Civil and Administrative Tribunal New South Wales Medium Neutral Citation: Health Care Complaints Commission v Al-Mozany (No 7) [2024] NSWCATOD 86 Hearing dates: 17 June 2024 Date of orders: 17 June 2024 Decision date: 27 June 2024 Jurisdiction: Occupational Division Before: R C Titterton OAM, Senior Member Dr G Labour, Senior Member Dr N Xouris, Senior Member D Telford, General Member Decision: (1) Under s 149A(1)(a) of the Health Practitioner Regulation National Law, the Tribunal reprimands the respondent. (2) The Tribunal imposes the conditions on the respondent's registration set out in Attachment A to these reasons. (3) The respondent is to pay 70% of the applicant's costs of the proceedings. Catchwords: TRADES AND PROFESSION –– dentist –– Health Practitioner Regulation National Law –– unsatisfactory professional conduct –– professional misconduct –– reprimand ordered –– conditions placed on registration Legislation Cited: Health Practitioner Regulation National Law (NSW), ss 3, 3B, 138E, 139B, 149A Cases Cited: Al-Mozany v Dental Council of New South Wales [2021] NSWCATOD 110 Health Care Complaints Commission v Al-Mozany (No 6) [2024] NSWCATOD 8 Health Care Complaints Commission v Do [2014] NSWCA 307 Health Care Complaints Commission v Haasbroek [2018] NSWCATOD 177 Health Care Complaints Commission v Litchfield (1997) 41 NSWLR 630 Health Care Complaints Commission v Livermore [2021] NSWCATOD 115 Health Care Complaints Commission v Lord [2019] NSWCATOD 182 Health Care Complaints Commission v Philipiah [2013] NSWCA 342 Health Care Complaints Commission v Pittard (No 2) [2024] NSWCATOD 74 Health Care Complaints Commission v Richards [2024] NSWCATOD 37 Health Care Complaints Commission v Schmaman [2019] NSWCATOD 82 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 Category: Principal judgment Parties: Health Care Complaints Commission (Applicant) Saad Abdul-Hassan Al-Mozany (Respondent) Representation: Counsel: A Petrie (Applicant) Solicitors: Health Care Complaints Commission (Applicant) Respondent (self-represented) File Number(s): 2020/00365306 Publication restriction: Pursuant to s 64(1)(a) of the Civil and Administrative Tribunal Act 2013 (NSW), the disclosure of the names of the persons identified in the Schedule to the Amended Complaint, together with any information or material which could identify those persons, is prohibited. REASONS FOR DECISION Introduction 1. These are the Stage 2 reasons for decision in this matter. 2. These reasons assume a knowledge of the Stage 1 reasons for decision published on 23 January 2024, Health Care Complaints Commission v Al- Mozany (No 6) [2024] NSWCATOD 8 (the Stage 1 Decision). 3. Suffice it to say, the Tribunal found 25 instances of unsatisfactory professional conduct, which collectively amounted to be conduct of a sufficiently serious nature for a finding of professional misconduct. 4. The conduct found proven related to 11 patients over a prolonged period of time. There are significant similarities between the findings in relation to multiple patients, giving weight to the fact that this was not an isolated occurrence and a departure from the practitioner's ordinary day to day professional conduct. 5. Some of the practitioner's patients were minors. 6. The findings in relation to 12 patients included a failure by the practitioner to: 1. conduct appropriate initial assessments, (5 patients); 2. formulate appropriate treatment plans, (5 patients); 3. obtain informed consent, (3 patients); and 4. provide an appropriate course of orthodontic treatment (7 patients). 1. The practitioner denied the Particulars found proven. 2. The Tribunal found that the practitioner's conduct found proven amounted to unsatisfactory professional conduct within the meaning of s 139B(1)(a) of the Health Practitioner Regulation National Law (NSW) (National Law) and professional misconduct within the meaning of s 139E of the National Law. Evidence on Stage 2 Evidence of the Commission 1. The applicant (Commission) filed no evidence for the Stage 2 hearing. Evidence of the practitioner 1. The practitioner relied on two statements respectively filed on 16 April 2024 and at the hearing on 17 June 2024. 2. In addition, the practitioner relied on: 1. various Continuing Professional Development (CPD) courses certificates of completion; and 2. documents setting out the learning objectives of those CPD course. First statement of the practitioner 1. This is a 24-page statement. It is in part what is often referred to in Stage 2 proceedings as a "Reflection". The practitioner relevantly states: What the last 5.5 years has taught me? Since November 2018 I have been through five and a half years of being able to reflect on my working life and the way I conducted my Dental and Orthodontic practice. I have had to look wholistically and introspectively into how I practiced Dentistry, be honest with myself and understand how I am in the position I am in now. During this self-reflective journey, I have identified aspects of my practice that need to change and how I can do better and improve how I practiced Dentistry and Orthodontics. 