Civil and Administrative Tribunal New South Wales Medium Neutral Citation: Health Care Complaints Commission v Soliman [2022] NSWCATOD 16 Hearing dates: 6 – 8 September 2021 Date of orders: 23 February 2022 Decision date: 23 February 2022 Jurisdiction: Occupational Division Before: Cole DCJ, Deputy President Dr S Cowap, Senior Member Dr S Ieraci, Senior Member D Telford, General Member Decision: 1. Dr Soliman is suspended from medical practice for a period of 6 months. 2. Dr Soliman's General Registration is subject to the following conditions: (1) To obtain Medical Council of NSW approval prior to changing the nature or place of his practice. (2) To practise only in a hospital position or group practice approved by the Medical Council of NSW where there are at least two registered medical practitioners (excluding the subject practitioner): (a) Where the patients and patient records are shared between the medical practitioners. (b) Where there is always one other registered medical practitioner on site. (3) To practise under category A supervision in accordance with the Medical Council of NSW's Compliance Policy – Supervision (as varied from time to time) and as subsequently determined by the appropriate review body. (a) At each supervision meeting the practitioner is to review and discuss his practice with his approved supervisor with particular focus on: (i) Doctor-patient relationship (ii) Professional behaviour (iii) Professional boundaries (iv) Accurate medical records (v) Correct use of accessing patient records (b) Dr Soliman must authorise the Medical Council of NSW to provide proposed and approved supervisors with the decision which imposed these conditions. (c) Dr Soliman must not practise until a supervisor has been approved by the Medical Council of NSW. (4) Not to consult, examine, treat or perform any procedures on any female (a) The practitioner may only provide emergency medical services to such persons in compliance with section 139C(c) of the Health Practitioner Regulation National Law (NSW). (b) If any such event occurs, the practitioner must notify the Medical Council of NSW within 24 hours and provide details of the event and any other information as requested by the Council. (5) To submit to a random audit/inspection of the practitioner's medical practice by a person or persons nominated by the Medical Council of NSW. (a) The audit/inspection is to be held as required by the Council to assess his compliance with conditions imposed on his registration. The auditor(s) may: (i) Inspect medical records; (ii) access, copy or retrieve appointment diaries, patient booking schedules and contact details. (b) Dr Soliman must authorise the auditor(s)/inspector(s) to provide the Council with a report on their findings. (c) Dr Soliman must meet all costs associated with the audit(s)/inspector(s) and any subsequent reports. (6) To authorise and consent to any exchange of information between the Medical Council of NSW and future relevant persons or organisations at locations where he works as a medical practitioner in Australia of any issues arising in relation to compliance with these conditions. (7) To authorise and consent to any exchange of information between the Medical Council of NSW and Medicare Australia for the purpose of monitoring compliance with these conditions. 3. The Medical Council of New South Wales is the appropriate review body for the purposes of Part 8, Division 8 of the Health Practitioner Regulation National Law (NSW). 4. Dr Soliman is to pay the costs of the Health Care Complaints Commission except for the costs of the hearing on 6 September 2021, in relation to which each party shall bear their own costs. The quantum of the costs to be paid is to be agreed or assessed. 5. The disclosure of the name of Patient A, which is set out in the Schedule to the complaint in this matter, is prohibited under s 64(1)(a) of the Civil and Administrative Tribunal Act 2013 (NSW). Catchwords: OCCUPATIONS — Medical practitioners — Misconduct and discipline OCCUPATIONS — Medical practitioners — Doctor–patient relationship Legislation Cited: Civil and Administrative Tribunal Act 2013 (NSW) Health Practitioner Regulation National Law (NSW) Cases Cited: Briginshaw v Briginshaw (1938) 60 CLR 336 Bronze Wing International Pty Ltd v Safework NSW [2017] NSWCA 41 Chen v Health Care Complaints Commission [2017] NSWCA 186 Foster v Hunter New England Area Health Service [2010] NSWCA 106 Texts Cited: Medical Board of Australia: Good medical practice: a code of conduct for doctors in Australia, March 2014 Category: Principal judgment Parties: Health Care Complaints Commission (Applicant) Hatem Mahmoud Samy Moustafa Ahmed Soliman (Respondent) Representation: Counsel: P Atkin (Applicant) M Hutchings (Respondent) Solicitors: Health Care Complaints Commission (Applicant) HWL Ebsworth Lawyers (Respondent) File Number(s): 2021/00051694 Publication restriction: Pursuant to s 64 of the Civil and Administrative Tribunal Act 2013 (NSW), the publication of the name of Patient A is prohibited. REASONS FOR DECISION 1. The Health Care Complaints Commission ('the HCCC') has applied for disciplinary findings and orders under the Health Practitioner Regulation National Law (NSW) ('the National Law') with respect to Dr Soliman. Background 1. Dr Soliman obtained his medical degree in Egypt in 2009. 2. In 2018, Dr Soliman was registered as a medical practitioner in Australia. 3. In 2019, Dr Soliman was employed as a junior medical officer in the emergency department of a rural hospital. He was practising under supervision. He was living in the rural area. 4. The complaint against Dr Soliman relates to his interactions with a patient, Patient A, a 35 year old woman, who he first encountered in the emergency department in which he was working, on 19 March 2019. The Application 1. Two complaints are set out in the amended application, which was filed on 6 September 2021. The complaints in the application are as follows: COMPLAINT ONE The practitioner is guilty of unsatisfactory professional conduct under section 139B(1)(a) and/or (l) of the National Law in that the practitioner has: i. engaged in conduct that demonstrates the knowledge, skill or judgment possessed, or care exercised, by the practitioner in the practice of medicine is significantly below the standard reasonably expected of a practitioner of an equivalent level of training or experience; and/or ii. engaged in improper or unethical conduct relating to the practice or purported practice of medicine. BACKGROUND TO COMPLAINT ONE In 2009 the practitioner obtained his medical degree in Egypt and thereafter worked in various hospital settings there. On 8 May 2018 the practitioner was first registered as a medical practitioner in Australia. On 14 May 2018 the practitioner commenced working as a junior medical officer in the emergency department at Armidale Hospital ("the hospital") under the Hunter New England Local Health District ("the LHD"). The practitioner was practising under clinical supervision at the hospital and resided in the Armidale area under a Temporary Work Visa arrangement. In 2019 Patient A was a 35-year-old woman who had moved into the Armidale area from overseas in February, had limited friends and no family in Armidale. By the time of her contact with the practitioner she was in financial difficulty. She had a history of mental health issues, seizures, and alcohol abuse and homelessness. She had presented to the hospital on 9 March 2019 and 13 March 2019 but was not seen by the practitioner. On 19 March 2019 the practitioner assessed Patient A in the emergency department after a recent fall and injury while intoxicated. The practitioner diagnosed fractures, treated her, and referred her to the hospital's fracture clinic. Patient A was discharged with advice. On 21 March 2019 Patient A re-presented to the hospital with a social worker, with complaints of alcohol withdrawal. The practitioner assessed her, discharged her and provided her with advice. PARTICULARS OF COMPLAINT ONE 1. On 21 March 2019 during his assessment of Patient A the practitioner breached his professional boundaries by offering to personally drive her over the weekend from Armidale to Sydney so that Patient A could see her family. 