(a) Allegation 1 - access and use of child abuse material: That the respondent has engaged in professional misconduct as defined by meanings (a) and (c) at section 5 of the National Law; and

(b) Allegation 2 - failure to report to the Board with being charged with offences related to the above: That the respondent has engaged in unprofessional conduct as defined by the National Law.

1. Under section 196 of the National Law determines to:

(a) Reprimand the respondent under section 196(2)(a);

(b) Disqualified from applying for registration as a registered health practitioner for a period of six years from the date of these orders, under section 196(4)(a); and

(c) Prohibit the respondent from providing any health service unless he is registered as a health practitioner under the National Law under section 196(4)(b).

1. Under section 80 of the Victorian Civil and Administrative Tribunal Act 1998 (Vic), the respondent in this proceeding must for 10 years from the date of these orders be referred to as 'TNS'.

1. In March 2023, the Paramedicine Board of Australia (the Board), under the Health Practitioner Regulation National Law (Victoria) Act 2009 (the National Law)[1] referred two allegations against TNS to VCAT.
2. Until he surrendered his registration with effect from 25 January 2021, TNS was a registered paramedic under the National Law.[2]
3. In 2021, he pleaded guilty to and was convicted of using a carriage service to access child abuse material; and possessing or controlling child abuse material obtained or accessed using a carriage service.
4. In the referral, the Board made two allegations:

1. Between 10 September 2020 and 15 November 2020, TNS used a carriage service to access child abuse material in contravention of section 474.22(1) of the Criminal Code Act 1995 (Cth) (Criminal Code); and
2. Between 1 November 2020 and 29 December 2020, TNS possessed or controlled child abuse material obtained or accessed using a carriage [service] in contravention of section 474.22A(1) of the Criminal Code.

TNS failed to notify the Board of these charges within seven days of becoming aware of them, as required by s 130(1) of the National Law.

1. TNS admits to both allegations, including admitting the highly disturbing particulars (details) of the Allegations, which are not necessary to set out here.
2. On 16 October 2024, VCAT heard the Board's referral. While at the end of the hearing we advised the parties we would make the findings and determinations which they proposed, we formally reserved our decision, to provide these written reasons and decide the 'anonymity application' (see below).
3. As the parties submitted, VCAT has found:
   1. the 'Allegation 1 conduct' constitutes professional misconduct within the meaning of paragraphs (a) and (c) of the definition of that term in s 5 of the National Law;
   2. the 'Allegation 2 conduct' amounts to unprofessional conduct within the meaning of that term in s 5 of the National Law; and
4. As the parties submitted, VCAT has determined that TNS be:
   1. reprimanded;
   2. disqualified from applying for registration as a registered health practitioner for a period of six years from the date of the above orders; and
   3. prohibited from providing any health service unless he is registered as a health practitioner under the National Law.
5. There was also before VCAT, for the presiding member to decide, an application by TNS that an interim pseudonym order be confirmed as an ongoing order. The Board opposed TNS's application.
6. The effect of such an order would be to, in practical terms, not identify TNS in these orders and reasons.
7. That order is made.
8. The deciding of this case at VCAT is long delayed. The Tribunal Book was finalised in August 2023. Delay at VCAT was due to then current health practitioner members (with expertise in paramedicine) not able to hear this case, given past professional acquaintance and a friendship (now ended) with TNS, in the small working community of paramedics.
9. Recently, new health practitioner (paramedic) members with no shared past with TNS were appointed to VCAT.
10. While the hearing ended on 16 October 2024, there was further delay to late November 2024, to enable TNS to provide further psychological evidence concerning whether he should remain 'anonymised' in this proceeding.

1. The first step in this proceeding is to decide whether allegations are proven.
2. The evidence was a 498-page Tribunal Book including documents relating to the notification to the Australian Health Practitioner Regulation Authority (Ahpra) which gave rise to the allegations, the Ahpra investigation that followed, Victoria Police documents, court documents and the relevant code of conduct.
3. The parties' August 2023 Statement of Agreed Facts, Findings and Determinations was provided separately.

