Civil and Administrative Tribunal New South Wales Medium Neutral Citation: Health Care Complaints Commission v Anderson [2024] NSWCATOD 155 Hearing dates: 22 April 2024 Date of orders: 18 September 2024 Decision date: 18 September 2024 Jurisdiction: Occupational Division Before: T Simon, Principal Member H Dowling, Senior Member, A Lee, Senior Member B Seth, General Member Decision: (1) Ms Anderson is reprimanded. (2) If either party seeks costs of the proceedings, they are to notify the Tribunal and the other side by 20 September 2024 and include written submissions as to the basis for the costs' application. Catchwords: HEALTH — professional registration — registered pharmacist — conviction — unsatisfactory professional conduct — appropriate protective orders — reprimand — conditions — costs Legislation Cited: Crimes Act 1900 (NSW) Health Practitioner Regulation National Law (NSW) Road Transport Act 2013 (NSW Cases Cited: Health Care Complaints Commission v Do [2014] NSWCA 307 Health Care Complaints Commission v Lord [2019] NSWCATOD 182 Health Care Complaints Commission v Perera [2018] NSWCATOD 112 Health Care Complaints Commission v Philipiah [2013] NSWCA 342 Lee v Health Care Complaints Commission [2012] NSWCA 80 Category: Principal judgment Parties: Health Care Complaints Commission (Applicant) Anna Marie Anderson (Respondent) Representation: Counsel: N A Wootton (Applicant) T Flaherty (Respondent) Solicitors: Health Care Complaints Commission (Applicant) Bennett & Philp Lawyers (Respondent) File Number(s): 2023/00419756 Reasons for decision 1. The Health Care Complaints Commission (HCCC), the applicant, initially referred three complaints to the Tribunal for orders under the Health Practitioner Regulation National Law (NSW) (National Law) against the respondent Anna Marie Anderson, a pharmacist. 2. An amended complaint was filed on 9 February 2024 and the third complaint was not pressed. 3. The first complaint is that on 18 May 2022, Ms Anderson was convicted at the District Court of New South Wales of aggravated dangerous driving occasioning grievous bodily harm contrary to s 52A(4) of the Crimes Act 1900 (NSW). 4. The second complaint is that Ms Anderson is guilty of unsatisfactory professional conduct because she failed to notify the National Board that she had been charged with the following offences (punishable by 12 months imprisonment or more), within seven days of becoming aware of that fact: 1. On 4 April 2021, she had been charged with driving with high range PCA - first offence contrary to s 110(5)(a) of the Road Transport Act 2013 (NSW). 2. On 4 April 2021, the practitioner was charged with aggravated dangerous driving occasioning grievous bodily harm contrary to s 52A(4) of the Crimes Act 1900 (NSW). 3. On 4 April 2021, the practitioner was charged with dangerous driving occasioning grievous bodily harm - drive manner dangerous contrary to s 52A(3)(c) f the Crimes Act 1900 (NSW). 1. Ms Anderson also failed to notify the National Board, within 7 days, that on 18 May 2022, she had been convicted by a New South Wales Court of aggravated dangerous driving occasioning grievous bodily harm contrary to s 52A(4) of the Crimes Act 1900. 2. In a reply to the amended application filed with the Registry on 14 March 2024, Ms Anderson admits complaints 1 and 2 and accepts that a reprimand is a suitable action. Complaint 1 - Criminal Conviction 1. Section 144(a) of the National Law provides as follows: 144 Grounds for complaint about registered health practitioner [NSW] The following complaints may be made about a registered health practitioner— (a) Criminal conviction or criminal finding A complaint the practitioner has, either in this jurisdiction or elsewhere, been convicted of or made the subject of a criminal finding for an offence. 1. A certificate of conviction for aggravated dangerous driving occasioning grievous bodily harm contrary to s 52A(4) of the Crimes Act 1900 (NSW) is contained in the applicant's documents (exhibit 1, pp 256-257). The certificate discloses that Ms Anderson was convicted of the offence of aggravated dangerous driving occasioning grievous bodily harm. 2. Having considered the evidence, we find that Ms Anderson has been convicted of criminal offences and the first complaint is proven. Complaint 2 - Unsatisfactory Professional Conduct 1. Section 144(b) of the National Law provides as follows: 144 Grounds for complaint about registered health practitioner [NSW] The following complaints may be made about a registered health practitioner— … (b) Unsatisfactory professional conduct or professional misconduct A complaint the practitioner has been guilty of unsatisfactory professional conduct or professional misconduct. 