A Brisbane doctor who single-handedly treats hundreds of vulnerable patients for opioid dependence has been cleared to work without conditions.
General practitioner Stuart Reece had to close his Highgate Hill practice late last year after the Medical Board of Australia imposed conditions on his registration requiring him to work under supervision of another doctor with experience in addiction medicine.
However, Dr Reece said no such doctors were available despite multiple inquiries for suitable practitioners, which the tribunal accepted was "uncontested".
The inability of the public system to cope with the influx of patients left more than 1,000 people who are on opioid substitution medication at risk of a return to illicit substance use, overdose, criminality and death, according to a leaked internal Queensland Health report obtained by the ABC.
ABC News spoke with half a dozen patients struggling to find alternative treatment for their heroin addiction as well as several health professionals who were distressed about the woeful lack of services available in the state health system.
Dr Reece challenged the medical board's action in the Queensland Civil and Administrative Tribunal (QCAT), which this week stayed the conditions, pending the outcome of his full appeal.
The QCAT decision said the conditions were imposed after a performance assessment of the 64-year-old doctor, which was sparked by "notifications from four patients or former patients over a nine-month period, together with one anonymous notification".
The nature of the notifications was not revealed and investigations into them "were not complete" when the assessment of Dr Reece was undertaken by two other general practitioners.
According to the QCAT decision, the assessment found Dr Reece "became dogmatic and combative" when questioned and that his practice "is substantially below the standard expected of a competent Australian GP".
The assessors said Dr Reece "does not comprehensively explore the patient history, completes very little physical examination and relies on extensive use of investigations" but also that he has "good rapport" with patients and is a "kind and caring doctor" with "an extremely high workload" and "very challenging patient demographic".
As a result of the assessment, the medical board-imposed conditions limiting the number of patients Dr Reece could see and requiring quarterly audits of his medical record keeping.
Crucially, it required him to be supervised by another doctor with knowledge of addiction medicine – a condition Dr Reece said he could not meet because none were available despite making multiple inquiries.
Dr Reece said he could not comment for legal reasons. His practice has reopened.
Queensland Health flooded with 'desperate' calls for help
The QCAT decision outlines an affidavit from addiction medicine expert Jeremy Hayllar, who is Queensland Health's clinical director of the Alcohol and Drug Service at Metro North.
Dr Hayllar told the tribunal opioid treatment services in south-east Queensland were already at capacity before Dr Reece closed his practice and in one week the state's Alcohol and Drug Information Service received "400 calls more than would normally be expected".
He said his clinic and others were already "at capacity" before the closure of Dr Reece's practice, and his service was treating some of Dr Reece's patients.
His evidence outlined the "increasingly desperate nature" of phone calls to public clinics highlighting the "negative consequences of being unable to continue treatment, which represents a public health crisis which current public clinics are not equipped to manage".
The QCAT decision said there was no suggestion in the Medical Board decision that any patients had been harmed by Dr Reece.
It noted Dr Hayllar has "historically reported other doctors practising in the addiction space to the board" and that he expressly stated he "does not have any concerns from interactions with Dr Reece that his prescribing skills or clinical judgement are unsatisfactory".
Judge Geraldine Dann found the tribunal "is satisfied that the public interest operates in favour of a stay" and granted Dr Reece's application.
In delivering the decision, the tribunal noted there were substantive merits to be explored at a future hearing of Dr Reece's application for review of the board decision and that Dr Reece had submitted references and other material to the tribunal which suggested "that there are different views by professionally qualified people about the matters dealt with in the performance assessment report".
The decision said the medical board "neither consents to nor opposes the grant of a stay".
Queensland Health said in a statement it was "committed to providing a well-functioning, strong and robust system of treatment, care and support to meet the needs of Queenslanders experiencing severe mental illness and/or problematic alcohol and other drug use, as well as their families and carers".
"However, there are significant challenges and complex pressures on the delivery of opioid dependence treatment (ODT), not just in Queensland, but across the country," the statement said.
"Following the closure in late 2022 of a GP practice working with clients as part of ODT, we have been working collaboratively with alcohol and drug (AOD) services in south-east Queensland to consider approaches to support displaced clients and develop contingency plans.
"Developing strategies to improve access to ODT across the state is a key priority, and these collaborative meetings have identified potential short, medium and longer term options to improve the availability of opioid prescribers."
Anyone who wants information on treatment options can call the 24/7 drug and alcohol service ADIS on 1800 177 833.
