When an honesty or probity concern is raised with your Council or Board in New Zealand, the authority is asking whether it can trust what you say and what you sign. That question sits under everything else it does, which is why authorities, Professional Conduct Committees and the Health Practitioners Disciplinary Tribunal treat dishonesty as one of the gravest concerns a practitioner can face. A probity concern can go straight to a Professional Conduct Committee and, from there, to the Tribunal. Do three things now. Get advice from your indemnity insurer, your professional association or union, or a lawyer before you say or write anything. Never give an account you cannot support, and never alter a record. Where the facts are against you, accept them early and plainly, and show what you understand and what has changed.
What an honesty or probity concern is
A probity concern is any question about whether you have been honest and open in your professional life. The concerns that reach a Council or Board fall into these groups.
- A false or altered record. A clinical note written to describe something that did not happen, or changed after the event to look better.
- A claim to ACC or an insurer. A claim for treatment not given, a consultation recorded as longer or different from what took place, or a claim made in another practitioner's name.
- Qualifications or a CV. A qualification, a post or experience claimed that you do not hold, in an application, a CV or a profile.
- Undeclared interests. A financial or personal interest in a referral, a product or a supplier that you did not declare to a patient or an employer.
- An untrue account to an investigator. A statement to your employer, the Health and Disability Commissioner, your Council or Board or a Committee that turns out not to be true.
- A conviction not declared. A conviction or a matter you were required to declare on your practising certificate application or to your authority, and did not.
Why it is treated so seriously
A gap in competence can be closed with supervision, a programme and audit, and the authority can check that it has closed. Dishonesty is different. The register, the practising certificate, the clinical record and every response an authority receives depend on the practitioner's word. If the authority cannot rely on your word, it cannot rely on your account of the event, your reflection or the evidence you offer of change.
Under the Health Practitioners Competence Assurance Act 2003 (the HPCA Act), the Tribunal can find professional misconduct where conduct has brought or was likely to bring discredit to the profession, and dishonesty is assessed on that basis. In published decisions the Tribunal has treated dishonesty as serious in itself, separate from whether a patient was harmed, and has suspended or cancelled registration in matters involving it. The penalties available include censure, a fine, conditions, suspension for up to three years and cancellation of registration. The guide to a Tribunal hearing explains how a charge is heard.
Convictions and declarations
When a health practitioner is convicted of certain offences, the HPCA Act requires the court's Registrar to send notice of the conviction to the practitioner's responsible authority. The authority can then refer the conviction to a Professional Conduct Committee. A conviction does not need to be about clinical work to reach your authority.
Separately, your authority's code and its practising certificate application ask you to declare matters such as convictions. Read what your authority asks you to declare and when. A declaration that leaves out something the authority later learns of from the court or another source becomes a second concern, and it can be treated as more serious than the conviction it left out.
What happens step by step
- The concern is raised. From an employer, ACC, an insurer, a colleague, a patient, the court's notice of a conviction, or the authority's own checks.
- The authority considers the route. A probity concern goes to conduct, and the authority can refer it to a Professional Conduct Committee without a competence review first.
- Interim orders are considered. While a Committee investigates, section 69 of the HPCA Act lets the authority suspend you or set conditions if it considers that necessary to protect the public, after giving you the chance to be heard.
- The Committee investigates. It gathers records, claims, applications and statements, and gives you the chance to respond and to be heard.
- The Committee decides. It can recommend no further action, counselling, a competence review or conditions, or it can lay a charge before the Tribunal.
- The Tribunal hears a charge. It decides whether the charge is made out and, if it is, what penalty applies.
The guide to interim suspension and conditions explains how interim orders are made and lifted, and the guide to what happens after a notification sets out every route.
How to respond when the facts are against you
- Get advice before anything else. For doctors the Medical Protection Society, for nurses NZNO, for midwives NZCOM, and for other professions your indemnity insurer or professional association. A probity concern can have consequences beyond your registration, including for your employment and with ACC or an insurer.