1. Section 139B(1)(b) provides that contravention by a practitioner of a provision of the National Law amounts to unsatisfactory professional conduct. 2. Section 130(1) of the National Law requires that a registered health practitioner must, within 7 days after becoming aware that a relevant event has occurred, give the National Board established for the practitioner's profession, written notice of the event. Section 130(3)(a)(ii) includes, in the meaning of a relevant event, if a practitioner is charged with an offence punishable by 12 months imprisonment or more. Section 130(3)(b)(ii)) also includes where the practitioner is convicted of or the subject of a finding of guilt for an offence, whether in a participating jurisdiction or elsewhere, punishable by imprisonment (s 130(3)(a)(ii)). 3. Pursuant to s 52A(4) of the Crimes Act 1900 (NSW), a person found guilty of the offence of aggravated dangerous driving occasioning grievous bodily harm, is liable to imprisonment for 11 years. 4. The Pharmacy Council of NSW received an anonymous complaint in relation to Ms Anderson's charges on 6 April 2021 (exhibit 1, pp 17-18). Ms Anderson admits that she failed to notify the National Board within the required time. 5. Having considered that evidence, we are satisfied that Ms Anderson failed to notify the National Board within the time limit specified in relation to both the charges laid on 4 April 2021 and her conviction in relation to one of charges on 18 May 2022. We are satisfied that the complaint of unsatisfactory professional conduct is proven. Appropriate Protective Orders 1. Sections 149A-149C of the National Law set out the orders that the Tribunal can make once it has been found that the complaint against the practitioner has been proved. 2. The power to make those orders is protective rather than punitive. 3. Section 3(2)(a) of the National Law provides that one of the objectives of the national registration scheme is: (a) to provide for the protection of the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered; … 1. In Lee v Health Care Complaints Commission [2012] NSWCA 80, the Court of Appeal held (at [20]-[21]): "20. Essential to a proper assessment of a tribunal's discretionary judgment 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 were 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 effects 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. 21. The task of the Tribunal (and of this Court on appeal) centres not on punishment as such but on the protection of the public and the maintenance of proper professional standards." 1. In Health Care Complaints Commission v Do [2014] NSWCA 307, the Court of Appeal said (at [35]): "The objective of protecting the health and safety of the public is not confined to protecting the patients or potential patients of a particular practitioner from the continuing risk of his or her malpractice or incompetence. It includes protecting the public from the similar misconduct or incompetence of other practitioners and upholding public confidence in the standards of the profession. That objective is achieved by setting and maintaining those standards and, where appropriate, by cancelling the registration of practitioners who are not competent or otherwise not fit to practise, including those who have been guilty of serious misconduct. Denouncing such misconduct operates both as a deterrent to the individual concerned, as well as to the general body of practitioners. It also maintains public confidence by signalling that those whose conduct does not meet the required standards will not be permitted to practise." 1. As noted above, Ms Anderson submits that a reprimand is an appropriate order. 2. By way of the amended application, the HCCC submits that a reprimand with conditions placed on Ms Anderson's registration, are the appropriate orders. 3. The conditions proposed are as follows: 2.1. To practice under Category C supervision in accordance with the Pharmacy Council of NSWs Compliance Policy - Supervision (as varied from time to time): a) To participate in review meetings with her supervisor on a quarterly basis b) Each review meeting to be held for a minimum of one (1) hour c) To authorise the supervisor to provide reports to the Pharmacy Council of NSW on a monthly basis d) To authorise the Pharmacy Council of NSW to provide proposed and approved supervisor with a copy of any relevant decision/report. 2.2. To practice no more than forty (40) hours per week with no more than ten (10) hours in any twenty-four (24) hour period. 