Medical Board Of Western Australia and A Medical Practitioner
[2007] WASAT 20
•29 JANUARY 2007
JURISDICTION : STATE ADMINISTRATIVE TRIBUNAL
STREAM: VOCATIONAL REGULATION
ACT: MEDICAL ACT 1894 (WA)
CITATION: MEDICAL BOARD OF WESTERN AUSTRALIA and A MEDICAL PRACTITIONER [2007] WASAT 20
MEMBER: JUDGE J CHANEY (DEPUTY PRESIDENT)
MS D DEAN (MEMBER)
DR P QUATERMASS (SENIOR SESSIONAL MEMBER)
DR K FAULKNER (SENIOR SESSIONAL MEMBER)
HEARD: 23 NOVEMBER 2006
DELIVERED : Ex tempore with full reasons delivered 29 JANUARY 2007
FILE NO/S: VR 122 of 2006
BETWEEN: MEDICAL BOARD OF WESTERN AUSTRALIA
Applicant
AND
A MEDICAL PRACTITIONER
Respondent
Catchwords:
Medical practitioner Suspension from practise Breach of conditions previously imposed on right to practise Depressive illness History of alcohol abuse Period of significant progress in dealing with medical problems Whether further period of suspension appropriate
Legislation:
Health Act 1911 (WA), Sch 4
Medical Act 1894 (WA), s 12BA, s 12BB(1)(a), s 13(1)(b), s 13(1)(c), s 13(1)(d), s 13(1)(e), s 13(9)(ba), s 13(9b)
Poisons Regulations 1965 (WA), s 44
State Administrative Tribunal Act 2004 (WA), s 61, s 62
Result:
Suspension terminated and further conditions imposed on right to practise
Category: B
Representation:
Counsel:
Applicant: Ms M Naylor
Respondent: Self-represented
Solicitors:
Applicant: Tottle Partners
Respondent: Self-represented
Case(s) referred to in decision(s):
Medical Board of Western Australia and Roberman [2005] WASAT 118
REASONS FOR DECISION OF THE TRIBUNAL:
Summary of Tribunal's decision
The respondent, a medical practitioner, had previously been the subject of disciplinary proceedings arising because of his misuse of certain drugs. His misconduct was attributable to a depressive illness. As a result of those proceedings, conditions were imposed on the respondent's right to practise.
The respondent breached the conditions and was involved in erratic behaviour, and the Medical Board imposed an interim suspension on his right to practise. It then sought an extension of that suspension by the Tribunal.
Both the respondent's treating psychiatrist and a psychiatrist appointed by the Medical Board agreed that, since his erratic behaviour in mid 2006, the respondent had complied with his medical treatment and made very successful progress in his rehabilitation. They agreed that he was capable of successful return to medical practice, subject to supervision, but disagreed whether the return should be immediate, or delayed for a further 6 months.
The Tribunal considered that the public interest would be best served by permitting an immediate return to practice, subject to strict conditions. It also considered that this was an appropriate case not to publish the respondent's name.
The background
The Medical Board brought an application pursuant to sections 13(1)(b), 13(1)(e) or 13(9)(ba) of the Medical Act 1894 (WA) (Medical Act). The application initially sought orders:
i.the interim suspension imposed on the respondent by the applicant on 30 June 2006 be affirmed; and
ii.the name of the respondent be removed from the register, or alternatively;
iii.the registration of the respondent be suspended not exceeding 12 months.
The Board also sought an order that the respondent pay its costs of the application.
This application has a fairly lengthy history. It follows previous proceedings in the Tribunal that resulted in consent orders being made for the respondent's suspension from practice. It is useful to review the background to those orders which are recited in the consent orders that were made.
On 2 October 2003, the Board conducted an enquiry under s 13(1)(c) of the Medical Act. The notice of enquiry alleged that the respondent may have been guilty of improper or alternatively infamous conduct in a professional respect in that he had, on a number of occasions, self administered the drugs pethidine, in the period March 2001 to September 2001, and benzodiazepine, in the period mid 2000 to September 2003, without lawful excuse or authority.
