Dr. Simon Rose: A Rural Doctor's Battle with AHPRA
Dr. Simon Rose, a 71-year-old physician, serves as a locum doctor in remote, one-doctor hospitals across the Australian outback. His work includes intensive, 24-hour on-call shifts in places like Brewarrina, 760 kilometers north-west of Sydney, where he addresses a wide range of medical conditions in under-serviced facilities. Rose expresses his enjoyment for this type of medicine and country living.
AHPRA Investigation Initiated
Rose has spent the past year engaged in a dispute with the Australian Health Practitioner Regulation Authority (AHPRA), a healthcare watchdog. The regulator initiated an investigation into his practice, which at one point sought to suspend his medical registration.
Documents indicate that AHPRA's investigation included allegations later described as false, legally questionable tactics, and delays. Rose states the initial complaint was partly based on a misinterpretation of his prescription history. Nurses who have worked with Rose describe him as an experienced clinician and highlight the difficulty regional hospitals face in attracting senior doctors.
Rose has publicly criticized AHPRA, calling for reform and describing it as a "Kafkaesque organisation that’s accountable to nobody."
He states he has had several interactions with the regulator since 2016, leading to significant stress and consideration of early retirement. An agreement reached recently allows Rose to continue his work in rural areas but prevents him from treating addiction patients, though the broader AHPRA investigation remains ongoing. An internal investigation was initiated by the medical board after an AHPRA staff member reportedly used covert methods to gather evidence against Rose.
Dr. Rose's Distinguished Career
Originally from Melbourne, Rose developed a passion for understanding patients' stories. In the 1990s, he provided sexual health checks for sex workers in Melbourne, becoming familiar with the challenges faced by many who struggled with addiction.
He opened First Step, a low-cost, award-winning addiction clinic in St Kilda, with funding from philanthropist Peter White. The clinic offered detox treatment and adopted a whole-of-patient approach, considering social and underlying health factors. Rose advocated for drug courts, which treat addiction as a medical issue, and was awarded a Centenary Medal for this work.
He also continued treating a small number of addiction patients after leaving the clinic in 2004, often without charging or taking formal clinical notes. Patients described his care as a "lifeline."
The Suspension Incident
Last year, an addiction patient of Rose's experienced increased anxiety due to an assault and home invasion, leading to a temporary increase in benzodiazepine prescription. The patient subsequently relapsed on heroin and was hospitalized.
A hospital doctor reviewed the patient's history, noting what appeared to be a high quantity of benzodiazepine prescriptions from Rose over three weeks. This assessment, however, did not fully account for dispensing limits and cancellations. Rose was reported to AHPRA, which then used its "immediate action" powers to suspend his medical practice, alleging his prescribing was "dangerous and excessive" and posed a risk to public safety. This led to the cancellation of his rural shifts and his addiction patients being told to find new doctors.
Rose challenged AHPRA's assessment, stating that the prescriptions had limits and that patients could not access the quantities claimed by the regulator. His insurer declined to fund his legal defense, so he proceeded with his own legal representation. A lawyer familiar with the case described AHPRA's actions as drastic and based on limited evidence.
VCAT Tribunal Findings
During a Victorian Civil and Administrative Tribunal (VCAT) hearing in February, Rose clarified that several cited prescriptions were either canceled or had tight weekly dispensing restrictions. Rural colleagues provided references, praising his clinical judgment, and a medical recruiter testified about the critical shortage of doctors in rural medicine.
The tribunal's senior member found AHPRA's concerns about prescription quantities "questionable." The member concluded that the patient's relapse was due to the distress from the stalker, not the medication.
While acknowledging Rose's administrative failures, such as a lack of note-taking and unawareness of the Safe Scripts website (a tool to prevent doctor-shopping), the tribunal found the public safety risk to be less significant than AHPRA had asserted.
The interim ban on Rose's outback work was lifted, recognizing his "important role in giving rural and remote communities access to necessary medical care."
Challenges in Rural Healthcare
Rose continues to work in various rural hospitals, treating diverse cases. He has encountered difficult situations, including finding the body of an Aboriginal man who died by suicide and counseling his family. Locals in towns like Moranbah have reported serious health incidents due to a lack of experienced doctors.
For example, a man claimed his daughter developed sepsis after being turned away from a local hospital for dehydration.
In Brewarrina, residents highlight significant gaps in medical services. Annika Frail described giving birth prematurely at a hospital where staff were unprepared to deliver a baby, leading to her daughter needing regular airlifted care to Dubbo for basic medical needs. Community elders, including Aunty Blake and Loreen Coffey, cited issues such as a shortage of dialysis machines for the town's high diabetes rate and a lack of patient-respecting practitioners.
Ongoing Investigation and Resolution
Rose stated that for over a year, AHPRA requested extensive information within tight timeframes but was slow to provide updates, contributing to his reported depression and anxiety. An AHPRA employee acknowledged the impact and claimed progress was being made. In July, Rose submitted a defense, asserting administrative failures did not apply to his rural work, which constitutes 95% of his practice and is "vital, under-serviced, and in great demand."
By October, AHPRA expanded its investigation to include a covert inquiry into Rose's prescription of legal nicotine vapes via telehealth. This tactic led to an internal investigation into AHPRA's methods, as it lacks powers for covert evidence gathering. In November, AHPRA indicated the investigation might not conclude until early 2026. Rose confirmed through Safe Scripts that none of his patients had engaged in doctor-shopping, a key element of AHPRA's initial risk assessment.
In January, an independent expert report to AHPRA found that most of Rose's prescriptions included clear dispensing instructions and demonstrated "safe prescribing practices."
While it noted some risky prescribing for addiction patients and a lack of clinical notes, the report's findings were significantly less severe than AHPRA's initial assessment. This prompted a change in AHPRA's approach.
The current agreement allows Rose to continue his rural practice, acknowledging his "good standing" in remote areas, while the investigation into other aspects continues. Rose has agreed to stop treating addiction patients, finding it difficult to manage remotely.
Rose called the process "outrageous," stating, "Except for the paperwork, they won’t find anything wrong with me. How has this taken a year? Justice delayed is justice denied."
AHPRA's Stance and Dr. Rose's Future
AHPRA states that its immediate action powers are for public protection and practitioners have the right to review or appeal. A spokesperson mentioned internal reviews and an "end-to-end review" of its investigation system to improve timeliness, transparency, fairness, and empathy, claiming more complaints are being resolved sooner than in the past. Rose affirms that medicine remains a large part of his life and he intends to continue providing his service.