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1. The Registrant has been given Notice of today’s hearing, by letter dated 14 April 2016 sent to the registered address of the Registrant, in accordance with Rule 3 of the Procedure Rules 2003 which state, “In these Rules a reference to the sending of a notice or other document to any person is a reference to it being sent—… (b) in the case of a health professional, to his address as it appears in the register…(2) All communications to be sent for the purposes of these Rules may be sent by post and any such communication shall be treated as having been sent on the day on which it was posted.”
Proceeding in absence
2. The Panel accepted the advice of the Legal Assessor to consider the HCPC Practice Note entitled “Proceeding in the Absence of the Registrant”. The Panel decided to proceed in the absence of the Registrant today, on the grounds that he has deliberately and voluntarily failed to appear at the hearing and therefore he has waived his right to attend. The Panel will be able to ensure a fair hearing as it has a range of documents, including his email to the HCPC dated 10 January 2016 and the representations made on his behalf to the Court. The Panel is satisfied that he would not attend on a future date if the hearing today was adjourned. It is in the public interest to proceed with the hearing expeditiously.
Application to amend the allegation
3. The Panel granted an application to amend the allegation and delete the second reference to the year 2015 in the date of the Court hearing.
Conviction and caution allegations
4. Article 22(1)(a)(iii) of the Health and Social Work Professions Order 2001 provides that one of the grounds upon which an allegation may be made is that a Registrant’s fitness to practise is impaired by reason of: “(iii) a conviction or caution in the United Kingdom for a criminal offence…”
5. Conviction and caution allegations are not about punishing a registrant twice. The Panel was advised by the Legal Assessor to consider the guidance in the HCPC Practice Note entitled “Conviction and Caution Allegations” and followed that advice. The Practice Note states, “A conviction or caution should only lead to further action being taken against a registrant if, as a consequence of that conviction or caution, the registrant’s fitness to practise is found to be impaired…”
6. The Registrant is an HCPC registered Paramedic. He was sentenced at Birmingham Crown Court (the Court) on 2 November 2015, following guilty pleas to six charges of making an indecent photograph or pseudo-photograph of a child, to a total of six months imprisonment suspended for two years, a Supervision Order for two years, a Sexual Harm Prevention Order and a requirement to undertake a Facing Forward rehabilitation programme. His name will be placed on the Sex Offenders Register for seven years. The Registrant admitted to the police on 23 October 2014 that he had downloaded indecent images onto two computers consisting of 65 Category A images, 65 Category B images, and 11,331 Category C images, plus one Category A movie, two Category B movies and one Category C movie. He admitted he had been viewing child pornography for five to ten years through an internet site. He had not shared these images with any other person. The images include children aged three to four years, with Category A being the most extreme images of the sexual abuse of children.
7. The Registrant resigned from the West Midlands Ambulance Service on 23 October 2014 after 13 years of service.
Decision on Facts and Grounds
8. The HCPC relies on the Certificate of Conviction to prove the facts of the conviction and sentence. The sentencing remarks of HH Judge Laird QC show that the Registrant had shown genuine remorse and made attempts to address his offending behaviour with the Lucy Faithful Foundation. The Panel finds the fact of the conviction has been proved.
Decision on Impairment
9. The Panel considered the HCPC Practice Note on “Finding that Fitness to Practice is Impaired”. In determining whether fitness to practise is impaired, panels must take account of a range of issues which, in essence, comprise two components:
1. the ‘personal’ component: the current competence, behaviour etc. of the individual registrant; and
2. the ‘public’ component: the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession.
10. Under the HCPC “Standards of Conduct, Performance and Ethics”, registrants are required to comply with the following standards:
3 You must keep high standards of personal conduct.
13 You must behave with honesty and integrity and make sure that your behaviour does not damage the public’s confidence in you or your profession.
11. The Panel finds that the Registrant failed to comply with standards 3 and 13, above.
12. In considering impairment, there is no definition to be relied upon but it is sometimes described as a negative subsisting impact on a person’s performance. It is a matter for the judgment of the Panel; there is no burden or standard of proof to be applied at this stage. It is important to note that the test of impairment is expressed in the present tense. In considering this stage of the process, the Panel has taken into account the “critically important public policy issues” identified by the High Court in the case of Cohen v GMC  EWHC 581 (Admin).
13. The Registrant has been complicit in child sexual abuse and exploitation of children by downloading pornographic images of children over an extensive period of time. He has been convicted of serious offences involving very young children over an extended period and a large number of images depicting thousands of children in photographs and films. Serious harm will have been caused to the children concerned.
14. The mitigating circumstances are that the Registrant has acknowledged the impact on himself, on others, and on children. He made immediate admissions and “is ashamed” of his behaviour. However, his email to the HCPC dated 10 January 2016 does not provide insight or remorse and relates to the impact of the convictions upon himself. The Registrant had a 13-year exemplary career as a Paramedic, but that was his public face and in reality, he was leading a parallel life in which he was continually complicit in the sexual abuse of children.
15. He paid for a course of treatment with the Lucy Faithful Foundation and pleaded guilty to the offences. However, this does not provide evidence of remediation as there is no information as to how the course has influenced his motivation, behaviour, or future actions and, therefore, it is the Panel’s judgement that he continues to pose a risk to children. He sought to minimise the seriousness of his behaviour by saying that his “inclination is towards 13 year old girls or thereabouts”, but the images found by the police included children aged three to four years old and the majority of children were ten years old.
