Reis v State of Queensland (Queensland Ambulance Service) [2021] QIRC 95 contains salutary lessons for paramedics and in fact anyone.

Mr Reis is a paramedic employed by the Queensland Ambulance Service (QAS).  On 14 March 2019 a former patient complained that Mr Reis had contacted her on 2 March 2019. They ‘then proceeded to exchange messages over the following days, some of which were a sexual nature’ ([12]).  Notwithstanding her participation in the text messaging, the patient reported (at [60]) the contact ‘affected the patient more than what she had thought and [she] becomes stressed just seeing an ambulance’.

Mr Reis entered a plea of guilty to the criminal charge of using a ‘restricted computer without consent’ contrary to the Criminal Code 1899 (Qld) s408E(1).  The QAS investigated the matter and was able to confirm that Mr Reis had accessed the electronic Ambulance Report Form (eARF) relating to this patient on 2 March 2019 whilst he was at work.  The QAS alleged

1)         a breach of the Public Service Act in particular ‘Ensuring the employee’s personal conduct does not reflect adversely on the reputation of the public service’ (s 26(1)(k);

2)         a breach of the Ambulance Service Act in particular that he was guilty of misconduct because of ‘inappropriate or improper conduct in a private capacity that reflects seriously and adversely on the ambulance service’ (s 18A); and

3)         ‘That between 2 March 2019 – 14 March 2019 you used the confidential patient information you inappropriately accessed for a personal benefit.’  

An investigation was commenced, and all the allegations were substantiated. Mr Reis appealed the finding that allegation 3 had been made out and QAS issued a new ‘show cause’ notice with respect to that allegation. Mr Reis was given details of the allegation and invited to respond, after which Deputy Commissioner Deanne Taylor-Dutton found the allegation was made out and recommended disciplinary action.

The rules of ‘natural justice’ require that in such an investigation the first step is to determine if the allegation is made out. The second step is to determine penalty. Having found the allegation proved, it was recommended that Mr Reis’ employment be terminated. Before he addressed that, Mr Reis again took the matter to the Supreme Court alleging various procedural failings. The result is that at the time of hearing, the allegation had been substantiated but as yet no decision has (or had) been made about Mr Reis’ future.

The grounds of appeal were technical relating to how information relating to one allegation could be used when deciding the other. The actual grounds of appeal need not concern us. Suffice to say Commissioner Knight was (at [123]) ‘satisfied the decision was fair and reasonable in so far as it relates to the substantiation of allegation three and any conclusions reached by the Service with respect to grounds for discipline.’

Why this case is important is first, the use made of the Paramedicine Board’s Code of Conduct for registered paramedics.  The decision maker referred to the Code of Conduct. Mr Reis alleged there was an error in that he was not told that the decision maker would rely on the Code. QAS argued (at [57]):

… on the basis of what is expected of registered health practitioners by Ahpra and the Health Practitioner Regulation National Law (Queensland) and the requirement to be aware of and comply with the standards, the Service did not consider it necessary to particularise that which registered health practitioners are required to be aware of and comply with …

Commissioner Knight did find (at [54]) that ‘the reference to a breach of the relevant professional standards of conduct would have been better placed in the original show cause notice’ but that the reference to the Code did not invalidate the decision.

Whilst it is not an essential point – it is what we lawyer would call ‘obiter dictum’ – the decision does remind paramedics that they are expected to know and comply with the Code of Conduct and a decision maker can refer to as part of their decision making even if a specific breach has not been alleged.  

The most important lesson for readers of this blog is to reinforce the obligation to use information that is given for one purpose only for that purpose. The patient gave her name and phone number to Mr Reis so that he could provide health care to her, not so that he could later locate her and send her text messages.   Apart from the consequences for the patient there are now consequences or Mr Reis and his ongoing employment is, at the time of writing, at risk.  No doubt in the very near future a decision will be made about the appropriate penalty.