A doctor in Victoria has been reprimanded and suspended for six months after he struck a patient in the face, twice, and abused him.  The longer story is that the patient ‘was verbally and physically aggressive’ (Medical Board of Australia v Hambly [2026] VCAT 818, [2]). A decision was made to sedate and restrain the patient pending transfer to a mental health facility.  The details of what happened are set out at [11]:

…

iv. At approximately 5.15 pm to 5.46 p.m., the patient, who had been sleeping, awoke and pulled out his cannula and began using it as a weapon to splash his blood onto staff. The patient became physically and verbally aggressive towards BRHS staff, including making death threats to staff and punching Dr Hambly in the back. A code grey was called at 5.18 p.m. in relation to this incident and a decision was made at approximately 5.30 p.m. to chemically and physically restrain the patient and to institute a mental health assessment order.

v. Between approximately 8.11 to 8.54 p.m. (relevant period), the patient was awoken to prepare for his transfer to another facility under the mental health order. The patient again became aggressive and made a number of death threats towards staff. BRHS staff attempted to physically restrain and chemically sedate the patient. Staff involved included Dr Hambly [and 4 registered nurses]. Two security staff were also present at this time.

vi. During the relevant period, the patient was physically restrained by staff members while chemical sedation was administered. Dr Hambly then put his hands on the patient’s face with force to assist in restraining him. At this point, Dr Hambly claims that the patient turned and bit Dr Hambly on the lateral aspect of his right hand. The Board neither agrees nor disagrees with this point.

vii. The patient then began thrashing about and raising his torso up to the level of people who were in the vicinity. During this period, staff, including Dr Hambly, tried to restrain the patient, at which point the patient spat at Dr Hambly. In reaction to this, Dr Hambly punched the patient in the face and/or head twice.

Dr Hambly: 

1. said words to the patient to the effect of “you fucking spat in my eye” or “’you can’t spit in my face without consequences”;

2. yelled obscenities at the patient; and

3. used profanity towards the patient.

The Medical Board alleged, and Dr Hambly agreed, that his conduct amounted to ‘professional misconduct’ ([11]).  With respect to the Health Practitioner Regulation National Law (Vic) s 5 definition of ‘professional misconduct’ it was agreed that his conduct represented a failure to maintain professional behaviour and a failure to communicate in a professional manner and that this was ‘conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience’ and/or ‘conduct of the practitioner … that is inconsistent with the practitioner being a fit and proper person to hold registration in the profession’.

With respect to the ‘Good medical practice: a code of conduct for doctors in Australia’ (the Code of Conduct) it was agreed that Dr Hambly did not meet the requirements of 

  • Professionalism;
  • Providing good care;
  • Working with patients;
  • Patient safety and minimising risk; and 
  • Professional behaviour.

All well and good.  Notwithstanding the patient’s reprehensible behaviour the person was there and behaving the way he was because he needed medical care (even if he did not recognise that or want it). The Tribunal said (at [45]-[48]):

The conduct was very serious, in that it involved the use of physical force — punching in the head twice — and angrily abusing the patient. It is true the patient was aggressive, and had punched, abused, perhaps bitten, and spat in Dr Hambly’s face. However, the patient was highly vulnerable. Because of his behaviour, he had to be restrained. He was strapped down by the ankles and wrists. Nevertheless, he was still able to sit up and writhe around. Five staff were holding him down to enable a sedative injection to be given, including Dr Hambly holding his head.

As Dr Hambly readily acknowledges, even in the face of this behaviour, for him to punch the patient in the head twice was completely unacceptable. Unfortunately, the need to deal with patients who behave in that way arises not infrequently, especially due to mental health issues, and drug use. But health practitioners have a clear obligation to protect such patients and to treat them in a respectful and professional way.

The reaction of Dr Hambly’s colleagues is indicative of the extent of the departure from professional standards which occurred. It bespeaks shock at his actions. His colleagues were visibly distressed.

A determination is required which is consistent with the gravity of what occurred. A not insubstantial period out of practice must be imposed, for the purposes of general deterrence.

And Dr Hambly’s conduct did impact upon the patient. Apart from an injury that needed treating the patient reported (at [12]) 

… that following the incident he had experienced difficulty in accessing medical care, including because he had not got along with the team at the hospital, and that he had to stop seeing his psychologist of 6 years, because Dr Hambly had gone to work at the clinic from which his psychologist practised. He also said he struggled to see male doctors.

