Mr Ramon Priess

Profession: Occupational therapist

Registration Number: OT70677

Interim Order: Imposed on 31 Oct 2019

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 15/12/2021 End: 17:00 15/12/2021

Location: This hearing is being held remotely via video conference.

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

As a registered Occupational Therapist (OT70677) your fitness to practise is
impaired by reason of conviction. In that:

1. On 11 March 2020 you were convicted at Westminster Magistrates Court of
assaulting Service User A by beating on 3 April 2019 contrary to section 39 of
the Criminal Justice Act 1988.

2. By reason of your conviction your fitness to practice is impaired.

Finding

Preliminary Matters

Service

1.A Notice of Hearing dated 15 November 2021 was sent by email to the Registrant’s registered email address. The notice gave the date, time, and details for attending the (remote) hearing and details of the purpose of the hearing. The Panel was shown an email delivery receipt and a Certificate to confirm the Registrant’s email address.

2. The Panel was satisfied that in those circumstances good service of the Notice of Hearing had taken place for the purposes of the HCPC (Conduct and Competence Committee) (Procedure) Rules 2003 as amended by the HCPC (Coronavirus) (Amendment) Rules Order in Council 2021 (‘the 2003 Rules’).

Proceeding In absence

3. Ms Lankester on behalf of the HCPC invited the Panel to proceed with the hearing in the absence of the Registrant.

4. Ms Lankester relied on the Registrant’s response to the Notice of Hearing to support her application that the hearing be conducted in the absence of the Registrant and she referred to the principles set out in the HCPTS Practice Note “Proceeding in the Absence of the Registrant”, September 2018. The Panel received advice from the Legal Assessor, which it accepted.

5. The Panel was provided with the Registrant’s email dated 25 November 2021 which set out the following: “I will not be attending the hearing nor will I be represented at the hearing. I will however submit statements from my current employer and my supervising therapists.”

6. In exercising its discretion to proceed in the absence of the Registrant, the Panel took into account the following matters: that this was a mandatory review hearing; the Registrant’s period of suspension was due to end on 23 January 2022; the Registrant was aware of the hearing and was given an opportunity to attend; he had deliberately chosen not to do so or to be represented at the hearing; the Registrant had not requested an adjournment, and any adjournment was unlikely to result in the Registrant attending a hearing at a later date. The Panel recognised it had to balance fairness both to the Registrant and the regulator, as well as the wider public interest which all justified the expeditious disposal of the case.

7. In view of those considerations, the Panel decided that it was fair in all the circumstances to proceed in the absence of the Registrant. Therefore, the Panel decided that the hearing be conducted in his absence.

Background

8. The Registrant is a registered Occupational Therapist. At the time to which the allegation relates, the Registrant was a self-employed consultant providing services as an Occupational Therapist for a business known as Maximum Potential, a paediatric Occupational and Speech and Language therapy service specialising in sensory integration.

9. From January 2018, the Registrant had been providing occupational therapy services for Maximum Potential to Service User A, a 4-year-old boy whom he was treating for sensory processing difficulties. Service User A was also described as having difficulties with language, communication, and motor skills, and possible Attention Deficit Hyperactivity Disorder (ADHD).

10. On 3 April 2019, during an occupational therapy session at premises of Maximum Potential in London, the Registrant slapped Service User A on several occasions on the face with an open hand in the presence of Service User A’s mother.

11. On 8 April 2019, the Registrant was suspended from further work by Maximum Potential. The Registrant self-referred to the HCPC on 14 April 2019.

12. The mother of Service User A reported the incident to the Police, who interviewed the Registrant under caution on 3 June 2019 in which he provided a prepared statement as follows:

“I am a trained Occupational Therapist with over 8 years of experience working with vulnerable and young clients between a few months and 24 yrs old. I am specifically qualified and trained to deal with children. In 2018 i obtained a certificate in providing sensory integration therapy from the university of southern California. On 3rd April i did not slap [Service User A] 10 to 20 times on his face. All of the techniques i used during this session were conducted appropriately, in line with recognised standards, in accordance with what i deemed appropriate in light of [Service User A’s] specific needs given his mild neurological impairment.”

13. On 19 September 2019, the Registrant was charged by the Police with assault by beating. On 24 October 2020, the Registrant attended Westminster Magistrates’ Court and pleaded not guilty.

