• the respondent's conduct was unlawful and had the potential to damage the standing and reputation of the nursing profession;
• the respondent's conduct falls within ss 5(a) and 5(c) of the categories of professional misconduct under the National Law and constitutes a serious departure from acceptable professional standards inconsistent with her being a fit and proper person to hold registration in the nursing profession; and
• the respondent's conduct should be regarded as "disgraceful and dishonourable" and worthy of strong reprobation by professional peers.

Health practitioners - Complaint by the Nursing and Midwifery Board of Australia - Professional misconduct - Inappropriate prescribing, illicit drug use and false and misleading statements made to authorities - Registration cancelled, disqualified from applying for registration for six months, reprimand and costs order

Health Practitioner Regulation National Law (South Australia) Act 2010 ss 5, 156, 193, 196

Controlled Substances Act 1984 (SA)

Craig v Medical Board of South Australia [2001] SASC 169; (2001) 79 SASR 545

Medical Board of Australia v Singh [2017] WASAT 33

Order suspending Practitioner Registration for a Specific Period

Made under the Health Practitioner Regulation National Law (South Australia) Act 2010

1. The complainant, the Nursing and Midwifery Board of Australia (the Board), has referred this matter to the Tribunal pursuant to s 193(1)(a) of the Health Practitioner Regulation National Law (South Australia) Act 2010 (SA) (the National Law), concerning the conduct of the respondent, Natalya Herzog.
2. The Board alleges that Ms Herzog engaged in conduct which it reasonably believed amounted to professional misconduct within the meaning of s 5 of the National Law.
3. The Board sought sanctions for this professional misconduct pursuant to s 196 of the National Law, and submitted that the Tribunal should make a finding that Ms Herzog has engaged in professional misconduct within the meaning of s 5(a) and (c) of the National Law; determine that Ms Herzog should be reprimanded; that her practitioner's registration as a nurse should be cancelled pursuant to s 196(2)(e) of the National Law; and further order that Ms Herzog should be disqualified from applying for registration as a health practitioner for a period of six to nine months from the date of the Tribunal's order.
4. Ms Herzog admitted both the conduct alleged by the Board, and that the conduct amounted to professional misconduct. However, she denied it was inconsistent with concluding she was a fit and proper person continuing to hold registration, or that it would be regarded as disgraceful or dishonourable by nursing colleagues of good repute and competence.

1. The agreed misconduct which formed the basis of the application comprised the following circumstances.
   • Ms Herzog misappropriated prescription pad stationery from the consulting room of a psychiatrist, Dr Natasha Chow, on 7 April 2017, when she was attending an appointment with another psychiatrist, Dr Aarti Goel, in adjoining rooms or premises.
   • On 8 April 2017 Ms Herzog forged prescriptions for Paxam and Oxazepam using the stolen prescription pad and presented the forged prescriptions at pharmacies and obtained these medications without a valid prescription.
   • On 13 April 2017 Dr Chow reported the theft of the prescription pad, having been contacted by another pharmacy in relation to another prescription. Ms Herzog was then interviewed by the police (SAPOL) and issued a formal caution, and SAPOL officers secured the prescription pad.
   • Nevertheless, Ms Herzog retained repeat prescriptions from this prescription pad for Lorazepam, Paxam and Oxazepam.
   • On 27 April 2017 the Board suspended Ms Herzog's registration under s 156 of the National Law, and her registration remains suspended.
   • Ms Herzog subsequently disclosed her misconduct to Dr Goel (her psychiatrist) and to Dr Chow. She wrote to Dr Chow on 9 May 2017 apologising for her actions and expressing "deepest regret" and assuring her "nothing like this will ever happen again".
   • On 18 and 19 May 2017 Ms Herzog presented repeat prescriptions from the forged prescriptions at pharmacies and obtained medication without valid prescriptions.
   • Ms Herzog was interviewed by SAPOL on 18 June 2017 and was charged with four counts of forging prescriptions to obtain a prescription drug, and four counts of uttering forged prescriptions to obtain prescription drugs, both contrary to the Controlled Substances Act 1984 (SA).
   • Ms Herzog pleaded guilty to these charges and on 5 July 2018 was found guilty on both charges and entered into a good behaviour bond of $500.
2. The Board also provided information concerning Ms Herzog's disciplinary history.
3. While Ms Herzog conceded the information concerning the disciplinary history as advised by the Board, she did not agree with some of the facts upon which the disciplinary actions were based, and she has consistently maintained that position.
4. The Board states (and it is agreed) that its Performance and Professional Standards Panel (PPS Panel) reprimanded Ms Herzog in relation to events which occurred on 1 October 2013.
5. The PPS Panel was satisfied that on 1 October 2013 Ms Herzog had entered a restricted area on level 4 of the Royal Adelaide Hospital (RAH) and had attempted to steal medication and medical paraphernalia, namely two boxes of Propofol, two boxes of Clonazepam, two strips of Lignocaine 20ml, and a strip of syringes. Ms Herzog had denied she was stealing these items and said she was collecting them for another staff member who had requested her assistance. The PPS Panel rejected this explanation and was satisfied that Ms Herzog had provided false or misleading information in the course of the investigation and issued a reprimand. Ms Herzog lodged an appeal against this decision but did not proceed with it.
6. The Board submitted that the Tribunal should consider the matters referred to in the PPS Panel Decision.

1. The Board submitted that Ms Herzog's conduct should be characterised as conduct which was substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience (within s 5(a) of the National Law), or, 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 (within s 5(c) of the National Law), and that the conduct should be regarded as "disgraceful and dishonourable" and worthy of strong reprobation by professional peers.
2. The Board also relied on the applicable code of conduct and code of ethics, and submitted that Ms Herzog's conduct was clearly unlawful and has the potential to damage the standing and reputation of the nursing profession, and was contrary to the conduct statements contained in the Code of Professional Conduct for Nurses in Australia.
3. The Board's view was that as, in its assessment, Ms Herzog's conduct constituted a serious departure from acceptable professional standards and was inconsistent with her being a fit and proper person to hold registration in the nursing profession, the Tribunal ought cancel her registration. The Board's view was that there was no evidence Ms Herzog was currently a fit and proper person to hold such registration. The Board refers to the admitted conduct relating to the prescription pad, as well as the findings of the PPS Panel, and expressed the view that Ms Herzog had failed to take responsibility for that conduct and this demonstrated a lack of insight and a failure to respond appropriately to the reprimand of the Panel. In addition, the Board was of the view that Ms Herzog had not demonstrated a capacity to practice nursing safely and ethically for any extended period of time, and all these considerations supported its view that it was not appropriate for her to return to nursing practice yet.
4. The Board submitted that if Ms Herzog's registration was cancelled, it would be appropriate to disqualify her from applying for registration for a period of 6 to 9 months from the date of the Tribunal's order.
5. The Board considered a reprimand also ought to be issued to Ms Herzog.
6. In addition, the Board sought an order for costs against Ms Herzog.

