Civil and Administrative Tribunal New South Wales Medium Neutral Citation: Segal v Medical Council of New South Wales [2020] NSWCATOD 86 Hearing dates: 17 July 2020 and 24 July 2020 Date of orders: 30 July 2020 Decision date: 30 July 2020 Jurisdiction: Occupational Division Before: Boland AM ADCJ, Deputy President Decision: (1) Application for a Stay is refused. (2) The costs of the Stay Application are reserved. (3) It is noted that on 24 July 2020 the appeals by Dr Shaun Segal under s 159 and s 159B of the Health Practitioner Regulation National Law were expedited. Catchwords: HEALTH – professional registration and discipline – complaints – medical practitioner – where delegates ordered suspension of practitioner – application for a stay of suspension pending hearing of an appeal under s 159B of the Health Practitioner Regulation National Law Legislation Cited: Civil and Administrative Tribunal Act 2013 (NSW) Health Practitioner Regulation National Law (NSW) Medical Practice Act 1992 (NSW) (repealed) Cases Cited: Ghosh v Medical Council of New South Wales [2020] NSWCA 122 Health Care Complaints Commission v Karalasingham [2007] NSWCA 267 Hill v Medical Council of NSW [2019] NSWCATOD 52 House v The King (1936) 55 CLR 499; [1936] HCA 40 Kirby v Dental Council of NSW [2020] NSWCA 91 Legal Services Commissioner v Barker [2005] QCA 482 Liu v Chinese Medical Council of NSW [2019] NSWCATOD 13 Medical Council of New South Wales v Lee [2017] NSWCA 282 Minister for Immigration and Border Protection v Eden [2016] FCAFC 28 New South Wales Bar Association v Stevens [2003] NSWCA 95 Pharmacy Council of NSW v Ibrahim [2020] NSWSC 708 QSuper Board v Australian Financial Complaints Authority Limited [2020] FCAFC 55 Robb v Law Society of the Australian Capital Territory (Federal Court of Australia, 21 June 1996, unreported) Steel v Medical Council of New South Wales [2020] NSWCATOD 77 Taylor v Medical Board of Australia [2018] NSWCATOD 50 Windsor v Health Care Complaints Commission [2020] NSWCA 110 Texts Cited: Nil Category: Procedural and other rulings Parties: Dr Shaun Segal (Applicant) Medical Council of New South Wales (Respondent) Representation: Counsel: P Griffin SC with Dr P Dwyer (Applicant) D Forrester (Respondent) Solicitors: HWL Ebsworth Lawyers (Applicant) Health Professional Councils Authority (Respondent) File Number(s): 2020/00207196 Publication restriction: Pending further order, pursuant to s 64 of the Civil and Administrative Tribunal Act 2013 (NSW) an order is made prohibiting publication of the name of the patient or persons other than Dr Shaun Segal referred to in the delegates' reasons dated 7 July 2020. REASONS FOR DECISION Introduction 1. Dr Shaun Segal (the practitioner) is a registered medical practitioner and a Fellow of the Royal Australian College of General Practitioners. He carries on practice in the field of skin cancer medicine and surgery. On 22 June 2020, following a hearing before delegates of the Medical Council of New South Wales (the Council), the practitioner's registration was suspended. 2. On 14 July 2020 the practitioner filed an external appeal in the Tribunal under s 159 and s 159B of the Health Practitioner Regulation National Law (the National Law). On the same day he filed an application for a stay of the suspension order pending determination of his appeal under s 159B. 3. The stay application came before me for hearing on 17 July 2020 by Audio Visual Link. I heard preliminary submissions and granted leave to the practitioner to file amended Grounds of Appeal and further submissions in support of his stay application. I also provided for additional submissions on the stay application to be made on behalf of the Council and adjourned the matter for further hearing on 24 July 2020. Background 1. The following facts are extracted from the delegates' reasons or material before them at the hearing convened under s 150 of the National Law and the Affidavit of the practitioner sworn 14 July 2020. 2. The practitioner is presently aged 46 years. He obtained the degrees of Bachelor of Medicine and Bachelor of Surgery from the University of Witwatersrand, South Africa in 1997. He thereafter, in 1999, moved to the United Kingdom where he asserts he completed his surgical rotation. 3. In 2008 the practitioner moved to Australia and obtained his fellowship of the Royal Australian College of General Practitioners. In 2018 he completed a diploma of skin cancer and in 2020 attained Fellowship of the Australian College of Cutaneous Oncology. 4. The practitioner carries on practice at several locations in the Sydney metropolitan area including in Rose Bay, NSW. At the Rose Bay practice the practitioner now engages exclusively in skin cancer procedures. In earlier years at this practice the practitioner saw general practice patients on an urgent basis when no other general practitioner was available. 5. On 23 May 2020 the Health Care Complaints Commission (HCCC) received a written complaint by a woman about the practitioner. I will refer to the woman as Patient A. The complaint was referred to the Council. Patient A asserts that she engaged in a sexual relationship with the practitioner between October 2016 and April 2019. Patient A states that on Sunday 30 October 2016 the practitioner brought her into the Rose Bay practice through the back entrance having first turned off the security camera and they engaged in oral sex. Patient A says the practitioner's practice manager made appointments to fit her in between patients and that she and the practitioner engaged in sex at the practice. She says she was bulk billed for appointments. She also asserts the practitioner "spread a horrible rumour" about her after she commenced a relationship with her partner. She asserts the practitioner engaged in "predatory and grooming behaviour". 6. The practitioner denies that he had a sexual relationship with the patient. He does not dispute that he saw Patient A as a patient, provided prescriptions for her and they engaged in regular telephone conversations. The delegates' reasons – a summary 1. It is not necessary for the purposes of this stay application that I record in detail the delegates' reasons. However, aspects of the reasons are pivotal to the points of law appeal and hence relevant to the stay application. 2. The delegates' reasons follow a "template" form which was subject of extensive consideration in Steel v Medical Council of New South Wales [2020] NSWCATOD 77. In particular they pose two questions which do not reflect the language of s 150 namely "Does the practitioner's practise accord with the public interest" and "Is it appropriate that Dr Segal's registration be suspended" "If not are there conditions that could be imposed to minimise that risk" [my emphasis]. 3. After referring to the nature and places of the practitioner's practice, the delegates refer to the practitioner's health noting that, in 2017, he commenced seeing a psychologist after his wife noticed he had been communicating with Patient A on his personal mobile phone. The practitioner is recorded as having engaged in discussions about "boundary setting" with the psychologist. 4. The reasons also note that between 2013 and 2014 the practitioner consulted a psychiatrist at a time of a complaint made against him by a staff member of the clinic at which he then practised and when criminal charges were laid against him arising out of the complaint. I will refer to this woman as Person B. 5. At page 4 of their reasons, the delegates particularise the complaint made by Patient A. The reasons record Patient A's assertions that she performed oral sex on the practitioner in his rooms on 30 October 2016 and that they engaged in other sexual encounters at his home and at the Rose Bay practice. Patient A is recorded as asserting the practitioner prescribed oral contraceptives for her. 6. The delegates record that the practitioner denies a sexual relationship with Patient A but that he admits to long telephone conversations her and referring her to his treating psychiatrist. 7. The delegates record that the practitioner's evidence is that he first saw Patient A in October 2016 at Rose Bay when he attended her child who had suffered an injury. 