2. On 21 March 2019 during his assessment of Patient A breached his professional boundaries by giving Patient A his personal mobile number on a card and offering that she could call him if, using words to the effect, "she needed help or if she got worse overnight". 3. On 1 April 2019 the practitioner breached his professional boundaries by contacting Patient A on her personal mobile number, and asking her about non-clinical issues (not related to his care of her at the hospital), and offering to assist her to find cheap accommodation. 4. During the above phone call on 1 April 2019 the practitioner breached his professional boundaries by offering to let Patient A stay at his home if Patient A could not get into emergency accommodation. 5. On 7 April 2019 the practitioner breached professional boundaries with Patient A in agreeing, by text message exchange with Patient A, to go out and meet her for a coffee the following week. 6. On 7 April 2019 at about 2118 hours and again at about midnight, the practitioner replied to a text message from Patient A while he was working at the hospital and after his shift. The practitioner inappropriately requested Patient A contact him at midnight after his shift, and then asked Patient A to call him at about midnight after she expressed concern to him about her welfare. 7. On 7 April 2019 at about midnight the practitioner answered a call from Patient A, who was distressed, and informed him that she had gotten into an argument with her friend and needed assistance. The practitioner breached professional boundaries by asking Patient A to send him her address and offering to collect her from where she was staying using his car and taking her to his house. 8. On 7 April 2019 at about midnight the practitioner breached professional boundaries by collecting Patient A in his car from where she was staying and driving her to his home. 9. On 7 April 2019 at about midnight the practitioner breached professional boundaries by offering and permitting Patient A to sleep in his room overnight. 10. On 8 June 2018 2019 the practitioner breached professional boundaries by twice sending Patient A a text message stating, "Hi [Patient A] Is everything is (sic) ok?". 11. On 9 June 2018 2019 the practitioner breached professional boundaries by sending Patient A a text message stating, "Hi [Patient A] How is everything?". 12. On 11 June 2019 the practitioner breached professional boundaries by twice calling Patient A on her mobile phone. 13. On 11 June 2018 2019 the practitioner breached professional boundaries by twice sending Patient A a text message stating, "Hi [Patient A] Is everything is (sic) ok?". 14. By his conduct in particulars (1) to (13) the practitioner failed to have regard to his professional boundaries with Patient A who was a vulnerable patient, and the power imbalance in the doctor patient relationship, contrary to 3.2.6, 3.7.3, 3.8.4, 8.2. of the Medical Board of Australia's Code of Conduct ("the Code of Conduct"). 15. Prior to engaging with Patient A as set out in particulars (1) to (13), and after, the practitioner failed to discuss with his supervisor or other senior medical officer his contact with Patient A, contrary to 2.2.1, and 2.2.9 of the Code of Conduct. 16. Prior to engaging with Patient A as set out in particulars (1) to (13), and afterwards, the practitioner failed to consider the role of and involve Patient A's social worker, or other community supports for her social, financial or accommodation issues, contrary to 2.2.1, 2.2.9, and 3.8.3 of the Code of Conduct. 17. The practitioner failed at any time during the period of his conduct set out in particulars (1) to (13) to educate Patient A that it was inappropriate to engage in the conduct and to inform her of the need to attend the hospital, contact her social worker or advise her community services she should contact instead of him, contrary to 2.2.1, 2.2.9, 3.2.6, 3.7.3, 3.8.4, 8.2 of the Code of Conduct. 18. Sometime after midnight on 7 April 2019 and before the morning on 8 April 2019 at his home the practitioner inappropriately: a. came into the bed where Patient A was lying down; b. put his arm around Patient A's shoulders or back; and c. after Patient A told him to stop repeated the conduct in (a) and (b). 19. By his conduct in Particular (18) the practitioner acted contrary to 8.2 of the Code of Conduct. 20. On 21 March 2019 during his assessment of Patient A the practitioner, inappropriately and without her express consent, wrote down Patient A's mobile number from her clinical record and offered to use the number to contact her after her discharge from the hospital. ... 24. By his conduct in particulars (20) to (23) the practitioner acted contrary to his obligations under 3.2.3 and 3.4 of the Code of Conduct, and Health Privacy Principle 10 of the Health Records and Information Privacy Act 2002. COMPLAINT TWO The practitioner is guilty of professional misconduct under section 139E of the National Law in that the practitioner has: i. engaged in unsatisfactory professional conduct of a sufficiently serious nature to justify suspension or cancellation of the practitioner's registration, and/or; ii. engaged in more than one instance of unsatisfactory professional conduct that, when the instances are considered together, amount to conduct of a sufficiently serious nature to justify the suspension or cancellation of the practitioner's registration. PARTICULARS OF COMPLAINT TWO 1. Particulars (1) to (17) are repeated and relied on cumulatively. … 3. Particulars (1), (4), (5), (7), (8), (9), (18) of Complaint One are repeated and relied on individually. 4. The particulars of Complaint One are repeated and relied on cumulatively. The Reply 1. In his reply, Dr Soliman admits all of the particulars to Complaint One except for: * Particulars 2, 4, 18 and 19. * Particular 20, with respect to which Dr Soliman pleads as follows: …on 21 March 2019, with the patient's consent and during a discussion with her, he made a note of her mobile phone number on a piece of paper with a view to contacting her if he found some way to assist her with her housing needs. 1. Dr Soliman does not respond to Complaint Two in his reply, except to say: The respondent respectfully leaves this matter to the Tribunal. Onus and Standard of Proof 1. The HCCC bears the onus of proof. 2. The standard of proof is proof on the balance of probabilities, having regard to the gravity of the allegations made (see Foster v Hunter New England Area Health Service [2010] NSWCA 106 at [22]-[23] and Bronze Wing International Pty Ltd v Safework NSW [2017] NSWCA 41 at [126]-[127])). In view of the nature of the allegations, and bearing in mind the range of possible consequences of adverse findings, despite the fact that the rules of evidence are not strictly applicable in the Tribunal when exercising this jurisdiction, we consider that it is appropriate to make findings of fact in this matter on the basis that only clear and cogent evidence will be capable of meeting the standard of proof required (see Briginshaw v Briginshaw (1938) 60 CLR 336). Unsatisfactory professional conduct 1. Section 139B(1) defines unsatisfactory professional conduct to include: 139B Meaning of "unsatisfactory professional conduct" of registered health practitioner generally [NSW] (1) "Unsatisfactory professional conduct" of a registered health practitioner includes each of the following-- (a) Conduct that demonstrates the knowledge, skill or judgment possessed, or care exercised, by the practitioner in the practice of the practitioner's profession is significantly below the standard reasonably expected of a practitioner of an equivalent level of training or experience. … (l) Any other improper or unethical conduct relating to the practice or purported practice of the practitioner's profession. 1. The National Law provides, in s 41: 41 Use of registration standards, codes or guidelines in disciplinary proceedings An approved registration standard for a health profession, or a code or guideline approved by a National Board, is admissible in proceedings under this Law or a law of a co-regulatory jurisdiction against a health practitioner registered in a health profession for which the Board is established as evidence of what constitutes appropriate professional conduct or practice for the health profession. 