to re-gain registration to be able to re-enter the profession that I loved ...... During this time, the physical scars from the injuries that I received whilst in the violent relationship have continued to fade. Likewise, the emotional scars 59 will always be there, but they too slowly fade.
The authorities suggest that where misconduct is related to a medical condition or mental health issue, it does not excuse the behaviour but may be taken into 60 account as a mitigating factor. Subsequent action taken by the practitioner to address the underlying circumstances is relevant when assessing future risk of the 61 practitioner re-engaging in the same or similar conduct. This is consistent with the overarching purpose of disciplinary proceedings as protective, not punitive.
It is possible that the respondent’s personal circumstances before or at the time of her misconduct were a significant contributing factor to her poor judgement and decision-making. It is also possible that those personal circumstances have now changed. However, her lack of involvement in these proceedings makes it difficult to assess whether she has addressed any underlying vulnerabilities to mitigate the risk of re-occurrence.
The respondent’s failure to provide honest, accurate information to Calvary Hospital and her disregard for Ahpra’s instruction to cease practice until a supervisor was approved heightens the level of risk. There is no evidence of remorse or insight. The respondent’s email to Ahpra, quoted above, does not demonstrate any acceptance that her conduct was seriously wrong or a
58 Book of Documents at 21 59 Book of Documents at 135-136 60 Medical Board of Australia v Stone [2023] ACAT 38 (Stone) at [14]; Health Ombudsman v HSK [2018] QCAT 419 at [28]; Health Ombudsman v Joy [2020] QCAT 202 at [11] 61 Stone at [13] willingness to identify risk factors and mitigation strategies to avoid similar 62 behaviour in the future.
General deterrence of other practitioners
A reprimand would be a formal and public denunciation of the respondent’s conduct.
A disqualification and prohibition period ordered by the ACAT would be additional to the three-year disqualification and prohibition ordered by the NTCAT, even if the periods were to run concurrently.
That sanction would have significant personal, financial, and reputational implications for the respondent. It also sends a strong message to other health professionals that any failure to comply with registration conditions, even for a short period, is serious and will not be tolerated.
Protect the public and maintain public confidence in the profession
Midwifes hold important responsibilities in the Australian community. They provide essential, primary care to mothers and their families from pregnancy to 63 postpartum, and in relation to reproductive health care. Patients are particularly vulnerable and rely on their midwife to exercise sound judgement in identifying and responding appropriately to unexpected situations and risks. This includes assisting patients to identify and manage health risks and seek appropriate help.
The respondent’s failure to recognise the protective purpose of her conditions (for herself and her patients), her poor professional judgement (which led to her non-compliance), and her misleading interactions with her supervisors at Calvary
62 For consideration of insight and remorse, see Williams v Medical Practitioners Board of Victoria [2008] VCAT 1784 at [99] 63 Australian College of Midwives, The Role of Midwifery in the First 2000 Days (9 November 2023) Hospital, risk undermining the reputation of, and public confidence in, the health profession.
Non-compliance with regulatory framework and previous disciplinary history
I have determined that the respondent’s misconduct contravened the legal and regulatory framework governing conditional registration: specifically, section 120(1) of the National Law and clauses 1.1(b) and 4.2(b) of the Code of Conduct.
I accept that her conduct occurred over a relatively short period, but it was unethical, unlawful and its seriousness should not be underestimated.
The respondent has a relevant disciplinary history. In 2014, she provided a signed undertaking to the Board after concerns were raised that she had reported to work affected by alcohol on several occasions between 2010 and 2013. In the same year, she failed to comply with that undertaking and her registration was suspended.
In 2023, the Board commenced disciplinary action against the respondent in relation to her work as a registered nurse in the Northern Territory. The NTCAT made disciplinary orders after finding she had engaged in false and/or misleading conduct with her employer and Ahpra.