2.3. Within seven (7) days of the end of each calendar month, the practitioner is to provide the Pharmacy Council of NSW with a copy of her work rosters for the preceding calendar month. The roster must include the following: a) Name and signature of the owner / co-owner of the Pharmacy where she is working for each corresponding day. b) Date, time, name of pharmacy and location of each shift 2.4. To obtain Pharmacy Council of NSW approval before changing the nature or place of her practice. 2.5. To forward evidence to the Pharmacy Council of NSW prior to commencing practice that she has provided a copy of her full conditions to her employer or owner of pharmacy. 2.6. To comply with the Pharmacy Council of NSW's Alcohol Screening Policy and Participant Procedure: breath testing for alcohol as varied from time to time and undergo regular breath testing. The practitioner is to bear responsibility for the costs incurred in meeting this condition. Review The appropriate review body for the purpose of a review under section 163 -163C of the Health Practitioner Regulation National Law is the Pharmacy Council of NSW when the respondent has a principal place of practice in NSW. 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 Pharmacy Board of Australia. 1. Relevantly, s 149A of the National Law relevantly provides as follows: 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. In the initial referral to the Tribunal the applicant had made three complaints. Complaint 3 was made pursuant to s 144(d) of the National Law. It was pleaded that the practitioner had an impairment within the meaning of s 5 of the National Law. Complaint 3 was not pressed by the time the matter came to hearing. Counsel for the respondent made submissions that the Tribunal could not consider whether it could make an order for conditions as complaint 3 had been withdrawn. As far as we could understand the submissions made by Counsel that was for two reasons. 2. The first was that it raised an issue of procedural fairness. We reject that the matter raises a procedural fairness issue as the respondent was on notice prior to the hearing that the HCCC was seeking conditions and the respondent was able to address that matter by way of submissions at the hearing. 3. The second basis is that because complaint 3 was not pressed, there was not a sufficient nexus between the complaints 1 and 2 and the protective orders sought. The applicant submitted that complaints 1 and 2 should have been matters referred to and dealt with by the relevant Council and that the provisions of s 149A of the National Law should be read down. 4. Section 144 of the National Law identifies the grounds for complaint about a registered health practitioner. They include that a complaint the practitioner has been convicted for an offence (s 144(a)) and a complaint that the practitioner has been guilty of unsatisfactory professional conduct or professional misconduct (s 144(b)). 5. Section 145B(1)(c) of the National Law allows a Council to refer a complaint to the Tribunal. 6. Section 145C(1)(a) also provides a discretion for the HCCC to refer a complaint to the Council for the health profession in which the practitioner or student is registered or, after consultation with a Council, to a Committee or the Tribunal. 7. Section 145D of the National Law provides that: 145D Serious complaints must be referred to Tribunal [NSW] (1) Both a Council for a health profession and the Commission are under a duty to refer a complaint to the Tribunal if, at any time, either forms the opinion that it may, if substantiated, provide grounds for the suspension or cancellation of a registered health practitioner's or student's registration. (2) However, either the Council or the Commission may decide not to refer the complaint to the Tribunal if of the opinion the allegations on which the complaint is founded (and on which any other pending complaint against the registered health practitioner or student is founded) relate solely or principally to— (a) for a practitioner, the physical or mental capacity of the practitioner to practise the practitioner's profession; or (b) for a student, the physical or mental capacity of the student to undertake clinical training in the health profession in which the student is registered. (3) If the Council decides not to refer the complaint to the Tribunal, the Council must instead refer the complaint to a Committee or Impaired Registrants Panel. (4) If the Commission decides not to refer the complaint to the Tribunal, the Commission must instead refer the complaint to the Council. (5) This section does not require the Council or the Commission to refer a complaint the Council or Commission thinks is frivolous or vexatious. Note— A referral under this section is an application made to the Tribunal for a general decision for the purposes of the Civil and Administrative Tribunal Act 2013. 