8. The delegates refer to their examination of the clinical records for Patient A, and note the practitioner's acknowledgement that his record keeping of consultations with Patient A was of a poor standard. 9. The delegates also note the practitioner's evidence that he had received a text message from Patient A and that he had conversations with her as he was driving to and from work. The delegates also record the practitioner's explanation that he was fascinated by Patient A's stories about her personal life and that he accepted he had allowed the doctor-patient boundary to become blurred. 10. The delegates record their questioning of the practitioner about why he had continued to see Patient A when he claimed he only saw urgent one-off cases as a general practitioner and when he had received past advice from the Council, his psychologist and psychiatrist about the importance of maintaining doctor-patient boundaries. The delegates also note they had expressed their concern to the practitioner that he had assumed a therapeutic role and his lack of qualifications for that role. 11. At page 6, the delegates canvass the practitioner's evidence about his nurse who attends all his skin cancer locations and then referred to the letter from the nurse who has worked for the practitioner since April 2016. They note the nurse advised she was "unaware of Dr Segal undertaking a sexual relationship with a patient". The delegates explain the nurse also recorded that the practitioner does not lock the doors of his consulting room. They then record the practitioner's evidence about what occurred if the nurse came in to his room during a consultation with Patient A. The delegates said that they found it "unusual" that the nurse would be "walking in and out of the room whilst these discussions were occurring. Dr Segal advised that when the nurse entered the room, [Patient A] would 'switch off'." [original emphasis] 12. Thereafter, the delegates refer to the practitioner's records of his work commitments. They explain the practitioner submitted these records to support his contention that he could not have attended Patient A's home for sex on the dates she stipulated because of his work commitments. The delegates conclude "It is noted this evidence does not account for the entirety of Dr Segal's day, however does account for his work hours on the dates named by [Patient A]". 13. The delegates then record their criticism of the practitioner for referring Patient A to his own treating psychiatrist and concluded this was "a conflict of interest". They also conclude that the practitioner had acted inappropriately in engaging in long telephone counselling sessions, outside the clinical context, with Patient A and "determined that these actions were unsatisfactory and breached doctor-patient boundaries". 14. The delegates then consider the relevance of the practitioner's prior complaints history with the Council noting that the complaints "suggest a similar pattern of behaviour over a significant period of time, particularly where the themes appear to be of a similar nature". 15. The delegates note a complaint of sexual harassment in 2011, an anonymous complaint alleging sexual harassment and inappropriate relationships with patients and staff in 2013, complaints of a 19 year old employee who made allegation of indecent assault on three occasions in 2013 (Person B) and finally a complaint by the Operations Manager at a clinic where the practitioner formerly practised which alleged inappropriate relationships with staff and sexual harassment of staff in 2013. 16. Thereafter, the delegates consider, in some detail, the complaints made by an employee of a clinic at which the practitioner was practising in 2011 (Person C). The delegates noted that in a conduct interview before the Council the practitioner had acknowledged his errors in respect of Person C in "blurring the boundaries of their relationship". 17. The delegates noted the similar features to those in the current complaint including a lack of record keeping, the development of a "friendship" where conversations about private matters were occurring, and his subsequent consultations with a psychologist to discuss boundary crossing issues. 18. Thereafter, the delegates discuss the anonymous complaint and the complaint made by the former operations manager of the clinic, including a complaint that no actions had been taken by the directors of the clinic, and that used condoms and lubricants were found in the practitioner's office bin. 19. The delegates record the practitioner's response to these complaints, namely, that there had been a toxic culture with employees on a "witch hunt" and that the other directors took no action on the complaints, finding them to be baseless. The delegates record that the practitioner explained the staff requests for a pay rise had been refused and they were disgruntled. 20. The delegates then record their examination of the 2013 complaints by the 19 year old staff member, Person B, which resulted in criminal charges against the practitioner. The delegates record that the practitioner explained this woman was one of the "disgruntled staff" and that she "consequently admitted that she 'made it up in court'". After recording the submissions of the practitioner's counsel about the dismissal of the charges the delegates explain: The delegates were unable to make any assessment of what occurred with the criminal charges, as no documentation was available for this hearing. It is however noteworthy to highlight that the Medical Council is not bound by decisions or outcomes of other jurisdictions or regulatory bodies, and the role of the delegates is to undertake a risk assessment and determine appropriate action for the health and safety of the public, or otherwise in the public interest. 1. The delegates thereafter record that they did not accept the practitioner's evidence that the complaints were all vexatious and made in an attempt at revenge by disgruntled employees. 2. The delegates explain at pages 11-12: It did not seem plausible that a number of individuals would make similar complaints relating to Dr Segal's inappropriate behaviour of a sexual nature over an extended period of time and that all these individuals were, as Dr Segal contends, lying. 1. The delegates then pose the question "Does Dr Segal pose a risk to the health and safety of the public?" The delegates then set out, in some detail, the submissions made by counsel for the practitioner, including the support for the practitioner's version from the clinical notes of his psychologist, the reference from his practice nurse, together with the letter from the principal of the Rose Bay practice which confirmed the security cameras at the premises are unable to be manually turned off and the lack of any complaints by patients. 2. The delegates, however, explain they did not find the practitioner's evidence to be persuasive. They conclude that the practitioner did have an inappropriate relationship with Patient A. The delegates go on to express concern because boundary issues and inadequate record keeping issues had been raised on several occasions in the past with the practitioner. They note the practitioner said he had learnt from the experience and would change his behaviour and practice. 3. The delegates conclude that the practitioner had not heeded advice he had been given and that they could not express "any confidence" in the practitioner's assertions he would not engage in this behaviour again. The delegates then conclude that the practitioner "does pose a risk to the health and safety of the public". 4. The delegates then pose the question "What is in the public interest?" The paragraph which follows in the reasons is identical to that of the reasons of the delegates in Steel v Medical Council of New South Wales and I repeat the comments made in that decision at [51]. The delegates then canvass the topic of whether the practitioner's practise accords with the public interest. They conclude the conduct would not be deemed acceptable of a medical practitioner by the public, that his actions were in breach of the Medical Board of Australia's Code of Conduct and also the Guidelines to Sexual Boundaries in the Doctor-Patient relationship. 