Williams v A Professional Conduct Committee - [2018] NZHC 2472

IN THE HIGH COURT OF NEW ZEALAND AUCKLAND REGISTRY

I TE KŌTI MATUA O AOTEAROA TĀMAKI MAKAURAU ROHE

CIV-2017-404-002113

[2018] NZHC 2472

IN THE MATTER OF an appeal pursuant to s 106(2) of the Health Practitioners Competence Assurance Act 2003

BETWEEN

JOSEPH WILLIAMS

Appellant

AND

A PROFESSIONAL CONDUCT

COMMITTEE OF THE MEDICAL COUNCIL

Respondent

Hearing: 21 August 2018

Appearances:

A H Waalkens QC and A Holloway for Appellant A K Miller and B Johns for Respondent

Judgment:

20 September 2018

JUDGMENT OF WYLIE J

This judgment was delivered by Justice Wylie On 20 September 2018 at 4.00 pm
Pursuant to r 11.5 of the High Court Rules Registrar/Deputy Registrar

Date:…………………………

Solicitors/counsel:
DLA Piper/A H Waalkens QC, Auckland Claro, Wellington

WILLIAMS v A PROFESSIONAL CONDUCT COMMITTEE OF THE MEDICAL COUNCIL [2018] NZHC
2472 [20 September 2018]

Introduction

[1] The appellant, Dr Williams, appeals against a decision of the Health Practitioners Disciplinary Tribunal (the Tribunal) dated 1 September 2017, which found him guilty of two charges of professional misconduct, censured him, fined him
$10,000, imposed conditions on his continued practice and ordered him to pay
$145,000 in costs.1

[2] Dr Williams appeals the Tribunal’s finding of professional misconduct and seeks to quash that determination. In the alternative, he appeals that part of the decision which imposed the $10,000 fine and seeks to quash that fine.

[3] The respondent, the Professional Conduct Committee (the PCC), opposes the appeal and argues that the Tribunal’s decision was correct.

Factual background

[4] Dr Williams is a general practitioner – based in Auckland. He has some 38 years’ experience in that capacity. Over the years, he has developed a specialist interest in the treatment and management of patients with eczema. He published a book on the topic in February 2014 which has sold nearly 3,000 copies.

[5] Eczema is a chronic inflammatory disease affecting about 30 per cent of New Zealand children. It appears before the age of five years in approximately 90 per cent of those who suffer from it; 60 per cent of sufferers experience it before turning one year old. The disease is distressing for those affected and it imposes considerable costs on the health system. Its treatment is complex and multifaceted, but it is commonly accepted that a core component of therapy is to manage the inflammation with topical corticosteroids.

[6] In about 1963, Dr Williams and a chemist developed what Dr Williams believes is an effective treatment for eczema. It is a compound (or mix) of two creams. One cream is a topical corticosteroid (betamethasone valerate 0.1%) and the other is an anti-fungal cream (clomazol 1%). They are mixed together in one of three different

1 Professional Conduct Committee v Williams HPDT 909/Med16/371P, 1 September 2017.

strengths or ratios. Dr Williams calls this compound product “betaclom”. He claims to have successfully used betaclom for some years; indeed, he estimates that some 47,300 patients have been treated with betaclom, all without complaint or issue. He says that many of those patients specifically sought…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

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Details

Case: [2018] NZHC 2472
Decision Date: 20 September 2018

CaseChat Overview and Summary

Dr Joseph Williams, a general practitioner, appeals against a finding of professional misconduct made against him by the Health Practitioners Disciplinary Tribunal. The Tribunal found that Dr Williams had prescribed a combination of betamethasone valerate 0.1% (a potent topical corticosteroid) and clomazol 1% (an antifungal cream) to various patients, in circumstances that amounted to professional misconduct. It imposed a number of sanctions on Dr Williams, including a fine of $10,000. The appeal was heard de novo by Wylie J. The Court considered that the Tribunal was correct to find that the mixture of betamethasone valerate 0.1% and clomazol 1% did not dilute the potency of the betamethasone valerate 0.1%. The Court found that Dr Williams’ prescribing of betaclom, a combination of betamethasone valerate 0.1% and clomazol 1%, was inappropriate and amounted to professional misconduct. The appeal was dismissed with costs.

Orders