Civil and Administrative Tribunal New South Wales Medium Neutral Citation: Health Care Complaints Commission v Windsor [2019] NSWCATOD 149 Hearing dates: 18 June 2019 Date of orders: 01 October 2019 Decision date: 01 October 2019 Jurisdiction: Occupational Division Before: Cole DCJ, Deputy President Dr M Diamond, Senior Member Dr C Newberry, Senior Member J Houen, General Member Decision: (1) Dr Windsor's registration as a general practitioner is cancelled. Catchwords: PROFESSIONS AND TRADES - health care professionals - medical practitioners – disciplinary proceedings – impairment – capacity to practice Legislation Cited: Health Care Complaints Act 1993 Health Practitioner Regulation National Law (NSW) Cases Cited: Briginshaw v Briginshaw (1938) 60 CLR 336 Ng v Health Care Complaints Commission [2017] NSWSC 53 Category: Principal judgment Parties: Health Care Complaints Commission (Applicant) Dr Gina Windsor (Respondent) Representation: Counsel: R Mathur (Applicant) Solicitors: Health Care Complaints Commission (Applicant) Respondent (Self-Represented) File Number(s): 2018/00148692 Publication restriction: Unrestricted REASONS FOR DECISION 1. The Health Care Complaints Commission ("the HCCC") has brought a complaint against Dr Gina Windsor ("Dr Windsor") and seeks orders under Part 8, Division 3, Subdivision 6 of the Health Practitioner Regulation National Law (NSW) ('the National Law'). Background and events leading to the complaint 1. Dr Windsor achieved full registration as a general practitioner in New South Wales on 8 December 1999. 2. By 2015, at least part of Dr Windsor's practice involved her visiting nursing homes. 3. On 3 April 2015, a complaint about Dr Windsor was made by the daughter of a nursing home resident who had died a short time prior to the complaint. The complaint was that Dr Windsor took more than 8 hours to attend at the nursing home to certify the death of the patient. At some point during the wait for Dr Windsor to arrive, a member of the nursing staff had telephoned Dr Windsor to ask her how much longer she expected to be. The telephone was on loudspeaker so that the deceased's daughter and son could hear the conversation. In the course of the conversation, Dr Windsor said that she had more important things to do than to come and see a dead body. There were inconsistent accounts as to whether Dr Windsor knew that the deceased's children could hear what she was saying. Ultimately, after some correspondence, the investigation of this complaint was discontinued. This incident is not the subject of the complaint in these proceedings. 4. On 4 April 2016, the HCCC received an anonymous complaint in writing about Dr Windsor. The complaint made the following allegations: * Dr Windsor visits nursing homes until the early hours of the morning and then practises at a medical practice during the day. * Dr Windsor does not understand her own safety or that of her patients. * Dr Windsor has been seen wearing the same clothes for a week. * Dr Windsor has been sleeping in her car or in the nursing home she visits. * Dr Windsor eats dinner at the homes she visits. * Dr Windsor sometimes sees nursing home residents late at night when they are asleep. * Dr Windsor interferes in her clients' lives and also in the management of the nursing home. * Dr Windsor "influences her clients' so that she can get more clients to provide her medical service too" [sic]. * Dr Windsor issues prescriptions to her clients without proper consultations. * Dr Windsor abuses the prescription of medication to her clients. 1. The HCCC informed Dr Windsor of the complaint. An email apparently from Dr Windsor was received at the HCCC on 23 May 2016. It said the following: I refer to your letter dated 3 May 2016 on the above matter my response to which is as follows: 1. This complaint is based on blatant lies and malicious libels written with spiteful intent which far exceeds not only Commission's own standards for a "complaint made in good faith" but also the standard of proof of an offense under s99 of HEALTH CARE COMPLAINTS ACT 1993; [sic] 2. I am surprised that the Commission even decided to give life to this Anonymous Letter of Lies and Libels and by so acting to plant a psychological seed, however intended that may be, to adversely affect my own safety and wellbing; [sic] 3. The allegation that I have a Medical Practice where I conduct in-practice consultations in [suburb] (or any other location for that matter) between the hours of 6:00am to 6:00pm is one of the BLATENT LIES fabricated to found the rest of the false allegations. [sic] I hope this information will satisfy the Commission in assessing the subject Anonymous Complant. [sic] Yours Sincerely. Dr Gina Windsor 1. On 31 May 2016, an officer of the HCCC initiated a telephone conversation with Dr Windsor. That officer made the following file note of that conversation: 3:45 PM I telephoned Dr Windsor on [redacted], which was the primary telephone number registered with AHPRA. An Internet search revealed this was the number for Mobile Medical Centre, located at [suburb], which was also Dr Windsor's address as registered with AHPRA. The call was answered, "Hello, Dr Windsor's surgery, Louise speaking". I did not say where I was calling from and asked to speak to Dr Windsor. I discussed the complaint with Dr Windsor, and her response. She advised she does not work in a medical centre in [suburb]. She only works in nursing homes, disability group homes, a government disability centre, and certain hostels. She visits these locations and provides health care to the patients there. She mostly visits locations in the Western suburbs of Sydney, but also in the East and South. She is on-call 24 hours a day, so works day and night. A typical day might begin at 2:00PM, and she might work through the night. She confirmed she has at times slept in her car or at a nursing home, as it would not be safe to drive home if she was far from home or too tired to drive. During the course of our conversation, Dr Windsor's responses to my questions were in effect confirming rather than denying the allegations made in the complaint, although we did not discuss every allegation that was made (eg personal relationships with clients, inappropriate prescribing etc). Dr Windsor's verbal disclosures were inconsistent with her outright denial of the allegations in her written response. 