1. From 1990 to January 2021 TNS was employed as a paramedic with Ambulance Victoria with a diverse range of achievements to his name.
2. In January 2021, Ahpra received a notification regarding TNS. The notification reported that in December 2020, TNS had been charged with several sexual offences.
3. Shortly after, he surrendered his paramedic registration. Therefore, the Board did not need to consider immediate action to suspend registration.
4. Allegation 1 relates to the conduct itself.
5. Allegation 2 is based on the requirement of section 130 of the National Law that a registered health practitioner must, within seven days after becoming aware of being charged with an offence punishable by 12 months imprisonment or more, give the National Board established for the practitioner's profession written notice of the event.
6. TNS was required to, but did not, notify the Board of the charges against him within seven days of becoming aware of them. He was arrested and charged with three sexual offences on 29 December 2020, each of which was punishable by more than 12 months imprisonment.
7. On 7 January 2021, Ambulance Victoria notified Ahpra of the charges.

1. In Pharmacy Board of Australia v Hopkinson,[3] VCAT said regarding the approach that is taken where the parties to a disciplinary proceeding have reached agreement on specified matters:

The principles that apply to our approach to such an Agreed Statement are well established. The agreement between the parties is a highly relevant matter for our consideration with respect to the factual findings, the characterisation of those findings and the determinations that should be imposed. It remains, of course, our duty to determine these matters and no agreement between a regulator and the professional person under review can supplant that duty. Nevertheless, departure from an agreed position ought not take place without clear or exceptional reason. The Tribunal will not lightly depart from an agreed sanction where the negotiated settlement and proposed penalty are broadly speaking within the permissible range, having regard to all the circumstances. The Tribunal will, however, reality test and hear submissions in relation to any joint proposal.

1. The conduct with respect to both allegations, as the Board alleges, which TNS admits, which is supported by the documentary evidence before us, is proven.
2. The material before the Tribunal shows TNS's conduct in accessing and possessing child abuse material was sustained and serious. The charged conduct involved using a peer-to-peer file sharing network to access files of child abuse material on six separate dates between 10 September 2020 and 15 November 2020. There was evidence of TNS accessing child pornography on 7 December 2012. In his interview with police, he said he had been searching for and accessing child pornography on and off in the last few years.
3. In sentencing, the Judge said (in part):

You were fully cognisant of the serious criminality you were engaging in when accessing this material. The number of child victims is significant. The extent to which some of them have been degraded, humiliated and subjected to the most exploitative behaviour is awful. Your conduct contributes to the market for this material and encourages such exploitation. Although there is some overlap in the criminal conduct between the charges, in the sense that it was the accessing of the material that enabled you to possess the material, the possession and retention of the material even for limited periods of time constitutes separate criminal conduct. I note, for example that you possessed a total of 114 files of category 4 material including some 71 videos of this vile and depraved material.

1. However, the Judge also accepted that the offending 'took place in a situation where colloquially described you were somewhat vulnerable' because TNS was 'passive, isolated, your marriage dysfunctional, and under mounting significant pressure from your onerous work'. The Judge acknowledged the significance of his service to the community as a paramedic for over 30 years. The Judge also noted TNS's practice was to 'look at the files for some time and then become disgusted with yourself and delete the files', indicating 'that you were to some extent appreciating the repugnance of your offending whilst succumbing to it.'
2. The Court sentenced TNS:
   1. On Count 1: to 18 months' imprisonment, released upon entering a recognisance in the amount of $2,000 to be of good behaviour for a period of three years and required to be subject to the supervision of the Deputy Commissioner, Community Correctional Services and Sex Offender Management for a period of two years.
   2. On Count 2: to a Community Corrections Order of two years' duration, with conditions requiring 300 hours of unpaid community work, mental health assessment and treatment, supervision and to undertake any programs to address his offending behaviour as deemed necessary by Corrections Victoria.
   3. To undertake and complete the Sex Offender Treatment Program conducted by Central Melbourne Psychology and abide by any lawful directions regarding ongoing treatment for the duration of the Community Corrections Order.
   4. The Court also ordered that TNS was to be registered on the Sex Offenders Register, pursuant to the Sex Offenders Registration Act 2004 (Vic) (SORA), with a reporting period of eight years.

1. With the conduct proven, the second step is to decide whether the conduct falls within the definitions of 'professional misconduct' and/or 'unprofessional conduct' under the National Law.

