Chief Justice Coke was not the first person to equate delayed justice with the denial of justice, nor would he be the last. Complaints about the delays of justice have echoed through the centuries, culminating in the great complaints in the 19th century about the courts’ delays. These problems no doubt inspired the famous phrase (attributed to Gladstone) that “justice delayed is justice denied.”

So said Lord Dyson in a lecture delivered to open the Magna Carta 800th anniversary celebrations convened by the Law Society of England and Wales on 22 April 2015, available in the Judicial Commission of New South Wales, Handbook for Judicial Officers at https://www.judcom.nsw.gov.au/publications/benchbks/judicial_officers/delay_defeats_justice.html#ftn.id-1.3.6.5.1.1.1. 

So it is with proceedings by the Health Registration Boards as shown again in Paramedicine Board of Australia v Loveridge [2025] QCAT 101.  In this case the Queensland Civil and Administrative Tribunal (QCAT) dealt with a matter that had been referred to it by the Paramedicine Board on 23 February 2024.  So QCAT took until 8 April 2025, just a little over a year after the matter was referred, to make a final decision.  But the events in question took place on 11 June 2019, so the Paramedicine board took about 4 years and 8 months to refer the matter to the Tribunal!

It should be noted that the judgment says (at [26]) ‘On or around 18 January 2021 (almost 7 months after the incident), the Board decided to take immediate action and impose conditions on the practitioner’s registration…’. If the incident happened on 11 June 2019, then 18 January 2021 was almost 19 months after the incident.  For the reference to 7 months to be correct either the incident took place in June 2020, not 2019; or the decision to take immediate action was made in January 2020, not 2021.  At [10] the QCAT refers to ‘further email communication with the investigator dated 27 January 2020 and 4 February 2020, and submissions … in the show cause process prior to the Board taking immediate action …’. From that one might infer that the immediate action was taken in January 2020, not 2021 that is 7 months after the event and 4 years before the matter was referred to the Tribunal. However at [26] it is said ‘At the time the Board took immediate action, it noted in its reasons that the practitioner had an unblemished employment history of 13 years working for the QAS and he had continued to practise as a paramedic  for 15 months without incident’ (emphasis added) which implies that the immediate action was indeed taken in January 2021 or 19 months after the event.  Whether it was 7 or 19 months, it was hardly ‘immediate’.

The Tribunal says (at [27]):

By letter dated 2 August 2023 the respondent requested to relinquish his registration.  He has informed the Board by letter dated 24 October 2023 that he does not intend to practice as a paramedic ever again.

Hardly surprising giving that the conditions on his registration were that he ‘could only practise in places of practice approved by the Board and no such place was approved’ ([26]).  Effectively he was suspended from practice without any formal determination of misconduct and at that time, there was no end in sight as there had still not been a referral to the Tribunal!  The respondent paramedic took no part in the proceedings before the Tribunal, again hardly surprising.

So what happened?  On 11 June 2019 ([12]) the respondent was the more senior paramedic in a crew of two dispatched to a nursing home to assist with Patient A, an 81-year-old patient, suffering from advanced dementia who:

… was agitated and aggressive, had open wounds on her arms and would not tolerate dressings on those wounds.  Earlier that afternoon, Patient A had thrown a hot cup of tea at another resident and was assessed as a high risk to herself, fellow residents and staff;

At [16] we are told:

In attempting to engage Patient A onto the stretcher for transportation to hospital, the respondent reported in his eARF completed some little time after the incident that he said to Patient A words to the effect “if you hit me, I will have to defend myself”. Others present state he said to Patient A “these girls may not defend themselves, but I will” and “if you hit me, I will hit you back”.

The allegation was (at [18]):

… that he struck Patient A, in response to Patient A striking him, or lashing out at him, first.  In that regard, two personnel from the nursing home, who were eye witnesses to the events, stated that the respondent struck or slapped Patient A’s face, as, ultimately, did the respondent’s colleague.  The two nursing home personnel made written statements shortly after the events.  The QAS investigated the matter, including interviewing each of them and some others, including the respondent. The QAS investigation concluded that the respondent had struck Patient A.

This was also accepted by the Queensland Industrial Relations Commission when rejecting a claim by Mr Loveridge to be reinstated to his position (see Loveridge v State of Queensland (Queensland Ambulance Service) (No. 2) [2023] QIRC 207 discussed in my post Paramedic dismissed for striking elderly patient (July 31, 2023)).  The respondent, Mr Loveridge, consistently denied the allegation but (at [20]):

…  in his letter of 24 October 2023 to the Board, in responding to the proposed notification against him, the respondent stated he found himself in the position he could not morally and ethically make admissions to something he did not do but he must respect the recollections of others and the decision of the Industrial Commissioner.

He did not therefore, challenge the finding that he did strike patient A. The QCAT also found (at [21]) ‘that the respondent struck or slapped Patient A’s face in response to Patient A striking out or slapping him.’  At [32] the Tribunal said it was:

… comfortably satisfied that the established conduct in each allegation is, as the Board submits:

(a) a significant departure from the professional conduct obligations of a paramedic;

(b) inexcusable and cannot be tolerated, no matter what provocation is offered or what the background circumstances may be…

The Tribunal was satisfied (at [35]) that ‘the respondent’s conduct in respect of each allegation is substantially below the standard reasonably expected of a paramedic of an equivalent level of training or experience’ and constituted ‘professional misconduct’ ([39]).  The Tribunal made orders reprimanding Mr Loveridge and banning him from seeking registration as a paramedic or otherwise providing health services for 12 months ([48] and [56]).