5. The delegates make extensive comments about the confidence and trust the public repose in the medical profession, and that practitioners will not take advantage of the public. The delegates express concern, given the complaints over a period of time from multiple complainants, that the practitioner may lack a commitment to ethical behaviour towards patients. 6. The delegates concluded their assessment of the public interest as follows: The community trusts health practitioner because they believe that, in addition to being competent, health practitioners will not take advantage of them and will display qualities such as respect, propriety and integrity. The recurrent allegations against Dr Segal, of inappropriate behaviour over an extended period of time, from multiple complainants, raises the concern that Dr Segal may lack a commitment to ethical behaviour towards patients, and also lack of insight into his own deficiencies in this critical area. The delegates formed the view that in light of the accusations made against him over an extended period, Dr Segal's ability to make decisions in the best interests of patients is called into question. Additionally, the delegates determined a failure to act in these circumstances would erode the confidence of the public in the medical profession, particularly in light of Dr Segal's complaints history and failure to remediate despite the intervention of the Medical Council, and treatment and counselling by a psychologist and psychiatrist. 1. Based on their conclusions the delegates explain that they determined it was appropriate to take action in the public interest. 2. The delegates then posed the question "Is it appropriate that Dr Segal's registration be suspended?" 3. The delegates note it is not their role to make findings of fact but rather to undertake a risk assessment and to determine what action is appropriate in the circumstances. 4. Ultimately, the delegates explain why, although there were inconsistencies in the details of Patient A's account, "the differences do not discount the general elements of the complaint". The delegates record that they accept, on balance, Patient A's account to be plausible. 5. The delegates conclude their reasons explaining that they determined action was required in the public interest and that the practitioner posed a risk to the health and safety of the public. The delegates state: Given that the protection of the public is of paramount consideration, the delegates determined that the only action appropriate in the circumstances was to suspend Dr Segal's registration. Principles relevant to the granting of a stay and relevant statutory provisions 1. It is undisputed that the Tribunal's only power under the National Law to grant a stay is pending the hearing of an appeal on a question of law under s 159B (see Medical Council of New South Wales v Lee [2017] NSWCA 282). The principles applicable to this stay application are subject of well-established authority. I repeat my summary of the authorities as set out Taylor v Medical Board of Australia [2018] NSWCATOD 50 at [10]-[11]. The relevant principles to be applied in determining a stay application in the context of a commercial dispute were set out in this Tribunal by Wright J in Bentran Pty Ltd v Sabbarton [2014] NSWCATAP 37. That decision refers to a number of authorities on the topic of stays including Alexander v Cambridge Credit Corporation Ltd (1985) 2 NSWLR 685. Additional considerations apply to matters which may affect the public (see NSW Bar Association v Stevens [2003] NSWCA 95 at [91] and Kirbach v Health Care Complaints Commission [2015] NSWCATAD 195). In this and in all matters under the National Law the Tribunal is required to apply the objective and guiding principle set out in s 3A. Section 3A provides as follows: 3A Objective and guiding principle [NSW] In the exercise of functions under a NSW provision, the protection of the health and safety of the public must be the paramount consideration. The general principles to be applied in considering whether to grant or refuse a stay are summarised by the Full Court of the Family Court in Aldridge v Keaton (Stay Appeal) [2009] FamCAFC 106. While the Full Court refers to the taking into account the best interests of a child in parenting proceedings as a paramount consideration, similarly in applications under the National Law third party interests (the health and safety of the public) are the paramount consideration. The Full Court explained at [18]: The principles to be applied in determining an application for a stay of orders both in the general law and in respect of parenting proceedings are also well known (see The Commissioner of Taxation of the Commonwealth of Australia v Myer Emporium Limited [No.1] [1986] HCA 13; (1986) 160 CLR 220 at 222; Alexander v Cambridge Credit Corporation (1985) 2 NSW LR 685; Jennings Construction Limited v Burgundy Royale Investments Pty Limited [1986] HCA 84; (1986) 161 CLR 681; Clemett & Clemett [1980] FamCA 90; (1981) FLC 91-013; JRN & KEN v IEG & BLG (1998) 72 ALJR 1329 at 1332). The authorities stress the discretionary nature of the application which should be determined on its merits. Principles relevant to this matter include the following: • a person who has obtained a judgment is entitled to presume the judgment is correct; • the mere filing of an appeal is insufficient to grant a stay; • the onus to establish a proper basis for the stay is on the applicant for the stay. However it is not necessary for the applicant to demonstrate any "special" or "exceptional" circumstances; • a person who has obtained a judgment is entitled to the benefit of that judgment; • the bona fides of the applicant; • a stay may be granted on terms that are fair to all parties - this may involve a court weighing the balance of convenience and the competing rights of the parties; • a weighing of the risk that an appeal may be rendered nugatory if a stay is not granted - this will be a substantial factor in determining whether it will be appropriate to grant a stay; • some preliminary assessment of the strength of the proposed appeal - whether the appellant has an arguable case; • the desirability of limiting the frequency of any change in a child's living arrangements; • the period of time in which the appeal can be heard and whether existing satisfactory arrangements may support the granting of the stay for a short period of time; and • the best interests of the child the subject of the proceedings are a significant consideration. 1. Of particular relevance in this stay application are the principles espoused by Spigelmen CJ in New South Wales Bar Association v Stevens [2003] NSWCA 95 at [90]-[104] and at [106]. His Honour explained at [91]: The relevant authorities indicate that the protection of the public is a matter entitled to significant weight on an application for a stay once it appears that a professional person has acted improperly to a substantial degree. 1. Later, at [103]-[104] his Honour further referred to the importance of public interest considerations as follows: The significance of the public interest dimension in the exercise of the discretion to grant a stay in such circumstances, was highlighted by Kirby J in Bryant v Commonwealth Bank of Australia (1996) 70 ALJR 306 at 309 where his Honour said: "In the exercise of the jurisdiction to provide a stay, it has often been emphasised that cases involving a stay of the operation of the criminal law or of laws designed to protect the public (e.g. deregistration of a professional lawyer or medical practitioner) are in a class different from cases involving no more than the suspension of the operation of orders affecting two private litigants only." It is clear from this consideration of the authorities that each case must turn on its specific facts. The range of relevant considerations is broad. Nevertheless the fact that the issues involved in professional rights to practice concern the protection of the public, means that the public interest is always entitled to significant weight. 