Mrs Rachel Bruce
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Application for hearing to be heard in private
1. By consent it was agreed that the whole of the hearing should be conducted in private in order to protect the private life of the Registrant.
2. On 18 March 2013 a Panel of the Investigating Committee of the HCPC determined that there was a case to answer in respect of an allegation against the Registrant which related to her competence in the area of practice of dysphagia.
3. On 23 October 2013 that allegation was considered by a panel of the Conduct and Competence Committee and transferred to be considered by a Health Committee of the HCPC. Following correspondence between the parties and a hearing of the Health Committee of the HCPC on 14 April 2014 a Consent Order imposing agreed conditions of practice on the Registrant’s registration for a period of three years was made.
4. This is the first review hearing of that Conditions of Practice Order.
Representations of the HCPC
5. On behalf of the HCPC, Ms Stark submitted that the Registrant’s fitness to practise remained impaired by reason of her health conditions. Ms Stark submitted that a Conditions of Practice Order was no longer appropriate or workable given that the Registrant was no longer working as a Speech and Language Therapist. She invited the Panel to consider making a Suspension Order and contended that, if the Panel was satisfied that there was no realistic prospect of remediation, a Striking Off Order might be an appropriate sanction at this stage.
Representations on behalf of the Registrant
6. On behalf of the Registrant, Mr Bruce explained the background of this matter. He told the Panel that the Registrant’s health condition persisted. He explained that the Registrant was currently employed as a Research Manager. She was not currently working in the NHS or as a Speech and Language Therapist but, she wished to retain the possibility of doing so in the future. Mr Bruce referred the Panel to the documents which had been submitted on the Registrant’s behalf. He outlined the concerns which had led the Registrant not to pursue an application for voluntary removal from the register. The Registrant was unable to state with certainty that she might not wish to return to the register in the future. Further, by agreeing to voluntary removal a Registrant is treated as if s/he has been struck off the register. The Registrant considered that this was a harsh and unfair outcome where matters of ill-health had given rise to the situation requiring a cessation of registered practice. Mr Bruce emphasised the Registrant’s desire to work with the HCPC to find a solution to the unusual circumstances of this case.
7. Before reaching its decision the Panel carefully considered the oral submissions made on behalf of the HCPC and on behalf of the Registrant. It considered the documents before it, including the detailed written submissions made by the Registrant and the addendum dated 9 March 2017. The Panel reviewed the HCPC Practice Note on ‘Article 30 Reviews’ and accepted the advice of the Legal Assessor.
8. The Panel has concluded that there has not been any significant change in circumstance since the Conditions of Practice Order was made by consent in April 2014.
9. The Panel has not been provided with any updated medical evidence in relation to the Registrant’s health condition. It is therefore unable to form a view as to the extent to which the Registrant’s health condition has improved, deteriorated or remained the same. Without specific medical evidence the Panel cannot be satisfied that difficulties in relation to her practice relating to the management of dysphagia are unlikely to recur.
10. The Panel notes that because she is no longer working as a Speech and Language Therapist, the Registrant has not maintained her knowledge and skills in relation to practice as a Speech and Language Therapist. It accepts that her current employment as a Research Manager does not require registration with the HCPC.
11. In these circumstances the Panel is bound to conclude that the Registrant’s fitness to practise remains impaired by reason of her health condition.
12. The Panel next considered whether an Order remained necessary having regard to all the circumstances of this case, including its conclusion that the Registrant’s fitness to practise is impaired. It has determined that an Order is necessary in order to protect the public and to maintain confidence in the profession.
13. The Panel has considered the question of what a proportionate sanction in this case might be. It has concluded that a Caution Order is not appropriate. The Panel next considered a Conditions of Practice Order. It notes that, whilst the existing Conditions on the Registrant’s registration are practical in a narrow sense, they have not enabled the Registrant to remediate the concerns which arise in this case. In that sense, the Panel has concluded that the existing conditions are not appropriate. The Panel has considered whether the existing Conditions of Practice Order could be varied so that the Conditions are appropriate, realistic and verifiable. The Panel has concluded that it cannot. The Panel is unable to formulate relevant conditions of practice which provide the degree of public protection necessary in all the circumstances of this case.
14. Accordingly, the Panel has determined that the proportionate Order is a Suspension Order. The Panel considers that a Suspension Order for a period of twelve months is appropriate. An Order of twelve months duration will enable the Registrant to reconsider what, if any, steps are available to her in respect of her continued registration with the HCPC.