Civil and Administrative Tribunal New South Wales Medium Neutral Citation: Ng v Health Care Complaints Commission [2018] NSWCATOD 105 Hearing dates: 7 March 2018 Date of orders: 02 July 2018 Decision date: 02 July 2018 Jurisdiction: Occupational Division Before: A Britton, Principal Member Dr T Stewart, Senior Member Dr S Lake, Senior Member G Alder, General Member Decision: The parties are invited to comment on the proposed conditions at [56] of this Decision. Any written submissions must be filed and served within 14 days of the date of this decision. Catchwords: TRADES AND PROFESSION –– reinstatement of health practitioner under Health Practitioner Regulation National Law –– assessment of character –– assessment of risk of re-offending Legislation Cited: Health Practitioner Regulation National Law (NSW) Cases Cited: Bahramy v Medical Council of NSW [2014] NSWCATOD 116 Briginshaw v Briginshaw (1938) 60 CLR 336 Dawson v Law Society of NSW [1989] NSWCA 58 Ex parte Tziniolois; Re Medical Practioners Act (1966) 67 SR (NSW) 448 Health Care Complaints Commission v Ng [2015] NSWCATOD 139 In Re Jason Martin [2010] NSWMT 13 Re Lenehan (1948) 77 CLR 403 at 424; [1948] HCA 45 Re Mansoor Haider Zaidi [2006] NSWMT 6 Scully v HCCC [2013] NSWNMT 7 Shah v HCCC [2014] NSWCATOD 94 Zaidi v HCCC (1998) 44 NSWLR 82 Category: Principal judgment Parties: Kuan Ng (Applicant) Health Care Complaints Commission (Respondent) Representation: Counsel: P. Dwyer (Applicant) A. Britt (Respondent) Solicitors: Meridian Lawyers (Applicant) Health Care Complaints Commission (Respondent) File Number(s): 2017/00234017 Publication restriction: Pursuant to Schedule 5D cl 7 of the Health Practitioner Regulation National Law publication of the name of the patient the subject of the consultation of 16 August 2011 by the respondent (Patient A), or any other patient of the respondent, including members of Patient A's family, is prohibited. REASONS FOR DECISION Introduction 1. In December 2015, the Tribunal (differently constituted) cancelled the registration of osteopath Dr Kuan Ng, under s 149C(1) of the Health Practitioner Regulation National Law (NSW) (the National Law) having found him guilty of unsatisfactory professional conduct and professional misconduct: Health Care Complaints Commission v Ng [2015] NSWCATOD 139. The Tribunal ordered that Dr Ng be prohibited from applying for re-registration for a period of 18 months. In addition, the Tribunal prohibited Dr Ng, for the period of his deregistration, from providing any health service that involves the physical examination or treatment of female patients: s 145C(5). 2. That period has now elapsed. Dr Ng applies under ss 163A and 163B of the National Law for review of the order to cancel his registration and an order for reinstatement of his registration. 3. On receipt of an application for review of a cancellation order, the Tribunal must conduct an inquiry: s 163B. Having conducted an inquiry, the Tribunal has discretion to exercise a number of powers including the power to dismiss the application, to make a reinstatement order or to vary the prohibition order: s 163B. In this case, the Health Care Complaints Commission (the Commission) opposes the application and submits that a further non-review period of 18 months should be imposed. 4. These proceedings are not a re-hearing. In conducting this review, we cannot review the original decision or any findings of fact made in connection with that decision: s 163(2). Rather, our task is "to determine the appropriateness, at the time of the review, of the order concerned": s 163C(1). 5. In short, the fundamental issue in this review is whether Dr Ng has proven on the balance of probabilities that he is now a fit and proper person to be registered. It is he who bears the onus of proof on that question. Background 1. In August 2011, Patient A attended Dr Ng's practice for assessment and treatment of a groin complaint. The Tribunal found that: 1. Dr Ng had inappropriately placed his finger under Patient A's underwear and inserted his finger in her vagina for a period of about 30 seconds; 2. Dr Ng had failed to provide adequate information or explanation to the patient in relation to the assessment or treatment of her groin condition; 3. Dr Ng had failed to obtain consent from the patient before commencing the assessment or treatment he conducted in relation to the groin complaint; and 4. The placing of his finger underneath her underwear and insertion of his finger in her vagina for about 30 seconds was without clinical indication or justification. 