Lee v Medical Board of Australia - [2022] WASAT 28

JURISDICTION     :   STATE ADMINISTRATIVE TRIBUNAL
ACT: HEALTH PRACTITIONER REGULATION NATIONAL LAW (WA) ACT 2010
CITATION:   LEE and MEDICAL BOARD OF AUSTRALIA [2022] WASAT 28
MEMBER:   PRESIDENT PRITCHARD
JUDGE H JACKSON, DEPUTY PRESIDENT
DR H HANKEY, SENIOR SESSIONAL MEMBER

HEARD:   8 FEBRUARY 2022
DELIVERED          :   6 MAY 2022
PUBLISHED           :   6 MAY 2022
FILE NO/S:   VR 58 of 2021
BETWEEN:   KENNETH LEE
Applicant
AND
MEDICAL BOARD OF AUSTRALIA
Respondent

Catchwords:

Vocational regulation Immediate action Proper construction of s 156 of the National Law Multiple charges of domestic violence Whether immediate action necessary to protect against risk to public health or safety Scope of public interest as basis for immediate action Conduct outside scope of clinical practice as basis for immediate action Suspension or imposition of conditions

Legislation:

Health Practitioner Regulation National Law (WA) Act 2010 (WA), s 4, s 11
Health Practitioner Regulation National Law (WA) Amendment Act 2018 (WA), s 57
Health Practitioner Regulation National Law (Western Australia), s 3(3)(c), s 155, s 156, s 156(1)(a), s 156(1)(e), s 159(2), s 199(1), s 199(1)(h), Sch 7 cl 8
State Administrative Tribunal Act 2004 (WA), s 92
State Administrative Tribunal Rules 2004 (WA), r 10

Result:

Removal of suspension of the practitioner's medical registration
Conditions imposed on the practitioner's medical registration

Category: B

Representation:

Counsel:

Applicant	:	Mr T Pontre and Mr E Panetta
Respondent	:	Mr D J Pratt and Ms C Babington

Solicitors:

Applicant	:	Panetta McGrath Lawyers
Respondent	:	King & Wood Mallesons

Case(s) referred to in decision(s):

Cheema v Medical Board of Australia [2020] SACAT 40
Coutinho v Dental Council of New South Wales [2018] NSWCATOD 98
Farshchi v Chinese Medicine Board of Australia [2018] VCAT 1617
Medical Board of Australia and Lee [2018] VR 123

REASONS FOR DECISION OF THE TRIBUNAL:

Introduction

On 21 September 2020, the Medical Board of Australia (Board) decided to take immediate action against Dr Lee, pursuant to s 156 of the Health Practitioner Regulation National Law (Western Australia)[1] (National Law) by suspending Dr Lee's medical registration (2020 Decision). Dr Lee subsequently applied to the Board to revoke that decision. On 12 July 2021, the Board refused to end the suspension of Dr Lee's registration (2021 Decision).
[1] The Health Practitioner Regulation National Law (Western Australia) is contained in the Schedule to the Health Practitioner Regulation National Law (WA) Act 2010 (WA), and applies as a law of Western Australia by s 4 of that Act.
The 2020 Decision and the 2021 Decision were made after the Board became aware that Dr Lee had been charged with a number of domestic violence offences, which were alleged to have been committed between December 2018 and January 2020 (Charges). (The nature and number of the Charges are discussed below.)
Dr Lee now seeks a review by the Tribunal of the 2021 Decision (Application).
Section 156 of the National Law permits the Board (and the Tribunal on review) to 'take immediate action' if it 'reasonably believes' that certain criteria are established.
The Board submitted that on the basis of the evidence before the Tribunal, it could form a reasonable belief that immediate action was required on two bases: first, because of Dr Lee's alleged conduct, the Tribunal could reasonably believe that Dr Lee poses a serious risk to persons, and that it is necessary to take immediate action to protect public health or safety (under s 156(1)(a) of the National Law); and secondly, because the Tribunal could reasonably believe that immediate action is otherwise in the public interest (under s 156(1)(e) of the National Law). The Board submitted that the only way in which public health or safety could be protected, and that the public interest could be maintained, was by suspending Dr Lee's registration, so that he is prohibited from practising medicine.[2]
[2] Respondent's Submissions dated 19 January 2022 (Respondent's Submissions), para 13.
Dr Lee conceded that there is a basis for the Tribunal to reasonably believe there is a need for immediate action in the public interest, pursuant to s 156(1)(e), but resisted the Board's submission that that is also the case in relation to s 156(1)(a).[3] He submitted that the appropriate form of immediate action was to impose restrictions on his registration by way of conditions, rather than by suspending his registration entirely.[4]
[3] Applicant's Submissions dated 29 December 2021 (Applicant's Submissions), para 9.
[4] Applicant's Submissions, para 26.
For the reasons set out below, we are satisfied, and we find, that:
(a)the evidence supports a reasonable belief that Dr Lee poses a serious risk to persons and that it is necessary to take immediate action to protect public health;
(b)taking immediate action is also in the public interest; and
(c)the protection of public health and the maintenance of the public interest will be achieved by the imposition of conditions on Dr Lee's registration that require, amongst other things, that he give notice to prospective patients of the fact that he is facing the Charges, and that he not be permitted to treat female patients. The conditions which should be imposed on Dr Lee's registration are set out in full in the Annexure to these reasons.
The correct and preferable decision on the review is therefore to set aside the 2021 Decision and to substitute a decision that imposes immediate action in the form of the imposition of conditions on Dr Lee's registration as a health practitioner, in the terms set out in Annexure A to these reasons.[5]

The Charges

[5] Cf National Law, s 202.

At the time of the 2020 Decision and the 2021 Decision, the Board had received information which indicated that Dr Lee faced 20 Charges.
By the time of the hearing, Dr Lee's solicitors advised the Tribunal that he faced 23 Charges. They comprised nine counts of aggravated assault occasioning bodily harm, contrary to s 317(1) of the Criminal Code, nine counts of common assault in circumstances of aggravation, contrary to s 313(1)(a) of the Criminal Code, three counts of endangering the life, health or safety of a person, contrary to s 304(1)(b) of the Criminal Code, one count of aggravated indecent assault, contrary to s 324 of the Criminal Code, and one count of unlawful damage, contrary to s 445 of the Criminal Code. The alleged offences are said to have been committed on various dates between December 2018 and January 2020. The Charges relate to one female complainant.[6] Dr Lee says that the complainant is his former partner, and that the Charges arise from allegations she made in the context of an acrimonious breakdown of their relationship.
[6] On 8 February 2022, the Tribunal made an order prohibiting the publication of the name and any identifying information in relation to the victim of the alleged offences.
Dr Lee has entered pleas of not guilty to each of the Charges. Some of the Charges will be tried in a trial listed for 31 October to 4 November 2022, and the remainder of the Charges will be tried in a trial listed for 12 December to 16 December 2022.