16. His behaviour has undermined public confidence in the paramedic profession. Paramedics occupy a role of trust and he has breached a fundamental tenet of the profession by reason of these convictions, and continues to pose a real risk to the public.
17. In this case, the principle issue is the maintaining of public confidence and upholding proper standards of conduct outside the workplace. The Registrant was of previous good character, as stated by the sentencing Judge. However, his conduct is not congruent with that of the professional standards which the public would expect of HCPC registrants. Knowledge of these offences would damage public confidence in the profession, and in the regulatory process, if this serious criminal conduct did not lead to a finding of impairment.
18. The Panel’s role is to protect the public and maintain the high standards and reputation of the profession concerned. In considering the nature, circumstances and gravity of these criminal offences, the Panel took account of public protection in its broadest sense and concluded that the Registrant’s actions brought the profession concerned into disrepute, undermined public confidence in the profession, and posed a risk to the public. The Panel adopted a 'retrospective' approach and considered the conviction as if the Registrant was applying for registration with the HCPC.
19. Accordingly, the Panel finds that the Registrant’s fitness to practise is currently impaired on both personal and public policy grounds, and on the grounds of public protection.
Decision on Sanction
20. The purpose of fitness to practise proceedings is not to punish registrants, but to protect the public. The Panel has considered the HCPC “Indicative Sanctions Policy”.
21. There is a public interest in upholding the reputation of the profession and maintaining public confidence in the HCPC regulatory process. In deciding what, if any, sanction to impose under Article 29 of the Health and Social Work Professions Order 2001, the Panel has had regard to the principle of proportionality and the need to balance the interests of the public with those of the Registrant, in accordance with the advice of the Legal Assessor.
22. The Panel heard submissions in relation to the mitigating and aggravating factors before considering (in ascending order) what, if any, sanction to impose.
23. The criminal offences in this case involve the sexual abuse and exploitation of thousands of young children over a prolonged period. The Panel has had regard to the terms of the sentence of the Court. It is inappropriate to allow the Registrant to remain in or return to unrestricted practice whilst he is subject to a suspended prison sentence and on the Sex Offenders Registers until 2022.
24. There is a significant risk that damage has been caused to the reputation of the Paramedic profession. A Paramedic occupies a position of trust and the Registrant’s behaviour undermines that essential position of trust.
25. The mitigating features are that the Registrant cooperated with the police, made admissions and pleaded guilty. He had a previously good record during his 13-year career as a Paramedic. There is evidence that he is ashamed of his behaviour and expressed remorse at the Court hearing. He has demonstrated insight in undertaking a course, but there is no indication in his email of 10 January 2016 that he has remediated his behaviour and the motivation which led to his offending. It is the Panel’s judgement that, whilst giving consideration to these mitigating factors, they can go no way towards remediating or indeed, providing insight into the Registrant’s motivation or behaviour in being complicit in the sexual abuse of children.
26. The aggravating factors are that this was a five to ten year period of downloading and making of indecent images and pseudo-photographs of children, whose ages range from three to ten, with the majority of images being of ten year old girls or thereabouts. There was a very high volume of Category C images (over 11,000 images), together with images of Category B and Category A (the worst images readily available), as well as films of these categories. The Registrant said that he was disgusted by the Category A images, but this did not stop him downloading 65 such images, together with viewing a film of this category which involved a three year old child. Such images of children carry with them a high degree of harm for the victims; by making the images, the Registrant is complicit with the sexual abuse of children.
27. The Registrant, as a registered Paramedic, has breached the trust of the public, which is a fundamental tenant of the profession. The Panel has decided that it is necessary to impose a sanction to mark the seriousness of the Registrant’s convictions.
28. The Panel finds a caution order would be contrary to the “Indicative Sanctions Policy”, due to the Registrant’s serious criminal behaviour.
29. The Panel concludes that conditions of practice are not an appropriate or proportionate sanction in this case due to the serious offences committed, which are likely to undermine public trust in the Paramedic profession. Also, there is a lack of remediation and a real risk to the public remains, on the evidence available in this case.
30. It appears the Registrant is now employed as a delivery driver, but he continues to pose a risk to the public as an HCPC registrant. He is subject to a suspended prison sentence until November 2017 and it is not in the public interest for him to be free to practise when the period of the suspended sentence (and the other Court orders) has not yet expired. There is no further evidence from the Registrant before the Panel today and it is unlikely that he will engage with the HCPC in the future. The Panel concluded that the Registrant’s behaviour remains completely incompatible with his continued registration.
31. Therefore the Panel has considered imposing a Striking Off Order. The “Indicative Sanctions Policy” states, “Striking off is a sanction of last resort for serious, deliberate or reckless acts involving abuse of trust such as sexual abuse.”
32. The criminal conduct of the Registrant has breached one of the fundamental tenets of the profession. He has been complicit in the sexual exploitation of thousands of children and thereby undermined public trust and confidence in Paramedics. There has been an absence of recent engagement by the Registrant with the HCPC process.
33. The Panel concluded that a Striking Off Order is the only appropriate sanction in this case, to protect the public and maintain public confidence in the regulatory process and the reputation of the profession.
That the Registrar is directed to strike the name of Mr Andrew Grant from the Register from the date this order comes into effect.
History of Hearings for Andrew Grant
|Date||Panel||Hearing type||Outcomes / Status|
|24/06/2016||Conduct and Competence Committee||Final Hearing||Struck off|