Mr Philip Ma

Preliminary matters
Hearing in Private
1. Ms Yildiz on behalf of the HCPC submitted that matters that related to the personal circumstances of the Registrant should be received in private. This application was supported by the Registrant. Having taken the advice of the Legal Assessor, the Panel acceded to this application but directed that save for such matters, the hearing should proceed in public.

Background
2. The Registrant qualified as a Counselling Psychologist in 1997. He commenced employment with the North East London NHS Foundation Trust (“the Trust”) on 3 March 2003. On 8 February 2010, he was transferred to work at the Intake and Brief Intervention Team.

3. The Panel was informed that Patient B was referred to the Trust on 5 January 2010. She was assessed by a psychiatric nurse who later discussed the case with the Registrant, and an appointment was made for Patient B to see the Registrant on 10 March 2010.

4. The Registrant saw Patient B on four occasions: 10 March 2010; 19 March 2010; 1 April 2010; and 9 April 2010.
5. On 21 April 2010, the Registrant was sent a letter inviting him to a multidisciplinary review meeting which was due to take place on 26 April 2010 regarding Patient B. The Registrant was unable to attend, and so he was required to write a report in advance of the meeting to update the team on Patient B’s progress.

6. It was accepted by the HCPC that the Registrant’s intention was to summarise the history that he had obtained from Patient B, together with the social work records that he had accessed, and to summarise the work he had done with Patient B. However, it was alleged, and accepted, that he gave the report a heading that was misleading, namely: “psychology report”. He informed the substantive panel that this was a mistake on his part. He admitted that he had been told previously not to use this heading “because of the connotation of what it means”, but that he had continued to use it; he said that he had not realised that it was inappropriate. He accepted that the heading raised very different expectations. He also accepted that the problem was further compounded by the content of the first sentence of the final paragraph of his report, which stated: “From her presentation it was my impression that Patient B does not pose a risk in the care of her children”.

7. In relation to sub-Particular 1(a), the substantive panel found that an integral part of preparing a psychological report in relation to Patient B was the carrying out of a formal risk assessment. The Registrant had admitted that he did not undertake such an assessment and the Panel found the sub-Particular proved.

8. In relation to sub-Particular 1(b), the substantive panel found that the Registrant did not analyse risk-related matters which had come to light during Patient B’s appointments with the Registrant. The substantive panel accepted expert evidence that the Registrant had made “no attempt to explore highly pertinent and risk laden facts mentioned by the client”.

9. In relation to sub-Particular 1(c), the substantive panel found that the Registrant’s report was “poorly constructed and lacked structure”. The Registrant admitted that the heading was misleading, that he had not made clear what other documents had been relied on, and that he had reached conclusions that he was not qualified to give, and that were not justified in the circumstances. The substantive panel concluded that the report was “not objectively well constructed. It did not set out what the purpose of the document was and how it was intended to be used. It reached a conclusion that the Registrant was not entitled to find, on the basis of the work he had done, without carrying out an assessment, or having the appropriate experience and knowledge to do so. It was not clear how its conclusions had been reached or the reliance that was intended to be placed upon it”.

10. The substantive panel concluded that the facts found proved amounted to misconduct in that “this was an instance of acting well below the necessary standards that applied to a Practitioner Psychologist. He gave a misleading impression based on his misplaced desire to help Patient B, without any proper regard to the consequences for Patient B or her children. Ultimately such consequences would not have been in the best interests of anyone”.

11.  When appearing before the substantive panel, the Registrant accepted that his behaviour had been wrong, and that he had not thought about the impact that his actions would have on the general public. He accepted that “other people would have perceived that I had done a full risk assessment on the client”, and that he was conscious now of what could have happened if someone had been led to believe that he had done a risk assessment. He said that this had not been apparent to him at the time and that he had been acting out of a desire to support Patient B, albeit that he now accepted that that desire could have backfired because “she might use it against others and cause conflict with others in the team” and he agreed that it could also have the potential to cause harm to children and that his report would have allowed Patient B to “carry on doing what she was doing”.