Police investigated the matter and took no action against either Dr Hambly or the patient.

Delay

What concerns me, and as I have noted in numerous reports about other disciplinary matters, is the time delay.  This case was heard on 29 September 2026. Orders were made on that day and the reasons for the decision published on 9 October 2026. The incident occurred on 16 March 2022!  That is 4 ½ years earlier!  

The Tribunal explained what had happened in that time. It said (at [3]-[7]):

Dr Hambly did not work for 5 months after the incident. On 28 April 2022, conditions were imposed on his registration limiting him to practising only as a general practitioner (GP), under supervision, and not in an emergency department or hospital. In August 2022, he commenced working in the area as a GP.

A health assessment was conducted by the Board. A report was provided to the Board by Dr Peter Smith, consultant psychiatrist, dated 12 August 2022. It concluded that Dr Hambley’s health conditions were appropriately managed, he acknowledged that his conduct was inappropriate, and that his capacity to practise safely was not adversely affected by any diagnosed health condition.

The Board’s health notification was closed on 13 February 2023, and all conditions on Dr Hambly’s registration were removed on 30 May 2023. Nevertheless, since then he has continued to work as a GP, up to the time of this hearing.

At the time of the incident, Dr Hambly was close to completing the training programme of the Australian College of Rural and Remote Medicine (ACRRM). He commenced this in 2014 and passed his final exam in around July 2022. However, admission to fellowship by the college has been deferred pending the resolution of finalisation of this disciplinary process.

On 19 December 2024, the Board commenced this disciplinary proceeding at VCAT. There were negotiations between the parties, in particular through a compulsory conference in December 2025. This ultimately led to an Agreed Statement of Facts, Findings and Proposed Determinations (Agreed Statement) being signed by both parties.

At [38] the tribunal said ‘In Dr Hambly’s case, there is considerable evidence that he has taken advantage of the period of delay to properly rehabilitate and develop insight and remorse. As such, it was submitted that the delay should be taken into account in this matter as being significantly mitigatory.’

So the incident happens in March 2022. He’s allowed to return to practice subject to conditions. He returns to practice but not in emergency.  All restrictions removed in May 2023.  It then takes the Board a year and a half to commence proceedings then another year to come up with agreed facts and then another 9 months for the matter to get before a tribunal to agree to the proposed sanction.  

The order

The period of suspension was for the purposes of general deterrence ie to communicate to other practitioners the seriousness of such conduct. The Tribunal occurred that specific deterrence ie an order to communicate to Dr Hambly the seriousness of his conduct was not an important factor in this case. The Tribunal said (at [49]-[63]):

… there are a number of mitigating factors which largely obviate the need for specific deterrence and tend to reduce the period out of practice which would otherwise be imposed.

In terms of the incident itself, it was said for Dr Hambly that punching the patient was a reflex response. It was certainly not pre-meditated and followed what might be described in a non-professional setting as very provocative actions by the patient. That mitigates, but as he accepts, does not excuse.

…

As Dr Hambly’s counsel has pointed out, in the period leading up to the incident, Dr Hambly had been working long hours in very stressful environments. For example, when the incident occurred, he was working his 9th consecutive 10-hour shift in the Emergency Department. As was acknowledged, an ability to deal with stressful situations is part and parcel of working in Emergency Departments. But it is a matter of degree. The particular stresses impacting on Dr Hambly at that time had reached a peak. This is illustrated by his anger expressed in a meeting in the hospital 4 days before. In line with other doctors, he was unhappy about what was perceived by them as a failure to implement a demand escalation protocol when the demands on this relatively small facility exceeded its ability to provide care to the community. The correspondence provided to us included descriptions of the hospital being bed-blocked, ambulance ramping, urgent cases having to wait hours for attention, and then being treated on ambulance trolleys. From the material provided to us, it is clear this issue was coming to a head just at the point at which this incident occurred.

We accept that the fact that Dr Hambly had seen his partner [one of the paramedics assigned to transport the patient] being threatened by the patient likely contributed to his actions in that moment.

In terms of insight, we accept that the incident has significantly affected Dr Hambly’s mindset. This is apparent from the statements of regret and apology that he has made subsequent to the incident, and in the course of the investigation.