1. Three volumes of casebooks were provided by the parties and they were accepted into evidence. In addition, both parties provided written submissions and outlines, and these are all taken into account along with the oral evidence provided at the hearing, supplementing their written reports, of Dr Kelly, Dr Angelakis and Dr Pols.
2. Ms Herzog did not give evidence at the hearing.

1. Mr Schatz made it clear that the Board was not asserting that Ms Herzog was suffering from any mental illness at the time of the agreed events. He referred to the general principle that misconduct does not cease to be such because of matters such as drug use or some medical condition. This consideration is relevant to the sanctions to be imposed on Ms Herzog.
2. Mr Schatz told the Tribunal that Ms Herzog's conduct amounted to deliberate conduct, which occurred not only on one occasion but even after she had been apprehended by the police and after she had given assurances (to police and others) that it would not recur. He submitted this demonstrated that the events were not a result of some overbearing of the mind, but of deliberate and intentional acts. The Board's view was that there was no mental impairment and this would not explain the misconduct.
3. Mr Schatz submitted that the authorities demonstrate that even if mental health issues did contribute to the relevant conduct, this is irrelevant: what is relevant is whether any mental health issues have been addressed by the respondent such that any risk to the public is addressed.
4. Mr Gardner for Ms Herzog told the Tribunal there could be no basis for any allegation that Ms Herzog had engaged in any incompetent practice, and Mr Schatz indicated that he accepted this was the case and there was no such allegation.
5. He submitted further however that the evidence of Dr Kelly in his medical report was that as a result of her substance abuse and personal disorder it would be unsafe for Ms Herzog to practice, and in his submission these assertions amount to impairments, and on this basis he suggested that the Board was really arguing that Ms Herzog was unfit to practice as a result of her health conditions. Mr Gardner submitted that the facts demonstrated that the circumstances arose out of Ms Herzog's benzodiazepine abuse, and he submitted that accordingly her actions were driven by her health issues. Accordingly, he submitted, the issue before the Tribunal was not just one of fitness and propriety, but also of impairment.
6. Mr Gardner told the Tribunal that Ms Herzog accepted that her conduct amounted to professional misconduct, but her position was that there was no risk to her returning to practice in the future because her health no longer posed such a risk: she had taken steps to improve her health, and the issue for the Tribunal to consider was what risk there might be in the future.
7. Mr Gardner told the Tribunal Ms Herzog's registration had, at the time of the hearing, already been suspended for more than three years, and this was relevant to the sanction to be imposed.

1. Dr David Kelly, a psychiatrist of 35 years' experience and an addiction medicine specialist, gave evidence at the hearing, supplementing his written report of 21 July 2017, following a consultation with Ms Herzog on 16 June 2017 at the request of the Board.
2. In his report Dr Kelly concluded he found no evidence to support a diagnosis of post-traumatic stress disorder (PTSD) which Ms Herzog had told him her previous psychiatrist Dr Goel had made, and he considered that the stressor, namely, being detected removing medications from the RAH and the subsequent investigation and decision, "does not fulfil the first criteria for a post-traumatic stress disorder". He reports that although Ms Herzog denied significant abuse of benzodiazepines and opioid-related analgesics, nevertheless there were "repeated instances of her being associated with these substances", and she had a poor recollection of the events relating to her theft of the prescription pad and forging prescriptions. He states that he found it "difficult to accept the veracity of Ms Herzog concerning these events". He states that he did not find any specific evidence to suggest she suffered from a personality disorder but speculated that she might have such a disorder and that at times of stress it may be the case "she resorts to the intermittent abuse of substances available to her in her workplace". He did not make a diagnosis of substance abuse disorder and concluded that "at best ... one could consider her to be suffering from an adjustment disorder with depressed mood". He states that such a diagnosis "in itself would not prevent her from being able to function as a nurse", but "her actions are, in my opinion, not compatible with her working as a nurse".
3. Dr Kelly made a second report concerning Ms Herzog on 4 May 2020, having been provided with other documents and information, including the reports of Dr Angelakis, Dr Osenk (another psychiatrist who briefly treated Ms Herzog), Dr Goel, and Dr Pols. He again concluded a diagnosis of PTSD not appropriate "as she fails to meet the first criteria of this, of a life-threatening event". He concludes that Ms Herzog had given only partial and limited information to each of these practitioners, and states "the various omissions provided to various health professionals were those which would have placed Ms Herzog in a more negative light. It is my opinion that the conclusions reached by those practitioners, especially that of Dr Pols, are based on inadequate information".
4. In that report Dr Kelly concluded that Ms Herzog had a Polysubstance Use Disorder which had involved "multiple benzodiazepines, including Clonazepam, Oxazepam and Midazolam", and possibly abuse of substances of other classes.
5. He concluded that this history as well as the events relating to the theft of the prescription pad and filling of fraudulent prescriptions even after the warning by the police, "places her at high risk of recurrence of benzodiazepine abuse in the future. Her history is strongly indicative of abusing substances opportunistically". His view was that "working in any setting where substances which have the potential for abuse are present places her at great risk of relapse and this would place both her safety and her ability to practice as a nurse safely and ethically in jeopardy". He concluded that he did not believe Ms Herzog could safely return to practice as a nurse and if she did so would be at great risk of her substance use disorder recurring.
6. At the hearing Dr Kelly said the opinions expressed in the reports still represented his view.
7. Dr Kelly said that at the consultation on 16 June 2017 Ms Herzog had told him of her medication and dosages, in particular of fluoxetine (Diazepam) of 40-60 mg daily. He said that the Medicare records did not indicate the prescribing to Ms Herzog was of the degree she described. He said that the dosages Ms Herzog described to him were very high and rarely used except in detoxification situations. He said Dr Goel's report indicated she was prescribing Ms Herzog dosages of diazepam for use in "minimal quantities" of 2-4 mg daily. He said he had seen nothing to support Ms Herzog's assertions that Dr Goel was prescribing 40 mg of Diazepam or more for daily use.
8. Dr Kelly referred to the drugs which Ms Herzog was accused of attempting to remove from the RAH in the 2013 event. The PPS Panel Decision reports that she was found with Propofol, which Dr Kelly described as an anaesthetic agent, frequently abused; Lignocaine, a local anaesthetic, not generally abused; and Clonazepam, a long acting benzodiazepine known as a "date rape drug". This is often known by its trade name Paxam, one of the same drugs Ms Herzog obtained using the stolen prescription pad. He noted that Dr Goel and Dr Pols report that Ms Herzog told them (separately) only that she had been accused of taking Lignocaine, with no reference to the other drugs. Dr Kelly regarded as a significant omission to exclude reference to the other drugs she had been accused of taking, as this meant both Dr Goel and Dr Pols lacked relevant information, in particular concerning the nature of the drugs involved. He was concerned that Ms Herzog had not been "up front" with her doctors concerning her use of substances.
9. Dr Kelly suggested that if Ms Herzog had a personality disorder, or became anxious and stressed, it is likely she will look for ways to dampen down this anxiety, and that is the effect of benzodiazepines. He said that taking any benzodiazepine will generate a tolerance, and so there will be a need to increase the dose to have the same effect, and if the drug is used regularly the dose will escalate quickly.