1. In a letter of 21 September 2016 to the Medical Council, Dr Windsor disputed some aspects of the account of the telephone conversation of 31 May 2016. In her account, she told the HCCC officer that she does not have a practice in [suburb], but that she lived in [suburb]. She denied that she told the HCCC officer that she visited in the Eastern suburbs. She said that she had conceded that she sometimes "have taken a rest in the car and in a room provided by Nursing Homes. And I do it for my own safety". 2. Dr Windsor was requested by the Medical Council to attend a health interview with a panel on 6 September 2016. The panel was comprised of two psychiatrists. 3. Dr Windsor attended at the panel accompanied by her husband, Mr Neil Windsor. 4. The panel's report of the interview included the following: Dr Windsor attended punctually and was accompanied by her husband Mr Windsor, who advised that he was her practice manager. Dr Windsor was unable to participate in the interview as her husband answered questions on her behalf, spoke over her and refused to allow her to speak. He terminated the interview, advised his wife that she must not participate, and struck her on the shoulder in order to make her stand up and leave the interview. Little information could be gathered about her practice or health. The information that could be gathered is as follows: * • Mr Windsor wrote the response to the notification. * • Dr Windsor approved the response. * • Dr Windsor denied that she has any health problems. * • Mr Windsor believes that there is a plot against him, his wife and two children (aged [xx] and [xx]) and that the decision of the HCCC to convene this Health Interview is part of a "bigger issue". He believes that he is a target because of a web page he has written about "Atlantian Genocide", a discovery he recently made. He told the Interviewers that people were after him and his family and that they were in danger. * • Mr Windsor provided the Council with a copy of his web page flyer. * • Mr Windsor believes that his phones, the Council's phones and the interview room were all bugged and that the people who are after them are dangerous. * • Mr Windsor said that they had been persecuted for four years. * • Dr Windsor agreed that she thought her phone was bugged. Observations during the Interview Dr Windsor was very quiet during the interview, and when she spoke her husband repeatedly told her not to say anything, and he terminated the interview at a time when Dr Windsor told the interviewers that she wished to proceed. Mr Windsor was belligerent, paranoid and angry. He raised his voice and seemed preoccupied by the persecutory and somewhat bizarre beliefs outlined above, which appeared to be of a delusional nature. Mr Windsor's thought form appeared disjointed and was difficult to follow at times. Mr Windsor struck his wife on the shoulder and demanded that she leave with him. The interview was then terminated. ISSUES ARISING: • The interview could not be conducted because of Mr Windsor's anger, hostility and paranoia. • No information could be gathered about Dr Windsor other than her share belief that their phones are bugged and they are under surveillance. • Mr Windsor is the practice manager and this could place the public in danger given his aggression, overt hostility and paranoia. • Dr Windsor appears to be unduly influenced by her husband and this could place the public in danger if she acts on delusional beliefs, particularly as they seem to share beliefs that might be delusional. • Dr Windsor does not appear to be able to cooperate with the Council or its processes. • Dr Windsor does not seem to appreciate her professional responsibilities regarding making an appropriate response to a complaint and cooperating with regulatory authorities. • If Mr Windsor is the practice manager, then Dr Windsor has a responsibility to ensure the public are protected and the Interviewers were not satisfied that she could ensure the public were protected. 1. Arrangements were made for an Acute Care Team to visit Dr Windsor at home. Dr Windsor and Mr Windsor refused to participate in an interview with the Acute Care Team. 2. The Medical Council decided to arrange for Dr Windsor to attend a medical assessment with a psychiatrist, Dr Samuels, to determine whether Dr Windsor was suffering from an impairment. An appointment was arranged for 16 September 2016. Dr Windsor was informed of the appointment by telephone and by letter. In the letter, Dr Windsor was informed that 'the Council has decided that you must undergo an examination by a Council-appointed psychiatrist, in order to obtain an independent assessment of your health, and further: 'Failure to attend without a good reason will be viewed with concern, and may constitute evidence that you do not have the capacity to practice medicine safely.' 1. We consider that the letter amounted to a direction to Dr Windsor to undergo an examination by Dr Samuels, a registered psychiatrist, under s 145E of the National Law. 2. Dr Windsor did not attend the appointment with Dr Samuels. 