DENTAL BOARD OF AUSTRALIA and DHILLON
[2017] WASAT 20
•25 JANUARY 2017
DENTAL BOARD OF AUSTRALIA and DHILLON [2017] WASAT 20
| STATE ADMINISTRATIVE TRIBUNAL | Citation No: | [2017] WASAT 20 | |
| HEALTH PRACTITIONER REGULATION NATIONAL LAW (WA) ACT 2010 | |||
| Case No: | VR:238/2014 | 18 OCTOBER 2016 | |
| Coram: | JUSTICE J C CURTHOYS (PRESIDENT) MR D MACLEAN (MEMBER) DR C PEARS (SENIOR SESSIONAL MEMBER) | 25/01/17 | |
| 19 | Judgment Part: | 1 of 1 | |
| Result: | Practitioner disqualified from applying for registration for a period of two years and six months Practitioner ordered to pay the Dental Board of Australia's costs fixed at $90,000 | ||
| B | |||
| PDF Version |
| Parties: | DENTAL BOARD OF AUSTRALIA RANDEEP SINGH DHILLON |
Catchwords: | Penalty Disqualification from applying for registration Dishonesty Failure to maintain clinical records |
Legislation: | Criminal Code (WA), s 409 Health Practitioner Regulations National Law (WA) Act 2010, s 130(3)(a), s 130(3)(b), s 195, s 196(1)(b), s 196(2) State Administrative Tribunal Act 2004 (WA), s 87, s 87(2) |
Case References: | A Solicitor v Council of the Law Society of NSW [2004] HCA 1; (2004) 216 CLR 253 Barristers' Board v Darveniza [2000] QCA 253; (2000) 112 A Crim R 438 Chan v The Nurses Board of Western Australia [2005] WASAT 115 Craig v Medical Board of South Australia (2001) 79 SASR 545 Dental Board of Australia and Dhillon [2016] WASAT 78 HCCC v Fraser (No 2) [2014] NSWCATOD 84 HCCC v King [2011] NSWMT 5 Law Society of New South Wales v Foreman (1994) 34 NSWLR 408 Legal Practitioners Complaints Committee v Thorpe [2008] WASC 9 Legal Profession Complaints Committee and A Legal Practitioner [2013] WASAT 37 (S) Legal Profession Complaints Committee and in de Braekt [2012] WASAT 58 (S); (2012) 80 SR (WA) 194 Legal Profession Complaints Committee and in de Braekt [2013] WASAT 124 Legal Profession Complaints Committee and Leask [2010] WASAT 133 Legal Profession Complaints Committee v Brickhill [2013] WASC 369 Legal Profession Complaints Committee v Detata [2012] WASCA 214 Legal Profession Complaints Committee v Love [2014] WASC 389 Legal Profession Complaints Committee v Masten [2011] WASC 71 Legal Profession Complaints Committee v Segler [2014] WASC 159 Medical Board of Australia and Myers [2014] WASAT 137 (S) Medical Board of Australia and Veettill [2015] WASAT 124 (S) Medical Board of Western Australia v Bham [2006] WASAT 190 New South Wales Bar Association v Cummins [2001] NSWCA 284; (2001) 52 NSWLR 279 New South Wales Bar Association v Hamman [1999] NSWCA 404 Psychologists Registration Board of Victoria v Ferriere (2000) PRBD (Vic) 3 Quinn v Law Institute of Victoria [2007] VSCA 122 Re A Practitioner (1984) 36 SASR 590 Re Maraj (a Legal Practitioner) (1995) 15 WAR 12 Smith v New South Wales Bar Association [1992] HCA 36; (1992) 176 CLR 256 Veterinary Surgeons Investigating Committee v Howe (No 2) [2003] NSWADT 159 |
Orders | 1. Randeep Singh Dhillon is disqualified from applying for registration as a dental practitioner for a period of two years and six months as from the date of this order.,2. Randeep Singh Dhillon is ordered to pay the Dental Board of Australia's costs fixed at $90,000. |
Summary | On 6 November 2015, the Tribunal found Dr Randeep Singh Dhillon, a dental practitioner, guilty of unprofessional conduct and professional misconduct for the purposes of s 196(l)(b) of the Schedule to the Health Practitioner Regulation National Law (WA) Act 2010.,As Dr Dhillon's registration as a dental practitioner lapsed on 6 January 2017, the Tribunal determined that the appropriate penalty was to impose a period which prevents Dr Dhillon from applying for registration for two years and six months.,This was a case in which no penalty short of a period preventing Dr Dhillon from applying for registration would sufficiently mark the Tribunal's disapproval of Dr Dhillon's conduct, bring home to Dr Dhillon the magnitude of his failings and adequately protect the public. The Tribunal also ordered Dr Dhillon to pay the Dental Board of Australia's costs fixed at $90,000. |
