You would expect that if a doctor, nurse or psychologist had been found to have kissed, groped or had sex with a patient, they would no longer be allowed to practise.
But that's not always the case.
Four Corners has reviewed a decade of published disciplinary decisions and has discovered almost 500 health practitioners have been sanctioned by tribunals for sexual misconduct involving patients since 2010.
More than 160 are still allowed to work today.
These are some of them.
Warning: This story contains details some readers may find confronting.
Keith Ian Brennan
"...that day. It was clearly a breach of professional boundaries … It was improper and unethical conduct."
GP Keith Brennan was found by a NSW tribunal to have pursued a patient for romance and sex, including offering to impregnate her after she suffered a miscarriage.
One kiss during a consult — in which he put her hand on his groin — was described as "improper and unethical conduct".
Dr Brennan had his registration cancelled in 2018 for the conduct.
He was labelled an "excellent clinician" in a later tribunal hearing, and was allowed to return to practise in 2020 with conditions against his registration, including that he work with a mentor.
Kelvin Thuc Minh Vo
"...no clinical basis; conducted inappropriate examinations of Patient B’s genitalia that were not clinically warranted; and during an examination…"
GP Kelvin Vo was deregistered in 2014 after a NSW tribunal found he had performed oral sex on one male patient and offered the same to another. He was also accused of inappropriate sexual comments and sniffing one patient's genitals.
He was allowed to return to practise in 2018, with a psychiatrist writing that the "likelihood of him reoffending is very low" — partially because he had acknowledged his sexuality. He was also described as traumatised by his journey to Australia as a refugee from Vietnam aged 18. Among the long list of conditions allowing him to return to practise was continuing psychiatric care.
Bruce Desmond Litchfield
"…he acknowledged that the purpose of his carrying out certain examinations was for his sexual gratification. In respect of the fourth patient…"
GP Bruce Litchfield was deregistered in 1997 after the complaints of three women were upheld. According to published tribunal findings, he placed one patient's hand on his erect penis when she attended for a contraceptive device. Two other women complained about breast examinations unrelated to the reasons for their visits.
He was allowed to return to practise in 2012 with a long list of conditions, including that he work under supervision and continue seeing a psychiatrist.
Last year, a NSW tribunal found he made a number of inappropriate comments to a patient who had been repeatedly sexually assaulted by her ex-husband, including that she "must be into S&M".
Dr Litchfield's lawyer told the tribunal the GP's behaviour was explained "by a combination of personality issues, outdated clinical knowledge … and a misplaced desire to address a multitude of matters". He had further conditions placed on his practise.
Richard Young
"..engaged in unprofessional conduct of a serious nature by engaging in sexual relationships with two female patients. Those sexual relationships had taken place…"
Cosmetic physician Richard Young was struck off by a Victorian tribunal after paying a patient the price of her pathology for oral sex. He'd been disciplined in previous hearings for having sex with two female patients and telling a young woman during a pap smear "Holy mackerel, you are small".
At a 2010 hearing, a Victorian tribunal was told Dr Young had shown insight into his behaviour, that he was receiving therapy, and that he had never had sex with patients who weren't sex workers.
In 2013, he was allowed to return to work as long as a chaperone supervised any of his interactions with female patients.
Dr Young is currently suspended for an unrelated matter.
Mohamed Payenda Zhouand Safi
"… respondent was found to have behaved inappropriately, and in a manner for sexual pleasure whilst conducting an internal vaginal examination…"
Western Sydney GP Mohamed Safi lost his registration in 2017 after he was found by a NSW disciplinary tribunal to have unnecessarily rubbed a woman's vagina and clitoris during an internal examination, then non-consensually hugged and kissed her at the end of the appointment.
Dr Safi denied the conduct at the time and was subsequently acquitted in a criminal court of charges of indecent assault in relation to the patient.
In a decision about his reinstatement as a doctor last year, a NSW tribunal heard he now admitted to deliberately touching the patient's genitals and expressed remorse. He said he was attracted to the patient and believed she may have been attracted to him.
He was allowed to return to practise with a long list of conditions, including that he does not treat female patients older than 13 without a chaperone present.
Doctor knows best
When Tom Monagle's neurologist asked him to strip naked during an appointment booked to discuss his Tourette syndrome, the then 19-year-old felt uncomfortable, but obliged.
"The presumption as soon as you walk into a doctor's room is that everything that's occurring in this room is related to what I'm presenting," Tom says.
Andrew Churchyard explained he was performing what he called a "full body examination" and touched Tom's body from the head down, ending at his penis and testicles.
Confused, Tom discussed the appointment with his parents, who are both GPs.