1. The Medical Board of Australia Code of Conduct, dated March 2014, provides, at p 18: 8.2 Professional boundaries Professional boundaries are integral to a good doctor-patient relationship. They promote good care for patients and protect both parties. Good medical practice involves: 8.2.1 Maintaining professional boundaries. 8.2.2 Never using your professional position to establish or pursue a sexual, exploitative or other inappropriate relationship with anybody under your care. This includes those close to the patient, such as their carer, guardian or spouse or the parent of a child patient. Specific guidelines on sexual boundaries have been developed by the Medical Board of Australia under the National Law. 8.2.3 Avoiding expressing your personal beliefs to your patients in ways that exploit their vulnerability or that are likely to cause them distress. Professional misconduct 1. The National Law defines professional misconduct, in s 139E, as follows: 139E Meaning of "professional misconduct" [NSW] For the purposes of this Law, professional misconduct of a registered health practitioner means-- (a) unsatisfactory professional conduct of a sufficiently serious nature to justify suspension or cancellation of the practitioner's registration; or (b) more than one instance of unsatisfactory professional conduct that, when the instances are considered together, amount to conduct of a sufficiently serious nature to justify suspension or cancellation of the practitioner's registration. 1. In Chen v Health Care Complaints Commission [2017] NSWCA 186, Basten JA said, at [20]: There is no category of unsatisfactory professional conduct which is not capable, depending on the circumstances, of giving rise to professional misconduct and hence engaging the power of either suspension or cancellation of registration. The only requirement is that it be "sufficiently serious" to justify such an order, a characterisation which must depend upon an evaluative judgment made by the Tribunal. Some, perhaps all, categories include conduct which may reveal a defect of character as to which the Tribunal may conclude that the person should not be allowed to practise his or her profession unless at some future date the practitioner is able to satisfy the Tribunal that the defect has been overcome. Incompetence or inadequate care may in some circumstances be remediable by specific steps; in other circumstances the Tribunal may be concerned that the carelessness, for example, is such as to cast doubt on the suitability of the person to practise medicine. Each of the criteria for cancellation or suspension may be analysed in this way. Each case will depend upon an evaluative judgment to be made by the Tribunal as to the nature and seriousness of the conduct. The Evidence of fact 1. The HCCC tendered a folder of documents (A1) which includes the transcript and decision in relation to proceedings under s 150 of the National Law with respect to the events the subject of the application. Documents relating to Dr Soliman's registration and employment in New South Wales, hospital records with respect to Patient A and witness statements and other documents concerning the events alleged were also included. 2. Dr Soliman also tendered a folder of documents (R1), which includes his statement in this matter, his supervision reports, and evidence of various courses which he has undertaken. 3. Patient A and Dr Soliman gave oral evidence before us. 4. It was Patient A's evidence that she came to Australia from another country in March of 2019 in order to escape from domestic violence. 5. Patient A suffers from bipolar disorder. In March of 2019, she was addicted to alcohol. At the time that she met Dr Soliman, she had been in Australia for only a couple of weeks and she did not have stable accommodation, but was reliant on friends and acquaintances. One of those friends introduced her to a local social worker, Ms Kasey Mitchell. 6. On 19 March 2019, Patient A had a fall and sustained injuries to her right arm and elbow and her left knee. She presented at the hospital at which Dr Soliman was working in the Emergency Department and Dr Soliman saw her. He gave her a sling for her right arm (see transcript, p19). 7. On 21 March 2019, Patient A returned to the Emergency Department and saw Dr Soliman again. She was trying to stop drinking alcohol and was concerned about the possibility of alcohol withdrawal seizures. Despite her desire to stop drinking alcohol, she was still drinking it periodically to forestall the onset of seizures. She was also concerned about her right elbow, which was causing her pain. Patient A was accompanied by her social worker, Ms Kasey Mitchell. 8. Dr Soliman gave Patient A another sling for her arm and told her to keep it still. Patient A and Dr Soliman had a general conversation. Patient A said that she had come to the area from Sydney, where she had been visiting members of her family. Dr Soliman told Patient A that his wife and two children were living in Sydney. Dr Soliman offered to drive Patient A to Sydney (a 6-hour drive) should she wish to see her family. 9. In her statement, Patient A said, in relation to the 21 March 2019 consultation [Exhibit A1 Tab 14 paragraph 15] (Patient A calls Dr Soliman Dr Hatem. Hatem is one of Dr Soliman's given names.): During the assessment, a question came up as to where I would be staying that night. I told Dr Hatem that I wanted to get into [name] Detox Clinic, but there were no beds available until the following day. I remember Dr Hatem telling me that if I needed somewhere to stay, I could stay with him. I am not sure if he meant the offer to be for that night in particular, or if it was just a general offer. I remember telling him I would manage to find somewhere else to stay that evening. There was no other discussion with Dr Hatem about temporary or permanent accommodation options, either for that evening, or for future evenings. 1. Although Patient A was cross-examined, she was not cross-examined specifically in relation to this allegation. 2. In her statement, dated 10 June 2020, Ms Mitchell said that she was present on 21 March 2019 throughout Dr Soliman's consultation with Patient A. Ms Mitchell said [Exhibit A1 Tab 13]: 15. The doctor told [Patient A] that she did not need to be admitted overnight for her alcohol withdrawal. He then wrote his mobile number on the back of a business card and gave it to [Patient A], telling her that she could call him if she needed help or if she got worse overnight. I remember thinking that this was an odd thing for a doctor to do, as I have not seen a doctor give anyone their mobile number before. I remember thinking that because he was not admitting [Patient A] overnight, maybe this was his way of covering himself in case anything happened to her. 1. Ms Mitchell was not required for cross-examination and was not cross-examined. We accept Ms Mitchell's statement. It was clear, consistent and detailed. 2. In his evidence, Dr Soliman denied that he gave Ms Mitchell his mobile phone number on 21 March 2019. 3. It was Ms Mitchell's evidence that Patient A could not stay at the Women's Shelter on the night of 21 March 2019 because she had been drinking alcohol. She was seeking to get into a residential detoxification program, but no bed was available until the following day. Patient A stayed the night in a Motel, paid for by the Women's Shelter. The following morning, she was admitted to the residential detoxification program, where she was an in-patient until 4 April 2019. 4. It was Patient A's evidence that, whilst she was an in-patient at the residential detoxification program, Dr Soliman telephoned her on her mobile phone and asked her if she needed him to bring her any 'emergency supplies, like clothes, toiletries and hairbrushes'. In her statement of 25 March 2021, Patient A said, of this telephone call (paragraph 18): He also again offered to let me stay at his place if I needed somewhere. 1. Patient A was not cross-examined in relation to that evidence. 2. Dr Soliman admitted telephoning Patient A on her mobile phone on 1 April 2019, but he said that it was to check that she was alright and to offer her help finding accommodation, should she need it. He said that he had become aware of a possible accommodation option for her. Dr Soliman denied offering to bring Patient A clothes, toiletries or hairbrushes. 