JURISDICTION : STATE ADMINISTRATIVE TRIBUNAL ACT : HEALTH PRACTITIONER REGULATION NATIONAL LAW (WA) ACT 2010 CITATION : DENTAL BOARD OF AUSTRALIA and DHILLON [2017] WASAT 20 MEMBER : JUSTICE J C CURTHOYS (PRESIDENT)
- MR D MACLEAN (MEMBER)
DR C PEARS (SENIOR SESSIONAL MEMBER)
- Applicant
AND
RANDEEP SINGH DHILLON
Respondent
Catchwords:
Penalty - Disqualification from applying for registration - Dishonesty - Failure to maintain clinical records
Legislation:
Criminal Code (WA), s 409
Health Practitioner Regulations National Law (WA) Act 2010, s 130(3)(a), s 130(3)(b), s 195, s 196(1)(b), s 196(2)
State Administrative Tribunal Act 2004 (WA), s 87, s 87(2)
Result:
Practitioner disqualified from applying for registration for a period of two years and six months
Practitioner ordered to pay the Dental Board of Australia's costs fixed at $90,000
Summary of Tribunal's decision:
On 6 November 2015, the Tribunal found Dr Randeep Singh Dhillon, a dental practitioner, guilty of unprofessional conduct and professional misconduct for the purposes of s 196(l)(b) of the Schedule to the Health Practitioner Regulation National Law (WA) Act 2010.
As Dr Dhillon's registration as a dental practitioner lapsed on 6 January 2017, the Tribunal determined that the appropriate penalty was to impose a period which prevents Dr Dhillon from applying for registration for two years and six months.
This was a case in which no penalty short of a period preventing Dr Dhillon from applying for registration would sufficiently mark the Tribunal's disapproval of Dr Dhillon's conduct, bring home to Dr Dhillon the magnitude of his failings and adequately protect the public. The Tribunal also ordered Dr Dhillon to pay the Dental Board of Australia's costs fixed at $90,000.
Category: B
Representation:
Counsel:
Applicant : Mr H Quail
Respondent : Mr J Neo
Solicitors:
Applicant : Tottle Partners
Respondent : Wang Lawyers Pty Ltd
Case(s) referred to in decision(s):
A Solicitor v Council of the Law Society of NSW [2004] HCA 1; (2004) 216 CLR 253
Barristers' Board v Darveniza [2000] QCA 253; (2000) 112 A Crim R 438
Chan v The Nurses Board of Western Australia [2005] WASAT 115
Craig v Medical Board of South Australia (2001) 79 SASR 545
Dental Board of Australia and Dhillon [2016] WASAT 78
HCCC v Fraser (No 2) [2014] NSWCATOD 84
HCCC v King [2011] NSWMT 5
Law Society of New South Wales v Foreman (1994) 34 NSWLR 408
Legal Practitioners Complaints Committee v Thorpe [2008] WASC 9
Legal Profession Complaints Committee and A Legal Practitioner [2013] WASAT 37 (S)
Legal Profession Complaints Committee and in de Braekt [2012] WASAT 58 (S); (2012) 80 SR (WA) 194
Legal Profession Complaints Committee and in de Braekt [2013] WASAT 124
Legal Profession Complaints Committee and Leask [2010] WASAT 133
Legal Profession Complaints Committee v Brickhill [2013] WASC 369
Legal Profession Complaints Committee v Detata [2012] WASCA 214
Legal Profession Complaints Committee v Love [2014] WASC 389
Legal Profession Complaints Committee v Masten [2011] WASC 71
Legal Profession Complaints Committee v Segler [2014] WASC 159
Medical Board of Australia and Myers [2014] WASAT 137 (S)
Medical Board of Australia and Veettill [2015] WASAT 124 (S)
Medical Board of Western Australia v Bham [2006] WASAT 190
New South Wales Bar Association v Cummins [2001] NSWCA 284; (2001) 52 NSWLR 279
New South Wales Bar Association v Hamman [1999] NSWCA 404
Psychologists Registration Board of Victoria v Ferriere (2000) PRBD (Vic) 3
Quinn v Law Institute of Victoria [2007] VSCA 122
Re A Practitioner (1984) 36 SASR 590
Re Maraj (a Legal Practitioner) (1995) 15 WAR 12
Smith v New South Wales Bar Association [1992] HCA 36; (1992) 176 CLR 256
Veterinary Surgeons Investigating Committee v Howe (No 2) [2003] NSWADT 159
Introduction
1 On 6 November 2015, the Tribunal found Dr Randeep Singh Dhillon, a dental practitioner, guilty of unprofessional conduct and professional misconduct for the purposes of s 196(l)(b) of the Schedule to the Health Practitioner Regulation National Law (WA) Act 2010 (the National Law) - see Dental Board of Australia and Dhillon [2016] WASAT 78 (Dhillon).
