A hearing before the Health Practitioners Disciplinary Tribunal (the HPDT) is the final stage of the conduct route under the Health Practitioners Competence Assurance Act 2003 (the HPCA Act). A charge is laid by a Professional Conduct Committee (PCC) or by the Director of Proceedings at the Health and Disability Commissioner. The Tribunal, chaired by a lawyer and sitting with practitioners from your profession and a lay member, hears the evidence, decides whether the charge is proved and, if it is, decides the penalty. The penalties are cancellation of registration, suspension for up to three years, conditions, censure, a fine and costs. The decision is published. Everything you do between the charge and the hearing, and everything you did before the charge, is evidence the Tribunal weighs on penalty, which is why representation and remediation both start on the day the charge arrives.
What the Tribunal is
The Tribunal is established under Part 4 of the HPCA Act and sits apart from the Councils and Boards. It hears charges against practitioners of every regulated profession. Each hearing panel is drawn from a chair or deputy chair, who is a lawyer, members of your own profession and a lay member. The Tribunal is a judicial body: evidence is given on oath, witnesses are cross-examined and the standard of proof is the civil standard, with the seriousness of the allegation taken into account. Its decisions are published on its website and can be appealed to the High Court.
The grounds on which the Tribunal can make a finding are set by the Act. In plain words they are: malpractice or negligence in your scope of practice; professional misconduct, meaning conduct likely to bring discredit to the profession; a conviction for an offence that reflects adversely on fitness to practise; practising outside your scope or without a practising certificate; and breaching an order of the Tribunal or a condition on your practice.
Who lays a charge and what the charge says
Two bodies can lay a charge. A PCC lays one after its own investigation, where it considers the conduct may meet a ground for discipline; the guide to how a Professional Conduct Committee runs describes that stage. The Director of Proceedings lays one after the Health and Disability Commissioner has found a breach of the Code of Health and Disability Services Consumers' Rights and referred the matter; the guide to an HDC breach finding and the Director of Proceedings describes that path.
The charge sets out the particulars: the facts alleged, dated and specific, and the ground relied on. It is served on you with a date for the hearing to be set. Read it with your lawyer line by line. Each particular is something the prosecuting body has to prove, and each is something you can admit, dispute, or admit in part. While the charge is pending your Council or Board can suspend your practising certificate or impose conditions under section 69 where it believes the public is at risk; the guide to interim suspension and interim conditions explains that test.
What happens step by step
- The charge is laid and served. You receive the charge and the particulars. Contact your indemnity insurer and professional association the same day and instruct a lawyer.
- Pre-hearing directions. The Tribunal sets a timetable: disclosure of the prosecution's evidence, your response to the charge, exchange of witness statements, any application for name suppression and the hearing dates.
- Your response to the charge. You say which particulars you admit and which you dispute. An agreed summary of facts can be prepared where the facts are not in issue.
- The hearing on the charge. The prosecuting lawyer opens and calls witnesses; your lawyer cross-examines; you give evidence and are cross-examined; both sides make submissions. Hearings are in public unless an order is made.
- The finding. The Tribunal decides whether each particular is proved and whether the proved facts amount to the ground charged. It may give its decision at the hearing or reserve it.
- The hearing on penalty. If the charge is proved, both sides make submissions on penalty. This is where your reflection, your remediation with dated evidence, references and your conditions proposals are presented.
- The decision, costs and publication. The Tribunal issues a written decision with reasons, the penalty, any suppression orders and the costs order, and publishes it.
Representation, suppression and attending
- Representation. You are entitled to a lawyer, and the charge will be prosecuted by one. Indemnity cover through the Medical Protection Society for doctors, NZNO for nurses or NZCOM for midwives can include representation; the other professions should ask their insurer or association. If you have no cover, instruct a lawyer with regulatory experience as early as you can.
- Name suppression. The Tribunal's starting position is open justice: the hearing is public and the decision is published with your name. You can apply for interim suppression before the hearing and permanent suppression at it. The Tribunal weighs the public interest against your interests and those of others, such as a patient who could be identified. Grounds and evidence are needed; an application without them is refused.
- Attending. Attend every day of the hearing. The Tribunal watches how you listen to the evidence, how you give your own, and whether what you say matches the records. A practitioner who does not attend gives the Tribunal nothing to weigh in their favour.
What the Tribunal weighs on penalty
In published decisions the Tribunal has set out the purposes of penalty: protecting the public, maintaining professional standards and public confidence, and, where possible, rehabilitating the practitioner. It has also said that the penalty should be the least restrictive that meets those purposes. Against that it weighs the following.
- The seriousness of the conduct. Harm or risk to a patient, whether the conduct was deliberate or careless, whether it was one event or a pattern, and whether it involved dishonesty or a breach of trust.
- Insight. Whether you understand what you did, why it was wrong and what it meant for the patient and the profession. An early admission, an apology and a reflection that engages with the conduct read as insight; denial of what the records show, or blame placed elsewhere, reads as its absence.
- Remediation. What you have done since: supervision, an audit, courses with dated certificates, changes to your practice, and whether those steps match the conduct charged.
- Prior history. Earlier findings, conditions or warnings, and conduct since the charge.