12. The substantive panel concluded that the Registrant had provided it with evidence of some insight into his behaviour. He had provided testimonials which dealt with positive attributes of his character. However, the substantive panel concluded that these did not address the core issues in the case. The substantive panel noted that the Registrant showed some remorse but was concerned that he was focusing on the failings of his colleagues rather than on his own failings.

13. The substantive panel took into account a combination of events that were occurring in the Registrant’s professional and personal life at the time. The substantive panel concluded that the Registrant’s actions had been overly sympathetic to his patient and that he had failed to analyse the potential risk to Patient B’s children. The Registrant had provided a document that was misleading and contained opinions that were not justified, were not appropriate and were outside his professional expertise.

14. The substantive panel concluded that the Registrant’s behaviour was remediable but was unable to say that it had been fully remedied in light of the limited ways in which he had sought to remedy his behaviour. The substantive panel noted that the Registrant had recognised that his report writing was below par but had not addressed this deficiency, nor sought to increase his skill level. He had recognised that he had become overly involved in focusing on Patient B’s issues to the exclusion of other relevant criteria, but had not attended courses on maintaining professional boundaries and self-care. He had not demonstrated learning about assessment and formulation, the writing up of assessments, or how his learning had been put into practice. He appeared to have reflected on how he might have dealt differently with Patient B but it was not apparent that he had learnt how to apply his learning to other situations.

15. The substantive panel concluded that the Registrant’s fitness to practice was impaired on the basis that he posed a risk to the public, and also on wider public interest grounds, in that there was a need to declare and uphold proper standards and to maintain confidence in the regulatory process.

16. In determining sanction, the substantive panel emphasised the seriousness of the case, and the Registrant’s failure to evidence full insight or to demonstrate appropriate remedial action. The substantive panel concluded that a Conditions of Practice Order would be sufficient to address the risks identified and to protect the wider public interest.

17. The substantive panel imposed the following Conditions:

“The Registrar is directed to annotate the Register to show that for 18 months, from the date that this Order comes into effect (“the Operative Date”), you, Mr Philip Ma, must comply with the following conditions of practice:
1. You must inform the following parties that your registration is subject to these conditions:
a. any organisation or person employing or contracting with you to undertake professional work which requires HCPC registration.
b. any agency you are registered with or apply to be registered with (at the time of application) when seeking to undertake professional work which requires HCPC registration.
c. any prospective employer (at the time of your application) when seeking to undertake professional work which requires HCPC registration.

2. When undertaking professional work, which requires HCPC registration, you must place yourself and remain under the supervision of a suitable and appropriately qualified supervisor who is registered with the HCPC and supply details of your supervisor to the HCPC within 21 days of commencing any such professional work. You must attend upon that supervisor as required and follow their advice and recommendations.

3. You must work with that supervisor to formulate a Personal and Professional Development Plan within 2 months of commencing supervision. That plan should be designed to address the deficiencies in the following areas of your practice:
- report writing, to the extent they form part of your practice and acting within your scope of practice
- maintaining professional boundaries
- reflective practice and self-care.

4. You must forward a copy of your Personal and Professional Development Plan to the HCPC within one month of it having been formulated.

5. You must meet with your supervisor on at least a monthly basis to reflect on and consider your progress towards achieving the aims set out in your Personal and Professional Development Plan.

6. You must allow your supervisor to provide information to the HCPC concerning your progress towards achieving the aims set out in your Personal and Professional Development Plan.

7. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.”

18. The substantive panel decided to impose the Order for 18 months.

Review Hearing on 25 May 2018
19. At the review hearing on 25 May 2018 the Registrant was not present but was represented by Mr Lazarus of Counsel.
 
20. Having considered all the material before it, the first review panel concluded that the Registrant’s fitness to practise remained impaired. It decided to vary the Conditions of Practice Order and it extended that order for a further period of 12 months. It expressed its reasons in the following terms:

“At that review hearing both parties accepted that the Registrant’s fitness to practise was still impaired. The panel after careful consideration came to its own conclusion on this matter and found that the information supplied did not demonstrate full remediation of the Registrant’s practice and the matters which had been found proven by the substantive panel.