Delay

The outrageous issue in this case, in my opinion, is not that Mr Loverdidge struck Patient A, but that it took nearly 6 years (June 2019 to April 2025) to resolve it.  During that time Mr Loveride was investigated by QAS, dismissed and ran his application for reinstatement. He was also investigated by the Board and immediate action was taken.  What more did the Board need to investigate before putting the matter before the Tribunal?  Even if there were some procedural hurdles eg inviting Mr Loveridge to make submissions as to whether there should be further action, these canot justify this inordinate delay.

The Health Practitioner Regulation National Law (Queensland) s156 says that a national board may take immediate action if:

(a) the National Board reasonably believes that—

(i) because of the registered health practitioner’s health, conduct or performance, the practitioner poses a serious risk to persons; and

(ii) it is necessary to take immediate action to protect public health or safety;…

There is an obligation to notify the practitioner and allow them to make submissions as to whether ‘immediate action’ is justified (s 157) but it still seems unreasonable to take 19 months to take action that immediately necessary to protect public health or safety.

Section 162 says:

The National Board must ensure an investigator it directs to conduct an investigation conducts the investigation as quickly as practicable, having regard to the nature of the matter to be investigated.

In this case we’re given no details of the investigation by the Board but we know that the investigation by QAS was completed and the Board was sufficiently well informed to make the decision to take immediate action.  It is not clear, or obvious, what further investigation was required before making a decision to refer the matter to the Tribunal.

If Mr Loveridge struck patient A in front of three witnesses this would be an example of a simple assault.  One cannot imagine police taking nearly 4 years to put a person before a court in those circumstances.  It looks like the Boards want to only put people before the Tribunals when they are absolutely certain they will win, in this case by the fact that Mr Loveridge had already surrendered his registration and was taking no further active part in the profession.  That, of course, misses the point of the role of the Tribunal.  The Board, like police in a simple assault, should have put the matter before the Tribunal at a much earlier stage and the Tribunal could have heard evidence and made its own decision as to whether Mr Loveridge struck patient A as alleged, rather than waiting until Mr Loveridge was so traumatised by the process as to surrender his registration and take no active part in the proceedings.

If the aim of disciplinary proceedings is not to punish the practitioner but the protect the public then they need to move faster.  If immediate action is required it is required immediately, not 19 months later.  If the practitioner is a threat to health and safety that needs to be identified.  And if the appropriate response, as in this case, was suspension for 12 months it needs to be recognised that Mr Loveridge had already been, in effect, suspended for 4 years (since 18 January 2021).   

This is not the first case where delays in proceedings have appeared inordinate and inappropriate. For example:

  • John Larter’s registration as a paramedic was suspended on 17 September 2021. His suspension was lifted on 14 June 2022 with conditions imposed upon his registration. On 7 February 2023 the NSW Civil and Administrative Tribunal ordered that the conditions be removed (see ‘Ways to lose your job – Part 1’ Response, Winter 2022 pp. 46-49 and Paramedic John Larter’s appeal to NCAT – you lose some, you win some (February 9, 2023)).
  • Dr Spencer’s agreed not to practice medicine from January 2015 until approved by the Board. He was re-registered, subject to conditions, in March 2021 and practised until suspended by the Board in July 2023. He remains suspended to this day (see Doctor remains suspended over CPR performance (September 7, 2024)).
  • Dr Bay’s registration as a medical practitioner was suspended on 17 August 2022.  He remained suspended until 13 December 2024 when the Queensland Supreme Court ruled that the investigation by the Board and AHPRA, and the decision to refer Dr Bay to QCAT was affected by bias and was beyond power (see Health Practitioner Regulation National Law survives constitutional challenge (December 13, 2024)). 

These three practitioners have been subject to suspension, or conditional registration for approximately 17 months, 10.5 years and 2.33 years respectively, without any public determination that they have been guilty of any form of unsatisfactory conduct under the Health Practitioner Regulation National Law.  In both Mr Larter’s case and Dr Bay’s case, the restrictions were lifted by NCAT and the Queensland Supreme Court respectively over challenges to the relevant Board’s process rather than any determination about their conduct.  For Mr Loveridge, the subject of this post, it’s been over 6 years between the incident and an outcome.

Other cases have taken in excess of:

In most, if not all of these cases the facts were not in dispute and the practitioners were subject to either suspension or conditional registration pending the final determination of the matter. The current practice of the Boards, AHPRA and the relevant tribunals appears to be examples of `Sentence first–verdict afterwards’ (Lewis Carroll, Alice’s Adventures in Wonderland (1994, 30th ed, Project Gutenburg), chapter XII,<https://www.cs.cmu.edu/~rgs/alice-XII.html>).

This blog is made possible with generous financial support from (in alphabetical order) the Australasian College of Paramedicine, the Australian Paramedics Association (NSW), the Australian Paramedics Association (Qld), Natural Hazards Research Australia, NSW Rural Fire Service Association and the NSW SES Volunteers Association. I am responsible for the content in this post including any errors or omissions. Any opinions expressed are mine, and do not necessarily reflect the opinion or understanding of the donors.

This blog is a general discussion of legal principles only.  It is not legal advice. Do not rely on the information here to make decisions regarding your legal position or to make decisions that affect your legal rights or responsibilities. For advice on your particular circumstances always consult an admitted legal practitioner in your state or territory.