Auckland doctor accused of prescribing ADHD medication without specialist approval

Dr Tony Hanne. Photo / File

An Auckland doctor is facing a Health Practitioners Disciplinary Tribunal over allegations he wrote thousands of stimulant medication prescriptions for patients with ADHD without written specialist approval.

Dr Tony Hanne, who is well-known in the ADHD community, has been charged with breaching his professional and/or legal obligations by the Professional Conduct Committee (PCC).

The committee alleges that on at least 5662 occasions between August 22, 2014, and April 2, 2019, he prescribed Methylphenidate (Ritalin) or Dexamphetamine to patients without first gaining a written recommendation for the treatment from a psychiatrist or paediatrician.

In New Zealand, only a psychiatrist or a paediatrician can write recommendations for those medications, and people on the medicines need to get a special authority number to continue getting the medicines subsidised every 24 months.

Hanne is also accused of submitting 214 false, misleading or inaccurate application forms to Pharmac for a subsidy for the medications by special authority for his patients.

In these, the PCC alleges he stated that a psychiatrist or paediatrician had been consulted in the past two years and had recommended the treatment, and that he said the details contained within were correct when they were not.

As well as this, the committee said he had continued making the prescriptions and applications described earlier despite inquiries into his actions in 2010 and 2014.

Hanne is also accused of breaching a voluntary undertaking he submitted in 2018 in which he agreed to only prescribe the medicines in line with Gazette Notices.

Finally, the committee said he provided treatment to someone close to him for years when it was inappropriate.

The defence is yet to present arguments but is expected to argue that the system has not been working for decades and access to psychiatrists is too expensive for many.

It is understood it will argue that Hanne's actions were motivated by necessity to the patients.

PCC lawyer Belinda Johns told the panel during opening arguments it was accepted that Hanne, as a general practitioner, had a recognised expertise and knowledge in respect to ADHD developed over his lengthy career.

However, she said Hanne's expertise in the field did not absolve him of his professional responsibilities.

Johns said from 1999 to 2018 Hanne had an arrangement with a psychiatrist, which she said involved him outlining his diagnosis of the patient with ADHD and unless he heard back from the psychiatrist he deemed approval was given.

Hanne would then apply for the special authority number and prescribe the medication, Johns told the hearing.

The beauty of this arrangement, she said, was that patients would not have to see a psychiatrist.

Following the psychiatrist's retirement in 2018 she said Hanne went on to prescribe the medication using his own name.

Johns also noted Hanne had previously asked the Ministry of Health for dispensation from the rules so he could prescribe the medicines without the required sign-offs.

PCC witness Medsafe Medicines control manager Michael Haynes told the hearing the agency had received concerns from Hanne regarding his patients' access to appropriate services.

He said Hanne's application for dispensation to be able to prescribe the medicines was not approved.

Hanne's lawyer, Harry Waalkens, said his client had been "at pains" to "repeatedly" write to authorities including the Ministry of Health and the Medical Council regarding concerns over the difficulties he said clients faced trying to get access to psychiatrists.

Haynes said when Medsafe had received correspondence from Hanne the concerns were taken seriously and were carefully considered.