1. The fundamental objective of the National Law is to maintain public safety and public confidence in the health profession and the standards of conduct of health practitioners. Section 3A provides that the main guiding principle of the national registration and accreditation scheme is the protection of the public, and that public confidence in the safety of services provided by registered health practitioners and students, are paramount.
2. VCAT's power to make findings is at section 196 of the National Law.
3. Section 5 of the National Law defines professional misconduct as:
   1. 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;
   2. 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
   3. 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.
4. It defines unprofessional conduct as 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, providing examples, none of which are directly applicable here.
5. TNS was required to adhere to the Board's interim Code of Conduct for registered health practitioners (June 2018) (Code) which in part says that practitioners must always act in accordance with the law and that in addition to being competent, practitioners will display qualities such as integrity, truthfulness, dependability and compassion.
6. As VCAT said in Osteopathy Board of Australia v Ratliff ('Ratliff') (a principle that applies here):[4]

The consumption of child pornography leads to profound harm to children in the production of such material. An interest in that material, albeit that it was an activity pursued outside the conduct of his practice, is inconsistent with the attributes of care and trust required in an osteopath in carrying out their profession.

1. As the parties agreed, TNS's conduct constitutes 'professional misconduct', being substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience, under meanings (a) and (c) as defined in the National Law.

1. As the parties agreed TNS's conduct is unprofessional conduct as defined in the National Law.

1. The third step in this decision-making process, with findings made is to make determinations under National Law, under section 196.
2. VCAT's role is to protect the public, not to punish the practitioner. That said, its decisions may involve a degree of punishment for the purpose of specific deterrence (to deter the individual from repeating the misconduct) and/or general deterrence (to warn others in the profession against such misconduct). VCAT's role is also to uphold the profession's reputation.
3. We accepted the parties' submissions as follows.
4. Here, the focus is on specific deterrence, general deterrence and upholding the reputation of the profession of Paramedicine.

1. Under section 196(2)(a) of the National Law we reprimanded TNS. Reprimand is a serious form of censure and condemnation, combined with a finding of professional misconduct.

Disqualification for applying for re-registration

1. At the VCAT hearing, counsel for TNS advised that having surrendered registration in 2021, TNS has no intention of ever seeking re-registration as a paramedic.
2. However, disqualification for applying for reregistration is appropriate, as the parties agree, in the interests of general deterrence and to uphold the reputation of the profession.
3. In our view, the proposed six-year disqualification from the date of these orders is appropriate, given the disgraceful conduct involved.
4. We agree with submissions from both parties that it is appropriate to set this time limit in line with the period for reporting relating to the Sex Offenders Register.
5. Also, as submitted, the proposed and now decided determinations are 'within the permissible range'.
6. In Nursing and Midwifery Board of Australia v Pang,[5] the practitioner pleaded guilty to and was convicted of one count of knowingly possessing child pornography. The practitioner's registration had lapsed by the time the matter was heard by the Tribunal. The Tribunal imposed a reprimand and imposed a disqualification period of four years, noting that it had been around two and a half years since the practitioner had been convicted and two years since he had been registered as a nurse.
7. In Ratliff, the practitioner pleaded guilty to and was convicted of knowingly possessing child pornography as well as one charge of committing an indecent act with a child under 16 and one charge of incest. After considering comparable cases, the Tribunal commented that '[s]ubstantial preclusions have ... been imposed for convictions for possession of child pornography - often between four and six years'. The Tribunal imposed a disqualification period of six years from the date of its decision, which amounted to nine years since the date when the practitioner's registration was suspended. The Tribunal also imposed a prohibition order, preventing the practitioner from providing any health service for the same period.
8. In Nursing and Midwifery Board of Australia v Ramirez,[6] the practitioner was convicted of importing, accessing, and distributing child pornography. The Tribunal reprimanded the practitioner, cancelled his registration, and imposed a prohibition order with a period of five years.
9. In Nursing and Midwifery Board of Australia v M,[7] the practitioner pleaded guilty to and was convicted of producing written child exploitation material and possessing child exploitation material in the form of images and videos. The Tribunal reprimanded the practitioner, cancelled his registration and imposed a disqualification period of five years, commenting that this was consistent with the purposes of the disciplinary penalties and with the outcome in similar cases.

1. TNS is prohibited from providing any health service unless he is re-registered as a health practitioner under the National Law.
2. This broad prohibition is clearly appropriate. A person who is engaged in child abuse conduct cannot be entrusted with providing any health service to the community.
3. While the parties proposed that the relevant order be a prohibition. 'until he is reregistered as a health practitioner', in order to avoid any concept that the phrase allows for a time when he may be reregistered, in our view the more appropriate word is, 'unless'.
4. That allows for the possibility of re-registration after the six years has passed, with no sense or expectation that will occur.