3. Dr Samuels prepared a report dated 16 September 2016, based upon information given to him, including the anonymous complaint, the response to that complaint apparently written by Mr Windsor and adopted by Dr Windsor, the phone call with the HCCC officer, the transcript of the health interview on 6 September 2016 and a photocopy of the document provided to the panel at that interview by Mr Windsor. 4. Dr Samuels said, in his report: OPINION On the basis of the material I have reviewed there are strong suggestions of severe mental illness in Dr Windsor's husband. His behaviour in the interview conducted by Dr Arnold and Dr Friend raises the possibility that Dr Windsor has become affected by her husband's mental illness or that he is exerting a degree of control over her that is placing her at risk or impacting upon her ability to practice as a medical practitioner. The original notification occurred under unusual circumstances and the content of the notification is concerning and not entirely refuted by Dr Windsor. Until there is an opportunity to properly assess her in the absence of her husband in order to ascertain exactly what is going on, she probably should not be engaged in the practise of medicine. 1. The Medical Council received a letter dated 16 September 2019 from Dr Windsor. In that letter, Dr Windsor said that she was writing: "to formalise my refusal to present for a Health Assessment for an invented mental impairment and to furnish reasons for my decision". 1. Dr Windsor said that she had been misled about the nature of the interview with the panel on 6 September 2016, and that if she had known that it was a formal assessment of mental impairment, she would not have attended. She said that she had only become aware during the interview that it was voluntary. Dr Windsor wrote, in the letter: 5. Further, Medical Council's action is neither based on a just or reasonable cause nor any evidence, let alone prima facie evidence. The only purported evidence presented as the basis for the Assessment of Mental Impairment comes in the form of false allegations, made in an unsigned letter of unknown origin, neither having legal standing nor being factually accurate, in addition to not being even remotely indicative of a mental illness. It is a blatant overreach of Medical Council's lawful authority. 6. In my email reply to the Health Care Complaints Commission (Commission) dated 23, May 2016 2:17pm, I denied the allegations made in the Anonymous letter while implying that the Commission had overreached its legal Authority. With the benefit of contextual insight, I state my surprise that the Commission decided to act on this anonymous letter and politely implied some probability of Commission's lack of good will and or good faith, hoping this matter would end there. 7. I denied the allegations again at the time of the interview and provided further documentary evidence (with a link to the website: www.[redacted]) of my husband's political activities, which I had reasonably attributed to the Commission's initial legal overreach. Further, I refused to undergo an assessment of Mental Impairment. 8. This legal overreach against me has now evidently gone beyond the Medical Council and the Commission, (the details of which I reserve) to such a level as to convince even impartial observers as to the "oddness" of this overreach. With the benefit of hindsight, these later events further confirm my initial view. 9. I re-assert that the Medical Council has no authority to coerce me to undergo an Assessment of Mental Impairment for an invented mental impairment and will take whatever measures necessary to defend my innocence while continuing to maintain my TRUST where it should belong. 10. I am appalled at seeing people in a predominantly Christian Nation "Doing unto others as they wouldn't have done unto them". 11. I am not a Christian and I subscribe to a doctrine called "Karmic Retribution" which neither discriminates nor favours, while becoming effective immediately during life, in addition to overruling any and all acquired and or contractual indemnities. 1. A hearing under s 150 of the Health Practitioner Regulation National Law (NSW) was arranged for 23 September 2016. 2. Dr Windsor responded to the notice of the s 150 hearing, and accompanying documents, with a letter dated 21 September 2016 (see [8], above). Dr Windsor had received notice of the meeting by means of a telephone call on 13 September 2016 and in a letter dated 14 September 2016, and had received a folder of documents on 19 September 2016. She objected that she had not been given sufficient time to prepare. In her letter of 21 September 2016, Dr Windsor asserted that the initial complaint was "lies and libels". Dr Windsor set out in some detail her recollection of the events at the interview of 6 September 2016, and asserted that it was her right to refuse to continue with the interview. Dr Windsor said, in the letter: 11e I think the Medical Council's having been exposed of its true motive and Mr Windsor's assertive ability to elicit that information from the panel made them feel humiliated and outsmarted and as a result, the panel's description of the events are unduly exaggerated with deliberate omissions as to what really happened and done so with a specific purpose of making a conclusion against me and Mr Windsor. As to the issue of phone bugging, Dr Windsor said: My understanding of the phone bugging is as follows: i. Mr Windsor believes it because of his own experience. ii. I don't have any experience of my phone being bugged and I always carry my phone. I am uninfluenced about what Mr Windsor believes. Dr Windsor said that she had never seen her husband's website. She denied being influenced by Mr Windsor, and said that his role as her practice manager was very small and did not place the public in danger. Dr Windsor objected to the suggestion that she suffered from a mental health disorder, on the basis that the interview panel had insufficient evidence to make that finding. 