1. As a result of those findings, the Tribunal concluded that Dr Ng was guilty of both unsatisfactory professional conduct, being conduct "significantly below" the relevant professional standard and being improper or unethical: ss 139B(1)(a) and 139B(1)(l). In addition, the Tribunal found the conduct amounted to professional misconduct, namely conduct that is of a sufficiently serious nature to justify suspension or cancellation of Dr Ng's registration: s 139E. Dr Ng was subsequently deregistered and, as we have noted, was prohibited from re-applying for registration for a period of 18 months. An appeal to the Supreme Court was dismissed. Dr Ng's evidence in support of the application 1. Dr Ng supported his application with his own evidence, from Dr Olav Nielssen, a consultant psychiatrist, from Dr Kevin Finnan, an osteopath, and from a number of referees. Dr Ng provided three written statements and in addition gave oral evidence. The statements and transcripts of the original hearing were admitted in evidence on this application. 2. In his three statements and oral evidence in the original proceedings, Dr Ng denied the allegation of having inserted his finger in Patient A's vagina. His explanation was that the patient had probably felt referred sensations from exterior palpations by him on a trigger point on her adductor magnus muscles. In this application he accepted the Tribunal's findings but maintained his denial of the conduct that resulted in his deregistration. He expressed deep remorse for having caused Patient A's distress. He explained that he had not been aware at the time of the possibility of such sensations being caused to the patient. 3. In his application for reinstatement Dr Ng wrote "from the beginning of my career in 2008, my mission has been to help patients overcome pain and suffering so that they can enjoy a good quality of life". He also said that he loved his profession and had been "devastated" by the Tribunal's decision to deregister him. He undertook that if he were to be reinstated, he would "devote" himself to best practice and act with integrity at the "highest level of professionalism" of a health practitioner. 4. Dr Ng also stated that he had strictly adhered to the Tribunal's protective orders during the prohibition period and had "diligently prepared" himself for resuming osteopathic practice. 5. Regarding his own character, Dr Ng asserted that he is "a good, decent person" and that he had no previous or current findings of unsatisfactory professional conduct or professional misconduct made against him. He stated that this matter was the only complaint ever made against him. He also stated that he had received calls from previous patients who both provided support and who were asking for his help. He said, "Those patients have … expressed their trust in me and my ability". He also provided a number of character references. These are addressed below. 6. Rehabilitation is a key issue in relation to this application. Concerning that question, Dr Ng stated that he was "profoundly apologetic" for inadvertently distressing the patient and that he had reflected constantly on the incident. He said, "My thoughts have continuously revolved around that one treatment … It has impacted my life and well-being and I have experienced trepidation and severe anxiety." He also said that he had suffered personally and financially as a result of his actions for which he took "full responsibility". 7. He also gave an account of improving his technical understanding of the potential for referred sensations from the adductor magnus trigger point. In 2016 and 2017 he undertook a certain amount of continuing professional development (CPD) work to maintain his professional knowledge and skills. 8. Dr Ng has been unemployed since his deregistration. He was badly injured in February 2017 and has exhausted his professional indemnity insurance. He is maintained by his family at present. He has, however, been offered employment as an osteopath in the event that the Tribunal reinstates him. The principal of the Ryde Natural Health Clinic, Dr Kevin Finnan, is aware of the details of the complaint made against Dr Ng but has given him both a character reference and an offer of employment. 9. Character evidence was given on behalf of Dr Ng by Dr Peter Baziotis, Registered Nurse, Mary Cesca (a former patient of Dr Ng's), Mr Jonathon Hapke (a former patient of Dr Ng's), Ms Sandra Husbands (a former patient of Dr Ng's), Dr Kevin Finnan (an osteopath, colleague and friend of Dr Ng's) and Mr Antony Nicholas, the Chief Executive Officer of Osteopathy Australia. 10. Dr Baziotis gave character evidence during the first and second stage of the original hearing. In his second statement, given after the Tribunal published its finding, he stated that he was "amazed and disappointed when I read the NCAT findings as the conclusions reached by NCAT are totally inconsistent with my regular observations of Kuan over many years". He said, "irrespective of the NCAT findings, [I] continue to have no hesitation in recommending Kuan as an osteopath to any of my family, friends or colleagues, male or female". 