17 Dec 2020
A tribunal has cancelled a medical practitioner’s registration for arranging a non-registered person to issue prescriptions to patients in the doctor’s name, while he was overseas.
The Medical Board of Australia (the Board) referred Dr Bhagwant Singh to the South Australian Civil and Administrative Tribunal (the tribunal) after he allowed a practice employee, who did not hold medical registration, to write prescriptions for some of his patients while the doctor was overseas.
Dr Singh was disqualified from applying for registration for 18 months.
The tribunal found that Dr Singh’s conduct was substantially below the standard reasonably expected of a registered medical practitioner of an equivalent level of training and experience.
Dr Singh took leave from the private medical practice where he worked, which was also nearby to a pharmacy, on two occasions in 2014 and in 2015.
In 2014, without Dr Singh knowing, the employee (who had previously been registered as a medical practitioner) had accessed Dr Singh’s patients’ medical records and generated prescriptions for some of his patients, using Dr Singh’s name and prescriber number. Dr Singh did not report this after he became aware that this had occurred.
When Dr Singh was due to travel overseas in 2015, he agreed that the practice employee could access patient records to generate prescriptions for routine medications and some urgent medications in his name, also using his prescriber number, and that a pharmacist nearby could dispense those prescriptions without Dr Singh having signed them.
This arrangement resulted in about 20 patients being issued with prescription medication, including Schedule 8 medicines, over two weeks in 2015. Two of the patients had not been issued with any prescription in the past by the practice but most had previously been issued with multiple prescriptions.
The tribunal said Dr Singh’s conduct breached various provisions of the Board’s Good medical practice: a code of conduct for doctors in Australia and was a risk to the safety of the patients for whom the prescriptions were generated. It also compromised the integrity of the Medicare and Pharmaceutical Benefits Scheme.
During the investigation into his conduct, Dr Singh indicated that he considered it would benefit his patients to have continuity of care during his absence in June 2015 but there was no registered practitioner to provide that care. In early 2015, Dr Sing was a sole practitioner.
The tribunal noted there was no evidence of Dr Singh attempting to arrange a locum or make arrangements with patients to ensure continuity of medication instead of the arrangement agreed to with the employee and the pharmacist.
Dr Singh had a duty to his patients to ensure they were treated and received the benefit of his professional expertise as to whether medication should be prescribed with reference to their medical history and circumstances at the time of the consultation.
The tribunal said patients being prescribed medication by a person who was not a registered medical practitioner and when no consultation by a medical practitioner had occurred, was ‘extremely serious’. Dr Singh’s abdication of care for his patients gave rise to the greatest risk to the patients.
In cancelling Dr Singh’s registration, the tribunal took into account the need to deter both Dr Singh and other medical practitioners from engaging in such conduct. The tribunal said:
‘It reflects the significant exposure to risk that patients bear if they are prescribed medications outside the strict regime that operates to protect the public from the disastrous consequences that wrongly prescribed medications can bring about.'
Read the tribunal’s decision on the AustLII website.
Read the related tribunal, Pharmacist suspended after tribunal finding of professional misconduct.