Findings in Dhillon
2 In Dhillon this Tribunal determined that:
1. Dr Dhillon engaged in unprofessional conduct in that he:
(a) failed to give the Board notice that he had been charged with a criminal offence punishable with a term of imprisonment of 12 months or more, within seven days, as required by s 130(3)(a) ands 130(3)(b) of the Health Practitioner Regulation National Law (WA) Act 2010;
and
(b) failed to give the Board notice that he had been convicted of a criminal offence punishable with a term of imprisonment of 12 months or more, within seven days, as required by s 130(3)(a) ands 130(3)(b) of the Health Practitioner Regulation National Law (WA) Act 2010.
2. Dr Dhillon engaged in professional misconduct in that he failed to maintain adequate clinical notes which constitutes a breach of paragraphs 2.2(e), 8.4(a) and 8.4(d) of the Code of Conduct for registered health practitioners.
3. Dr Dhillon engaged in professional misconduct when he:
(a) made entries in the clinical notes for Patient AS indicating that he had provided occlusal therapy and dental restorations to Patient AS when he did not ever provide such services to her;
(b) produced the clinical notes on 10 January 2014, to an AHPRA investigator appointed by the Board under the National Law without indicating that the notes did not reflect the dental services actually provided;
(c) stated on 10 January 2014, in a letter to the Investigator:
4 x item 531 on tooth 34 was a [an] error and was meant to be 531 x 3 on other teeth. Error is [in] regard to person billing out the item 531 codes on 4 teeth ...
which was false because Dr Dhillon had never undertaken any fillings or dental restorations on Patient AS; and
(d) Dr Dhillon stated on 16 September 2014, in a letter to the Board:
I only provided Invisalign services to [AS]. Do read enclosed letter and statement. Buccal filling[s] were done by me but teeth numbers were wrong. Buccal filling[s] were placed [on] lateral surface of 4 teeth. There is an error on part of the Biller or manipulation by other persons[.]
- which was false because Dr Dhillon had never undertaken any fillings or dental restorations on Patient AS.
(e) Dr Dhillon knowingly made claims to HBF for Item 982 and Item 961 for which he had already been paid by the Groupon voucher.
(f) Dr Dhillon knowingly made claims to HBF for Item 119, teeth whitening, when he knew he had already been paid for them by the Groupon voucher.
(g) Dr Dhillon knowingly made claims to HBF for Item 531, dental restorations, when he knew that he had never undertaken any fillings or dental restorations on Patient AS.
3 The Tribunal's powers in relation to penalty are set out in s 196(2) of the National Law which provides the Tribunal may decide to do one or more of the following:
(a) caution or reprimand the practitioner;
(b) impose a condition on the practitioner's registration[.]
4 If the Tribunal decides to cancel a person's registration under the National Law or the person does not hold registration under the National Law, the Tribunal may also decide to:
a) disqualify the person from applying for registration as a registered health practitioner for a specified period; or
b) prohibit the person from using a specified title or providing a specified health service.
Dr Dhillon's registration
5 Dr Dhillon was registered as a dental practitioner on 5 November 2005 and it lapsed on 6 January 2017. Dr Dhillon failed to renew his registration. Accordingly, Dr Dhillon is now not registered. As such, the penalties available are limited.