11. RN Cesca gave three references for Dr Ng, the last in January 2018. She also found the Tribunal's findings to be "totally inconsistent" with her observations of Dr Ng. She wrote, "It remains inconceivable to me to believe that Kuan [is] capable of the behaviour for which he has been accused." She described Dr Ng as "thorough, gentle, caring, respectful and a proper professional". She stated that despite the Tribunal's findings she would have no hesitation in recommending him to others. 12. Mr Hapke also gave character evidence in the original hearing. He described Dr Ng as "a very capable and conscientious practitioner" and said that over the years he had recommended Dr Ng to family members and friends, none of who had expressed any concerns to him about Dr Ng. He stated that he was "extremely surprised" by the Tribunal's findings against Dr Ng and continued to hold him in high regard. In January 2018, Mr Hapke gave another statement of support for Dr Ng in similar terms. 13. Ms Husbands was a patient of Dr Ng's for about two years. For the original hearing she gave a statement describing him as "very professional, caring, thorough and respectful". She said that she had recommended him to a number of other people including her 19-year-old daughter. She stated, "I would trust Kuan with my health and trust that he would always handle me in very [professional way] and always be respectful throughout every part of my treatment". After reading the Tribunal's findings, she maintained her high opinion of Dr Ng. 14. Dr Finnan met Dr Ng when they were students. They worked together in a clinic that Dr Finnan opened in 2009 until Dr Ng was deregistered. He described Dr Ng as being very popular with staff and patients. He stated, "my staff refer to the 'cult of Kuan' to reflect how high the patients value his treatment and the results he obtains". He gave evidence that he had never had any complaints about Dr Ng from patients and that he had never been made aware of any complaint before the incident in 2011. Notwithstanding the Tribunal's findings against Dr Ng, Dr Finnan's high opinion of him was unaffected. He said that the findings were "totally inconsistent" with his own knowledge and observations of Dr Ng. In these proceedings, Dr Finnan reiterated those views and stated that he was "more than willing" to re-employ Dr Ng and, if required, to provide ongoing mentoring if Dr Ng is reinstated. He stated that in his opinion Dr Ng did not pose a risk to patients. He said that if he had been of the view that Dr Ng posed a relevant risk, despite their friendship, he would not have offered him employment as it might jeopardise his practice which employs 20 clinical practitioners and six support staff. 15. In relation to the question of future risk, Dr Ng not only relies on character evidence, he adduced psychiatric evidence from Dr Nielssen. Dr Nielssen only saw Dr Ng once but he found Dr Ng not to be suffering from any cognitive or psychiatric disorder. He formed the view that Dr Ng had a good grasp of the legal and professional implications of the Tribunal's orders. In the history given to Dr Nielssen, Dr Ng reported that the incident had had a strong aversive effect on him. He found no significant risk factors in Dr Ng's history or presentation. In his report, Dr Nielssen offered the opinion that Dr Ng's risk of repeating the conduct that the Tribunal found against him was low. 16. The Commission did not require Dr Nielssen for cross examination nor did it provide any fresh evidence to contradict the evidence adduced on Dr Ng's behalf. The relevant principles 1. To practise as a health professional a person must, in general terms, be a "fit and proper person for general registration". The practitioner must be able to practise his or her profession competently and safely: s 55(1)(h). 2. The fundamental principle relating to regulation of the health profession is the protection of members of the public: s 3(2)(a). Orders made under the National Law are intended to be protective rather than punitive, although it is clear that one of the effects of protective orders may be the infliction of detriments to health practitioners. 3. It is against that principle, that Dr Ng bears the onus of proving, on the balance of probabilities, that he is a fit and proper person and qualified to practise as an osteopath. 