Health Ombudsman v Housego, Ian

[2024] QCAT 54

QUEENSLAND CIVIL AND ADMINISTRATIVE TRIBUNAL

REID, Judicial Member

Assisted by (all referrals):

DR CAVANAUGH

MS THOMSON

DR CHEW

Assisted by (No OCR219-19):

DR FRICK

DR WEBB

Nos OCR 219 of 2019, OCR 186 of 2020, OCR 327 of 2021, OCR 172 of 2022 & OCR 261 of 2023

HEALTH OMBUDSMAN

Applicant

HOUSEGO, Ian

Respondent

BRISBANE

THURSDAY, 1 FEBRUARY 2024

REASONS FOR DECISION

JUDICIAL MEMBER: This is an application by the Health Ombudsman against the respondent who was a general practitioner from 15 December 2000 and also a dentist from 30 December 2013. There were originally four referrals identified in paragraph 1 of the applicant’s submissions filed 22 September 2023.
As a result of discussions between the parties, the parties have agreed there should be a fifth referral to which I shall subsequently refer, relating to the cultivation of cannabis that was dealt with by way of the imposition of a period of imprisonment, albeit wholly suspended in 2022.
In essence, there are allegations relating to:
(a)inappropriate storage and prescription, and self-administration of Schedule 4 and 8 medications, including morphine;
(b)criminal convictions for criminal related offences, which have registration conditions; and
(c)significant boundary violation involving a female patient, who died as a result of misadventure with a drug, lignocaine.
The allegations arise out of the respondent engaging in a personal intimate relationship with the patient, who was in her mid-20s, including:
(a)residing at her home;
(b)prescribing and having the Schedule 4 and 8 drugs that I have referred to available to her in her house, improperly secured;
(c)self- administering such drugs in his clinic where she was employed; and
(d)allowing her access to those drugs at the clinic.
It is clear the respondent and the female patient both had significant cannabis and medicinal drug issues. Ultimately, the female patient, who was — it seems to me — a very vulnerable person by reason of her medical and drug-related issues, died in the way I earlier described.
This bland outline of the facts underscores the nature of the respondent’s offending.
In circumstances where the respondent could not ensure he had control of Schedule 4 and 8 medications, where his patient and partner had access to them, and had previously taken such drugs without prescription for her own use from an unlocked cupboard in the GP clinic; the respondent’s conduct was, in my view, reckless and tragically fatal. A consequence was that the Health Ombudsman was notified of the young woman’s death and of her relationship to the respondent on 12 April 2017.
On 12 January 2018, the Health Ombudsman was advised of the respondent’s admitted self-administration of controlled medications, including morphine and other drugs.
He was suspended from registration by the Dental Board of Australia on 25 January 2018, but ultimately that suspension was revoked, and conditions were imposed. The Medical Board of Australia itself imposed conditions on his registration in February 2018. His compliance with such conditions was poor. The Medical Board, on 17 September, ultimately suspended his registration. His registration with the Dental Board lapsed at the end of 2019.
The parties have agreed on a schedule of facts and documents, and in relation to the totality of the referrals, to findings and sanctions as set out in paragraphs 2(a)–(e) of the applicant’s submissions, with the proviso that the findings and sanctions now relate to the five referrals that I have referred to. In matters such as this, it is well established that the Tribunal ought not depart from a proposed agreed sanction, unless it falls outside a permissible range of sanction. The proposed orders are, in my view, within such a range. Especially in circumstances where:
(a)the respondent has not practiced due to suspensions as a doctor since 17 September 2020, and as a dentist from before then; and
(b)on the expiration of the proposed disqualifications on 17 September 2025, he will have not been practicing for some five years and would, I would think, have very great difficulty in ever regaining registration, both because of the fit and proper person test, and with issues relating to lack of recency of practice.
This, in my view, is especially so in light of his conviction 25 September 2023, of a number of drug-related offences before his Honour Judge Rackemann. On that occasion, he was being dealt with for cultivation of a significant and moderately sophisticated outdoor marijuana production area. The circumstances of that offending are set out in his Honour’s sentencing remarks. His Honour, on that occasion, imposed a two-year wholly suspended sentence. In doing so, it seems that he was conscious of the fact that Dr Housego was of the view that he was unlikely to again be able to practice medicine. It appears, from my enquiries of Dr Housego, that Judge Rackemann was not, however, informed of the details of the matters that are now before the Tribunal. In particular, that Dr Housego’s gross negligence in allowing his vulnerable partner to access dangerous drugs resulted in her death.
In such circumstances, one might wonder that if he had been informed of those matters, whether his Honour would have concluded, as he did, that it was correct for the Crown to concede before him that Dr Housego was not someone who was greatly in need of deterrence or ongoing supervision, a view with which his Honour agreed. I have very serious concerns about the need for Dr Housego to have some such supervision.
Be that as it may, I am inclined to accept, as I have said, the submissions about the appropriate penalty in this case.
In coming to the conclusions, I also take into account the respondent’s admission of the facts of the case, which is to some extent a demonstration of a level of insight and remorse, though the extent of that insight and remorse is uncertain for the reasons I have said, especially in circumstances where the respondent has not, himself, filed affidavit material to indicate his remorse or level of understanding of his wrongdoing. There are many concerning aspects of the matter, including:
(a)his partner’s known vulnerability;
(b)the obvious power imbalance between them, having regard to his position as a doctor, her being an employee, and their age difference;
(c)the ongoing and protracted nature of the offending; and
(d)the fact that he committed further offences even after the filing of the initial referral in this matter.
Of greatest concern, of course, is that the young woman has died in circumstances where the coroner concluded that her death, though accidental, was preventable if the respondent had properly stored and accounted for his medications and not allowed her uncontrolled access of them. He will bear the stain of that transgression of his responsibility forever.
In relation to the totality of the five referrals, the Tribunal orders as follows:
1.    pursuant to s 107(2)(b)(3) of the Health Ombudsman Act 2013 (Qld), the Tribunal decides that the respondent has behaved in a way that constitutes professional misconduct;
2.    pursuant to s 107(3)(e) of the Health Ombudsman Act 2013 (Qld), the Tribunal cancels the respondent’s medical registration;
3.    pursuant to s 107(4)(a) of the Health Ombudsman Act 2013 (Qld), the respondent is disqualified from applying for registration as a registered health practitioner until 17 September 2025;
4.    pursuant to s 107(4)(b)(1) of the Health Ombudsman Act 2013 (Qld), the respondent is prohibited from providing any health service until such time as he obtains registration as a health practitioner under the Health Practitioner Regulation National Law (Queensland) or corresponding law of another state or territory; and
5.    each party bear their own costs of the proceedings.

[2024] QCAT 54

1 February 2024