General principles in relation to penalty
6 Where there is a choice of sanctions, the Tribunal will choose that sanction which maximises the protection of the public (Medical Board of Australia and Veettill [2015] WASAT 124 (S)(Veettill) at [14] citing Quinn v Law Institute of Victoria [2007] VSCA 122 at [31]).
7 The Tribunal repeats what it stated in Medical Board of Australia and Myers [2014] WASAT 137 (S) (Myers). The jurisdiction of the Tribunal is protective rather than punitive, and such protection runs to both the public and the profession (Craig v Medical Board of South Australia (2001) 79 SASR 545 at [41]; ReMaraj (a Legal Practitioner) (1995) 15 WAR 12 at 25 ; Legal Profession Complaints Committee v Love [2014] WASC 389 (Love) at [19]; Law Society of New South Wales v Foreman (1994) 34 NSWLR 408 at 4400441A - B; Legal Profession Complaints Committee and in de Braekt [2013] WASAT 124 at [24]-[26]; New South Wales Bar Association v Hamman [1999] NSWCA 404 at [21] and [77]).
8 The dominant purpose of the disciplinary regulation of the medical profession is the protection of the public by the maintenance of proper standards within the profession. Hence, the impact which an appropriate penalty would have upon a practitioner guilty of misconduct, and personal hardship to a practitioner, are necessarily secondary considerations (see Veettill at [15], citing Legal Profession Complaints Committee v Detata [2012] WASCA 214 at [47] and Legal Profession Complaints Committee v Masten [2011] WASC 71 at [29]; Legal Profession Complaints Committee and Leask [2010] WASAT 133 at [54]).
9 There are circumstances in which a 'global' approach to sanction, rather than the imposition of separate sanction for each finding as to conduct, may be more appropriate in vocational disciplinary proceedings namely, where the facts of the case are so inextricably woven as to make it difficult to meet a clear standard of prescription (Veettill at [16]). Alternatively, where the practitioner's conduct, if considered alone, would be subsumed in the more serious conduct, it is appropriate to impose a global penalty.
10 The appropriate sanction is to be considered at the time of the making of the sanction and not by reference to the date of the conduct (Legal Profession Complaints Committee and A Legal Practitioner [2013] WASAT 37 (S) (A Legal Practitioner (S)) at [23]; Legal Profession Complaints Committee v Segler [2014] WASC 159 at [7]; A Solicitor v Council of the Law Society of NSW [2004] HCA 1; (2004) 216 CLR 253 (A Solicitor [2004] NSW) at [15]; Love at [16]).
11 It is the practitioner's conduct that attracts any sanction (A Legal Practitioner (S) at [24]; Smith v New South Wales Bar Association [1992] HCA 36; (1992) 176 CLR 256 at 267-268 and 211-212, A Solicitor [2004] NSW).
12 As the Tribunal explained in A Legal Practitioner (S) at [24]:
... [I]n determining the appropriate penalty, care needs to be taken that the penalty reflects the matters with which the practitioner is charged and not other conduct including the defence of the action by the practitioner which is ultimately held to be unsuccessful: Smith v New South Wales Bar Association [1992] HCA 36; (1992) 176 CLR 256 (Smith) at 267-268 and 271-272[.]
Subsequent matters
13 Due to media coverage, the Tribunal is aware of the fact that Dr Dhillon has been convicted of offences in the District Court of Western Australia. Those convictions have not been taken into account in the penalties imposed by this Tribunal.
Disqualification from registration
14 Although penalties for cancellation and suspension are not available by reason of the fact that Dr Dhillon is no longer registered, the principles applicable to cancellation and suspension provide useful guidelines for considering whether and what period of disqualification from registration should operate.
Cancellation of registration
15 The jurisdiction of the Tribunal to cancel a practitioner's registration is exercised not for the purpose of punishing the practitioner concerned, but for the protection of the public and the reputation and standards of the medical profession: Veettill at [18] citing Legal Practitioners Complaints Committee v Thorpe [2008] WASC 9 at [43].
16 Where an order for cancellation of a practitioner's registration is contemplated, the ultimate question is whether the material demonstrates that the practitioner is not a fit and proper person to remain a practitioner: Veettill at [19] citing A Solicitor [2004] NSW at [15].