The respondent admitted the allegations in that notice of enquiry, and, on 2 October 2003, the Board ordered that his registration as a medical practitioner be suspended for 12 months, and adjourned the enquiry to a date to be fixed in August 2004 to allow the Board to determine whether the suspension should be extended, the respondent's name should be removed from the register, or whether a condition should be imposed on his continued right to practise following his suspension.
On 26 July 2004, the Board reconvened the enquiry. It varied the suspension to allow the respondent to return to practice from 26 July 2004 subject to conditions. Those conditions were:
"5.1the Respondent be of good behaviour for a period of 5 years from 26 July 2004 ('Condition (a)');
5.2the Respondent limit his hours of clinical practice to 25 hours per week for 6 months and to 40 hours a week thereafter upon the receipt by the Board of a satisfactory report for the Respondent's treating psychiatrist ('Condition (b)');
5.3the Respondent undergo random urine testing for the presence of drugs for a period of 24 months:
(i)under a chain of custody regime approved by the laboratory;
(ii)the results of the urine tests are to be sent by the laboratory to the treating psychiatrist and to the Board;
(iii)at the Respondent's own cost;('Condition (c)')
5.4In the event that any urine test is 'positive', the Respondent will continue with the urine testing regime set out in this paragraph for a period of 24 months from the date of such positive test ('Condition (d)');
5.5The Respondent to notify the Board in writing of any travel arrangements that may interfere with the drug testing regime specified in paragraph 5.3 above, 7 days before undertaking such travel ('Condition (e)');
5.6Until 26 July 2006 the Respondent will not personally administer or prescribe drugs listed in Schedule 8 and Schedule 4 of the Health Act 1911 (WA) (sic - should read Poisons Act (WA) (S8 Drugs) save in an emergency. Where, in an emergency, the Respondent has personally administered drugs listed in Schedule 8 and Schedule 4 of the Health Act, the Respondent shall notify the Board of the reason and circumstances of the emergency ('Condition (f)');
5.7Until 26 July 2006 the Respondent will consult a psychiatrist for treatment, the regularity of the treatment to be determined by the treating psychiatrist ('Condition (g)');
5.8The Respondent undertake to provide the Board with progress reports from his treating psychiatrist every 3 months ('Condition (h)');
5.9The Respondent undertake that until 26 July 2006 he will undergo a formal psychiatric review every 6 months by a medical practitioner appointed by the Board to reassess his mental condition. In the event of a positive urine test the Respondent undertake that he will attend such psychiatric reviews every 3 months ('Condition (i)');
5.10The Respondent undertake that until 26 July 2006 he will provide all and any consents to the Board that are required to enable the Board, its officers or agents, to access at any time, his prescribing data ('Condition (j)');
5.11The practitioner undertake clinical practice in a practice in which there are at least 3 principals and within one month of commencement of employment in that practice, the Respondent advise the Board of the name of the practitioner prepared to act as his mentor for a period of 24 months from 26 July 2004 ('Condition (k)');
5.12the Respondent undertake that until 26 July 2006 he will immediately notify the Registrar of the Board should he change his place of practice, and advise the Registrar of the Board of his new place of practice, or employer if any ('Condition (l)');
5.13the Respondent's mentor will provide a report to the Board every 3 months ('Condition (m)')."
On 24 August 2004 the Board resolved, in particular, that;
(a)the respondent should send copies of his appointments monthly and his random urine screening should occur 6 times per month; and
(b)Professor Burvill was nominated as the Board's appointed psychiatrist.
On 6 September 2004 a doctor at a country medical centre accepted the Board's appointment as the respondent's mentor.
By a letter dated 10 September 2004 the Board sent the respondent the Board's Urine Testing Protocol and:
(a)advised the respondent that he was required to:
(i)undertake 6 random urine tests per month; and
(ii)provide his appointment sheets to the Board so that the Board could monitor the hours he worked:
(b)advised the respondent of the appointment of his mentor; and
(c)confirmed that the respondent was required to notify the Board if he had recommenced practice.
