Mr Jason Mariah
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Between 29 December 2014 and 21 April 2015, during the course of your employment as a Radiographer by Buckinghamshire Healthcare NHS Trust, you:
1. On 23 January 2015, left the department during working hours and/or during a theatre case.
2. On or around 16 February 2015:
a. Were verbally abusive and/or made threats of violence towards a member of the public in the hospital.
b. Were verbally abusive and/or made threats of violence on approximately two occasions towards a member of staff.
3. The matters described in paragraphs 1 - 2 constitute misconduct.
4. By reason of your misconduct your fitness to practise is impaired.
Application for hearing to be held in private
1.Ms Wills invited the panel to hear part of the HCPC case in private. Ms Wills submitted that a hearing in private would protect the Registrant’s right to a private life.
2.The Panel accepted the Legal Assessor’s advice which had drawn their attention to the HCPTS Practice Note on ‘Conducting Hearings in Private’.
3.The Panel was satisfied that there was a need to protect the Registrant’s rights to a private life and decided that parts of the review should be held in private.
4.The Registrant worked as a Band 5 Radiographer at Wycombe Hospital, Buckinghamshire Healthcare NHS Trust (‘the Hospital’) between 29 December 2014 and 21 April 2015.
5.On 16 February 2015 the Hospital had cause to conduct an investigation into the Registrant’s behaviour as a result of concerns raised.
6.One of the concerns was that on the 23 January 2015 the Registrant was reported to have arrived late in theatre where he was due to shadow another Radiographer. It was also reported that he was later missing from approximately an hour before he returned to the main department.
7.The other concerns related to incidents on 16 February 2015. The first incident involved the Registrant and a member of the public who was a vagrant and was known to some of the Hospital staff. Colleagues of the Registrant gave evidence, to the Panel, that the Registrant had informed them that he would “knock him out”.
8.There were also additional reports of two further incidents in the afternoon of the 16 February 2015 involving the Registrant and a senior colleague. The Registrant admitted making a cheeky comment to the colleague which was inappropriate and intended to rile her.
9. At the Substantive Hearing on the 3-7 April and then the 9-10 October 2017, the Panel found as follows:
I. Particular 1 – proved. The panel found that the Registrant was late to theatre. They also found that by leaving theatre while the radiography was required on the case, his work was not complete.
II. Particular 2(a) – proved. The panel found that the Registrant was verbally abusive and that he did threaten violence towards the vagrant.
III. Particular 2(b) - proved. The panel found that the Registrant was verbally abusive on two occasions and made a threat of violence on one occasion.
10.The panel went on to consider whether the proven facts constituted misconduct or a lack of competence on the Registrant’s part. The panel decided that in respect of particulars 1 and 2 that the Registrant’s conduct was in breach of HCPC Standards of Conduct, Performance and Ethics (1, 3, 7 and 13) and that both amounted to misconduct.
11.The Registrant gave evidence to the panel. He gave account of his health difficulties. He also gave evidence that he took the view that his health was a factor that contributed to his behaviour. However, he also stated that his behaviour was due to the circumstances in which he was placed. He said that the situation with the vagrant was unique and he described his colleague as a “horrible person”.
12.The Registrant informed the previous panel that he had been working since July 2017 in a reception role, at Loughborough University. The Registrant stated that he was doing well in his current position, although he did not provide any evidence of this. He also did not provide any references from present or previous employers or any testimonials.
13.The previous panel considered the level of the Registrant’s insight. The Registrant had acknowledged that in relation to the incidents, outlined at particular 2, that he overreacted on both occasions. However, the panel found that the Registrant continued to blame others and does not take full responsibility for his actions.
14.The previous panel, in October 2017, considered that there had been an improvement in the Registrant’s demeanour and the level of his insight since the hearing in April 2017, but the panel still had concerns that he did not take the Allegation sufficiently seriously.
