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Guidelines and Policies


Australian Health Practitioner Regulation Authority

AHPRA was formed by an Act of Parliament and is bound by the Health Practitioner Regulation National Law (2009) (The National Law) as in force in each State and Territory and its Regulations.

Nursing and Midwifery Board of Australia
Registration Standards
Codes and Guidelines

Medical Board
Registration Standards
Codes, Guidelines and Policies

AMA policies
Guidelines for Medical Practitioners on Certificates Certifying Illness – 2011
Medical Professionalism – 2010
Use of the title ‘Doctor

Legislation

Health Practitioner Regulation National Law (NSW) No 86a NSW
The creation of the National Registration Scheme in Australia and the functioning of this scheme in NSW. Outlines requirements of professional conduct under Part 8 and matters that will constitute unsatisfactory professional conduct or professional misconduct.

All States and Territories have enacted the National Law.

Health Practitioner Regulation National Law Act 2009 QLD

Health Practitioner Regulation National Law (Victoria) Act 2009 VIC

Health Practitioner Regulation National Law (ACT) Act 2010 ACT

Health Practitioner Regulation (National Uniform Legislation) Act 2010 NT

Health Practitioner Regulation National Law (Tasmania) Act 2010 TAS

Health Practitioner Regulation National Law (South Australia) Act 2010 SA

Health Practitioner Regulation National Law (WA) Act 2010 WA

Health Professions Registration Act 2005 Vic
Providing for the registration of health practitioners and a common system of investigations into the professional conduct, professional performance and ability to practise  of registered health practitioner.

National Health Reform Act 2011 Cth
Empowers the Australian Commission on Safety and Quality in Health Care (ACSQHC), an independent statutory authority to develop standards to improve the quality of health service provision in Australia. The Standards provide a nationally consistent statement of the level of care consumers should be able to expect from health services and this includes systems of error reporting and investigation.

Cases

HCCC v Allen [2010] NSWMT 8 NSW
A doctor was found guilty of professional misconduct for making a false statement in relation to the investigation of Dr Sood (R v Sood [2006] NSWSC 1141)

HCCC v Dene & Donnelly (No 2) [2010] NSWPST 4 NSW
A failure to make a mandatory report may also be unprofessional conduct or professional misconduct.

Health Care Complaints Commission v Karalasingham [2007] NSWCA 267 NSW
NSWCA
Doctor found guilty of professional misconduct when found guilty of issuing false medical certificates to three students to excuse them from attending clases in order to fulfil visa requirements.

Health Care Complaints Commission v Litchfield (1997) 41 NSWLR 630 NSW
NSWSC
Court judgement on the professional misconduct of a medical practitioner found guilty of sexual misconduct over an extended period.

Nursing and Midwifery Board of Australia v McAtamney (Occupational and Business Regulation) [2011] VCAT 1235 VIC
A nurse was found guilty of unprofessional conduct for falsifying medical certificates to give to her employer.

Skehan v Medical Board of Australia [2012] VSCA 9 VIC
The Victorian Court of Appeal upheld a finding of unprofessional conduct on the part of a doctor who created a false medical certificate and consultation notes for a patient he was having a sexual relationship with.

I v Medical Board of Australia [2011] SAHPT 18 SA
The decision of an IAC to suspend a medical practitioner’s registration was upheld in circumstances where the practitioner was charged with two counts of aggravated indecent assault against female patients.

HCCC v Underwood (2011, Medical Tribunal of NSW, 40011/2011) NSW
A doctor was reprimanded and had conditions placed on his registration for having sex with the mother of two infant patients.

Psychology Board of Australia v Dall [2011] QCAT 608 QLD
The continuance in secret of the sexual relationship after the end of the therapeutic relationship was said to be harmful to the patient’s treatment.

Dewan v Medical Board of Australia (Occupational and Business Regulation) [2012] VCAT 1327 VIC
A surgeon was found guilty of unprofessional conduct for operating on a child and removing part of his bowel without making adequate investigations and enquiries regarding the child’s reasons for faecal incontinence. The child’s problems were psychological but the surgeon made no effort to investigate non-surgical options for treatment.

Medical Board of Australia v Bernadt [2012] WASAT 108 WA
A doctor was found to have acted carelessly when he performed, without an adequate history or physical examination, an adenoidectomy on a child with a cleft palate.

Medical Board of Australia v Jabbar (Occupational and Business Regulation) [2010] VCAT 1772 VIC
A doctor was reprimanded and suspended for three months for performing a botched circumcision which cut off the boy’s urinary tract and caused Fournier’s Gangrene, leaving the boy severely scarred.