3. Patient A became friends with another patient whilst in the detoxification program. When Patient A left the detoxification program, she went to stay at this friend's house. On 7 April 2019, in the evening, Patient A had an argument with the friend, which resulted in her leaving his house, with her belongings. 4. Patient A telephoned Dr Soliman, who was at work, and he agreed to collect her from the friend's house after he finished his shift. She was very upset and had been drinking alcohol. Dr Soliman collected Patient A from the friend's house. 5. It was Patient A's evidence that she asked Dr Soliman if she could stay with him when he picked her up from her friend's house. She said that he did not raise any difficulty with that request. She agreed, though, in cross-examination, that she was emotional and that she does not have a good recollection of the conversation she had with Dr Soliman in his car (see transcript p 21 to 22). 6. It was Dr Soliman's evidence that he told Patient A, in the car, that it was not appropriate for him, as a married man, to allow her to stay at his lodgings. He said that he suggested that she go to a motel, but she said that she had no money for this. He said that it did not occur to him that he could offer to pay for a motel room (transcript, p 63). Dr Soliman conceded that his memory of the conversation in the car was possibly not complete (see transcript p 65). Patient A had no recollection of Dr Soliman telling her it would be inappropriate for her to stay at his lodgings or suggesting a motel. 7. It was Patient A's evidence that, soon after she arrived, she got into the bed, in her clothes. In her statement of 25 March 2021, Patient A said: 31. I can't remember exactly what happened immediately after we arrived. I just remember wanting to go to sleep so that I could go to the Women's Shelter in the morning. Dr Hatem told me I could sleep on the bed, which I did, fully clothed. I must have fallen asleep or been nearly asleep soon after I lay down. The next thing I knew, Dr Hatem tried to lie up against me; I can't remember if he was touching me with his hands or his body. He wasn't groping or grabbing at me, he was just there, lying next to me and trying to spoon me, with his body facing toward me. I remember that he was clothed; I think he was wearing pants and a top. He didn't say anything when he lay down and tried to spoon me, though it was blatantly obvious that it was a sexual advance. 32. I remember telling Dr Hatem that I was really uncomfortable. I can't remember how I told him this, whether it was 'what are you doing' or 'don't do this', I just remember making it clear that I was not happy. 33. I think this might have been when I asked to go to the bathroom and was how I found out the bathroom was a shared bathroom. I remember Dr Hatem made me stand at the doorway to his room while he waited and checked the hallway to make sure no-one else was there. Dr Hatem said I was not supposed to be there, which is why he had to check the hallway. He also told me to be quiet when I went to the bathroom. I very much had the feeling that I had been snuck into a place that I was not supposed to be at. 34. While I went to the bathroom Dr Hatem held the door to his room open so that I could get back in. 35. When I got back into the room, I lay down in Dr Hatem's bed and he again came over and did the same thing. That is, he lay down next to me and tried to spoon me. I told him that I didn't want to lie down with him and so I got up and went and sat in the armchair. I can't remember if he said or did anything in response to this. 36. I can't remember if Dr Hatem ended up staying and sleeping in the bed for the rest of the night. He didn't bother me again though once I moved to the arm chair, and I ended up drifting in and out of sleep while I was sitting there. It was not a proper sleep and I would have most likely still been a bit drunk from the night before. 1. Ms Turner, a support worker at the residential detoxification facility, provided a statement in this matter on 6 April 2021. We note that the statement was dated almost exactly two years after the night the subject of the allegation in particular 18 of Complaint one. Ms Turner recalled being told by Patient A about Patient A spending the night at a doctor's apartment 'on his couch or chair'. Ms Turner's account of Patient A's account is not inconsistent with Patient A's statement, within the tolerance of what would be expected of the recollection of a conversation nearly two years after that conversation. We do not take account of Ms Turner's evidence as proof of what occurred between Patient A and Dr Soliman on 7 April 2019, we simply note that Ms Turner's statement of what Ms Turner told her is not inconsistent with Patient A's evidence. Although the Tribunal is not bound by the rules of evidence, hearsay in these circumstances is not sufficiently probative of the occurrence of the events the subject of the conversation to be admissible as proof of those events. The evidence is admissible only as evidence of the fact of the occurrence of the conversation in the terms related. 2. A statement of Ms Barlin, dated 14 April 2021 was tendered by the HCCC. Ms Barlin is a social worker and, in 2019, was working at the Women's Shelter from which Patient A was obtaining assistance. Ms Barlin made a note of a conversation with Patient A which occurred when she picked Patient A up from outside the residential detoxification facility on 8 April 2019. Ms Barlin's note is in a case note made contemporaneously with her contact with Patient A on 8 April 2019 and says: In the car [Patient A] said when she was kicked out at midnight she called her doctor, who let her stay at his place (she stayed in the bed, he slept on the floor) 1. In her statement of 14 April 2021, Ms Barlin said that Patient A had not said the words she put in the note, but that this was Ms Barlin's interpretation of what Patient A said to her. We understand from this that Ms Barlin was indicating that the note may not be precisely accurate, which is understandable in the circumstances. The information in the note was peripheral to the purpose of Ms Barlin's interaction with Patient A. 2. Ms Barlin's evidence, like Ms Turner's, is only admissible as evidence of the conversation which took place. Given Ms Barlin's statement that her brief note of the conversation was her interpretation of what was said, that note is of no assistance in making findings at to what occurred at Dr Soliman's lodgings in the night of 7 April 2019. 3. In an interview with Dr Soliman on 3 July 2019, in the course of the investigation of the matter, Dr Soliman said that, on 7 April 2019, when he had shown Patient A his room, he collected his jacket, his wallet, his mobile phone and his laptop and went to sleep on a couch in the corridor, where he stayed all night (see Exhibit A1 tab 46 page 10). He said that he next saw Patient A when he knocked on the door of the bedroom in the morning and she answered the door. 4. The next morning, Dr Soliman drove Patient A to the detoxification clinic, at her request. At some point on that day, Patient A was collected by someone from the Women's Shelter and taken to the Women's Shelter. 5. On the 8 June 2019, Dr Soliman sent a text to Patient A which said "Hi [Patient A] is everything is ok?" [sic]. 6. On the 9 June 2019, Dr Soliman sent a text to Patient A which said "Hi [Patient A] How is everything?". 7. On 11 June 2019, Dr Soliman called Patient A twice on her mobile phone number and then texted her, saying "Hi [Patient A] is everything is ok?" [sic]. Consideration of the evidence of fact 1. In her written evidence and in her oral evidence, Patient A was very frank about the influence of her alcohol use at the time of the events the subject of her complaint on the formation of her memories and on her ability to recall aspects of the events. 2. Patient A had been sober for two years prior to giving evidence. She impressed us as an intelligent and honest witness who was doing the best she could to give truthful evidence. 