1. While we accept that the power to refer a complaint under s 145B or s 145C is discretionary, we reject that s 145D limits a referral to the Tribunal to only when there are serious complaints. Section 145D simply places an additional duty on the HCCC to refer when a complaint is serious and where there are grounds for suspension or cancellation. Section 145D mandates circumstances, in which complaints must be referred. It was always within the HCCC's discretion to refer the complaint, even without complaint 3, or in circumstances where the complaint was later withdrawn in the proceedings. 2. We are of the view that the Tribunal has the power to impose conditions on the practitioner's registration pursuant to s 149A(1)(b) should it find it appropriate to do so. There is no basis to read the provision down as was submitted by the respondent. Circumstances of the Offence 1. Ms Anderson completed a Bachelor of Pharmacy at the University of Sydney in 1998 and obtained a diploma in Hospital Pharmacy in 1989. She was first registered as a Pharmacist in NSW on 14 February 1990 (exhibit 1, p11). Ms Anderson is a part-owner of a pharmacy (exhibit 1, p 212). 2. In an email dated 31 January 2023, sent by Ms Anderson to the HCCC, she states that on 1 April 2021 (the date of the offence the subject of complaint 1) she had worked at the Pharmacy from 8am to 12:30pm. She states that after work (12.50 – 1.55pm) she purchased a bottle of red wine, from the Aldi store next door to the Pharmacy, and consumed the wine in the Aldi car park. She states she would never consume alcohol whilst rostered to work in the pharmacy either whilst on duty or in the pharmacy (exhibit 1, p 52). 3. The summary of agreed facts state that at approximately 2pm, Ms Anderson collided with another person's car by failing to give way where necessary. Ms Anderson was asked by a police officer, Senior Constable Miller, if she had anything to drink that day and she replied "no". Ms Anderson then underwent a roadside breath test, which returned a reading of 0.316 grams of alcohol in 210 litres of breath (exhibit 1, p 227). 4. The summary of agreed facts also disclosed that Ms Anderson was then transported to a police station. En-route to the station, she stated words to the effect of "I had a big night last night, I can't believe I blew over". Senior Constable Miller told her she had had returned a "high range high" reading. As they pulled up into the police station, Ms Anderson said to Senior nstable Miller words to the effect of "How do I fix this? Before you do this?" At the police station and prior to undergoing a formal breath analysis, Ms Anderson told Senior Constable Miller that she had consumed one stubbie of Crown Lager between 1:30pm and 1:45pm that day. At 3:10pm, she underwent a formal Breath Analysis and returned a reading of 0.250 grams of alcohol in 210 litres of breath. Her Driver Licence was suspended and confiscated, and the Respondent was issued a Field Court Attendance Notice (exhibit 1, p 228). 5. Finally, the agreed facts also disclose that on 1 November 2021, a Forensic Pharmacologist provided an expert opinion that Ms Anderson's alcohol concentration was within a range of 0.223-0.239 grams of alcohol in 210 litres of breath and was most likely 0.228 grams of alcohol in 210 litres of breath, at the time of the accident. The person in the other car suffered sustained fractures through the main or mid-section of the bone of both the ulna and radius of the left arm. The person had surgery and continued to have constant pain in relation to the injury and was depressed. Further surgery was also required months later (exhibit 1, p 229) 6. The charge certificate (Exhibit 1, p206 -207) discloses that Ms Anderson was subsequently charged with the following offences: 1. Driving a motor vehicle with high range prescribed concentration of alcohol in their breath or blood contrary to section 110(5)(a) Road Transport Act 2013; 2. Aggravated dangerous driving occasioning grievous bodily harm contrary to section 52A(4) Crimes Act 1900; and 3. Dangerous driving occasioning grievous bodily harm in circumstances where the driver was driving in a manner dangerous to another person contrary to section 52A(3)(c) Crimes Act 1900. 