On 16 September 2004 Professor Burvill agreed to be the Board's appointed psychiatrist for the purpose of the Conditions.
By a letter dated 11 October 2004 the Board advised the respondent of Professor Burvill's appointment and advised the respondent to attend an appointment with Professor Burvill in January 2005, in order that Professor Burvill could prepare a report to the Board.
On 29 October 2004 the respondent asked the Board whether Condition (f) could be amended to allow the respondent to administer and prescribe schedule 4 drugs.
The respondent's mentor provided the Board a report concerning the respondent dated 12 November 2004.
The Board amended the Conditions on 21 December 2005 (the Amended Conditions). The Amended Conditions differed from the Conditions in that the reference to Sch 4 of the Health Act 1911 (WA) was deleted from the Condition (f), referred to in par 5.6 above.
By letter dated 1 March 2005 the Board advised the respondent that his psychiatric report was overdue.
Between 26 July 2004 and 16 October 2005 the respondent did not submit to a random urine test.
On 11 March 2005 the respondent advised a medical practitioner engaged by the Board, Dr Diane Faulkner‑Hill, that he was not practising medicine and did not plan to practise medicine at that time.
Dr Paul Skerritt, the respondent's treating psychiatrist, provided the Board with a report on the respondent's condition dated 16 March 2005, in which he said he had last reviewed the respondent on 18 December 2004 and that he planned to review the respondent at 6 monthly interviews.
In or about July 2005 the respondent commenced practice at a medical centre (Centre) south of the Perth Metropolitan area. The respondent did not inform the Board that he had commenced practice at the Centre.
Between July 2005 and 14 October 2005 the respondent prescribed and administered Schedule 8 drugs namely pethidine and morphine.
On 17 October 2005 the Board advised the respondent that he was required to attend Clinipath in Kwinana (Clinipath) on 18 October 2005 to submit a urine sample for drug testing.
On 18 October 2005 the respondent attended Clinipath and submitted a urine sample which was tested by Clinipath for the presence of drugs (Test).
On or about 18 October 2005, the Board received the Test results from Clinipath, which showed that benzodiazepines had been detected in the respondent's urine.
In the earlier proceedings it was common ground that the respondent breached the Conditions in that:
(a)on 18 October 2005 the respondent returned a urine sample in which benzodiazepines were present, in breach of Condition (a) (par 5.1 above);
(b)from 26 July 2004 to date the respondent failed to provide the Board with progress reports from his treating psychiatrist every 3 months, or at all from 16 March 2005, in breach of the undertaking required by Condition (h) (par 5.8 above);
(c)from 26 July 2004 to date the respondent failed to undergo a formal psychiatric review with Professor Burvill every 6 months, or at all, in breach of the undertaking required by Condition (i) (par 5.9 above);
(d)the respondent failed to inform the Board that he had commenced working at the Centre as a medical practitioner in July 2005 or at all, in breach of the undertaking required by Condition (l) (par 5.12 above); and
(e)between July 2005 and 14 October 2005 the respondent prescribed and administered schedule 8 drugs, namely pethidine and morphine, in breach of Condition (f) (par 5.6 above).
(f)The respondent on the following occasions administered or prescribed Schedule 8 drugs in breach of Condition (f):
29.08.05
Oxycodone 10 mg capsule
Oxycontin 20mg Slow Release Tablets
31.08.05
Methadone 10mg tablet
19.09.05
MS Contin 60mg Slow Release Tablets
21.09.05
Pethidine 75mg Morphine 10mg
21.09.05
Methadone 10mg tablet
23.09.05
Panadeine Forte 500mg/30mg
Pethidine 100 x 2
27.09.05
Panadeine Forte 500mg / 30mg
Pethidine 100mg
30.09.05
MS Contin 60mg Slow Release Tablets
October
Doctor's Bag Order for 5 x Morphine 15mg/ 1 ml injection, 5 x Pethidine 100mg / 2ml injection
03.10.05
Pethidine 150mg
07.10.05
Morphine 10mg x 2
Panadeine Forte 500mg / 30mg tablet
07.10.05
MS Contin 60mg Slow Release Tablets
21.10.05
MS Contin 60mg Slow Release Tablets
In respect of the doctor's bag order referred to above, whilst the drugs were dispensed to the respondent, the drugs were not entered into the Drugs of Addiction Register maintained by the respondent's employer pursuant to the provisions of s 44 of the Poisons Regulations 1965 (WA).