15.The previous panel decided that the Registrant’s mental health concerns were a contributory factor in the Registrant’s misconduct. However, the panel considered that there were other contributory factors. The previous panel considered that there was and continued to be a lack of maturity in the Registrant’s attitude. The previous panel reached its conclusions about the Registrant’s attitude from the contents of his answers. The panel indicated that the Registrant did not appear to have the understanding the panel would expect of the requirements of basic courtesy and respect for colleagues and members of the public.
16.The previous panel also considered the wider public interest considerations and determined that members of the public would not expect to see a Radiographer behaving as the Registrant did, even if health reasons were a contributory factor. The panel therefore determined that the Registrant’s fitness to practise was impaired on the basis of the personal and public components.
17.In terms of sanction, the panel decided that the aggravating features included:
I. the Registrant’s conviction in March 2015, after the events concerned in the Allegation, which led to the imposition of a Caution Order;
II. the Registrant’s misconduct involved the risk of harm to patients and colleagues;
III. the Registrant’s misconduct cannot be described as an isolated incident;
IV. the risk of repetition; and
V. the Registrant’s limited insight and limited remorse.
18.The previous panel decided that the mitigating features included:
I. the admissions made by the Registrant; and
II. matters relating to the Registrant’s health.
19. The previous panel decided that the appropriate and proportionate sanction was a Suspension Order for 12 months.
20.The previous panel stated that a Reviewing Panel may be assisted by the following:
I. up to date medical evidence;
II. a written reflection piece focussing on the decision of the Panel and the impact of the Registrant’s actions on others;
III. evidence of how the Registrant is managing stressful or confrontational situations, this might include evidence of relevant training courses, the Registrant’s reflection on any training courses, descriptions of any coping strategies, and examples of situations in which he has applied his learning and/or coping strategies;
IV. evidence that the Registrant has kept his skills and knowledge up to date such as any continuing professional development courses undertaken; and references or testimonials which may be from employment, voluntary work and/or the Registrant’s private life.
21.Ms Wills submitted, on behalf of the HCPC, that the Registrant’s fitness to practise remained impaired and that the minimum sanction which was sufficient in the circumstances was a continuation of the Suspension Order.
22.Ms Wills further submitted that whilst she acknowledged that the Registrant had provided two documents, which demonstrated that the Registrant had completed courses in his current workplace, the Panel were still without independent evidence regarding the Registrant’s up-to-date medical situation and health and therefore there was a high risk of repetition of his conduct.
23.The Registrant gave evidence, on oath, before the Panel. He indicated that he felt “embarrassed” and “remorseful” for his actions and was keen to stress that he felt that the situation had arisen because he was not on the appropriate medication at the time. The Registrant described his current behaviour as being like “night and day” compared to that of his previous conduct.
24.The Registrant also provided the Panel with two documents, which outlined the courses that he had undertaken since the previous Panel’s determination. He explained that the courses had been undertaken with his current employer in his own time, after working hours and consisted of face-to-face learning of approximately three to four hours with each course.
25.The Registrant made submissions to the Panel that the public could trust that he would not repeat his conduct and that his medication, which had recently been increased, kept him “level”. The Registrant indicated that he was managing his health well and following on from the substantive hearing that the “penny had dropped” in terms of his conduct and how it might have affected people.
26.The Registrant also described to the Panel how he had begun practising mindfulness and found that daily practise of writing and/or drawing kept him calm.
27.The Registrant indicated that when confronted with challenging situations at work, when managers or colleagues bothered him, he no longer got annoyed. Indicating that he deployed the learning from his courses and remained calm in the face of challenging situations. He also gave examples of when, in the past, he would have responded with road rage but now did not and also an example of another customer at an IKEA store been aggressive towards him but that he had not responded aggressively as he would have in the past.
28.The Panel accepted the advice of the Legal Assessor.
