20 June 2020

Unwell

In Health Care Complaints Commission v McGregor [2020] NSWCATOD 13 the NSW Civil and Administrative Tribunal has cancelled the registration of Sydney psychiatrist Dr McGregor after the practitioner posted a blog on his practice website which was “bizarre and suggestive of impaired reality testing” and verbally abused Medical Council panel members. NSWCAT considered whether McGregor's conduct constituted unsatisfactory professional conduct and professional misconduct, whether the practitioner is impaired whether he has “sufficient physical and/or mental capacity to practise medicine”, accordingly imposing appropriate protective orders.

The action was initiated by the NSW Health Care Complaints Commission. NSWCAT notes that
During 2017 Dr McGregor became suspicious that his wife, who was a receptionist at the practice, was having an affair with another psychiatrist in the practice. Around July 2017 he engaged a private investigator to download data from his wife’s mobile phone. On 22 December 2017 he provided that data, together with his own commentary, to the Australian Health Practitioner Regulation Agency (AHPRA). Dr McGregor characterised the notification as a “mandatory notification” alleging that the other psychiatrist had breached ethical guidelines. On 18 January 2018 a colleague who practised in the same building as Dr McGregor, complained to AHPRA about Dr McGregor’s behaviour in forwarding her a copy of the complaint he had sent to AHPRA. Dr McGregor said that he sent the complaint to his colleague to protect his reputation. As part of the investigation of the colleague’s complaint, investigators accessed Dr McGregor’s practice website and found a blog  - characterised by McGregor as his “Australian patriot blog” - on that psychiatric practice website.
Shortly thereafter an employee of the NSW Health Pharmaceutical Regulatory Unit (PRU)  poke with the Medical Director of the NSW Medical Council about the content of the blog. That content might politely be described as colourful, featuring reference to ' FISA wiretapping, M 16 connection, Assassination plots and ... unmentionable satanic ritual evidence'.

In praising QAnon and President Trump for fighting the satanic 'deep state' the blog stated
 Julian Assange is not in the Ecuadorian Embassy. He is either in Switzerland or Washington. Q and the MoD, SVR (Kremlin) confirm this. He is an Australian hero and would make a fine future PM. When the infant torture, rape and satanic rites cannibalism by elites is provided by Trump on tape – seek the comfort of others. Pay attention to the news cycle. Follow Q breadcrumbs on 8chan. Message, tweet, post and discuss with friends and family. Be open to new knowledge and cross check information thoroughly. Await the Australian Treason Trials (TT’s). 
After reviewing the blog, the NSW Medical Council decided to raise an 'own motion' complaint against McGregor with the Health Care Complaints Commission, expressing considerable concern for the practitioner's mental health and well-being. The Commission referred the complaint to NSWCAT as a serious complaint under s 145D of the Health Practitioner Regulation National Law, seeking an order from the Tribunal that McGregor’s registration be cancelled either because he is not competent to practise medicine or because he is guilty of professional misconduct: s 149C(1)(a) and (b). The Commission also sought an order under National Law s 149C(7) that McGregor cannot reapply for registration for a period of 12 months.

McGregor was on notice that the Tribunal would hear the complaint on 11 December 2019 but   did not attend. The HCCC provided McGregor with a copy of all the material it had lodged with the Tribunal, including the orders it was seeking.  Rather than alleging that McGregor had expressed extreme political views on his blog, the HCCC alleged that “the information published by the practitioner had the potential to expose his patients to harm when accessing the practice website for information or to make an appointment.”

McGregor did not respond and had not attended a meeting with a consultant psychiatrist, required by the Council. NSWCAT states 'We note that if a medical practitioner fails, without reasonable excuse, to comply with a requirement to attend a medical appointment, that failure is evidence the person does not have sufficient physical or mental capacity to practise medicine: National Law, s 152B(4)'.  McGregor did not respond to subsequent contact by the Medical Council apart from stating 'regardless of what Council does, it won’t change his political views and he won’t remove the blog from his website'.