1. Dr Angelakis is a psychologist whose PhD research related to PTSD. Her PhD in Clinical Psychology was awarded in 2015, and she commenced her clinical practice in 2014. Ms Herzog initially consulted with her on 22 June 2015, in Dr Angelakis' first year of private clinical practice.
2. Dr Angelakis said she had initially diagnosed Ms Herzog as suffering from PTSD. She said Ms Herzog had all the relevant symptoms, including anxiety and hyper-arousal, and in her view met all the criteria for this diagnosis, including the Criterion A stressor in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Dr Angelakis explained she believed this diagnostic tool was often interpreted and applied too rigidly and narrowly and was restricted to threats to physical safety, but that it should be extended to include threats to a person's personal integrity and sense of self. She believed this is what had occurred to Ms Herzog as a result of the RAH 2013 incident, leaving Ms Herzog "hopeless and helpless". She said a diagnosis of PTSD was appropriate and enabled better treatment options to be considered. She agreed that by the time Ms Herzog consulted with Dr Pols in 2018 she no longer had PTSD as she had "been cured", and she said she may have already recovered from PTSD by the time Dr Kelly saw her in 2017.
3. Dr Angelakis said Ms Herzog had discussed the RAH incident with her, but she agreed she had not seen the PPS Panel Decision report. She told the Tribunal that regardless of the truth of the events the circumstances and outcome would have been a traumatic event for Ms Herzog which could have led to PTSD, and she had believed Ms Herzog's account, and still did.
4. However, Dr Angelakis conceded that if she had seen the Report and the Panel's findings this may have changed her diagnosis and treatment, and acknowledged it was now clear to her she had been given only a partial account by Ms Herzog. She agreed that if she had known more detail of these events she would have been more concerned about the reliability of Ms Herzog's accounts of her circumstances, and these concerns might affect her assessment of the risk Ms Herzog posed and her future suitability to practice as a nurse. She also conceded that if she had known that one of the forged prescriptions admitted by Ms Herzog was for Clonazepam, and that this was one of the drugs she had been found with at the RAH, this would have caused her concern, and changed her view of Ms Herzog's circumstances.
5. Dr Angelakis said Ms Herzog's treatment had focussed on treatment for PTSD and the RAH incident until there was an accusation that Ms Herzog had misappropriated Fentanyl at Western Hospital in July 2016, and then the prescription pad incident of April 2017. The accusations concerning Western Hospital had occurred shortly after Ms Herzog had confirmed to her she had overdosed on Midazolam (a benzodiazepine) at home in 2016. Ms Herzog had assured her this would not happen again and she had no further access to Midazolam, but Ms Herzog had again used Midazolam a few weeks later. Midazolam is a highly restricted drug and she said Ms Herzog was vague as to how she had obtained it. She said focus then turned to treatment of substance abuse. She said that Ms Herzog had been "upfront and forthright" about the theft of the prescription pad, but at that time was being prescribed "a lot of medication". She said that after being warned by the police Ms Herzog had seemed very honest and very remorseful. She said by this time the treatment "was very driven by Natalya [Ms Herzog]", who had recognised that medication was an unhelpful coping strategy and was trying to reduce her substance use. Dr Angelakis said Ms Herzog had been very open with her concerning her use of medication, but it had been difficult to determine the exact extent of her substance use and abuse. However, she said Ms Herzog had been forthright and did not try to hide the abuse from her.
6. Dr Angelakis told the Tribunal Ms Herzog no longer has substance abuse issues. She said her use of medication had steadily decreased and she now sticks to use only of the prescribed amounts. She said Ms Herzog's vulnerabilities had now significantly decreased. She disagreed that Ms Herzog was not able to safely return to nursing practice and was adamant that Ms Herzog's issues of substance abuse were no longer of significance.
7. In cross examination Dr Angelakis conceded she now could see that Ms Herzog had been partial in the information she had provided. She acknowledged Ms Herzog had not provided her with a copy of the PPS report concerning the RAH incident, and she was unaware of the details of the drugs she had been accused of attempting to steal. She conceded that Ms Herzog could only have obtained Midazolam (used in her in July 2016), unlawfully, and this meant it was an unsafe medication; she conceded she would have been concerned at Ms Herzog's account that she took 20-80 mg per day of Diazepam had she known the prescribed amount was less than 5 mg; and she agreed Ms Herzog told her she had been "dumped" by Dr Goel.
8. Dr Angelakis said Ms Herzog had led her to understand that Dr Goel had facilitated her addiction by excessive prescribing, and then had "dumped" her. She conceded that Ms Herzog had not told her that Dr Goel had only prescribed 2-4 mg of Diazepam for daily use, and had made arrangements for her treatment to be taken over appropriately and had discussed the ending of their therapeutic relationship in an appropriate interview with Ms Herzog and her partner, and nor had she told Dr Angelakis that she had caused the ending of that relationship by the repeated use of the stolen prescription pad even after her apology and assurances to Dr Goel and Dr Chow.
9. Dr Angelakis agreed that all these inconsistencies now raised in her mind significant concerns about her own capacity to assess whether Ms Herzog was telling her the truth, and told the Tribunal that had she known all this information at the time she would have made different assessments and undertaken different treatment for Ms Herzog.
10. Dr Angelakis also agreed that Ms Herzog's circumstances and history, as she now understood them, suggested there still might be difficulties in the future if she returned to nursing practice. She agreed that if the RAH incident did occur as the report found, this raised concerns, but she noted Ms Herzog still denied this account. Dr Angelakis believed Ms Herzog was not presently engaged in substance abuse and was strongly committed to maintaining this position and recovery. She suggested that if Ms Herzog did return to practice, there needed to be significant strategies and conditions to support her. She concluded however that as an opportunistic drug abuser, allowing Ms Herzog to return to a hospital as a nurse might place her at risk of a relapse.