4. The principles relating to the reinstatement of a deregistered health practitioner have been considered and discussed in numerous cases over the years. In Re Lenehan (1948) 77 CLR 403 at 424; [1948] HCA 45 the High Court considered the case of a young man who sought to be restored to the solicitors' roll. Latham CJ, Dixon and Williams JJ said at [27] and [33]: When such a person applies for reinstatement he is in a more disadvantageous position than an original applicant because he must displace the decision as to probable permanent unfitness which was the basis of his removal. A solicitor may be restored to the roll after he has been struck off, but the power to reinstate should be exercised with the greatest caution and only upon solid and substantial grounds… "There must be a strong disinclination to admit to the profession of a solicitor any person who has been shown ever to have been guilty of improper conduct. It is a disinclination founded upon the unsafety of such a course and the need of strictness in maintaining the standards of the profession. But the false steps of youth and early manhood are not always final proof of defective character and unfitness. The presumption which, according to circumstances, they may appear to raise may surely be overcome by a subsequent blameless career. 1. In Ex parte Tziniolois; Re Medical Practioners Act (1966) 67 SR (NSW) 448 at [461], in which Walsh JA stated in obiter dicta that: Reformations of character and of behaviour can doubtless occur but their occurrence is not the usual but the exceptional thing. One cannot assume that a change has occurred merely because some years have gone by and it is not proved that anything of a discreditable kind has occurred. "If a man has exhibited some serious deficiencies in his standards of conduct and his attitudes it must require clear proof to show some years later he has established himself as a different man. 1. The application of reinstatement principles under the National Law has been laid out in recent tribunal decisions such as Bahramy v Medical Council of NSW [2014] NSWCATOD 116; Scully v HCCC [2013] NSWNMT 7 and Shah v HCCC [2014] NSWCATOD 94 ("Shah"). The approach to reinstatement is succinctly summarised in Shah at [34] as follows: 1. The applicant bears the onus of proving that he is a fit and proper person to be engaged in the profession of nursing as an endorsed enrolled nurse (see Scully [41] and the authorities there referred to); 2. The standard of proof to be applied by the Tribunal is the civil standard of proof, the balance of probabilities, tempered by the requirements of Briginshaw v Briginshaw (1938) 60 CLR 336; (see Scully [41] and the authorities there referred to; see also In Re Jason Martin [2010] NSWMT 13 at [41]) 3. The purpose of the jurisdiction is "not punishment or further punishment" of the former practitioner, rather the jurisdiction that is exercised is for the protection of the public (see Scully [47] and the authority there referred to); 4. The power to reinstate should "be exercised with great caution and only upon solid and substantial grounds" (see Scully [48] and the authority there referred to); 5. There is no public interest in denying forever the chance of redemption and rehabilitation to former practitioners. The public is better served if, in appropriate cases, those who have offended, once they have affirmatively proved reform, are afforded a second chance (see Scully [49] and the authority there referred to); 6. In making an assessment of the applicant's worthiness and reliability for the future, the Tribunal may draw inferences from what has happened in the past and, in particular, what led to their being removed from the Register. At [50] the Tribunal in Scully referred to In Re Jason Martin [2010] NSWMT 13 where the Medical Tribunal pointed out it is not "a question of what an applicant has suffered in the past. It is a question of his [her] worthiness and his [her] reliability for the future." That Tribunal noted the difficulty associated with predicting how a practitioner would behave in the future and remarked "the decision in the particular case is to a greater or lesser extent dependent upon the Tribunal's assessment of the applicant". 1. In Re Mansoor Haider Zaidi [2006] NSWMT 6 (at [42]) the Medical Tribunal made the obvious point that: [A]n applicant for reinstatement … is in a more disadvantageous position than an original applicant. He must displace the decision for deregistration which has been made. As a consequence, presumptions of fitness which might otherwise arise than from an absence of contrary suggestions can no longer advantage him, precisely because of the removal of his name from the Register on the basis of unfitness. 1. In that case, the Medical Tribunal also stated at [42]: [T]he ultimate issue … is a question of [the applicant's] worthiness and his reliability for the future. What in this respect the Tribunal must determine is whether it is satisfied that for the future the applicant will act in accordance with the high standards and responsibilities of the profession. 