Pseudonym order (made by Deputy President Proctor)

1. To avoid artificial language, here I, (Deputy President Proctor) write in first person tense, because whether to continue the pseudonym order involves a question of law to be answered by the presiding member.
2. Before the hearing in this case, TNS had applied for orders, under the VCAT Act that he be referred to by an acronym, not his name and closing the VCAT file from inspection, and, under the Open Courts Act 2012 (Vic) (Open Courts Act), closing the VCAT hearing, and suppressing the reporting of his and others' identities.
3. On 25 September 2024, VCAT, as an interim step, ordered that:

The respondent in this proceeding must be referred to as 'TNS'.

The above order will remain in force until further orders of the Tribunal following hearing submissions [from] the parties at the VCAT hearing (scheduled on 16 October 2024) ...

The above order is made to preserve the respondent's position with respect to privacy on an interim basis, before the application is decided, given that otherwise his name would be published in the VCAT Law List with reference to the scheduled hearing.

The merits of the respondent's application have not been considered beyond deciding the status quo as to privacy should be preserved on this interim basis.

1. At the start of the hearing, with only VCAT members, lawyers, employees of Ahpra and TNS present, who all knew his name, there was no need to consider closing the Tribunal hearing.
2. If others had attended, a 'closed tribunal order' would have been most unusual. If say members of the media were present with a pseudonym order in place, discussion during the hearing would not identify the person.
3. The VCAT proceeding file had previously been closed, by VCAT order, to all but the parties in the proceeding. This is a standard order in cases under the National Law, which is made as a first step in most cases.
4. By the end of the hearing, TNS only sought to, on an ongoing basis, be identified by acronym, principally with respect to these published orders and reasons. He based his application on risk to his teenage daughter of publication and risk to his mental health.
5. However, while TNS was starting a course of psychological treatment, he was not yet able to provide a current psychological report concerning the impact of publication on his mental health. Orders were made providing time for that report to be provided which is now available, dated 29 October 2024.
6. At the end of the hearing, the Board opposed this application. After the psychological report was received, the Board advised that it neither consented to nor opposed TNS's 'pseudonym application', but submitted the law as it had provided in written submissions should be applied.

1. The principles under which this application is to be decided were set out by the Supreme Court of Victoria Court of Appeal in WEQ (a pseudonym) v Medical Board of Australia ('WEQ').[8]
2. While the Court was considering the principles that apply to proceeding suppression orders under the Open Courts Act, the observations also apply to pseudonym orders.

First, the power to make a proceeding suppression order depends on the court or tribunal being satisfied that the order is 'necessary' to achieve at least one of a number of enumerated purposes set out in s 18 of the Act. Necessity is a stringent standard, requiring a high degree of satisfaction; it is not enough that it would be reasonable or desirable to make an order for one of the purposes identified in s 18.

Secondly, the requisite standard is to be satisfied on the basis of evidence or 'sufficient credible information' showing that the relevant ground is made out: s 14. This is a substantive requirement applicable even when an application is consented to or not opposed. By reference to such information, the court or tribunal must carefully 'scrutinise the justification for, and the nature and scope of, the proposed order'.

Thirdly, the duration and scope of any proceeding suppression order must not exceed what is necessary to achieve its purpose. Any proceeding suppression order must not exceed the duration 'reasonably necessary' to achieve the purpose for which it is made: s 12(4).

Similarly, any order must not apply to (and so restrict the disclosure of) any more information than necessary to achieve the relevant purpose: s 13(1)(b). The information to which the order does apply must be specified with sufficient particularity so that the scope of the order is readily apparent from its terms: s 13(1)(c).

Fourthly, the court or tribunal that makes a proceeding suppression order (other than an interim order) must provide reasons setting out the ground(s) relied on, and justifying the duration and scope of the order: s 14A(1).

1. In WEQ, the Court set aside the proceeding suppression order (noting that VCAT may in that case choose to make a much narrower order) saying:

... sparing family members from adverse publicity is ordinarily no warrant for suppressing the identity of a medical practitioner who is subject to disciplinary proceedings. Any embarrassment or hurt caused to family members by publication of the allegations against the practitioner is usually an acceptable incident of the disciplinary process, just as it is when (more serious) criminal allegations are tried. Here, there is potential for specific material to be published in the context of the Tribunal proceeding that might raise more substantial privacy concerns. That relates to the medical history of the applicant's former wife, which might be canvassed in respect of one of the allegations; and the potential for psychological harm to the children, in respect of the other. Those matters are both confined in scope, and could conceivably form the basis for a much narrower proceeding suppression order if and when it becomes clearer what invasion of privacy might be likely and how serious the harm might be. They do not justify an order suppressing, in effect, the entire proceeding.