1. I also have regard to the decision of Legal Services Commissioner v Barker [2005] QCA 482 and in particular the discussion in that decision of a stay in the context of a legal practitioner where protection of the public is a relevant consideration. Other authorities in this Tribunal also stress the unique considerations to be taken into account in considering a stay involving a health professional (see Liu v Chinese Medicine Council of NSW [2019] NSWCATOD 13; Hill v Medical Council of NSW [2019] NSWCATOD 52). 2. As noted above, the appeal on a point of law and the stay application fall to be determined under the National Law. As with all applications under the National Law the object in s 3A is relevant, namely, that the health and safety of the public must be the paramount consideration. 3. Only two provisions of the National Law deal with stays pending an appeal. Those provisions are s 161B and s 165L (2). 4. Section 161B provides as follows: 161B Appeal does not stay decision [NSW] An appeal under this Division does not operate to stay the effect of the decision being appealed against unless the Tribunal otherwise orders. 1. Section 161B is found in Sub-Division 4 of Division 6 of Part 8 of the National Law. The appeal rights dealt with in Division 6 are appeals against a decision of a Committee or a Council or appeals on a point of law from such a decision making body. 2. The second provision is s 165L (2). It provides as follows: (1) … (2) The Tribunal may, in respect of an appeal under section 159B, make an order staying the decision of the Council appealed against until the appeal has been disposed of. 1. It is also necessary that I set out s 165L in its entirety as it is submitted on behalf of the practitioner that this section provides the necessary power for me to stay the suspension on terms by imposing conditions on the practitioner's registration. (1) The Tribunal may, during any proceedings under this Law, exercise any power or combination of powers conferred on the Tribunal by section 149A, except the power to caution or reprimand. (2) The Tribunal may, in respect of an appeal under section 159B, make an order staying the decision of the Council appealed against until the appeal has been disposed of. (3) The Tribunal may, during any proceedings under this Law, suspend a registered health practitioner's or student's registration if— (a) it has found the subject-matter of the complaint against the practitioner or student to have been proved; and (b) the complaint has not yet been finally disposed of; and (c) it is satisfied that it is appropriate to do so for the protection of the health or safety of any person or persons (whether or not a particular person or persons) or the action is otherwise in the public interest. 1. Section 149A of the National Law provides as follows: (1) The Tribunal may do any one or more of the following in relation to the registered health practitioner— (a) caution or reprimand the practitioner; (b) impose the conditions it considers appropriate on the practitioner's registration; (c) order the practitioner to seek and undergo medical or psychiatric treatment or counselling (including, but not limited to, psychological counselling); (d) order the practitioner to complete an educational course specified by the Tribunal; (e) order the practitioner to report on the practitioner's practice at the times, in the way and to the persons specified by the Tribunal; (f) order the practitioner to seek and take advice, in relation to the management of the practitioner's practice, from persons specified by the Tribunal. (2) The Tribunal may do any one or more of the following in relation to the student— (a) caution or reprimand the student; (b) impose the conditions it considers appropriate on the student's registration; (c) order the student to seek and undergo medical or psychiatric treatment or counselling (including, but not limited to, psychological counselling); (d) order the student to complete an educational course specified by the Tribunal. (3) If the health practitioner is no longer registered, an order or direction may still be given under this section but has effect only— (a) to prevent the practitioner being registered unless the order is complied with; or (b) to require the conditions concerned to be imposed when the practitioner is registered. (4) If the Tribunal makes an order or imposes a condition on the registered health practitioner's or student's registration, the Tribunal may order that a contravention of the order or condition will result in the practitioner's or student's registration being cancelled. (5) The order or condition concerned is then a critical compliance order or condition. 1. This provision is found immediately after s 149 which provision requires, as a condition precedent to the exercise of the powers under the sub-division, including the powers under s 149A, that the subject matter of a complaint is admitted by the practitioner, or proved. 2. The Council submits that s 165L(2) does not, on its face, permit the granting of a stay on terms, for example, that I could grant a stay and impose conditions on the practitioner's registration. Rather, it is submitted that if I determine the stay should be granted, the practitioner's suspension will be stayed pending the determination of the s 159B appeal. Reference is made to the express language of the sub-section which is "staying the decision". 3. The limited nature of the stay power is explained by Sackville AJ A in Medical Council v Lee as follows at [96]. His Honour says, albeit in the context of an appeal brought under s 159, of the National Law at [90]: On its face, s 150(2) of the National Law [NSW] suggests that the only two ways in which a suspension can be ended is by disposing of the complaint or by a determination of the Council. Section 150(2) cannot be read literally as the National Law [NSW] contemplates that a suspension may be lifted in other circumstances. For example, the Tribunal is expressly empowered on an appeal on a point of law to stay the decision (s 165L(2)). Nonetheless s 150(2) is important since it recognises that the Council plays a significant role in deciding whether to terminate or vary the suspension of a medical practitioner. 1. Later at [112] his Honour said: The absence of power in the Tribunal to stay a suspension decision made under s 150, except where the appeal is with respect to a point of law, does not mean that the suspension must remain in force pending determination of an appeal made by a medical practitioner. The issue is left to the Council to decide, either on an application for review (s 150A) or in the exercise of the Council's power to end the suspension (s 150C). This reflects a legislative judgment that the Council is best placed to assess whether the interim measure of suspending the registration of the medical practitioner should remain in place, having regard to the paramount consideration of protecting the health and safety of the public. [my emphasis] 1. The language in s 165L (2) may be compared and contrast to the language in s 43 (2) of the Civil and Administrative Tribunal Act 2013 (NSW) (the CAT Act). The latter provides: (2) A pending general application or appeal does not affect the operation of the decision to which the application or appeal relates, or prevent the taking of action to implement the decision, unless the Tribunal makes an order staying or otherwise affecting the operation of the decision. [my emphasis]. 1. In his submissions, senior counsel for the practitioner points out that s 165L deals with interlocutory orders and provides in ss (1) that the Tribunal may during any proceedings under the National Law exercise any power or combination of powers conferred on the Tribunal under s 149A, except the power to caution or reprimand. 