I accept that the 2014 suspension was more than ten years ago, and the NTCAT proceedings do not involve a breach of registration conditions. However, those matters raise similar questions as in the current proceedings about the respondent’s integrity, understanding of the need for protective measures, and respect for the regulatory framework. This is relevant to future risk and will need to be considered if the respondent were to apply for re-registration in the future. Comparative decisions
Each case must be decided on its facts having regard to the specific conduct in the circumstances. It can, however, be helpful to consider comparative cases as a 64 general guide as to what sanctions were considered appropriate in those matters. 65
In Medical Board of Australia v CQW , the practitioner failed to present for urine tests, was positive for drug use, provided dilated urine samples over several years and knowingly and willingly provided false and/or misleading information to the Board/Ahpra. The practitioner had a history of drug and alcohol misuse and her misconduct occurred during a period of significant stress and poor mental health. She admitted to her conduct and orders on sanction were made by consent, being a reprimand, six months suspension and conditions on registration for 12 months. 66
In Nursing and Midwifery Board of Australia v Stokes , the practitioner contravened her conditions to undertake urine drug screening, hair analysis for drug screening and blood alcohol testing on 41 occasions over seven months. The practitioner had some history of misuse of alcohol and illegal drugs, and her registration had previously been suspended for 18 months. The practitioner admitted the conduct and there was evidence of subsequent rehabilitation. The tribunal accepted that the practitioner’s 18-month period of suspension already served due to immediate action was sufficient to protect the public. 67
In Osteopathy Board of Australia v Canagasabai , the practitioner breached conditions on his registration by practicing in the absence of his supervisor and failing to present for urine and hair analysis tests. This misconduct occurred for seven months. The practitioner had previously been diagnosed with a drug use disorder, which relapsed during periods of high stress, and a personality disorder. The practitioner self-reported to Ahpra and surrendered his registration The tribunal imposed a reprimand only, noting that the practitioner did not intend to
64 Lee v Health Care Complaints Commission [2012] NSWCA 80 at [34]; Chinese Medical Board of Australia v Zhou [2020] SACAT 23 at [98] 65 [2021] VCAT 346 66 [2021] VCAT 1319 67 [2024] VCAT 358 reapply for re-registration and so there was no utility to either his rehabilitation or the protection of the public by making a disqualification order. 68
In Medical Board of Australia v QLX , the practitioner breached conditions by failing to present for drug screening tests on four occasions, during which time he used drugs on two occasions. He self-reported to Ahpra. The practitioner had previously been diagnosed with a psychiatric condition and had received treatment. The practitioner obtained treatment for his underlying condition and provided evidence that he was in sustained remission. At the time of his disciplinary proceedings, the practitioner had returned to work on strict conditions and the Board did not seek orders for a suspension or further conditions. The tribunal ordered a reprimand only.
In Crivici, the practitioner was convicted of criminal offences involving the possession and distribution of child exploitation material. She failed to report her convictions to the Board, which contravened the National Law and relevant Code of Conduct. The practitioner had a difficult personal history. However, she did not participate in her disciplinary proceedings which made it difficult for the tribunal to assess whether her underlying vulnerabilities had been addressed sufficiently, or at all, to mitigate future risk. The practitioner was not registered at the time of her final hearing and the tribunal made orders for a reprimand, a four-year disqualification period, and a prohibition on providing any health service until she was re-registered under the National Law.
A distinguishing feature in the first four cases mentioned above is that the practitioner acknowledged the seriousness of their conduct, demonstrated remorse and took steps to identify and mitigate against future risk. It is also relevant that, in some instances, prohibition orders were considered unnecessary either because the practitioner did not intend to return to practice or had successfully returned to practice under strict conditions.
Conclusion on sanction
68 [2023] QCAT 60 orders, are appropriate to achieve the purpose of protecting the public, maintaining proper professional standards and upholding the public’s confidence in the profession.
This sanction is higher than the sanction proposed by the Board in its written 69 submission. However, I am satisfied this does not raise natural justice difficulties for the respondent. The Application for Disciplinary Action identified the full range of determinations available to the Tribunal under section 196(2) of 70 the National Law. The sanction I have imposed is within that range. As mentioned, I am satisfied the respondent is on notice of these proceedings and has been afforded procedural fairness in relation to the Board’s allegations and orders sought. The respondent’s request for Ahpra not to contact her, combined with her lack of involvement in these proceedings, means I see no utility in adjourning the proceedings to allow further time for her to engage.
My approach is consistent with that taken in Crivici, where the tribunal relevantly stated:
To the extent that the Tribunal had any discretion to adjourn the proceedings to further attempt service, I was not prepared to exercise it. An applicant must be given the opportunity to present their case to the tribunal, but they cannot be compelled to take it. I was satisfied she had been given 71 such an opportunity. Costs
At the end of the hearing, I reserved my decision and directed the parties to each provide a submission on costs.
On 26 February 2026, the Board provided an itemisation of its costs (including disbursements) and the percentage claimed from the respondent.
The Board’s itemisation provides a summary of its legal costs and disbursements incurred on a ‘party/party’ basis. The total is $14,562.50, including GST. The
69 The Board sought a six-month disqualification and prohibition period 70 Application for Disciplinary Action at [10]-[12] 71 At [31] itemisation does not include costs incurred on a solicitor/client basis, such as the provision of legal advice.
The Board claims 70% of its costs and 100% of its disbursements, being a sum of $10,751.30.
The Board served its itemisation on the respondent in accordance with the previous orders on substituted service. There is nothing to suggest that her addresses for service have changed.
The respondent did not provide a response.
I am satisfied the Board’s itemised costs and disbursements have been fairly and reasonably incurred and have ordered the respondent to pay the sum claimed. This is consistent with section 195 of the National Law which gives the Tribunal a wide discretion to award costs, and the general principle that costs are awarded 72 to compensate a successful party.
……………………………….. Senior Member E Morrison
Date(s) of hearing: 17 February 2026 Solicitor for the Applicant: M Pappas, Australian Government Solicitor Respondent: No appearance
72 Health Care Complaints Commission v Neale [2024] NSWCATOD 16 at [8]; Health Care Complaints Commission v Philipiah [2013] NSWCA 342
NURSING AND MIDWIFERY BOARD OF AUSTRALIA
GOURZIS (Occupational Discipline)
[2018] QCAT 419
[2020] QCAT 202
[2024] VCAT 358
(1938) 60 CLR 366