1. A main focus of TNS's application was to protect the welfare of his now 14-year-old daughter if his name was published in these orders and reasons, with the risk of following publicity and the impact of that publicity on her.
2. This was in context that at the end of the criminal proceedings against him, in December 2021 the County Court had made a suppression order[9] on the grounds that it was necessary to protect the safety of the family of the offender. The Court ordered that all media outlets be prohibited from publishing any personal identifying details in relation to TNS, including but not limited to names, addresses, and other similar details, for a period of two years.
3. The Court has not published any reasons for this order.
4. The Board submitted that given that the County Court's proceeding suppression order expired in December 2023, it follows there is no longer a basis for a restriction on further publication of information as specified in the order.
5. I asked the Board's counsel whether the Court's two-year order might recognise the reality that any publicity based on the Court's orders would have passed after two years. The point was made that the Court's sentencing remarks remain published.
6. Ordinarily, the damage that publicity surrounding legal proceedings related to child abuse material does to the reputation of the perpetrator, and the negative effect on those around the perpetrator, does not override the public interest in a transparent justice system.
7. However, there are exceptions, here where it is apparent, and recognised by the Court, that there are risks to safety to young teenagers who find themselves in the appalling situation of a father who has been consuming child pornography.
8. Here I infer, given the Court's orders, the publication of TNS's name in these orders and reasons would endanger his daughter's safety in terms of her mental health.
9. I do not accept that in imposing a two-year time limit on the proceeding suppression order, the Court necessarily considered that the safety of the daughter would no longer be threatened by publication of her father's name in connection with his offending.
10. While the Court's sentencing remarks remain published, the reality is that the lapsing of the Court's proceeding suppression order would not have created a situation where, two years later, there was any interest by any person to uncover and publicise TNS's identity.

1. The psychological report from Mr Simon Candlish, Consultant Psychologist, was based on an earlier report prepared in October 2021, and an interview and psychological testing conducted in late October 2024. It summarised TNS's presentation and mental state examination, his lifestyle since 2021, treatment engagement and psychometric test results.
2. Mr Candlish concluded that TNS meets the criteria for a major depressive disorder (severe, with anxious distress) and meets the criteria for the diagnosis of gambling disorder (in early remission).
3. Concerning whether or not a pseudonym order should be made, Mr Candlish described evidence of the highly negative effects of a perpetrator being identified in terms of undermining prospects of rehabilitation and negative psychological effects on the perpetrator. He noted that public notification can lead to isolation, withdrawal, shame, anger and depression. He mentioned the prospect of such negative experiences being, 'often related directly or indirectly to a person's risk for further sexual recidivism'. Mr Candlish wrote of publication also being able to lead to risk of harm and TNS experiencing depression and suicidality.

1. I have decided that the pseudonym order should be made, principally to protect the teenager, as described above.
2. While the psychological evidence provides some support for the making of the pseudonym order, without the opportunity to explore Mr Candlish's opinion at a VCAT hearing, it would have been difficult to decide the pseudonym order application on psychological evidence alone. The opinion does not give me a sense of the severity of risk to TNS if he was identified in this VCAT proceeding. I do not intend any criticism of Mr Candlish's report and opinion.
3. As the Court of Appeal said in WEQ, orders suppressing identity are to be cast in the narrowest reasonable terms.
4. In my view, a ten-year order in this case is sufficient. In ten years, the daughter will be a young adult.
5. Concerning TNS's welfare, in 10 years' time, TNS may have continued on a path of rehabilitation and non-offending, rebuilding a life in the community, which he could point to if later identified.
6. If TNS, in 10 years' time, remained critically concerned at being identified by this proceeding, he could make a further application to the Tribunal.

[1] As set out in the schedule to the Health Practitioner Regulation National Law Act 2009 (Qld) adopted in Victoria under the Health Practitioner Regulation National Law (Victoria) Act 2009 (Vic). Referral made under section 193.

1. [2] Section 139A of the National Law enables the Board to take the action taken here against TNS as if he was still registered as a paramedic.

[3] [2018] VCAT 982.

[4] [2021] VCAT 658.

[5] [2018] VCAT 1221.

[6] [2021] VCAT 211.

[7] [2023] WASAT 106.

[8] [2021] VSCA 343.

[9] Under section 18(1)(c) of the Open Courts Act, dated 17 December 2021.