Mr John Young

Profession: Paramedic

Registration Number: PA39109

Hearing Type: Final Hearing

Date and Time of hearing: 10:00 28/06/2021 End: 17:00 29/06/2021

Location: Virtual Hearing via video conference

Panel: Conduct and Competence Committee
Outcome: Suspended

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Allegation

The allegation against you is as follows:


As a registered Paramedic (PA39109) your fitness to practise is
impaired by reason of misconduct in that:


1. On 18 November 2019, you sent to Person A, a message as set
out in Schedule A.


2. The matter set out in paragraph 1 constitutes misconduct.


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

Finding

Preliminary Matters

Service of Notice

1. The Panel had sight of information that the Notice of today’s hearing was emailed on 7 April 2021 to the Registrant’s email address on the HCPC’s register. The method of service by email has been effected in accordance with the published HCPC Guidance, following a change of policy, due to the HCPTS offices being closed due to the COVID-19 pandemic, and a number of hearings are being held remotely. The Panel was satisfied that in the unprecedented circumstances, service was properly effected.

Proceeding in Absence

2. Ms Reid, on behalf of the HCPC, applied for the hearing to proceed in the Registrant’s absence. Ms Reid informed the Panel that the final hearing bundle had been served on the Registrant on 7 October 2020, and that he had, in response, provided written submissions dated 19 October 2020, which were before the Panel. Ms Reid referred to an email from the Registrant dated 25 May 2021 which stated:

“As I imagine you have surmised by this point, I will not be attending the hearing.”

3. Ms Reid submitted that the Registrant had voluntarily absented himself, reminding the Panel that he had not sought an adjournment. She submitted that it was in the public interest to hear the case expeditiously, particularly because a witness called by the HCPC was in attendance to give evidence. Ms Reid also confirmed that no further correspondence had been received from the Registrant since his email dated 25 May 2021.

4. The Panel took into account the guidance as set out in the HCPTS Practice Note “Proceeding in the Absence of the Registrant”, and accepted the advice of the Legal Assessor.

5. The Panel was mindful of fairness to the Registrant and that the discretion to proceed should be exercised with the utmost care and caution. The email from the Registrant dated 25 May 2021 was not ambiguous, and made it clear to the Panel that he had voluntarily waived his right to attend. The Panel took into account the potential disadvantage to the Registrant in proceeding today, but in this regard noted that the Registrant had provided written submissions, and which were before this Panel today. The Panel decided, in the circumstances, that it was in the public interest to proceed expeditiously, and that it was appropriate, proportionate and fair to proceed today.

Background

6. The Registrant was employed by the Scottish Ambulance Service (SAS) as a Registered Paramedic from 2017 until 1 September 2019.

7. In 2017, Person A, who also worked for the SAS, was made aware that Person B had raised a concern about the Registrant’s practice. This resulted in an internal investigation. The matter was the subject of a referral to the HCPC by SAS, but when the case went to the Investigating Committee Panel (ICP), no case to answer was found in June 2019.

8. On 18 November 2019, Person A is said to have received a message from the Registrant on Facebook Messenger, which is the subject of the HCPC Allegation (“the message”). Person A submitted a referral to the HCPC on 29 November 2019.

Decision on Facts

9. The Panel had before it the HCPC final hearing bundle. The Panel heard submissions on facts from Ms Reid as well as reading her written submissions.

10. The Panel also read the Registrant’s written submissions dated 19 October 2020 (“the Registrant’s written submissions”).

11. The Panel accepted the advice of the Legal Adviser who advised that the Registrant should be taken to be a person of good character, and that he is entitled that his good character be taken into account by the Panel when considering his credibility and his propensity to act as alleged.

12. The Panel was aware that the burden of proof is entirely on the HCPC to the civil standard, namely the balance of probabilities.

13. The Panel heard live evidence from Person A, who is an Honorary senior Lecturer at the University of Stirling, and works as a registered Paramedic with SAS. The Panel considered Person A to be a clear and credible witness.

14. The Panel took into account the Registrant’s written submissions, and did not draw any adverse inference from his absence in relation to its findings of facts. The Panel took into account his good character.

Particular 1

15. The Panel noted the history to the message which is the subject of the Allegation. Person A explained that in his previous role as a Consultant Paramedic, he was involved in a research project. Person B, an academic from the University of Aberdeen, was undertaking research which involved going out in ambulances with different crews to observe and obtain data. Person A was liaising with Person B to arrange the times at which she could go out with different ambulance crews.