1. Dr Windsor provided written submissions to the Medical Council by fax on 22 September 2016. Those submissions repeated Dr Windsor's view that the events of the health interview had been exaggerated. She characterised Mr Windsor's touch to her shoulder when he was asking her to leave the meeting as 'trivial'. She accused the panel of a 'lack of professionalism'. In her written submissions Dr Windsor responded to some of the words used in the interview panel's report, including the following: … b. delusional – even if the panel used this word in a non-medical sense, the word still is an exaggeration. During the interview, Mr Windsor mentioned the word "discovery" and furnished an artwork, but did not give any details. The panel couldn't have arrived at the description of "delusional" without further discovery on their own. For a dictionary definition of delusion: "false or unrealistic belief or opinion" to be correct in the context, the panel has to base the opinion relative to their own beliefs on the perceived reality, in addition to having the full knowledge of the author's intent, appropriate context, and varying degrees of meaning and factual accuracy of the content. Unless, the panel claims to fathom all of the above, their opinion becomes a result of their own illusions and delusions, which they fail to realise. c. bizarre – I find this whole series of events leading up to this proceeding bizarre. Mr Windsor isn't the cause of the bizarre situation. I think Mr Windsor acted in an appropriate way to suit the bizarre situation, which the panel fails to recognize. d. persecutory – The situation he described using different words is not a belief he hold. [sic] It is based on real events, real experiences and real facts that can be proven. e. paranoid, paranoia – From my experience with him, which is far greater than the panel, he is neither paranoid nor having paranoia. He has an accurate, calculated sense of risk based on his own experience. And he is qualified and capable to accurately assess risks certainly more than a typical doctor. Dr Windsor repeated her objection that she had not had 'a reasonable time' to prepare for the s 150 proceedings or to get legal advice, and she indicated that she did not intend to attend the proceedings. We reject Dr Windsor's categorisation of description of the health interview by the panel as exaggerated. 1. Dr Samuels provided a further report dated 22 September 2016. Dr Samuels had read Dr Windsor's letter of 16 September 2016. Dr Samuels said: My opinion remains unchanged and I continue to feel that Dr Windsor should not engage in the practise of medicine until she has been assessed by an independent psychiatrist and not in the presence of her husband. 1. The proceedings under s 150 of the National Law were heard on 23 September 2016 in the absence of Dr Windsor. 2. The panel decided to suspend Dr Windsor's registration as a medical practitioner from 5pm on the day of the hearing. Dr Windsor was notified of her suspension. Reasons for decision dated 7 October 2016 were prepared by the panel which conducted the s 150 proceedings. After a detailed account of the history of the matter, the panel concluded: The delegates are of the opinion that given the immediacy and severity of the potential risks to public safety, and the public interest issues that this risk potentially raises given the vulnerable population she treats, there are no conditions that could reasonably be imposed to mitigate the risks at this time. Until such time as further information is available about Dr Windsor's health and the potential risks to public safety and for the reasons provided, the delegates are of the view that suspension of Dr Windsor's registration is required for the protection of the public and otherwise in the public interest. Order Pursuant to s 150(1)(a) of the National Law (NSW) the delegates suspended Dr Gina Windsor's registration on 23 September 2016 with effect from 5:00pm Friday 23 September 2016. The matter was referred to the HCCC for consultation, with a recommendation that it be dealt with as a complaint for investigation. 1. An investigation proceeded. Email interactions took place between officers of the HCCC and Dr Windsor in the first half of 2017. On 29 June 2017, in the context of having sought information from Dr Windsor regarding certain Medicare records, an officer of the Medical Council received an email in the following terms from Mr Windsor: To The President, Dr Gregory John Kesby and all concerned: Final Response: SCREW YOU Post Script: All 19 Members of the Medical Board of NSW, all employees, all contractors (and all associated entities, their board members, employees, contractors etc) are on a WATCH LIST! WATCH [Mr Windsor's website] and enjoy your life while you still can! 1. The Medical Council reported the matter to the police. The police attended at Mr Windsor's home in the afternoon of 18 July 2017. The following is an extract of the police report of that attendance. P/N1 is Mr Windsor: About 3:00pm that afternoon police attended the P/N1 and P/N2s address and spoke to the P/Ns in relation to the email. P/Ni informed police that he sent the email to the P/R in the heat of the moment when he found out that him and his wife had been