Queensland Judgments
Authorised Reports & Unreported Judgments
  • sclq logo
  1. Caselaw
  2. QCAT
  3. 2024
  4. Heath v Medical Board of Australia - [2024] QCAT 163

Authorised Reports & Unreported Judgments
Exit Distraction Free Reading Mode
  • Unreported Judgment
  • Appeal Discontinued (QCA)

Heath v Medical Board of Australia[2024] QCAT 163

Heath v Medical Board of Australia[2024] QCAT 163

QUEENSLAND CIVIL AND ADMINISTRATIVE TRIBUNAL

CITATION:

Heath v Medical Board of Australia [2024] QCAT 163

PARTIES:

richard heath

(applicant)

v

medical board of australia

(respondent)

APPLICATION NO/S:

OCR274-23

MATTER TYPE:

Occupational regulation matters

DELIVERED ON:

2 May 2024

HEARING DATE:

26 March 2024

FURTHER SUBMISSIONS

Further submissions received 3 April 2024 and 4 April 2024

HEARD AT:

Brisbane

DECISION OF:

Judge Dann, Deputy President

Assisted by:

Prof P Baker, Medical Practitioner Panel Member

Prof S Brun, Medical Practitioner Panel Member

Dr W Grigg, Public Panel Member

ORDERS:

  1. The amended application to review a decision filed 18 March 2024 is upheld.
  2. Pursuant to s 24(1)(b) of the Queensland Civil and Administrative Tribunal Act 2009 (Qld), the decision of the respondent made 11 March 2024 (but identified in the statement of reasons as 11 March 2023) is set aside.
  3. Pursuant to s 178(1)(a)(i) of the Health Practitioner Regulation National Law (Queensland), the applicant, because of his conduct, performance or health, poses a serious risk to patients and it is necessary to take immediate action to protect public health or safety.
  4. Pursuant to s 178(2)(c) of the Health Practitioner Regulation National Law (Queensland), conditions are imposed on the applicant’s registration in the form contained in ‘Annexure A’ to this decision.

CATCHWORDS:

PROFESSIONS AND TRADES – HEALTH CARE PROFESSIONALS – MEDICAL PRACTITIONERS – DISCIPLINARY PROCEEDINGS – PROCEEDINGS BEFORE BOARDS, TRIBUNALS, ETC – where the applicant was subject to immediate registration action by the Board – where the applicant sought review of the decision – where less onerous action could be taken – decision set aside and substituted

ADMINISTRATIVE LAW – ADMINISTRATIVE TRIBUNALS – QUEENSLAND CIVIL AND ADMINISTRATIVE TRIBUNAL – where the Tribunal exercises its review jurisdiction – whether the decision was correct and preferable – decision set aside and substituted

Health Ombudsman Act 2013 (Qld) ss 94(2)(b), (3)–(5), 127

Health Practitioner Regulation National Law (Queensland) ss 41, 140, 141, 156, 199

Human Rights Act 2019 (Qld) ss 8, 9, 13, 48, 58

Queensland Civil and Administrative Tribunal Act 2009 (Qld) ss 19, 20, 21, 23, 24

AMS v Medical Radiation Practice Board of Australia [2019] QCAT 400

CJE v Medical Board of Australia (Review and Regulation) [2019] VCAT 178 

Colagrande v Health Ombudsman [2017] QCAT 107

Dental Board of Queensland v B [2004] 1 Qd R 254; [2003] QCA 294

Health Ombudsman v MacBean [2019] QCAT 300

Health Ombudsman v Wallace [2020] QCAT 286

Ladhams v Medical Board of Australia (No 2) [2014] QCAT 286

LCK v Health Ombudsman [2020] QCAT 316

Liddell v Medical Board of Australia [2012] WASAT 120

Loney v Nursing and Midwifery Board of Australia [2020] QCAT 486

Oglesby v Nursing and Midwifery Board of Australia [2014] QCAT 701

Pawape v Medical Board of Australia [2023] QCAT 262

Pearse v Medical Board of Australia [2013] QCAT 392

Peters v Medical Board of Australia [2020] QCAT 169

TXA v Medical Board of Australia [2021] QCAT 279

WD v Medical Board of Australia [2013] QCAT 614

APPEARANCES &

REPRESENTATION:

 

Applicant:

J R Jones instructed by Moray and Agnew for the applicant

Respondent:

S Robb KC instructed by Piper Alderman for the respondent

REASONS FOR DECISION

  1. [1]
    Dr Heath applies for review of a decision by the Medical Board of Australia (‘Board’) to impose conditions on his registration prohibiting him from having contact with female patients. The Board opposes his application.
  2. [2]
    The Tribunal’s decision is:
    1. the review is upheld;
    2. the Board’s decision of 11 March 2024 (but identified in the Statement of Reasons as made on 11 March 2023) is set aside;
    3. the Tribunal finds that the practitioner because of his conduct, performance or health, poses a serious risk to patients and it is necessary to take immediate action to protect public health or safety. The serious risk posed is a serious risk the practitioner will communicate inappropriately with female patients in consultations about contraceptive devices and that, consequently, his actions may give rise to concerns in the patients about the propriety of the consultations;
    4. the least onerous action which can be taken which is still effective to protect against the risk is to prohibit the practitioner from consulting with female patients about contraceptive devices and to require the practitioner to participate in further education.
  3. [3]
    The Tribunal otherwise sees no difficulty arising from the matters raised in this review in the practitioner returning to practice from the practice locations at Mt Coolum and Sunrise Beach.
  4. [4]
    The Tribunal has prepared a form of proposed conditions which it will hear the parties on. The reasons for the Tribunal’s decision follow.

What is the review application about?

  1. [5]
    After receiving notifications about Dr Heath from three different female patients, related to alleged conduct in consultations involving contraceptive devices, on 12 October 2023 the Board decided to take immediate action under section 156 of the Health Practitioner Regulation National Law (Queensland) (‘National Law’) to suspend Dr Health’s registration (‘Initial Decision’).
  2. [6]
    After the Tribunal on 8 March 2024 invited the Board to reconsider the Initial Decision,[1] on 11 March 2024, the Board set aside the Initial Decision and substituted a new decision by deciding, under s 156(1)(a) of the National Law, to revoke the suspension and, in lieu, to impose  a gender-based restriction on Dr Heath’s registration which precludes him from having contact with female patients (‘Reconsideration Decision’). The Board made the Reconsideration Decision after receiving notification of further alleged conduct from two more female patients.
  3. [7]
    The conditions imposed by the Board also prohibit the practitioner from practicing as a medical practitioner until approved practice locations are published — the conditions in the Reconsideration Decision state “the following approved practice locations: nil”.
  4. [8]
    By letter dated 15 March 2024, the Board advised Dr Heath that his nomination of places of practice (being practices he owns and operates at Mr Coolum and Sunrise Beach) was not approved. This decision of the Board is not a reviewable decision under s 199 of the National Law.
  5. [9]
    This is a review of the Reconsideration Decision.[2] It has come on quickly, ultimately, because the practitioner is facing significant financial pressures relating to the commercial arrangements of the two medical facilities he operates under the banner Noosa Health Centres, having had his registration suspended by the Board since 12 October 2023[3] and having, since 11 March 2024, no approved practice locations for him to work consistent with gender restrictions now imposed on him. 
  6. [10]
    By his amended application for review Dr Heath seeks:[4]
    1. an order setting aside the Reconsideration Decision to impose conditions on his registration; or alternatively
    2. an order setting aside the Reconsideration Decision to impose conditions on his registration and substituting a decision that imposes less onerous conditions that address the perceived serious risk.

Whilst in written submissions Dr Heath submits that the allegations and surrounding facts do not support a reasonable belief that he poses a serious risk to persons or that it is necessary to impose conditions on his registration to protect public health and safety, in oral submissions, Dr Heath abandoned this argument, accepting that, in respect of one of the notifications there was a basis to accept that serious risk was established. That concession was withdrawn in written submissions after the hearing, as is dealt with further below.

  1. [11]
    However, the oral argument was conducted on the basis that, accepting for the review that the serious risk limb is established, the practitioner submits that less onerous action is capable of addressing the perceived serious risk. Those conditions were identified as conditions requiring the presence of a chaperone for all female patients and (or or) that he not undertake consultations or procedures regarding contraceptive devices.[5]
  2. [12]
    The Board opposes his application. It contends the Reconsideration Decision should be maintained because the risk the practitioner presents, taking into account all the material before the Tribunal, is a risk that the practitioner will engage in a sexualised boundary violation with a patient who is a woman. It contends that violation could range in seriousness from making inappropriate and/or sexualized comments through to committing a sexual assault. It contends the likelihood of that risk is high, based on the practitioner’s history of making inappropriate comments to and transgressing boundaries with female patients.  It further contends that obvious consequences of the risk include, inter alia, that the risk was not adequately mitigated, that a person is exposed to a boundary violation and suffers harm, loses confidence in the medical profession and may be less likely to seek medical treatment in the future and that the reputation of the medical profession suffers.[6]
  3. [13]
    Thus, it contends, the gender conditions are the least onerous conditions that could be prescribed in the circumstances.[7]

What does the law say?

  1. [14]
    The Tribunal, in exercising its review decision under the QCAT Act:
    1. has all the functions of the decision maker for the reviewable decision being reviewed;[8]
    2. has, as is the purpose of the review, ‘to produce the correct and preferable decision’;[9]
    3. must hear and decide a review of a reviewable decision by way of a fresh hearing on the merits.[10]
  2. [15]
    This means the Tribunal must determine whether it holds a reasonable belief that Dr Heath, by his conduct or performance, poses a serious risk to persons and that it is necessary to take immediate action in the form of the conditions imposed by the Board to protect public health and safety.[11]
  3. [16]
    If the Tribunal determines that it reasonably believes that because of Dr Heath’s conduct or performance he poses a serious risk to persons and that it is necessary to take immediate action to protect public health and safety, the Tribunal must identify the serious risk posed and the particular aspects of Dr Heath’s conduct which caused or cause that risk.  It also requires the Tribunal, having identified relevant risk, to identify the particular action necessary to protect public health and safety.[12]
  4. [17]
    The Tribunal can consider material beyond that considered by the Board and it can consider circumstances which have changed or developed since the Board made its decision.[13]
  5. [18]
    On a review application, the Tribunal can confirm or amend the decision, set the decision aside and substitute its own decision or set the decision aside and return it to the decision maker for reconsideration with directions considered appropriate.[14]
  6. [19]
    Section 21 of the QCAT Act obliges the Board to use its “best endeavours to help the Tribunal so that it can make its decision on the review.”  The Tribunal otherwise agrees with the observations in Pawape that in a review hearing, each party has a practical onus to advance their respective positions before the Tribunal.[15]
  7. [20]
    Under s 156(1)(a) of the National Law, the Board may take immediate action against a registered practitioner if, relevantly:
  1. The National Board reasonably believes that:
  1. because of the registered health practitioner’s health, conduct or performance, the practitioner poses a serious risk to persons; and
  2. it is necessary to take immediate action to protect public health or safety
  1. [21]
    That is a reviewable decision pursuant to s 199 of the National Law.
  2. [22]
    The apposite legal principles on a review application under the National Law may be stated:
    1. “serious risk” is not defined in the National Law but means “of grave aspect, weighty or important; giving rise for apprehension; critical; to be considered as an extreme example of its kind”. It is not sufficient for there to be some risk, it must be a risk which fairly merits the description “serious risk”;[16]
    2. reasonable belief of a serious risk requires the existence of a factual matrix sufficient to induce that belief in a reasonable person. Belief is an inclination of the mind towards assenting to, rather than rejecting, a proposition;[17]
    3. available material should be carefully scrutinised to determine the weight to be attached to it;[18]
    4. an immediate action order does not entail a detailed inquiry and is one which requires action on an urgent basis because of the need to protect the public;[19]
    5. immediate action is not a substitute for action that may be taken after an investigation;[20]
    6. any immediate action which is taken ought be the least onerous to address the relevant risk.  Whilst protection of the public is and must remain the paramount consideration, the impact of immediate action on a health practitioner cannot be underestimated;[21]
    7. whether an identified risk posed by a practitioner can fairly be described as serious can be considered through the nature of the risk, the likelihood of its eventuating and the seriousness of the consequences if it does eventuate;[22] and
    8. a reasonable belief may be held that a practitioner poses a serious risk to persons if, based upon evidence of past conduct, there is a real possibility that the practitioner will engage in conduct which could be harmful to persons, it is more probable than not that it will be engaged in.[23]
  3. [23]
    In this case, each of the five patients’ accounts and Dr Heath’s account differ significantly on the issues of concern. When a consultation is witnessed, as two of them were (and those two being the ones that involve the most serious alleged conduct), the witness’s account of the consultation supports Dr Heath’s account. The witnesses to each witnessed consultation are different. In a case such as this, where determinations will turn (at least to some extent) on issues of credit, pointers to credibility, limited as they are at the interim stage of the matter, have been found, nevertheless, to assist the Tribunal in determining, objectively, whether because of his conduct or performance the practitioner poses a serious risk to persons which renders it necessary to impose conditions on his registration to protect public health and safety.[24]  The Tribunal has earlier observed that it is legitimate to examine the respective accounts carefully, as this may assist in ascribing weight, at this stage, to their accounts where they differ.[25] To credibility, I would add indicators of probability can also assist the Tribunal.
  4. [24]
    Codes or guidelines approved by a National Board are admissible in these proceedings as evidence of what constitutes appropriate professional conduct or practice for the health profession.[26]
  5. [25]
    In the Hearing Bundle are the Medical Board of Australia’s Guidelines: Sexual Boundaries in the Doctor Patient Relationship dated 12 December 2018 (‘Guidelines’) and Good medical practice: a code of conduct for doctors in Australia dated October 2020 (‘Code’).
  6. [26]
    The summary of the Guidelines states, relevantly that:
  • Sexual misconduct is an abuse of the doctor-patient relationship and can cause significant and lasting harm to patients…
  • A doctor must only conduct a physical examination of a patient when it is clinically indicated an with the patient’s informed consent.
  • Good, clear communication is the most effective way to avoid misunderstandings in the doctor-patient relationship.
  • Doctors are responsible for maintaining professional boundaries in the doctor-patient relationship.[27]
  1. [27]
    Clause 3 of the Guidelines is headed “Breaches of sexual boundaries (spectrum of behaviours)”. It provides, relevantly:

