Health Care Complaints Commission v Alexakis (No. 2) [2024] NSWCATOD 82

Civil and Administrative Tribunal New South Wales Medium Neutral Citation: Health Care Complaints Commission v Alexakis (No. 2) [2024] NSWCATOD 82 Hearing dates: 28 February 2024 Date of orders: 21 June 2024 Decision date: 21 June 2024 Jurisdiction: Occupational Division Before: Coleman SC ADCJ, Principal Member Dr H Mukhtar, Senior Member Dr D King, Senior Member Mr R Wellington, General Member Decision: (1) Pursuant to s 149A(1)(a) of the Health Practitioner Regulation National Law (NSW) Dr Peter Alexakis is reprimanded. (2) Pursuant to s 149A(1)(b) of the Health Practitioner Regulation National Law (NSW) the following conditions are imposed on the registration of Dr Peter Alexakis as a medical practitioner: 1. To obtain Medical Council of New South Wales approval prior to changing the nature of place of his practice. 2. To practice only in a group practice approved by the Medical Council of New South Wales where there are at least 2 registered medical practitioners (excluding Dr Alexakis): a. Where the patients and patient records are shared between the medical practitioners. b. Which is an accredited practice. 3. Not to undertake locum positions. 4. Not to conduct home or nursing home visits. 5. Not to treat more than 36 patients in any one day. 6. Not to possess, supply, administer or prescribe any "drug of addiction" (Schedule 8 drug) as defined by the Poisons and Therapeutic Goods Act 1966 (NSW). 7. Not to possess, supply, administer or prescribe any substance listed in Schedule 4 Appendix D of the Poisons and Therapeutic Goods Regulation 2008 (NSW). 8. To practice in accordance with the current Medical Council of New South Wales' guideline for self-treatment and treating relatives as notified and varied from time to time. 9. To authorise and consent to any exchange of information between the Medical Council of New South Wales and Medicare Australia and Pharmaceutical Services for the purpose of monitoring compliance with these conditions. 10. To nominate an experienced General Practitioner to act as his professional mentor for approval by Medical Council of NSW in accordance with the Medical Council of NSW's Compliance Policy – Mentoring (as varied from time to time) and as subsequently determined by the appropriate review body: a. at each mentoring meeting the practitioner is to include discussion of the following: i. maintaining boundaries ii. prescribing iii. managing difficult patients b. to authorise the mentor to report, in an approved format, to the Council every 3 months about the fact of contact, and to inform the Council if there is any concern about his professional conduct or personal wellbeing c. to authorise the Medical Council of NSW to provide approved mentors with a copy of the decision/s which led to the imposition of this condition. 11. To complete within 12 months of the date of this decision "Palliative Care, the essentials" course organised by the RACGP: a. within 1 month of the date of this decision to provide evidence to the Medical Council of New South Wales of enrolment into the abovementioned course b. within 1 month of completing the abovementioned course, to provide evidence to the Medical Council of New South Wales from the training provider that they have satisfactorily completed the course c. to bear responsibility for any costs incurred in meeting this condition d. if the "Palliative Care, the essentials" course organised by the RACGP is unavailable, the Practitioner must propose to the Council for approval a similar course to be undertaken in accordance with the requirements of this condition and provide a written explanation as to the reasons why they are making this proposal, by no later than 2 months from the (date of recommencement of practice). 12. To complete within 12 months of the date of this decision "Ethical Decision Making" course organised by DAVAAR Consultancy a. within 1 month of the date of this decision to provide evidence to the Medical Council of New South Wales of enrolment into the abovementioned course b. within 1 month of completing the abovementioned course to provide evidence to the Medical Council of New South Wales from the training provider that they have satisfactorily completed the course c. to bear responsibility for any costs incurred in meeting this condition d. if the "Ethical Decision Making" course organised by DAVAAR Consultancy is unavailable, they must propose to the Council for approval a similar course to be undertaken in accordance with the requirements of this condition and provide a written explanation as to the reasons why they are making this proposal by no later than 2 months from (date of recommencement of practice). 