suspended from practising medicine. P/Ni stated the allegations of fraud were a conspiracy by an unknown agent acting on behalf of the U.S Government from previous interactions with them in the 1980s. P/N1 stated that he never intended harming anyone at the Medical Council of NSW rather wanted to make a point and get the staff members to look at his personal blog for spiritual enlightenment. Police were of the opinion that the P/N1 was delusional and was not capable of carrying out a physical harm or violence towards the staff members at the Medical Council of NSW. 1. An appointment for Dr Windsor to attend a medical examination by Dr Samuels was arranged for 19 July 2017. Dr Windsor failed to attend. Dr Samuels provided a further report, dated 19 July 2017, based upon the correspondence, saying that his opinion was unchanged and that, in his opinion, Dr Windsor should not engage in the practice of medicine until she has been assessed by an independent psychiatrist, not in the presence of her husband. 2. The HCCC sent Dr Windsor, by email, a letter dated 3 August 2017. In the letter, the HCCC said that it was proposing to refer the matter to the Director of Proceedings under section 39(1)(a) of the Health Care Complaints Act 1993 for determination as to whether to prosecute a complaint. The letter said that the basis for the proposed action was that Dr Windsor suffers from an impairment as defined in section 5 of the National Law and was not competent to practise as a registered health practitioner in accordance with s 139(a) of the National Law. The basis for this was Dr Samuel's opinion, based on the material provided to him. The letter also said: The evidence also indicates that on 16 September 2016 and 19 July 2017: 3. You failed to comply with a direction under section 145E(1) of the National Law to undergo an examination by a specified registered health practitioner at a specified reasonable time and place. A failure to comply with such a direction is prima facie evidence of the matters set out in section 145F of the National Law which provides: … (a) for a registered health practitioner, does not have sufficient physical or mental capacity to practise the health profession in which the practitioner is registered.. Dr Windsor was invited to make submissions within 28 days. 1. The officer of the HCCC who sent the email referred to in [29] received a response in the following terms: Dear Criminals No submission. Bring It On! The response came from the email address held by the HCCC for Dr Windsor, which seems to be an email address shared by Dr Windsor and Mr Windsor. 1. A further email was received by the officer of the HCCC from Mr Windsor on 3 August 2017, purportedly on behalf of Dr Windsor. Apparently misunderstanding the letter of 3 August 2017, it sought a copy of 'the complaint', saying: 'If you had acted like a decent, law abiding, non-psychopathic human, you would have at least given Dr Windsor a copy of the Medical Council's Complaint to which you are now inviting a response.' It also said that the State of Israel and its secret intelligence service, Mossad, with help from the Freemasons, had been terrorising Mr Windsor's family with "sophisticated "remotely controlled" mind tampering tools employing modern spying and mind control technology". The email detailed some of the correspondence Mr Windsor said that he had engaged in with various politicians concerning this topic. Mr Windsor suggests that the officer read his website and says: 3. Unless you are already an associate/member of a criminal secret society such as freemasonry which is colluding with the criminal principals, you are an unwitting patsy, having been complicit in a criminal plot, involving extra-judicial serial acts of terrorism. You, as an individual, have the freedom to be a believer, a non-believer or a skeptic of the information given and/or linked above and/or below based on your own personal perspective. However, by your interactions I judge your role to be one of a criminal patsy, criminal accomplice or a criminal principal in the overriding criminal plot against our family based on my personal perspective. And, I will act accordingly. Within this extra-judicial criminal context, it will be their own real personal experience that will eventually make non-believers and skeptics believe what they fail to make believe! 1. A letter dated 10 October 2017 from the HCCC was sent to Dr Windsor by email informing her that the decision had been made to refer the matter to the Director of Proceedings under s 39(1)(a) of the Health Care Complaints Act 1993 for the preparation of a complaint. Detailed information about the process was provided. 2. The complaint was filed in the Tribunal on 11 May 2018 and subsequently provided to Dr Windsor. 3. A response was received from Mr Windsor by email on 22 May 2018 to one of the officers of the HCCC. It said: Read this link thoroughly. And then study the links in the postscript to slowly absorb the real facts [reference to Mr Windsor's website]. Whether you have less or more of venomous animal blood of the evil ugly ape, which is wrongly named as genus "Homo" Stupidus Neanderthal, you must have to be totally retarded and out of mind to prosecute this case which is founded upon a fabricated anonymous complaint, made to look more frivolous by a few criminals masquerading as doctors and lawyers. If I hadn't made it clear before, this matter is only a part of an over 10 year old, extra-judicial terrorist operation by Israeli Mossad, in which every one of you have been tragically entangled as criminal accomplices, with every word you ever uttered being securely on record within local and American counter