1. Dr Pols has a lengthy public and private psychiatric practice. He first saw Ms Herzog in October 2018 and provided an assessment report dated 19 November 2018 and a further report dated 2 February 2020.
2. In reporting to AHPRA on 6 January 2020 Dr Pols said that "there was a serious misunderstanding" at the RAH in 2013 which "escalated quite inappropriately when her colleague did not disclose that she had asked Ms Herzog to assist her in carrying out her duties". This assessment was based on Ms Herzog's account of the RAH incident to Dr Pols. He reports that Ms Herzog "developed a severe depressive illness" for which she was prescribed increasing doses of benzodiazepines. Dr Pols reports that Ms Herzog had responded well to treatment, and he concludes that she is no longer taking any benzodiazepines, and "there are no indicators that she should relapse with the misuse of medications in the future".
3. Dr Pols recounted Ms Herzog's account to him of the RAH incident in 2013, and states that she told him that "one of my mates ... asked me to help and whilst I was doing that the clinical nurse asked what I was doing there. I tried to explain and my friend said she had not asked me to help her. I was then accused of theft...". Dr Pols described this as a "false accusation against her" with a "gross miscarriage" of justice. He described the RAH event as "a relatively minor disciplinary incident" on her account, which had become "a major disaster in her life", leaving her with PTSD, severe social anxiety disorder with panic, and major depressive disorder. He characterised this event as "severe organisational bullying", as he understood there had been no "due process afforded to her during this disciplinary process". In cross-examination Dr Pols said that he had believed Ms Herzog's account of these events, and that although he had seen the PPS Panel report he had not read it prior to writing the two reports that are before the Tribunal. He agreed that if he had seen other information contrary to the account Ms Herzog had given; he would have taken more caution in his approach. However, he said he still considered the issue at RAH as "very unusual".
4. Dr Pols had accepted Dr Angelakis' assessment that Ms Herzog had "full-blown PTSD in 2015", but that by 2018 as a result of treatment from Dr Angelakis this condition had been "attenuated" to that of severe social disorder with panic, and major depressive disorder. He agreed that the RAH incident did not formally fulfil the criterion for PTSD, but he suggested that for Ms Herzog, the event had been "symbolically life threatening". He considered the RAH event as central to what he saw as the disintegration of Ms Herzog's circumstances: he queried how she could have changed from a disciplined competent person who had faced no major traumas, into a drug addict by 2014. He surmised she had become dependent on benzodiazepines following her distress after the 2013 RAH incident.
5. Dr Pols reports that Ms Herzog had developed "significant benzodiazepine dependence". He comments that the use of benzodiazepine for the treatment of PTSD "should be strictly limited" but this had not occurred, and it was in this context that Ms Herzog had stolen the prescription pad. He reports that this had occurred in a context where at the same time she had been falsely accused of taking Fentanyl, and Dr Goel was reducing her diazepam. He understood Ms Herzog had "panicked", and in that state had stolen the prescription pad and forged the prescriptions. He reports that Dr Goel had thereafter refused to see her and Ms Herzog had been reported to the police.
6. Dr Pols conceded in cross examination that in the light of other evidence it was clear these events had occurred somewhat differently than he had understood from Ms Herzog and set out in his report. He agreed the events did not all occur "at the same time", as he had reported: the Western Hospital event was in July 2016, and Ms Herzog stole the prescription pad in April 2017. He conceded that the circumstances with Dr Goel were significantly different to how they had been described to him by Ms Herzog.
7. Dr Pols regarded Ms Herzog as "a remarkable young woman" who had the potential to become an "exemplary member" of the nursing profession. He said she had already achieved highly and had significant ambitions. He describes the theft and illegal use of the prescription pad as "totally alien acts" for Ms Herzog.
8. Dr Pols initially told the Tribunal he believed Ms Herzog could return to nursing, but she would need a graded return to work. He suggested that to manage risk she could be regularly drug tested, and she could be required to work with an agency to supervise her return to work, and be required to continue to work with her psychologist and general practitioner with regular reports to the Board. He told the Tribunal Ms Herzog had told him she had worked shifts in multiple other organisations over a period of time, and nursing agencies were happy with her work.
9. However, at the conclusion of his evidence Dr Pols told the Tribunal it was clear to him following a consideration of the material which he saw during these proceedings that Ms Herzog had been taking drugs over an extended period of time, and was seriously benzodiazepine dependent, and that she had been dishonest with numerous of those providing her with medical support and advice, including himself, concerning her history and circumstances as well as her drug use. He concluded to the Tribunal that if Ms Herzog went back to nursing with access to benzodiazepines there would always be a risk of relapse, which presented a danger to herself, her patients, and the organisation within which she was working. He emphasised there was always a risk of relapse where there had been serious dependence.