They decided to give the highly-regarded Melbourne specialist the benefit of the doubt.
"I must admit, I thought, 'How could it be a sexual assault?'," Tom's mother, Dr Sharon Monagle says. "I'm sitting in the waiting room, and this was a renowned neurologist who'd come recommended."
Tom attended a second consult with Dr Churchyard without incident.
But at his third appointment, the doctor again insisted on examining the teenager's naked body — and this time he appeared to ejaculate.
"I realised this is just entirely for his sexual gratification," Tom says.
"This has got nothing to do with my wellbeing."
It was not the first time Dr Churchyard had abused the trust of someone in his care.
Disciplined doctors still registered
A six-month Four Corners investigation has found Australia's system of health regulation allows some doctors with serious findings against them to continue to treat patients.
Our review of a decade of published disciplinary decisions found:
- Four convicted paedophiles are still registered as doctors (none of whom are featured in this story)
- Nearly 500 practitioners with findings against their name related to sexual conduct involving patients
- Almost 200 health workers who have been disciplined for related matters outside their direct practice, for example, sexually harassing colleagues
- Doctors make up just 15 per cent of all registered health workers, but they account for almost half of those disciplined for sexual misconduct
- More than one-third of all publicly disciplined practitioners are still on the national register
In most states and territories, the reasons why someone has been allowed to return to practise after losing their registration for serious wrongdoing are not made public.
The conditions often placed upon practitioners with proven disciplinary findings against their name — like mandatory education on professional boundaries — have also never been independently tested to make sure they actually work.
The vast majority of Australia's 850,000 registered health professionals do the right thing, but those who breach their patients' trust can inflict serious harm.
The former head of the NSW Health Care Complaints Commission, Merrilyn Walton, believes the only appropriate action in response to proven sexual misconduct is to remove a person's registration.
"Sexual relationships with patients has always been zero tolerance," Professor Walton says.
"To me, there comes a time when the regulators say, 'Enough is enough. You do this, you're out'."
With the support of his parents, Tom notified police and AHPRA of the assaults by Dr Churchyard, hoping to protect future patients.
But the Medical Board permitted Dr Churchyard to continue to practise while under investigation on the condition he treat male patients under the supervision of a chaperone.
His registration wasn't suspended until another man notified the regulator he too had been allegedly assaulted.
In a rare public interview, AHPRA chief executive Martin Fletcher says there are "huge lessons to learn" from the handling of the Churchyard matter.
AHPRA and the Medical Board commissioned an independent review into the use of chaperones in 2016, and has since scrapped the use of mandatory chaperones and established a specialist committee that deals with sexual misconduct complaints.
"Five years, six years later, the way we deal with these sort of concerns is completely different from what happened back in 2016 and before," Mr Fletcher says.
Andrew Churchyard took his own life in 2016, facing charges of indecent assault.
Using freedom of information laws, Tom's mother extracted information from AHPRA on Dr Churchyard's disciplinary history — discovering a similar complaint had been lodged with the former Medical Board in 2006. The doctor was reprimanded, cautioned, and ordered to undertake further education.
Sharon has since been contacted by other men alleging further sexual assaults.
"I spoke to a man who had seen Churchyard for years for migraine and the treatment that he was being offered was masturbation," she says.
More than 50 former patients settled with his estate.
A trusted GP
Samantha Christensen will only see female doctors after she says she was sexually harassed by her GP of five years.
She alleges that after peppering her with strange innuendo about her love life, Mustafa Jamnagarwalla then suggested she could use her large drink bottle to masturbate.
"He said, 'Yeah, you could use it for other things too … you could also insert it', and laughed," she says.
The doctor denied the allegation he had made inappropriate remarks about her drink bottle and apologised for other comments about her dating life as an attempt at "light-hearted banter".
Samantha found it anything but funny.
She made a complaint to the clinic and was later informed by its parent company that while "appropriate action had been taken", it was unable to direct doctors how to perform "medical services".
Feeling fobbed off, Samantha decided against pursuing the matter with the HCCC.
It's a decision she now regrets.
A disciplinary tribunal has since heard that about one year after Samantha's alleged experience, Dr Jamnagarwalla touched the bare upper thigh of a 12-year-old girl and tried to look up the skirt of the teenage relative who accompanied her to the appointment.
The conduct was described in published New South Wales Civil and Administrative Tribunal (NCAT) findings as "inappropriate behaviour of a sexual nature" — and led to his removal from the national register of practitioners in January.
He can apply for reinstatement next year.