Procedural history and the Tribunal's jurisdiction on the review

On 1 July 2020, the Board became aware that Dr Lee was the subject of the Charges. By letter dated 14 September 2020 the Board gave notice to Dr Lee of its intention to take 'immediate action' to suspend his registration because the Charges alleged (in broad terms) acts of domestic violence, which caused the Board to reasonably believe that suspension was necessary pursuant to s 156(1)(a) and s 156(1)(e) of the National Law. The Board invited Dr Lee to make submissions about the proposed immediate action.
By letter dated 17 September 2020 Dr Lee responded by vehemently denying the Charges, and by denying there existed a basis for immediate action. He did, however, indicate, on a without prejudice basis, that he was prepared to provide an undertaking not to practise.
On 21 September 2020 the Board notified Dr Lee of its decision to suspend his registration (that was the 2020 Decision).
Pursuant to s 159(2) of the National Law a suspension of a practitioner's registration continues to have effect until one of various matters occurs, one of which is the revocation of the suspension by the Board.
Although the National Law does not expressly provide that a health practitioner may apply for the revocation of a suspension, such an application appears to be anticipated by s 159(2) of the National Law. By a letter dated 1 June 2021 Dr Lee's solicitors applied for the revocation of the suspension of his registration, and indicated, amongst other things, that Dr Lee was willing to be subject to conditions on his registration, as an alternative to suspension.
On 12 July 2021, the Board refused the application to revoke the suspension (that was the 2021 Decision).
On 20 July 2021, Dr Lee filed the Application.
The Tribunal's jurisdiction to review decisions of the Board derives from s 199(1) of the National Law. That subsection sets out a list of decisions which may be the subject of an appeal to a responsible tribunal (in this State, that appeal is by way of a review by the Tribunal[7]). A decision to 'suspend the person's registration' is an appellable decision.[8] The list of appellable decisions does not include a decision to refuse to revoke a decision to suspend a person's registration.
[7] Health Practitioner Regulation National Law (WA) Act 2010, s 11.
[8] National Law, s 199(1)(h).
The question, then, is whether the Application falls within the Tribunal's jurisdiction.
The written submissions filed on behalf of Dr Lee raised the jurisdictional issue, and contended that the Tribunal had jurisdiction. The Board's submissions proceeded on the basis that 'the application is to be treated as or will be amended to be an appeal under s 199(1)(h), National Law'.[9] Furthermore, at the hearing, counsel for the Board did not contend that the Tribunal lacked jurisdiction to review the 2021 Decision.
[9] Respondent's Submissions, para 7.
In the 2021 Decision, the Board reviewed all of the evidence before it, and the submissions made by Dr Lee's legal representatives. The Board concluded that on the basis of the evidence before it, the reasonable beliefs it had formed in order to make the 2020 Decision had not been displaced, namely that 'because of his conduct, Dr Lee poses a serious risk to persons, and it is otherwise in the public interest to take immediate action and it is necessary to … continue to take immediate action to protect public health or safety'.[10]
[10] Respondent's Bundle of Documents, page 630.
In our view, the Board's decision to refuse to revoke Dr Lee's suspension is properly characterised, in a legal and practical sense, as a reconsideration of whether immediate action was necessary under s 156(1) of the National Law. The Board decided that immediate action, namely to suspend Dr Lee's registration, continued to be necessary under s 156(1) of the National Law. Consequently, the 2021 Decision can, in our view, properly be characterised as a decision to suspend Dr Lee's registration. On that basis, the 2021 Decision is an appellable decision pursuant to s 199(1)(h) of the National Law.
For the sake of completeness, we note that even if we had taken the view that the 2021 Decision was not an appellable decision, it would have been open to Dr Lee to seek leave to amend the Application in order to seek a review of the 2020 Decision, and to seek an extension of time within which to do so.[11] In all of the circumstances, and having regard to the fact that the Board did not contend that the Tribunal lacked jurisdiction, we would have granted leave to amend the Application, and an extension of time in which to apply for the review of the 2020 Decision.
Relevant Statutory Provisions and their History
[11] Cf State Administrative Tribunal Act 2004 (WA), s 92; State Administrative Tribunal Rules 2004 (WA), r 10.
The Board relied on both s 156(1)(a) and s 156(1)(e) of the National Law as the basis for its conclusion that immediate action was necessary. Those provisions are in the following terms:
(1)A National Board may take immediate action in relation to a registered health practitioner or student registered in a health profession for which the Board is established if —
(a)the National Board reasonably believes that —
(i) because of the registered health practitioner's conduct, performance or health, the practitioner poses a serious risk to persons; and
(ii) it is necessary to take immediate action to protect public health or safety;
…
(e)the National Board reasonably believes the action is otherwise in the public interest.
The 'immediate action' which may be taken under s 156 includes suspending a practitioner's registration, imposing a condition on a practitioner's registration, accepting an undertaking from the practitioner, accepting the surrender of the practitioner's registration, and in cases where immediate action has previously been taken, in the form of suspension of the practitioner's registration or the imposition of conditions on that registration, imposing conditions or suspending the practitioner's registration, respectively, instead.[12]
[12] National Law, s 155.
Section 156(1)(e) was inserted as an amendment to the National Law in 2018.[13] Prior to that amendment, s 156(1)(a) was in its current form, but immediate action could not be taken on the basis that it was in the public interest to do so. The Explanatory Memorandum for the relevant Bill[14] explains that:
New paragraph 156(1)(e) broadens the grounds on which a National Board may take immediate action against a health practitioner or student. This enables a National Board to take action if it reasonably believes the immediate action is in the public interest. …
The threshold for immediate action in its current form in section 156 may constrain a National Board from taking swift action where it is warranted to protect public health, public safety or the public interest. For example, if a practitioner has been charged with a serious crime, and the relationship between the alleged crime and the practitioner's practice is not yet well established, the 'public interest' may require a National Board to constrain the practitioner's practice until the criminal matter is resolved, both for the protection of the public and for public confidence in the health profession.
This amendment broadens the grounds on which a National Board may take immediate action or to enable immediate action to be taken by a National Board if it reasonably believes the immediate action is in the public interest … .
[13] Health Practitioner Regulation National Law (WA) Amendment Act 2018, s 57.
[14] Provision for consideration of extrinsic materials is specifically provided for in the National Law, Sch 7 cl 8.
The Explanatory Memorandum thus acknowledged that, in some cases, an allegation that a practitioner has engaged in conduct (such as the alleged commission of a serious crime) unrelated to their health practice may not, of itself, found a reasonable belief that the practitioner poses a serious risk to persons, and yet the public interest may nevertheless warrant immediate action to be taken against the practitioner. Furthermore, as the Explanatory Memorandum makes clear, while it was contemplated that that public interest may lie in the protection of the public, other public interest considerations, such as the maintenance of public confidence in the health profession, may also warrant immediate action being taken.
The express purpose for including s 156(1)(e) in the National Law was, therefore, to expand the bases on which immediate action could be taken beyond those cases already covered by s 156(1)(a).
For present purposes, it is not necessary to determine the scope of the power in s 156(1)(e). It suffices to say that the Parliament plainly contemplated[15] that an allegation that a health practitioner has committed a serious crime, albeit one that lacks an obvious connection to clinical practice, may, depending on the circumstances, warrant immediate action against the practitioner. Immediate action may be warranted having regard to various public interest considerations, including the protection of the public, or maintenance of public confidence in the medical profession. Other public interest considerations may also be relevant.
[15] See the example in s 156(1)(e) of when action may be taken in the public interest.
In some cases, there may be an overlap in the operation of s 156(1)(a) and s 156(1)(e) of the National Law, in that the same set of facts may warrant action under either or both of s 156(1)(a) and (e). For example, in a case where a health practitioner's conduct, performance or health, is such that the practitioner is regarded as posing a serious risk to persons, it may be necessary to take immediate action to protect public health or safety, and immediate action may also be warranted having regard to the public interest in the protection of public health and safety, or the public interest in the maintenance of confidence in the medical profession.
Is Immediate Action Necessary?
The parties' submissions
Mr Pratt, who appeared for the Board, submitted at the hearing that the Tribunal ought to be satisfied that immediate action is required under s 156(1)(a) because Dr Lee:
poses a serious risk of psychological harm to victims of abuse that he sees in a clinical setting. That risk arises from vulnerable persons feeling let down or betrayed by a system which allows them to be treated by someone who has multiple charges pending for offences involving domestic violence.[16]
[16] ts 49, 8 February 2022.
Mr Pratt confirmed that the psychological harm which the Board claimed would arise was harm which would result from the patient subsequently discovering that they had been treated by a person who faced those criminal charges.[17]
[17] ts 50, 8 February 2022.
The Board's written submissions in relation to s 156(1)(a) went somewhat further than concern for the psychological health of those who may have suffered from domestic violence. Its written submissions included that immediate action under s 156(1)(a) was warranted because '[t]he number of alleged offences … suggests that Dr Lee has a propensity to engage in violent acts against women'.[18] However, Mr Pratt made no oral submissions in support of this contention.
[18] Respondent's Submissions, para 25.
Mr Pratt also submitted that the Tribunal ought to be satisfied that immediate action is required under s 156(1)(e) for two reasons. The first was the same as the basis for immediate action under s 156(1)(a), that is, that there is a public interest in 'protecting members of the public who may be adversely affected by being treated by Dr Lee whilst he has serious criminal charges pending for domestic violence'.[19] Mr Pratt submitted that if a person who had suffered the direct or indirect effects of domestic violence attended Dr Lee as a patient, and later discovered that at the time Dr Lee was facing the Charges, that person may suffer from further possible trauma.[20] The second aspect of the public interest which Mr Pratt submitted was engaged was the public interest in the 'protection of public confidence in the medical profession and in particular, public confidence in the integrity, trustworthiness and compassion of medical practitioners'.[21]
[19] ts 4950, 8 February 2022.
[20] ts 49, 8 February 2022.
[21] ts 50, 8 February 2022.
Counsel for Dr Lee, Mr Pontre, conceded that immediate action was warranted under s 156(1)(e), but did not concede that immediate action was warranted under s 156(1)(a).[22] In respect of s 156(1)(e), Mr Pontre submitted that Dr Lee accepted that there was a public interest at stake, namely to avoid the risk that a patient who was the victim of domestic assault was not treated by a doctor who was himself the subject of such allegations.[23] He also accepted that there was a need for immediate action in order to maintain public confidence in the profession.[24]
[22] ts 28, 8 February 2022.
[23] ts 28-29, 8 February 2022.
[24] ts 32, 8 February 2022.