1. Mr Schatz submitted to the Tribunal there was no dispute concerning Ms Herzog's conduct and facts concerning the theft of the prescription pad and the forging of the prescriptions, or their seriousness.
2. He also referred to detail contained in material provided in the three Books of Evidence. Many details of the material contained in those Books were discussed with the witnesses, and together with the oral evidence, establish a set of facts concerning Ms Herzog's actions and circumstances, particularly over the period 2010 (when she came to Adelaide to undertake her nursing degree) to 2017.
3. Mr Schatz told the Tribunal that the oral evidence presented by both Dr Angelakis and Dr Pols acknowledged that significant aspects of the story as told to them (separately) by Ms Herzog were neither accurate nor complete. Mr Schatz submitted these inaccuracies in Ms Herzog's accounts were highly relevant to the issue of how much weight should be placed on their opinions and their assessment of the risk she might pose in the future.
4. Mr Schatz submitted to the Tribunal that the evidence, oral and documentary, before the Tribunal demonstrated that Ms Herzog had significant substance abuse for a lengthy period.
5. Mr Schatz said the evidence clearly established that Ms Herzog preferred to use benzodiazepines, in particular Clonazepam, based on what she took from the RAH in 2013 and the prescriptions she forged in 2017. She also used Midazolam, a highly restricted benzodiazepine, although it is not clear where she obtained this. She told Dr Angelakis that she had bought it online, but elsewhere she suggested she had obtained it from a friend. Other possibilities were that she obtained it from Sports Med, where she had been working the night before she overdosed on it in July 2016 and was found unconscious. Ms Schatz submitted that none of these options for obtaining Midazolam, a highly restricted drug, involved an innocent explanation.
6. Mr Schatz told the Tribunal that no proof had been adduced to demonstrate that Ms Herzog is a reformed character and no longer abuses substances: rather, the reliance to establish this is placed on the medical records and opinions of Dr Angelakis and Dr Pols. However, Mr Schatz submitted, these medical reports and opinions cannot be relied on, given the concessions both had made in cross examination that Ms Herzog had withheld information from them both over a significant period such that they would most likely have reconsidered their assessments. He suggested that Ms Herzog's accounts to these doctors now should not be trusted.
7. Mr Schatz said that all experts agreed that by mid-2017 Ms Herzog did not have PTSD. He told the Tribunal that Ms Herzog did not at any stage suffer from PTSD, as the DSM does not recognise that PTSD can be triggered by a perceived threat to a person's integrity, as Dr Angelakis and Dr Pols argued, but requires an actual life threatening event. However, he conceded that even if Ms Herzog had an adjustment disorder, or a personality disorder with borderline traits, this shares many common symptoms with PTSD. He told the Tribunal that these borderline traits should have raised questions concerning dishonesty, fraud, and manipulation in relation to the ongoing treatment and assessment of Ms Herzog.
8. Mr Schatz submitted that the appropriate sanction in this matter was the cancellation of Ms Herzog's registration, a disqualifying period of 6-9 months from the date of the Tribunal's order, a reprimand, and costs.

1. Mr Gardner told the Tribunal that the evidence demonstrated that the clearest and most likely explanation for Ms Herzog's actions, which she accepts represents deplorable conduct, was that she had a substance abuse problem and impulsively took the prescription pad when she saw it was available, and then forged the prescriptions.
2. Mr Gardner said Ms Herzog accepted the seriousness of her conduct. However, it occurred in circumstances where she was subject to considerable stress. In August 2016 after working a shift at Western Hospital she had been accused of interfering with two vials of Fentanyl and an investigation was commenced in which she had been the only suspect. She denied she had interfered with the Fentanyl vials, but in April 2017 the Board indicated it proposed to take action against her. She was extremely distressed at this and it was in these circumstances that she impulsively took the prescription pad when she saw it. She recognises it was an impulsive and stupid move, but it was not a calculated action. There has been no suggestion there was any commercial or financial benefit to Ms Herzog in her actions or that she wanted the benzodiazepines for anyone other than herself. Nor did she pose any danger to patients as there was no connection to her practice in the commission of the offence or deprive patients of their medications.
3. Mr Gardner submitted that since the date of the offending, Ms Herzog has done all she can to redress her circumstances: she has admitted her circumstances to her medical advisors and engaged with them, and she has progressed in her recovery. Dr Pols' evidence was very strong in support of Ms Herzog. His opinion was that her substance abuse was now under control, and any risk could be managed by conditions on her registration, and she accepted these conditions would apply to protect the public and support her.
4. Mr Gardner said there was no evidence presented by the Board suggesting any substance abuse after 2017. He said Ms Herzog had been very open about her drug use, although he conceded this had not always been the case, but he submitted that she had admitted everything across various environments without being forced to do so.
5. Mr Gardner submitted that if Ms Herzog's substance abuse is controlled, then there was no longer any issue of risk.
6. Mr Gardner emphasised that Ms Herzog had never presented any danger of harm to patients. He submitted that the Western Hospital incident should not be taken into account as it represented allegations only, and no action was taken following investigation. With respect to the RAH incident he submitted Ms Herzog should not be subject to a double punishment, and he emphasised that Ms Herzog still denied the account contained in the PPS report.
7. In relation to the appropriate sanction to be applied in this matter, Mr Gardner made the following points:
   • At the time of the hearing Ms Herzog had already had her registration suspended for more than three years
   • As a consequence, she has suffered a significant financial penalty, and this in itself represented a deterrence
   • Ms Herzog had admitted the conduct, which reduces the need of the Board to investigate, and this should be acknowledged
   • She admitted her conduct amounted to professional misconduct
8. Mr Gardner concluded that the only outstanding matter in issue was that of risk. In relation to this, he submitted that both Dr Angelakis and Dr Pols had considered that Ms Herzog could safely practise as a nurse, subject to conditions, and Dr Kelly had conceded that her circumstances had improved.
9. Mr Gardner concluded telling the Tribunal that Ms Herzog was a good person who had made poor choices, but she is now a fit and proper person to practise as a nurse. He said her substance abuse disorder is now under control and is managed and she does not suffer from any impairment. She has willingly participated in extensive treatment, accepts that conditions on her registration are appropriate, and now poses no risk.

1. Section 196 of the National Law governs the Tribunal's determination in this matter. There are two matters to be determined: the characterisation of Ms Herzog's conduct; and the appropriate disciplinary sanction to be imposed.
2. Section 196(1)(b) of the National Law empowers the Tribunal to decide one or more of the following as the appropriate characterisation of the practitioner's conduct:

(i) the practitioner has behaved in a way that constitutes unsatisfactory professional performance;

(ii) the practitioner has behaved in a way that constitutes unprofessional conduct;

(iii) the practitioner has behaved in a way that constitutes professional misconduct;

1. Professional misconduct is defined in s 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.

1. The Tribunal is satisfied that Ms Herzog was a registered health practitioner within the meaning of the National Law at all relevant times (as a nurse she "practices a health profession" - see s 5 of the National Law), and that she has agreed her conduct amounts to "professional misconduct" within the meaning of this definition.
2. The Tribunal notes Ms Herzog pleaded guilty to the charges arising out of her theft of the prescription pad, and she was convicted in relation to those charges. In the Statement of Agreed Facts Ms Herzog also formally admitted to the conduct the subject of the charges made by the Board and before this Tribunal. Ms Herzog has also accepted that this conduct amounts to professional misconduct.
3. The issue before the Tribunal is essentially the appropriate sanction to apply to Ms Herzog's conduct. It was in that context that the parties addressed her personal and medical history in order to address the question of the appropriate sanction in the context of any risk she might pose to the public, herself and her employer should she return to nursing practice.