3. Dr Soliman experienced some difficulties in his oral evidence. Sometimes he did not answer the question which was asked, but instead launched into saying what he wanted to say on the general topic being addressed. From time to time he sought clarification of a question, often a simple question, which may have been the product of a language issue, or an apprehension by him that a language issue may exist. Frequently, he gave succinct, often single-word answers. 4. Dr Soliman was asked, at the beginning of his cross-examination, whether he had been given copy of the Australian Medical Association's Code of Conduct when he came to Australia. He said no. The following exchange took place: Q. At any stage, have you been made aware of the AMA's Code of Conduct while you've been working in Australia? A. …it was when I received the former complaint of 25 June 2019 I started to be aware of all these things including the AMA Code of Conduct. 1. Dr Soliman said that he did several courses about the Code of Conduct after 25 June 2019. 2. Dr Soliman was then taken to an 'orientation report' which he had signed on 14 August 2018, about 8 months prior to the events the subject of the complaint. The orientation report says (among other things) (Exhibit A1,Tab 59): Medical practitioners should be familiar with the structure of the Australian health care system and the roles of the various bodies with which contact would occur or which have particular areas of responsibility. Orientation to the Australian healthcare system .. Medical Board of Australia – registration, code of conduct, professional performance, conduct and health assessment and monitoring relevant under the Health Practitioner Regulatory National Law as in force in each state and territory. … 1. Dr Soliman agreed that the cross in the box on the orientation report indicated that he had either read the item described in the text or had it explained to him. However, he said, he did not read the Code of Conduct. The following exchange took place (transcript, p 37): Q. Can you explain then what you understood the x to mean in that square against that entry? A. Because I didn't realise that there is a big difference in my practice in my country and here in Australia, there is a big difference in the boundaries and doctor/patient relationships so I just thought that it's quite similar to our practice because I didn't realise that there's a big difference. 1. Dr Soliman said that no-one explained to him how the difference in the doctor/patient relationship in Australia worked in his orientation. 2. Dr Soliman was taken to the Code of Conduct and asked if he had seen it before. He said that he had first seen it on or after 25 June 2019. 3. Dr Soliman was taken to his work performance report of 13 June 2018, which was signed by him and by his supervisors. One of the items on p 5 of that work performance report, under the heading 'Professionalism' was: Exhibits high standards of moral and ethical behaviour towards patients, families and colleagues including an awareness of appropriate doctor/patient boundaries. Beside this item, level 4, which was 'Performs consistently at the level expected' was selected and initialled by both Dr Soliman and his supervisor. 1. Dr Soliman agreed that he had never asked his supervisor what was meant by 'an awareness of appropriate doctor/patient boundaries'. 2. On the work performance report of 13 June 2018, Dr Soliman's supervisor wrote: will contact [name of hospital] for courses: continues with online training. 1. Dr Soliman was asked what online courses he had done. He searched his computer for his records and said that he had done an online course on 13 June 2018. The following exchange occurred (transcript p 62): Q. And what was the course that you completed? A. It was a code of conduct. Q. And that's the code of conduct we have been talking about? A. It was a joint course about, could have contact with Dr, with nursing staff was a host of the staff was a patient with ever you want with Doctor. Doctor relationship all about code of conduct yeah. [sic] Q. Do you mean it was a course based on the Medical Board of Australia's document that appears behind tab 61 or something else? A. I can't remember the material, I can remember some of the material of the course, I can't remember the material of the code because it was a very long time ago. Q. All right. But it also covered the doctor/patient relationship, is that right? A. Yes, it's one partition about doctor/patient relationship. Q. And did it talk about boundary crossing? A. I will try to find the material if you have better watch, watch part he's talking about, are you talk to a patient relationship. [sic] Q. Did you understand from doing that course that you needed to be careful about seeing patients or contacting patients outside of the clinical context? A. It was talking it was not about all the games but I can find the part I'm talking about the doctor/patient relationship, I can read it to you. [sic] Deputy President Cole Q. So Dr Soliman you are being asked about your memory of the course? A. Yes. Q. And I want you to answer directly please? A. Yes, okay I can't remember exactly the material of the course. 1. To be fair to Dr Soliman, his evidence was not generally as incoherent as it was in the section of the cross-examination quoted. However, his inclination to promote his preferred narrative rather than answering the questions asked when he was under pressure is illustrated by the above exchange. His preferred narrative was that he had not been told about the requirement for doctor/patient boundaries in Australia being different from the doctor/patient boundaries which are the standard in Egypt, the salient difference being that, he said, in Egypt, a doctor is expected to give general social help to patients, rather than confining him or herself to the giving of medical help. This is in conflict with the referral of Dr Soliman to the Code of Conduct in his orientation report and his undertaking of the online course on the Code of Conduct during the year prior to the conduct the subject of these proceedings. It is also at odds with his experience in the emergency department in question, in which he interacted with social workers like Ms Kasey Mitchell in the present case. Dr Soliman's evidence was, to some extent, self-serving. 2. In general, we found Patient A to be a more reliable witness than Dr Soliman. She freely conceded the shortcomings in her evidence arising from her alcohol consumption in the period which includes the events complained of, but she remained clear about the essential elements of her complaint. 3. The factual contests to be resolved lie in particulars 2, 4, 7, 18 and 20 of Complaint One. 4. The allegation in particular 2 of Complaint One is that, in the emergency department on 21 March 2019, Dr Soliman gave his personal mobile number, on a card, to Patient A saying that she could call him if "she needed help or if she got worse overnight". The evidence relied upon by the HCCC is the statement of Ms Kasey Mitchell, Patient A's social worker, who was present throughout the consultation in the emergency department on 21 March 2019. Ms Mitchell was not required for cross-examination, so her memory and her credibility were not put in issue. As we have said, we accept Ms Mitchell's evidence. 5. Dr Soliman has denied that he wrote his mobile number on a card and gave it to Patient A. However, he concedes that he telephoned Patient A on her mobile phone on 1 April 2019. He also admits that he engaged in a text exchange with Patient A on 7 April 2019. Patient A rang him on his mobile phone in the evening of 7 April 2019. She was clearly in possession of his mobile phone number by at least 7 April 2019. Dr Soliman plainly did not think that there was any problem with Patient A having his mobile phone number. Even if he had not given it to her by writing it on a card and handing it to her on 21 March 2019, he gave it to her by telephoning her on 1 April 2019 or by texting her on 7 April 2019. We find, though, on the basis of the evidence of Ms Mitchell, that he wrote it on a card and gave it to her on 21 March 2019, saying the words alleged. The allegations in particular 2 of Complaint One have been proven to the applicable standard of proof. 