2. It is submitted that as s 149A (1) (b) empowers the Tribunal to impose conditions it considers appropriate on the practitioner's registration, that I could grant the stay subject to imposing conditions on the practitioner's registration. It is submitted that as the legislation is beneficial it should be read widely. I note and accept that this submission is prima facie consistent with cl 7 of Schedule 7 of the National Law which provides as follows: (1) In the interpretation of a provision of this Law, the interpretation that will best achieve the purpose or object of this Law is to be preferred to any other interpretation. (2) Subclause (1) applies whether or not the purpose is expressly stated in this Law. 1. By contrast, the Council submits that first regard must be had to the language of s 165L (2) which refers to an order staying the decision. Further, it is submitted that regard must be had to the fact that s 149A is found in Division 3 of Part 8 concerning "Complaints". Reference is made to the fact that complaints may be referred to the Tribunal under s 145D and that Sub-division 6 of Division 3 sets out the disciplinary powers of the Tribunal. It is pointed out that s 150 is found within Sub-division 7, the division dealing with powers of a Council for the protection of the public. It is further submitted that under s 149 if the Tribunal finds a complaint proven or the complaint is admitted it may exercise any of the powers in s 149A. 2. The Council submits that s 165 L (2) "sits wholly outside this complaints handling framework", and that s 165L (2) is confined to being exercised in respect of an appeal under s 159B and "the provision has no interrelationship with the disciplinary powers conferred on the Tribunal when it is considering a complaint as the first instance decision maker". It is further submitted that, any interlocutory order imposing conditions "would necessarily operate apart from the stay itself. The stay would remain unconditional. Any conditions would operate on the registration". 3. It is also submitted that the practitioner has not advanced, with any detail, the nature of the conditions that might be imposed, other than referring to conditions generally. Reference is made to the "falling out of favour" of chaperone conditions following the report commissioned by the Medical Board of Australia in 2017 entitled Independent Review of the Use of Chaperone conditions. 4. I turn then to general principles of statutory construction including the text, context and purpose of the statute (see Project Blue Sky v ABA (1988) 194 CLR 355; [1988] HCA 28). I first note that the word "proceeding" in s 165L (1) is defined in the dictionary to the National Law as "proceeding means a legal or other action or proceeding". 5. It is arguable, therefore, that a stay application is a proceeding under the National Law and hence s 165L (1), which provides that in the exercise of its discretion the Tribunal may exercise any power under s 149A, applies. Further support for this interpretation is that s 165(2) is found in the context of a section which sets out a number of interlocutory orders that may be made by the Tribunal. 6. I next consider the provision in the context of the National Law. I find weight must be given to the interpretation advanced by the Council. First, s 165L (3) only permits suspension during proceedings if a complaint against a practitioner is proved, and it is necessary to do so for the health or safety of a person or persons or is otherwise in the public interest. This provision relates squarely to disciplinary proceedings. Section 149A sits in the sub-division dealing with disciplinary proceedings not complaints. This strengthens the argument that s 165L (1) relates to disciplinary proceedings not a stay in respect of an appeal. Further, I accept the argument that the stay, if granted, would be independent of registration conditions. Finally, the granting of a stay on conditions does not accord with the explanation of the statutory scheme by Sackville AJA in Medical Council v Lee. 7. Ultimately, as I have determined below that the stay should not be granted, it is unnecessary that I determine this point. My preliminary view however is that there is merit in the submissions of the Council. Clearly, if a points of law appeal unequivocally demonstrates error in a Council's decision then the granting of a stay of the decision will be appropriate. 8. I also find that no specific conditions which would satisfy the protection of the health and safety of the public or the public interest have been identified on behalf of the practitioner except a chaperone condition. I note senior counsel for the practitioner in his oral submissions indicated that proposed conditions would be discussed with the Council and agreement sought if I determined to grant the stay. The practitioner's grounds of appeal on a point of law and submissions on the stay application 1. I commence by noting that the submissions filed on behalf of the practitioner mistakenly refer to the s 159B appeal being expedited and that his appeal under s 159 will be heard separately. This is not the case, no order was made on 17 July 2020 expediting the s 159B appeal or severing it from the appeal under s 159. Rather, leave was granted to the practitioner to file amended grounds of appeal as the appeal notice filed stated, apparently in error, that the reasons had not been available at the time of filing. 2. The applicant now relies on the following grounds as "errors of law" under s 159B as follows: 1. The Medical Council failed to properly discharge its duty in line with the Court of Appeal's directive in Kirby v Dental Council of New South Wales [2020] NSWCA 91, in that where (as here) the evidence is incomplete and further investigation is needed, the issue for the Council was not whether the allegations are proved, but whether the evidence establishes a risk to the public requiring suspension, or imposition of a condition, for protection of the public. 2. The Medical Council failed to have proper regard to all of the objectives and guiding principles of the National Law (NSW) as set out in s3, including s3(3)(c) (formerly ground (a)). 3. The Medical Council took into account an irrelevant consideration, that is, that [the practitioner's nurse] did not refer to [Patient A] in her letter (formerly ground (e)). 4. The Medical Council denied Dr Segal procedural fairness in that it did not invite him to provide further evidence from [the nurse] about the complainant, if it suspected she had important evidence to give (formerly ground (f)). 5. The Medical Council took into account an irrelevant consideration, namely the complaint made by [Person B], which had been dismissed at the level of prima facie case (formerly ground (d)). 6. The Decision is so unreasonable and plainly unjust that it is wrong in law. 1. The practitioner's submissions assert that the delegates did not comply with the instructions from the Court of Appeal in Kirby v Dental Council of NSW [2020] NSWCA 91. I note that this decision was handed down on 20 May 2020 and that three other relevant decisions have been published by the Court of Appeal and the Supreme Court recently (Windsor v Health Care Complaints Commission [2020] NSWCA 110; Ghosh v Medical Council of New South Wales [2020] NSWCA 122; and Pharmacy Council of NSW v Ibrahim [2020] NSWSC 708). 2. It is submitted that the delegates "appear to have reached a conclusion that the alleged sexual relationship was proved" because they stated they "did not find Dr Segal's evidence to be persuasive". 3. It is further submitted that the delegates found there had been a positive breach of the Medical Board of Australia's Guidelines to Sexual Boundaries in the Doctor-Patient relationship. I note that the delegates stated at page 14 "Dr Segal's alleged actions are also in breach of the Medical Board of Australia's Guidelines to Sexual Boundaries." 4. It is further submitted in support of this ground that the delegates' conclusion, at page 16, constitutes a positive finding of fact rather than establishing a risk to the public because the delegates state "the delegates were persuaded to accept the account provided by [Patient A]" and that although they recognised inconsistencies in Patient A's evidence that they had "on balance, …accepted Patient A's account as plausible". 5. In respect of Ground 2, it is asserted the delegates failed to have sufficient regard for s 3 (3) (c) of the National Law and failed to give consideration to whether there was a less draconian alternative available to ensure that "health services 'could be provided safely and are of an appropriate quality'". 