There is a wide range of behaviours that breach sexual boundaries, from making unnecessary comments about a patient’s body or clothing to criminal behaviour, such as sexual assault …[28]

And at cl 3.1 under the title “Spectrum of behaviours” the Guidelines provide that breaches of sexual boundaries include:

  • engaging or seeking to engage in a sexual relationship with a patient…
  • conducting a physical examination which is not clinically indicated or where the patient has not consented to it…
  • behaviours of a sexual nature including:

○ making sexual remarks including sexual humour or innuendo

○ flirtatious behaviour

○ touching patients in a sexual way…

○ using words or acting in a way that might reasonably be interpreted as being designed or intended to arouse or gratify sexual desire

○ asking a patient about their sexual history or preferences, when these are not relevant to their healthcare and without explaining why it is necessary to discuss these matters…

○ sexual harassment

○ sexual assault.[29]

  1. [28]
    A number of these matters are further defined in the definitions section of the Guideline. They include that:

sexual harassment means any unwelcome sexual behaviour which is likely to offend, humiliate or intimidate…

[and] includes:

  • …irrelevant mention of a patient’s … sexual practices, …
  • comments about sexual history that are not relevant to the patient’s healthcare… [and]
  • making suggestive comments about a patient’s appearance or body[30]
  1. [29]
    In articulating standards of ethical and professional conduct expected of doctors, the Code states, amongst other things, that “good communication underpins every aspect of good medical practice”.[31]  The Code further says:
  1. 4.2
    A good doctor-patient partnership requires high standards of professional conduct.  It involves:

4.2.1  Being courteous, respectful, compassionate and honest.

4.2.2  Treating each patient as an individual…[and]

4.2.6 Recognising that there is a power imbalance in the doctor-patient relationship and not exploiting patients in any way…[32]

  1. [30]
    As the Tribunal is acting in an administrative capacity in the conduct of this review, it must apply the Human Rights Act 2019 (Qld) (‘HR Act’).[33] Dr Heath is entitled to certain human rights, which may be limited because of the review process and any decision the Tribunal makes.[34] Dr Heath’s human rights include the right to recognition and equality before the law, to freedom of expression, to privacy and reputation and the right to a fair hearing. When the Tribunal is exercising its functions it must interpret statutory provisions in a way which is compatible with human rights[35] and act or make a decision in a way which is compatible with human rights.[36] The Tribunal does not consider there is any ambiguity in this review which requires consideration, apart from the plain meaning of the statute. The Tribunal is satisfied that this review process offers Dr Heath the right to a fair hearing, and that that right has not been limited. Similarly, there has been no limitation on Dr Heath’s right to recognition and equality before the law. The Tribunal’s review of the Reconsideration Decision does not unlawfully or arbitrarily interfere with Dr Heath’s person, privacy, family, home or correspondence, because the review is conducted within statutory parameters. A finding of serious risk to persons may limit Dr Heath’s other identified human rights. The National Law provides that the main guiding principle of the national registration and accreditation scheme is that the paramount considerations are the protection of the public and the maintenance of public confidence in the safety of services provided by registered health practitioners.[37]  I am satisfied that any limitation on Dr Heath’s rights arising because of any finding of serious risk to persons, is consistent with the paramount principles in the National Law. These considerations outweigh Dr Heath’s private interests so that any limitation which the Tribunal imposes is reasonable and justified in the circumstances.

What material is before the Tribunal?

Dr Heath’s qualifications and experience

  1. [31]
    Dr Heath completed his MBBS in 1983, a certificate in anaesthetics and ICU through the Royal Australian College of General Practitioners (‘RACGP’) in 1986 and a Diploma through the Royal Australian College of Obstetricians and Gynaecologists in 1987. He attained fellowship of the RACGP in 1993 and has been a general practitioner in the Sunshine Coast community since 1991. He started Noosa Health Centres in 1998 with the two locations being the Sunrise Beach Medical Centre and the Mount Coolum Medical Centre. Dr Heath has also worked in various other capacities as a health practitioner, including as a designated senior aviation medical examiner and a senior hyperbaric (commercial) diving examiner. He spent almost 20 years working as a RACGP credentialed anaesthetist at the Nambour Day Surgery, performing anaesthetic services for ASA 1-2 Elective Procedures only and General Anaesthesia as part of a full operating team.  Amongst other things, he was the medical director of the Woodford Folk Festival for approximately 16 years and worked as a medical educator and examiner for the RACGP and several universities.[38]

Other material

  1. [32]
    The Tribunal has before it two broad categories of material. The first category is a series of notifications to the regulator from five different female patients who have consulted Dr Heath. They allege different types of conduct, from inappropriate comments through to acts which, if established, could constitute sexual assault. There is no suggestion that the patients have colluded with each other in making their notifications.
  2. [33]
    The second category is about other regulatory action which has been taken, or is in the process of being taken, or investigated, involving Dr Heath.

What should the Tribunal make of the notifications by the five female patients?

Patient TH - consultation 18 October 2022

  1. [34]
    TH made an oral complaint to the Office of the Health Ombudsman (‘OHO’) on 18 October 2022 about a consultation which had occurred about an hour beforehand. TH has also provided two statements in the investigation. Dr Heath has sworn to the events of the consultation. Whilst there are broad similarities about in what occurred, the accounts given by TH and Dr Heath differ substantially on the critical points. No one else was present for any part of the consultation.
  2. [35]
    It was TH’s first consultation with the practitioner at Sunrise Beach. Her usual GP was at the related clinic but didn’t do Mirena IUD implants.
  3. [36]
    TH’s first complaint is that Dr Heath breached confidentiality relating to other patients’ records when she entered the consultation hearing room. In her OHO complaint, TH said that when she walked into the consulting room and went to sit down, Dr Heath had his computer up and was filling out paperwork. He said to her words to the effect of “Excuse me, I’m filling out paperwork”. In her first statement TH said that from where she was sitting, she could easily see what looked like patient information.[39] In her second statement she said she didn’t remember any specific patient details but she could see what was on the computer, she could almost read what was on the screen.[40] Conversely Dr Heath deposes that he checked TH’s electronic file immediately before she came into the consultation room and if she could have seen anything on the screen, it would have been her information. He denies having confidential and private clinic information on his screen when TH entered the consulting room.  Dr Heath has attached photographs to his affidavit which show his consulting room from where the patient sits and from where the patient enters the room as it was on the day TH had her consultation.
  4. [37]
    Dr Heath says he was late to start the consultation, for which he apologised which he says TH acknowledged but that she seemed unimpressed. He deposes that matters specific to TH’s presentation, existing medical conditions and circumstances were considerations for him in the context of TH’s request for the insertion of the Mirena IUD. These matters are supported by the contents of TH’s clinical records.
  5. [38]
    TH’s second complaint is that he took two phone calls during the consultation he had with her.  TH told the OHO in her oral complaint that Dr Heath took a phone call during the consultation and she could hear the other person discussing a patient from New South Wales or something. It was just their location, and it was still quite vague and then he realised she was uncomfortable and ended the call. TH said that Dr Heath had his scheduling thing up at the time. Dr Heath confirms he took an urgent telephone call. He says that it was at the end of the consultation. He denies he discussed any confidential or private information about the other patient in TH’s presence. Dr Heath says it was about a suicidal patient he was managing that day. He says TH left the clinic during the course of this phone call.
  6. [39]
    TH says Dr Heath asked the purpose of her attendance and TH said she was inquiring about Mirena insertion. He then got a piece of paper and was writing dot points about what was involved, how many patients he had inserted the device into.  This seems broadly consistent with Dr Heath’s statement that he spent time explaining how the device worked. In TH’s view he was more generic in his responses which she says caused her to ask more questions about the risks associated with the procedure.  It was when she was asking about associated pain that he used inappropriate language. TH says he said something like “I’ve been doing this for 30 fucking years”[41] and again said “Shit”. According to TH when she gave her statement this was not aggressive – more like it just slipped through as though normal conversation.[42] In the oral complaint TH said it was however, a word said in annoyance and frustration. Dr Heath denies using any profanities in the consultation.
  7. [40]
    TH says they were both sitting down and she was asking if the procedure was painful and whether she should get a local anaesthetic. Dr Heath said he was trained in anaesthesiology so if she needed this he and the nurses at the clinic could administer it. She asked him if many of his patients experienced discomfort and what he would recommend and this was when he said “show me your cervix”. She was a bit shocked and confused at that question and felt uncomfortable.[43] Dr Heath’s affidavit does not address this comment.
  8. [41]
    TH says Dr Heath then made a gesture with his hand trying to demonstrate, she guessed, what her cervix size was. She guesses she still appeared confused. TH says she was still sitting directly in front of him and he grabbed her right hand, without saying he was going to or asking permission. He then made a similar gesture with her right hand and put his finger on her thumb and hand. TH says she assumed he was demonstrating the size comparison to her own cervix to convey that inserting the device shouldn’t be too painful. Directly after this she was very uncomfortable about what had just happened.[44] Dr Heath denies grabbing her hand without asking for her permission. He says he asked if he could use her hand as a prop to demonstrate the size of the average cervix and the size of the device itself in order to assuage her concerns about pain associated with the procedure. Dr Heath says TH had a strong focus on ensuring she would be sedated for the procedure in a manner which he could not accommodate at the clinic. Dr Heath says that when he said he would consider referring her elsewhere, TH became immediately and obviously annoyed. Dr Heath says he explained to her that the consulting rooms were not equipped appropriately for him to perform the procedure with the level of sedation which she was seeking.
  9. [42]
    TH says when he let go of her hand, Dr Heath then explained that the Mirena is around the size of a matchstick. He said words then to the effect “you’ll be fine” and “it’s the size of a matchstick”. Dr Heath says he does not recall saying she would be fine.
  10. [43]
    TH says that after some further discussion she asked why a Mirena insertion with Dr Heath was so cheap in comparison to a provider in a clinic in Nambour, to which Dr Heath is alleged to have responded that the other provider ‘price gouges’ and was ‘a bit shit’. Dr Heath denies describing the other practice as ‘a bit shit’ or suggesting they were price gouging.  He says the practice in question is one he has a longstanding relationship with, and one where he regularly refers patients to, where he is on very good terms, having, himself, worked there. TH’s clinical records include a referral to the clinic where Dr Heath had worked for many years.[45]
  11. [44]
    TH says Dr Heath took the phone call after the comment about price gouging.[46] She thinks he was talking to a colleague about another patient as he was discussing appointment times.[47] TH says after he got off the phone he then came back to the conversation, discussing the procedure and going back over the prior discussion. He said he could give her a prescription for the IUD device but she did not have to decide whether to have the procedure that day. She said she did not feel completely comfortable and would like to discuss it with her GP further. He then got up and they walked out towards the reception area. She was waiting for him to hand her the script so she could get the device if she wanted to proceed with the procedure.[48]
  12. [45]
    TH says that as she was trying to end the consultation and had stepped out of the consulting room, Dr Heath asked her if she had had a Pap Smear but before she could answer it, he took another phone call. TH says they were standing near the reception desk and no one else was there or in the waiting area. She was standing there not knowing what to do. TH says that after that phone call finished, she asked him for the piece of paper he’d written notes on and that was when he said: “Sorry, my fucking daughter is at the beach today instead of doing admin.  And Daddy’s doing it instead of her”.  Dr Heath denied referring to his daughter not being at work and going to the beach instead.  He deposes he may have said to her they were so short staffed he had even asked his daughter to come and help out, although he has no recall of actually doing so.
  13. [46]
    TH says Dr Heath wrote the phone number of the clinic down and told her he’d provided a script for the device, but he did not do so.  The consultation ended when he said word to the effect of “you have a think and if you want it call us anytime” and she said words to the effect that she “wanted to discuss it with her usual GP”. As she left she did not sign anything, did not provide her Medicare card.[49]
  14. [47]
    Dr Heath denies telling TH to return to the clinic for the insertion of the IUD if she decided to go ahead. He deposes he explained to her that the Mirena might be a good option for her but he was not prepared to perform the procedure because of the sedation risk in her particular circumstances. He denies telling her to think about it and then call the clinic and make a booking if she wanted to proceed.
  15. [48]
    TH described feeling uncomfortable and said she found the behaviour in the consultation creepy. In her second signed statement TH said her recollection of the appointment is that it was strange. Dr Heath was unprofessional by swearing throughout and she did not walk away from the appointment with answers to the questions she had asked.[50]
  16. [49]
    TH says she has since had the procedure, in circumstances where the doctor thoroughly discussed an informed consent form that she had to sign; she did not get this at the practitioner’s clinic and in hindsight felt a bit odd.[51]
  17. [50]
    Dr Heath’s long-term receptionist was absent from the Sunrise Clinic that day and there were no administrative staff members to provide cover on that day.
  18. [51]
    In the Reconsideration Decision the Board sets out that its reasonable belief is based on, relevantly:[52]
    1. TH’s allegation that Dr Heath made inappropriate comments, using profanities such as “fuck” and “shit” and asked her to “show [him her] cervix” followed by grabbing her hand to make a gesture to demonstrate the size and shape of her cervix; and
    2. TH said that Dr Heath made her feel shocked, confused and extremely uncomfortable.
  19. [52]
    In carefully scrutinising all the material before the Tribunal about this notification, a number of things suggest to the Tribunal that aspects of Dr Heath’s recounting of the consultation are inherently more probable than TH’s:
    1. TH’s clinical presentation was objectively documented at the time. The assessors confirm that aspects of that clinical presentation would likely have had significance for Dr Heath being able and willing to perform the procedure which TH was seeking at the clinic;
    2. the photographs of the consulting room indicate:
      1. from where the patient entered the room, the distance between the screen and the entry is significant, such that it seems objectively unlikely a patient could make out anything on the screen at the doorway;
      2. from where the patient sits, the practitioner’s screen is off to the left of the patient and almost flat against the wall. The Tribunal infers that without craning their head significantly, it seems improbable that a patient could easily discern what was on the screen; and
    3. whilst TH initially said that she saw the confidential information when she walked into the consulting room, TH does not describe anything she actually made out on the screen, saying, rather that ‘he had his computer up’ when she entered the consultation room.  It is only in TH’s subsequent statements that she referred to being able to see confidential information on Dr Heath’s screen, but TH says this is when she was sitting down. Even then, she says that she could ‘almost read’ what as on the screen, not that she could read it. Similarly, in the context of any disclosure of confidential patient information during a phone call, TH herself says it was quite vague. In so far as the Board may have relied on these aspects of TH’s complaint in making its decision,[53] it is not apparent that the Board has had any regard to whether there is reliable information that there was, in fact, confidential information visible to or heard by TH. In those circumstances, this has some impact on the overall weight of TH’s notification in the eyes of the Tribunal, as it tends to demonstrate TH was looking to find fault with Dr Heath.  
  20. [53]
    Whilst Dr Heath denies using profane language, even if he did, the context in which TH says it occurred is non-sexual to the Tribunal’s mind, by reference to the spectrum of behaviours set out at clause 3.1 of the Guidelines:
    1. the word ‘shit’ was used, on TH’s oral version, to describe another medical practitioner or medical clinic and, additionally, in her written statement in the context of his experience; and
    2. the word ‘fucking’ was used, on TH’s oral version, to describe the practitioner’s daughter who had not come to work, but had gone to the beach, or additionally, in TH’s first written statement, to describe Dr Heath’s experience in performing the procedure under discussion.  Neither use carries any suggestion of a sexual overtone and TH says this seemed to her to be non-aggressive, like it just slipped out and used in annoyance or frustration.
  21. [54]
    If, ultimately, these matters were established as TH alleges, it may well be that such conduct demonstrates a failure of effective communication and a failure to treat TH with appropriate respect but the Tribunal is not satisfied there is any sexualised element to these comments.
  22. [55]
    Both parties agree that Dr Heath used TH’s hand to demonstrate to her the size and shape of a cervix and to relate that to the size of the Mirena device. Both parties agree Dr Heath had been discussing aspects of the procedure before this occurred.
  23. [56]
    TH says both parties were sitting down at the time Dr Heath grabbed her hand, without her permission, having said “show me your cervix”.  
  24. [57]
    On TH’s version, the making of the statement or the grabbing of her hand does not occur in the context of any discussion of sexual matters, any intimate examination, or when TH is undressed or lying down. The Tribunal concludes that if TH’s evidence is accepted on this issue, it again demonstrates a failure of effective and appropriate communication. It is not apparent that there is anything of a sexual nature about it when the subject of the consultation was obtaining information about the insertion of a Mirena IUD.  It is unclear whether the Board has relied on this conduct as inappropriate physical contact with a female patient in the Reconsideration Decision.[54]
  25. [58]
    The Board has characterised the statement “show me your cervix”, as an inappropriate statement, without characterising it as having any sexual connotation in the Reconsideration Decision.[55]
  26. [59]
    The Guideline defines “sexual exploitation or abuse” in the doctor patient relationship to mean

