Mrs Deena Best

Profession: Paramedic

Registration Number: PA34571

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 17/04/2020 End: 17:00 17/04/2020

Location: Remote hearing

Panel: Conduct and Competence Committee
Outcome: Struck off

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Allegation

The following allegation was considered by a Panel of the Conduct and Competence Committee at the substantive hearing.

Whilst registered as a Paramedic and working for London Ambulance Service:

1. On or around 29 May 2017, you made the following comments during conversation with Person A and / or about Person A:

a) “I don’t differentiate between people, I don’t like Muslims” or words to that effect.

b) “Mosques are bloody popping up everywhere” or words to that effect

2. On or around 29 May 2017 you made the following comments during conversation with colleagues:

a) “I don’t want to talk to [Person A] anymore as he’s a Muslim” or words to that effect.

b) [not proved]

c) Person A “he looks like a bomber because of the way he dresses” or words to that effect.

3. On unknown date(s) you:

a) Said to Person B “you should be careful running with your Paramedic bag as you could be mistaken for a bomber” or words to that effect.

b) Called Person B “Osama” or words to that effect

c) Told Person B to “shave his beard” or words to that effect

4. Your comments at paragraphs 1-3 were discriminatory and/or inappropriate.

5. The matters described in paragraphs 1 - 4 amount to misconduct

6. By reason of that misconduct, your fitness to practise is impaired.

The Panel found the facts proved (save for Particular 2(b)), that these amounted to misconduct, and that the Registrant’s fitness to practise was impaired. The Panel imposed a Suspension Order for a period of 9 months.

Finding

Preliminary Matters

1. This is a mandatory review under Article 30(1) of the Health and Social Work Professions Order 2001. The Panel has read the 56-page HCPC bundle.

Service

2. The Registrant was notified by letter and email dated 18 February 2020 that this Substantive Review was listed for hearing on 20 March 2020. The review was then re-listed for hearing remotely ‘on the papers’ today. Due to government recommendations on containing the current Covid-19 pandemic, the HCPC has suspended all public hearings.

3. The Registrant was notified on 19 March 2020 that the original review hearing had been cancelled. The Registrant was sent a new Notice of Hearing on 24 March. This Notice was sent to her registered email address and there has not been an undelivered reply. The Registrant has not made an application to adjourn the hearing and she corresponded with the HCPC via the same email address on 10 March 2020.

4. The Panel is satisfied that there has been good service of the Notice of Hearing in accordance with Rule 6(1) of the Conduct and Competence Committee Procedure Rules 2003 (the “Rules”). In the circumstances the Panel finds that the Registrant has been properly served with notice of the re-listed hearing date.

Proceeding in the Absence of the Registrant

5. The HCPC has applied to have this matter heard in the Registrant’s absence, under Rule 11 of the Rules.

6. The Panel considered the HCPTS Practice Note on “Proceeding in the Absence of the Registrant” and the advice of the Legal Assessor.

7. The Panel must consider all the circumstances of the case when considering a decision to proceed in a registrant’s absence, balancing fairness to the Registrant with fairness to the HCPC and the interests of the public.

8. The Registrant did not engage in the HCPC investigation, nor attend the substantive hearing, although she did make representations to the HCPC Investigating Committee (ICP).

9. The Panel has found there has been good service of the Notice of Hearing in accordance with Rule 6(1) of the Rules. There has been no request for an adjournment and the Panel finds that the Registrant is aware of the hearing and has voluntarily absented herself from taking part in the hearing today, and has waived her right to provide written evidence or submissions to the Panel. The HCPC has encouraged her to engage with this review hearing but she has chosen not to do so. Furthermore, as this is a mandatory review of the current Order, it is in both the Registrant’s interests and in the public interest for a review of the Order to take place before it expires.

Background

10. The Registrant is an HCPC-registered Paramedic. She joined the London Ambulance Service (LAS) NHS Trust on 7 January 2008, and was based at Bromley station. In May and June 2017 the Registrant made discriminatory comments about and to a number of colleagues based on race and religion. These matters were referred to the HCPC, and a substantive hearing took place between 01 and 04 July 2019 before a panel of the Conduct and Competence Committee. The Registrant did not attend that hearing. She had made representations to the ICP denying all the allegations. These representations were considered by the substantive hearing panel.