The reviewing panel determined that there was a continuing state of impairment of the Registrant’s fitness to practise.”

21. The reviewing panel did not accept Mr Lazarus’s argument that Condition 1 be removed. If, as stated, it was the Registrant’s intention to declare the existence of the Conditions of Practice Order then it made little difference and it was, in the reviewing panel’s view, not disproportionate for this condition to remain in its current form. The Panel did however take the opportunity of amending other conditions and the amended conditions are set out above.

22.  The varied Conditions of Practice Order was in the following terms:

“1. You must inform the following parties that your registration is subject to these conditions:
a. any organisation or person employing or contracting with you to undertake professional work which requires HCPC registration.
b. any agency you are registered with or apply to be registered with (at the time of application) when seeking to undertake professional work which requires HCPC registration.
c. any prospective employer (at the time of your application) when seeking to undertake professional work which requires HCPC registration.

2. When undertaking professional work, which requires HCPC registration, you must place yourself and remain under the supervision of a suitable and appropriately qualified supervisor who is registered with the HCPC and supply details of your supervisor to the HCPC within 21 days of commencing any such professional work. You must attend upon that supervisor as required and follow their advice and recommendations.

3. You must work with that supervisor to formulate a Personal and Professional Development Plan within 2 months of commencing supervision. That plan should be designed to address the deficiencies in the following areas of your practice:
- report writing, to the extent they form part of your practice and acting within your scope of practice
- maintaining professional boundaries
- reflective practice and self-care.

4. You must forward a copy of your Personal and Professional Development Plan to the HCPC within one month of it having been formulated.

5. You must meet with your supervisor on at least a six weekly basis to reflect on and consider your progress towards achieving the aims set out in your Personal and Professional Development Plan.

6. You must allow your supervisor to provide information to the HCPC concerning your progress towards achieving the aims set out in your Personal and Professional Development Plan.

7. you must write and submit a reflective piece within one month of the next review hearing that demonstrates your understanding and acceptance that you did not adequately manage your professional standards and explaining how you have addressed this with regard to your future practice.
8. Prior to your next hearing you must provide up to date testimonials in respect of any work you have undertaken whether paid or unpaid.

9. You must promptly inform the HCPC of any disciplinary proceedings taken against you by your employer.”

Review Hearing on 30 May 2019
23.  At the review hearing on 30 May 2019 the Registrant was present and was represented by Mr Lazarus of Counsel and Mr Ekstein.

24.  The panel determined that the Registrant’s fitness to practise remained impaired. It expressed its reasons in the following terms:

 “The Panel noted that both parties accepted that there had been no remediation and that the Registrant’s fitness to practise was therefore impaired. It was however a matter to be considered and determined by this Panel. In this regard the Panel noted that there had been nothing further furnished to the Panel today to demonstrate increased insight or evidence of appropriate training. In the absence of this information the Panel has concluded that on the personal component of its decision the Registrant remains impaired.

In relation to the public interest element of its decision, the Panel noted that conditions had now been in place for two and a half years and there had been no evidence of the Registrant undertaking steps to address the personal failings that had led to the finding of misconduct. The public would rightly be concerned if in the absence of any obvious willingness to engage or remediate if a registrant were allowed to return to unrestricted practice. The Panel has therefore concluded that there is impairment on this component too.”

25.  The Panel determined that a period of suspension for 6 months was appropriate and proportionate. It expressed its reasons in the following terms:

“The Panel considers the information placed before it by Mr Lazarus provides a mixed message. This process of review is a legal process which has to be adhered to. The Panel has taken seriously the fact that there has been noncompliance with the conditions of practice and no tangible evidence of a determination or willingness to comply with a further set of conditions. The Panel was of the view that the Registrant has had 30 months of conditions. He has had ample opportunity to write a reflective piece, as well as providing evidence of addressing the issues of report writing and professional boundaries. This could have been done despite the Registrant’s difficulties in obtaining employment.