1. The practitioner then sets out those aspects of his practice that he will need to "change completely and improve in the future" if the Tribunal permits him to return to practice. In summary, these are: 1. his recording of initial assessments, treatment plans, informed consent and orthodontic treatment; and 2. how he would improve the initial assessment, treatment plan, informed consent and ongoing orthodontic treatment records. 1. The practitioner sets out more than 10 pages of detailed submissions dealing with these issues. 2. The practitioner recognises that there have been shortcomings in his dental and orthodontic practice. 3. The practitioner then sets out the courses that he has either undertaken or is undertaking to improve his clinical practice. He says that, on reflection on the Tribunal's decision, he focused on the following areas: 1. conducting an appropriate initial assessment; 2. formulating an appropriate treatment plan; 3. obtaining informed consent; 4. adequately monitoring patients' general dental health; and 5. providing an appropriate course of orthodontic treatment. 1. In the next section of this statement, "Future mentoring and path back to work", the practitioner relevantly states: I have not been able to practice Dentistry or Orthodontics since November 2018 due to the conditions imposed on me by the Dental Council of NSW. The conditions imposed on me do not allow me to work at all in my profession as a Dentist or Orthodontist. The condition imposed to me by the Dental Council amounts to a suspension as it does not allow me to practice any aspect of Dentistry whatsoever. This condition has been in place for approximately 5.5 years. The Dental Council's Condition Handbook states in the Forward section that: "Creating conditions to be imposed on the registration of health practitioners is not as easy as it looks. The aim is to create conditions that achieve the aim of protecting the health and safety of the public, whilst also allowing health professionals to practise their profession." The conditions imposed on me by the Dental Board has not allowed me to practice my profession in any capacity for the last 5.5 years. The condition imposed on me by the dental Board is tantamount to a full suspension. I respectfully ask the Tribunal to consider the timeframe of my inability to work as a Dentist or Orthodontist for the last 5.5 years in their decision after the Stage 2 hearing. After much thought and introspection, I accept that due to the time period I have not practiced I should not be allowed to commence practice unsupervised and accept that if the Tribunal would allow me to return back to work in Dentistry and Orthodontics then conditions need to be imposed on my registration for a period of time until the Tribunal is satisfied that I am able to return back to work in a full capacity. (Emphasis added by the practitioner) 1. Finally, the practitioner comments on the conditions the Commission proposed should be placed on his registration. 2. Suffice it to say, the practitioner accepted the proposed conditions and the need for such conditions to be placed on his registration. Importantly, both in his statement and in his oral evidence in cross-examination, he provided a detailed account about how he would comply with those conditions in practice, and accepted the appropriateness of those conditions in the circumstances of the matter. Second statement of the practitioner 1. The second statement sets out further details of the 68 CDP courses he has attended or is enrolled in (overwhelmingly this year). This amounts to a total of 74.8 hours of CPD. Completion certificates 1. It is not necessary to comment on these certificates, save that they provide probative evidence that the practitioner has completed or is completing various CPD courses. Course learning Objectives 1. These documents provide probative evidence of the relevance and appropriateness of how the courses address the various deficiencies in the practitioner's practice identified in the Stage 1 Decision. Cross-examination 1. We were satisfied that the practitioner demonstrated deep insight into the various deficiencies in his practice identified in the Stage 1 Decision, suitable remorse, and a particular commitment to addressing those deficiencies and contributing once again to the important work of dentists and orthodontists in serving the community. Submissions Submissions of the Commission 1. The Commission's submissions commence by setting out a summary of the Stage 1 Decision as follows. 