On five specified occasions the respondent altered patient notes dealing with the administration or prescribing of Schedule 8 drugs after conclusion of the consultancy: the respondent explained that those alterations amounted simply to the completion of notes where time to complete them was not available during the consultation.
Against that background, on 25 October 2005, the Board made an order under s 12BA of the Medical Act suspending the respondent from practising medicine on an interim basis. It then referred the matter to the Tribunal under s 12BB(1)(a). It also brought an application for breaches of s 13(1)(d) by reason of the breaches of the conditions.
Those proceedings were resolved by consent in January 2006, with the medical practitioner being suspended from practice for 9 months commencing on 31 October 2005, with the position to be reviewed by the Board one month before the expiry of that suspension.
While the respondent was still under the suspension imposed in January 2006, the Board received a report from his treating psychiatrist, Dr Skerritt, dated 18 June 2006. That letter reported that the respondent had lapsed into erratic behaviour associated with ceasing medication for his depression, and excessive alcohol consumption. The respondent had missed a series of appointments with Dr Skerritt, and Dr Skerritt expressed the opinion that the respondent should be regarded as unfit for medical practice until further notice "which in effect would mean a substantial period such as 6 months of closer and regular follow up with appropriate treatment and control of symptoms and avoidance of alcohol". Dr Skerritt remained optimistic on the long‑term prognosis, and noted that recent problems more associated with alcohol rather than addictive drugs "but do indicate a continuing risk when exposed to availability of the latter".
On 5 July 2006, the Board issued an order pursuant to s 13(9b) of the Medical Act ordering that the respondent not practise medicine until 30 August 2006 and directing that the order be referred to the State Administrative Tribunal pursuant to s 13(9ba) within 14 days. These proceedings were then commenced on 14 July 2006.
On 29 July 2006, Dr Skerritt reported that the respondent's management had been much more satisfactory and uneventful since his report of 18 June 2006, and at that stage he had been abstinent from alcohol for 8 weeks. Dr Skerritt expressed the view that, with an ordinary level of antidepressant medication and avoidance of alcohol and other drugs, with close and assertive follow up, the respondent could be returned to good health and to the practice of medicine.
On 5 September 2006, Dr Skerritt provided a further report having seen the respondent on 31 August 2006. He reported that, at that time, the respondent had apparently been free of alcohol and other addictive drugs for some 3 months, and was asymptomatic with respect to his psychiatric disorder of depression. Dr Skerritt expressed the opinion that it would be quite safe at the present time for the respondent to return to the practice of medicine. He suggested that a return to practice might include conditions limiting the availability of opiate drugs, regular monitoring in any practice in which the respondent might be employed, regular psychiatric visits, psychiatric reviews and urinal blood monitoring.
By report dated 24 October 2006, Dr Skerritt repeated the opinion that it would be safe to restore the respondent to practise either now, "or after an arbitrarily selected period of 6 months".
The respondent attended Prof Burvill on 10 October 2006 for review. Prof Burvill prepared a report dated 26 October 2006. He had the benefit of Dr Skeritt's recent reports concerning the respondent. Prof Burvill agreed with Dr Skerritt that the respondent would be able to practise medicine at present but suggested that it would be prudent to have a period of further surveillance of the respondent's response to, and co‑operation with, Dr Skerritt's prescribed treatment plan before allowing him to practise medicine in future. He suggested a further 6 months of medical supervision and certain conditions which should be required of the respondent if and when he is permitted to practise medicine again. He considered the respondent's period of abstinence from alcohol as "still rather short". He thought a further period of suspension would frustrate the respondent and would be "a good testing time to see his reaction to the anticipated stress engendered by the delay".
