1. In essence, the facts are not in dispute. The parties have filed a joint "Statement of Admissions and Agreed Facts".[2] We make findings in accordance with the contents of that document.
2. In summary, the respondent was employed by a company whose business it was to provide patient transport services. He was employed as a paramedic. On 19 August 2019 he was assigned (with a co-worker) the task of transporting the patient from a hospital in one country centre to another country centre for treatment, and then return.
3. The patient was a vulnerable person. She was known to display manipulative behaviours, including seeking to divert health workers from their duties to other activities, seeking inappropriate health interventions from them, or offering or requesting sexual favours. The respondent was advised of these matters. He was instructed that his only role was to drive the ambulance and let his female co-worker attend to the patient.
4. During the transfer, the patient attempted to get the respondent and his co-worker to take her to a department store and a fast-food restaurant. She constantly complained of pain and requested fentanyl or other pain relief medication.
5. The respondent, at the request of his co-worker, participated in professional assessment of the patient and decisions concerning her medical care and need for pain relief. He, together with his co-worker, provided advice to the patient about management of her pain.
6. On completion of the transfer the respondent requested and obtained the patient's mobile phone number. He also hugged the patient, as did his co-worker.
7. On 21 August 2019 the respondent initiated contact with the patient by text message. He asked her to "keep in touch". He continued to communicate with her by text, phone, and multi-media messages. It was clear that he was seeking a personal relationship and the communications were not for the purpose of her medical care. Between 21 August 2019 and 11 October 2019, the respondent and the patient exchanged at least 1746 text or multi-media messages and had at least 190 phone conversations.
8. The respondent's communications quickly became suggestive of a developing friendship and romantic interest. By 24 August he texted that he was "incredibly happy that we have become friends". On that day, the patient and the respondent slept together. Subsequently, the patient attended at the respondent's home and slept in the same bed with him approximately two nights a week during the period until about 10 October 2019. Their relationship was sexual and intimate and, on the agreed facts, included an occasion or occasions of sexual intercourse. The patient and the respondent engaged in social outings together and the respondent accompanied the patient to medical appointments.
9. In short, the respondent misused his professional contact with the patient, and his knowledge of her vulnerability gained in that context, as an opportunity to pursue his own desires and needs, without due regard for the interests of the patient. He took advantage of a vulnerable person and thereby put her at risk of harm.
10. On about 13 September 2019 the respondent's employer suspended him from duty due to allegations that he was in a personal or sexual relationship with the patient. On 30 September 2019 he resigned his employment. Despite these developments, the relationship continued until about 11 October 2019.
11. The relationship ended acrimoniously, with the patient making complaints to Victim Support Services and the Police concerning the respondent's conduct.
12. Meanwhile, a notification was made to AHPRA and a decision made to investigate. On 11 October 2019, the Board took immediate action by way of suspending the respondent's registration. He remains suspended.
13. In letters dated 8 October and 29 November 2019, and in an interview on 13 July 2020, the respondent gave a false account to AHPRA of his relationship with the patient. He falsely claimed that the communications had been initiated by the patient. He claimed that they were not dating or in a sexual relationship before 16 September 2019. In the interview, he falsely claimed that they were not in a personal relationship until after 30 September 2019 when he had resigned his employment. He falsely stated that he had deleted all relevant messages from his phone.
14. In summary, the respondent sought by a number of false statements to minimise his own responsibility for his misconduct.

1. The respondent admitted that each aspect of his conduct constituted professional misconduct.
2. The respondent took advantage of his position as a paramedic to pursue an inappropriate relationship with a patient whom he knew to be vulnerable. He acted in breach of the relevant Code of Conduct and contrary to the clear ethical requirements of his profession. He acted in furtherance of his own desires and needs without due regard for his professional responsibilities or the welfare of the patient. He exposed the patient to the risk of harm and the relationship ended acrimoniously. We have no doubt that this constitutes serious professional misconduct.
3. The respondent failed to take full responsibility for his misconduct. He sought to minimise his responsibility by providing a false account of what occurred. He persisted in this account over a significant period of time. Lack of candour with the professional regulator is a serious matter. Considered overall, the false statements to AHPRA also constitute professional misconduct.

1. The purpose of disciplinary action is entirely protective and does not involve any element of punishment. The purposes for which disciplinary action may be imposed have been discussed in many cases[3] and need not be restated here. This Tribunal reviewed some of the authorities in Medical Board of Australia v Tunbridge [2020] SACAT 34 at [19]-[24].
2. The submission of the Board is that the Tribunal should impose a reprimand, cancel the registration of the respondent, disqualify the respondent from applying for registration for two years, and prohibit him from providing any health service for two years.
3. The respondent does not oppose these proposed orders, save for the prohibition order under s 196(4)(b) of the National Law.
4. The respondent states that he does not intend to work again as a paramedic. However, he performs voluntary work for the Red Cross as a driver, transporting patients to medical appointments and the like. He is keen to continue this voluntary work. The prohibition order may well prevent him from doing so.
5. The Tribunal is of the view that the respondent has demonstrated limited insight into his misconduct. He admits professional misconduct. He accepts that his conduct was contrary to the Code of Conduct and the standards of his profession. However, he appeared to have limited insight into the rationale which underlies such ethical standards. He appeared to have limited insight or understanding in relation to the vulnerability of the patient, the risk of harm which his conduct involved, the underlying factors which may have prompted his conduct, and the need to address such factors going forward. The evidence before the Tribunal leaves us unconvinced that the respondent could be relied upon to adequately regulate his behaviour in any similar situation in the future.
6. Accordingly, we consider that it is appropriate to cancel his registration. We have regard to the fact that the respondent's registration has been suspended since October 2019. However, given the seriousness of the professional misconduct (including the false statements), we consider that a disqualification for a further period of two years is appropriate. Such is necessary to protect the public, to send a message to practitioners that such conduct will not be tolerated, and to assure the public that appropriate standards will be maintained.
7. We also consider that a prohibition from providing any health service should be imposed for the same period. We have considered the information provided to us from the Red Cross, including positive comments about the respondent and his contribution as a volunteer. However, the volunteer work appears to the Tribunal to give rise to the same (or similar) concerns as we would have if the respondent was practising as a paramedic. We consider that it would be inconsistent with our findings to allow the respondent to provide any health service.
8. We further consider that a formal reprimand is appropriate in the circumstances.
9. The Board has sought an order for costs and there is no basis on which that could be opposed.
10. In summary:

(a) The respondent's conduct with respect to the relationship with the patient constitutes professional misconduct

(b) The respondent's conduct in making false statements to AHPRA constitutes professional misconduct

(c) The respondent is reprimanded

(d) The respondent's registration is cancelled.

(e) The respondent is disqualified for a period of two years from applying for registration as a health practitioner.

(f) The respondent is prohibited for a period of two years from providing any "health service" as defined in the National Law.

(g) The respondent must pay the Board's costs to be agreed or fixed by the Tribunal.

1. Pursuant to s 60 of the South Australian Civil and Administrative Tribunal Act 2013, the Tribunal prohibits the publication of the name of, or any material tending to identify, the patient referred to in the complaint.

[1] The National Law is to be found in Schedule 2 to the Health Practitioner Regulation National Law (South Australia) Act 2010.

[3] Craig v Medical Board of South Australia [2001] SASC 169 at [41]- [48]; Nursing and Midwifery Board of Australia v Symons [2020] SACAT 28 at [50]- [51]; Marin v Chiropractors Board of Australia [2020] SASCFC 74 per Kourakis J at [73].