1. The charge certificate indicates that two of the charges were later withdrawn, leaving Ms Anderson charged with aggravated dangerous driving occasioning grievous bodily harm contrary to section 52A(4) Crimes Act 1900 (NSW). 2. The sentencing transcript discloses that Ms Anderson pleaded guilty at the earliest opportunity to the charge (exhibit 1, p 235). It was also noted by the Judge in his sentencing remarks that in 2019, Ms Anderson was suffering anxiety symptoms for over-tiredness, burnout, depression, inability to sleep, loss of appetite and increased consumption of alcohol. Ms Anderson was diagnosed with premenstrual dysphoric disorder and prescribed an antidepressant. She was also diagnosed with general anxiety disorder and alcohol dependence disorder and commenced treatment with medicine for general anxiety disorder and engaged in gym-based exercise to manage her general anxiety disorder. In October 2020 on referral from a General Practitioner, Ms Anderson began to see a counsellor for anxiety, depression and alcohol use. She had attended at least one session of counselling prior to the committing of the offence on 1 April 2021. Ms Anderson's general practitioner had recommended that she go into a residential rehabilitation centre in 2020, which she did not do due to her work and household responsibilities (exhibit 1, p 237). 3. The Advice of Court Result (exhibit 1, p253 -255) records that Ms Anderson was convicted of the charge in the District Court of New South Wales on 18 May 2022. Ms Anderson was sentenced to a term of imprisonment to be served by way of an Intensive Correction Order in the community subject to conditions, expiring on 17 March 2024. Those conditions included: 1. not leave her residence between the hours of 8:30pm and 6:30am for a period of 4 months commencing on 18 May 2022; 2. perform 300 hours of Community Service program; 3. engage in the following treatment: 1. attendance at the Sober Driver's program; 2. attendance on her GP at least monthly; 3. therapy on a weekly or second weekly basis; 4. attend the SMART program on a weekly or twice weekly basis; 5. continue to see her alcohol counsellor on a monthly basis or as needed. 1. Ms Anderson was also disqualified from driving until 18 May 2024, and subject to the imposition of an Alcohol Interlock Order until 17 May 2025. 2. On 13 April 2021, the Pharmacy Council held a hearing pursuant to s 150 of the National Law. The written reasons for the decision for the s 150 proceedings note that Ms Anderson did not attend the s 150 hearing as she had voluntarily admitted herself to a hospital for treatment of mental health issues. The Council determined to suspend the Respondent's registration on that day, effective from 16 April 2021. The Council referred the matter to the HCCC for investigation pursuant to s 150D of the National Law (exhibit 1, p 20 – 24) Steps taken since the Offence 1. In her statement in reply to the amended application, dated 8 March 2024, (exhibit 7, p 27) Ms Anderson realty states the following: "I have gained significant further insight into the important role that pharmacists have in the community and the standards that they are expected to reflect to uphold public confidence in the profession. I am truly remorseful of my actions and the ensuing criminal charges and conviction. I have diligently complied with all requirements of the intensive correction order handed down by the District Court of New South Wales on 18 May 2022, which expires on 17 March 2024. At the time of the incident, I was experiencing significant personal and professional issues. These have since resolved. I understand, after much reflection, that I can be a much better contributor to the pharmacy industry if I take care of myself and ensure my emotional and mental wellbeing is being properly looked after. To this end, I have taken proactive steps to reduce my alcohol consumption and now only drink in social settings on an infrequent basis. I also engage with health professionals, who I have successfully practiced, without issue, under registration conditions imposed by the Pharmacy Council of New South Wales (Council) since September 2021. Those conditions have been reduced over the course of these proceedings. I am confident that, in moving forward, I can now practice without the need for any conditions on my registration. I am passionate and dedicated pharmacist, who enjoys working in this profession and providing services to the community as I have done for approximately the past 35 years. I am beyond apologetic for my omission in failing to notify the National Boardof the criminal charges against me. At the time of being charged, I was not aware