In respect of the criteria for immediate action under s 156(1)(a), however, it was not conceded that Dr Lee posed a serious risk to the public, or that any such serious risk required immediate action to protect public health or safety.[25] Mr Pontre relied on the fact that the Charges did not arise in a patient/practitioner context, but rather arose in a domestic context, and pertained to one complainant, with whom Dr Lee had been in a relationship. As a consequence, he submitted, a more general proposition could not be drawn that Dr Lee posed a risk to public health (that is, to other persons more generally). Mr Pontre submitted that the specific set of circumstances in which the Charges arose meant that the high threshold of a serious risk to persons, which engaged public health or safety concerns, was not met.[26]
[25] ts 28, 8 February 2022.
[26] ts 31-32, 8 February 2022.
We note that notwithstanding that Dr Lee did not concede that the requirements for immediate action under s 156(1)(a) were met, there is a considerable (if not complete) overlap between his concession as to the foundation for one aspect of the public interest on which the Board relies under s 156(1)(e) and the foundation for the Board's claim that s 156(1)(a) is engaged.
The basis for immediate action in this case
We accept that if a person who has been the victim of domestic violence were to be treated by a medical practitioner, in relation to physical or psychological harm they had suffered as a result of that domestic violence, and later came to discover that that medical practitioner was, at the time, facing multiple serious charges for domestic violence offences spanning a substantial period of time, there is a risk that the patient may suffer further psychological harm. That psychological harm may arise from trauma at having been subject to a physical examination (perhaps even an intimate examination) by an alleged perpetrator of domestic violence. Or that psychological harm may result from feelings of shame or anxiety about having conveyed a report of domestic violence to an alleged perpetrator of domestic violence, or from concern about whether their report was accepted as genuine, or whether the practitioner treated them appropriately, in light of the practitioner's alleged perpetration of domestic violence. We accept that the risk that a patient in those circumstances may suffer psychological harm of that kind is a serious risk.
In our view, the existence of that risk in relation to one or more persons involves a matter of public health. We accept that it is necessary to take immediate action to protect that aspect of public health.
In so far as the Board submitted that the Charges supported the conclusion that Dr Lee posed a risk of violence to women generally, we are unable to accept that submission. The Charges pertain to one complainant, and arose in a domestic context, rather than in a clinical context. In our view, it is not possible to extrapolate from allegations made in those circumstances a risk of violence to patients generally, or a risk of violence to women generally, so as to give rise to a need for action to protect public health or safety on that account.
Nevertheless, on the basis we have described, there is a need for immediate action pursuant to s 156(1)(a) of the National Law.
Turning to the public interest in s 156(1)(e), we also accept that there is a public interest in protecting public health by taking action to avoid the risk to patients described above.
We do not consider that public confidence in the medical profession would be jeopardised in every case in which a medical practitioner faces a criminal charge. We consider that members of the public are able to distinguish between allegations of criminal conduct and convictions for criminal conduct. However, in our view, the number of Charges, the nature of the conduct underlying those Charges, the fact that the Charges are of a serious nature, and the substantial period of time in which those Charges are alleged to have been committed, are such that public confidence in the medical profession would be undermined if Dr Lee were permitted to continue to practise without any limitation, pending his trials for those Charges.
In our view, therefore, this is a case in which immediate action is warranted under both s 156(1)(a) and s 156(1)(e) of the National Law.
What immediate action should be taken in this case?
The primary area of dispute in this case concerned what immediate action should be taken against Dr Lee. Whether the basis for immediate action lies in the protection of public health or safety under s 156(1)(a), or the public interest under s 156(1)(e), any restriction on Dr Lee's registration must be no more than is necessary. According to s 3(3)(c) of the National Law, the guiding principles of the national system of registration established by the National Law include that:
restrictions on the practice of a health profession are to be imposed under the scheme only if it is necessary to ensure health services are provided safely consistent with best practice principles.
Further, and in relation to s 156(1)(e), it is well established, and the parties agreed, that the 'public interest' is 'not a one-sided construct'.[27] Rather, the public interest is a multi-faceted concept. In Farshchi the Victorian Civil and Administrative Tribunal referred to the variety of public interest considerations which may arise in cases such as this:
The public interest includes maintenance of a regulatory system which responds in a fair and proportionate manner when allegations are made.
There is a public interest in members of health professions, in whom training and expenditure has been made, being able to practise.
There is a public interest in "area of need" professionals being able to practise.
There is a public interest in proportionality, particularly where a matter is unlikely to finalise quickly.
There is a public interest in ensuring immediate action is only taken when it is necessary to do so. …[28]
[27] Farshchi v Chinese Medicine Board of Australia [2018] VCAT 1617 at [70].
[28] Farshchi v Chinese Medicine Board of Australia [2018] VCAT 1617 at [71] - [75], adopted in Cheema v Medical Board of Australia [2020] SACAT 40 at [47].
As indicated above, we are satisfied that there are two aspects of the public interest which are engaged in this case:
(1)the public interest in avoiding the risk of psychological harm to victims of domestic violence; and
(2)the public interest in maintaining public confidence in the profession.
Dr Lee submitted that because of the bases for immediate action in this case, the provision of an undertaking, or the imposition of conditions, which would restrict aspects of his practice, would suffice.
The Board submitted that the only immediate action which would suffice to protect public health and safety, and to maintain the public interests engaged by this case, having regard to all of the circumstances, was to suspend Dr Lee's registration.
Why suspension is not warranted in this case
In support of its submission that suspension was warranted in this case, the Board submitted that the Tribunal ought to have regard to both the serious nature of the Charges and to Dr Lee's disciplinary history.
Turning first to the nature of the Charges, there is no doubt that the alleged offences, which are the subject of the Charges, are serious. But that is not, in and of itself, a reason for imposing suspension. The question is whether suspension is necessary to guard against the risk to public health to which Dr Lee's alleged conduct gives rise, and/or is necessary to maintain the public interests engaged in this case.
Before we deal with the substance of the Board's submissions which rely on Dr Lee's disciplinary history, it is convenient to first outline the elements of that disciplinary history on which the Board places particular reliance.
The Board relied upon four elements of Dr Lee's disciplinary history.[29]
[29] Respondent's Submissions, para 32.
First, the Board contended that Dr Lee resumed self-prescribing medicine shortly after the lifting of a reprimand for the same behaviour, more specifically:
(a)Dr Lee self-prescribed various Schedule 4 medicines between about 8 August 2015 (being only a few days after obtaining general registration) and July 2017.
(b)On 1 November 2018, the Tribunal reprimanded Dr Lee in relation to those selfprescriptions and restricted his registration by conditions which prohibited him from prescribing medication for himself, family members or others with whom he had a personal relationship.[30]
(c)On 17 July 2019, the Board revoked the conditions restricting Dr Lee's registration and on 24 July 2019 wrote to Dr Lee to advise him of that decision.
(d)Dr Lee re-commenced self-prescribing medications on 26 July 2019, a few days after the Board's revocation of the conditions.
[30] Medical Board of Australia and Lee [2018] VR 123.
Secondly, the Board submitted that in re-commencing selfprescription, Dr Lee took steps to avoid detection.
Thirdly, in responding to a request to comment on a particular instance of alleged self-prescription, Dr Lee provided the Board with a legitimate prescription provided by his psychiatrist which he had altered by back-dating it, in an attempt to deceive the Board into believing that he had not, in fact, self-prescribed.
Fourthly, the Board relied upon Dr Lee's failure to notify the Board of the first of the Charges laid against him, contrary to his statutory obligations, and at a time when the Board was investigating the allegations of self-prescription.
Dr Lee was crossexamined about these matters.[31] He did not seek to dispute any of the allegations as to his self-prescribing, or his attempts to avoid detection, although he did seek to explain the context in which that occurred, and his reasons for self-prescribing.
[31] ts 1726, 8 February 2022.
As to his failure to disclose the first of the Charges to the Board, Dr Lee's evidence was that he was unaware of the obligation to disclose and said that he was not legally represented by his current solicitors at the relevant time.[32] The Board did not seek to undermine that explanation. The Tribunal accepts that Dr Lee's evidence explained his failure to disclose and we accept his explanation.[33]