6. Ground 3 is squarely based on oft quoted statement in House v The King (1936) 55 CLR 499; [1936] HCA 40. It is submitted that the delegates took into account an irrelevant consideration, namely, that the practitioner's nurse did not refer to Patient A in her letter before the delegates. It is submitted the delegates' reasons failed to note that counsel appearing at the s 150 hearing had explained that this was the fault of the practitioner's legal advisors who had been in contact with the nurse to request specific information go into her statement. I pause to note I did not have a transcript of the s 150 hearing, but this submission was not challenged by counsel for the Council. 7. Submissions in respect of Ground 4 (the procedural unfairness ground) argue that the practitioner was denied procedural fairness because the delegates did not invite him to provide further evidence from the nurse about Patient A. 8. The submissions in respect of Ground 5 also relate to the principles espoused in House v The King. It is submitted that the delegates took into account an irrelevant consideration, namely the complaint by Person B which had been dismissed at the level of a prima facie case. It is asserted that the delegates, who I pause to note are not lawyers, "appear not to have understood the significance of the criminal matter being dismissed with no prima facie case to answer, even after the Magistrate had heard from the complainant". It is acknowledged that the delegates were not bound to accept the findings of the Magistrate, but go on to suggest that "they appear to have given them no weight at all in circumstances where there was no other way to assess the veracity of the allegation". 9. The submissions in respect of Ground 6 are scant. It is submitted that "for the reasons outline [sic] above the decision is so unreasonable and plainly unjust that it is wrong in law". 10. In his oral submissions, senior counsel for the practitioner drew attention to the fact that although the delegates had noted submissions made by Dr Dwyer, counsel for the practitioner at the s 150 hearing, about a chaperone condition, that they had failed to address her submission in their reasons and accordingly the reasons for decision are deficient. There is no ground of appeal directed to a lack of adequate reasons, however I accept this submission is directed to the unreasonableness ground. The Medical Council's submissions in respect of the stay application 1. The Council's comprehensive submissions set out background material, an overview of the delegates' reasons and summarise their conclusions of risk to the health and safety of the public and public interest considerations. 2. The submissions advance the proposition that the points of law appeal must be heard and determined prior to any s 159 appeal. However, at the hearing counsel for the Council did not object to both expedited appeals being heard on the same days. I accept that the s 159B appeal is to be heard and determined by the judicial officer presiding, and the s 159 appeal is to be heard by a fully constituted panel. I am satisfied, in this instance, listing both appeals at the same time is consistent with objects of the CAT Act to ensure the proceedings are heard in a just and timely manner minimising costs. 3. The submissions refer to the applicable principles to be observed by a Council determining a matter under s 150, and those applicable to the granting of a stay under s 165L (2) of the National Law. 4. In addressing Ground 1 of the points of law appeal, the submissions advance the proposition that the delegates did not err in their risk assessment task, noting "That is not to say that if certain matters are proven, admitted or if the delegates are otherwise satisfied that the relevant allegations are plausible, action under s 150 cannot be taken". The submissions go on to note the various admissions which were made by the practitioner. It is submitted that reading the decision fairly and as a whole that the delegates did not misunderstand their task. 5. In respect of Ground 2 the submissions note the paramountcy of s 3A and submit that s 3 (3) c) of the National Law is directed to the collective noun "health professionals" and not an individual health practitioner. The submissions further note that the test under the National Law is that the delegates find it is appropriate to take action. 6. In addressing Ground 3 it is noted that "Taking into account irrelevant considerations will only amount to jurisdictional error where the decision-maker is 'bound not to or not permitted' to take those matters into account" citing Minister for Aboriginal Affairs v Peko-Wallsend Ltd (1986) 162 CLR 24. 7. Ground 4, the procedural unfairness ground, is addressed by noting that the practitioner was legally represented before the delegates, that he was given adequate notice of the issues and had ample opportunity to address matters both orally and in writing. I pause to note that before me, senior counsel for the practitioner very appropriately conceded that the practitioner had notice of the complaint on 6 June 2020, some three weeks prior to the s 150 hearing. 8. The submissions in respect of Ground 5 commence by noting that the Council is required under s 41O to take into account a practitioner's complaints' history to the extent it is reasonably relevant. The submissions note the delegates' acknowledgement that the criminal matter did not proceed, that there was no prima facie case and the matter was dismissed. It is asserted the approach does not demonstrate any error on the part of the delegates. 9. The submissions address the unreasonableness ground on the basis the ground is weak, noting the task in reviewing a decision on the ground of legal unreasonableness is "strictly supervisory", not a merits review, and that the existence of a "merely arguable ground of appeal is not a sufficiently cogent reason for granting a stay". 10. The submissions conclude by addressing issues of reputational impact and financial impact of the interim suspension. Consideration 1. I commence my consideration of this stay application by first considering the nature of an appeal on a point of law. Nature of an appeal on a point of law 1. The expression "point of law" was considered by Basten JA in Health Care Complaints Commission v Karalasingham [2007] NSWCA 267 at [14]. His Honour was considering the phrase in the context of the Medical Practice Act 1992 (NSW) (repealed). His Honour explained that "it is sufficient that the Tribunal needs to identify and apply a principle in reaching its decision and, in doing so makes an error with respect to a point of law". Has the practitioner established it is appropriate to stay the suspension order? 1. I observe that the submissions on behalf of the practitioner commence by referring to the stay power in s 43 (3) of the CAT Act. I am satisfied that that provision has no relevance to the granting of a stay under the National Law (see Medical Council of New South Wales v Lee). Will the appeal be rendered nugatory if a stay is not granted? 1. Senior counsel for the practitioner appropriately conceded that the appeal would not be rendered nugatory if a stay is not granted. This is a significant factor weighing against the grant of the stay sought. The likely strength or otherwise of the practitioner's appeal 1. My consideration of the likely strength or otherwise of the practitioner's appeal on this application must be confined to his points of law appeal, not his appeal under s 159 which is a hearing de novo at which fresh evidence or evidence in addition to or in substitution for the evidence that was before the Council may be given. 