The Board's application
The Board's application originally sought orders that:
i.the interim suspension imposed on the respondent by the applicant on 30 June 2006 be affirmed;
ii.the name of the respondent be removed from the register, or alternatively;
iii.the registration of the respondent be suspended for a period not exceeding 12 months.
When the matter came on for hearing, it was clear that the respondent made no challenge to the affirmation of the interim suspension, but sought to have the suspension terminated subject to conditions suggested by the Board being imposed upon his right to practise. Counsel for the Board advised the Tribunal that, in the light of the psychiatrist reports and the progress that had been made by the respondent since the incidents in mid 2006, the Board no longer sought the removal of the respondent's name from the register, but did seek, based on Prof Burvill's opinion, a continuation of the suspension for a period of somewhere between 6‑12 months.
The decision
After deliberating on the submissions received, and the evidence of the two psychiatrists, we have decided that the existing suspension should be terminated with immediate effect, on the basis that conditions be imposed on the respondent's right to practise. We accept the evidence of Dr Skerritt and Prof Burvill that the respondent is presently capable and able to perform the functions of a medical practitioner.
The real issue which falls for determination is the question of when practice should be resumed. Dr Skerritt's position was that he was comfortable, in effect, with the fact that 6 months of abstinence had already been demonstrated. On the other hand, Prof Burvill considered that the safety of the public required that a longer period of abstinence be experienced, and suggested that another 6 months would be appropriate.
There are several reasons why we have reached the decision to prefer the opinion of Dr Skerritt in this regard. The first is that both psychiatrists agree that the period of abstinence that might be adequate is fairly arbitrary, and there is no magic in either the 6 months suggested by Dr Skerritt (from July 2006), or the 12 months suggested by Prof Burvill. We consider that Dr Skerritt's assessment as to the capacity of the respondent to return to practice under proper supervision, can be relied upon because of his more intimate knowledge of the background and circumstances of the respondent's illness. He has had more involvement in, and knowledge of, the respondent's situation over the past 6 months, and indeed, the events which took place in April and May 2006, because of his position as the treating psychiatrist. Against that, Prof Burvill has had relatively short contact with the respondent because of the nature of his engagement as the Board's nominated psychiatrist.
We are mindful, as well, that the object of these proceedings is the protection of the public. It is the public interest which drives our decision. There is nothing in any of the materials which suggests that any of the respondent's past problems have manifested themselves in the context of treatment of patients, or created any potential safety issues for his patients. The most recent incidents of erratic behaviour occurred while the respondent was not practising medicine, and were evidently associated with the respondent's personal circumstances. Those circumstances have now significantly changed for the better.
We are not, of course, suggesting that there is not an inherent concern for patient safety associated with a doctor practising with any sort of psychiatric disability, or any propensity for substance abuse. But the fact is that the problems which have manifested themselves for the respondent, have been largely manifested themselves in a personal context, rather than in the context of his practice. And we are confident, given Dr Skerritt's reports, that there is no immediate danger to the public in allowing the respondent to return to practice, provided, of course, he observes the conditions which need to be imposed.
There is a further factor which has caused us to reach the decision we have. That is that the capacity to monitor and regulate the respondent's conduct and treatment through the conditions that can be imposed upon his practice, lead to a much better outcome than a mere suspension, which would leave questions of monitoring and supervision entirely in the respondent's hands.
When any further period of suspension was completed, the respondent would be entitled to return to practise, and the scope for the Board to condition that return would be limited. By taking the opportunity which now presents itself to impose conditions, a more satisfactory mechanism to ensure the minimisation of any risk to patients, or to the respondent's wellbeing, can be achieved. Recognising that the respondent is a well‑trained (and prior to his difficulties emerging in 2000) a successful country general practitioner, we think that his return to the workforce is itself in the public interest. If that return is achieved in a way which enables close monitoring and supervision of his conduct, then that is, in fact, serving the public interest. A further aspect of that public interest is that the longer the respondent is kept from practising, the more difficult it is for him to resume practice without some erosion of the skills and training which he undoubtedly has. We can see no real advantage in holding him out of practice for a further 6 months.