The Panel is encouraged that the Registrant wants to do the educational courses he has described, however the Panel notes that there is uncertainty about his ability to successfully enrol upon these courses. This willingness to partake in education going forward does not however resolve the fact that to date the Registrant has done little to show his willingness to engage in this regulatory process or to remediate his failings. The Panel has therefore little confidence that a further set of conditions will produce the much needed demonstration of insight and compliance. The Panel has therefore concluded that condition of practice will serve little purpose.

The Panel has therefore concluded that a short period of suspension is appropriate and proportionate in this instance at this time. It will provide the Registrant additional time to reflect on his previous behaviour and take the opportunity to resolve the issues previously identified.

The imposition of a period of suspension sends a clear message to the Registrant that he must take this review process seriously, and to the profession and the public that the process should be respected and adhered to. This measure will provide public protection and it is in the wider public interest, as it demonstrates an upholding of standards and the maintenance of the reputation of the profession and the regulatory process.

The Panel considers that the period of suspension is to be 6 months, sufficiently long to provide the Registrant with the ability to demonstrate his commitment to remediation of his failings and future training. The Registrant will be able during that time to ask for an early review if he is able to furnish the requisite evidence before the expiration of this Order.”

26. The panel gave guidance as to what might assist any reviewing panel. It stated as follows:

“Whilst this Panel cannot prescribe information which a future reviewing panel may wish to see, this Panel considers that the Registrant provides information which would demonstrate that he has addressed the matters identified by the substantive panel and the two reviewing panels, i.e that which has previously been requested by the conditions orders.”

27. The substantive panel gave the following guidance as to what might assist a reviewing panel:

“A reviewing panel may be assisted by evidence of how you have developed your:
• reflective practice for example through a reflective diary/log or a
• reflective piece covering issues that have challenged you.
• self-care and
• resilience skills.

In addition how any improved report writing skills and techniques have been put into practise. This evidence need not be solely related to paid employment and some elements of the conditions imposed may be achievable by taking advantage of your current opportunities.”

The Decision of this Panel
28. Ms Yildiz summarised the relevant facts and the conclusions of the previous panels. In brief summary, both in her opening and in her closing submissions, she submitted that the Panel should find that the Registrant’s fitness to practise remains impaired. She said that the Registrant had not successfully addressed any of the failings established at the substantive hearing. She also submitted that there was no significant evidence of insight or remorse. She submitted that in all the circumstances and taking account of the Registrant’s evidence to the Panel, the Panel should make a Striking Off Order. 

29. The Registrant gave evidence and made submissions. In addition the Registrant produced a number of documents.

30. The documents produced by the Registrant include the following;
• A document written by the Registrant entitled “A subjective Journey”.
• Certificates of attendance from training provided by the British Psychological Society dated 16 May 2018, 20 June 2018, 11 July 2018 and 11 January 2019.
• A volunteer Application Form dated 15 December 2018 and a related email dated 23 July 2019.
• Various emails and other documents relating to 2010.
• A reference dated 30 November 2019 from Dilemma Consultancy.
• A Supervision Report dated 27 November 2019 from a Practitioner Psychologist.
• Two Statutory Sick Pay statements dated 21 December 2018 and 10 October 2019 stating that the Registrant was not fit to work.

31.  In brief summary the Registrant stated as follows;
• With the exception of one “low cost client” to whom he had spoken via Skype on an occasional and ad hoc basis, he has been unable to find any paid employment since August 2011.
• At the present time he is unable to find any voluntary work and this has been the case for a long time.
• His health conditions presently preclude him from working.
• He accepts that as a result of his present state of health, his fitness to practise is currently impaired.
• He hopes to be able to resume his career. He accepts that he would require retraining and he hopes to find appropriate courses.
• He therefore asked the Panel to consider making a Conditions of Practice Order.

32. The Panel heard and accepted the advice of the Legal Assessor.

33. The Panel is aware that it has all the powers that are set out in Article 30 [1] of the Health and Professions Order 2001 [The Order] and which are summarised in the letter dated 30 October 2019 sent to the Registrant, giving notice of this hearing.