NSWCAT states
On 5 March 2018, the Council held a hearing under s 150 of the National Law. During that hearing, the panel attempted to contact Dr McGregor by phone. Eventually Dr McGregor spoke with the three Council delegates on the panel. He repeatedly asserted that it was his politically views, as expressed in his blog that had brought him to the Council’s attention. Despite the Presiding Member telling him that it was concerns about his mental health that had triggered their response, Dr McGregor continued to assert that he was being persecuted because of his political opinions. At one stage during the phone call, Dr McGregor explained that, “there are great political changes occurring in the world at the moment and um I uh you know I need to uh uh get that across to other people and um ah if you uh feel that because uh my opinion is a little different to yours that you need to take away my registration that’s up to you . . um but . . .” He went on. “Um if you had any understanding of politics um you would understand that that that the beliefs that are actually put on the blog are actually um the uh directives um from ah from President Trump.” 
The issue for the Council delegates at that hearing was whether McGregor’s registration should be suspended to protect the health or safety of any persons or because the delegates were satisfied that suspension was necessary in the public interest. The delegates concluded that Dr McGregor showed such impaired judgment that exposure to those views had significant potential to expose his patients to risk of harm. McGregor’s response on hearing of the consequent suspension was visceral.
McGregor later stated on his blog
Sadly I was deregistered from practicing as a doctor today. The Medical Council of NSW found me guilty of publishing a website and expressing a political opinion which they disagreed with. . . . I sincerely apologise to all of my patients who have been terribly affected by this. I am very sorry to have caused you so many difficulties. . . . The truth is that it is very likely that I shall go bankrupt, and shut down, as my practice has enormous running costs. Thus it is best not to wait to see if The Medical Council of NSW will change its mind, but rather to find another Psychiatrist. 
He then requested an 'immediate reinstatement of my right to practice medicine', claiming the Presiding Member 'knowingly used the power of Political Correctness to inflict woman to male intimidation and assault against me. She knew that my political beliefs were different to hers and as such I felt she was using legal, financial and reputational intimidation as a woman against me. I feel her behaviour was that of a feminist thug used to deny me consent and respect'.

 In the written decision next month the Council delegates gave detailed reasons for suspending the registration, expressing the view that McGregor has an impairment with severely distorted judgement, construed as evident in the 'bizarre nature of aspects of his blogs (such as his reference to cannibalism and Satanic rituals) and publishing such disturbing material on his practice website where vulnerable patients could easily access the content'. Later in April a lengthy email from McGregor to the Council about the proposed s 150A hearing appears to have characterised the Council as 'clearly a Government Institution with bigoted/intolerant socially left wing zealots who conform to groupthink and take political views to further their careers'. The Council set aside the decision to suspend Dr McGregor’s registration and instead, imposed a condition that he is not to practise medicine, referring the matter to the Commission under s 150F to the HCCC. Doubling up, McGregor stated
 The Medical Council of New South Wales is a Paedophile Protection Agency. The operatives who have been involved in Politically destroying me are deranged President Trump haters and those who are Political sycophants of what the Deep State represents. That is, they Sensor and Punish any Patriot who criticises Paedophilia, and other Deep State crimes. . . . Furthermore, the Council has allowed a Politically malevolent pre-determined report be used against me by a Council affiliated Psychiatrist/Political activist/operative for the intention to entrap by The Political Abuse of Psychiatry.  ...
 Elite globalist satanic paedophiliac rituals, child trafficking, torture and cannibalism will be exposed in time. It will change the political landscape forever. The elite use secret societies and satanic infant/child abuse to maintain control and cohesion. The in-group allegiance is absolute with these binding behaviours. The initiation rites enforce compliance with the aims of the NWO – which is subjugation of the world’s people for their own benefit.