2. The practitioner is aged in his mid-40s. 3. In 2003, the practitioner was first registered as a Dental Practitioner in New Zealand. 4. In 2010, the practitioner joined Gentle Dental Care (GDC) as a general dentist and in 2012 commenced working as an Orthodontist there. 5. In 2011, the practitioner completed his Doctor of Clinical Dentistry and Orthodontics at the University of Sydney. 6. In 2014, the practitioner entered into partnership with four dental practitioners. 7. From 2012 to late 2017, the practitioner was the only specialist Orthodontist employed by GDC. 8. By late 2017, the practitioner was working 6 to 7 days a week across 5 different locations and seeing 80 to 100 patients per day. 9. From 2017 onwards, the practitioner was involved in a contractual dispute with GDC. 10. On 15 April 2018, the practitioner's employment was terminated by GDC and he has not treated any patients in Australia since that time. 11. The practitioner continued practising in New Zealand until around October 2018, at which time the New Zealand Health Practitioners Disciplinary Tribunal censured the Respondent and cancelled his registration as a General Dentist and Orthodontist. 12. Following a s 150 hearing on 16 November 2018, the Dental Council of New South Wales (Council) placed a condition on the practitioner's registration that he not practise dentistry. 13. On 9 August 2021, an appeal of the Council's s150 decision was dismissed by the Tribunal for want of prosecution: Al-Mozany v Dental Council of New South Wales [2021] NSWCATOD 110. 14. The practitioner has not worked as an Orthodontist or Dental Practitioner since October 2018, being a period of approximately five and a half years. 15. The Commission then sets out what it submits are the relevant legislation provisions and principles. 16. After referring to s 149A of the National Law, the Commission submits that the appropriate protective order is that the practitioner be reprimanded, and permitted to practise subject to a series of conditions. 17. We note that, by and large, we made the orders sought by the Commission. Those orders and conditions imposed are set out in Attachment A to these reasons. 18. Finally, the Commission's submissions deal with costs. In summary, in its written submissions the Commission sought an order that the practitioner pay its costs as agreed or as assessed. 19. In oral submissions, after taking instructions and in response to observations from the Tribunal, the Commission's counsel Ms Petrie submitted that the Commission sought an order that the practitioner pay 80% of its costs as agreed or as assessed. Submissions of the practitioner 1. The practitioner did not oppose the imposition of a reprimand. Nor did he oppose the imposition of conditions on his registration. 2. Nor did he oppose an order for costs, agreeing that he should pay the Commission's costs, although he did note that there were many particulars of the Amended Complaint in which the Commission was not successful. Relevant law and principles 1. The starting point is s 3B [1] of the National Law which provides: In the exercise of functions under an NSW provision, the protection of the health and safety of the public must be the paramount consideration. 1. Section 149A of the National Law relevantly provides: 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; (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. 1. The Commission notes in its submissions that in Health Care Complaints Commission v Lord [2019] NSWCATOD 182 at [41] - [42] the Tribunal considered the difference between a reprimand and caution and said: 41 In Health Care Complaints Commission v Dowla (No 2) [2019] NSWCATOD 156 (Dowla (No 2)), the Tribunal considered at [42] the difference between a caution and a reprimand under s 149A(1)(a) of the National Law and cited with approval the decision of the Victorian Civil and Administrative Tribunal in Psychologists Registration Board of Australia v Coleman (Review and Regulation) [2013] VCAT 738 (Coleman), in which the Tribunal explained at [14]: [T]he ordinary meaning of the words leads to the conclusion that a reprimand is an official rebuke for past wrongful conduct whereas a caution is a reminder to take care in the future and avoid repetition. Of the two, we consider a reprimand provokes more serious consequences. In Peeke v Medical Board of Victoria (unreported, Marks J. 19 January 1994). His Honour commented on a view that had been expressed to the effect that to impose a reprimand was to trivialise a serious lapse in professional standards. His retort was succinct - I am not able to agree with the Board that a reprimand is a trivial penalty. It may be inappropriate or inadequate in many circumstances, but a reprimand, to a professional person, has a potential for serious adverse implications. 