a doctor using the power imbalance, knowledge or influence developed in the doctor-patient relationship to abuse or exploit the patient’s trust or vulnerability for sexual purposes or sexual gratification, including by conducting unwarranted physical examinations. (emphasis added)

  1. [60]
    Dr Heath did not conduct any physical examination. TH does not allege any action by Dr Heath which would suggest he has derived any sexual gratification or had any sexual purpose in any of these actions. The Board does not set out any analysis as to how the matters it sets out in paragraph 2a of the Reconsideration Decision could be viewed as sexually exploitative of TH as it appears to find in paragraph 2b. The Tribunal is not satisfied that TH’s notification is one in which Dr Heath’s alleged conduct as “inappropriate communication which could be viewed as sexually exploitative”.
  2. [61]
    The Tribunal is not satisfied that the weight of TH’s complaint supports the risk the Board now contends for, which is that Dr Heath will engage in a sexualised boundary violation with a patient who is a woman.[56]  The Tribunal is satisfied that the weight of TH’s complaint supports a risk that Dr Heath will engage in conduct which is ineffective communication and failing to treat patients with respect and, to that extent, may be inappropriate conduct.

Patient SC- consultation 25 July 2023

  1. [62]
    SC consulted Dr Heath for advice about issues associated with an Implanon bar he had implanted.  They were the only two people present in the consultation.
  2. [63]
    SC’s made a notification to the OHO about 2 weeks after the consultation. In it SC said that she went to see Dr Heath because there were no other doctors she could see and that he had implanted the contraceptive bar for SC “as he was the only doctor who could do it”.[57] SC says that it had been a normal appointment and she felt fine with Dr Heath.
  3. [64]
    When she explained her issue, SC says Dr Heath’s first comment was “You mustnt [sic] have had a good root for a while”.[58] SC says Dr Heath said it like it was meant to be a joke but she didn’t find it funny.  SC says she was shocked and didn’t say anything. SC says Dr Heath’s comment was inappropriate and insulting and it made her feel uncomfortable. SC says she will never consult with him or any other male doctor in respect of a similar issue. She found this very inappropriate from a 63-year-old doctor who she had gone to see about something very personal.
  4. [65]
    Dr Heath categorically denies making the alleged comment.
  5. [66]
    The Reconsideration Decision deals with SC’s complaint by:
    1. Categorising the alleged statement as an inappropriate comment;[59] and
    2. Relying on SC’s comments about her distress and/or losing trust in male medical practitioners.[60]
  6. [67]
    Dr Heath accepts the comment would come within the definition of sexual harassment within the Guideline, whilst maintaining that the comment was not made[61].  Even if it was a comment made as a joke, the Tribunal is satisfied it would fall within the definition of sexual harassment set out in the Guidelines. 
  7. [68]
    The Tribunal is satisfied that the weight of SC’s complaint supports some risk that Dr Heath will engage in a sexualised boundary violation with a patient who is a woman, by the making of an inappropriate comment which is sexual in nature.

Patient MW – consultation 30 May 2023

  1. [69]
    MW attended Dr Heath for the insertion of a Mirena IUD. There were three people present for the consultation and procedure, MW, Dr Heath and a registered nurse to assist and act as chaperone. MW says expressly that the nurse was there the whole time the conduct she complains of occurs; Dr Heath also says the entire procedure was performed in the presence of the nurse (although the nurse herself says she was present for the vast majority of the consultation but left briefly to get equipment).
  2. [70]
    Dr Heath had seen MW on five previous occasions, over several months, prior to the consultation giving rise to the notification.   MW described him as her usual general practitioner.
  3. [71]
    The nurse observed MW to be a nervous about the procedure and very shaky and nervous throughout the procedure and afterwards. The nurse’s notes of the consultation with MW are consistent with that position being observed afterwards.[62]  Dr Heath also recalls MW as being a very anxious patient who he had to continuously reassure during the procedure and who the nurse was also constantly reassuring throughout the procedure. There is some support for these opinions in the materials[63] in that:
    1. MW’s notes record current problems as including Anxiety neurosis; and
    2. the medical records contain a letter sent by Dr Heath to a psychologist about MW’s anxiety about 2 weeks prior to the consultation the subject of the complaint.
  4. [72]
    MW recalls that Dr Heath asked her to take off her socks and undies and lay on the bed, then told her to move down the bed towards him so her bottom was near the end. This is broadly consistent with Dr Heath’s recall that he asked MW to remove her underwear in a private area and then lay on the bed under the sheet. The nurse says she can understand how Dr Heath standing at the bottom of the examination table and asking the patient to scoot down to the end of the examination table while his hands were placed at around the level of the patient’s knees might have been uncomfortable for the patient, given his close proximity and the intimate nature of the procedure.
  5. [73]
    Dr Heath says he performed a bimanual examination of her pelvis then examined the patient’s pelvis to determine the position of the uterus.
  6. [74]
    MW says Dr Heath had himself pressed against the table and his belly was touching her leg during the procedure which made her very uncomfortable. MW says Dr Heath was standing up at the table whilst performing the insertion and she felt that he was uncomfortably close to her and that he was so close to her that he could have been having sex with her. Dr Heath denies being uncomfortably close to MW.
  7. [75]
    They all agree Dr Heath asked MW to assist to hold the speculum.
  8. [76]
    All three parties confirm that Dr Heath was rubbing her leg during the procedure. MW says he was rubbing his hands down her leg during the procedure, which he was doing in a soothing sort of way, but she felt uncomfortable and it felt almost sexual and unwarranted. MW describes this was from the knees down, it occurred during the procedure and Dr Heath was wearing gloves.  Dr Heath says sometimes he will pat a patient’s calves during the procedure in a soothing manner and to ensure his hand was guarding against sudden movements. The nurse says she observed Dr Heath rubbing the patient’s legs around the knee region which she did not believe was sexual in nature.  She thought Dr Heath was attempting to comfort the patient whilst doing this.
  9. [77]
    MW alleges that Dr Heath commented on her cervix, stating that she has a very small cervix and “it almost got me excited” and stated a few times that she had a very small cervix. MW felt it was sexual when he said this. Dr Heath rejects that he said this. Dr Heath says he recalls saying to MW that she had a very small cervix. He says this was in the context of advising her that she had cervical insufficiency, which is a physiological feature which increases risks associated with pregnancy loss, pre-term labour and a complicated delivery. He gives his opinion is that it is entirely appropriate that a patient is aware that they have cervical insufficiency to assist with any future planned pregnancies. The nurse says she cannot recall Dr Heath discussing the size of MW’s cervix or making any comment that “it almost got me excited” or anything that was sexual in nature in her presence during the examination.[64]
  10. [78]
    Dr Heath says that after the procedure he left MW in the procedure room for observation with the nurse. The nurse told him MW was reporting being anxious, nauseous and feeling pain in the lower abdomen. When he immediately went back in to review her, the nurse and her boyfriend were both with her and her vitals were unremarkable. The nurse recalls after the procedure, MW experienced nausea and pain. She called Dr Heath for review and he arrived promptly.
  11. [79]
    Dr Heath says MW recovered and left the clinic after a period of observation and extensive reassurance. The nurse, too, says that ultimately MW made a good recovery and left the clinic. She did not express any concerns to the nurse about the practitioner or the consultation.
  12. [80]
    The nurse (who no longer works for Dr Heath) says that she worked for him for 4 – 5 months and in that time, she says she did not observe anything sexually inappropriate.[65]
  13. [81]
    The receptionist was working in the clinic that day. She contacted MW’s boyfriend to attend the clinic to sit with MW, after being asked to. She recalls that MW seemed content when she was leaving the clinic and there was absolutely no indication that she had any concerns.
  14. [82]
    The Board summarises the impugned conduct on which it acted as that Dr Heath has allegedly made inappropriate comments and inappropriate physical contact with MW:[66]

[MW] alleges the practitioner made inappropriate comments about her cervix:

  1. A.
    saying during the procedure that her [sic] was very small and that it “almost got [him] excited”;
  2. B.
    telling her male partner that, “she’s alright, a really good girl, really tight cervix”, and patting him on the back after he came to pick her up…

[MW] alleges that during the insertion of a Mirena IUD, the practitioner stood so close to her that his body was pressed against the table and his belly was touching her legs and he was so close that he could have been having sex with her.