[32] ts 2526, 8 February 2022.
[33] Cf also Coutinho v Dental Council of New South Wales [2018] NSWCATOD 98 at [52].
Of the remaining matters concerning Dr Lee's disciplinary history, the most troubling were those which concerned dishonest attempts by Dr Lee to avoid detection, and which he accepted.
The Board submitted that in light of Dr Lee's disciplinary history, any immediate action less than suspension would likely be inadequate to guard against the risk to which the Charges give rise, and to maintain the public interest. That was said to be for two reasons.
First, it was submitted that in light of Dr Lee's disciplinary history, the Tribunal could have no confidence that he would comply with conditions restricting his practise of medicine.[34] While the history of dishonest avoidance raises a legitimate concern in this regard, that behaviour was, in our view, of a different nature, in that Dr Lee's past behaviour sought to avoid detection of behaviour of a personal nature, and as a result of which he stood to benefit personally. In contrast, in this case, the conditions which would need to be imposed to protect public health, and to maintain the public interest, are conditions concerned with Dr Lee's engagement with patients. There is no evidence, nor any basis for an inference, that it would be in Dr Lee's personal interest to take steps to actively avoid the effect of the proposed conditions. We do not consider, therefore, that Dr Lee's past attempts to avoid detection of his non-compliance with a condition of his registration can be regarded as a reliable indicator of his likely compliance with the sort of conditions which would need to be imposed in this case.
[34] Respondent's Submission, paras 33(a) and (c).
Furthermore, the consequences for Dr Lee, should he now fail to comply with any conditions imposed, would undoubtedly be serious. Dr Lee is undoubtedly aware that that is so, and that, of itself, is likely to operate as a strong disincentive for Dr Lee to breach the conditions.
Secondly, the Board submitted that in light of Dr Lee's disciplinary history, a suspension was necessary to avoid undermining public confidence in the medical profession, because the Charges go to the question of Dr Lee's honesty, ethical behaviour and trustworthiness.[35]
[35] Respondent's Submissions, para 33(b).
At the hearing, however, counsel for the Board conceded that confidence in the profession as a whole was not likely to be so undermined by allegations of dishonest conduct against a single doctor that it required immediate suspension of that doctor's registration.[36] With respect, that concession was properly made. To insist otherwise would mean that a doctor charged (but not convicted) of tax fraud, for example, would require immediate suspension in order to protect the good standing of the profession as a whole.
[36] ts 61, 8 February 2022.
Furthermore, in our view, the Board's response to Dr Lee's disciplinary history undermines its claim that a suspension is necessary in this case. In our view, it is significant that:
(a)on 20 March 2020, the Board determined to allow Dr Lee to continue to practise on conditions while it concluded its investigations into his further selfprescription; and
(b)the Board did not rely upon any of Dr Lee's disciplinary history in determining to suspend in the 2020 Decision or the 2021 Decision.
Finally, for completeness, it is necessary to address two further matters which were raised by Dr Lee in opposition to the suspension of his registration.
The first is the personal hardship that Dr Lee has suffered, and the hardship he contends that he will suffer, as a result of the suspension of his registration thus far, and any continuation of that suspension. Dr Lee provided an affidavit sworn 30 December 2021[37] which set out in some detail the '[p]ractical impact of suspension to date' and the '[c]onsequences if [s]uspension is maintained'. At the hearing, counsel for Dr Lee summarised that evidence and described the impacts on Dr Lee of the suspension to date as 'devastating'.[38] It would appear that that impact may have prompted Dr Lee to apply to the Board for revocation of the suspension.
[37] Affidavit of Kenneth Charles Lee.
[38] ts 36, 8 February 2022.
We accept that in some circumstances the impact of a particular course of immediate action on a practitioner may be relevant in determining what form of immediate action is necessary or warranted. Such a consideration may be relevant to whether a suspension, as opposed to the imposition of conditions, is necessary to protect public health or safety, or whether suspension alone is warranted in the public interest, having regard to all relevant aspects of the public interest (such as the need for immediate action which is proportionate, having regard to the reason for taking the immediate action).
However, in the present case, we have reached the view that immediate action in the form of a suspension of Dr Lee's registration is not necessary, without the need to consider what, if any, weight should be attributed to the impact of suspension on Dr Lee.
Secondly, Mr Pontre pointed to the possible consequences which might flow if Dr Lee is convicted of the Charges. He submitted that the Tribunal could not discount the possibility that 'even if all the allegations are substantiated, there is at least some prospect that the final penalty imposed would be less than the penalty that [Dr Lee] is suffering on an interim basis'.[39] We understood the import of that submission to be that if Dr Lee is convicted of the Charges, and if the Board pursues disciplinary action against Dr Lee, and if that disciplinary action succeeds, then any penalty imposed under s 196(2) of the National Law is likely to be less significant than the period of suspension imposed as immediate action under s 156 if the latter continues until the disciplinary proceedings are resolved.
[39] ts 47 and 48, 8 February 2022.
We are unable to accept that submission for two reasons. First, with respect, to engage in the comparison invited by counsel for Dr Lee would be to misunderstand the task under s 156. Under s 156 immediate action, which may include a suspension, may be taken to protect public health or safety, or is taken in the public interest. A decision to take immediate action does not entail a detailed enquiry and the taking of immediate action does not require proof of the alleged conduct. In contrast, a penalty imposed under s 196(2) of the National Law, which may include suspension of a practitioner's registration, will be imposed because the Tribunal is satisfied that the Board has proved that the practitioner has behaved in a way that constitutes unsatisfactory professional performance, unprofessional conduct or professional misconduct, and if a suspension is imposed, the Tribunal will specify the period of the suspension. A range of different considerations, including, but not limited to, protection of the public or maintenance of public confidence in the profession, will be relevant in identifying the appropriate penalty which should be imposed in any given case.
Because there are different rationales for taking immediate action under s 156, as opposed to imposing a penalty under s 196(2), a comparison between the outcomes of either course, in the manner suggested by counsel for Dr Lee, is not apt to assist in the determination of what form of immediate action should be taken under s 156. (That is not to ignore the fact that a lengthy period of suspension imposed by way of immediate action can be productive of unfairness, for example, if disciplinary proceedings are unable to be resolved pending delays in the completion of criminal proceedings against a practitioner. However, that was not an issue specifically advanced in this case.)
Secondly, and in any event, it is not possible to make any comparison between a penalty which might be imposed for proven disciplinary conduct against Dr Lee and a period of suspension if immediate action in the form of a suspension were to continue, because the Tribunal does not know all the facts on which any disciplinary action might be based. Disciplinary proceedings against Dr Lee have not been commenced. The alleged facts underlying the Charges were not in evidence, nor was evidence of the personal circumstances relevant to the practitioner, which might impact on any penalty ultimately imposed. To engage in the comparative exercise, as we were invited to do, would necessarily involve such considerable speculation as to render the comparison meaningless. Such a speculative exercise is well outside the scope of what is intended to be undertaken under s 156 of the National Law.
We are not satisfied that suspension of Dr Lee's registration is necessary to protect public health, or that it is warranted in response to the public interest considerations engaged in this case. Rather, both bases for immediate action can be properly addressed by the imposition of suitable conditions on Dr Lee's registration.
Why the imposition of conditions constitutes the correct and preferable decision as to the form of immediate action in this case
At the conclusion of the hearing, we invited the parties to confer and to submit, on a without prejudice basis, a set of agreed conditions or a list of conditions indicating those that Dr Lee submitted were appropriate, and indicating any concerns identified by the Board. The parties were unable to reach agreement. By email dated 11 February 2022, Dr Lee's solicitors submitted two sets of conditions, which contained common conditions, and in each case an additional, different, condition. By letter dated 13 February 2022, the Board's solicitors confirmed that the Board maintained that suspension was required, but provided detail of the standard form of some of the proposed conditions, and identified potential issues in the form of the conditions proposed by Dr Lee, in order to assist the Tribunal.