17 A practitioner is not a fit and proper person to be a registered practitioner and should be removed from the register where the conduct is so serious that the practitioner is permanently or indefinitely unfit to practise (Veterinary Surgeons Investigating Committee v Howe (No 2) [2003] NSWADT 159 at [27]; Barristers' Board v Darveniza [2000] QCA 253; (2000) 112 A Crim R 438 at [38]; Love at [17]-[18]; A Legal Practitioner (S) at [21]-[25]; Legal Profession Complaints Committee v Brickhill [2013] WASC 369 at [19][20] (Thomas JA, McMurdo P and White J agreeing); New South Wales Bar Association v Cummins [2001] NSWCA 284; (2001) 52 NSWLR 279 at [26] [28]); Love at [17][18]; Veettill at [19]).
Suspension
18 Suspension is a less serious result and differs from cancellation of an practitioner's registration because suspension is for a specified limited period (Myers at [20]).
19 The proper use of suspension is in cases where the practitioner has fallen below the high standards to be expected of such a practitioner, but not in such a way as to indicate that the practitioner lacks the qualities of character which are the necessary attributes of a person entrusted with the responsibilities of a practitioner (A Legal Practitioner (S) at [26]; Re A Practitioner (1984) 36 SASR 590 at 593 per King CJ). That is, suspension is suitable where the Tribunal is satisfied that, upon completion of the period of suspension, the practitioner will be fit to resume practice (A Legal Practitioner (S) at [27]; Myers at [21]).
General principles in assessing a penalty
20 The considerations which apply to penalty in disciplinary cases were stated by this Tribunal in Myers, and confirmed in Veettill. The Tribunal set out twelve matters which may require consideration in determining penalty. Those matters are interrelated and are not mutually exclusive or exhaustive. The twelve matters are:
a) Any need to protect the public against further misconduct by the practitioner.
b) The need to protect the public through general deterrence of other practitioners from similar conduct.
c) The need to protect the public and maintain public confidence in the profession by reinforcing a high professional standard and denouncing transgressions and thereby articulating the high standards expected of the profession such that, even where there may be no need to deter a practitioner from repeating the conduct, the conduct is of such a nature that the Tribunal should give an emphatic indication of its disapproval.
d) 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.
e) Whether the practitioner has breached any:
(i) Act;
(ii) Regulations;
(iii) Guidelines or Code of Conduct, issued by the relevant professional body; and
(iv) whether the practitioner has done so knowingly.
f) Whether the practitioner's conduct demonstrated incompetence, and if so, to what level.
g) Whether or not the incident was isolated such that the Tribunal can be satisfied of his or her worthiness or reliability for the future.
h) The practitioner's disciplinary history.
i) Whether or not the practitioner understands the error of his ways, including an assessment of any remorse and insight (or a lack thereof) shown by the practitioner, since a practitioner who fails to understand the significance and consequences of misconduct is a risk to the community.
j) The desirability of making available to the public any special skills possessed by the practitioner.
k) The practitioner's personal circumstances at the time of the conduct and at the time of imposing the sanction. However, the weight given to personal circumstances cannot override the fundamental obligation of the Tribunal to provide appropriate protection of the public interest in the honesty and integrity of legal practitioners and in the maintenance of proper standards of legal practice.
(l) The Tribunal may consider any other matters relevant to the practitioner's fitness to practise and other matters which may be regarded as aggravating the conduct or mitigating its seriousness. In general, mitigating factors such as no previous misconduct or service to the profession are of considerably less significance than in the criminal process because the jurisdiction is protective not punitive.
Is a global penalty appropriate?
21 The Board submitted that the proper penalty for:
1) failure to disclose criminal history, standing alone, would be a reprimand, a suspension of between six to12months or cancellation of registration, with an order of disqualification from applying for registration for a period of 1 year;
2) inadequate clinical notes standing alone would be a reprimand and conditions requiring further education prior to any further practice, and audit of notes; and
3) dishonest billing, false clinical notes, and dishonesty with the Board, standing alone, would be a reprimand, cancellation of registration, with an order of disqualification from applying for registration for a period of two to five years.
22 In this case, the imposition of a global penalty is appropriate. That is because Dr Dhillon's separate conduct, when considered together, is sufficiently serious to warrant a finding that he is disqualified from applying for registration. Hence, any less significant penalty which might be appropriate if some allegations stood alone, would be subsumed in the more serious finding.
Analysis of the case
Is there a need to protect the public against further misconduct by the practitioner?