1. We are satisfied that the following is a general chronology of the relevant events, derived from the material provided to the Tribunal in the various documents, as well as in oral evidence before it.
   • Ms Herzog is presently aged 29.
   • Ms Herzog graduated with a degree in Nursing from Flinders University in 2012, and then became registered to practice nursing in Australia.
   • She commenced employment at the RAH in March 2013 in a Transition to Professional Practice Program.
   • On 1 October 2013 she was accused of attempting to improperly remove drugs and medical paraphernalia from a restricted area in the RAH.
   • Ms Herzog was found with two boxes of Propofol, two boxes of Clonazepam, two strips of Lignocaine 20ml, and a strip of syringes.
   • Ms Herzog's employment was suspended and the RAH conducted an investigation of the incident.
   • Ms Herzog self-reported the incident in 2014 when she renewed her registration and it was formally notified to the Board on 30 May 2014 and an investigation was commenced.
   • A Performance and Professional Standards Panel was established by the Board to hear the matter, and it provided its Notice of Decision on 27 March 2015. The Panel found Ms Herzog had attempted to remove medication and medical equipment from her workplace without permission, and that she had provided false and misleading information to the Board.
   • The Panel found Ms Herzog had behaved in a manner which constituted unprofessional conduct and issued a reprimand.
   • Ms Herzog denied, and continues to deny, that she was attempting to remove the medication and medical equipment improperly.
   • The colleague who Ms Herzog said had asked her to collect the medication for her was never found or identified by Ms Herzog, the RAH, or the Panel.
   • Ms Herzog returned to nursing work as an agency nurse at Sports Med on or about 4 July 2016. On 5 July 2016 she overdosed on Midazolam (a benzodiazepine) and was found unconscious at her home but was nursed to recovery by her partner.
   • She again used Midazolam on or about 25 July 2016.
   • On 23-24 August 2016 Ms Herzog was working at Western Hospital as an agency nurse and was accused of taking or interfering with Fentanyl (a synthetic opioid). An investigation was commenced and the Board notified, but the investigation was later withdrawn.
   • Ms Herzog denied she had misappropriated or interfered with the Fentanyl.
   • On 7 April 2017 Ms Herzog stole a prescription pad from the consulting room of Dr Chow.
   • On 8 April 2017 Ms Herzog presented four forged prescriptions to pharmacies and obtained medication, namely Paxam (a trade name for Clonazepam) and Oxazepam, both benzodiazepines, without a valid prescription.
   • On 13 April 2017 she was apprehended by SAPOL, returned the prescription pad to the police, and was formally warned by the police.
   • On 27 April 2017 the Board suspended Ms Herzog's registration under s 156 of the National Law, and her registration remains suspended.
   • On or about 9 May 2017 Ms Herzog discussed these events with her psychiatrist Dr Goel, and on the same date wrote to Dr Chow apologising for her actions.
   • On 18 and 19 May 2017 Ms Herzog presented four forged prescriptions for medication, and obtained Lorazepam, Paxam and Oxazepam, all benzodiazepines, without valid prescriptions.
   • On 18 April 2017 Ms Herzog was charged with various criminal offences relating to the theft of the prescription pad and the forging of prescriptions, and on 5 July 2018 she pleaded guilty to these charges and was convicted in relation to them.
   • Over a period of seven years since her graduation, Ms Herzog worked as a nurse for about 7 months in 2013 at the RAH; at Sports Med (described as "her first shift back") in 2016; and at Western Hospital briefly in July 2016. There is no evidence before the Tribunal of other employment or nursing shifts.
   • The RAH issue arose during her period of work at RAH; her overdose of Midazolam followed "her first shift back" at Sports Med in 2016; and allegations were made and an investigation commenced but not pursued, that she had interfered with Fentanyl vials in the course of a shift at Western Hospital in July 2016. She has not worked as a nurse since July 2016.
   • Ms Herzog reported first using drugs in 2010, and that she had used benzodiazepines prior to 2013. On her own report she was still using benzodiazepines on 31 August 2017.
2. We are satisfied that the evidence establishes that Ms Herzog had a significant substance abuse condition extending over most of the period since before her graduation as a nurse. Dr Angelakis, a psychologist, and Dr Pols, a psychiatrist, gave evidence that Ms Herzog no longer has a substance abuse issue, and could safely return to nursing practice. Dr Pols was of the view that such a return should be subject to conditions; Dr Angelakis initially did not suggest there needed to be conditions. Dr Kelly told the Tribunal he did not believe Ms Herzog could, at the moment, safely return to nursing practice.
3. However, the Tribunal has significant concerns about the weight to be given to the primary evidence of both Dr Angelakis and Dr Pols. Both spoke very positively of Ms Herzog's progress and commitment to a recovery from her benzodiazepine dependence in both their written reports and to the Tribunal. However in cross examination and confronted with other evidence concerning Ms Herzog's history and circumstances, both conceded Ms Herzog had misled them in what she had told them of her circumstances, and had not disclosed significant information to them, and that had they been privy to this additional information they most likely would have made different assessments. Both agreed, in this context, that a return to nursing practice could expose Ms Herzog to the possibility of relapse.
4. The Tribunal is satisfied that Ms Herzog's present prognosis is not as clear as suggested by Dr Angelakis and Dr Pols. While there was evidence that she has undertaken a significant amount of treatment, and Dr Angelakis and Dr Pols spoke very positively about her successful commitment and response to that treatment, the Tribunal is not confident in accepting that evidence. The Tribunal notes Doctors Angelakis and Pols have both conceded that Ms Herzog has misled them in their therapeutic relationship, and has manipulated, limited, and distorted information she has provided to them in the course of that treatment and therapeutic relationship. In those circumstances, the Tribunal cannot be confident that their assessment of Ms Herzog's present circumstances, and their prognoses for her, can be relied on.
5. Taking these considerations into account the Tribunal prefers the opinion expressed by Dr Kelly. His evidence was that Ms Herzog has a significant history of abusing substances opportunistically, and that "working in any setting where substances which have the potential for abuse are present places her at great risk of relapse and this would place both her safety and her ability to practice as a nurse safely and ethically in jeopardy". He did not believe she could safely return to practice as a nurse without a significant risk of her substance use disorder recurring.
6. The Tribunal's view is that this opinion expressed by Dr Kelly is not inconsistent with the revised views suggested by both Dr Angelakis and Dr Pols following their cross examination and consideration of the other evidence put to them at the hearing of this matter.
7. There was no dispute concerning the matters immediately the focus of this complaint, namely the theft of the prescription pad, the forging of prescriptions and obtaining prescription drugs without prescription. Ms Herzog was charged in relation to these matters, pleaded guilty and was convicted. She has acknowledged this conduct amounts to professional misconduct for the purposes of the National Law.
8. We are satisfied it is appropriate for us to take into account the PPS Panel decision report concerning the RAH incident of 2013, as providing material and an account not only relevant to Ms Herzog's disciplinary history, but also as containing significant material in the context of her treatment and relevant to the opinions of her treating practitioners. While we note that Ms Herzog rejects the findings contained in the report and maintains the account she provided to the PPS Panel, we accept the findings contained in that report.
9. In considering these facts and Ms Herzog's circumstances, we note there are some significant factors in Ms Herzog's circumstances which apply in her favour:
   • Ms Herzog's age and relative inexperience, both at the time of the events and at present
   • Her undoubted remorse in relation to the events of 2017
   • Her apparent commitment to treatment
   • Her guilty plea to the criminal charges, and her acknowledgement of her misconduct relevant to these proceedings
   • The disadvantages and significant adverse consequences she has already suffered as a result of her own conduct, including public embarrassment, loss of employment, and financial loss
   • That her registration as a nurse has been suspended for a period of more than 3 years
10. However, while acknowledging these mitigating factors, the Tribunal's determination of sanctions must be governed by the legislative purpose of the sanctions under the National Law.