6. The allegation in particular 20 of Complaint One also relates to the consultation on 21 March 2019. The allegation is that Dr Soliman, without Patient A's consent, wrote down her mobile number from her clinical record and offered to use it to contact her after her discharge from the hospital. Dr Soliman, in his reply, said that he did this with Patient A's consent. The evidence relied upon by the HCCC was the evidence Dr Soliman gave to the delegates at the hearing under s 150 of the National Law, the transcript of which was before us. However, in that evidence, Dr Soliman said that Patient A consented to him noting her telephone number. It was Patient A's evidence, in her statement of 25 March 2021, that she was 'really surprised' to receive a call from Dr Soliman on her mobile phone on 1 April 2019, because she had not given him her number. We infer from her evidence that she had not given permission to Dr Soliman to copy her mobile number from her clinical records. Ms Mitchell, in her statement, does not mention any conversation about Dr Soliman seeking permission to copy Patient A's mobile number. Again, we prefer the evidence of Patient A. We find that particular 20 of Complaint One has been established to the requisite standard. 7. The allegation in particular 4 of Complaint One is that, during a telephone call on 1 April 2019, Dr Soliman offered to let Patient A stay at his home if Patient A could not get into emergency accommodation. 8. The evidence in support of this allegation is the evidence of Patient A, set out at [32], above. It is consistent with Patient A's behaviour in ringing Dr Soliman when she came to be in a situation where she needed accommodation at very short notice. Patient A was not cross-examined in relation to her evidence on this point. 9. Dr Soliman denied that he offered to let Patient A stay at his home in the telephone call on 1 April 2019, which he initiated. He said, instead, that he had become aware of a possible accommodation option for Patient A, and spoke of that to her during the telephone conversation. We prefer the evidence of Patient A, for the reasons outlined above. We find that, in the telephone call of 1 April 2019, Dr Soliman told Patient A that she could stay at his home if she could not get emergency accommodation. 10. The allegation in particular 7 of Complaint One is that, on 7 April 2019, when Patient A telephoned Dr Soliman and he answered her call, Dr Soliman asked Patient A to send him her address, and offered to collect her and take her to his house. In his Reply, Dr Soliman admitted particular 7 except to say that he did not offer to take Patient A to his house in the course of the telephone call. 11. For the reasons set out above with respect to credibility, we prefer the account of Patient A to the account of Dr Soliman with respect to both the conversation on the telephone on 7 April 2019 and the conversation in the car on the way to Dr Soliman's lodgings. We find that Dr Soliman, on the telephone on 7 April 2019, did offer to take Patient A to his house. He then, as he admits, took her to his lodgings. 12. The allegation in particular 18 of Complaint One relates to the night of 7 April 2019, when Patient A was in Dr Soliman's bedroom. The allegation is that Dr Soliman: 1. came into the bed where Patient A was lying down; 2. put his arm around Patient A's shoulders or back; and 3. after Patient A told him to stop repeated the conduct in (a) and (b). 1. It was Patient A's evidence that Dr Soliman got onto the bed, whilst she was lying on it, twice in the night of 7 April 2019. The first time, she said he "tried to lie up against me". "He wasn't groping or grabbing at me, he was just there, lying next to me and trying to spoon me, with his body facing toward me." Both Patient A and Dr Soliman were clothed. It was Patient A's opinion that "It was a sexual advance" (see [37], above). Patient A said that she voiced an objection, and got up and went to the bathroom. When she returned and again lay on the bed, she said Dr Soliman again lay next to her "and tried to spoon" her. She said that she got up and sat in the armchair, where she spent the rest of the night. 2. Dr Soliman denied staying in the bedroom whilst Patient A was on the bed. He said that he collected his jacket, his wallet, his phone and his laptop and went to the corridor, where he slept on a couch. 3. For the reasons set out above in relation to credibility, we accept the factual evidence of Patient A. We find that, at least once, Dr Soliman did get onto the bed when Patient A was lying on it, and that the front of his body did come into contact with her back. We find that both Patient A and Dr Soliman were fully clothed at the time. We note that the bed was a single bed. We make no finding, however, in relation to Patient A's assertion that Dr Soliman's actions constituted a sexual advance. The HCCC does not allege that Dr Soliman made a sexual advance. Although we understand why Patient A formed that perception, we also note that it is very difficult for two adults to lie on a single bed without making physical contact. The making of a sexual advance has not been shown on the evidence on the balance of probabilities. 4. Sub-particulars 18(a) and (c) have been established to the applicable standard of proof. Sub-particular 18(b) has not been established. Particular 19 has been established to the applicable standard of proof. Dr Forrester's report 1. Dr Forrester is an emergency physician who gave an expert report dated 12 July 2020. 2. The purpose of the report was to assist the Tribunal in assessing the seriousness of Dr Soliman's conduct. The report is expressly predicated upon the assumption that the allegations are true, although Dr Forrester was aware, of course, that the Tribunal had yet to make findings of fact at the time that he prepared his report. 3. Dr Forrester was not required for cross-examination. 4. In his report, Dr Forrester dealt with a number of issues which were not before us, because they were not the subject of the application. We will not address that material. 5. In relation to Dr Soliman's offer, on 21 March 2019, to drive Patient A to Sydney to see her family, Dr Forrester's view was that this conduct is below what would be expected of a medical practitioner of similar experience to Dr Soliman. Had the offer been made in the context of a patient transport process provided by the hospital, Dr Forrester said that it would still have been of concern, given that Dr Soliman was under supervision. There is no suggestion that a patient transport process was the subject of Dr Soliman's suggestion. We agree that the offer was below the standard expected. 6. Dr Forrester addressed the allegation that Dr Soliman gave Patient A his mobile phone number during the consultation on 21 March 2019. Dr Forrester's view was that there were contexts, such as if a range of time had been specified for the calling, whilst Dr Soliman was on duty, and for the purpose of dealing with a medical issue, in which the giving, by a doctor, of his mobile phone number, although 'irregular', might be appropriate in the circumstances. We note, however, that the context posed, or a like context, was not the factual context in this matter. In the context of the allegation before us, we consider that the giving by Dr Soliman of his mobile phone number to Patient A fell below the standard expected of a practitioner of equivalent experience to Dr Soliman. 7. In relation to Dr Soliman obtaining Patient A's mobile number from her clinical records, and using it for a purpose not associated with her medical care, Dr Forrester's opinion was that Dr Soliman's actions were well below the standard expected of a medical practitioner. We agree. As to Dr Soliman's assertion that Patient A consented to his use of her mobile telephone number, Dr Forrester noted that there is no record of this in Patient A's notes. 8. Dr Forrester said that Dr Soliman's conduct in agreeing, in the telephone call during the day on 7 April 2019, to meet Patient A for coffee, was below the standard expected of a medical practitioner of similar experience. We agree. 