23 The public requires protection against further misconduct by Dr Dhillon.
24 The findings in this matter encompass a range of conduct, from failure to disclose criminal history to the regulatory authority, failure to observe the requirements of clinical record keeping, the making of false clinical notes fraudulent health insurance claims for personal gain and dishonesty with the regulator.
25 The public are entitled to expect that:
a) their dentist will maintain proper clinical records of their treatment, as the failure to do so has the potential to compromise patient care and safety;
b) practitioners will make the registration disclosures required of them under the National Law, so that the Board and the Australian Health Practitioner Regulation Agency (AHPRA) are in a position to investigate the practitioner's background and conduct to ensure that only those that are properly qualified and of good character may practice. The legislative scheme places reliance upon frank disclosure by practitioners of issues such as criminal history;
c) practitioners will act honestly in dealings with health insurers and all parties; and
d) practitioners will be honest in their dealings with the regulator, otherwise the regulator will be inhibited in its ability to perform its functions.
Is there need to protect the public through general deterrence of other practitioners from similar conduct?
26 There is a clear need for both general and specific deterrence in the circumstances of this case.
27 In terms of general deterrence:
1) practitioners must be discouraged from lack of candour with regulators, as the legislative scheme is reliant upon that candour for its effective functioning;
2) health insurance fraud is difficult to detect, and increases the cost of that insurance to the public;
3) practitioners should be discouraged from conduct which expressly breaches professional standards and guidelines promulgated for the profession; and
4) practitioners should be aware that dishonesty of any kind may result in suspension or cancellation of their registration.
28 There is a particular need for specific deterrence in this case. Dr Dhillon was evasive in his evidence and not a credible witness (Dhillon at [31]). In relation to work he claimed to have done on Patient AS his account was 'deliberately misleading' (Dhillon at [215]). In relation to his failure to disclose his criminal history he 'was prepared to give answers in crossexamination that suited his perceived needs at the time' (Dhillon at [61]). In evidence he attempted a later self-admitted 'ridiculous' privacy explanation for changing the dates in records (Dhillon at [75]). He was also prepared to blame third parties for what the Tribunal found were his own failings (Dhillon at [164] and [192]). These matters together with his repeated denials of his dishonest dealings with the Board and fraudulent HBF claims leads the Tribunal to conclude that Dr Dhillon has little insight into his conduct, no remorse and that he requires specific deterrence.
Is there a need to protect the public and maintain public confidence in the profession by reinforcing a high professional standard and denouncing transgressions?
29 There is a clear public interest in the imposition of a penalty which reflects the high standards of the profession of dentistry.
30 In this case, Dr Dhillon's conduct is so serious that nothing short of an order disqualifying him from registration for a period would achieve that objective.
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
31 The making of fraudulent health insurance claims for personal gain, making false clinical notes and dishonesty with the regulator is clearly conduct that is entirely inappropriate for a dental practitioner. Although the false amount claimed by Dr Dhillon was not particularly large, any dishonesty in claiming needs to be treated seriously. This is particularly so where there is other dishonest conduct.
32 Patients will generally have little knowledge of claims made on their behalf. Most patients simply sign the documents provided to them without asking directly whether the appropriate claims against appropriate items have been made by the practitioner. Most patients place great trust in their practitioner to make appropriate and honest claims.
33 Part of the role of the regulator is to police compliance with the obligations imposed on a practitioner. If a practitioner does not answer questions from the regulator honestly, it only compounds their dishonest behaviour.
34 If a professional person is prepared to be dishonest with his/her professional body, the public is entitled to be concerned whether she/he is committed to or capable of honesty with them: Psychologists Registration Board of Victoria v Ferriere (2000) PRBD (Vic) 3 at [23] and Medical Board of Western Australia v Bham [2006] WASAT 190 (Bham) at [54].
35 The dishonest alteration of clinical notes for a practitioner's own ends is entirely inappropriate. Clinical notes exist for a reason. They are required to be accurate.
36 What is of particular concern is that even after Dr Dhillon was 'caught out' by the regulator, he offered a false account of the teeth that had been treated.
37 In light of the Tribunal's findings, neither the public, the profession, the health insurance funds, nor the regulator could place any reliance upon the word of the practitioner.
38 Public confidence in the profession, and patient safety, both demand that only scrupulously honest people are allowed to practise in professions. The public expects health practitioners to be 'scrupulously honest' (Bham at [54]).
