Patients don't know he killed his wife

Dr Sliwinski himself had a history of mental illness. This led him to either leave or be dismissed from four medical facilities in the 1980s. In 1987, after a decade of chronic drug and alcohol abuse, he shot his former wife, Alice, four times, a month after their divorce. One of the shots, to her head, killed her.

But Dr Sliwinski was released on parole in 1990. And he was employed as a resident medical officer at the Central Coast Mental Health Service in July 1994, shortly after successfully appealing to the Medical Tribunal of NSW to be re-registered. The Australian Medical Association publicly opposed the re-registration.

Dr Sliwinski was employed as a psychiatric registrar at Gosford and Wyong hospitals in 1996, and continues in this role.

But, to this day, many of his patients are unaware of his past - and there is no obligation for DrSliwinski or authorities to tellthem.

The case of Dr Sliwinski raises difficult issues of a patient's

right to know the record and background of their doctor and the ability of someone to redeem themselves and begin a new life.

In 1994 the Medical Tribunal said it had "some difficulty" deciding whether he was fit to be a doctor. But it concluded he was suitable because he did not intend to kill his wife, had no history of violence and was supported strongly by three psychiatrists who gave evidence that he had been fully rehabilitated and was very unlikely to relapse.

And yet questions remain unanswered. The Health Department will not reveal how it monitored Dr Sliwinski to ensure he met strict conditions imposed by the tribunal, such as regular urine and/or blood tests, psychiatric treatment and constant supervision. The tribunal also appeared to be unaware that Dr Sliwinski's wifealleged he had a history of violence against her. It found the killing was an "isolated occasion", despite her allegations, set out in an Apprehended Violence Order summons issued in the year before her death.

The Royal Australian and New Zealand College of Psychiatrists - which is responsible for ensuring the suitability of psychiatrists - has refused to comment on what processes it undertook to assess him. And in the 1990s the NSW Medical Board was not required to independently notify employers of a doctor's restrictions. A spokeswoman for the board, Edwina Light, said it was prohibited from revealing why DrSliwinski's strict conditions were lifted in 1999.

Doctors are not legally obliged to tell patients they are working under conditions or have been deregistered in the past, and the Health Department has no policy requiring disclosure.

Dr Sliwinski went on trial in the Supreme Court for the murder of Alice on October 1, 1987, a month after they divorced.

He pleaded guilty to manslaughter on the fourth day of his trial, in 1988, and was sentenced to a maximum of eight years' jail.

He had shot Alice four times but said he could not recall the incident and successfully argued diminished responsibility because of his intoxicated state.

In sentencing him, Justice Ray Loveday said there was no motive for the killing and described it as "quite bizarre".

According to the tribunal's 1994 judgment, he had been abusing alcohol and a cocktail of prescription drugs, mostly tranquillisers, for almost a decade and had sought psychiatric help several times from 1979, including stays at psychiatric hospitals in 1985 and 1987. He feared "dying and going mad".

His drinking dated back to the late 1960s, when he drank on the job as a medical trainee because he found attending cancer wards difficult.

His father died of bone cancer when Dr Sliwinski was 11 and his mother had schizophrenia.

The drug addiction began in 1977 after his first wife, Barbara, left him with their children and a doctor gave him Serepax after he was unable to administer anaesthesia due to a panic attack at Moree Hospital.

However, in its judgment in 1994 the tribunal concluded that Dr Sliwinski was not an intrinsically violent person. "[The shooting] does not indicate a tendency to vice or violence or any lack of probity. It has neither connection with nor significance for any professional function. There is no evidence that the appellant [previously] committed acts of violence towards his ex-wife or any other person …" the tribunal said.

However, a summons was issued to Dr Sliwinski over an allegation that he assaulted her by attempting to choke her in August 1986.

The AVO application, seen by the Herald , alleged that Dr Sliwinski, who had been drinking heavily, said to his wife, "If I hear you have done anything to foul up my career I will kill you", and had assaulted her three or four times during their five-year marriage. The AVO was withdrawn by his wife.

Three years before the killing, he was twice told to take sick leave from his job as a psychiatric registrar at Morriset Hospital due to his depressed mental state and concerns that he was suicidal.

He was also told to take sick leave from the Mater Hospital in Newcastle not long after that.

In 1987 he was sacked from a practice at Kilburn Bay and told to seek psychiatric help. He had come to the North Coast after he left Moree Hospital in 1980 after "difficulties with the Medical Board, [and] with the Hospital Board", and moved to Newcastle, the tribunal said.

He had been investigated by the Medical Board for failing to attend to an unconscious patient at Moree who had had a stroke, and was cautioned over the incident.

A spokeswoman for the Northern Sydney Central Coast Area Health Service, Jenny Dennis, said: "All appropriate background checks required at the time of his employment were conducted." She later confirmed "this included the NSW Medical Board".

"Central Coast Mental Health Service can confirm that Dr Sliwinski complied with the restrictions placed on him by the Medical Board," she said. She said there had been "no formal complaints about his work".

Ms Light, said it was the responsibility of the Royal Australian and New Zealand College of Psychiatrists to determine whether Dr Sliwinski was fit for psychiatry. The college would not comment.

The board's registrar, Andrew Dix, said it regularly monitored conditions. "It's up to the doctor to comply but if they don't comply we know about it very quickly because we've got a data base following this," Dr Dix said.

Alice's sister, Noleen Tasoulis, said the family was devastated that Dr Sliwinski was practising psychiatry. "I think it's disgusting," Mrs Tasoulis said.

She alleged that at the time of his marriage to her sister he was a "violent" alcoholic and her sister supported him with $335,000 she won in a lottery just before they married. "The seven years that he was married to my sister … he was in various [psychiatric] clinics … so it seems rather unbelievable that he could even practise."

Dr Sliwinski had a solicitor, Denis Williams, contact the Herald to arrange an interview yesterday to respond to questions about his past and what monitoring he was subjected to by the area health service.

Dr Sliwinski did not show up but a senior psychiatrist, Chris Tennant, who is a visiting medical officer at Gosford and Wyong hospitals, did, and strongly defended him.

Professor Tennant said "he met all the conditions imposed on him by the board".

He said whether he told the tribunal he was considering a career in psychiatry was irrelevant. "It's not their business," he said.

He declared the Herald "mother f---ers" after the meeting.

Mr Williams said Dr Sliwinski's suitability had been "extensively considered" by the college and the tribunal. "There's been no record anywhere of this bloke not doing the right thing since the day he was readmitted," he said.

Asked whether Dr Sliwinski divulged to the tribunal that there had been other allegations of assaulting his wife, Mr Williams said: "It's too long ago."

Asked about the alleged threat Dr Sliwinski made to his wife that he would kill her, Mr Williams said: "I think we'll end this now. Goodbye."