In broad summary, the conditions proposed by Dr Lee were as follows:
·a condition requiring that Dr Lee disclose the Charges to each patient as soon as reasonably practicable after a booking is made for a consultation with him, and prior to the patient's first consultation (disclosure condition);
or, in the alternative:
·a condition prohibiting Dr Lee from having contact with any female patients (gender-based condition);
and, in either case, the following conditions:
·a condition requiring that Dr Lee submit to an audit of his practice within three months, and quarterly thereafter, to focus on his compliance with the disclosure condition or the gender-based condition (as the case may be) (audit condition);
·a condition prohibiting Dr Lee from self-prescribing any medications (self-medication condition);
·a condition prohibiting Dr Lee from practising as a self-employed medical practitioner, and requiring that he practise only at practice locations approved by the Board (practice location condition);
·a condition that Dr Lee provide written confirmation that AHPRA may seek reports from the senior person at each place of practice to confirm compliance with the practice location condition, and requiring him to notify AHPRA of the identity of that senior person within seven days of commencing at a new practice location (location reporting condition); and
·a condition requiring that Dr Lee undertake treatment with a general practitioner, psychologist and psychiatrist, that he provide AHPRA with the contact details for those practitioners, and that he acknowledge that AHPRA may seek reports from them to confirm compliance with this condition (treatment condition);
·a condition that Dr Lee and the Board are liable for their own costs associated with compliance with these conditions (costs condition).
For the reasons which follow, the imposition of a suite of conditions, comprising the conditions listed below, will protect public health by avoiding the risk of psychological harm which we have found to exist, and are warranted in response to the public interest considerations engaged in this case:
·    gender-based condition;
·    disclosure condition;
·    audit condition;
·    practice location condition;
·    location reporting condition;
·    self-medication condition;
·    treatment condition;
·    costs condition.
As noted above, the Board's submissions focused on what was said to be the inadequacy of any immediate action less than suspension in protecting against the risk of psychological harm to members of the public.[40] In other words, the Board submitted that no conditions could adequately protect against that risk. The primary basis for that submission was that even if Dr Lee was precluded from treating female patients he may still interact with women who accompanied their male partners or children to appointments.[41]
[40] Respondent's Submissions, paras 2729.
[41] Respondent's Submissions, para 29(b).
In its written submissions, the Board also referred to other reasons why suspension would not be adequate, by reference to the terms of two alternative undertakings Dr Lee had previously proffered. First, in response to a proposal that Dr Lee see female patients only by telehealth consultations, the Board submitted that a condition of that kind would not be sufficient to ameliorate the risk of psychological distress that may follow from the discovery by a female patient that she had been treated by a doctor charged with multiple charges of serious domestic violence.[42] We accept that is so but as the proposal for telehealth consultations with female patients was not ultimately pursued by Dr Lee it is not necessary to say anything more about this.
[42] Respondent's Submissions, para 29(c).
Secondly, it was said that a gender-based condition would not address the possibility that Dr Lee might need to respond to disclosures of domestic violence from male patients.[43] The Board did not develop this submission at all, and we do not understand it to have been seriously pursued.
[43] Respondent's Submissions, para 29(a).
We accept that a condition prohibiting Dr Lee from treating female patients is warranted in order to meet the risk of psychological harm to female patients, which we have identified above.
In our view, a gender-based condition which prevents Dr Lee from treating female patients is also required to maintain public confidence in the profession. We note that gender-based conditions have been imposed in other cases where a risk to female patients has been found to exist.[44]
[44] Such a condition was imposed by the SACAT in addressing allegations of aggravated indecent assault by Dr Cheema against his patient during a home visit consultation Cheema v Medical Board of Australia [2020] SACAT 40.
The gender-based condition which is proposed by Dr Lee, and which reflects the gender-based condition in the National Restrictions Library maintained by AHPRA, extends beyond female patients and encompasses 'any spouse, partner, parent, family member or guardian/carer of this individual'. In other words, the proposed condition prohibits any contact with a female patient, or with any person who attends with them.
Despite the breadth of that condition, we acknowledge that such a condition may not prevent Dr Lee from having contact with women who may have suffered domestic violence, if they accompany male patients to appointments. However, in our view the risk of such interaction is both less likely (in that the majority of male patients will not attend with a female companion) and the potential impact less severe (in that the accompanying woman would not be a patient) than would be the case in relation to a female patient. The circumstances giving rise to a risk of psychological harm for female patients includes the very real chance of a physical (and perhaps intimate) examination by Dr Lee. That circumstance would not arise in relation to an accompanying person.
Counsel for Dr Lee pointed out that gender-based restrictions are not uncommon (indeed, AHPRA includes such conditions within its National Restrictions Library) and yet there does not appear to be any example of a condition designed to protect women accompanying male patients. The absence of any such condition, which suggests that such a condition has not been required in any previous case, lends some support to the conclusion that the risk of psychological harm posed by a practitioner, facing charges such as those in the present case, to women accompanying male patients to appointments, is likely to be very low.
Having said that, we accept that a gender-based condition on Dr Lee's registration will not suffice, on its own, to avoid the risk (albeit a low risk) of psychological harm to a woman accompanying a male patient to an appointment with Dr Lee, and who later discovers that Dr Lee was facing the Charges at the time of the consultation. However, we do not consider that a complete suspension of Dr Lee's ability to practice would be necessary to avoid such a risk. Instead, the imposition of a disclosure condition will adequately address this risk.
Furthermore, a gender-based restriction, on its own, would not preserve public confidence in the medical profession. That public confidence may be undermined if a practitioner facing serious criminal charges is allowed to continue to practise medicine, without patients being given the opportunity to make an informed decision as to whether they wish to be treated by that practitioner.
The Board submitted that confidence in the profession may be undermined simply by the fact that 'a medical practice employs someone charged with serious offences relating to domestic violence'.[45] We are unable to agree. The Charges against Dr Lee remain untested allegations. In the course of the hearing, counsel for the Board, Mr Pratt, conceded that the public understood the distinction between a charge and a finding of guilt.[46] That was an appropriate concession.
[45] Schedule summarising the parties' responses to conditions, cl 2.
[46] ts 60, 8 February 2022.
In our view, a condition which requires disclosure of the existence, number and nature of the Charges would ensure that all patients attending consultations with Dr Lee are able to make an informed decision about whether they wish to attend the appointment.
The disclosure condition should require that Dr Lee disclose to all patients, as soon as practicable after making an appointment, that he is the subject of 23 charges of domestic violence offences.
The disclosure condition should also require a written notification to be displayed at the practice location, so that persons accompanying a patient will also be given notice of the Charges, and can decide whether they wish to attend the appointment with the patient.
Counsel for Dr Lee submitted that the information required to be disclosed need only properly include the plural nature of the Charges, rather than their quantity. We do not agree. In our view, the number of Charges, and the fact that they were committed over a 13 month period, as well as the fact that the Charges relate to allegations of domestic violence, are all important considerations to enable patients, or persons accompanying patients to appointments, and who may be the victims of abuse, to make an informed choice about whether they wish to see Dr Lee, and to avoid or mitigate the risk of subsequent psychological harm to that person.
The Board asserted that a disclosure condition would not adequately protect the public or the public interest because 'victims of abuse are highly vulnerable and may, upon learning that a medical practice employs someone charged with serious offences relating to domestic violence, be dissuaded from seeking medical treatment, whether at that practice or at all'.[47] The likelihood that a victim of abuse, who had determined to seek medical assistance, would choose not to see a medical practitioner at all in light of the information disclosed pursuant to the disclosure condition, seems to us to be very low. The suspension of Dr Lee's registration is not, in our view, necessary to address that possibility. The more likely consequence of disclosure is that a victim of abuse may well prefer to see another medical practitioner apart from Dr Lee. The disclosure condition ensures that an informed choice can be made.
[47] Schedule summarising the parties' responses to conditions, cl 2.
We are satisfied that the audit condition, practice location condition, location reporting condition, self-medication condition, treatment condition and costs condition, should be imposed, in conjunction with the gender-based condition and the disclosure condition. The proposed terms of these additional conditions were consistent with the standard terms included in the National Restrictions Library but in our view the standard terms of the practice location condition require amendment, to require the Board to advise whether a proposed practice location is approved, and so that the orders we make are complete on their face. These additional conditions will permit the Board to ensure Dr Lee practises from an approved practice, will enable AHPRA to monitor compliance with the conditions imposed, will ensure that Dr Lee refrains from engaging in behaviour that may increase the risk of noncompliance, and will ensure that he receives treatment for underlying medical conditions which may increase the risk of noncompliance with the conditions imposed. Dr Lee did not object to the self-prescribing or treatment conditions being imposed.
In the Tribunal's view, the imposition of a disclosure condition, in combination with a gender-based condition, together with the suite of other conditions outlined above, will be sufficient to avoid the risk of psychological harm to female victims of domestic violence, who might have attended Dr Lee for treatment, or who may accompany male patients to appointments, and who may subsequently discover that Dr Lee was facing the Charges at the time.
In our view, the public interest in maintaining public confidence in the medical profession as a whole will be maintained by the imposition of such a comprehensive suite of conditions.
We are of the view that conditions should be imposed by the Tribunal, rather than by accepting an undertaking by Dr Lee in effectively the same terms. Although the outcome would be the same in either case, in our view, public confidence in the profession is more likely to be maintained by the public seeing that, in light of the Charges, a regulatory body has assessed whether immediate action is required, and has itself determined to restrict the circumstances in which Dr Lee will be able to continue to practise medicine, in a manner which it considers adequately protects public health. Dr Lee had no objection to the imposition of conditions, rather than the provision of an undertaking.[48]