It may be some little time before arrangements can be put in place for him to resume work, in any event. In that sense, some further period out of practice may occur, although, it is open to the respondent to take up any opportunity for employment that might now present itself.
Costs
The Board also sought an order the respondent pay its costs of the application. For the reasons expressed by the Tribunal in Medical Board of Western Australia and Roberman [2005] WASAT 118 at [30], an order that disciplinary proceedings successfully brought by a vocational regulatory body will normally result in an order that the practitioner concerned meet the regulatory body's costs. There is no reason to depart from that general rule in this case.
No submissions were made to us as to the quantum of the Board's costs. It is appropriate that there be an order that the respondent pay the applicant's costs to be agreed, but if not agreed, to be determined by an application to Deputy President of the Tribunal, Judge Chaney
Suppression of the respondent's name
At the conclusion of the hearing, counsel for the Board indicated that the Board had no objection to an order being made pursuant to s 62 of the State Administrative Tribunal Act 2004 (WA) (SAT Act) that the respondent's name not be published, save that the registrar of the applicant should be at liberty to communicate the full terms of the orders to competent medical registration authorities, hospitals, clinics, government authorities or medical practitioners on a confidential basis.
As a general rule, the proceedings of the Tribunal, should be held in public (s 61 of the SAT Act). The Tribunal's general practice is that its reasons for decision, and its orders, are published on the internet. There is a clear public interest in the open administration of the law, and in providing accessibility to the public of proceedings before the Tribunal, and determinations made by it. There are, however, cases where the identity of participants in the Tribunal's processes is suppressed. Typically, the Tribunal avoids publication of the name of a patient of a medical practitioner, or a client of a lawyer, whose medical condition, or legal affairs, might necessarily be disclosed in explaining the reasons for a determination in relation to the professional conduct of the doctor or lawyer. In the medical context, the Tribunal readily recognises the entitlement to confidentiality of a person's medical history.
In order to put the decision in these proceedings in context, it is necessary to explain the respondent's medical history, and disclose some details of his diagnoses by his treating psychiatrist and Prof Burvill. They are matters which would, generally, remain confidential. It is a recognition of that confidentiality which underlies the Board's motion to the Tribunal to avoid publication of the respondent's name, subject to proper disclosure to specific bodies who, in the public interest, should be aware of the respondent's background, and the orders made in these proceedings.
Against that interest, we are mindful of the interests of the public in being able to have details of any disciplinary proceedings against a medical practitioner whom they may choose to consult.
We have outlined above the aspects of the public interest that have led us to the conclusion that the suspension should not be extended, but that conditions on practice should be imposed. Essentially, the objective of the conditions is to achieve the respondent's rehabilitation while at the same time affording protection to the public. An element of the public interest is the restoration of the availability of the respondent's services. It would be counterproductive to jeopardise the respondent's rehabilitation and return to the profession by disclosure of his medical history.
In the circumstances of this case, we consider that the balance of the public interest favours the non disclosure of the respondent's name. We would emphasise that each case must be considered on its merits, and we would not wish to be thought to be establishing any precedent for the approach to making suppression orders in vocational proceedings.
One suggestion made by the Board was that the Tribunal's order could be published, but publication of its reasons should be limited by an order preventing publication other than through the Tribunal's website. It was suggested that an order to that effect would prevent republication of the respondent's details in the media or otherwise. Given the public accessibility of the Tribunal's website, that proposal would amount to a significant disclosure of the respondent's medical history.
In our view, the appropriate balance between the competing interests is achieved by the making of an order that the respondent's name not be published other than by the applicant to competent medical registration authorities, hospitals, clinics, government authorities or medical practitioners on a confidential basis.
Orders
1.The Tribunal finds that the respondent is suffering from mental illness, namely major depressive disorder and alcohol abuse to such an extent that his practice of medicine is likely to be affected.
2.The name of the respondent shall not be published. However, the Registrar of the Applicant may communicate the respondent's name together with the orders, and reasons of the Tribunal for making those orders, to competent medical registration authorities, hospitals, clinics, government authorities or medical practitioners on a confidential basis.