It is backed up by the report of Dr Amber Fougere, forensic psychologist, of 30 March 2023. She noted his remorse, and Dr Hambly’s reflections on the deeper causes of his behaviour. These include reflections on attitudes stemming from his childhood, and his response to the perception of threats towards his partner. He has undertaken work to more readily identify psychological arousal and to reinforce existing coping strategies to manage heightened emotional states in the moment.

Dr Fougere reported that while Dr Hambly could not guarantee a similar incident would not happen in the future, he has openly engaged in the therapeutic process and developed management plans to manage the risk of future incidents. He also understands that any similar incident may have drastic consequences for his career.

…

It was said the impacts on Dr Hambly from the incident and its sequelae have been profound, and are continuing. This relates to his state of mind, and also to his career. Indeed, it is not apparent that Dr Hambly has decided to seek to return to emergency medicine, despite having completed the requirements for his Fellowship of ACRRM in 2022. He is still considering his position.

In our view, that is appropriately consistent with his journey of insight and rehabilitation.

It also serves, incidentally, to emphasise to the profession generally the extent of the adverse impact which perpetrating such actions on a patient can have for a practitioner.

The fact that the Board proposes a suspension of Dr Hambly’s registration, and not cancellation, indicates it believes he is now a fit and proper person to practise. We agree. The multiple positive references from professional colleagues provide reassurance in this regard.

In summary, taking into account the impacts on the patient, and the seriousness of the conduct, tempered by the mitigating factors, including the consequences already felt by Dr Hambly, and giving due weight to the carefully negotiated position reached between the parties and their legal representatives, we have concluded that it is appropriate to suspend his registration for 6 months.

Discussion

I don’t quibble with the finding that the conduct was serious and unacceptable by a professional.  We are told that assaults on health staff are on the rise and will not be tolerated by health institutions but that does not imply a licence for ‘self -help’.  And the term ‘assault’ can be misapplied. An assault requires an intention and in turn requires insight.  A person affected by drugs and or a mental illness may not have the mental capacity to understand the nature and consequences of what they are doing so even though they, in popular language, assault a health care worker they may not be guilty of any criminal offence. Their behaviour may reflect the very medical condition that the health care worker is there to treat.  Dr Hambly did have options including walking away.

But I struggle to see how suspending a practitioner for six months, 4 and ½ years after the event; after he has taken steps to deal with his own issues and at the same time remove himself from the stressors that led to this behaviour, is helpful.  I note too that Dr Hambly has been working in regional Victoria and at the time of this incident in an overloaded emergency department. As noted above ‘he was working his 9th consecutive 10-hour shift in the Emergency Department’.  He and his colleagues had communicated their ‘anger’ at 

… what was perceived by them as a failure to implement a demand escalation protocol when the demands on this relatively small facility exceeded its ability to provide care to the community. The correspondence provided to us included descriptions of the hospital being bed-blocked, ambulance ramping, urgent cases having to wait hours for attention, and then being treated on ambulance trolleys.’  

Dr Hambly is providing GP services in a regional community that is probably short of GPs and his conduct was at least in part a reflection of bigger systemic issues.  He’s already spent 5 months out of practice, no longer works at the local health service emergency department and his career has been impacted. What does a further, forced 6 months holiday achieve?

In terms of general deterrence surely a reprimand, the publication of the details as well as showing the impact it has had upon him, his career and the steps he has taken to mitigate future risk would achieve the desired outcome of emphasising ‘to the profession generally the extent of the adverse impact which perpetrating such actions on a patient can have for a practitioner’ and patient.

I can understand the delay from March 2022 to May 2023 when the issue was Dr Hambly’s mental health and various health assessments were conducted as provided for in the National Law, but ‘The Board’s health notification was closed on 13 February 2023, and all conditions on Dr Hambly’s registration were removed on 30 May 2023’ ([5]). At that point they’ve ruled out impairment.  But how it took from May 2023 to September 2026 to get the matter before the Tribunal if the facts were never really in question is, again, beyond me.  Suspension for six months (or even longer as he wouldn’t have had the chance to demonstrate his ongoing fitness to practice) may have made sense.  Now it seems very much like closing the proverbial stable door now that the horse has not so much ‘bolted’ but returned to the paddock where it is grazing calmly. 

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.