Chinese Medicine Registration Board of Victoria v Ghaffurian (Occupational and Business Regulation) [2012] VCAT 478 VIC; Chinese Medicine Registration Board of Victoria v Huang (Occupational and Business Regulation) [2012] VCAT 1903 VIC; HCCC v Hameiri [2011] NSWMT 13 NSW
The failure to protect patients with proper infection control is a disciplinary matter.

Dental Board of Australia v Gan [2011] SAHPT 4 SA
A dentist was disciplined for having a messy and dirty practice. There were bloodstains and rust on equipment and there was no system for sterilisation. Conditions were placed on his registration that were then ignored. The dentist was fined and restrictions were placed on his practice.

Assaulting patients

Nursing and Midwifery Board of Australia v Rogers [2011] SAHPT 16 SA
Using unnecessary or excessive force against patients is grounds for professional discipline.

Nursing and Midwifery Board of Australia v Geary [2012] QCAT 294 QLD
Even minor assault such as throwing water in a patient’s face may breach professional standards.

Nursing and Midwifery Board of Australia v Hughes-Fischer [2011] QCAT 627 QLD
Self- defence will not excuse assault if there were other options apart from physically harming a patient.

Nursing and Midwifery Board of Australia v Carroll [2011] QCAT 264 QLD
A nurse was convicted of orally raping a patient after drugging her with morphine. The nurse was disentitled from applying for registration until after 8 years.

HCCC v Gillies [2010] NSWNMT 7 NSW
A nurse was convicted of assaulting a patient in a nursing home after abusing an incontinent patient and roughly grabbing her and turning her over to clean her up after she had smeared herself with faeces. She also roughly wiped the patient’s eyes causing a laceration. The nurse was found guilty of assault but no conviction was entered by the Magistrate and the nurse was released on a good behaviour bond.

Criminal convictions for behaviour outside of nursing

HCCC v Schmich [2009] NSWNMT 19 NSW
In a case involving a nurse’s convictions for driving, drugs and stealing offences, the NSW Tribunal adopted a list of considerations to take into account when considering whether a person is a fit and proper person to hold registration.

Nursing and Midwifery Board of Australia v Quiroga (Occupational and Business Regulation) [2012] VCAT 1280 VIC
When the convictions have little to do with the practice of nursing if it can be shown that the behaviour creates risks to the public then it is relevant to the issue of the person being ‘fit and proper’ for the practice of nursing.

Nursing and Midwifery Board of Australia v McKenzie [2011] QCAT 338 QLD
Convictions for social security fraud have been found to render a person unfit to practise, given the centrality of honesty to nursing.

Nursing and Midwifery Board of Australia v Brearley [2012] QCAT 323; Nursing and Midwifery Board of Australia v Buckley [2010] QCAT 392 QLD
Convictions for possession of child pornography may also be grounds for disciplinary action

HCCC v Vincent [2012] NSWNMT 2 NSW
A nurse convicted of possession of child pornography argued that he was not a threat to society or to any person as a result of what he had done. The Tribunal disagreed and found it inappropriate for him to be considered for re-entry into the nursing profession until there was evidence that he had gained insight into the nature and effect of his crimes.

Nursing and Midwifery Board of Australia v Hutchison [2011] SAHPT 5 SA
Nursing and Midwifery Board of Australia v FH
[2010] QCAT 675 QLD
Failure by nurses to report their convictions may also be grounds for finding unprofessional conduct and professional misconduct.

Poor professional performance

Deano v HCCC [2012] NSWSC 693 NSW
A nurse was deregistered for sleeping during night shift in patient beds, for not supervising enrolled nurses, and for signing medication charts when she did not witness the medication being administered.

HCCC v Santos [2012] NSWNMT 8 NSW
Cumulative effect of continual unprofessional conduct can lead to findings of professional misconduct, as per s 139E(b) of the National Law.

Poor communication skills

HCCC v Xie [2007] NSWNMT 13 NSW
Section 55(1)(d) of the National Law requires nurses to possess competent communication skills and command of English to practise nursing. Failure to have such communication skills is grounds for discipline:

HCCC v Smith [2011] NSWNMT 9 NSW
A nurse was deregistered for failing English proficiency tests on the basis that proficiency in English was necessary to protect the public.

Nursing and Midwifery Board of Australia v Hancock [2011] SAHPT 13 SA
Being discourteous and insensitive may also be grounds for censure.

Failure to properly examine patients

HCCC v O’Connor [2012] NSWNMT 6 NSW
A nurse was found guilty of unsatisfactory professional conduct for failing to conduct appropriate monitoring of blood pressure, blood sugar and temperature on patients.

Impairment

Nursing and Midwifery Board of Australia v SB [2012] QCAT 332
Nursing and Midwifery Board of Australia v Bates
[2011] QCAT 662
QLD
Impairments include disabilities, mental health issues.