Substantive hearing on 01 to 04 July 2019

11. The allegations, except Particular 2(b), were found proved at the substantive hearing. The substantive hearing panel considered that those comments were both discriminatory and inappropriate. The nature of each comment was that of an inherent derogatory stereotype based on race and/or religion. They portrayed a stereotypical, negative view that all Muslims are extremists or terrorists. They also suggested a dislike of an individual based on their race or religion. The substantive hearing panel did not consider that the Registrant’s assertion that such comments were ‘banter’ amongst colleagues made them any less discriminatory or inappropriate. The substantive hearing panel noted that Paramedics, in a frontline emergency service, encounter all manner of individuals, and are expected to be professional and considerate to everyone, regardless of race, religion, or any other personal characteristic. The substantive hearing panel determined that the matters found proved amounted to misconduct and that the Registrant’s fitness to practise was impaired.

12. The substantive hearing panel had limited information from the Registrant, and no recent material or evidence of reflection by her to allow it to assess whether the comments expressed by her were indicative of a prejudicial and discriminatory attitude held by her, or were examples of ill-judged and inappropriate comments without appreciation of the potential impact on the recipients.

13. The substantive hearing panel had no evidence to demonstrate that the Registrant recognised that such comments were discriminatory and not appropriate topics for ‘banter’, nor that she had thought about how expressing such discriminatory views may impact on the confidence of the public in the profession. The substantive hearing panel concluded that the Registrant had not therefore remediated her behaviour and they could not rule out the risk of repetition. The substantive hearing panel imposed a Suspension Order for a period of 9 months and recommended that the Registrant provide the following to a reviewing panel:

a. A reflective piece regarding her behaviour, including the potential impact of it on the colleagues to whom it was directed, and how it may impact on public confidence in the profession;

b. Testimonials; and

c. Evidence of awareness in equality and diversity matters (e.g. relevant reading, participation in relevant training, or completion of relevant courses).

HCPC Submissions

14. The Registrant supplied further information to the HCPC on 01 March 2020, repeating previous information concerning the difficulties the Suspension Order has caused and other personal problems. She is working at a Band 3 level (but it is unclear in what role), and reiterated that she denies the HCPC allegations. She feels let down by both the LAS and the HCPC, and stated: “If my registration is taken from me I will obviously be devastated as I am always hopeful that one day I can return to do the job I love. If there is anything I can do to keep my registration please let me know”.

15. The HCPC replied on 04 March 2020, repeating advice as to information she could provide to the reviewing Panel. The Registrant replied on 07 March 2020 that she would like to be removed from the HCPC Register.

16. She was then advised that a Voluntary Removal Agreement was not considered to be appropriate in this case.

17. Ms Simpson, on behalf of the HCPC, submits that if the hearing today had been an oral hearing held before the Covid-19 pandemic, the HCPC would have requested a Striking Off Order be imposed. This is due to: the lack of meaningful engagement by the Registrant in the investigatory process; the lack of any evidence of insight or remedial action; and the real risk of repetition of the misconduct. She submitted that a finding that the Registrant is no longer impaired would be seriously detrimental to the public interest, professional standards, and the reputation of the profession.

18. The Registrant has not had the opportunity to attend the hearing in person and to make oral representations today, although she indicated she would not have attended in any event. The HCPC therefore submits it would be fair and proportionate for the Panel to impose a further period of suspension for 12 months.

Advice of the Legal Assessor

19. The Legal Assessor advised the Panel that the purpose of the review today was not to conduct a rehearing or to go behind the previous panel’s findings. He advised that in carrying out this review, the Panel must have regard to the HCPTS Practice Notes on “Article 30 Reviews” and on “Finding that Fitness to Practice is ‘Impaired’”. If the Panel finds that the Registrant’s fitness to practise remains impaired, the HCPC Sanctions Policy should be considered in relation to the available sanctions, starting with the least restrictive.