Conclusion

[48] Schedule summarising the parties' responses to conditions, cl 1.

The correct and preferable decision is that there is a need for immediate action to protect public health, that taking immediate action is also in the public interest, and that in all the circumstances, the immediate action which should be taken is the imposition of conditions on Dr Lee's registration.
The particular conditions to be imposed are set out in the Annexure to these reasons. They largely reflect the terms of the conditions proposed by Dr Lee, but with some proposed amendments to the disclosure condition, and to the practice location condition. In view of those proposed amendments, we will hear from the parties as to the terms of those conditions, before making orders. We consider a costs condition in the standard form is adequate. It goes without saying that the Board and AHPRA will bear any costs they incur in monitoring compliance with the conditions.

Orders

The orders which should be made are:
1.The respondent's decision made on 12 July 2021, to refuse to revoke the suspension of the applicant's registration, is set aside.
2.Pursuant to s 156 of the National Law, immediate action is imposed in relation to the applicant, namely that the applicant's registration is subject to the conditions set out in the Annexure hereto.

I certify that the preceding paragraph(s) comprise the reasons for decision of the State Administrative Tribunal.
MC
Associate to Deputy President Judge Jackson
6 MAY 2022

ANNEXURE

CONDITIONS APPLICABLE TO REGISTRATION IMPOSED BY THE
STATE ADMINISTRATIVE TRIBUNAL OF WESTERN AUSTRALIA

NAME OF PRACTITIONER: DR KENNETH CHARLES LEE

PROFESSION: MEDICAL PRACTITIONER
REGISTRATION NUMBER: MED0001857758

Informing patients

Following the commencement of these conditions, the Practitioner must ensure that a written or oral declaration in the terms set out below is made to each patient as soon as reasonably practicable after a booking is made for a consultation with the Practitioner (and in any event at least prior to the patient's first consultation). In addition, the Practitioner is to ensure that the declaration is on display at the practice location so that it may be seen by any accompanying person who attends with a patient for a consultation:
"Dr Lee is the subject of twenty three (23) pending charges relating to allegations of domestic violence,alleged tohavebeen committed over a13month period. The charges are denied and will be defended by Dr Lee. The charges are listed for trial in the Magistrates Court of Western Australia in October and December 2022. Should these matters be of concern to you, you have a right to see an alternative doctor."

The declaration contained in condition 1 may be made to patients by the Practitioner, or by any other staff member employed by the Practitioner for the purpose of scheduling bookings.

The Practitioner must inform the Australian Health Practitioner Regulation Agency (AHPRA) as soon as reasonably practicable if there is a change in the number of charges or dates for hearing so the parties may agree an updated form of disclosure.

The Practitioner must ensure that, prior to consultation with the Practitioner, all patients sign and date a form acknowledging that the declaration contained in condition 1 has been made to the patient.

For the avoidance of doubt, the obligations in conditions 14 do not apply if the Practitioner practises in a nonclinical role.

Gender-based restriction

The Practitioner must not have any contact with female patients.

6.1.'Patient' is defined as any individual awaiting, requiring or receiving the professional services of the practitioner or a registered health practitioner within the same place of practice as the practitioner and any spouse, partner, parent, family member, friend or guardian/carer of this individual.
6.2.'Contact with a patient' includes consultation, interview, examination, assessment, prescribing for, advising, or otherwise treating a patient, whether it is in person or on a communication device.
6.3.'Male' is defined as any individual whose biological sex is that of a male, as well as all individuals whose gender identity or gender expression is that of a male.
6.4.'Female' is defined as any individual whose biological sex is that of a female, as well as all individuals whose gender identity or gender expression is that of a female.