2. The original ground of appeal relied on by the practitioner is one of unreasonableness. The "modern" law of what is encompassed by unreasonableness in the context of administrative review is enunciated by the Full Court of the Federal Court in Minister for Immigration and Border Protection v Eden [2016] FCAFC 28 at [58]-[65]. As this was the initial ground of appeal in the points of law appeal, and continues to be relied on as encompassing all the other grounds of appeal, it is appropriate I set out the Full Court's exposition of the law: First, the concept of legal unreasonableness concerns the lawful exercise of power. Legal reasonableness, or an absence of legal unreasonableness, is an essential element in the lawfulness of decision-making: Li at 350[26] and 351[29] (French CJ), 362[63] (Hayne, Kiefel and Bell JJ) and 370[88] (Gageler J); Singh at 445[43]; Stretton at [4] (Allsop CJ) and [53] (Griffiths J). Second, the Court's task in determining whether a decision is vitiated for legal unreasonableness is strictly supervisory (Li at 363[66]). It does not involve the Court reviewing the merits of the decision under the guise of an evaluation of the decision's reasonableness, or the Court substituting its own view as to how the decision should be exercised for that of the decision maker: Li at 363[66] (Hayne, Kiefel and Bell JJ); Stretton at [12] (Allsop CJ) and [58] (Griffiths J); see also M64/2015 v Minister for Immigration and Border Protection [2015] HCA 50; (2015) 90 ALJR 197 at 203[23]. Nor does it involve the Court remaking the decision according to its own view of reasonableness: Stretton at [8] (Allsop CJ). Third, there are two contexts in which the concept of legal unreasonableness may be employed. The first involves a conclusion after the identification of a recognised species of jurisdictional error in the decision making process, such as failing to have regard to a mandatory consideration, or having regard to an irrelevant consideration. The second involves an "outcome focused" conclusion without any specific jurisdictional error being identified: Li at 350[27]-351[28] (French CJ), [72] (Hayne, Kiefel and Bell JJ); Singh at [44]; Stretton at [6] (Allsop CJ). This appeal is primarily concerned with whether the outcome of the Minister's exercise of power was legally unreasonable. That said, some of the primary judge's reasons for concluding that the decision was unreasonable, and some of the appeal grounds and submissions, are directed at the Minister's reasons and alleged errors in the decision-making process. Fourth, in assessing whether a particular outcome is unreasonable, it is necessary to bear in mind that within the boundaries of power there is an area of "decisional freedom" within which a decision-maker has a genuinely free discretion: Li at 351[29] (French CJ),363[66] (Hayne, Kiefel and Bell JJ). Within that area, reasonable minds might differ as to the correct decision or outcome, but any decision or outcome within that area is within the bounds of legal reasonableness: Li at 363[66] (Hayne, Kiefel and Bell JJ); Stretton at [7] (Allsop CJ). Such a decision falls within the range of possible lawful outcomes of the exercise of the power: Li at 375[105] (Gageler J); Stretton at [11] (Allsop CJ). Fifth, in order to identify or define the width and boundaries of this area of decisional freedom and the bounds of legal reasonableness, it is necessary to construe the relevant statute: Li at 349[24] (French CJ), 363[67]-364[67] (Hayne, Kiefel and Bell JJ); Stretton at [55] and [62] (Griffiths J). The task of determining whether a decision is legally reasonable or unreasonable involves the evaluation of the nature and quality of the decision by reference to the subject matter, scope and purpose of the relevant statutory power, together with the attendant principles and values of the common law concerning reasonableness in decision-making: Stretton at [7] and [11] (Allsop CJ). The evaluation is also likely to be fact dependant and to require careful attention to the evidence: Singh at 445[42]. Sixth, where reasons for the decision are available, the reasons are likely to provide the focus for the evaluation of whether the decision is legally unreasonable: Singh at 446[45]-447[47]. Where the reasons provide an evident and intelligible justification for the decision, it is unlikely that the decision could be considered to be legally unreasonable: Singh at [47]. However, an inference or conclusion of legal unreasonableness may be drawn even if no error in the reasons can be identified. In such a case, the court may not be able to comprehend from the reasons how the decision was arrived at, or the justification in the reasons may not be sufficient to outweigh the inference that the decision is otherwise outside the bounds of legal reasonableness or outside the range of possible lawful outcomes: Li at 367[76] (Hayne, Kiefel and Bell JJ); Stretton at [13] (Allsop CJ). Seventh, and perhaps most importantly, the evaluation of whether a decision is legally unreasonable should not be approached by way of the application of particular definitions, fixed formulae, categorisations or verbal descriptions. The concept of legal unreasonableness is not amenable to rigidly defined categorisation or precise textural formulary: Stretton at [2] and [10] (Allsop CJ) and [62] (Griffiths J). That said, the consideration of whether a decision is legally unreasonable may be assisted by reference to descriptive expressions that have been used in previous cases to describe the particular qualities of decisions that exceed the limits and boundaries of statutory power. A number of those cases, and the descriptive expressions used in them, are referred to in Li and in the judgment of Allsop CJ in Stretton (at [5]). The expressions that have been utilised include decisions which are "plainly unjust", "arbitrary", "capricious", "irrational", "lacking in evident or intelligible justification", and "obviously disproportionate". It must be emphasised again, however, that the task is not an a priori definitional exercise. Nor does it involve a "checklist" exercise: Singh at 445[42]. Rather, it involves the Court evaluating the decision with a view to determining whether, having regard to the terms, scope and purpose of the relevant statutory power, the decision possesses one or more of those sorts of qualities such that it falls outside the range of lawful outcomes. [footnotes omitted] 1. In Legal Services Commissioner v Barker [2005] QCA 482 Chesterman J, with whom McMurdo P and Helman J agreed explained at [30]: It goes without saying that the demonstration of an arguable appeal is a condition precedent to obtaining a stay. No court or tribunal would consider staying the operation of an order where it is clear that there was no realistic prospect of a successful appeal. That is not to say that the existence of arguable grounds of appeal is a sufficiently cogent reason for granting a stay. Both Robb and Stevens stand as authority against that suggestion. 1. I have set out the grounds of appeal now relied on in the points of law appeal earlier in these reasons. It is not appropriate that I give detailed consideration for the grounds on the points of law appeal as that is a matter for the hearing of that appeal. While the grounds of appeal are arguable, generally, the submissions of the Council addressing the grounds of appeal appear to me, to have considerable weight particularly the unreasonableness ground. However, the grounds can only be explored fully at the appeal. 2. I do not find that the grounds of appeal on a point of law are entirely hopeless. Accordingly, I give some weight to this factor in considering whether to grant the stay sought but it cannot be determinative of my decision. In reaching this conclusion, I note the caution expressed in the authorities about a "broad and fair" reading of the reasons in an administrative review context, particularly where the decision makers are not lawyers (see QSuper Board v Australian Financial Complaints Authority Limited [2020] FCAFC 55 at [89]). Considerations of the interests of justice including whether or not the appeal should be expedited Prejudice to either party 1. There is no doubt that, as submitted by senior counsel for the practitioner, and referred to by the practitioner in his affidavit, the suspension is causing personal and financial harm to the practitioner. I accept that he has significant financial responsibilities for his family, including his young children. I also accept that the suspension is likely to cause reputational damage to him. 2. There is no doubt that a suspension has grave consequences for a practitioner and that it is inevitable that a practitioner subject of such order will suffer hardship (see Liu v Chinese Medical Council of NSW [2019] NSWCATOD 13 at [37]). But that fact of itself cannot be determinative of this stay application. 