  1. [83]
    The Tribunal weighs carefully a number of things about MW’s allegation in respect of the conduct of which she complains:
    1. primarily, the statement of the registered nurse, who MW agrees was present throughout the consultation and the procedure, does not support any of the allegations MW makes about Dr Heath’s conduct being sexual in nature or that Dr Heath said anything that was sexual in nature during the consultation;
    2. whilst the Board submits that an employee of the practitioner may be in a position of conflict, there is no evidence that supports that submission. Dr Heath’s use of the registered nurse as an observer is consistent with section 7.1 of the Guideline which provides that an observer, who is a witness to the consultation, may be a registered nurse employed in the practice and that such an observer can provide an account of the consultation if later there is an allegation of improper behaviour.[67] The nurse had a short period of association with Dr Heath’s practice, she no longer has that association and she did not have that association at the time she gave her statement. Further, the registered nurse has mandatory reporting requirements as a registered health practitioner. There is nothing raised on the material before the Tribunal to suggest she would not adhere to those obligations. Significant weight should be given to her evidence;
    3. whilst the nurse confirms that she can understand how MW may have been uncomfortable given Dr Heath was in close proximity to MW and the intimate nature of the procedure, she states MW was very shaky and nervous during the procedure and she (that is, the nurse) did not see any behaviour which was sexual in nature. The Tribunal observes that the nature of the procedure requires the practitioner to stand close to the patient to perform the examination and insert the IUD;
    4. MW confirms Dr Heath was wearing gloves when he rubbed her legs during the consultation. MW is not certain that the touching of the leg was sexual as she recounts her complaint. MW says he was doing so in a soothing sort of way, from the knee downwards, but she felt uncomfortable and it felt almost sexual and unwarranted.[68] MW’s statement about this conduct which she describes as feeling soothing but at the same time almost sexual and unwarranted suggests MW herself is ambivalent about the nature of the conduct.
  2. [84]
    Weighing those matters, the Tribunal is not satisfied that MW’s complaint about Dr Heath standing too close to her carries weight to give rise to the risk the Board now contends for.
  3. [85]
    Conversely, the statement about “almost getting excited” would be inconsistent with the standards set out in the Guideline, assuming it was made. Dr Heath denies saying it and the nurse, who MW accepts was present, cannot recall it being made, or (perhaps more relevantly) Dr Heath saying anything that was sexual in nature in her presence.  It is improbable that, if Dr Heath made such a statement, the nurse would not recall it, or find it objectionable, given its obviously objectionable nature. The nurse’s recollection about MW’s anxious, shaky and nervous demeanour inclines the Tribunal to the view that MW’s allegation that Dr Heath made this statement may not be a strong one.
  4. [86]
    As to the comment allegedly made to MW’s male partner, it is first referred to in paragraph 7aiiiB of the Reconsideration Decision.  As it is specifically included, the Board has evidently placed some weight on this in reaching its decision. There is no statement from the male partner before the Tribunal to provide any evidence of this and MW does not refer to it in her complaint. The Board accepted in the oral hearing that it was not particularly relying on the statement from the boyfriend.[69] The Tribunal determines it should be given negligible weight and is not satisfied that this should be considered any further on this review.

Patient RB – consultation 10 December 2021

  1. [87]
    The Board first considered RB’s allegations as part of the Reconsideration Decision, RB having first complained to the OHO on 11 November 2023 about Dr Heath’s alleged conduct in a consultation on 10 December 2021.
  2. [88]
    RB attended a clinic where Dr Heath acted as the anaesthetist for a procedure to have a Mirena IUD inserted by a female gynaecologist.  She had not seen Dr Heath before.
  3. [89]
    The parties agree that RB had a pre-anaesthetic examination with Dr Heath and they were the only two people in the room. RB said she was wearing a surgical gown and socks with no underwear.
  4. [90]
    RB says Dr Heath asked about her medical history and listened to her chest and back with a stethoscope. She alleges Dr Heath asked her to lean forward so that her body weight was supported by his arm with her breasts in contact with his inner forearm. She then had to take deep breaths in and out. As RB does not have a medical background, she cannot say if this is standard procedure or a case of inappropriate touching. She left it almost two years to lodge the complaint because of her uncertainty about this. After seeing similar cases in the media and realising that complaints are often not made, or are deflected by institutions, she felt obliged to put her experience on the record.
  5. [91]
    RB further says:
    1. that after the physical examination,

Dr Heath then went through a form and asked [her] lots of questions, he kind of had what seemed like a comedy routine, like, if the question was ‘do you drink’, then he said ‘only if someone else is paying’.

When he asked ‘are you allergic to anything?’ he then said ‘only boys’ like that was funny.

[He] seemed unhappy that RB was not finding his comedy routine amusing.[70]

  1. There was a problem with the anaesthetic and she rang the clinic the next day and they got the practitioner to call her. He seemed defensive and said “this sometimes happens” and “that he had sent a letter to [her] doctor”.[71]

At the end of the call he said something like “happy Christmas, happy hanukkah, happy easter” and the call ended.[72]

  1. She thought about the consultation “a bit after it happened because it all seemed a bit off”;[73]
  2. She now tried to avoid male medical professionals. She had a few complications from the IUD and a year later she had it removed but she didn’t want to go back to that clinic.[74]
  1. [92]
    Dr Heath sets out his usual practice in performing a pre sedation assessment.[75] He disputes RB’s allegation as to his performance of the assessment because it is not consistent with his usual practice and it would be illogical for him to perform it as RB says he did. Dr Heath denies that he interacted in any way inappropriately with RB including by making ‘jokes’ about her being allergic to boys. Dr Heath further says:
    1. he has not reviewed any records of his interactions with RB as he does not have access to them and the Board has not disclosed them;
    2. he has an independent recollection of RB because she made numerous complaints to the ECWC about multiple staff members. The practice owners, who were not clinicians, asked him to speak to RB at the time to address her complaints about multiple staff she interacted with that day after the procedure. Whilst he cannot now recall the complaints, he does not believe any of them related to his pre-sedation assessment or any suggestion that he had inappropriately asked her to place her breasts on his forearm. To the best of his recall, RB’s complaints were addressed shortly after they were made;
    3. when AHPRA notified him of the RB notification, it advised him he was not required to respond to the notification;
    4. the Board has never invited him to provide a response to RB’s notification; and
    5. he is concerned the Board did not consider his affidavit evidence filed in the proceedings which provided sworn evidence in relation to the RB notification. 
  2. [93]
    The information relied on by the Board relevant to RB in the Reconsideration Decision is:
    1. RB’s allegation that the practitioner asked questions in a manner akin to a comedy routine including asking:[76]
      1. “Do you drink?” and saying, “Only if someone else is paying”; and
      2. “Are you allergic to anything?” and saying, “Only boys”;
    2. that whilst applying a stethoscope to her back during a physical examination, Dr Heath held her bodyweight against his forearm, such that her breasts were pressed against his forearm, which she found to be unusual and unlike previous examinations she has had;[77]
    3. RB says she now tries to avoid male medical practitioners.[78]
  3. [94]
    The Board does not refer in the Reconsideration Decision to Dr Heath’s response to RB’s allegations in his affidavit of 18 January 2024 and it is not apparent the Board has had any regard to it.
  4. [95]
    The Tribunal notes that RB states:
    1. she was uncertain whether the physical examination she alleges occurred involved standard medical procedure or inappropriate touching; and
    2. she took two years to make the notification and she did so after ‘seeing similar cases in the media’.[79] Nowhere does RB describe what those ‘similar incidents’ are, who they involved, what she knew about them (so she could make as assessment that they were ‘similar cases’) or when she learned about them.
  5. [96]
    Given these matters, and particularly RB’s own expressed uncertainty about the propriety of the physical examination she says occurred, the Tribunal affords little weight to RB’s allegations concerning the physical examination. The Tribunal is not satisfied that this conduct supports the risk the Board currently contends for.
  6. [97]
    Further, as to the alleged inappropriate comments, accepting they were made as RB alleges, which Dr Heath denies,:
    1. the first one, related to drinking and payment, has no apparent sexual connotation;
    2. the second one does not readily come within any of the examples set out in the definition of ‘sexual harassment’ within the Guideline;
    3. further, when looking at the umbrella definition of ‘sexual harassment’ as being ‘any unwelcome sexual behaviour which is likely to offend, humiliate or intimidate’ – it is not readily apparent what gives either statement the character of being sexual behaviour, particularly where RB’s impression was that it was a joke, but not a funny one.
  7. [98]
    In those circumstances, the Tribunal is not satisfied that either alleged comment has any potential to expose female patients to the risk contended for by the Board, which is a risk that the practitioner will engage in a sexualised boundary violation with a patient who is a woman.
  8. [99]
    The Board, in oral submissions, accepted that continually making dirty jokes to patients doesn’t seem to be the type of serious risk that the National Law is directed to for immediate action.[80] The Tribunal is satisfied that, if established, these comments may be found to be situationally inappropriate and evidence that Dr Heath fails to tailor his professional behaviour to each patient.