13. To complete within 12 months of the date of this decision the "Safe Professional Boundaries" course organised by DAVAAR Consultancy: a. within 1 month of the date of this decision to provide evidence to the Medical Council of New South Wales of enrolment into the abovementioned course b. within 1 month of completing the abovementioned course, to provide evidence to the Medical Council of New South Wales from the training provider that they have satisfactorily completed the course c. to bear responsibility for any costs incurred in meeting this condition d. if the "Safe Professional Boundaries" course organised by DAVAAR Consultancy is unavailable, they must propose to the Council for approval a similar course to be undertaken in accordance with the requirements of this condition and provide a written explanation as to the reasons why they are making this proposal, by no later than 2 months from (date of recommencement of practice). 14. Not to supervise any other medical practitioner or medical student. 15. These conditions may be altered, varied, or removed by the Medical Counsel of New South Wales and the Medical Council is the appropriate review body for the purposes of Part 8 Division 8 of the Health Practitioner Regulation National Law (NSW). 16. Sections 125 to 127 of the Health Practitioner Regulation National Law (NSW) are to apply whilst the practitioner's principal place of residence is anywhere in Australia other than New South Wales, so that a review of these conditions may be conducted by the Medical Board of Australia. The Tribunal notes the intention of the Respondent to complete the following RACGP courses, and recommends that he do so: a. Self Care for GPs b. Professional in Practice (RACGP) c. SafeScript NSW – new approval management functionality d. Practical Pain Management in General Practice – things I didn't know but wish I had (RACGP). (3) The Respondent pay 60% of the Applicant's costs as agreed or assessed on the ordinary basis. (4) A party seeking an order other than order 3 has leave to file written submissions not exceeding 7 pages in length in support of such order within 21 days. (5) A party resisting an application pursuant to order 4 file and serve written submissions not exceeding 7 pages in length in support of such opposition within 42 days. (6) A party opposing any application pursuant to order 4 being determined on the papers include submissions in support of such opposition in any submissions filed by that party pursuant to order 5 or order 6. Catchwords: HEALTH PRACTITIONERS - medical practitioners - whether imposition of conditions in lieu of cancellation or suspension of registration of medical practitioner sufficiently protects public health and safety - nature and extent of conditions necessary to protect public health and safety - whether reprimand adequately reflects seriousness of practitioner's proven misconduct and upholds public confidence in medical profession and Tribunal's disapproval of professional misconduct Legislation Cited: Health Practitioner Regular National Law (NSW) 2009 Health Practitioner Regulation (NSW) Regulation 2010 Health Practitioner Regulation (NSW) Regulation 2016 Medical Practice Regulation (NSW) 2008 Poisons and Therapeutic Goods Act (NSW) 1966 Cases Cited: Chen v Health Care Complaints Commission [2017] NSWCA 186 Clyne v NSW Bar Association (1960) 104 CLR 186; [1960] HCA 40 Director-General, Department of Ageing, Disability and Home Care v Lambert [2009] 74 NSWLR 523; [2009] NSWCA 102 Health Care Complaints Commission v Bours (No. 2) [2015] NSWCATOD 80 Health Care Complaints Commission v Do [2014] NSWCA 307 Health Care Complaints Commission v Dowla (No. 2) [2019] NSWCATOD 156 Health Care Complaints Commission v Dr Della Bruna [2014] NSWCATOD 31 Health Care Complaints Commission v Gazal [2023] NSWCATOD 92 Health Care Complaints Commission v Haasbroek [2018] NSWCATOD 177 Health Care Complaints Commission v Jane Waddell (No. 2) [2013] NSWMT 2 Health Care Complaints Commission v Karalasingham [2007] NSWCA 267 Health Care Complaints Commission v Litchfield [1997] NSWSC 297; [1997] 41 NSWLR 630 Health Care Complaints Commission v Lord [2019] NSWCATOD 182 Lee v Health Care Complaints Commission [2012] NSWCA 80 NSW Bar Association v Meakes [2006] NSWCA 340 Prakash v Health Care Complaints Commission [2006] NSWCA 153 Rich v ASIC [2004] HCA 42; (2004) 220 CLR 129 Category: Principal judgment Parties: Health Care Complaints Commission (Applicant) Dr Peter Alexakis (Respondent) Representation: Counsel: P Lowson (Applicant) L Ellison SC (Respondent) L Fernandez (Respondent, junior counsel) Solicitors: Health Care Complaints Commission (Applicant) Teece Hodgson & Ward Solicitors (Respondent) File Number(s): 2020/148494 Publication restriction: Publication of the name of any patient referred to in this decision, or matters capable of revealing the identity of such patient is prohibited.