The Practitioner must comply with the genderbased restriction protocol in force at the date these conditions are imposed and then as amended from time to time.

Within 7 days of the notice of the imposition of these conditions the Practitioner is to provide acknowledgement, on the approved form (GBR1) that:

8.1.he has read and understood the genderbased restriction protocol;
8.2.he is aware that he is not permitted to practise until such time as approved practice locations are published;
8.3.he understands the definition of 'patient', 'practise', 'practice location', 'male', 'female', and 'contact' as detailed in this condition; and
8.4.he is aware of the actions AHPRA may take for the purposes of monitoring compliance with the genderbased restriction.

Audit

The Practitioner must submit to an audit of his practice (the audit), including any supporting records, within 3 months of the notice of the imposition of these conditions and thereafter on a quarterly basis, by permitting an auditor (the auditor) approved by the Medical Board of Australia (Board) to attend any and all places of practice (public and private) for the purpose of the audit and by permitting the auditor to provide a report in relation to the findings of the audit. The audit and the audit report are to focus on the Practitioner's compliance with these conditions 14 and 68 above.

Within 28 days of the notice of the imposition of these conditions, the Practitioner must:

10.1.provide to AHPRA:
10.1.1.nomination, on the approved form (HPN12), of an auditor(s) to be approved by the Board
10.1.2.acknowledgement, on the approved form (HPN12), that AHPRA will seek reports from the approved auditor at the conclusion of each audit; and
10.1.3.acknowledgement, on the approved form (HPNA12), from the nominated auditor.

10.2.make contact with a Board approved auditor and establish an audit plan outlining the form the audit(s) will take and how the areas of concern for the Board will be addressed. The audit(s) will take the form determined by the auditor;
10.3.provide the Board approved auditor with a copy of the conditions on their registration;
10.4.provide to AHPRA, on the approved form (HP8), acknowledgement that AHPRA will seek reports from the auditor; and
10.5.provide to AHPRA a copy of the audit plan, together with written acknowledgement, on the approved form (HPNA8), from the approved auditor.

Prohibition on self-prescribing

The Practitioner must not selfprescribe any medications.

Within 7 days of the notice of imposition of these conditions, the Practitioner must provide to AHPRA:

12.1.acknowledgement, on the approved form (HP1), that AHPRA may obtain reports from the senior person at each and every place of practice on a monthly basis or as otherwise required by the Board or AHPRA;
12.2.acknowledgement, on the approved form (HP1), that for the purposes of monitoring compliance with the condition restricting access to medication, AHPRA may contact Medicare and/or drugs and poisons regulatory authorities in relevant states or territories; and
12.3.confirmation, on the approved form (HPS1), from the senior person at each place of practice that they are aware AHPRA will seek reports from them.

Practice locations

The Practitioner must not practise as a selfemployed medical practitioner.

The Practitioner must not practise as a medical practitioner until the Board approves a practice location or practice locations for the Practitioner.

The Practitioner may only practise at approved practice locations.

For the purposes of these conditions, the following definitions apply:

16.1.'Practise' is defined as any role, whether remunerated or not, in which the Practitioner uses his skills and knowledge as a medical practitioner in his profession. It is not restricted to the provision of direct clinical care and includes using the knowledge and skills of a medical practitioner in a direct nonclinical relationship with a client, working in management, administration, education, research, advisory, regulatory or policy development roles and any other roles that impact on safe, effective delivery of services in the medical industry.
16.2.'Practice location' means any location where the Practitioner practises the profession including any place where the Practitioner:
16.2.1.is selfemployed;
16.2.2.shares premises with other registered health practitioners;
16.2.3.is engaged by one or more entities under a contract of employment, contract for services or any other arrangement or agreement;
16.2.4.provides services for or on the behalf of one or more entities, whether in an honorary capacity, as a volunteer or otherwise, whether or not the Practitioner receives payment from an entity for the services; or
16.2.5.provides professional services at the residential premises of a patient.

The Board, or the Chair of the Board, is to advise the Practitioner whether a practice location proposed by the Practitioner is approved, within 10 days of the Practitioner's submission of that practice location for approval.

When seeking approval of a place of practice, the Practitioner is to provide to AHPRA on the approved form (HPS10), acknowledgement from the Senior Manager/other as appropriate (the senior person) at each place of practice that AHPRA may seek reports from them.

Within 7 days of a role being approved by the Board or Chair of the Board, and within 7 days of the commencement of practice at each subsequent place of practice, the Practitioner must provide to AHPRA, on the approved form (HPS7), acknowledgement from the senior person at each place of practice that they are aware AHPRA will seek reports from them.

Practice locations – Reporting requirements

Within 7 days of the notice of the imposition of these conditions, the Practitioner must provide to AHPRA on the approved form (HP7), acknowledgement that AHPRA may:

20.1seek reports from the senior person at each place of practice on at least a monthly basis or as otherwise required;
20.2request and access from the senior person at each place of practice copies of rosters, pay slips, or the equivalent; and
20.3have contact with and access information from, where relevant, Medicare, private health insurers and/or practice billing data.

Within 7 days of the notice of the imposition of these conditions the Practitioner must provide to AHPRA, on the approved form (HPC), the contact details of a senior person at each current place of practice. In providing this form, the Practitioner acknowledges that AHPRA will contact the senior person and provide them with a copy of the conditions on the Practitioner's registration or confirm that the senior person has received a copy of the conditions from the practitioner. The Practitioner will be required to provide the same form:
21.1.within 7 days of the commencement of practice at each subsequent place of practice, and
21.2.within 7 days of each and every notice of any subsequent alteration of these conditions.

Attend treating practitioner(s)

The Practitioner must undertake treatment with a General Practitioner, Psychologist and Psychiatrist (the treating practitioner(s)) and attend at a frequency determined by the treating practitioner(s).

Within 7 days of the notice of the imposition of these conditions, the Practitioner must provide to AHPRA:

23.1.the contact details, on the approved form (HPF3), of all treating practitioners;
23.2.acknowledgement, on the approved form (HPF3) from the Practitioner that AHPRA may seek reports from the treating practitioner(s) on a monthly basis;
23.3.confirmation, on the approved form (HPNA3), from the treating practitioner(s) that they have seen a copy of these conditions on the Practitioner's registration and are aware AHPRA may contact them to seek reports.

Costs

All costs associated with compliance with the conditions on their registration are at the Practitioner's own expense.