Management of practitioners with health impairments

Health Care Complaints Commission v Paris-Browne [2017] NSWCATOD 70 is a disciplinary matter in which misconduct was alleged in the antenatal care of patient with severe pre-eclampsia. The practitioner had, by the time of the hearing, ceased to practice.

Of interest is the following, unfortunately brief, passage at [64] – [68]:

Wider Issues

  1. Finally, we wish to observe that there are issues raised by this case of a wider, systemic kind.
  2. The first set of issues relate to appropriate management of practitioners with health impairments. The practitioner stated that he sought from hospital management during 2014 a change in duties that would have taken him out of on-call obstetric duties, because of the increasing difficulty he was experiencing in coping with the physical demands involved following treatment for cancer, and was rebuffed. He said he felt that he was compelled to continue as directed, as the only other choice provided was resignation from all work.
  3. Later in his statement, he said that after ‘the full force of the calamity which befell [Patient A] and my part in the outcome hit me’ he had a meeting with management which led quickly to a decision he agreed with standing him down from all on call duties and allowing him to continue performing elective gynaecology.
  4. We are not making any finding in regard to the accuracy or otherwise of this account. These matters lie outside the scope of our task in these proceedings.
  5. There are other observations by Professor Pepperell in his report that relate to broader aspects of clinical management and practice at the time of the events the subject of these proceedings. Again, they are not germane (in an immediate sense) to the task we are called on to perform in these proceedings. However, they deal with contextual factors that, on their face, contributed to the failures of performance of the practitioner. The NSW Department of Health should, we think, consider again the broader health care and managerial concerns raised by this case.


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