This case considers the mental incapacity of a GP, based on the behaviour of the respondent and her husband, and the refusal to undergo a reasonably required psychiatric assessment to establish competency to practice as a GP.

Background facts

The respondent was a General Respondent (GP), with part of her practice involving the visitation of nursing homes. On 4 April 2016, the Health Care Complaints Commission (HCCC) received an anonymous complaint in writing about the respondent. The accusations made involved safety issues, interference with client's lives and clinical management including prescribing practices. The HCCC informed the respondent, and received a reply apparently from the respondent which refuted the accusations on 23 May 2016. The respondent's registration as a medical respondent was suspended by the Medical Council of New South Wales (the Council) on 23 September 2016.

Relevant circumstances

The respondent was requested to attend a health interview by the Council, which included a panel with two psychiatrists. The respondent attend with her husband, Mr Neil Windsor, who, by the account of the panel, "answered questions on her behalf, spoke over her and refused to allow her to speak". Mr Windsor ended this interview abruptly, and required the respondent to leave with him.

In the proceeding telephone and email correspondence between the respondent and her husband, and the Council and HCCC, Mr Windsor became quite aggressive and paranoid. The respondent did not object to his representation on her behalf.

The Council arranged a psychiatric assessment for the respondent under s 145E of the Health Practitioner Regulation National Law (NSW) (the National Law), to determine whether the respondent suffered from an impairment, and an appointment was scheduled for 16 September 2016. The respondent did not attend, and did not provide reasoning for her non-attendance. The psychiatrist, based on information given to him, including correspondence and a transcript of the health interview, prepared a report dated 16 September 2016. This report noted that there were "strong suggestions of severe mental illness in Dr Windsor's husband… raises the possibility that Dr Windsor has become affected by her husband's mental illness…". The psychiatrist was also concerned that the respondent's husband was exerting a degree of control over the respondent that was "placing her at risk or impacting upon her ability to practice" as a GP.

A further psychiatric assessment was arranged on 19 July 2017, with the respondent again failing to attend. After this failure to attend, the psychiatrist provided a further report, based on the correspondence that had ensued between the time of the last report, that it was his opinion that the respondent should not engage in the practice of medicine until she had been assessed by an independent psychiatrist, to be conducted not in the presence of her husband. Mr Windsor sought leave to represent the respondent at the Tribunal hearing, and was refused.

Complaint 1 was that the respondent had an impairment within the meaning of section 5 of the National Law, taking into consideration the dealings with the Council and the HCCC, and the failure of the respondent to attend a psychiatric assessment as requested by the Council.

Complaint 2 considered the respondent's lack of mental capacity, diminished control over autonomy, and diminished insight into her professional obligations and adverse effects of her personal relationship with Mr Windsor to her profession obligations. The Tribunal considered that the events set out above in relation to the conduct of the respondent and her husband, along with the respondent's decision not to participate in the proceedings, made for a finding that the complaint had been established. The Tribunal drew particular attending to the fact that the respondent, without reasonable excuse, refused to attend the psychiatric evaluation on 16 September 2016.

Complaint 3 relied on the factual background as Complain One and Two and sought a finding that the respondent "[was] not otherwise a suitable person to hold registration as a medical respondent". The Tribunal considered the respondent unsuitable to hold registration as a GP.

Sanction

Due to the respondent's refusal to attend a psychiatric evaluation and surrounding circumstances, the Tribunal found that Complaints Two and Three were made out. As such, the Tribunal found that the respondent was not competent to practice as a GP within the meaning of s 149C(1)(c) of the National Law. The Tribunal made the order that Dr Windsor's registration as a GP was cancelled.