39 Honesty is fundamental to the concept of professionalism. Calculated dishonesty of this magnitude, in such a range of contexts, is inimical to membership of a profession.
40 It is critical that dentists and other health practitioners, employers and institutions be able to rely upon the honesty of their colleagues: Chan v The Nurses Board of Western Australia [2005] WASAT 115 at [89]. This is important both to patient safety and the standing of the profession in the eyes of the public.
Breach of Act, Regulation, Code or Guidelines, and whether the practitioner has done so knowingly
41 In failing to maintain adequate clinical notes, Dr Dhillon was in breach of paragraphs 2.2(e), 8.4(a) and 8.4(d) of the Board's 'Code of conduct for registered health practitioners' (Code of Conduct).
42 Making false claims to HBF for dental services to Patient A, which had not been authorised by Patient A, and which he had not in fact provided would potentially amount to an offence under s 409 of the Criminal Code (WA), the penalty for which includes substantial periods of imprisonment.
Incompetence
43 The failure to maintain proper clinical notes in 28 separate cases establishes a lack of professional competence.
Was the incident isolated?
44 None of the categories of findings could be considered isolated, either in a temporal or general sense.
45 The findings span a range of different types of conduct, arising in a variety of contexts. Some of the conduct occurred in a clinical context (in 28 separate cases), some arose in a financial context, and some arose in dealings with the regulator. Dr Dhillon was dishonest with both HBF and AHPRA.
46 In terms of timing:
1) the failure to disclose criminal charges subsisted from 5 February 2014 - 16 September 2014 (despite the requirement in s 130(3)(a) of the National Law to disclose laying of charges within seven days). Disclosure was only made on 16 September 2014 in circumstances where the Board was already aware of the charges;
2) the failure to disclose criminal conviction subsisted from 25 March 2014 - 16 September 2014 (despite the requirement in s 130(3)(b) of the National Law to disclose conviction within seven days). Disclosure was only made on 16 September 2014 in circumstances where the Board was already aware of the charges;
3) the relevant HBF claims relating to Patient AS's treatment occurred on 2 July 2013 and 2 August 2013. The misleading entries in the clinical notes for Patient AS were presumably made over a similar period;
4) Dr Dhillon's false statements to AHPRA occurred on 16 September 2014 and 10 January 2014. Thesubmission of misleading notes to AHPRA occurred on 10 January 2014; and
5) the clinical notes in respect of which adverse findings have been made were maintained between approximately June 2011 - August 2013 (see Applicant's Bundle Volume 2 pages 397-398).
The practitioner's disciplinary history
47 Dr Dhillon's was the subject of prior disciplinary findings as follows:
1) On 26 November 2015, Dr Dhillon failed to comply with the Dental Board's Code of Conduct by failing to communicate effectively in the cancelling and rescheduling of appointments without explanation; and in failing to keep a patient informed of all aspects of clinical care in the context of Invisalign treatment; and
2) On 23 June 2016, Dr Dhillon's treatment of a patient and the placement of her dental crowns were below the standard to be reasonably expected of a dental practitioner; and his knowledge and judgment was also below the standard to be expected.
48 Dr Dhillon was also the subject of interim orders but the Tribunal has not taken these into account.
49 Although these matters exhibit some previous breaches, they are not particularly related to the conduct the subject of the Tribunal's findings in this matter and the Tribunal has not taken them into account in fixing a penalty.
Whether or not the practitioner understands the error of his ways, including an assessment of any remorse and insight (or a lack thereof)
50 The onus of proof in relation to insight is on Dr Dhillon. See, for example, HCCC v King [2011] NSWMT 5 at [61]: Dr Dhillon made no admission in relation to his failure to disclose his charges and convictions until it was clear that the regulator was already aware of the issue.
51 It was clear from Dr Dhillon's conduct at hearing that except in relation to some of his note keeping practices, he had no insight into the manner in which he might have transgressed, or any remorse for the conduct that had brought him before the Tribunal.
52 Dr Dhillon's admitted dishonesty affects the weight which the Tribunal can give to assertions of remorse by Dr Dhillon. See HCCC v Fraser (No 2) [2014] NSWCATOD 84 at [110].