3.The respondent be permitted to practise medicine, subject to the following conditions:
(a)The respondent be of good behaviour for a period of 5 years from the date of this order.
(b)For a period of 6 months the respondent limit his hours of clinical practice to 35 hours per week or for such longer periods as his treating psychiatrist may approve in writing to the Board.
(c)Commencing from the date of this order, the respondent undergo random urine testing for the presence of pethidine, benzodiazepines and alcohol in accordance with the applicant's Urine Drug Screening Policy issued September 2003 and attached to this order:
(i)in Group 1, 12 to 16 times per month for a period of 12 months;
(ii)thereafter, in Group 3, 4 to 8 times per month months for a period of 4 years;
(d)In the event that any urine test is "positive", the respondent will continue with the urine testing regime set out in this paragraph for a period of 36 months from the date of such positive test.
(e)The respondent notify the applicant in writing of any travel arrangements that may interfere with the drug testing regime specified in par 2 above, 7 days before undertaking any such travel.
(f)Until 23 November 2001 the respondent will not personally administer or prescribe benzodiazepines or drugs listed in Sch 8 of the Poisons Act 1964 (WA)(Poisons Act) save in an emergency. Where, in an emergency, the respondent has personally administered benzodiazepines or drugs listed in Sch 8 of the Poisons Act, the respondent shall notify the applicant of the reasons and circumstances of the emergency.
(g)The respondent provide to the Board a report from any mentor nominated under condition (s) setting out arrangements in place at the practice to inhibit the respondent's access to benzodiazepines or drugs listed in Sch 8 of the Poisons Act.
(h)Until 23 November 2011 the respondent will consult a psychiatrist for treatment every 3 months or at such frequency as his treating psychiatrist shall determine.
(i)The respondent shall provide the applicant with progress reports from his treating psychiatrist every 3 months.
(j)The respondent remain on any medications prescribed by his treating psychiatrist at all times.
(k)The respondent attend a drug and alcohol treatment programme approved by the Board for a period of 12 months or for so long as his treating psychiatrist recommends.
(l)Until 23 November 2011 the respondent shall undergo a formal psychiatrist review every 6 months by a psychiatrist appointed by the applicant to reassess his mental condition. In the event of a positive urine test, the respondent shall attend such psychiatric reviews every 3 months.
(m)The respondent see his general practitioner:
(i)every month until 23 November 2007;
(ii)every 2 months until 23 November 2009;
(iii)every 3 months until 23 November 2011.
(n)The respondent will ensure that his general practitioner monitors his mental health, stress levels and use of drugs or alcohol.
(o)The respondent provide a report from his general practitioner to the applicant every 3 months.
(p)Until 23 November 2011 the respondent shall provide all and any consents to the applicant that are required to enable the applicant, its officers or agents, to access at any time, his prescribing data.
(q)Until 23 November 2011 the respondent shall immediately notify the Registrar of the applicant should he change his place of practice, and advise the Registrar of the applicant of his new place of practice, or employer, prior to commencement of employment.
(r)The respondent undertake clinical practice in a practice:
(i)approved by the Board; and
(ii)with at least 3 principals.
(s)Prior to commencement of employment in any practice, the respondent advise the applicant of the name of a medical practitioner from that practice prepared to act as his mentor for a period of 24 months from the date of this order.
(t)The respondent will provide a report from his mentor to the applicant every 3 months.
4.The applicant and the respondent to ensure these orders are drawn to the attention of the respondent's treating psychiatrist, general practitioner and mentor, and the reviewing psychiatrist who may from time to time be involved in his case.
5.If the respondent changes his treating psychiatrist, general practitioner or mentor he must advise the applicant within 7 days of the identity of his new treating psychiatrist, general practitioner or mentor.
I certify that this and the preceding [58] paragraphs comprise the reasons for decision of the State Administrative Tribunal.
___________________________________
JUDGE J CHANEY, DEPUTY PRESIDENT
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