"Dr Jamnagarwalla's proven conduct in relation to a 12-year-old girl in a vulnerable situation is abhorrent to community standards and expectations," the tribunal ruled.
Samantha cries talking about the incidents.
"I feel terrible that I didn't complain [to the HCCC] because I know that he continued to behave badly," she says.
Dr Jamnagarwalla declined to comment.
Gender restrictions
It took four years for the 12-year-old's complaint to be fully resolved by a tribunal — a time frame that Four Corners has discovered is not unusual.
Pending final sanction, Dr Jamnagarwalla was allowed to practise on the condition he treat only male patients. He was found to have breached the restriction on 33 occasions.
A Health Professional Councils Authority spokeswoman said the gender restriction was imposed as an interim measure. She also said his breaches of that condition were referred to the HCCC.
"This action ultimately contributed to the … eventual disciplinary findings against Dr Jamnagarwalla," the spokeswoman said.
In Samantha's view, gender conditions are offensive.
"When a teacher is inappropriate with a female student, they don't send him to a boys school, they go 'you're not fit to be a teacher'. If you're a doctor and you are sexually harassing people and making people feel inappropriate, you're not fit to be a doctor," she says.
Conditions are sometimes used when a person is under investigation, allowing them to keep working until findings of fact are made.
But sometimes, tribunals impose restrictions around treating men, women and certain age groups even after a serious complaint is upheld, instead of revoking or suspending the practitioner's registration.
For example, a GP convicted of digitally raping a patient and separately reprimanded by the Medical Board for "inappropriate conduct" with seven other female patients was given the all-clear to return to work on the condition he did not treat women or people under 16.
He continues to work today.
While not commenting on specific cases, UTS law professor Jenni Millbank says if a person can't be trusted with a segment of the population they should not be working with patients.
"If the public, if the profession, if the regulator can't have faith in you and that you will behave professionally when the doors are closed, then you shouldn't be in the profession," Professor Millbank says.
Mr Fletcher acknowledges there are sometimes tribunal decisions "where we've been disappointed", but he says recent amendments to health regulation laws could result in fewer such outcomes.
"I completely understand that there are people in the community that would believe that there's certain behaviour that should mean you should never be registered as a health practitioner again," Mr Fletcher says.
"I think that's a debate to have in the community more widely."
Doctor and University of Melbourne law and public health professor Marie Bismark says there are good reasons to keep some practitioners working, but worries there's not enough data on how practise conditions actually protect the public.
"Because we invest so much in training our doctors … if they can be rehabilitated and returned to safe practise, that's usually seen as a good thing," she says.
"When it comes to sexual misconduct, I think it's much less clear whether people can be effectively rehabilitated, and I think we really need good information about whether the conditions that are being imposed are effective or not."
That research has never been done, save for AHPRA's review into chaperones.
A secret process
Practitioners assessed as posing a potential risk to public safety can be removed from AHPRA's national register and disqualified from applying to return for a set time frame.
Some do return to practise. And in every state and territory except NSW, the decision to allow them to return to work is one that can happen entirely behind closed doors.
No one — not even AHPRA — knows how many people have been reinstated after losing their registration for sexual misconduct.
Professor Millbank has published research on the reinstatement process, and says much more transparency is needed.
"We're kind of operating in the dark. We can find someone who's back on the register who may have been removed previously and just know nothing about what happened in between," Professor Millbank says.
Mr Fletcher says he supports making the process public, but says laws would likely have to change to allow that.
"I think transparency and regulation is a really important thing, not just in this context but more widely," Mr Fletcher says.
The peak representative body for doctors, the Australian Medical Association (AMA), declined an interview with Four Corners.
"The AMA condemns in the strongest terms sexual misconduct and supports robust regulatory action being taken against doctors who engage in inappropriate behaviour," AMA president Steve Robson said in a statement.
"These complaints need to be investigated and dealt with promptly with fair, transparent, and timely processes which balance the rights of patients and health practitioners."
When Four Corners sent its findings to Federal Health Minister Mark Butler, he called for a rapid review of whether recommendations from previous reviews had been promptly implemented.
"If that framework is falling short of protecting patient safety, then Australians rightly expect governments at all levels to work to strengthen it," he says.
Mr Butler says the vast majority of health professionals deserve patients' trust.
"But where practitioners abuse it, regulators must step in."
Watch the full Four Corners investigation 'Do No Harm: The doctors who break their sacred oath but are still allowed to practise' on ABC iview.
Credits:
Story by: Emily Baker, Amy Donaldson and Maddy King
Digital producer: Nick Wiggins
Developer: Katia Shatoba
Design: Nick Wiggins and Alex Palmer
