Karalasingham v Medical Council of New South Wales [2021] NSWCATOD 47

Civil and Administrative Tribunal New South Wales Medium Neutral Citation: Karalasingham v Medical Council of New South Wales [2021] NSWCATOD 47 Hearing dates: 29 March 2021 Date of orders: 22 April 2021 Decision date: 22 April 2021 Jurisdiction: Occupational Division Before: Le Poer Trench ADCJ, Principal Member Dr H Haikal-Mukhtar, Senior Member Dr N Willcocks, Senior Member Honorary Associate Prof P Macneill, General Member Decision: (1) A reinstatement order under s 163B(1)(c) of the Health Practitioner Regulation National Law (NSW) is made in respect of Rupasenan Karalasingham (the practitioner) subject to the following conditions being imposed on his registration: General conditions (a) Not to undertake after-hours and hospital work, including in an Emergency Department. (b) To obtain Medical Council of New South Wales' (the Medical Council) approval prior to changing the nature or place of his practice. (c) To authorise the Medical Council to notify current and future persons or organisations at any places where he works as a medical practitioner in Australia of any issues arising in relation to compliance with these conditions. (d) To practise only in a group practice approved by the Medical Council, where there are at least two registered medical practitioners (excluding the subject practitioner), and: (i) Where there is always one other registered medical practitioner on site; and (ii) Where the patients and patient records are shared between the medical practitioners. (e) To practise under category B supervision in accordance with the Medical Council's "Compliance Policy – Supervision" (as varied from time to time) and as subsequently determined by the appropriate review body. (i) At each supervision meeting the practitioner is to review and discuss his practice with his approved supervisor with particular focus on: (A) communication; (B) patient assessment; (C) clinical diagnosis and judgment; (D) management planning; (E) follow-up and safety-netting; (F) clinical outcomes; (G) workload, including discussion of working hours and stress management; (H) continuing professional development; (I) ethical questions. (ii) At each supervision meeting, the Council-approved supervisor is to review a random selection of at least five medical records from the preceding fortnight. (iii) In addition to fortnightly supervision meetings, the practitioner is to attend observation sessions with the Council-approved supervisor. The observation sessions are to alternate between: (A) the practitioner observing the supervisor conduct at least three consultations with patients; and (B) the supervisor observing the practitioner conduct at least three consultations with patients. (iv) The observed consultations are to be discussed during supervision meetings and feedback and details regarding the practitioner's progress during the period of observation are to be recorded in the supervision reports. (v) To authorise the Medical Council to provide proposed and approved supervisors with a copy of the decision which imposed this condition and any other decision or report relevant to the practitioner. (vi) Not to practise until a supervisor has been approved by the Medical Council. (f) To nominate an experienced General Practitioner to act as his professional mentor for approval by the Medical Council in accordance with the Medical Council's "Compliance Policy – Mentoring" (as varied from time to time) and as subsequently determined by the appropriate review body. (i) At each mentoring meeting the practitioner is to include discussion of the issues highlighted in the decision which imposed this condition, any ethical or medico-legal issues and any personal and/or practice issues as they arise. (ii) To authorise the mentor to report, in an approved format, to the Medical Council every three months about the fact of contact, and to inform the Medical Council if there is any concern about his professional conduct or personal wellbeing. (iii) To authorise the Medical Council to provide proposed and approved mentors with a copy of the decision which imposed this condition and any other decision or report relevant to the practitioner. (g) To treat no more than 25 patients in any one day. (h) To work no more than 5 days per week. (i) The practitioner is to submit to an audit of his medical practice, by a random selection of his medical records by a person or persons nominated by the Medical Council and: (i) The audit is to be held within six months from the date the practitioner recommences medical practice (or such date as the Medical Council is able to achieve given its current workload) and subsequently as required by the Medical Council; (ii) The auditor(s) is to assess the practitioner's compliance with good medical record keeping standards and legislative requirements; (iii) To authorise the auditor(s) to provide the Medical Council with a report on their findings; (iv) To meet all costs associated with the audit(s) and any subsequent reports. (j) To authorise and consent to any exchange of information between the Medical Council and Medicare Australia for the purpose of monitoring compliance with these conditions. Private health conditions (k) To attend for treatment by a psychiatrist of his choice. The frequency of treatment is to be determined by the treating practitioner. The practitioner: (i) Is to authorise the treating practitioner to inform the Medical Council of any of the following: (A) failure to attend for treatment; (B) termination of treatment; (C) a significant change in health status (including a significant temporary change). (ii) Must provide the Medical Council with the professional details of the treating practitioner. (l) To attend for assessment by a Council-appointed psychiatrist, as directed by the Medical Council and at the Medical Council's expense, and then to attend for review by a Council-appointed psychiatrist on a three-monthly basis or as otherwise directed by the Medical Council. (m) To attend a review interview conducted by the Medical Council on a three-monthly basis, or as otherwise directed by the Medical Council. (n) To authorise the Medical Council to forward copies of this decision, any subsequent Medical Council review interview or other report and any other information relevant to his health and treatment to the Council-appointed psychiatrist and to his treating practitioner(s). (2) The Medical Council is the appropriate review body for the purposes of Part 8, Division 8 of the Health Practitioner Regulation National Law (NSW) (the National Law). (3) Sections 125–127 of the National Law are to apply whilst the practitioner's principal place of practice is anywhere in Australia other than in New South Wales, so that a review of these conditions can be conducted by the Medical Board of Australia. Catchwords: HEALTH — professional registration and discipline — registration — application for reinstatement Legislation Cited: Health Practitioner Regulation National Law (NSW) Cases Cited: Baez v Medical Council of NSW [2020] NSWCATOD 127 Ex parte Lenehan (1948) 77 CLR 403; [1948] HCA 45 Health Care Complaints Commission v Karalasingham [2019] NSWCATOD 23 Peter Cecil Harcourt Dawson v The Law Society of New South Wales [1989] NSWCA 58 Texts Cited: Nil Category: Principal judgment Parties: Rupasenan Karalasingham (Applicant) Medical Council of New South Wales (Respondent) Representation: Counsel: R Mathur (Applicant) A Horvath (Respondent)