terrorism agencies. When the full extent of the damage is prosecuted against each and every one of you, your criminal complicity will be duly dealt with in accordance with criminal anti-terrorism provisions, where you will be detained and tortured without a charge for years. This is only if you happen to be lucky and you are prosecuted judicially. Otherwise, your consequences will be in kind and of the kind which is unfathomable to stupid, ignorant, animalised mongrels like you, masquerading as lawyers and doctors and deluded arbiters of justice. So, BACK OFF for your own sake! 1. The complaint was amended on 4 June 2018, and it is this complaint which is the subject of these proceedings. The Complaint 1. The amended complaint set out three complaints against Dr Windsor, in the following terms. Person A is Mr Windsor: AMENDED COMPLAINT as at 4 JUNE 2018 IN THE CIVIL AND ADMINISTRATIVE NO. Of TRIBUNAL OF NEW SOUTH WALES OCCUPATIONAL DIVISION HEALTH PRACTITIONER DIVISION LIST In the matter of Dr Gina Nicole Windsor, a person registered under the Health Practitioner Regulation National Law (NSW) The Health Care Complaints Commission of Level 13, 323 Castlereagh Street, Sydney NSW, having consulted with the Medical Council of New South Wales in accordance with sections 39(2) and 90B(3) of the Health Care Complaints Act 1993 and section 145A of the Health Practitioner Regulation National Law (NSW) ("the National Law") HEREBY COMPLAINS THAT Dr Gina Windsor of [address redacted] ("the practitioner") being a medical practitioner registered under the National Law, COMPLAINT ONE Has an impairment within the meaning of section 5 of the National Law, being a physical or mental impairment, disability, condition or disorder that detrimentally affects or is likely to detrimentally affect the practitioner's capacity to practice the profession of medicine. BACKGROUND TO COMPLAINT ONE In 1994 the practitioner obtained her medical degree from the University of Colombo, Sri Lanka. In 1998 the practitioner was granted conditional registration to practise in Australia. On completion of supervised training, on 8 December 1999 the practitioner was granted general (unconditional) registration. The practitioner subsequently attained Fellowship to the Royal Australian College of General Practitioners. On date 4 April 2016 an anonymous complaint was made about the practitioner to the Health Care Complaints Commission. After considering the anonymous complaint, the Health Committee of Medical Council of New South Wales ("the Council") resolved to invite the practitioner to attend a non disciplinary health interview ("the health interview") with two psychiatrists appointed by the Council ("the interviewers"). On 6 September 2016 the practitioner attended the health interview and was accompanied by a close family relative, Person A. On 12 September 2016 the Council sent the practitioner a letter under section 145E of the National Law requiring her to undergo an examination by Council appointed psychiatrist, Dr Anthony Samuels, on 16 September 2016 ("the CAP examination"). On 23 September 2016 the Council convened a meeting between two Council delegates, one of whom was a psychiatrist and the practitioner under section 150 of the National Law ("the s150 proceedings") The practitioner did not attend the s150 proceedings but provided three letters to the Council prior to the proceedings. The practitioner's registration as a medical practitioner was suspended by the Council pursuant to s150 of the National Law on 23 September 2016. PARTICULARS OF COMPLAINT ONE 1. During the health interview on 6 September 2016, when Person A repeatedly told the practitioner not to say anything during the health interview, the practitioner largely complied and did not speak. 2. At the health interview Person A made statements including: i. that there was a plot against Person A, the practitioner and other close family members, ii. Person A believed there was a plot against him because of a web page about "Atlantian Genocide", iii. Person A provided a flyer to the interviewers about a web page, iv. that his phones, the Council's phones and the health interview room were all bugged, v. that the people after Person A, the practitioner and other close family members were dangerous. 3. During the health interview the practitioner did not express disagreement with Person A's statements set out at particular 2 above. 4. At the health interview, the practitioner stated that she agreed with Person A that her phone was bugged. 5. When Person A directed the practitioner to leave the health interview at a time when the interviewers had not completed their questioning, the practitioner complied and left the interview. 6. The practitioner failed, without reasonable excuse, to comply with a direction by the Council under section 145E of the National Law to undergo an examination by a specified health practitioner, Dr Anthony Samuels, scheduled for 16 September 2016. Pursuant to section 145F of the National Law the practitioner's failure to attend Dr Samuels' examination is evidence that the practitioner does not have sufficient physical or mental capacity to practise medicine. 7. By letter dated 14 September 2016 the practitioner was informed by the Council that it would be convening proceedings under section 150 of the National Law on 23 September 2016 and that the proceedings would be recorded. On 22 September 2016 the practitioner was informed that Person A would not be able to attend the proceedings. The practitioner failed to appear before the s150 delegates on 23 September 2016 to be interviewed. 