34. The Panel is aware that the process under Article 30 [1] of the Order is one of review and not one of appeal and that its function is to determine whether the Registrant’s fitness to practise is still impaired and if so whether the Suspension Order under review remains the appropriate and proportionate means of public protection or should be varied or replaced by some other order.

Decision of this Panel on Impairment
35. The Panel has concluded that the Registrant’s fitness to practise remains impaired. It has taken account of the submissions that it has received from Ms Yildiz. It has paid careful attention to the submissions and evidence of the Registrant and to the written material that he has produced. The Panel has concluded that there is a serious risk that the Registrant would, if allowed to practise unrestricted, act in a manner that would put service users at risk of unwarranted harm, constitute a breach of the fundamental tenets of his profession and damage the reputation of the profession. The Panel also concluded that public confidence in the profession and in the HCPC as its regulator would be undermined if the Panel was to determine that the Registrant’s fitness to practise was not impaired. The Panel further concluded that the need to preserve proper standards within the profession required such a finding. In coming to all of these conclusions the Panel kept in mind that the Registrant himself acknowledged that his fitness to practise is presently impaired. The Panel noted that the Registrant had not shown any appropriate remorse or insight. Moreover there was no evidence that the Registrant had addressed or remediated the deficiencies found by the previous panels or complied with the suggestions made by previous panels as to what would assist a reviewing panel. The Panel concluded that in substance there had been no change in the underlying facts from those that had existed at the three previous hearings.  

Decision on Sanction
36. In considering the appropriate sanction the Panel had regard to the Sanctions Policy published in March 2019 and the advice of the Legal Assessor.

37. The Panel has applied the principle of proportionality. The Panel is aware that the purpose of sanction is not to be punitive and that it must consider the risk the Registrant may pose to services users in the future and determine what degree of public protection is required. The Panel has considered the sanctions available in ascending order of severity. The Panel considered that to take no action or to impose a Caution Order would not be sufficient or appropriate as neither outcome, would afford the necessary public protection or satisfy the public interest.

38. The Panel next considered whether a Conditions of Practice Order would adequately address the concerns identified. The Panel concluded that a Conditions of Practice Order would not be the appropriate Order to make. The Panel noted that the Registrant had been the subject of two previous Conditions of Practice Orders. It noted that the Registrant had not shown insight or remorse. It concluded that the failings that he had exhibited were persistent and general and were likely to be repeated. The Panel did not think that the Registrant would comply with any conditions that it might impose. It concluded that albeit in restricted practice, the Registrant would pose a risk of harm to service users. Moreover given the fact that the Registrant had not been in any substantive paid employment since August 2011, it did not think that any appropriate conditions could be formulated.  

39. The Panel next considered making a further Suspension Order. It concluded that such an Order would not in the present circumstances be appropriate. The Panel kept in mind the Registrant’s lack of insight and remorse. Moreover the Panel considered that the Registrant was likely to repeat the failings identified by the substantive panel and the Panel did not think that the Registrant would be able to resolve or remedy his failings. The Panel concluded that no proper purpose would now be served by making a Suspension Order. It has concluded that a Striking Off Order with immediate effect was the only appropriate and proportionate sanction and was required in order to protect the public and to address the public interest that it has identified. 

That the Registrar is directed to strike the name of Mr Philip Ma from the Register with immediate effect.

Right of Appeal
You may appeal to the High Court in England and Wales against the Panel’s decision and the order it has made against you.

Under Articles 30(10) and 38 of the Health Order 2001, any appeal must be made to the court not more than 28 days after the date when this notice is served on you.

European Alert Mechanism
In accordance with Regulation 67 of the European Union (Recognition of Professional Qualifications) Regulations 2015, the HCPC will inform the competent authorities in all other EEA States that your right to practise has been prohibited.

You may appeal to the County Court against the HCPC’s decision to do so.  Any appeal must be made within 28 days of the date when this notice is served on you. This right of appeal is separate from your right to appeal against the decision and order of the Panel.

History of Hearings for Mr Philip Ma