42 As noted by the Tribunal in Dowla (No 2) at [44], a reprimand, if imposed, will appear on the record of a practitioner's registration maintained by the Australian Health Practitioner Regulation Agency (AHPRA): s 225(j). In contrast, the National Law does not require AHPRA to record a caution on practitioner's record." 1. The Tribunal stated in Health Care Complaints Commission v Pittard (No 2) [2024] NSWCATOD 74 at [17] that the principles relating to protective orders are well known. The Tribunal noted that in Health Care Complaints Commission v Richards [2024] NSWCATOD 37 the Tribunal had accepted that the relevant principles included the following: 1. the Tribunal must consider the maintenance of standards of the profession, preservation of public confidence in the profession and, more broadly, the protection of the community: Prakash v Health Care Complaints Commission [2006] NSWCA 153 at [91]; 2. public protection is achieved by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered: National Law, s 3(2)(a); 3. deterring others from engaging in similar conduct is a necessary part of maintaining the standards of the profession and thereby ensuring public safety and faith in the profession: Health Care Complaints Commission v Litchfield (1997) 41 NSWLR 630 at 637; 4. protecting the health and safety of the public is not confined to protecting current or potential patients but includes protecting the public from similar misconduct of others and upholding public confidence in the standards of the profession: Health Care Complaints Commission v Do [2014] NSWCA 307 at [35]; 5. the Tribunal's jurisdiction is primarily protective, not punitive: Litchfield at 637. 1. To these principles can be added the following additional principles set out in the Commission's submissions. 2. First, In Health Care Complaints Commission v Haasbroek [2018] NSWCATOD 177 at [94] the Tribunal considered the need for general deterrence and said: Our orders must also have an element of deterrence, so that other practitioners will be aware of the consequences of inappropriate behaviour in both their professional and personal lives. 1. Secondly, in Lee v Health Care Complaints Commission [2012] NSWCA 80 the Court of Appeal, per Barrett JA, with McFarlan JA and Tobias AJA agreeing. considered the exercise of powers by Tribunals to make protective orders and stated: 21 Essential to a proper assessment of a Tribunal's discretionary judgement in a disciplinary jurisdiction in accordance with these criteria is a clear understanding of the nature of the jurisdiction and an appreciation of the purpose of orders made in exercise of it. These matters are explained by Basten JA in Director General, Department of Ageing, Disability and Home Care v Lambert [2009] NSWCA 102: (2009) 74 NSWLR 523 at [83]. His Honour made several important points: 1. The specific purpose for which orders are made is protective in the public interest and is not punitive with respect to the individual. 2. That is not to deny that such orders may be punitive in effect and that punitive effect may be relevant in formulating a protective order. 3. The punitive effects may be directly relevant to the need for protection so that, in a particular case, there may be a factual finding that the harrowing experience of disciplinary proceedings, together with the real threat of loss of a livelihood, may have opened the eyes of the individual concerned to the seriousness of his or her conduct so as to diminish significantly the likelihood of its repetition and to produce a level of insight into his or her own character or misconduct which did not previously exist. 22 The task of the Tribunal … centres not on punishment as such but on the protection of the public and the maintenance of proper professional standards." 1. The Commission also notes that Basten JA stated in Prakash at [91]: The purpose of any order consequent upon a finding that a complaint has been proved, is said to be protective of the interests of the public at large, but more particularly patients or potential patients of the practitioner concerned. However the public interests include indirectly, the standing of the medical profession and the maintenance of public confidence in the high standard of practitioners. There is also an element of deterrence or, to put it more positively, encouragement to other practitioners to recognise the importance of complying with professional standards and the risks of failing to do so. The powers of a Tribunal having two members of the medical profession should, at least in relation to professional standards be accorded a degree of flexibility which might not necessarily be accorded to a Tribunal differently constituted. 