A veteran pharmacist has been reprimanded but will be able to reapply for registration when he leaves jail, after making false PBS claims on high-cost drugs
The Queensland Civil and Administrative Tribunal has heard the case of a pharmacist who made false PBS claims to keep his failing business afloat so he could sell it.
The Health Ombudsman had alleged that the pharmacist’s behaviour had constituted professional misconduct, in that he obtained money dishonestly via the false PBS claims.
The pharmacist was first registered in 1981. At the time of the behaviour in question, he was operating a pharmacy business in a Brisbane shopping centre.
In 2016, a customer came to the pharmacy and presented a script for a high-cost drug, and was told that it could only be dispensed by the pharmacy at a public hospital, as was the case.
However, the pharmacy owner held onto a copy of the script.
Between August and November that year, the pharmacist made six claims for payment for the supply of that medicine to a named person.
“The names of the customer and the prescribing doctor were changed from those on the copy of the prescription when the claims were made, but other information from it was used, which enabled the [Health] Department to detect the incorrect supply,” the Tribunal noted.
“The medication concerned was a very expensive one, and each claim resulted in a payment to the
respondent of $22,176.25, except for the last, when the payment was $22,075.39.
“No such medication had been dispensed to the named person, and the claims were made dishonestly.”
The pharmacy owner’s explanation for this conduct was that at the time, he was suffering from “serious financial problems”.
He said that the money was used to keep his struggling business going until he could sell it, which happened several months after the last fraudulent claim was made.
During the hearing the Tribunal noted that his landlord had threatened to terminate his lease for non-payment of rent, and his bank had threatened to sell his home because he was not servicing his loans.
“His business had been marginally viable for about twenty years, but the landlord then, under cover
of a refurbishment, made changes which financially disadvantaged him, and left him with growing debts be could not service,” it said.
“He apparently became another victim of a rapacious shopping centre landlord.”
After the sale of the business, he worked as an employee pharmacist.
In 2019, the six claims were investigated, and he was charged with six counts of obtaining a financial advantage by deception, charges to which he pleaded guilty at the first opportunity, in February 2020.
In October 2020, his lawyers advised AHPRA and the matter was referred to the Ombudsman.
In November 2020, the pharmacist fronted the District Court and was sentenced to two years’ imprisonment on each charge, to be served concurrently, apart from one which was only partly concurrent.
This meant an overall custodial sentence of three years, and the pharmacist is expected to be released in mid-September 2021, though he will be subject to a good behaviour bond for three years.
The Tribunal heard that the pharmacist mortgaged a house he owned with his wife in order to pay back the money to the Health Department, which he had done.
It also noted that the pharmacist had “always expected that at some point he would be caught”.
Since June 2021, he has not been registered to practise as a pharmacist, with the Tribunal noting that AHPRA had initially declined to renew it until after the outcome of the August 2021 hearing.
It later decided he was not a “fit and proper person” to be registered because of his imprisonment, and refused to renew the registration.
The Tribunal said it was satisfied that the conduct was “substantially below the standard reasonably expected of a registered pharmacist, of an equivalent level of training or experience”.
The Ombudsman had sought for the pharmacist to be disqualified from applying for registration for 12 months, but the pharmacist wanted to return to work after he leaves prison, partly to help pay off his mortgage debt.
“The respondent presents as a good functional pharmacist, and I understand that there is now some shortage of pharmacists,” the Tribunal decided, pointing out that the pharmacist’s former employer “would have him back”.
“No doubt that is greater in provincial areas, such as where the respondent was working before his sentencing…
“The offending occurred in the context of his being trapped in a failing business, and was prompted by need rather than greed, as the sentencing judge recognised.”
The Tribunal decided not to impose a preclusion period on the pharmacist before he can apply for registration.
It said that the conduct in question did amount to professional misconduct, however, and reprimanded him.