53 Dr Dhillon's lack of insight and remorse is reflective in his submissions at the penalty hearing. He accused the health funds of fraud rather than acknowledging his own culpability. Dr Dhillon suggested that 'someone' might be worried that Dr Dhillon knew of matters that should be investigated. He accused the Dental Board of unfair conduct without any substance whatsoever.
54 Dr Dhillon submitted that there were no complaints of harm to the community. Plainly, he chose not to understand that dishonesty causes harm to the community. Equally, a failure to keep proper records exposes patients to harm.
Are there any special skills possessed by the practitioner?
55 Dr Dhillon does not possess any special skills which would influence any penalty to be imposed.
The practitioner's personal circumstances
56 Dr Dhillon submitted that he had lost his family and his practice and that he had spent $800,000 on lawyers. None of these matters lead the Tribunal to conclude that the Tribunal should not act in accordance with its primary duty which is to protect the public.
Conclusion as to penalty
57 Had Dr Dhillon's registration not lapsed, the Tribunal would have cancelled his registration on the grounds set out above. A period of suspension would not have reflected the seriousness of Dr Dhillon's conduct. He lacked and lacks any insight as to his conduct.
58 Dr Dhillon's registration having lapsed, the appropriate penalty is to impose a period which prevents Dr Dhillon from applying for registration for two years and six months.
59 This is a case in which no penalty short of a period preventing Dr Dhillon from applying for registration would sufficiently mark the Tribunal's disapproval of Dr Dhillon's conduct, bring home to Dr Dhillon the magnitude of his failings and adequately protect the public.
Costs
60 The Tribunal may make any order about costs it considers appropriate for the proceedings, pursuant to s 195 of the National Law, and s 87(2) of the State Administrative Tribunal Act 2004 (WA) (SAT Act).
61 The Tribunal's approach and practice in relation to costs in vocational disciplinary proceedings costs was summarised in Legal Profession Complaints Committee and in de Braekt [2012] WASAT 58 (S); (2012) 80 SR (WA) 194 (in de Braekt) at [51] and [53] as follows:
Although s 87(1) of the SAT Act contemplates that, generally, parties bear their own costs in proceedings before the Tribunal, s 87(2) of the SAT Act confers a discretion on the Tribunal to make an order for the payment by a party of all or any of the costs of another party. The Tribunal's established practice in relation to the exercise of its discretion as to costs under s 87(2) of the SAT Act in vocational disciplinary proceedings is that a successful application by a vocational regulatory body, such as the Committee, will usually result in an order for costs being made in favour of the vocational regulatory body: Medical Board of Western Australia and Roberman [2005] WASAT 81 (S); (2005) 39 SR (WA) 47 (Roberman) at [30] referred to with approval in Paridis v Settlement Agents Supervisory Board [2007] WASCA 97; (2007) 33 WAR 361 at [35]. The policy basis behind this practice is that vocational regulatory bodies 'perform a function which promotes the public interest, and usually with limited resources' and '[t]he financial burden of bringing disciplinary action if the body had no capacity to recover some or all of its costs may be such as to provide a disincentive to bring disciplinary action, or when brought, to ensure that the allegations against the practitioner concerned are properly and thoroughly presented': Roberman at [30].
62 Despite what the Tribunal stated in in de Braekt, every case must be considered individually on its merits bearing in mind s 87 of the SAT Act. There is no presumption that a disciplinary body will be awarded costs if successful.
63 The Board was successful on all allegations save one (allegation 1.1(b), Further Amended Application). The prosecution of the unsuccessful allegation did not substantially affect the cost of the proceedings or the time taken to prosecute them. In this case, the Tribunal is satisfied that the Board should be awarded costs.
64 Since the matter was relatively complex (and was made more so by the conduct of Dr Dhillon during the proceedings), the Board seeks a costs order for twothirds of its total costs. The Board's application for costs was supported by a very detailed schedule of costs. The Tribunal has considered the schedule and is satisfied that Dr Dhillon pay the Board's costs fixed at $90,000.
Orders
1. Randeep Singh Dhillon is disqualified from applying for registration as a dental practitioner for a period of two years and six months as from the date of this order.
2. Randeep Singh Dhillon is ordered to pay the Dental Board of Australia's costs fixed at $90,000.
I certify that this and the preceding [64] paragraphs comprise the reasons for decision of the State Administrative Tribunal.
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JUSTICE J C CURTHOYS, PRESIDENT
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