1. In Scully, the Nurses and Midwives Tribunal also considered the relevant principles relating to applications for reinstatement. It applied the principles outlined above in an unexceptional way but it is noteworthy for a reference to a dissenting judgment of Kirby P in Dawson v Law Society of NSW [1989] NSWCA 58 at [17] in which His Honour remarked: There is no public interest in denying forever the chance of redemption and rehabilitation to former practitioners. On the contrary, the public is better served if, in appropriate cases, those who have offended, once they have affirmatively proved reform, are afforded a second chance …. Submissions 1. The Commission submitted that the Tribunal should not assume that a practitioner who was deregistered has become a reformed person. It contended that Dr Ng must demonstrate such a reformation of character that the Tribunal can have confidence that he accepts and will abide by the high professional standards imposed on osteopaths. Patients must be able to trust osteopaths treating them because they are being treated physically by the practitioner and also frequently disclose highly personal and confidential information in the course of treatment. 2. The Commission argued that the key issue is "whether the conduct perpetrated by Dr Ng … has been overcome by a sufficient shift in his character to justify the conclusion that he no longer possesses these defects in character and whether he remains a risk to the public if allowed to practise". 3. In arguing against reinstatement, the Commission emphasised that Dr Ng continues to deny the acts that were found by the Tribunal to have occurred. It conceded, fairly, that the fact that he does not make such an admission is not determinative of the key issue: see Zaidi v HCCC (1998) 44 NSWLR 82. But it argued that a practitioner's expressed intention not to re-offend will carry little weight unless accompanied by insight into the wrongfulness of the relevant conduct. The Commission argued that Dr Ng, by continuing to deny the act of digital penetration, demonstrated that he has limited insight into his unethical conduct and therefore remains unfit to be registered and a risk to the public. 4. The Commission further argued that the Tribunal should be concerned by the fact that Dr Ng is "frustrated" by the Tribunal's decision to deregister him and feels "hard done by"; that he has not undertaken additional ethical training; that he did not seek out medical advice following the Tribunal's decision; that he was seen only once by Dr Nielssen; and that he has provided only a limited number of character references. The Commission is also critical of the nature of the character evidence given in that some of the referees have not had recent contact with Dr Ng and one is a potential employer who does not fully accept the Tribunal's findings of fact. It argued that Dr Finnan lacks objectivity in relation to his friend Dr Ng. 5. The Commission submitted that the nature of the misconduct was serious and that Dr Ng has failed to establish that he is a suitable person to be registered. It argued that he had not discharged his onus of proof and that the Tribunal could not be satisfied to the requisite degree that he is a fit and proper person, competent in his profession and able to conduct practice as an osteopath safely. 6. It was submitted for Dr Ng that while he does not concede that he had committed the act of digital penetration, he has conceded everything else that the Tribunal found against him and accepts and respects the Tribunal's findings. 7. Secondly, in relation to risk to members of the public, Dr Ng relied on his own evidence that he has given long and deep thought to the distress he says that he inadvertently caused to the patient as well as the psychiatric evidence of Dr Nielssen that he is at low risk of again behaving in such a way as the Tribunal found against him. 8. Thirdly, he submitted that the character evidence shows him to have been a person of good character and that he is still highly regarded by those who know him. Neither before nor since the incident has there been anything to suggest that he has a tendency to act in an unethical or improper way. Rather the weight of evidence, except for the findings in relation to the 2011 incident itself, suggest that he has always been and continues to be a person of good character who can be trusted to act honourably towards patients. It was argued on his behalf that the character evidence demonstrates Dr Ng to be a compassionate, respectful and highly skilled practitioner who is deeply remorseful for the distress he caused the patient. 