9. Dr Forrester said that Dr Soliman's conduct in collecting Patient A in his car in the evening of 7 April 2019 was significantly below the standard expected of a medical practitioner of similar experience. We agree. Dr Forrester noted that the appropriate course for Dr Soliman, upon receiving Patient A's call, was to speak to his supervisor with a view to engaging with community services to assist Patient A. 10. Dr Forrester said that Dr Soliman's conduct in allowing Patient A to stay at his lodgings overnight on 7 April 2019 was significantly below the standard expected of a medical practitioner of similar experience as Dr Soliman. We agree. We also consider Dr Soliman's conduct whilst Patient A was in his bedroom to be significantly below the standard expected of a medical practitioner of equivalent experience to Dr Soliman. 11. Dr Forrester said that Dr Soliman's conduct in sending texts to Patient A on 8, 9 and 11 June 2019 and calling her on 11 June 2019 was below the standard expected of a medical practitioner of equivalent experience, given that there was no medical context for the texts and the call. In our opinion, in the factual context established on the facts, this contact was significantly below the standard expected. Complaint One 1. In his reply, Dr Soliman admitted that he had contravened s 139B(1)(a) and/or (l) of the National Law. We take that to be an admission that he contravened both s 139B(1)(a) and (l) of the National Law. We agree with that assessment. 2. We determine that all of the conduct alleged against Dr Soliman, taken together, contravened both s 139B(1)(a) and (l) of the National Law and constitutes unsatisfactory professional conduct. The conduct was improper because, at Dr Soliman's instigation, it took the interactions between him and Patient A, to varying degrees, beyond the bounds of a doctor/patient relationship and into a form of social relationship which was incompatible with an appropriate doctor/patient relationship. This occurred in circumstances, and at a time, when Patient A was highly vulnerable, because she was newly arrived from overseas, severely affected by her substance abuse issues, suffering from a fractured arm, homeless and without financial or significant social resources. Complaint Two 1. Complaint Two alleges that particulars (1) to (17) of Complaint One, taken together, constitute professional misconduct, or, alternatively, that each of particulars 1, 4, 5, 7, 8, 9 or 18 individually constitute professional misconduct. 2. In considering Complaint Two, we bear in mind that the HCCC has not alleged that Dr Soliman engaged in any of the conduct alleged in the pursuit of a sexual interaction with Patient A. The HCCC has not alleged that the conduct the subject of particular 18 of Complaint One was sexual conduct. We have acknowledged that it was Patient A's honest impression that the conduct was sexually motivated, but we are not persuaded, on the balance of probabilities, that her perception necessarily accurately reflects Dr Soliman's state of mind at the time of the conduct alleged. 3. In these circumstances, on the material before us, Dr Soliman's conduct is the product of a failure, by him, to pay sufficient attention to the Code of Conduct and his ethical obligations to patients. The relevant information was available to him, both in his orientation and in the online course he took prior in 2018. He also, to some extent, failed to perceive that the expectation of doctor/patient boundaries in Australia is different from what he assumed that it would be. We do not mean to imply, however, that this is a case in which an overseas qualified doctor has continued to act in Australia in the manner in which he would act in his country of origin. Dr Soliman pointed out several times in his evidence that it was not appropriate, in Egypt, for a married man to be alone with a woman who was not a family member in a private setting. He admitted, in response to questions from Dr Ieraci, that he never invited patients to his home in Egypt, and nor was he aware of colleagues doing so (transcript p 77). Clearly, therefore, his behaviour on the night of 7 April 2019 would be highly inappropriate in Egypt as well. We do not accept Dr Soliman's argument that his behaviour with respect to Patient A arose from him taking a role in the social welfare of Patient A in a manner which is considered to be appropriate in Egypt. He was seeking a social connection with her which would not be appropriate in Egypt either, on his own evidence. 4. In addition to making wrong assumptions about the ethical requirements of an Australian medical practitioner, Dr Soliman failed to investigate and become fully informed about the context in which he was working. He should, for example, as a supervised junior doctor in the emergency department of a public hospital, have become aware by 2019 of the availability of social services in the area and of the fact that it was not appropriate for him to provide any services other than medical services. He should also, by observation and enquiry, have become aware that it was not appropriate to attempt to form social connections with patients. If any of his conduct was a product of him thinking that he already knew everything he needed to know about ethics from his education and experience in Egypt, when the conditions and culture in Australia are obviously different, then his conduct has involved a degree of arrogance. As we have said, we do not accept that critical aspects of Dr Soliman's conduct were consistent with his description of his understanding of what would be satisfactory professional conduct in Egypt, so Dr Soliman has exhibited a degree of dishonesty in the characterisation of his behaviour as alleged in the conduct of his case, as well as in the denial of the facts alleged in Particulars 2, 4, 18(a) and (c) and 20 of Complaint One. Arrogance and dishonesty are defects of character of the kind referred to in Chen (see [15], above). 5. We determine that Dr Soliman's conduct constitutes professional misconduct. Stage 2 1. In his statement dated 23 October 2019 to the panel conducting the hearing under s 150, Dr Soliman said: I deeply regret the mistakes I made in communicating with and meeting the patient outside of work, and in particular taking her back to my lodge which I accept was a very serious mistake. 1. In that statement, Dr Soliman characterised his behaviour as 'a misguided attempt to assist the patient'. 2. We take into account the information provided in that statement concerning the possible impact of the cancellation of Dr Soliman's registration upon his visa, but we note that there has been no updating of that information, which is now more than two years old. 3. We take into account the evidence in that statement concerning serious health issues in Dr Soliman's family. 4. We accept that Dr Soliman has undertaken at least four courses in medical ethics since he became aware of the complaint, and has completed relevant reading on topics pertinent to the subject matter of the complaint. He has demonstrated his understanding of what he has learned, to some extent, in his statement of 16 June 2021. He further demonstrated his understanding of the reasons for the need for doctor/patient boundaries to be maintained in his cross-examination (transcript p 73-74). 5. In his statement of 16 June 2021, Dr Soliman said that he had been participating in weekly meetings with his supervisor, which had been of assistance to him. 6. We take into account the favourable supervision reports concerning Dr Soliman provided in his materials. 7. No evidence as to Dr Soliman's state of mind at the time of the offending or subsequently, beyond his own self report, has been provided to the Tribunal. 8. Patient A was vulnerable throughout her interactions with Dr Soliman by reason of the following factors: * she had only recently arrived from overseas, having escaped domestic violence; * she had a mental illness, namely bi-polar disorder; * she was injured; her arm was fractured; * she was suffering from an addiction to alcohol; * she was homeless; * she had few supports in the local area. 1. 