that I had notify the National Board. My charges were widely known, given public media releases and the section 150 proceedings held by the Council. I have never hid or downplayed the seriousness of the charges. There was nothing clandestine. I have always been open with my colleagues about the reasons for why I have ended up in the situation I did and have taken full responsibility for my actions and the impact of them, both professional and personally. With regard to complaint that I failed to notify the National Board of my conviction within seven days, I am very sorry for this oversight. While I was convicted on 18 May 2022, I did not receive (and sign) my intensive correction order until 25 May 2022. On 26 May 2022, I attended to completing a Notice of Certain Events (form NOCE-00), which attached a copy of my signed intensive correction order, and then subsequently posted same to the National Board. While I accept that notification was outside of the seven-day period, I naively awaited a copy of the intensive correction order so that it could be provided with the notice. This was an honest mistake on my behalf and I now understand the importance of strictly complying with the seven day notification period. I cannot stress enough how devastating this whole experience has been for me, my family and work family. I sincerely apologise for my past conduct. With the insight and support systems I now have, I am confident that I can uphold the high standard of professional and ethical conduct that is expected of me by my community, my colleagues and by the profession." 1. Ms Anderson undertook an independent health assessment and a report from Dr Susan Messner has been provided to the Tribunal in that regard (exhibit 1, p160 - 167). The report concludes at p 7: "In my opinion, Mrs Anderson does not have symptoms of a psychiatric disorder currently. She has previously suffered from an Alcohol Use Disorder which is in sustained remission. She has also suffered from Generalised Anxiety Disorder for which she has received psychological and pharmacological therapy. She has a history suffering from a Major Depressive Disorder, also in remission. In my opinion, Mrs Anderson does not suffer from an impairment as defined in the National Law. Her Alcohol Use Disorder is in remission. She has good insight into the factors which contributed to her increased alcohol use and has made changes in her professional and personal life to address these and manage stress and anxiety without the use of alcohol." 1. Ms Anderson has also provided a series of letters of support. We have given those letters little weight as some of the letters do not refer to knowledge of the misconduct or the proceedings and others were for the purposes of the criminal sentencing. However, we accept that Ms Anderson is well liked by her colleagues and friends. Reprimand 1. In Health Care Complaints Commission v Perera [2018] NSWCATOD 112, at [99], the Tribunal stated the following in relation to the reprimands: We conclude that the appropriate order is to reprimand the practitioner. The reprimand reflects that compliance with conditions during their currency is of upmost importance and a breach of a condition or conditions reflects a lack of responsibility by the professional involved. It demonstrates that the practitioner is sanctioned for abrogating that responsibility through carelessness and/or inattention to detail. Secondly, the reprimand acts as a deterrent to other practitioners to engage in like conduct. Thirdly, and importantly, the reprimand upholds and reinforces the standards of the profession to which it expects its members to adhere. 1. In Health Care Complaints Commission v Lord [2019] NSWCATOD 182, at [41]-[42], the Tribunal explained the difference between a caution and a reprimand as follows: [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 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]: [The 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). In contrast, the National Law does not require AHPRA to record a caution on practitioner's record. 1. We conclude that it is appropriate in this case to reprimand the practitioner. The reprimand reflects that Ms Anderson is sanctioned for her conduct in relation to the conviction. Her actions were serious and the person with whom she crashed suffered injuries which required more than one surgery. Further, it is essential that a practitioner report a charge or conviction within a short time so that any investigation process can commence for the protection of the public. The reprimand acts as a deterrent to other practitioners not to engage in such like conduct and upholds and reinforces the standards of the profession to which it expects its members to adhere. Should conditions be placed on Ms Anderson's Registration? 