1. Importantly, the Commission also submitted that no order should be made which has more serious consequences for the practitioner than is reasonably necessary in execution of the protective purposes of the legislation: NSW Bar Association v Meakes [2006] NSWCA 340 at [114]; Health Care Complaints Commission v Schmaman [2019] NSWCATOD 82 at [88] Consideration 1. As we have noted above, at the conclusion of the hearing we imposed the protective orders sought by the Commission and (by and large) imposed the conditions on the practitioner's registration sought. 2. This was because we were satisfied that a reprimand and the imposition of conditions on the practitioner's registration was an appropriate and proportionate protective order to make in the circumstances of this case. We do not consider that a harsher order is required to protect the public, who face no risk from the practitioner in his practice of dentistry and provision of orthodontic services. 3. As we have also observed, we were satisfied that the practitioner demonstrated deep insight into the various deficiencies in the practitioner's practice identified in the Stage 1 Decision, suitable remorse, and a particular commitment to addressing those deficiencies and contributing once again to the important work of dentists and orthodontists in serving the community. Costs 1. As the Tribunal and the Court of Appeal has remarked on many occasions, this is a costs jurisdiction, and the ordinary rule is that costs follow the event: Health Care Complaints Commission v Philipiah [2013] NSWCA 342. 2. And, in Health Care Complaints Commission v Livermore [2021] NSWCATOD 115 the Tribunal stated at [19]: The authorities are clear on this issue. In applying the provisions of cl 13, the general rule is that costs follow the event and that costs are intended to compensate the successful party, absent any disentitling conduct: [Health Care Complaints Commission v ] Philipiah [2013] NSWCA 342 at [42]; Lucire v Health Care Complaints Commission (No 2) [20111 NSWCA 182; Qasim v Health Care Complaints Commission [2015] NSWCA 282 at [87]; Singh v Medical Council of NSW (No 2) [2015] NSWGATOD 28 at [45]. 1. We accept that the applicant is in straightened financial circumstances, and, indeed, he told us at the hearing that he was now bankrupt. We infer that he will be unable to satisfy any costs order in the short term. Nevertheless, we would fall into error were we not to award costs for that reason alone. The Tribunal and the Court of Appeal have repeatedly stated that impecuniosity is not a justifiable reason for departing from the general rule that costs follow the event: see by way of example, Philipiah at [42]. 2. However, as discussed at the hearing, the feeling of the Tribunal was that the Commission should not be able to recover 100% of its costs. In this respect, we note the very proper submission of the Commission to seek an order that the practitioner pay 80% of its costs. 3. Here we need to analyse the Stage 1 Decision. 4. Three complaints were made. Compliant One 1. Complaint One was that the practitioner was guilty of unsatisfactory professional conduct under ss 139B(1)(a) of the National Law in that the practitioner has engaged in conduct that demonstrates the knowledge, skill or judgment possessed, or care exercised, by the practitioner in the practice of the dental profession that is significantly below the standard reasonably expected of a practitioner of an equivalent level of training or experience. 2. There were 23 Particulars of Complaint One, relating to some 14 patients. 3. As we noted in the Stage 1 Decision: 219 … Complaint One can be divided into two sub-sets of allegations in respect of the 14 patients. 220 The first sub-set of allegations are the allegations that: (1) the practitioner failed to conduct appropriate initial assessments of Patients A, B, C, D, E, F, G, H, I, K, M and N; (2) the practitioner failed to formulate appropriate treatment plans for Patients A, C, D, E, F, G, I, K and M; (3) the practitioner failed to obtain informed consents from Patients A, B, C, D, E, F, G, I, J, K, L, M and N (or their guardians where appropriate). 221 In addition, there was an additional allegation in respect of Patient C, namely failing to diagnose significant periodontal disease. 222 The second sub-set of allegations relate to: (1) the failure of the practitioner to adequately monitor the general dental health of Patients A, C, E, F, G, H, I and J; (2) the failure of the practitioner to provide appropriate orthodontic treatment to Patients A, B, C, D, E, F, G, H, I and J and M. 1. For the reasons stated in the Stage 1 Decision, we found a total of 26 sub-particulars of Complaint One to be established. 