9. Finally, in the period he has been barred from practice he has continued to undertake CPD in preparation for resumption of practice. Discussion 1. As we have previously noted, this is not a re-hearing of the original complaint. We proceed on the basis of the findings made by the Tribunal in the original hearing. It is against that background that we must now assess Dr Ng. 2. The question of character is central to the current proceedings. The Commission argues that Dr Ng must demonstrate a "shift of character". This implies that a person's character lies somewhere on a spectrum or a line on a graph and that by some form of therapy, psychological or psychiatric treatment or personal resolve that character can be shunted back up the line or spectrum to the more virtuous end. 3. We are doubtful that such characterisation is helpful in assessing whether a person has a "good character". This is a simplistic, mechanical approach to human psychology that is inconsistent with the realities of human experience and behaviour. The biblical story of the self-righteous being told "let he who is without sin cast the first stone" is a classic account of the fact that human beings are complex and cannot be graded in black and white terms as the metaphor of a character shift implies. 4. Character evidence is admissible because it relates to the probability of a person either committing an act alleged against them or of the future risk of re-offending. The remarks of Walsh JA in Ex parte Tziniolois; Re Medical Practioners Act quoted above appear to suggest that if a person has been proven to be of bad character, it may be difficult for him (or her) to reform. But they do not explain what bad character is. It is self-evident that a momentary or single act of deviance from an otherwise unblemished course of conduct is much less indicative of ingrained "bad character" and an overall lack of fitness to practise a profession than a course of unethical conduct. We have no doubt that if a course of confirmed unethical behaviour is proven, it will be difficult for a person to prove that he or she is a person who is "fit and proper" for reinstatement. 5. On the other hand, a momentary or single act of misconduct should be seen against a person's whole history as well as the person's reputation as attested to by those who know the person. In applying the protective principle, the Tribunal is obliged to consider probabilities. It is more probable that a person who repeatedly misbehaves or breaches ethical codes will do so again than a person who does so only once in a long history of professional practice. The authorities cited above all acknowledge the general understanding that human beings can change their behaviour and learn from experience. 6. In this case, because he denies the allegation of digital penetration, it is argued that Dr Ng lacks insight into the seriousness of the misconduct the Tribunal found proven against him. While we are obliged to accept the findings of the Tribunal, it is theoretically possible that Dr Ng, as he continues to assert, did not commit the act of digital penetration. If that is so, it would be unjust to require that before he can be accepted as remorseful and having insight that he lie about this. We do not have to either accept or reject his denials. We simply note them. What is more important in our view is that he has given long and deep thought to the incident and its effect on the patient and is deeply remorseful for the distress it caused her. He is no doubt also sorry for himself and frustrated by the predicament in which he finds himself at present. The two lines of thought are not mutually exclusive. 7. Most human beings are adaptable and capable of learning from experience. Dr Nielssen's evidence that Dr Ng has been deeply affected by his experience is also of critical importance. The regulation of the conduct of health practitioners is intended to ensure the protection of members of the public. While the regime is protective, part of the protective effect can be and is achieved by deterrence of unethical conduct. Dr Nielssen gave evidence that the incident had had a strong aversive effect on Dr Ng. If that is so, and there is no reason to doubt it, Dr Ng has learned a very powerful lesson due to his own reflection on the incident. He has described how he has thought about it and what adaptations or amendments he would make to his practice if reinstated. 