14. A trial took place at Westminster Magistrates’ Court on 11 March 2020 at which the Registrant was convicted of assault by beating under section 39 of the Criminal Justice Act 1988. The case was transferred to Berkshire Magistrate’s Court for sentencing where a sentence of imprisonment of 12 weeks suspended for 12 months was imposed on 19 June 2020.

15. A hearing of the Conduct and Competence Panel took place remotely on 3-4 and 25 June 2021. The Registrant did not attend and nor was he represented. The Panel found that the statutory ground of conviction for a criminal offence had been established. The Panel concluded that the Registrant was not impaired by reference to the personal component of impaired fitness to practise but was impaired on the basis of the public component as set out in their decision paragraphs 20-47.

16. The Panel imposed a suspension of 6 months which is due to lapse on 23 January 2022.

17. The Registrant has been practising as an Occupational Therapist in Germany since at least December 2020.

HCPC Submissions

18. Ms Lankester on behalf of the HCPC submitted that the HCPC was taking a neutral stance in relation to whether the order should lapse on expiry. She submitted to the Panel that the decision in Abrahaem v GMC [2008] EWHC 183 (Admin) states there is a “persuasive burden” on the Registrant to demonstrate at a review hearing that he or she has fully acknowledged the deficiencies which led to the original finding and has addressed that impairment sufficiently “through insight, application, education, supervision or other achievement...”

19. Therefore, the Panel needs to be proportionate and strike a fair balance between interfering with the Registrant’s ability to practise and the overarching objective of public protection.

20. She referred the Panel to paragraphs 20-72 of the original Panel’s Decision. In her submissions she outlined that the Registrant has not provided any representations for the Panel to consider today only testimonials. She made it clear that the previous Panel found that he had shown insight and did not find impairment on the personal component. Therefore the Panel should look at the public component only.

21. All sanction options are open to the Panel including a Striking-Off Order. However, any sanction should not be disproportionate or overly punitive. 

22. Ms Lankester pointed out to the Panel that the Registrant had been working in Berlin but that the HCPC did not submit that this was a breach of the suspension order imposed. The suspension only applied to the UK but she could not confirm whether or not his German Regulator or Employer had been notified of his suspension.

Legal Advice

23. The Legal Assessor advised that the Panel is dealing with a Review under Article 30(1) of the Health Professions Order 2001 and should take into account the HCPTS Practice Note: Review of Article 30 Sanction Orders.

24. Article 30(1) provides that a Conditions of Practice Order or Suspension Order must be reviewed before it expires and that the reviewing Panel may: extend, or further extend the period for which the order has effect; make an order which could have been made when the order being reviewed was made; or replace a Suspension Order with a Conditions of Practice Order.

25. Any order made following an Article 30(1) review only takes effect from the date on which the order under review expires, so the Registrant must continue to comply with the expiring order until then.

26. The review process is not a mechanism for appealing against or ‘going behind’ the original finding that the Registrant’s fitness to practise is impaired. The purpose of review is to consider if the Registrant’s fitness to practise remains impaired; and, if so, whether the existing order or another order needs to be in place to protect the public and to address the public interest. The key issue which needs to be addressed is what, if anything, has changed since the current order was made.

27. The factors to be taken into account include: the steps which the Registrant has taken to address any specific failings or other issues identified in the previous decision; the degree of insight shown and whether this has changed; the steps which the Registrant has taken to maintain or improve his professional knowledge and skills; whether any other fitness to practise issues have arisen; whether the Registrant has complied with the existing Order.

28. The decision reached must be proportionate, striking a fair balance between interfering with the Registrant’s ability to practise and the overarching objective of public protection and public interest. Given that part of the Panel’s task is to assess whether the fitness to practise of the Registrant remains impaired, the Panel should also take into account the HCPTS Practice Note on Finding Impairment and the HCPC Sanction Policy.

29. As the previous panel did not find that the Registrant was impaired under the personal component this Panel ought to concentrate on the public component.

Decision

30. The Panel accepted the advice of the Legal Assessor. The Registrant had provided three testimonials, one from his current employer and two from supervising occupational therapists. Whilst the Panel was satisfied that the Registrant had notified his employer of his conviction it could not be confident that his employer was aware of his suspension.

31. The Panel noted that in the previous decision impairment was found on the Public Component alone. The Panel was concerned today at the lack of any information directly from the Registrant himself whether in written representations or attendance at the remote hearing.

32. The Panel considered the three elements of the public component. The first element of the public component - the need to protect service users which overlaps with the personal component. It noted that a registrant who has insight and is unlikely to repeat past acts or omissions is unlikely to present an ongoing/ future risk to service users. It did not go behind the findings of the previous panel.