1. The Respondent currently has conditions imposed by the Pharmacy Council on 30 November 2023. The HCCC seeks substantially the same form of conditions to be placed on Ms Anderson's Registration as a pharmacist by way of order in these proceedings, save that the HCCC's proposed orders would have Ms Anderson participating in review meetings with her supervisor on a quarterly (not monthly) basis. 2. The HCCC submits that the transcript of Ms Anderson's evidence at the s 150 hearing on 27 November 2023 (exhibit 4) was to the effect that: 1. She found the monthly supervision sessions very helpful, but that they came around quickly and considered she would benefit from quarterly sessions. 2. She had not been seeing her GP regularly. 3. She was no longer on anti-depressant medicines (on the advice of her doctor). 4. She continues to drink socially (but considered that she could control her consumption appropriately, because once she got her "stress levels under control that kind of melted away") 5. She was not participating in Alcoholics Anonymous or any other similar program. 1. The HCCC submits that while it may be accepted that Ms Anderson has demonstrated a recovery from her previous impairment of Alcohol Use Disorder, the risk of relapse cannot be discounted. Ms Anderson's evidence is that the stress of her employment as a community pharmacist played a major part in her falling into alcohol misuse in the first instance. It follows that a cautious approach in returning to fully unrestricted practice should be taken, and more gradual allowances are appropriate in respect of the conditions on her registration. The HCCC further submits that such gradual allowances will adequately ensure the "paramount consideration" of the "protection of the health and safety of the public" is achieved (National Law, s 3B), albeit balanced against the demonstrated recovery steps on the part of Ms Anderson to date. 2. Having considered the evidence of the parties, we are not of the view that it is appropriate to impose conditions on Ms Anderson's registration as a pharmacist. The criminal conduct occurred in April 2021. Three years have now passed, the evidence demonstrates that Ms Anderson has taken steps to address the circumstances which led to the conduct, including in relation to alcohol misuse and her anxiety and work-related stress. In particular, the report of Dr Messner reinforces that Ms Anderson does not currently have symptoms of a psychiatric disorder and that she is in sustained remission in relation to her previous Alcohol Use Disorder. She has received treatment for her Generalised Anxiety Disorder and is also in remission in relation to Major Depressive Disorder. We are also satisfied from the report and her own statement that Ms Anderson does have good insight into the factors which contributed to her increased alcohol use/misuse and has made changes in her professional and personal life to address those and manage her stress and anxiety without the use of alcohol. Ms Anderson has complied with the conditions relating to her criminal conviction and imposed by the Council. In our view to impose further conditions, for an indefinite period, would be in our view unnecessary and unduly oppressive. Costs 1. The HCCC seeks an order that the practitioner pay the HCCC's costs as agreed or assessed. 2. The Tribunal has power to order costs, as conferred by clause 13 of Schedule 5D to the National Law. Generally, costs of proceedings before the Tribunal follow the event unless there has been some disentitling conduct by the HCCC in the conduct of the proceedings: Health Care Complaints Commission v Philipiah [2013] NSWCA 342. 3. Given the Tribunal did not make the order for conditions, the Panel has a preliminary view that there may be proceedings in which an order is made that each party bear their own costs. If the parties agree to that course of action, then they are to advise the Tribunal immediately. Otherwise, parties are to notify the Tribunal by 20 September 2024 if they seek to make an application for costs. Orders 1. The Tribunal makes the following orders. 1. Ms Anderson is reprimanded. 2. If either party seeks costs of the proceedings, they are to notify the Tribunal and the other side by 20 September 2024 and include written submissions as to the basis for the costs application. ********** 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: 18 September 2024