Patient TS – consultation 9 June 2023

  1. [100]
    The Board first considered TS’s allegations as part of the Reconsideration Decision, TS having first complained to the OHO on 30 December 2023 about the practitioner’s alleged conduct in a consultation on 9 June 2023.
  2. [101]
    There were four people present in the room when TS had a procedure to have a Mirena IUD removed and a new one inserted. In addition to TS and Dr Heath, TS’s 19 year old daughter and a registered nurse attended. TS said she had her daughter with her for moral support as she finds having the procedure done very stressful and painful. The registered nurse recalled TS to have been somewhat anxious but not overly so.
  3. [102]
    TS said in her complaint that Dr Heath said before the procedure that she could have great confidence in him because he had worked for a number of years at Nambour Women’s clinic where this procedure is done on many women many times a week. Her complaint about the procedure was that instead of applying the lubricant gel to the speculum, Dr Heath applied it directly to her entire vulva, including massaging the clitoris for quite some time. He did this while looking into her eyes the entire time. She said she has had a number of procedures and pap smears requiring the speculum and in every other one the practice has been to apply the gel to the speculum before insertion.
  4. [103]
    TS further said that the application of gel was obscured by her leg, she presumed shielding this from the view of the nurse who was present. Her daughter was seated at her head end so was not aware of what was going on.
  5. [104]
    TS said she felt extremely uncomfortable. The act was unexpected and shocked her into submission and quietness or jovial joke making. In response she placed a nearby pillow over her face to save herself some embarrassment.
  6. [105]
    She did not put the complaint in straight away as she needed to overcome the shock and embarrassment, as well as recover from the procedure being done. This has made intimacy with her husband difficult and her trust in male doctors for this procedure will never be restored.
  7. [106]
    Through his solicitors Dr Heath categorically denies the allegation.
  8. [107]
    He says he met with TS accompanied by his chaperone. He explained the nature of the procedure to TS, obtained her consent to undergo that procedure, and he spent some time explaining to her the various steps involved. After explaining the procedure to TS, answering any questions she had and obtaining her consent, TS undressed and was placed in a lithotomy position on the examination table. As is his usual practice, Dr Heath explained to TS that he would perform a bimanual examination. He asked his assisting nurse to apply lubrication gel to his gloved fingers. He then explained to TS that he would start the manual internal examination. TS raised absolutely no concerns about him doing so.
  9. [108]
    Dr Heath says that after performing the bimanual examination, lubricant was applied to the speculum (with the assistance of the nurse) and the speculum was then used to assist him to remove the Mirena in situ, and then replace it. Throughout all of this procedure he explained to TS what he was doing.
  10. [109]
    Dr Heath denies he failed to apply lubricant gel to the speculum. His invariable practice, and indeed the invariable practice of those who assist him, including the registered nurse, is for lubricating gel to be applied to the speculum after it has been unpacked and is on the procedural trolley. He denies he applied gel directly to her entire vulva.  His invariable practice is to don sterile gloves and then ask those assisting him to apply gel to his fingers to enable him to perform a bimanual examination to maintain a sterile environment and he categorically rejects any assertion that he massaged TS’s clitoris at all, much less for ‘quite some time’.
  11. [110]
    The registered nurse who was present says relevantly:[81]
    1. she has a clear recollection of the consultation because TS’s daughter was there for the procedure which was very unusual;
    2. Dr Heath explained the procedure to TS including the steps that would be taken and confirmed she consented to it;
    3. Dr Heath explained he would undertake a clinical examination of the pelvic floor prior to the procedure to exchange the Mirena device and that he would do so by manually ascertaining the position of the uterus and to assess the pelvic floor muscles by performing an internal examination;
    4. TS was then placed into a lithotomy position on the procedural bed. Dr Heath was positioned at the bottom of the examination table and she (that is, the nurse) was positioned very close to him beside him, and her role was to control the examination light to ensure he had a good field of vision under light for the procedure. At all times during the procedure she was located in a very close proximity to Dr Heath whilst he performed the examination and she had a good field of view of TS’s vaginal region as her job was to ensure the lighting was optimal for the procedure. She had a “good field of view at all times say [sic] for occasional fleeting moments when her field of view might have been obstructed by Dr Heath’s hands”;[82]
    5. Dr Heath performed a bimanual examination. She recalls personally dispensing a small amount of lubricating gel onto his gloved fingers which she believes were his index and middle fingers. He then inserted those fingers into the vagina and conducted the bimanual examination of the vagina to locate the cervix to identify its positioning and identify any abnormalities. At the same time, he used his other hand to push down on TS’s fundus. After the bi manual examination was performed, gel was applied to the speculum (which had previously been dispensed onto the procedure pack tray) to assist in the removal of the existing Mirena and then replacement of the new Mirena device. She has watched Dr Heath perform many of these procedures previously and believes it is his invariable practice to apply lubricant gel to the speculum. Indeed, she would find it unusual if he did not apply lubricant gel to the speculum and would likely raise that with him on the assumption that he had forgotten to do so. The procedure then concluded, TS dressed and left with her daughter;
    6. she did not observe Dr Heath apply gel directly to TS’s vulva. She personally recalls applying the lubricating gel to Dr Heath’s fingers prior to performing the bimanual examination.
    7. she did not observe Dr Heath ‘massaging the clitoris’ for ‘quite some time’ or at all.  The bi-manual examination was swift and entirely consistent with every other one she has seen him perform. She denies Dr Heath did so. She says she does not think it is possible that the massaging of the clitoris might have occurred whilst her view was obscured by TS’s leg, because of her positioning at the end of the table and her field of view throughout the procedure;
    8. she has a clear recollection that TS did not raise any concerns or indicate any discomfort with the procedure. If a patient appears anxious, or raises any concerns at all about the examination, it is immediately stopped and then discussed with the patient. This did not occur with TS. She does not recall TS placing a pillow over her face during the procedure. She believes she would recall that occurring and she believes she would have asked for it to be noted in the clinical record as it would be very unusual. It would also act as an indicator to Dr Heath and herself that the patient was unusually uncomfortable or anxious and that would cause a degree of concern.  For these reasons she is confident in her recollection that TS did not place a pillow over her face during the consultation;
    9. she agrees with TS’s recollection that Dr Heath is likely to have made comment about his experience in performing these procedures at the Nambour Women’s Clinic and over many years of practice. This is something that he often does to try to put patients at ease; and
    10. she rejects TS’s assertion that there was anything inappropriate that occurred during the course of the procedures and that she was sexually abused.  
  12. [111]
    An enrolled nurse who was not present at the consultation, scribed the records for the registered nurse and entered them into the system. That nurse says that she knows the registered nurse from working with her for a year and that she has observed the registered nurse has strong and clear boundaries, a high moral standard, very high ethical standards and would call out immediately any conduct she saw as inappropriate.   
  13. [112]
    There is no statement from TS’s daughter.
  14. [113]
    After oral submissions, both of the professional assessors informed the Tribunal, for the first time, that in their professional experience, it can be a usual or normal incident of doing a bimanual examination so as to locate the cervix and determine the position of the uterus (anteverted or retroverted) that the patient may perceive the sensation that the clitoris is being massaged.  It depends on the particular patient’s circumstances and presentation. The bimanual examination, including pushing down on the patient’s fundus, is critical to establishing the position of the uterus prior to insertion of a Mirena IUD. If the position is not properly established, the device may pierce the uterine wall.  As it may be necessary to palpate and ballotte the area during the physical examination, it is not unusual for a patient to experience the sensation of the massage of the clitoris and surrounding vulval area, in a properly performed procedure.  As such, both of the professional assessors are firmly of the view that there is nothing in TS’s statement about the performance of the physical examination, relating to TS’s statement of feeling the massaging of the clitoris by the practitioner, which could give rise to a serious risk of harm in the context of the procedure being performed.
  15. [114]
    The Tribunal wrote to both parties after this discussion, advising them of it and asking for any further submissions.
  16. [115]
    Dr Heath submits that the provision of this information to the Tribunal is within the role of the assessor provided for in s 127 of the Health Ombudsman Act 2013 (Qld) (‘HO Act’). Given this information, Dr Heath has withdrawn his concession that TS’s complaint could found a reasonable belief that, because of his conduct, he posed a serious risk to persons (that concession having been made solely on the basis of TS’s complaint and where there was no expert opinion, evidence or advice before the Tribunal). Dr Heath contends that there is no basis to form a reasonable belief that he posed a serious risk to persons and the correct and preferable decision is that the Board’s decision of 11 March 2024 should be set aside.
  17. [116]
    The Board submits, relevantly that the assessors’ advice on a question of fact may be consistent with TS’s experience of having her clitoris massaged as having a clinical genesis, but it is not evidence that the conduct TS alleges did not occur and does not render TS’s allegations incorrect, incredible or clinically indicated. It highlights there are disputed factual matters.
  18. [117]
    The Board submits the Tribunal’s assessment of a reasonable belief as to a serious risk to persons and it being necessary to take immediate action to protect public health or safety occurs in a statutory context where the main guiding principle of the national registration and accreditation scheme is that the protection of the public and public confidence in the safety of services provided by registered health practitioners are paramount. Another guiding principle is 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 and are of an appropriate quality. The Tribunal must make its assessment on all relevant information before it.
  19. [118]
    The Board submits that on the relevant information, while the nature of the risk implied may not reach the level of a sexual assault, it might. The risk of less serious boundary violations or breaches of professional boundaries being engaged in by the applicant – such as the making of inappropriate comments – would appear to be high. The implied risk of Dr Heath committing a sexual assault is lower than the implied relative risk of his engaging in a less serious boundary violation. If that more serious risk is disregarded (which untested, would be difficult to do), the Tribunal still has evidence that gives rise to a reasonable belief that Dr Heath is likely to engage in conduct with a female patient in the future that will amount to a boundary violation, or sexual harassment, most likely in during a consultation concerned with contraception. The Board’s position is that it is necessary to take immediate action to protect public health and safety from that risk being realised.
  20. [119]
    Section 127(1) of the HO Act provides:

The function of an assessor in a hearing of a disciplinary proceeding is to sit with the tribunal and advise the tribunal about questions of fact.

  1. [120]
    In considering the role of the assessors under a previous statutory scheme (but where the role of the assessors was expressed in like terms in the statute) the Court of Appeal has observed:

Even if the facts are not disputed the weight to be given to them is also a matter upon which the assistance of the assessors, both professional and lay, may be of great help to the judge.[83]

  1. [121]
    Here the facts involving TS are hotly disputed and, on this application, it is not the Tribunal’s function to determine which facts it finds. It is, however, the Tribunal’s function to scrutinise carefully all of the material before it on this allegation.
  2. [122]
    It is agreed that there were two people in the room during the procedure, in addition to TS and Dr Heath, being the nurse and the patient’s daughter. The nurse supports Dr Heath’s account and TS says her daughter could not see anything from where she was standing. There is no evidence at all from TS’s daughter.
  3. [123]
    TS does not describe a bimanual examination occurring prior to the change of the Mirena IUD, yet it seems improbable that one was not performed. Dr Heath says he explained he would do one, and he did one; the nurse supports this. It seems, based on the assessors’ information,  the insertion of the Mirena IUD could not occur safely without a bi manual examination. The Tribunal infers that if the conduct TS alleges occurred, it was prior to the changing out of the Mirena IUD.
  4. [124]
    TS’s allegation is extremely serious; if established, the conduct would constitute a sexual assault. Dr Heath denies it. In that he is supported by the registered nurse.  TS’s allegations are disputed by that nurse, who says:
    1. she was standing beside the practitioner with a clear view of what was occurring;
    2. she did not observe the practitioner apply gel to the patient’s vulva. She personally applied gel to the practitioner’s gloved fingers before he performed the bi-manual examination;
    3. she did not observe the practitioner massage the patient’s clitoris and she denies that he did so; and
    4. gel was applied to the speculum.
  5. [125]
    The nurse is silent on the issue of whether Dr Heath made eye contact with TS.
  6. [126]
    The nurse also says that in the over 50 intimate examinations which she has assisted Dr Heath with, she has never observed any inappropriate behaviour. She has worked as a health practitioner for approximately 28 years and has known Dr Heath since 2011 when she first commenced working as a registered nurse with Noosa Health Centres. Further, she says that in all her time she has never observed Dr Heath engage in any inappropriate behaviour and she has never observed him undertaking an examination which she could consider to be in any way inappropriate.
  7. [127]
    The nurse is a registered health practitioner and, as a core part of her professional obligations, is required by law to notify the Health Ombudsman if she forms a reasonable belief that another registered health practitioner has behaved in a way that constitutes notifiable conduct (which includes engaging in sexual misconduct in connection with the practice of the profession).[84]
  8. [128]
    The Board submitted that the nurse, by reason of her employment by Dr Heath, had “some form of allegiance if not a clear conflict”.[85] As earlier noted, the presence of a registered nurse as an observer who can provide an account of what occurred in a consultation is expressly contemplated by clause 7.1 of the Guideline.  In so far as there is evidence about the attitude of the registered nurse it is directly contrary to the Board’s submission, viz:
    1. that another nurse in the practice has observed the nurse in question to have high moral and ethical standards; and
    2. the nurse herself has deposed that she would never stand for a patient being sexually abused when she was directly observing the activity said to constitute the sexual abuse and to suggest otherwise is offensive.
  9. [129]
    TS said she was anxious about the procedure and she had her daughter there for support. That suggests TS may have been hypervigilant about the procedure.
  10. [130]
    Whilst accepting that it is not impossible that it has occurred as TS alleges, the Tribunal regards it as improbable that a doctor, wearing gloves, would, in the presence of two other people, one of whom is there as an observer of the procedure and standing beside him, engage in the conduct TS alleges. The observer says that he did not do so.
  11. [131]
    Carefully scrutinizing all this material, the Tribunal considers on the current information before it that TS’s complaint is weak. Notwithstanding that, TS’s complaint must be afforded some slight weight, because it is about such serious subject matter.

Summary of the Tribunal’s conclusions on the review of each of the 5 notifications

  1. [132]
    The Tribunal has concluded:
    1. it is not satisfied that the weight of TH’s complaint supports the risk the Board contends for.  The Tribunal is satisfied that the weight of TH’s complaint supports a risk that Dr Heath will engage in ineffective communication with patients and not treat patients with respect;
    2. it is satisfied that the weight of SC’s complaint supports the risk that Dr Heath will engage in a sexualised boundary violation with a patient who is a woman by the making of an inappropriate comment;
    3. it is not satisfied that MW’s complaint about Dr Heath standing too close to her carries weight to give rise to the risk the Board now contends for. Conversely, whilst the alleged statement would clearly contravene the standards of conduct set in the Guideline, assuming it was made, the evidence that it was made is weaker than the evidence it was not.  On balance, the Tribunal gives some slight weight to MW’s complaint about the comment she alleges was made to her, and, consequently, the risk the Board contends for;
    4. the Tribunal is not satisfied that either comment Dr Heath is alleged to have made to RB, assuming it was made, has any potential to expose female patients to the risk the Board contends for. If ultimately it is accepted they were made, these comments may be found to be situationally inappropriate and evidence that Dr Heath fails to tailor his professional behaviour to each patient. For the reasons earlier set out, the Tribunal affords little weight to RB’s allegations concerning the physical examination. The Tribunal is not satisfied that this conduct supports the risk the Board currently contends for; and
    5. whilst the Tribunal’s assessment of TS’s complaint is that it is weak on the information currently before the Tribunal, TS’s complaint must be afforded some slight weight in assessing the issue of serious risk, because it is about such serious subject matter.