2. We further found that the conduct the subject of these proven Particulars amounted to unsatisfactory professional conduct under s 139B(1)(a) of the National Law. Complaint Two 1. Complaint Two was that the practitioner was guilty of unsatisfactory professional conduct under s 139B(1)(a) of the National Law in that the practitioner has engaged in conduct that demonstrates the knowledge, skill or judgment possessed, or care exercised, by the practitioner in the practice of the dental profession that is significantly below the standard reasonably expected of a practitioner of an equivalent level of training or experience. 2. There were 42 Particulars of Complaint One, relating to some 10 patients. Only 11 were pressed at the hearing. 3. For the reasons stated in the Stage 1 Decision, we found none of the Particulars proven. Complaint Three 1. Complaint Three was that the practitioner is guilty of professional misconduct under s 139E of the National Law in that the practitioner had 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 suspension or cancellation of the practitioner's registration. 2. In the Stage 1 Decision we concluded: 396 We have found a total of 26 sub-particulars established, of which we will take into account 25 sub-particulars in relation to determining whether the Commission has established Complaint Three. 397 Of those 25 sub-particulars: (1) 5 sub-particulars related to the practitioner's failure to conduct an initial assessment; (2) 5 sub-particulars related to the practitioner's failure to formulate an appropriate treatment plan; (3) 2 sub-particulars related to the practitioner's failure to obtain an informed consent; (4) 1 sub-particular related to the practitioner's failure to diagnose significant periodontal disease; (5) 12 sub-particulars related to the practitioner's failure to provide an appropriate course of orthodontic treatment. 398 In Chen v Health Care Complaints Commission (2017) 95 NSWLR 334; [2017] NSWCA 186, Basten JA, with whom Leeming JA agreed, stated: 19. … The term 'professional misconduct' does not have a specific meaning; it is merely a category of 'unsatisfactory professional conduct' which is sufficiently serious to justify suspension or cancellation. … 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. … Each case will depend upon an evaluative judgment to be made by the Tribunal as to the nature and seriousness of the conduct. …" (emphasis added) 399 We note that the seriousness of the conduct is not to be measured by reference to the worst cases, but by reference to the extent to which it departs from proper standards: Health Care Complaints Commission v Litchfield [1997] 41 NSWLR 630 at 638. 400 We do not consider that any individual proven Particular is of such a sufficiently serious nature to justify suspension or cancellation of the practitioner's registration. 401 However, we do consider that when the 25 [2] instances of unsatisfactory professional conduct we have found established are considered together, they amount to conduct of a sufficiently serious nature to justify suspension or cancellation of the practitioner's registration. Consideration 1. All this to say, there were three complaints agitated, only two of which were established. Of course, Complaint Three "piggybacked" off Complaints One and Two. 2. As the Commission noted in its submissions, costs are discretionary. 3. The Amended Complaint, alleged: 1. in relation to Complaint One, some 75 Particulars and sub-particulars; 2. in relation to Complaint Two, some 38 Particulars and sub-particulars, only 10 of which were pressed at the hearing; 1. Only 26 Particulars and sub-particulars of Complaints One and Two were established (25 of which we took into account), and only two of the three complaints were established. 2. In such circumstances, the Tribunal considers that the Commission is not entitled to recover its costs in full. And this appears to be accepted in the Commission's submission that an order be made that the practitioner pay it 80% of its costs as agreed or as assessed. 3. We consider that the appropriate order is that the Practitioner should pay entitled to 70% of the Commission's costs. Orders 1. The Tribunal makes the following orders: 1. Under s 149A(1)(a) of the Health Practitioner Regulation National Law, the Tribunal reprimands the respondent. 2. The Tribunal imposes the conditions on the respondent's registration set out in Attachment A to these reasons. 