HCCC v Stewart [2012] NSWNMT 12 NSW
Addiction to alcohol

HCCC v Williamson [2011] NSWNMT 1 NSW
Narcotics addiction

HCCC v O’Connor [2012] NSWNMT 6 NSW
Nurse was found not to be impaired when her cognitive problems were found to have been caused by treatable hydrocephalus and hypothyroidism. Treatment for these conditions would have returned the nurse to regular cognitive functioning.

Misuse of drugs

HCCC v Williamson [2011] NSWNMT 1  NSW
Nurse was found guilty of professional misconduct for (amongst other things) taking pethidine and morphine for self-administration.

HCCC v Swinhoe [2011] NSWNMT 12 NSW

Nursing and Midwifery Board of Australia v Pethic [2011] SAHPT 15 SA

HCCC v Taylor [2008] NSWNMT 9 NSW
Taking drugs meant for patients is also grounds for discipline

HCCC v Randall [2012] NSWNMT 9 NSW
Misuse of access cards and mishandling of Schedule 8 medications.

Nursing and Midwifery Board of Australia v McDonald [2011] SAHPT 3 SA
Failure to record non-administration and the false recording of drug information also led to discipline.

HCCC v Smith [2011] NSWNMT 9 NSW
The nurse had taken drugs but had given them to her husband to use for his livestock. The nurse was reprimanded.

Failure to keep proper records

HCCC v Thompson (No 1) [2012] NSWNMT 13 NSW
It was alleged that a nurse was guilty of unprofessional conduct because she had failed to make legible and contemporaneous entries regarding a patient’s condition, in circumstances where that patient later died from severe blood loss after a caesarean section. The Tribunal disagreed and found that the condition of the notes were understandable given the circumstances the nurse was working in.

HCCC v MacGregor [2012] NSWNMPSC 3 NSW
A midwife was reprimanded for not keeping records during a homebirth. She was also disciplined for failing to have a plan for the care and management of the patient and for not riding in the car with the patient when she was taken to hospital. She only gave a verbal report when handing over care to the hospital. The midwife was found guilty of unsatisfactory professional conduct and was required to undergo education and be supervised.

Misuse of electronic records and computer systems

HCCC v Burggraaf [2012] NSWNMT 4 NSW
A nurse was found guilty of unsatisfactory professional conduct and professional misconduct and reprimanded for having inappropriately accessed patients’ electronic records.

HCCC v Meyer [2008] NSWNMT 22 NSW
A nurse was found guilty of professional misconduct for accessing pornography and sexually explicit internet material whilst on duty and then lying about it.

Sexual and personal relationships with patients

HCCC v Pearsall [2012] NSWNMT 10 NSW
A nurse was alleged to have acted inappropriately by making personal statements to a patient, sitting on his bed and inappropriately touching the patient’s ankles and testicles. The nurse was criminally charged but acquitted. Nevertheless the Tribunal found there to have been professional misconduct on the part of the nurse. His registration was cancelled and he was ordered not to apply for registration for five years.

Nursing and Midwifery Board of Australia v McMahon [2011] SAHPT 22 SA
The nurse was found to have engaged in predatory behaviour and exploited a vulnerable mental health patient for his own sexual gratification. He was deregistered and disqualified from being registered for four years.

Nursing and Midwifery Board of Australia v Ascot [2011] QCAT 266 QLD
Commencement at the immediate end or same day as the termination of the therapeutic relationship is too soon:

HCCC v Karja [2012] NSWNMT 11 NSW
The nurse was the unit manager of a health clinic in a correction facility. She had sexual intercourse on four occasions with a patient/inmate. The nurse and inmate also exchanged letters and the nurse had given the inmate gifts including chocolates and CDs. The nurse was found to have committed unprofessional conduct and professional misconduct. She was deregistered for six months.

Nursing and Midwifery Board of Australia v Brennan [2011] QCAT 328 QLD
A nurse pursued a friendship with a psychiatric patient, gave her health information without being supervised and borrowed a small amount of money from her. He also texted her and sought to become her Facebook friend. The Tribunal suspended the nurse for three months and ordered him to undergo further training.

Soliciting gifts and loans from patients

Nursing and Midwifery Board of Australia v Farley [2012] QCAT 447 QLD
Taking substantial gifts or loans is a breach of professional guidelines.

Nursing and Midwifery Board of Australia v Brennan [2011] QCAT 328 QLD
Even small loans may breach professional standards:

HCCC v Belkadi (No 1) [2012] NSWNMT 5 NSW
A nurse was found guilty of unsatisfactory professional conduct after she solicited substantial loans of money from a patient and close relative of another patient.

Papers, Reports and Books

National Regulation of Health Practitioners – a new era in regulation
September 2010
Bennett and Reid
Medico-Legal Society of NSW

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