- Accept what is true, early. An authority gives weight to when a practitioner accepted the facts. An acceptance made at the first opportunity reads differently from one made when the evidence left no choice.
- Use the right word. If what happened was dishonest, do not describe it as an oversight, an administrative error or a misunderstanding. Calling dishonesty by another name reads as a lack of insight.
- Explain without excusing. Pressure, money or fear can be stated as facts about why it happened. They cannot carry the response, and each needs to be followed by what you have done about it.
- Put right what can be put right. Where money was paid on a false claim, or a false statement is still on file, ask your adviser how to correct it, and keep evidence of the correction.
- Keep every account consistent. Your statements to your employer, the Commissioner, your authority and a Committee will be read side by side.
The guide to writing a response to a notification sets out the structure of the response itself.
How insight is judged in a probity matter
In a probity matter an authority looks for insight in what you say and in what you have done. It asks whether your account has been the same from the first statement to the last. It asks whether you name what you did as dishonesty, and whether you understand what it did to the trust that patients, colleagues, the public and the authority place in you. It asks what has changed, in your circumstances and in how you make decisions, so that it will not happen again. A reflection that is honest about the dishonesty is the starting point; the guide to showing insight and building a remediation plan explains how to build one.
Where remediation fits
Remediation in a probity matter is evidence that you understand the duty you breached and have done the work to rebuild trust. Probity and Honesty for Healthcare Professionals covers the duty of honesty in records, claims, applications and dealings with a regulator. Rebuilding Trust of Patients, the Public and the Regulator covers what an authority needs to see before it can rely on you again. Ensuring No Repeat of Misconduct or Mistake covers how to show that the conditions that led to the conduct have changed.
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 each stage. Profession guides describe what happens after a notification to the Medical Council about a doctor, a notification to the Nursing Council about a nurse and a complaint to the Pharmacy Council about a pharmacist.
Sources and further reading
- New Zealand Legislation: the Health Practitioners Competence Assurance Act 2003, including the provisions on convictions, Professional Conduct Committees and the Tribunal.
- Health Practitioners Disciplinary Tribunal: published decisions, including matters involving dishonesty, and how penalties were set.
Frequently asked questions
Is a single dishonest act enough to put my registration at risk?
It can be. The Tribunal can find professional misconduct where conduct has brought or was likely to bring discredit to the profession, and in published decisions it has treated dishonesty as serious in itself, whether or not a patient was harmed. What follows depends on the facts, how you responded when the concern was raised, and the evidence of insight and change. Get advice from your indemnity insurer, professional association or a lawyer before you respond.
Do I have to tell my Council or Board about a conviction?
Read what your authority's code and its practising certificate application ask you to declare, and declare it. Under the HPCA Act the court's Registrar must also send notice of certain convictions to your authority, so the authority can learn of a conviction whether or not you tell it. A declaration that leaves out a conviction the authority later learns of becomes a second concern, and can be treated as more serious than the first.
What if I gave an untrue account before I took advice?
Tell your adviser at once and correct the account through them, in writing, as soon as you can. A correction you make yourself, before the authority finds the truth from another source, reads very differently from an account that stands until the evidence contradicts it. Do not add a further untrue statement to explain the first; a second untrue account is treated as more serious than the first.
Can I describe what happened as an administrative error?
Only if it was one. Where the evidence shows that a record, a claim or an application was false and you knew it, calling it an error, an oversight or a misunderstanding reads as a lack of insight, and the Committee or the Tribunal will say so. Use the plain word for what happened, explain why it happened without excusing it, and set out what has changed. Your adviser will help you with the wording.
What does insight look like in an honesty matter?
An account that has stayed the same from the first statement to the last. Naming what you did as dishonest. An understanding of what it did to the trust that patients, colleagues, the public and the authority place in you. Evidence that the conditions that led to it have changed, such as new arrangements for claims or declarations, and dated certificates for courses completed. A reflection written in your own words, read by your adviser before it goes.