7a. By letter dated 22 September 2016 the practitioner wrote to the Council expressing her view that Person A: a) held views as expressed to the health interview panel which "is not a belief he hold[s]. It is based on real events, real experience and real facts that can be proven"; b) is neither paranoid nor "having paranoia"; c) is "qualified and capable" of accurately assessing risks, "certainly more than a typical doctor". 8. On 27 June 2017 the Council emailed the practitioner directly concerning her suspension. On 29 June 2017 Person A replied to the email by: i. stating "Final Response: SCREW YOU!"; ii. stating that the Council and its employees were on a "watch list"; iii. telling the Council to view a conspiracy theory website; iv. threatening that the receivers of the email should "enjoy your life while you still can!", and v. the practitioner failed to independently respond to the Council's email. 9. On 3 August 2017, Person A communicated to the Commission by email, expressed to be on behalf of the practitioner, by: i. making derogatory comments to the Commission's staff; ii. espousing delusional, paranoid and persecutory beliefs; iii. referring to conspiracy websites and conspiracies; iv. stating that "I judge your role to be one of a criminal patsy, criminal accomplice or a criminal principal in the overriding criminal plot against our family…"and, v. the practitioner did not independently respond to the Commission's email. 10. On 3 August 2017 the Health Care Complaints Commission notified the practitioner directly by e-letter of proposed referral of her matter to the Director of Proceedings and the grounds for the referral. The e-letter also invited the practitioner to make submissions. Person A responded by email to the Commissioner on the same day stating, "Dear Criminals, No Submission. Bring It On!" and the practitioner did not independently respond to the Commission's e-letter. 11. Particulars 1- 10 (as amended) are relied upon to support a finding that the practitioner has Induced Delusional Disorder and/or another underlying mental health disorder which makes her vulnerable to paranoia and/or delusions. COMPLAINT TWO Is not competent to practice medicine within the meaning of section 139(a) of the National Law. BACKGROUND TO COMPLAINT TWO As for Complaint One. PARTICULARS TO COMPLAINT TWO 1. The particulars of Complaint One are repeated and relied upon individually and cumulatively. 2. By reason of the particulars of Complaint One the practitioner has demonstrated and demonstrates: a. a lack of mental capacity; b. diminished control over her autonomy; c. diminished insight into her professional obligations to regulatory authorities; d. diminished insight into and/or capacity to respond to the adverse effects of her personal relationship with Person A to her professional obligations. COMPLAINT THREE Is not otherwise a suitable person to hold registration as a medical practitioner. BACKGROUND TO COMPLAINT THREE As for Complaint One. PARTICULARS TO COMPLAINT THREE 1. The particulars of Complaint One and Two are repeated and relied upon individually and cumulatively. The Hearing 1. The hearing before us was the second occasion upon which the matter had been heard in the Tribunal. After the first occasion, prior to the delivery of any decision, the Tribunal was discovered to have been improperly constituted, and this panel was then appointed to hear the matter afresh. 2. Dr Windsor did not appear at any of the directions hearings leading to the second hearing. On most occasions, Mr Windsor attempted to appear for Dr Windsor. Given his involvement in the events leading up to the complaint, the absence of any training which would equip him to advise Dr Windsor in a manner likely to assist her and his plain desire to use the proceedings to expound his theories and beliefs, Mr Windsor was not given leave to represent Dr Windsor. The Tribunal requested Mr Windsor to inform Dr Windsor that it was desirable that she engage with her professional regulator and in the proceedings. 3. Mr Windsor filed a set of documents comprising a single volume, and then, prior to the hearing, filed "The Respondent's Written Submissions" Volumes 1 and 2. Mr Windsor included in Volume 1 a general power of attorney granted by Dr Windsor to him on 14 October 2016. He argued, in a directions hearing, that this power of attorney gave him authority to act on Dr Windsor's behalf in the hearing of the matter before the Tribunal, but this argument was unsuccessful. 4. We have taken into account the material in the volumes filed by Mr Windsor (who, by that time, was calling himself Dr Neil Windsor, a self-conferred title), in so far as they are relevant. They include, behind Tab 2, documents (among others) described in the index as 'references', which comprise letters or records, from either employers or co-workers of Dr Windsor, who comment positively about the quality of her work as a medical practitioner. We have taken note of those records and letters. Much of the material filed relates to Mr Windsor's theories and beliefs, which very far from being mainstream theories and beliefs. In some of the documents, Mr Windsor refers to himself as 'The Creator'. 5. Dr Windsor did not appear at the hearing of the matter. 