20. The Panel’s role today is to review the matter on the basis of the evidence available and decide whether the Registrant’s fitness to practise remains impaired, and, if so, to decide on the appropriate sanction, if any.

21. In determining whether fitness to practise is impaired, panels must take account of a range of issues which, in essence, comprise two components: the ‘personal’ component, i.e. the current competence, behaviour etc. of the individual registrant; and the ‘public’ component, i.e. the need to protect service users, declare and uphold proper standards of behaviour, and to maintain public confidence in the profession.

22. The personal component includes the issue of insight into the misconduct, the risk of repetition, whether the misconduct is remediable, and whether it has been remedied. In respect of the public component, the Panel has to consider public policy issues, which include the need to maintain confidence in the profession and to declare and uphold proper standards of conduct and behaviour.

23. Under Article 30(1) of the Health Professions Order 2001, the Panel may—

a. Extend the Suspension Order;

b. Make any order it could have made at the time of the original Order being imposed;

c. Replace the Suspension with a Conditions of Practice Order, with which the Registrant must comply if she resumes practice.

24. As this is a case based on a finding of misconduct, all sanctions are available to the Panel, up to and including a Striking Off Order.

Decision

25. The Panel accepted the advice of the Legal Assessor and had regard to the HCPTS Practice Notes on “Article 30 Reviews” and “Finding that Fitness to Practice is ‘Impaired’”, and the Sanctions Policy.

26. The Panel finds the Registrant’s fitness to practise is currently impaired because:

27. The Panel finds the Registrant has not developed insight into the matters giving rise to her suspension and there is a high risk of repetition of her misconduct. Her fitness to practice is still impaired on personal and public policy grounds. There has been no significant or meaningful engagement by the Registrant with the HCPC since the substantive hearing.

28. The Panel went on to consider what the appropriate and proportionate sanction should be, if any. It considered the available sanctions in order of severity, starting with the least restrictive.

29. In the light of the lack of engagement, the Panel determined that taking no further action, mediation, or imposing a Caution Order would not be sufficient to protect the public or be in the public interest.

30. The Panel considered whether to impose a Conditions of Practice Order. The Panel noted that the previous panel had determined that conditions of practice were not appropriate. This Panel noted that a Conditions of Practice Order remained inappropriate.

31. The Panel then went on to consider imposing a further period of suspension and the HCPC submission that a further suspension was appropriate because this review has been conducted remotely on the papers. However, the Panel is satisfied that this is a properly constituted hearing. The Registrant has been given the opportunity to engage with the Panel in writing, but has chosen not to do so. It is therefore fair and proportionate to deal with this review in the same way as the Panel would have done if this were a normal hearing.

32. The HCPC has explained in detail to the Registrant on several occasions how to meet the suggestions of the substantive hearing panel to assist this reviewing Panel. The Registrant has chosen not to engage with those suggestions and her most recent communication states that she wishes to be removed from the HCPC Register.

33. The Sanctions Policy states that discrimination in relation to a protected characteristic (which includes religion) is a serious matter which may give rise to a Striking Off Order. The proved breach of the “HCPC Standards of Conduct, Performance, and Ethics” Standard 1.5 (a registrant must not discriminate against service users, carers, or colleagues by allowing their personal views to affect their professional relationships) is also sufficiently serious to justify removal from the HCPC Register.

34. The Panel considered that there would be no useful purpose served by a further Suspension Order in this case, because the Registrant is unlikely to engage with any future review hearing.

35. Accordingly, a Striking Off Order is now the only appropriate and proportionate sanction.

Order

The Registrar is directed to strike the name of Mrs Deena Best from the Register from the date of expiry of the current Order.

Notes

The Order imposed today will apply from 1 May 2020.

Hearing History

History of Hearings for Mrs Deena Best

Date Panel Hearing type Outcomes / Status
17/04/2020 Conduct and Competence Committee Review Hearing Struck off
20/03/2020 Conduct and Competence Committee Review Hearing Hearing has not yet been held
01/07/2019 Conduct and Competence Committee Final Hearing Suspended