8. In our view, Dr Ng has demonstrated a high level of insight into the conduct that resulted in his deregistration and has given deep thought to how to improve his practice in future. We consider that the risk to members of the public if he is reinstated is low. 9. The Commission criticised the character evidence adduced on behalf of Dr Ng. We do not accept those criticisms. Persons who are best able to give useful character evidence are those who know the circumstances relating to which the evidence will be given (in this case, the allegations against Dr Ng) and who have a considerable length of experience in dealing with the person in question. The character evidence all suggests very powerfully that the 2011 incident was a one-off incident that is unlikely to recur. 10. The evidence of Dr Finnan was important in another way. He gave evidence not only in relation to Dr Ng's character but also that he would be willing to mentor Dr Ng to further ensure that Dr Ng would meet the high ethical standards of their profession. Conclusion 1. The regulation of health practitioners is protective not punitive. We adopt the remarks of Kirby P in Dawson that "There is no public interest in denying forever the chance of redemption and rehabilitation to former practitioners." We agree that, in appropriate cases, second chances are warranted. This is such a case. 2. In our view, the weight of evidence suggests that Dr Ng's misconduct was a one-off incident and an aberration in an otherwise unblemished career as an osteopath. The risk of a recurrence of the proven misconduct is low because he has gained insight and is deeply remorseful for the distress he caused his patient. In addition, the experience of being deregistered and being barred from practice, is likely to have a strong deterrent effect on Dr Ng. 3. There is no doubt that Dr Ng is technically competent to practise as an osteopath safely and to a high professional standard. 4. It is appropriate to order that Dr Ng be reinstated. Given the serious nature of the misconduct found proven, we also think it is appropriate that conditions be placed on his registration. 5. The parties are invited to comment on the following conditions proposed to be imposed on Dr Ng's registration under s163(4) of the National Law. Any written submissions must be filed and served within 14 days of the date of this decision. The following conditions are imposed on Dr Ng's registration for a period of 12 months or such longer period as determined by the Osteopathy Council (the Council): 1. Dr Ng is not to engage in solo practice or work as a locum for a period of 12 months or for any further period determined as appropriate by the Council. 2. Dr Ng must provide to the Council the name and contact details of any practice in which he works. 3. Dr Ng may only practise as an osteopath under the supervision of a registered osteopath who does not have conditions on his/her practice and is approved by the Council (the Supervisor). Supervision may be remote, that is, where the Supervisor is: 1. On site but not working in close proximity to Dr Ng; or 2. Off site or working remotely from Dr Ng. At all times the Supervisor must be accessible to Dr Ng to provide advice either in person or by telephone. 1. Dr Ng must provide the name and contact details of the proposed Supervisor to the Council for approval. 2. Dr Ng is to be responsible for all costs associated with the supervision arrangement. 3. Dr Ng is to ensure: 1. The Supervisor is given a copy of the decisions in Health Care Complaints Commission v Ng [2015] NSWCATOD 85; Health Care Complaints Commission v Ng [2015] NSWCATOD 139; Ng v Health Care Complaints Commission [2018] xxx. 2. He meets with the Supervisor on a monthly basis for at least one hour, the first meeting to occur within one month of being advised by the Council that the nominated supervisor has been approved. 3. Each meeting is to include (but is not limited to): an inspection of records kept in the course of his practice; a review of work progress over the previous month the consent forms provided by patients (see below). 4. At each meeting, the Supervisor completes a record of matters discussed at the meeting in a format prescribed or approved by the Council. 5. The Supervisor forwards to the Council, on a monthly basis, a Supervision Report in a format prescribed or approved by the Council. 6. The Supervisor is authorised to inform the Council immediately if there is any concern in relation to Dr Ng's compliance with the supervision requirements, any other matters of concern, or if the supervisor relationship ceases. 1. Before commencing any treatment Dr Ng must obtain written consent from the subject patient. Dr Ng must give to the patient a consent form which detail the type of treatment he proposes to provide. 2. Dr Ng must provide copies of the signed consent forms to the Supervisor on a weekly basis. 3. Dr Ng must not undertake any assessment or treatment of a female patient that involves or is likely to involve the palpation of Adductor Magnus or the pelvic floor region. ********** 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: 02 July 2018