What should the Tribunal make of the material concerning past, current or contemplated regulatory action involving Dr Heath?

  1. [133]
    There are several aspects of Dr Heath’s regulatory history which are said to have relevance to this review. They are:
    1. a notification in 2017 (‘2017 caution’);
    2. a decision of the Tribunal in 2022 on a disciplinary referral; and
    3. what I describe as ‘other regulatory matters’.

What was the 2017 caution about ?

  1. [134]
    A document on AHRPA letterhead described as Practitioner’s notification history[86] is in evidence before the Tribunal. It is not easy to understand. In respect of the 2017 caution, it records the concerns as “communication – disrespectful manner”. It goes on to record:   

During a consultation on 16 February 2017, while having a discussion regarding Mirena contraceptive device, the practitioner allegedly asked the patient “who would you drop your knickers for?” and “If Ryan Gosling was in the car park would you go on a dinner date?” When the notifier complained about his comments, he allegedly replied that he was “only lightening the mood” and touched her knee.

The Board acknowledged that the practitioner was aware the comments made during the 16 February 2017 consultation were below the standard expected of a medical practitioner and that he has indicated he will not use the same communication style in the future and completed further education.

  1. [135]
    AHPRA’s letter to Dr Heath dated 22 September 2017[87] confirms that Dr Heath admitted making the statement and accepted he may have been too informal. The Committee noted Dr Heath was aware of his obligations on ‘doctor-patient partnerships’ and ‘effective communication’ as those were set out in the Code.
  2. [136]
    That Dr Heath admitted making the comments on that occasion, is different from the position here for each of the current five complainants, which he strenuously denies.
  3. [137]
    Further, the Board did not take regulatory action in 2017 on the basis that, having made these statements to a female patient in the course of a consultation about a Mirena contraceptive device, Dr Heath had committed a sexualised boundary violation with a female patient. In so far as past risk may be a predictor of future risk, the Tribunal finds this caution supports a risk of inappropriate communication by Dr Heath to a patient in the context of a consultation about a Mirena or other contraceptive device.

How should the Tribunal assess the previous Tribunal proceeding on this review application?

  1. [138]
    The previous referral proceeded on agreed facts and characterisation. There were two aspects to the referral.
  2. [139]
    The first involved a boundary violation, including the practitioner having a sexual relationship with a patient (Patient A). Initially he saw Patient A as her general practitioner for about three years. He provide her with occasional treatment and medical services for about a further five years. At the time the sexually intimate relationship commenced, he had employed her as a casual receptionist for some months and he and Patient A had developed a close friendship. Patient A continued to work at the practice for a period during their intimate relationship (which was sexually intimate on 4 occasions) and he provided her with occasional treatment for minor medical issues. After they mutually decided to end the sexually intimate aspects of their friendship, Patient A continued to work at the practice on an occasional weekend as a registered nurse and Dr Heath continued to provide her with occasional treatment for minor medical issues. Knowing that Patient A had interpersonal familial difficulties with the father of her children, for a period of time Dr Heath arranged for Patient A and her children to appear on his private health insurance, which he paid for and Patient A rented a property from him for about 16 months paying him rent. The Tribunal found all of this conduct constituted professional misconduct, as the parties had jointly submitted. 
  3. [140]
    The second aspect to the referral involved Dr Heath attending Patient A at her home, after she had contacted him, saying she felt stressed because of issues in her relationship with her children’s father and she wanted a script for Lorazepam.  (This was after their intimate relationship had ceased; Patient A was residing with her children in Dr Heath’s investment property and paying him rent). Dr Heath went to her home, having prescribed and had filled a prescription for Diazepam 5 mgs with no repeats, in a standard sized packet of 50.  At her home he assessed her, and she reported she was feeling ok but needed to sleep. He formed the opinion that she was experiencing acute stress and anxiety but was not depressed. He gave Patient A the Diazepam containing the 50 tablets with instructions to take one only.  He did not make any clinical records of his attendance, assessment of Patient A or his treatment and after giving her the tablets he left her home. Patient A subsequently overdosed by consuming all 50 Diazepam. Dr Heath later returned to her residence, feeling uneasy about her presentation, and discovered Patient A in her bed, unconscious.  He called the ambulance which took her to hospital. He provided appropriate clinical information to the ambulance personnel and he remained with Patient A’s minor children whilst she received treatment and until the children’s father could attend to care for them.  The regulator did not contend that prescribing Diazepam was clinically inappropriate and the Tribunal accepted the parties’ contention that the conduct constituted unsatisfactory professional performance, because Dr Heath did not make any adequate clinical record of the diagnosis or treatment provided.
  4. [141]
    Whilst it took ten months for the regulator to tell Dr Heath of the notification, he responded via his lawyers within 4 days, admitting the facts and the seriousness of his conduct and accepting that the circumstances warranted conditions on his registration. Shortly after, on 7 March 2019 the Board took immediate action and suspended his registration. After he sought review of that decision, on 3 June 2019 the Board revoked the suspension and imposed conditions including indirect supervision, a prohibition on self-prescribing and on prescribing to family, persons who he was in an intimate relationship with and persons with whom he resided, certain others, a prohibition on prescribing Schedule 8 drugs, restrictions on his prescribing of benzodiazepines and a requirement that he keep an auditable register of all prescribing in his anaesthetic and general practice. 
  5. [142]
    On 12 December 2019 Dr Heath withdrew from medical practice voluntarily for personal reasons.  The decision records the Board again suspended his registration because he breached one of the conditions in October 2019 then, after a time reinstated it with conditions and on 19 May 2020 Dr Heath was granted registration as a medical practitioner upon providing an undertaking to the Board requiring limited mentoring. 
  6. [143]
    The Tribunal’s decision recorded that Dr Heath demonstrated insight and remorse by his prompt admissions and his co-operation during Tribunal proceedings. He completed education regarding professional boundaries and colleagues spoke very highly of him as a medical practitioner. The Tribunal determined that no suspension was required for protective purposes, observing that having regard to the consequences he had already suffered as a result of his conduct, a reprimand was sufficient.
  7. [144]
    The Board submits the sexual misconduct in that determined referral is unrelated to and different from the conduct in these allegations.[88] By that submission, the Board submits Dr Heath is a person who has presented with a lack of sensitivities to appropriate boundaries over a significant period of time.[89]
  8. [145]
    A finding of professional misconduct for a breach of boundaries with a patient is obviously serious. Whilst not minimising in any way the conduct, I observe the sexual boundary violation before the Tribunal then was of a qualitatively different kind from what is presently alleged:
    1. it involved a person with whom he had developed a close friendship over a number of months;
    2. whatever issues of power imbalance may have arisen, the conduct was consensual; and
    3. it did not occur in the clinical setting of a consultation.
  9. [146]
    Dr Heath was honest with both the QAS in the immediate aftermath of the overdose, ensuring patient safety and with the regulator, immediately, about what had happened, thereby enabling the findings against him and the sanction. In respect of these five patients, Dr Heath denies the conduct and, where the alleged conduct (both verbal and physical) was witnessed, the two different witnesses support his position.
  10. [147]
    The Tribunal is not persuaded that the findings in this decision say anything of significance about the risks the practitioner may pose in the future to female patients in a clinical setting.

Other regulatory matters

  1. [148]
    The Reconsideration Decision records:
    1. In paragraph 2d that Dr Heath’s registration is currently subject to restrictions for audit, approved places of practice, mentoring and prohibitions on prescribing. Dr Heath had been twice cautioned for failing to nominate a mentor within the required timeframe; he had self-reported a breach of the conditions imposed by immediate action on 18 August 2022, which had been referred to the Tribunal for hearing and that he is on notice of an investigation of concerns he has breached the prescribing conditions imposed on 3 June 2019.  
    2. In paragraph 8 that the Board considered Dr Heath’s alleged conduct is demonstrative of a lack of understanding of the psychological and/or emotional impact that his conduct may have on female patients (particularly young, female patients), as well as the possibility of an erosion of the trust patients and the community have in doctors and the medical profession more generally. The Board considered that the serious risk is heightened in circumstances where Dr Heath has previously been:
      1. cautioned by the Board in July 2017 in relation to making sexualised comments to a female patient while discussing the Mirena IUD (at which time the practitioner advised the Board that he undertaken further education to ensure such conduct would not reoccur in the future); and
      2. reprimanded in the Tribunal in February 2022 for engaging in sexual misconduct with a female patient. 
  2. [149]
    Orally the Board submitted in respect of these matters:
    1. the 2017 caution could be considered like conduct to some of the present complaints. As such, it would seem Dr Heath had not learnt from the earlier matter; and
    2. the 2022 reprimand imposed by the Tribunal for proven professional misconduct involving a boundary violation with a female patient who was also an employee and rented a property from him. Accepting that the factual circumstances were different, this event demonstrates Dr Heath’s propensity to be unable to adhere to proper professional conduct, effectively extending the ambit of areas where his activities may be concerning.
  3. [150]
    Further the Board submitted that it is problematic to rely on Dr Heath as the sole source of truth for information in relation to compliance and that his compliance history raises issues.[90] In support of that submission the Board points to parts of paragraph 13 of its letter to Dr Heath dated 15 March 2024.[91] They are:
    1. in respect of restrictions dated 3 June 2019, the Board decided on 8 January 2024 to refer Dr Heath to the Tribunal.[92] The 15 March 2024 letter states that is about alleged access to Schedule 8 medications, access to prohibited benzodiazepines and benzodiazepines in circumstances not permitted by the restrictions and failing to keep an auditable register. It appears from what was recited in the 2022 decision (set out at paragraph [141] above), that the conditions were imposed consequent upon the conduct giving rise to the 2022 decision. The referral is not in evidence in this proceeding and there are otherwise no details of the facts to be alleged against Dr Heath in evidence in this proceeding;
    2. in respect of restrictions dated 18 May 2020, the Health Ombudsman has referred Dr Heath to the Tribunal for allegedly providing inappropriate treatment to a patient’s finger in breach of then current restrictions which, in part, prohibited him from undertaking clinical work in general practice. Again the detail of the conduct alleged against Dr Heath giving rise to this referral is not before the Tribunal on this review;
    3. in respect of restrictions dated 20 May 2020, cautioning Dr Heath for failing to nominate a mentor, initially within a nominated timeframe and thereafter within an extended time frame; and
    4. in respect of restrictions dated 18 August 2022, having cautioned Dr Heath on 1 December 2022 for failing to submit forms, the Board referred Dr Heath to the Tribunal for prescribing a prohibited medication on 5 occasions and practicing at locations not approved on 157 occasions between 6 September 2022 and 30 June 2023.
  4. [151]
    Other than what is set out at (a) – (b) immediately above, there is nothing to inform the Tribunal of the content or context of the further referrals. Dr Heath has deposed that, having provided a submission to the Board on 6 January 2020, he has not been asked to respond to the information in (a) and that he is unaware of what conduct has been referred to the Tribunal.[93] The Tribunal does not give weight to either of these matters, given the paucity of information before it about them and how they can be said to support either the risk the Board currently contends for, or that less restrictive conditions which would rely, at least in part, on Dr Heath’s honestly, would be ineffective.
  5. [152]
    As to (c), it appears from AHPRA’s letter to Dr Heath dated 22 September 2022[94] that:
    1. the mentoring was required for managing patients with eating disorders;
    2. Dr Heath had given undertakings to undertake that mentoring;
    3. the Board decided he had failed to nominate a mentor within the specified timeframe and the then extended timeframe;
    4. Dr Heath had failed to submit necessary forms within the specified timeframe directed by the Board. Those forms related to his acknowledging of the restrictions and associated obligations, the contact details of the relevant senior person at each of the practice locations and the acknowledgment of the senior person’s understanding of the restrictions and requirements for reporting. The forms were submitted a day late;
    5. the Board:
      1. imposed a caution in respect of the failure to comply with the nomination of the mentor in the specified timeframe;
      2. approved the proposed mentor; and
      3. sought Dr Heath’s response about his failure to nominate the mentor within the extended timeframe and to submit relevant forms.
  6. [153]
    As to (d), it appears from the further AHPRA letter dated 5 December 2022[95] that the Board decided to caution Dr Heath for contravening the terms of the restrictions imposed on his registration on:
    1. 20 May 2022 by failing to nominate the mentor for approval by the Board within the extended specified timeframe being 26 August 2022; and
    2. 18 August 2022 by failing to submit relevant forms within the timeframe specified by the restrictions being 25 August 2022.
  7. [154]
    Further, that letter records:
    1. The restrictions of 18 August 2022 were an undertaking accepted under section 156 of the National Law that Dr Heath:
      1. Be prohibited from prescribing drugs of dependence or substances of misuse in his practice as a general practitioner; and
      2. Practice only at locations and positions approved by the Board. 