3. The respondent is to pay 70% of the applicant's costs of the proceedings. ******** Attachment A Under s 149A(1)(b) of the Health Practitioner Regulation National Law, the Tribunal directs that the following Conditions be imposed on the practitioner registration: Supervision 1. To practise under category B supervision in accordance with the Dental Council of NSW's Compliance Policy — Supervision (as varied from time to time) and as subsequently determined by the appropriate review body. 2. At each supervision meeting the practitioner is to review and discuss his practice with his approved supervisor with particular focus on: 1. conducting appropriate initial assessments of patients; 2. formulating an appropriate treatment plan; 3. obtaining informed consent; 4. undertaking adequate and appropriate record keeping; and 5. providing an appropriate course for orthodontic treatment. 1. To observe the approved supervisor's practice once a week for one hour. 2. To authorise the approved supervisor to provide written reports to the Council at monthly intervals, or as specified by the Council. 3. Not to practise until a supervisor has been approved by the Dental Council of NSW. Audit of practice & records 1. To submit to an audit by a random selection of the practitioner's clinical practice and patient and clinical records by a person or persons nominated by the Dental Council of NSW 2. The audits are to be held within 6 months from recommencement of practice and subsequently as required by the Council. 3. The auditor(s) is/are to assess the practitioner's compliance with: 1. the Dental Board of Australia's Code of Conduct; 2. good patient and clinical record keeping standards and compliance with legislative requirements; 3. compliance with conditions. 4. the initial assessments of patients; 5. the appropriateness of treatment plans; 6. informed consent; and 7. the provision of an appropriate course for orthodontic treatment. 1. To authorise the auditor(s) to provide the Council with a report on their findings. Group practice only 1. To practice only in a group practice approved by the Dental Council of NSW where there are at least 2 other registered practitioners who hold specialist registration in orthodontics (excluding the subject practitioner) and: 1. the patient records are shared between the practitioners; 2. there is always one other practitioner who holds specialist registration in orthodontics on site. 1. Not to practise until a group practice has been approved by the Dental Council of NSW. Practice time & patient limits 1. To practise no more than 35 hours per week. These hours are inclusive of any administrative work. 2. To treat/consult with no more than 120 patients in any one week. 3. The practitioner is to provide the Dental Council of NSW with copies of records confirming the number of patients/clients treated/consulted, their consultation times and hours worked on any dates as specified by the Council. 4. To treat/consult with no more than 8 new patients a week, and to treat/consult with new patients for at least 1 hour in an initial consultation. The practitioner is to provide the Dental Council of NSW with copies of records confirming the number of patients/clients treated/consulted, their consultation times and hours worked on any dates as specified by the Dental Council of NSW. Education 1. To satisfactorily complete within 12 months of recommencement of practice, education approved by the Dental Council of NSW and that has the following content and/or learning objectives: 1. Conducting appropriate initial assessments 2. Formulating appropriate treatment plans 3. Obtaining informed consent 4. Adequately monitoring patient general dental health 5. Maintaining satisfactory records 1. Within 6 months of publication of the Stage 2 reasons for decision the practitioner must provide evidence to the Dental Council of NSW of enrolment in the approved course. 2. Within 4 days of completing the approved course, the practitioner is to provide documentary evidence of satisfactory completion to the Dental Council of NSW. 3. The practitioner is to bear responsibility for any costs incurred in meeting this condition/order. Non-review period 1. These Conditions are to remain in place for 1 year, after which the practitioner can seek a review of the conditions by the Dental Council of NSW. Review 1. The appropriate review body for the purpose of a review under ss 163 -163C of the Health Practitioner Regulation National Law is the Dental Council of NSW when the respondent has a principal place of practice in NSW. 2. Sections 125 and 127 of the Health Practitioner Regulation National Law are to apply while the respondent's principal place of practice is anywhere in Australia other than NSW, so that a review of these conditions can be conducted by the Dental Board of Australia. Endnotes 1. Noting the recent amendments to the National Law with s 3B replacing s 3A. 2. Amended pursuant to s 63 of the Civil and Administrative Tribunal Act 2013 (NSW) on 17 June 2024. 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 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: 27 June 2024