- Cooperation and conduct in the proceedings. Whether you engaged with the PCC or the HDC, whether you admitted what could be admitted, and whether you kept to interim conditions.
- Personal circumstances and consequences. The effect of the proceedings on you, the time elapsed, references from colleagues and employers, and what a particular penalty would mean for your ability to practise.
Where the charge concerns a boundary with a patient or a colleague, or dishonesty, the Tribunal has treated the conduct as serious in itself and looked closely at insight; the guides to a professional boundaries concern and an honesty or probity concern cover those categories.
The penalties
- Cancellation of registration. Your name is removed from the register. You can apply for restoration later, and the Tribunal may set a period before you can.
- Suspension. For up to three years. You cannot practise during the suspension and the Tribunal can attach conditions to your return.
- Conditions. Supervision, a limit on scope, a requirement to complete named courses or an audit, for a set period. Conditions are entered on the register.
- Censure. A formal record of the Tribunal's disapproval, published with the decision.
- A fine. The Act sets a maximum; the Tribunal decides the amount with regard to the conduct and your means.
- Costs. A contribution towards the costs of the investigation, the prosecution and the hearing. In its decisions the Tribunal has set the contribution as a proportion of the actual costs, reduced where the practitioner admitted the charge or cooperated.
What you can do before the hearing
- Decide, with your lawyer, what to admit. Where the records are clear, an admission at the start is weighed in your favour and reduces the costs.
- Write your reflection. What happened, why, what you understand now, what you have changed. Written in your own words, read by your lawyer before it is filed. The guide to showing insight and building a remediation plan explains what reads as insight.
- Complete remediation that matches the charge, and keep the certificates. A dated certificate is a fact the Tribunal can record in its decision.
- Arrange supervision now. A named supervisor with a written log shows that the risk is already being managed and gives the Tribunal a condition it can adopt instead of a suspension.
- Gather references. From colleagues and employers who know about the charge and can speak to your practice since.
- Propose conditions. A written proposal for conditions you would accept gives the Tribunal a less restrictive option it can choose.
Where remediation fits
At the hearing on penalty the Tribunal asks what you have done, not what you intend. Remediation for Fitness to Practise covers how to build a plan with evidence a Tribunal can check. Insight for Fitness to Practise covers the reflection the Tribunal reads for. Ensuring No Repeat of Misconduct or Mistake covers what a regulator needs to see to be satisfied the conduct will not recur.
Each course is NZ$200, takes 2 CPD hours, is self-paced with immediate access, and ends with a dated certificate issued by Healthcare Ethics Courses that you can submit to your Council or Board or put in your remediation plan. The remediation courses for every Council and Board are on the hub page, and the Council and Board investigation process explained shows where the Tribunal sits among the stages.
Sources and further reading
- Health Practitioners Disciplinary Tribunal: published decisions, hearing lists, practice notes and the Tribunal's guidance for practitioners.
- Health Practitioners Competence Assurance Act 2003: Part 4, including the grounds for discipline, the penalties and the interim orders in section 69.
- Health and Disability Commissioner: the Director of Proceedings and the Code of Health and Disability Services Consumers' Rights.
Frequently asked questions
Who can lay a charge before the Tribunal?
Two bodies. A Professional Conduct Committee appointed by your Council or Board can lay a charge after its investigation, where it considers the conduct may amount to a ground for discipline. The Director of Proceedings, an office within the Health and Disability Commissioner, can lay a charge after the Commissioner has found a breach of the Code and referred the matter to the Director. A patient, an employer or the authority itself cannot lay a charge directly; the matter has to pass through one of those two routes first.
Do I need a lawyer at a Tribunal hearing?
You are entitled to be represented, and the charge is prosecuted by a lawyer for the PCC or the Director of Proceedings. The hearing involves evidence, cross-examination and legal submissions on both the charge and the penalty. Speak to your indemnity insurer or your professional association as soon as a charge is laid; indemnity cover for doctors through the Medical Protection Society, and for nurses through NZNO, can include representation. A practitioner who appears without representation is at a real disadvantage.
Will my name be published?
The Tribunal publishes its decisions on its website and the starting position is that the practitioner is named. You can apply for an order suppressing your name or other details, and the Tribunal decides by weighing the public interest in open proceedings against your interests and those of others, such as a patient whose identity could be revealed. Interim suppression can be sought before the hearing. Permanent suppression is not granted on request; it needs grounds and evidence.
What penalties can the Tribunal impose?
If a charge is proved the Tribunal can cancel your registration, suspend it for up to three years, impose conditions on your practice for a period, censure you, impose a fine, and order you to pay a share of the costs of the investigation and the hearing. It can combine these. It can also make no order on penalty where it considers the finding itself sufficient. The penalty is published with the decision, and a cancellation or suspension is entered on the register.
Can I admit the charge and still argue about the penalty?
Yes. You can admit the facts and the charge, or admit the facts but dispute whether they amount to the ground alleged, and then make submissions on penalty. An early admission, where the facts are not in dispute, is treated by the Tribunal as a mark of insight and saves the costs of a contested hearing, which affects the costs order. Decide this with your lawyer. The hearing on penalty is where your remediation, your reflection and your references are presented.