What does the Tribunal conclude on Dr Heath’s past, current and prospective regulatory history?

  1. [155]
    The Tribunal:
    1. Accepts that the facts of the 2017 caution support a risk of inappropriate communication being made in the context of a consultation with a female patient about a Mirena or other contraceptive device, rather than sexualised communication being made to female patients generally;
    2. is not persuaded that the findings in the Tribunal’s 2022 decision say anything of significance about the risks Dr Heath may pose to female patients in a clinical setting;
    3. does not give weight to the matters which may become a referral before the Tribunal, or which are being dealt as a referral before the Tribunal, given the paucity of information before it about them, how they can be said to relate to the risk the Board presently contends Dr Heath poses or why restrictions other than those imposed by the Board are unacceptable, and the fact that there has been no determination made in respect of the issues giving rise to them;
    4. gives some weight to the cautions received for failing to meet requirements of undertakings and completion of forms.

Does Dr Heath pose a serious risk to persons because of his health, conduct or performance?

  1. [156]
    The Tribunal has formed specific conclusions in respect of each of the five patient notifications and the practitioner’s regulatory history set out above.  The authorities suggest that in coming to a determination of whether a risk is serious, it is helpful to look through the rubric of:
    1. the nature of the risk posed;
    2. the likelihood of the risk occurring; and
    3. the consequences of the risk should it occur.
  2. [157]
    The real risk, Dr Heath submitted, is not that his communications (absent the TS notification) have a sexual element or sexual interest. The real risk is that his interaction with the five female patients has been less than ideal. Without the categorisation that the allegations constitute sexually exploitative conduct, the Tribunal should not be satisfied that the practitioner poses a serious risk to persons.[96] In respect of the TS notification, because no determination is being made as to whether the conduct occurred or did not occur, it is not possible to conclude that a chaperone is an ineffective measure.[97] 
  3. [158]
    The Board submits that careful scrutiny of the available material in this matter cannot overcome the volume of unrelated complaints made absent any suggestion of collusion or malice and the weight as much carries.[98]
  4. [159]
    In coming to a conclusion about whether the Tribunal is satisfied:
    1. the practitioner presents a risk;
    2. what that risk is; and
    3. that risk is “of grave aspect; weighty or important; giving rise for apprehension; critical; to be considered as an extreme example of its kind”;

the Tribunal considers a number of matters.

  1. [160]
    The five current patients, considered individually (as summarised at paragraph [132] above) and collectively raise a risk that Dr Heath will communicate with female patients in an inappropriate way, in breach of the Code, through any one or more of a misplaced sense of humour[99](reference SC and RB)  through failing to establish the necessary connection with the patient to enable him to discuss clinically relevant matters in a way the patient feels comfortable with (as with TH) or by acting in a way that the patient considers ‘a bit off’ (as with RB).
  2. [161]
    The Tribunal concludes that the nature of the consultation (being one about contraceptive devices and, sometimes, involving an intimate examination) contributes to that risk where:
    1. every complaint currently made against Dr Heath involves only such a consultation and on occasions when other female registered practitioners have been present, they have observed that nothing inappropriate was said or done (MW and TS); however
    2. a number of the patients were having their first consultation with Dr Heath because their own doctor could not do the procedure (TH and SC) or it was otherwise their first visit to the practitioner (RB), and/or they have said they were anxious, stressed or nervous about the procedure (TS) or appeared to be so (MW). The Tribunal is of the view that miscommunication has the potential to be heightened where there is no pre-existing relationship, or when a patient may be hypervigilant, or both in a consultation of this type.
  3. [162]
    The likelihood of a miscommunication or inappropriate communication is not insignificant, given the number of current complaints. Balanced against that is that it appears on the evidence of one of the registered practitioners that Dr Heath has performed many of these types of consultations without apparent incident and Dr Heath’s unchallenged evidence is that he has performed over 10,000 procedures at the Nambour clinic.[100] 
  4. [163]
    The risk if inappropriate communication occurs is significant in terms of potential patient discomfort, and potential loss of confidence in the profession generally, but less likely to tell in long-term patient harm.
  5. [164]
    The Tribunal accepts that, arising from two of the complainants, there is a risk that Dr Heath’s communication may involve conduct which is inconsistent with standards set out in the Guidelines (SC and, to a lesser extent MW). The Tribunal adopts the same observation about the nature of the consultation contributing to that risk as set out above.  There is a lesser likelihood of these communications occurring than of generally inappropriate communication occurring, but the consequence of that risk may be more grave because of the sexual character such a communication would carry.
  6. [165]
    The Tribunal accepts there is a risk that the physical examination being performed may be misinterpreted by the patient to constitute inappropriate touching, (RB being unsure if the consultation in fact involved inappropriate touching and, in the event that a final arbiter of fact is not satisfied MW and TS were inappropriately touched, nonetheless MW and TS each say they experienced this). There is a significantly lesser risk that a physical examination may in fact involve inappropriate touching (MW and TS each asserting that it did, which in each case is contested by Dr Heath and the registered nurse who was present for the consultation). There is also evidence from each of the registered nurses that in all the consultations they have been present for with the practitioner, he has not engaged in inappropriate or sexually inappropriate behaviour. The Tribunal assesses the likelihood of a patient misinterpreting the practitioner’s actions as higher than the risk of actual inappropriate touching. The Tribunal assesses the seriousness of the consequence of either of these risks is potentially greater than in the case of the inappropriate comments, because of the challenge to the patient’s physical integrity.  
  7. [166]
    The established regulatory history bears on these risks in the following respects:
    1. the 2017 caution suggests that Dr Heath’s difficulties with inappropriate communication with female patients in consultations concerning contraceptive devices are ongoing. That heightens somewhat the risk of further inappropriate communications occurring;
    2. the circumstances giving rise to the 2022 reprimand do not tell on some wider risk that Dr Heath will behave inappropriately towards female patients in consultations or that he generally has difficulties with professional boundaries;
    3. the cautions for failing to comply with the timeframes to nominate a mentor, where an identified mentor was ultimately approved, and for failing to lodge senior practitioner forms (being one day late) are not of such a magnitude that they satisfy the Tribunal Dr Heath will be unable or unwilling to comply with any restrictions imposed on him;
    4. the Tribunal does not take into account the undetermined referrals or the as yet unreferred matters (being those matters set out at paragraphs 13a, b and i of the letter of the Board dated 15 March 2024)[101] as there is inadequate information about each of those matters to enable it to make any informed conclusion as to how they bear on the question of any risk arising out of the notifications of the five patients.
  8. [167]
    Weighing these findings, the Tribunal rejects the Board’s submission that the relevant serious risk implied on the material before the Tribunal is that Dr Heath will engage in a sexualised boundary violation with a patient who is a woman, which could range in seriousness from the making of inappropriate and/or sexualised comments through to the committing of a sexual assault.
  9. [168]
    The Tribunal is, however, satisfied, given the number of complaints and the 2017 caution that there is a serious risk Dr Heath will communicate inappropriately with female patients in consultations about contraceptive devices and that, consequently, his actions may give rise to concerns in the patients about the propriety of the consultations. The Tribunal considers that risk is greatest in the form of inappropriate statements he is likely to make to patients.

Is it necessary to take immediate action to protect public health and safety? 

  1. [169]
    Having determined Dr Heath poses a serious risk, the Tribunal determines it is necessary, given the protective objects of the regulatory scheme, to take immediate action to protect public health or safety. 

What is the least onerous action which can be taken to protect against the relevant risk? 

  1. [170]
    That action needs to be that which is least onerous to Dr Heath, yet is still effective to protect against the risk.
  2. [171]
    In the Reconsideration Decision, the Board determined a condition limited to treating or consulting concerning contraceptive devices would be insufficient because:
    1. monitorability was questionable in terms of:
      1. the difficulty in staff ascertaining the purpose of an appointment; and
      2. such a restriction would have relied on Dr Heath’s honesty and there was no proposal for any oversight; and
    2. the actual conduct complained of was inappropriate comments or touching of female patients.[102]
  3. [172]
    It formed broadly the same views on a condition restricting intimate examinations.[103]
  4. [173]
    When pressed in oral argument, the Board submitted that its opposition to a condition limited to restrictions on the type of consultation was based on Dr Heath’s history of non-compliance[104] which I have dealt with above. I am not persuaded that, properly analysed on the information presently before the Tribunal, it supports a submission that Dr Heath cannot be relied upon to comply with conditions of a limited nature imposed on him.
  5. [174]
    Based on the assessed serious risk together with its assessment of likelihood and consequence, the Tribunal determines that the least onerous action it can take to mitigate against the identified serious risk is to prohibit Dr Heath from consulting with female patients about contraceptive devices (which will cover both consultations such as that involving TH and SC which were for information, as well as procedural consultations where there is an intimate examination). Dr Heath has previously indicated a willingness to provide an undertaking to this effect.[105]  One issue which needs to be addressed in addition to the matters set out in that undertaking is how female patients are notified of the limitation without exposing their confidential information. Another is as to the duration of the conditions.
  6. [175]
    The Tribunal also proposes to require Dr Heath to undergo some further education about appropriate and effective communication.
  7. [176]
    To that end, the Tribunal has prepared a form of proposed draft conditions which it will hear the parties on.
  8. [177]
    Subject to the finalisation of the conditions, the Tribunal anticipates that, in so far as issues are raised in this proceeding, Dr Heath will return to practice from the practices he owns and operates with immediate effect.

ANNEXURE A — CONDITIONS

RESTRICTIONS ON PRACTICE

  1. The practitioner must not treat, consult, discuss or engage with female patients about, or in relation to contraceptive devices.
  2. To ensure that each female patient is made aware prior to any consultation following the commencement of these conditions that the practitioner will not treat, consult, discuss or engage with female patients about, or in relation to contraceptive devices the practitioner must within 5 days of the imposition of these conditions:
  1. cause to be placed on the homepage of the practice website a notice notifying patients of the practice that the practitioner will not treat, consult, discuss or engage with female patients about, or in relation to contraceptive devices; and
  2. cause to be included in any recorded message played to patients as hold music on the practitioner’s practice telephone system a statement notifying patients of the practice that the practitioner will not treat, consult, discuss or engage with female patients about, or in relation to contraceptive devices; and
  3. require any staff member the practitioner employs who is responsible for scheduling appointments to inform all female patients at the time of making a booking that the practitioner will not treat, consult, discuss or engage with female patients about, or in relation to contraceptive devices; and
  4. cause an A4 notice to be placed at reception and in all consultation and treatment rooms stating that the practitioner will not treat, consult, discuss or engage with female patients about, or in relation to contraceptive device.
  1. Within seven (7) days of the imposition of these conditions, the practitioner must provide to Ahpra, on the approved form (HP7) acknowledgement that Ahpra may:
  1. Seek reports from the Director of Medical Services/Senior Practice Manager/Senior Manager/Senior Partner/proprietor/owner/partner in ownership/other as appropriate (the senior person) at each place of practice on at least a monthly basis or as otherwise required.
  2. Request and access from the senior person at each place of practice copies of rosters, pay slips, or the equivalent.
  3. Have contact with and access information from, where relevant, Medicare, private health insurers and/or practice billing data.
  1. Within seven (7) days of the notice of the imposition of these conditions 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.
  2. Within seven (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 the 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 or confirm that the senior person has received a copy of the conditions from the practitioner. The practitioner will provide the same form:
  1. within seven days of the commencement of practice at each subsequent place of practice, and
  2. within seven days of each and every notice of any subsequent alteration of these conditions.

FURTHER EDUCATION

  1. The Practitioner must undertake and successfully complete a program of education, approved by the Medical Board of Australia and including a reflective practice report, in relation to appropriate and respectful communications with patients.

The education must consist of a minimum number of 6 one hour sessions completed over a 6 month period.