3. In Legal Services Commissioner v Barker Chesterman J referred with approval to four matters relied on by Finn J in Robb v Law Society of the Australian Capital Territory (Federal Court of Australia, 21 June 1996, unreported) as relevant to the granting of a stay in a matter involving protection of the public as follows: [31] It is instructive to consider the four factors which Finn J mentioned as being relevant to a decision whether to grant a stay. His Honour was careful to point out that they are not the only factors which may be taken into account, but I think it right to say that those four factors should always be considered. The first is the seriousness of the misconduct found. Here it was very serious indeed, involving dishonesty in dealing with a client. The second is the likely prejudice to public confidence in the integrity of the disciplinary process and the reputation of the profession if the practitioner is granted a stay. The judgment in Stevens suggests that that prejudice is grave. The third factor is the means available to mitigate the prejudice. The respondent points to the conditions under which he is allowed to practise as alleviating the prejudice to public confidence. Those conditions make it very unlikely that the respondent would misbehave and to that extent the public is protected, but practising under those conditions does nothing to promote public confidence in the integrity of the disciplinary process which found the respondent unfit to practice, or the reputation of the profession. The fourth factor is the expedition with which the appeal can be heard. Hearing dates are available late in February or early in March 2006. If the appeal is successful the respondent will not have been prevented from practising for a protracted period. 1. Here, as distinct from the facts in Legal Services v Barker, the serious conduct asserted has not been established to the requisite standard. I accept that the delegates have accepted there were a number of actions by the practitioner which he has conceded were inappropriate (telephone conversations with Patient A, poor record keeping and blurring of boundaries with Person C). The delegates did, in their risk assessment, conclude based on aspects of the material before them that Patient A's account was plausible. As senior counsel for the practitioner most appropriately conceded before me, if the allegations are established at a disciplinary hearing it is likely that the practitioner's registration will be cancelled. Thus, I conclude a relevant matter in considering this stay application is the serious nature of the conduct alleged. However, I do not give as much weight to this factor as did the Court of Appeal in Barker because of the different factual circumstances. 2. As the authorities make clear, action under s 150 is temporary or interim in nature. In Ghosh v Medical Council of New South Wales Brereton JA stressed the necessity for the Council to be satisfied that before action is taken under either limb of s 150 (1) that there is an unacceptable risk. 3. It is clear that my task on this application is not to consider in depth the merits of the points of law appeal but I must, as in all applications under the National Law, consider the health and safety of the public as my paramount consideration (see s 3A of the National Law). 4. The delegates' reasons for decision evince a careful consideration of matters relevant to the health and safety of the public and the public interest. I find that public interest considerations would not be given proper weight if a stay of the suspension is granted unless it may be granted on terms. As I have found weight in the submissions of the Council on the power to be exercised under s 165L (2) (as compared to the powers to be exercised by the Tribunal under s 159C), this factor militates against granting the stay. Time until the appeal can be heard 1. I turn then to consider whether the prejudice to the practitioner may be overcome, or at least ameliorated, by expedition of his appeals. I accept that suspension from practice may be described as draconian, particularly for this practitioner with his financial responsibilities including those for his family. 2. Notwithstanding the submission made by the practitioner's counsel that if I granted the stay, appropriate conditions could be discussed between the parties, no indication of the type of condition or conditions that would protect the health and safety of the public and meet the public interest other than a chaperone condition was advanced at this hearing. I do not consider, even if I had power to do so, it is appropriate to grant a stay on the basis that suitable conditions may or may not be agreed between the parties. No doubt in light of the practitioner's concessions before the delegates, proposed conditions will be advanced at the hearing of the s 159 appeal. 3. At the hearing of the stay application, I confirmed to the parties that it was my view that the appeals should be expedited and I ordered accordingly. I have given weight in refusing the stay that both appeals can be heard in a relatively short time-frame. Special considerations when matter involves the health and safety of the public 1. The Council's submissions summarise or provide an "overview" of the delegates' decision including, at para 16, a recitation of the allegations admitted by the practitioner. At para 22 the submissions set out from the reasons those matters said to identify a risk to the health and safety of the public including the fact the delegates concluded that the practitioner's evidence was "not persuasive", that on the admissions made the practitioner did have an inappropriate relationship with Patient A, and notwithstanding he had been counselled in 2013 about maintaining professional boundaries, the delegates could not have confidence he would not engage in this behaviour again. In so doing the delegates were engaging a risk assessment as required by s 150. 2. At para 23 the Council's submissions refer to the finding of the delegates that his "actions and alleged actions" undermine confidence and trust in the medical profession. 3. In considering whether a stay should be granted I have given significant weight to the serious nature of the admitted and denied allegations. Those matters weigh heavily against the granting of a stay, particularly in circumstances where a de novo appeal under s 159 will be heard in a short period of time. I also take into account that the practitioner will, as will the Council, have the opportunity at the hearing of the s 159B appeal to fully argue his points of law appeal, and significantly both parties may rely on fresh evidence or evidence in addition to that which was before the delegates at the s 150 hearing in the s 159 appeal. Conclusions 1. Although the practitioner's proposed grounds of appeal on his points of law appeal are arguable, his appeal will not be rendered nugatory if a stay is not granted. Further, other factors, particularly those relevant to the health and safety of the public and the public interest militate against the granting of a stay. While the practitioner is suffering personally and financially because of the stay, expedition of his appeals will significantly ameliorate that prejudice. For these reasons, I decline to grant the stay sought. ORDERS 1. Application for a Stay is refused. 2. The costs of the Stay Application are reserved. 3. It is noted that on 24 July 2020 the appeals by Dr Shaun Segal under s 159 and s 159B of the Health Practitioner Regulation National Law were expedited. ********** I hereby certify that this is a true and accurate record of the reasons for decision of the Civil and Administrative Tribunal of New South Wales. Registrar Amendments 17 August 2020 - Catchwords added DISCLAIMER - Every effort has been made to comply with suppression orders or statutory provisions prohibiting publication that may apply to this judgment or decision. The onus remains on any person using material in the judgment or decision to ensure that the intended use of that material does not breach any such order or provision. Further enquiries may be directed to the Registry of the Court or Tribunal in which it was generated. Decision last updated: 17 August 2020