0n the night of 7 April 2019, Patient A was particularly vulnerable in that: * she was affected by alcohol; * she had just been involved in an altercation; * she had lost her accommodation for the night; * in her mind, no alternative form of accommodation was readily available to her. 1. We are concerned that Dr Soliman has not acknowledged the impact that his behaviour might have had, or did have, upon Patient A, particularly having regard to the extent of her vulnerability. We are further concerned that Dr Soliman has not acknowledged the impact that his behaviour is likely to have upon the confidence of the general public in the medical profession. 2. The more vulnerable the patient, the greater the importance that a doctor observe the doctor/patient boundaries and confine him or herself to interactions with the patient which are necessary for medical purposes. 3. The National Law provides, in s 149A(1) and s 149C(1): 149A General powers to caution, reprimand, counsel etc [NSW] (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; … 149C Tribunal may suspend or cancel registration in certain cases [NSW] (1) The Tribunal may suspend a registered health practitioner's registration for a specified period or cancel the registered health practitioner's registration if the Tribunal is satisfied— (a) the practitioner is not competent to practise the practitioner's profession; or (b) the practitioner is guilty of professional misconduct; or (c) the practitioner has been convicted of or made the subject of a criminal finding for an offence, either in or outside this jurisdiction, and the circumstances of the offence render the practitioner unfit in the public interest to practise the practitioner's profession; or (d) the practitioner is not a suitable person for registration in the practitioner's profession. 1. We bear in mind that the purpose of protective orders under the National Law is to protect the patients of the health practitioner the subject of the orders, and the public, to uphold the objectives of the National Law, and to provide for specific deterrence for the health practitioner the subject of the orders and general deterrence for all health practitioners, in the same discipline. 2. We are confident that Dr Soliman now understands the concept of doctor/patient boundaries, and the importance of maintaining those boundaries. We are concerned about his lack of frankness to the regulatory authorities, including the Tribunal, his convoluted and contradictory explanation about the difference between Egyptian and Australian culture and its impact upon his conduct, his misleading evidence regarding his knowledge of the Medical Board of Australia Code of Conduct prior to the conduct complained of, and prior to the complaint being provided to him, and his claim that he did not know that social services were available to patients who needed housing, notwithstanding that Ms Mitchell, to his knowledge, attended the second consultation with Patient A, and notwithstanding the length of time that he had worked in that emergency department. 3. We have been provided with the supervision report dated 21 April 2021. More specific evidence as to Dr Soliman's ability to apply his learning concerning ethics and professional boundaries would have been of assistance. Costs 1. The HCCC has applied for an order for costs. 2. Most of the first day of the hearing was not able to be used because Patient A, who was a witness in the HCCC's case, did not, on that day, have the appropriate computer, or other device, with a camera and microphone and a recent version of Safari or Google Chrome installed. 3. It was argued on behalf of Dr Soliman that he should either be awarded costs for the first day of the hearing, or that each party should bear their own costs for that day. 4. The Tribunal gives very clear direction to all parties as to what is required to participate in a hearing which is conducted by AVL, prior to that hearing. The Tribunal has been conducting hearings by AVL since the second half of 2020. It is the responsibility of the parties to ensure that their witnesses are able to participate in the hearing. 5. In the circumstances, we consider that the appropriate costs order is that Dr Soliman pay the costs of the HCCC, except for the costs of the hearing on 6 September 2021, in relation to which each party should bear their own costs. Non-publication Order 1. It is appropriate that an on-going order be made under s 64(1)(a) of the Civil and Administrative Tribunal Act 2013 (NSW) prohibiting the disclosure of the name of Patient A, to protect her privacy. No public interest would be served by the disclosure of Patient A's name. Orders 1. In all of the circumstances, we consider that the following protective orders are appropriate, and they will be made: 1. Dr Soliman is suspended from medical practice for a period of 6 months. 2. Dr Soliman's General Registration is subject to the following conditions: 1. To obtain Medical Council of NSW approval prior to changing the nature or place of his practice. 2. To practise only in a hospital position or group practice approved by the Medical Council of NSW where there are at least two registered medical practitioners (excluding the subject practitioner): 1. Where the patients and patient records are shared between the medical practitioners. 2. Where there is always one other registered medical practitioner on site. 1. To practise under category A supervision in accordance with the Medical Council of NSW's Compliance Policy – Supervision (as varied from time to time) and as subsequently determined by the appropriate review body. 1. At each supervision meeting the practitioner is to review and discuss his practice with his approved supervisor with particular focus on: 1. Doctor-patient relationship 2. Professional behaviour 3. Professional boundaries 4. Accurate medical records 5. Correct use of accessing patient records 1. Dr Soliman must authorise the Medical Council of NSW to provide proposed and approved supervisors with the decision which imposed these conditions. 2. Dr Soliman must not practise until a supervisor has been approved by the Medical Council of NSW. 1. Not to consult, examine, treat or perform any procedures on any female 1. The practitioner may only provide emergency medical services to such persons in compliance with section 139C(c) of the Health Practitioner Regulation National Law (NSW). 2. If any such event occurs, the practitioner must notify the Medical Council of NSW within 24 hours and provide details of the event and any other information as requested by the Council. 1. To submit to a random audit/inspection of the practitioner's medical practice by a person or persons nominated by the Medical Council of NSW. 1. The audit/inspection is to be held as required by the Council to assess his compliance with conditions imposed on his registration. The auditor(s) may: 1. Inspect medical records; 2. access, copy or retrieve appointment diaries, patient booking schedules and contact details. 1. Dr Soliman must authorise the auditor(s)/inspector(s) to provide the Council with a report on their findings. 2. Dr Soliman must meet all costs associated with the audit(s)/inspector(s) and any subsequent reports. 1. To authorise and consent to any exchange of information between the Medical Council of NSW and future relevant persons or organisations at locations where he works as a medical practitioner in Australia of any issues arising in relation to compliance with these conditions. 2. To authorise and consent to any exchange of information between the Medical Council of NSW and Medicare Australia for the purpose of monitoring compliance with these conditions. 3. The Medical Council of New South Wales is the appropriate review body for the purposes of Part 8, Division 8 of the Health Practitioner Regulation National Law (NSW). 4. Dr Soliman is to pay the costs of the Health Care Complaints Commission except for the costs of the hearing on 6 September 2021, in relation to which each party shall bear their own costs. The quantum of the costs to be paid is to be agreed or assessed. 5. The disclosure of the name of Patient A, which is set out in the Schedule to the complaint in this matter, is prohibited under s 64(1)(a) of the Civil and Administrative Tribunal Act 2013 (NSW). ********** 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 15 March 2022 - Order 3: the word "appeal" changed to "review" 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: 15 March 2022