Within four weeks of the notice of the imposition of these conditions, the Practitioner must, on the approved form (HPN11):

  1. nominate a person(s) to be approved by the Board to act as educator, and
  2. provide acknowledgement that Ahpra will obtain a report from the approved educator at the conclusion of the education.

The Practitioner must ensure that the nomination of an educator is accompanied by acknowledgement, on the approved form (HPNA11), from the nominated educator and by an education plan outlining the form the education will take and how the topics of the education will be addressed.

Within twelve months of the notice of the Board’s approval of the education, the Practitioner is to provide:

  1. evidence of the successful completion of the education:
  2. A report demonstrating, to the satisfaction of the Board, that the Practitioner has reflected on the issues that gave rise to this condition requiring they undertake education and how the Practitioner has incorporated the lessons learnt in the education into the Practitioner’s practice.

DURATION OF CONDITIONS

  1. These conditions will continue to have effect until:
  1. further order of the Tribunal following an application by either the practitioner or the Medical Board of Australia, or referral by the Medical Board of Australia to the Tribunal; or
  2. the Medical Board of Australia revokes the conditions pursuant to s 159(2)(b) of the Health Practitioner Regulation National Law (Queensland).
  1. All costs associated with compliance with the undertaking are at the practitioner’s own expense.

In accordance with section 225 of the National Law the practitioner acknowledges that the public national register will record that these conditions apply to his registration.

Footnotes

[1]Pursuant to s 23 of the Queensland Civil and Administrative Tribunal Act 2009 (Qld) (‘QCAT Act’).

[2]QCAT Act s 23(4)(a).

[3]Affidavit of Richard John Heath affirmed 18 March 2024 (‘Second Heath Affidavit’), [5]–[32].

[4]Hearing Bundle (‘HB’) p 042.

[5]Transcript of proceedings, 26 March 2024 (‘Transcript’), T 1-5, lines 13–18, T 1-52, lines 25–47.

[6]Board’s Outline of Submissions on the Immediate Action Review (‘Board’s submissions’), [28]–[31]. This is a different risk from that identified by the Board in the Reconsideration Decision but the applicant accepts that the Board is entitled to seek to support the Reconsideration Decision on a basis where the risk is differently articulated from that which is contained in the Reconsideration Decision: Transcript T 1-6, lines 35–42.

[7]Board’s submissions, [40].

[8]QCAT Act s 19(c).

[9]QCAT Act s 20(1).

[10]QCAT Act s 20(2).

[11]Pearse v Medical Board of Australia [2013] QCAT 392 (‘Pearse’), [40].

[12]Ladhams v Medical Board of Australia (No 2) [2014] QCAT 286 (‘Ladhams’), [47].

[13]AMS v Medical Radiation Practice Board of Australia [2019] QCAT 400 (‘AMS’), [34]; Pawape v Medical Board of Australia [2023] QCAT 262 (‘Pawape’), [27].

[14]QCAT Act s 24(1).

[15]Pawape, [29]–[31]; cf Colagrande v Health Ombudsman [2017] QCAT 107 (‘Colagrande’), [5].

[16]TXA v Medical Board of Australia [2021] QCAT 279 (‘TXA’), [8]; Health Ombudsman v Wallace [2020] QCAT 286 (‘Wallace’), [10].

[17]CJE v Medical Board of Australia (Review and Regulation) [2019] VCAT 178 (‘CJE’), [25]; Loney v Nursing and Midwifery Board of Australia [2020] QCAT 486 (‘Loney’), [7].

[18]Liddell v Medical Board of Australia [2012] WASAT 120 (‘Liddell’); WD v Medical Board of Australia [2013] QCAT 614 (‘WD’).

[19]WD, [8].

[20]CJE, [28]–[29].

[21]Colagrande, [18].

[22]Health Ombudsman v MacBean [2019] QCAT 300 (‘MacBean’), [14]; LCK v Health Ombudsman [2020] QCAT 316 (‘LCK’), [33]; Loney, [10].

[23]Oglesby v Nursing and Midwifery Board of Australia [2014] QCAT 701 (‘Oglesby’), [20].

[24]Peters v Medical Board of Australia [2020] QCAT 169 (‘Peters’), [33].

[25]Ibid, [34].

[26]National Law s 41.

[27]HB, p 369.

[28]Ibid, p 370.

[29]Ibid.

[30]Ibid, p 374 (emphasis in original).

[31]Ibid, p 380.

[32]Ibid, p 383.

[33]HR Act s 9(4)(b).

[34]Ibid, ss 8(b) and 13(2).

[35]Ibid, s 48.

[36]Ibid, s 58.

[37]National Law s 3A

[38]Ibid, pp 152–153.

[39]Ibid, p 201 [10].

[40]Ibid, pp 204–205 [10]–[12].

[41]Ibid, p 201 [14]; In her initial oral complaint she could not recall this; she could only recall use of the word ‘fucking’ in the context of the comment about his daughter.

[42]Ibid, p 201 [13]–[14].

[43]Ibid, p 201 [15].

[44]Ibid, p 201-202 [15] and [16].

[45]Affidavit of Richard John Heath affirmed 18 January 2024 (‘First Heath Affidavit’), [58]–[60]; within Section 21(2)(b) bundle, Tab 22.

[46]HB, p 202 [19].

[47]Ibid, p 202 [19].

[48]Ibid, p 202 [24]–[26].

[49]Ibid, p 202 [24]–[26].

[50]Ibid, p 205 [13].

[51]Ibid, p 202 [27].

[52]Reconsideration Decision, [7ai] and [7ci].

[53]Reconsideration Decision [2ai] and [6], where there is a reference to ‘further information and documentation’, suggesting that all the preceding information was also relied on.

[54]Reconsideration Decision [7b] does not cite it but, whilst it is not a comment, it is set out in [7ai].

[55]Reconsideration Decision, [7ai].

[56]Board’s submissions, [28].

[57]HB, p 149.

[58]Ibid.

[59]Reconsideration Decision, [7aii].

[60]Reconsideration Decision, [7cii].

[61]Transcript, T 1-8 lines 21–25.

[62]Section 21(2)(b) Bundle filed 22 December 2023 (‘Section 21(2)(b) Bundle’), Tab 37, p 2.

[63]Section 21(2)(b) Bundle, Tab 37, pp 1 and 5.

[64]HB, p 93 [17].

[65]Ibid, [19].

[66]Reconsideration Decision, [7aiii] and [7bi]. The word cervix is missing from [7aiii].

[67]HB, p 372.

[68]Ibid, p 151.

[69]Transcript, T 1-26 lines 4–8 and 22–35.

[70]HB, p 194 [17]–[19].

[71]Ibid, [22]–[24].

[72]Ibid, [25].

[73]Ibid, [26].

[74]Ibid, [27].

[75]First Heath Affidavit, [144].

[76]Reconsideration Decision, [7aiv].

[77]Reconsideration Decision, [7bii].

[78]Reconsideration Decision, [7ciii].

[79]HB, p 192.

[80]Transcript, T 1-24 lines 38–41.

[81]HB, pp 220-222 [12]–[33].

[82]Ibid, p 221 [17].

[83]Dental Board of Queensland v B [2004] 1 Qd R 254; [2003] QCA 294 (‘B’), [20] (Fryberg J, McPherson JA and Muir J concurring).  The terms of section 34 of the Health Practitioners (Professional Standards) Act 1999 (Qld) which provided for the Functions and powers of assessors are set out at [21] of that judgment.

[84]National Law ss 140(b) and 141(1)(a).

[85]Transcript, T 1-18 lines 42–43.

[86]HB, pp 133–142.

[87]Section 21(2)(b) Bundle, Tab 15.

[88]Board’s submissions, [17].

[89]Transcript, T 1-32 lines 44–45.

[90]Ibid, T 1- 46 lines 13–16.

[91]The Board conceded that it was not relying on the matters set out at [13j] of its letter and the Tribunal has had no regard to them.

[92]That the Board had made this decision was evidence given from the Bar table. The practitioner also refers to this apparent decision of the Board at [56] of the Second Heath Affidavit.

[93]Second Heath Affidavit, [56]–[57].

[94]Section 21(2)(b) Bundle, Tab 18.

[95]Section 21(2)(b) Bundle, Tab 20.

[96]Transcript, T 1-54 lines 13 - 24.

[97]Ibid, T 1-54 lines 30–43.

[98]Board’s submissions, [26].

[99]See, e.g. SC ([61]–[67] above) and RB ([86]–[98] above), who thought the practitioner was joking but that it was not funny.

[100]First Heath Affidavit, [58].

[101]HB, p 039, noting the Board did not rely on the matters set out at [13j].

[102]Reconsideration Decision, [11a].

[103]Ibid, [11b].

[104]Transcript, T 1-41 lines 14–23, T 1-46 line 13 – T 1-47 line 2.

[105]HB, p 171.

Close

Editorial Notes

  • Published Case Name:

    Heath v Medical Board of Australia

  • Shortened Case Name:

    Heath v Medical Board of Australia

  • MNC:

    [2024] QCAT 163

  • Court:

    QCAT

  • Judge(s):

    Judge Dann, Deputy President

  • Date:

    02 May 2024

Litigation History

EventCitation or FileDateNotes
Primary Judgment[2024] QCAT 16302 May 2024-
Notice of Appeal FiledFile Number: CA 6920/2430 May 2024-
Appeal Discontinued (QCA)File Number: CA 6920/2421 Oct 2024-

Appeal Status

Appeal Discontinued (QCA)

Cases Cited

Case NameFull CitationFrequency
AMS v Medical Radiation Practice Board of Australia [2019] QCAT 400
2 citations
Jump To
Cite 1 - [2019] QCAT 400
Cite 2 - [2019] QCAT 400
CJE v Medical Board of Australia [2019] VCAT 178
2 citations
Jump To
Cite 1 - [2019] VCAT 178
Cite 2 - [2019] VCAT 178
Colagrande v Health Ombudsman [2017] QCAT 107
2 citations
Jump To
Cite 1 - [2017] QCAT 107
Cite 2 - [2017] QCAT 107
Dental Board of Queensland v B[2004] 1 Qd R 254; [2003] QCA 294
4 citations
Jump To
Cite 1 - [2003] QCA 294
Cite 2 - [2003] QCA 294
Cite 3 - [2004] 1 Qd R 254
Cite 4 - [2004] 1 Qd R 254
Health Ombudsman v MacBean [2019] QCAT 300
2 citations
Jump To
Cite 1 - [2019] QCAT 300
Cite 2 - [2019] QCAT 300
Health Ombudsman v Wallace [2020] QCAT 286
2 citations
Jump To
Cite 1 - [2020] QCAT 286
Cite 2 - [2020] QCAT 286
Ladhams v Medical Board of Australia (No 2) [2014] QCAT 286
2 citations
Jump To
Cite 1 - [2014] QCAT 286
Cite 2 - [2014] QCAT 286
LCK v Health Ombudsman [2020] QCAT 316
2 citations
Jump To
Cite 1 - [2020] QCAT 316
Cite 2 - [2020] QCAT 316
Liddell v Medical Board of Australia [2012] WASAT 120
2 citations
Jump To
Cite 1 - [2012] WASAT 120
Cite 2 - [2012] WASAT 120
Loney v Nursing and Midwifery Board of Australia [2020] QCAT 486
2 citations
Jump To
Cite 1 - [2020] QCAT 486
Cite 2 - [2020] QCAT 486
Oglesby v Nursing & Midwifery Board of Australia [2014] QCAT 701
2 citations
Jump To
Cite 1 - [2014] QCAT 701
Cite 2 - [2014] QCAT 701
Pawape v Medical Board of Australia [2023] QCAT 262
2 citations
Jump To
Cite 1 - [2023] QCAT 262
Cite 2 - [2023] QCAT 262
Pearse v Medical Board of Australia [2013] QCAT 392
2 citations
Jump To
Cite 1 - [2013] QCAT 392
Cite 2 - [2013] QCAT 392
Peters v Medical Board of Australia [2020] QCAT 169
2 citations
Jump To
Cite 1 - [2020] QCAT 169
Cite 2 - [2020] QCAT 169
TXA v Medical Board of Australia [2021] QCAT 279
2 citations
Jump To
Cite 1 - [2021] QCAT 279
Cite 2 - [2021] QCAT 279
WD v Medical Board of Australia [2013] QCAT 614
2 citations
Jump To
Cite 1 - [2013] QCAT 614
Cite 2 - [2013] QCAT 614

Cases Citing

Case NameFull CitationFrequency
Health Ombudsman v Heath; Medical Board of Australia v Heath [2024] QCAT 3033 citations
1

Require Technical Assistance?

Message sent!

Thanks for reaching out! Someone from our team will get back to you soon.

Message not sent!

Something went wrong. Please try again.