33. The other two elements of the public component are maintaining professional standards and public confidence in the profession concerned. The professional standards expected of registrants are what the public expects of them. Panels should consider the need for the public to have confidence in the registrants they are treated by. The public is entitled to expect registrants to be professionally competent and to act with decency, honesty and integrity. The public should also be able to rely on the regulatory process to be robust, fair and transparent.

34. The Panel had concerns that the Registrant had not provided any evidence to the Panel that he had reflected at all on his suspension or the impact his conduct would have had on the public perception of his profession.

35. The Panel had regard to paragraph 65 of the original decision that stated: “A Conditions of Practice Order would not be sufficient either to maintain public confidence in the profession and its regulation or to declare and uphold professional standards of conduct, and would not provide a sufficient deterrent effect. Members of the public would again be troubled if they learned that, despite the gravity of the conduct in the context of registered practice, the outcome of the regulatory investigation were that the Registrant was at liberty to practise, albeit subject to Conditions of Practice.”

36. The Panel found that in effect the Registrant had been working unaffected in Germany despite being convicted of a serious offence against a vulnerable service user that occurred within the context of clinical practice within the UK. The Panel concluded that this would not give confidence to the Public that the regulatory process was robust, fair and transparent or that standards had been upheld within the profession.

37. The suspension imposed had seemingly had no impact on the Registrant which is contrary to the overarching aim of the regulatory process.

38. Therefore the Panel concluded that the Registrant remained impaired on the Public Component.

39. In considering the available sanctions today, the Panel considered the options in ascending order of gravity in accordance with the HCPC Sanctions Policy.

40. The serious nature of the misconduct means that it is not appropriate or proportionate to take no further action or to impose a Caution Order. The Panel went on to consider a Conditions of Practice Order. However, the Registrant had not attended which meant that he was unable to persuade the Panel that he would comply with conditions.

41. The Panel considered paragraph 108 of the SP states that Conditions of Practice are less likely to be appropriate in more serious cases, such as those involving particular features, including violence or convictions for serious criminal offences. Paragraph 109 states:
“There may be circumstances in which a panel considers it appropriate to impose a conditions of practice order in the above cases. However, it should only do so when it is satisfied that the registrant’s conduct was minor, out of character, capable of remediation and unlikely to be repeated.”

42. The Panel concluded that Conditions of Practice would not be appropriate because they would not reflect the seriousness of the conduct underlying the conviction. Conditions of Practice would not be sufficient to maintain public confidence in the profession and its regulation or to declare and uphold professional standards or conduct and would not provide a sufficient deterrent effect. Members of the public would be troubled if they learned that despite the gravity of the conduct in the context of registered practice the outcome of the regulatory investigation were that the Registrant was at liberty to practise, albeit subject to Conditions of Practice. For those reason the Panel concluded it would not be an appropriate sanction.

43. The Panel has decided that a Suspension Order for 3 months is appropriate to enable the Registrant to have the opportunity to provide some documentation and/or attend the next hearing. He would be advised to inform the next reviewing panel of his understanding of how his actions have brought the profession into disrepute and undermined the confidence of the public, in the profession and any remorse he may feel for this.

44. Accordingly, the Panel imposes a Suspension Order for 3 months. This is the least punitive sanction which the Panel could have imposed, in accordance with the HCPC Sanctions Policy. The Panel has also decided that this is the fairest outcome balancing the Registrant’s interests and the public interest.

45. To impose a Striking-off Order today would be unduly punitive and disproportionate, in all the circumstances. Today’s Suspension Order will be reviewed, before it expires.

46. The Registrant will be subject to a Suspension Order for 3 months effective from the expiry of the current Conditions of Practice Order.

47. The Panel directs the HCPC to inform the German regulator and the Registrant’s employer that the Registrant is suspended for a further period of 3 months.

Order

Order: The Registrar is directed to suspend the registration of Mr Ramon Priess for a further period of 3 months on the expiry of the existing Order.

Notes

The order imposed will apply from 23 January 2022.

Hearing History

History of Hearings for Mr Ramon Priess

Date Panel Hearing type Outcomes / Status
22/02/2022 Conduct and Competence Committee Review Hearing No further action
15/12/2021 Conduct and Competence Committee Review Hearing Suspended
25/06/2021 Conduct and Competence Committee Final Hearing Suspended