NSWCAT concluded
Complaint 1 
(1) Are the facts of the four incidents of alleged inappropriate conduct set out in Complaint 1 proved? Yes. 
(2) Did the blog publication conduct have the potential to expose Dr McGregor’s patients to harm when accessing the practice website for information or to make an appointment? Yes. 
(3) Did each of the four incidents of alleged inappropriate conduct set out in Complaint 1 relate to “the practice or purported practice of medicine”? Yes. 
(4) If so, (a) is the “complaint to Council” conduct “any other improper or unethical conduct”? No. (b) is the “distribution of the complaint to another medical practitioner” “any other improper or unethical conduct”? No. (c) is the “publication of blog” conduct; “any other improper or unethical conduct”? Yes. (d) Is the “abusive language” conduct “any other improper or unethical conduct”? Yes. 
Complaint 2 
(5) Did Dr McGregor self-prescribe the medications in the quantities and on the dates listed in the table set out under complaint 2, particular 1? Yes. 
(6) If so, was any self-prescribing in breach of the code of practice or the self-treatment guidelines? Yes, if Dr McGregor initiated these medications. 
(7) If so, has Dr McGregor “engaged in any other improper or unethical conduct relating to the practice or purported practice of medicine”? No. 
Complaint 3 
(8) Are any of the particulars in complaint 1 or complaint 2 sufficiently serious to justify suspension or cancellation of Dr McGregor’s registration? No. 
(9) If not, are all the particulars in complaints 1 and 2, or any other combination of particulars in complaints 1 and 2, when considered together, of a sufficiently serious nature to justify suspension or cancellation of Dr McGregor’s registration? Yes. 
Complaint 4 
(10) Does Dr McGregor have a “physical or mental impairment, disability, condition or disorder (including substance abuse or dependence)? Yes. 
(11) Does that disability, condition or disorder detrimentally affect or is it likely to detrimentally affect his capacity to practise medicine? Yes. 
Complaint 5 
(12) Does Dr McGregor have “sufficient physical and/or mental capacity to practise medicine”? No.
NSWCAT states
Between February 2018 and March 2019, the practitioner inappropriately published a personal Internet ‘blog on a website attached to his medical practice and identified himself as the author of the blog where the information published by the practitioner had the potential to expose his patients to harm when accessing the practice website for information or to make an appointment. (“publication of blog” – particular 1) Around 5 March 2018, the practitioner engaged in inappropriate and abusive language to the Council section 150 delegates by stating to the delegates, [abusive language]

NSWCAT bites the view that
McGregor's response to his marriage breakdown and concerns about harm to his reputation was “highly unusual . . . and likely to cause an escalation in conflict, and certainly took no account of his former wife’s privacy.” In the complaint to the Tribunal, the HCCC characterised this conduct as “inappropriate”. However, it must be more than inappropriate to meet the definition of unsatisfactory professional conduct in s 139B(1)(l). It must be “improper or unethical conduct.” In our view, Dr McGregor lacked judgment in making a complaint to AHPRA about his colleague and his wife having an affair. Their relationship is a private matter. The fact that Dr McGregor perceived that it impacted on his reputation, is not a sufficient reason for making the complaint. Dr McGregor did not point to any guidelines or codes of practice applicable to the medical profession which Dr Keighran was said to have breached. In our view, Dr McGregor’s complaint was misguided, but his conduct in making the complaint was not improper or unethical.   
... asked whether he thought he had breached his wife’s privacy in distributing such personal information, “he said that his wife gave him the mobile phone”, and that, “I still feel it was the right decision.” When Dr Wright asked him whether he thought there might be an ethical problem in distributing such material, he replied that, “there’s something in the back of my mind . . .” As with the previous particular, the HCCC characterised this conduct as “inappropriate”. In our view, Dr McGregor lacked judgment in distributing the complaint to a colleague especially when it contained sensitive personal information about his former wife. As we have said, her relationship with one of Dr McGregor’s colleagues is a private matter. His fears about loss of reputation do not justify distributing this material. In our view, Dr McGregor was misguided, but his conduct in distributing the complaint was not improper or unethical.
In discussing the blog on the practice site, NSWCAT comments
We find that Dr McGregor was the author of all the material lodged by the HCCC for that period and we rely on that material. In his 27 March 2018 report, Dr Wright accurately described the content of the blog: A review of the blog content shows it included opinions reflective of a global conspiracy perspective. Dr McGregor identifies the content as his opinions, and if they are indeed his opinions, some of the material is quite disturbing. They include references to “infant torture, rape and Satanic Rites cannibalism by elites is provided by Trump on tape . . elite globalist satanic paedophiliac (sic) rituals, child trafficking, torture and cannibalism will be exposed in time . . The elite use secret societies and satanic infant/child abuse to maintain control and cohesion. . expect the paedophilia and child torture/cannibalism to be fully exposed prior to the mid terms in November. 
Dr Wright expressed the view that: These are extraordinary beliefs for a consultant psychiatrist to publicly associate himself with, particularly on a website associated with his clinical practice. 
Some of this material reflects a loss of perspective and potential loss of reality testing. We agree with that opinion. Contrary to Dr McGregor’s assertions, the content of the blogs are not merely expressions of his political beliefs. Existing and potential patients had access to the website to obtain information or make an appointment. The publication of this material relates to the practice of medicine because it is on the practice website. The fact that Dr McGregor identifies himself as a medical practitioner and psychiatrist on the website gives his comments added credibility.