1. In considering the appropriate sanction to apply in this matter the Tribunal must bear in mind the purpose of such sanctions under the National Law. These general principles are set out in the judgement of Doyle CJ in Craig v Medical Board of South Australia [2001] SASC 169; (2001) 79 SASR 545 ('Craig'). The purpose of a disciplinary sanction is to protect the public and not to punish a practitioner in the sense in which punishment is administered pursuant to the criminal law. Accordingly, the factors in Ms Herzog's favour as referred to above have some weight in our consideration of the appropriate disciplinary sanction to be imposed, but that weight is limited by the overarching consideration of the protection of the public. At the same time, the disciplinary action must be proportional and appropriate to all the circumstances of the case.
2. It is well established in the case law that the purpose of disciplinary proceedings is to protect the public, maintain proper professional standards, and to assure the public that proper standards are being maintained in the relevant profession. A disciplinary sanction also assists in upholding the public trust and confidence in the profession, bringing home to the practitioner the seriousness of their conduct, deterring the practitioner from any future departures from appropriate standards, deterring other members of the profession from acting in a similar manner, and imposing restrictions on the practitioner's right to practice so as to ensure the public is protected.
3. In making an assessment of the risk Ms Herzog's future practice as a nurse might pose, both parties directed the Tribunal to the 12 points identified in Medical Board of Australia v Singh [2017] WASAT 33, a decision of the WA State Administrative Tribunal in 2017, as relevant in determining the issue of risk. The Tribunal adopts these considerations as appropriate in this matter.
4. These factors, and the Tribunal's considerations of them, are as follows:
   • Any need to protect the public against further misconduct by the practitioner. Ms Herzog argued this could be adequately addressed by appropriate conditions on her registration. The Tribunal is satisfied that it is clear this consideration applies here, both in relation to Ms Herzog herself, as well as patients and other members of the public.
   • The need to protect the public through general deterrence of other practitioners from similar conduct. Unacceptable conduct should be made clear, although Ms Herzog argued that the existing three years suspension of her registration, in addition to a reprimand, should provide a sufficient deterrence to others.
   • The need to protect the public and maintain public confidence in the profession ... [including] an emphatic indication of ... disapproval. Ms Herzog again argued this had already been made clear in her case with no need for a cancellation of her registration. The Tribunal is concerned that public confidence in the nursing profession must be maintained.
   • In the case of conduct involving misleading conduct, including dishonesty, whether the public and fellow practitioners can place reliance on the word of the practitioner. Ms Herzog submitted that evidence of dishonesty was limited to her substance abuse. Ms Herzog admitted the dishonesty in relation to the criminal activity and charges, but the Tribunal also notes the evidence from Doctors Angelakis and Pols acknowledging Ms Herzog's lack of honesty in some of her dealings with them, as well as the evidence relating to her assurances to Dr Goel and Dr Chow.
   • Whether the practitioner has breached any (a) Act; (b) Regulations; (c) Guidelines or Code of Conduct...; and (d) whether the practitioner has done so knowingly. Clearly Ms Herzog acted in breach of the law in relation to which she was convicted, and the Tribunal is also satisfied (and Ms Herzog concedes) she acted in breach of the relevant Code of Conduct.
   • Whether the practitioner's conduct demonstrated incompetence. It was agreed no incompetence was alleged and the Tribunal accepts this.
   • Whether or not the incident was isolated. Ms Herzog submitted the incident was isolated. The Tribunal notes that the events relating to the 2017 theft of the prescription pad and the subsequent actions took place over a period of several weeks and entailed several separate actions by Ms Herzog. In addition, the Tribunal notes Ms Herzog's disciplinary history.
   • The practitioner's disciplinary history. Ms Herzog acknowledged her disciplinary history and that it had led to a reprimand. The Tribunal notes however that Ms Herzog continues to assert that the facts are not those as found by the PPS Panel, that she was wrongly treated by the Panel and that, by implication, the reprimand was therefore undeserved. The Tribunal does not accept Ms Herzog's account of these events but accepts the view of the PPS Panel in its report. The Tribunal also notes allegations made against Ms Herzog in 2016 but notes the investigation into this matter was discontinued with no findings against Ms Herzog.
5. The weight of these considerations is significantly in support of a sanction to prevent Ms Herzog from practising as a nurse.
6. The Tribunal also notes that Dr Kelly's opinion was that Ms Herzog's return to nursing posed a significant risk, and Dr Angelakis and Dr Pols both conceded a relapse was very possible.
7. The Board's view was that there was no evidence Ms Herzog was currently a fit and proper person to hold such registration. The Board refers to the admitted conduct relating to the prescription pad, as well as the findings of the PPS Panel, and expressed the view that Ms Herzog had failed to take responsibility for that conduct and this demonstrated a lack of insight and a failure to respond appropriately to the reprimand of the Panel. In addition, the Board was of the view that Ms Herzog had not demonstrated a capacity to practice nursing safely and ethically for any extended period of time, and all of these considerations supported its view that it was not appropriate for her to return to nursing practice yet.
8. The Tribunal accepts the Board's submissions in relation to these matters, and is satisfied they are consistent with the evidence presented.
9. Taking all of these considerations into account, the Tribunal is satisfied that the sanctions sought by the Board are appropriate remedies in this matter.
10. The Board also relied on the applicable code of conduct and code of ethics. The Tribunal is satisfied that Ms Herzog's conduct was unlawful and has the potential to damage the standing and reputation of the nursing profession and is contrary to the conduct statements contained in the Code of Professional Conduct for Nurses in Australia. The Tribunal also takes this into account in considering the appropriate sanction.
11. The Tribunal accepts that Ms Herzog's conduct constituted a serious departure from acceptable professional standards inconsistent with her being a fit and proper person to hold registration in the nursing profession, and her registration should be cancelled. The Tribunal notes that Ms Herzog's registration has been suspended since 27 April 2017.
12. Ms Herzog submitted that a factor that ought be taken into account in considering the relevant sanction was the considerable delay which had already occurred in dealing with this matter. As a consequence, at the time of the hearing, Ms Herzog's registration as a nurse had already been suspended for a period of three years and nearly four months.
13. Mr Schatz addressed the issue of delay in this matter and told the Tribunal that the complaint was lodged on 19 April 2017 and the Board suspended Ms Herzog's registration on 28 April 2017. Subsequently, criminal proceedings eventuated with an information and summons issued against Ms Herzog in April 2018 and a guilty plea and conviction in July 2018. The Magistrates Court file was then provided to the Board. The Board process then took 12 months, and one month later the complaint was filed. Ms Herzog responded four months later, and then a process of obtaining medical reports and conferences followed. There was another three-month response period from Ms Herzog and the matter was then referred to the Tribunal in February 2020. There were some delays before the Tribunal in the matter coming to a full hearing. He submitted the principal delay was in waiting for the criminal process to take its course and no delay had been as a result of any delay by the Board.
14. The Tribunal accepts that although it has taken a significant amount of time for this matter to be finalised before the Tribunal, the principal cause of delay has been in awaiting the conclusion of the criminal proceedings.
15. Further, we note the impact of delay was considered by Doyle CJ in Craig (at 60). Chief Justice Doyle said:

In my opinion the delay is not to be given any significant weight. When the purpose of the order is the protection of the public, the main relevance of delay is that the absence of any complaint during the period of the delay might indicate the public does not require protection from the practitioner. But delay, and the fact that the practitioner may have had the matter hanging over the practitioner's head for some time, has no real weight in deciding what the public interest requires.

While the Tribunal accepts it ought take into account the length of time of the suspension of Ms Herzog's registration, the Tribunal notes and adopts the views expressed by the Chief Justice in Craig.

1. The Tribunal's view is that Ms Herzog's registration should be cancelled pursuant to s 196(2)(e) of the National Law.
2. In addition, the Tribunal is satisfied that Ms Herzog should be disqualified from applying for registration as a health practitioner for a period of 6 months from the date of the hearing of this matter. That period will expire on 17 February 2021. It is our view that a significant period of disqualification from seeking registration renewal is necessary to ensure that the standards of the profession are maintained in the eyes of the profession and of the public, noting that general deterrence is a significant factor relevant to a disciplinary sanction. However, we also have reference to the fact that Ms Herzog's registration has been suspended for a significant period of time.
3. The Tribunal also notes that all medical opinion expressed at the hearing of this matter supported placing conditions on any return to nursing practice by Ms Herzog. Ms Herzog also agreed to accept conditions on any return to nursing practice. The Tribunal draws this agreement and the suggestions concerning specific conditions to the attention of the Board and directs the terms of such conditions be agreed between the parties.
4. Further, the Tribunal is of the view that Ms Herzog's conduct should be characterised as conduct substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience (within s 5(a) of the National Law), or 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 (within s 5(c) of the National Law), and that the conduct should be regarded as "disgraceful and dishonourable" and worthy of strong reprobation by professional peers. This conduct in the Tribunal's view, is professional misconduct within the meaning of the National Law.
5. Having made this finding of professional misconduct and being of the view that this represents serious misconduct, the Tribunal is satisfied it is appropriate to issue a reprimand to Ms Herzog. In the Tribunal's view, a reprimand is a serious and important sanction indicating a public denunciation of the offending conduct.
6. In addition, the Board sought an order for costs against Ms Herzog.
7. The general rule is that costs follow the event.
8. Mr Schatz submitted that Ms Herzog should be liable for full costs. He told the Tribunal the matter could have proceeded with Ms Herzog's agreement but did not do so. In addition, he told the Tribunal the Board had a mandatory duty to refer the matter to the Tribunal pursuant to s 194 of the National Law, and once the Tribunal had carriage of the matter that Board had a duty to assist the Tribunal with respect to all aspects of the matter before the Tribunal. He also told the Tribunal the Board is not a public body funded by Government but is funded by members of its profession. He concluded the proceedings were required as a result of Ms Herzog's admitted misconduct, and there was no compelling argument to depart from the usual rule concerning costs.
9. Mr Gardner submitted that Ms Herzog had admitted to the conduct more than three years ago and having done so saved the Board considerable time and cost in investigation. In addition, he submitted that much of the hearing time had been spent on addressing evidence concerning the diagnosis of PTSD and other issues relating to Ms Herzog's mental health, and in the end, these were not matters of great significance.
10. We are not satisfied there are any considerations sufficient to displace the operation of the general rule and we will order costs in favour of the Board pursuant to s 195 of the National Law.

1. The Tribunal makes the following orders in relation to this application:
   1. The respondent is reprimanded.
   2. The respondent's registration is cancelled.
   3. The respondent is disqualified from applying for registration as a health practitioner until 17 February 2021.
   4. The respondent is to pay the Board's costs of and incidental to the proceedings as agreed with the Board or, failing agreement, as determined by the Tribunal.