29.The Panel considered that the Registrant demonstrated good evidence of developing insight when he explained that the “penny had dropped” in terms of reflecting on his previous conduct after the Substantive Hearing. The Panel recognised the Registrant’s genuineness in his evidence and found that he has made good progress regarding his insight and demeanour since the Substantive Hearing.
30.The Panel also recognised that the Registrant had undertaken some courses and whilst not all of these were relevant, or specific to him, they went some way to his remediation. The Panel were satisfied that the Registrant had taken the time to complete the courses, outside of working hours.
31.However, notwithstanding these steps, the Panel found that there was a lack of independent evidence before them regarding the Registrant’s current health. In Particular, the Panel noted that the previous Panel had indicated that the Registrant should provide up to date evidence.
32.The Panel also noted that there was a lack of information or evidence regarding the Registrant’s ability to manage confrontational situations and whilst he had provided some examples of how he was attempting to apply his theoretical knowledge to these situations, there was a lack of evidence to independently verify this. A reference or testimonials from his current employer would also have been of assistance to the Panel, but, as the Registrant explained he had not told his employer of these proceedings and had felt embarrassed to ask for a reference.
33.The Panel considered that they could not yet be confident that the Registrant has the required insight and that he has remediated his failings and therefore could not be confident that the behaviour would not be repeated. The Panel is not satisfied that in all the circumstances the Registrant did not still pose a real and on-going risk to the public and that public confidence in the profession would not be undermined should the Registrant be permitted to return to unrestricted practice.
34.Accordingly, the Panel concluded that the Registrant’s fitness to practise remained impaired.
35.The Panel considered the option of a Caution Order however, decided that it would not provide adequate protection for the public. It would not address the on going risk to the public identified by the Final Hearing Panel.
36.The Panel next considered the option of replacing the existing Suspension Order with a Conditions of Practice Order. However, the Panel decided that conditions would not be appropriate or sufficient because of the Registrant’s failure to provide independent evidence of his health, nor independent evidence of how he now responds to conflict and confrontation. Further, the Panel noted the Registrant’s own evidence when he indicated that he felt that his skills and knowledge were now “not up to speed”.
37.The Panel next considered extending the current Suspension Order versus imposing a Striking-off Order. The Panel noted the Registrant’s mitigating factors, as identified by the Substantive Hearing panel and also noted the Registrant’s progress.
38.The Panel considered a Striking-off Order, but decided that this would be disproportionate, taking into account all the reasons and circumstances outlined by the Substantive Hearing panel. The Panel decided that in the circumstances the Registrant should be afforded an opportunity to satisfy a future panel that his fitness to practise is no longer impaired.
39.The Panel therefore decided that the appropriate and proportionate Order is to extend the current Suspension Order. The Panel decided that this should be for the maximum period of twelve months to allow the Registrant time to reflect further and to demonstrate remediation of his misconduct. The Registrant may apply for an early review of the Order if his circumstances allow him to demonstrate that remediation before the expiry of the Suspension Order.
40.The Panel also considered that a review panel may be assisted by the following:
I. up to date medical evidence;
II. a written reflection piece that he can submit to the panel focussing on the decision of the Panel and the impact of the Registrant’s actions on others;
III. evidence of how the Registrant is managing stressful or confrontational situations, this might include evidence of the Registrant’s reflection on any training courses, descriptions of any coping strategies, and specific examples of situations in which he has applied his learning and/or coping strategies;
IV. evidence that the Registrant has kept his skills and knowledge up to date such as any continuing professional development courses undertaken; and
V. evidence concerning any voluntary work undertaken within a hospital or healthcare environment; and
VI. references or testimonials which may be from employment, voluntary work and/or the Registrant’s private life, particularly testimonials reporting how he has coped with conflict.
ORDER: The Registrar is directed to suspend the Registration of Mr Jason Mariah for a further 12 months from the date of the expiry of the current Order.
This order will be reviewed by the Committee no later than 07 November 2019 or earlier if new evidence which is relevant to the Order becomes available after it was made.