6. We find that Dr Windsor did indicate, in the interview on 6 September 2016, that she believed that her phone was bugged. We rely on the panel's record of the interview. Also, behind Tab 1 of Volume 1 of 'The Respondent's Written Submissions' there is an 'unofficial transcript' of the interview on 6 September 2016 which records, on p 68, the following exchange, which supports this finding: THE CREATOR: Ok, I'll just tell you one small thing. I hope you at least have enough empathy to understand. Today's technology allows private corporations and government agencies and to spy on people, by hacking into their smart phones, computers and even smart TVs. I am not talking about me, you or Dr Windsor. This applies to everyone who uses smart phones, computers and smart TVs. Because of the Website, the kind of political issues, and discoveries I write about on the Website, I have become a target. I won't be surprised if what's happening in this room is under surveillance. Dr Friend: And, you believe any of this? [Turning her face towards Dr Windsor] Dr Windsor: [Nod] or yes. 1. We find that Dr Windsor did leave the interview at the behest of Mr Windsor. We believe the report of that interview prepared by the panel over subsequent accounts given by Dr Windsor. Complaint One 1. On the basis of the material filed on behalf of the applicant, we find that the particulars of Complaint One have been established on the balance of probabilities, and on the standard set out in Briginshaw v Briginshaw (1938) 60 CLR 336 ('the Briginshaw standard'), assuming that has application (see Ng v Health Care Complaints Commission [2017] NSWSC 53). 2. However, we are not able to say, on the balance of probabilities, that Dr Windsor has Induced Delusional Disorder or another mental health disorder which makes her vulnerable to paranoia and/or delusions. Dr Samuel's opinion does not go that far. Although the evidence points in that direction, it is not possible for this Tribunal, or its medically trained members, to arrive at a diagnosis for Dr Windsor. A psychiatrist could not arrive at a diagnosis without considerably more information, which could only be gleaned from a psychiatric report prepared by a psychiatrist who had been afforded the opportunity to undertake an extensive interview with Dr Windsor. Dr Samuels has not been able to conduct such an interview because of Dr Windsor's refusal to attend an appointment with him. 3. Complaint One has not been made out. Complaint Two 1. Complaint Two relies upon the same particulars as Complaint One. 2. On the basis of the events set out above, and Dr Windsor's decision not to participate in these proceedings, we find that Dr Windsor has demonstrated diminished control over her autonomy, diminished insight into her professional obligations to regulatory authorities and diminished insight into and capacity to respond to the adverse effects of her personal relationship with Mr Windsor to her professional obligations. 3. The anonymous complaint which triggered the chain of event which led to these proceedings led to the Medical Council giving Dr Windsor a direction, under s 145E of the National Law, to undergo an examination by Dr Samuels, a registered psychiatrist, on 16 September 2016 at a specified reasonable time and place. 4. Given the substance of the anonymous complaint, it was reasonable for the Medical Council to require Dr Windsor to attend that appointment. We bear in mind the objectives of the National Law, set out in s 3, including s 3(2)(a) which says: 3(2) The objectives of the national registration and accreditation scheme are – (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; … Section 3A says: In the exercise of functions under a NSW provision, the protection of the health and safety of the public must be the paramount consideration. 1. Dr Windsor, without reasonable excuse, refused to attend the appointment with Dr Samuels on 16 September 2016. She has made no subsequent attempt to provide the Medical Council with the health information it has indicated that it requires. 2. We do not rely on Dr Windsor's failure to attend the further appointment arranged for 19 July 2017, as we have not been provided with any documentary evidence with respect to the communication of the direction to Dr Windsor to attend that appointment. 3. As to the question of whether Dr Windsor demonstrates a lack of mental capacity as alleged in Complaint Two, we refer to s 145F of the National Law, which provides: A failure by a registered health practitioner or student, without reasonable excuse, to comply with a direction under section 145B to attend counselling or under section 145E to undergo an examination is, for the purposes of the Law and any inquiry or appeal under this Law, evidence that the practitioner or student – (a) for a registered health practitioner, does not have sufficient physical or mental capacity to practice the health profession in which the practitioner is registered. 1. Complaint Two of the complaint has been made out. 2. Complaint Three 3. Complaint Three relies upon the same factual background as Complaints One and Two and seeks a finding that Dr Windsor 'is not otherwise a suitable person to hold registration as a medical practitioner'. 4. We have found, in the context of Complaint Two, that Dr Windsor is not currently competent to practice as a general practitioner within the meaning of s 149C(1)(a) of the National Law. It follows that she is presently unsuitable to hold registration as a general practitioner. 5. Summary and Conclusion 6. On the basis of Dr Windsor's refusal to undergo psychiatric evaluation, which is reasonably required on account of her behaviour throughout the events leading to these proceedings, and having regard to s 145F of the National Law, we determine that Complaints Two and Three are made out, and we find and determine that Dr Windsor is not presently competent to practice as a general practitioner within the meaning of s 149C(1)(a) of the National Law. 7. We make the following order: 1. Dr Windsor's registration as a general practitioner is cancelled. ********** 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: 01 October 2019