16. Person A told the Panel that during a meeting with Person B on 16 June 2017 she raised concerns about the practice of two paramedics she had been observing, one of which was the Registrant. Person A sought the advice of his line manager on how to proceed and it was decided that the allegations should be taken to SAS. Person B prepared a written statement for SAS and Person A prepared a written statement summarising the concerns raised with him by Person B. An internal investigation began, with which Person A had no involvement.

17. The Panel considered Person A’s evidence surrounding the receipt of the message, a screenshot of which was taken and exhibited by him. The Panel noted from the screenshot that the sender is said to be “John Young” and it was sent on 18 November 2019. Person A’s evidence was when he initially saw it he was not clear to what it referred as it had been some time since the concerns were highlighted by Person B. However, the contents of the message and the mention of Person B suggested it related to the concerns raised in 2017. He checked his NHS emails and found that John Young was one of the two members of ambulance staff who had been reported.

18. The Registrant’s written submissions do not deny that he sent the message.

19. In light of the evidence of Person A, the Panel was satisfied that on the balance of probabilities the Registrant did send the message to Person A.

20. The Panel therefore found Particular 1 proved.

21. The Panel also considered Person A’s clear and articulate evidence about the impact of the message. He felt “threatened” and “intimidated” and felt that it was “aggressive”, and a personal attack. He felt that the message was trying to belittle his professionalism as a paramedic. His evidence was that he received the message whilst he was at home with his children and this made the experience even more upsetting. Person A also stated that he felt that he may be physically threatened if he were to meet the Registrant face to face. Person A stated that the message has had an ongoing impact on his personal and professional life, and that because he does not know what the Registrant looks like, he is concerned about one day finding himself working alongside him or even coming across him when he and his family go into Glasgow.

22. Taking into account the evidence of Person A, the Panel decided, on the balance of probabilities that he found the message to be threatening, intimidating and aggressive and caused him ongoing anxiety.

Decision on Grounds

23. The Panel then considered whether the sending of the message constituted misconduct. The Panel was aware that there is no burden of proof at this stage and that misconduct is a matter for its own professional judgment.

24. The Panel had regard to the submissions of Ms Reid, both oral and in writing, who submitted that the matters found proved in Particular 1 constituted misconduct. The Panel also took into account the Registrant’s written submissions.

25. The Panel accepted the advice of the Legal Assessor.

26. The Panel was aware that a breach of relevant professional Standards in themselves do not necessarily mean that the Registrant’s actions constitute misconduct, nor does an absence of such breach necessarily mean that there is no misconduct.

27. The Panel was of the view that the Registrant breached the following Standards:

HCPC Standards of conduct, performance and ethics

“2 Communicate appropriately and effectively Social media and networking websites

2.7 You must use all forms of communication appropriately and responsibly, including social media and networking websites.

9 Be honest and trustworthy Personal and professional behaviour

1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.”

28. The Panel took into account that the message was written as a consequence of Person A’s involvement in reporting the concerns, raised by Person B, against the Registrant. The message therefore arose out of a concern in the workplace, and was below the expected standard in respect of which a paramedic should communicate with a fellow paramedic in respect of matters which arose in the workplace. The message contained language which was offensive and designed to cause upset, and moreover, is directed personally at Person A as a person and as a professional.

29. The Panel was of the view that this was an inappropriate use of social media. The use of social media, namely a personal Facebook account to which the message was sent, some years after the internal investigation took place, was designed to be intrusive and designed to cause upset. In this regard, the Panel took into account its findings with regard to the impact of the message upon Person A, as set out in its determination on facts.

30. Taking into account the way social media was used, the content of the message, and the impact upon Person A, the Panel decided that the message fell far below the standards expected of the Registrant, and as such, constituted misconduct.

Decision on Impairment

31. The Panel considered Ms Reid’s submissions, both oral and written, that the Registrant is impaired on both the personal and public components. The Panel accepted the advice of the Legal Assessor. The Panel took into account the HCPTS Practice Note entitled “Finding that Fitness to Practise is ‘Impaired’”. The Panel was aware that impairment is a matter for its own independent judgment and that public protection and the wider public interest should be considered.

32. The Panel accepted the advice of the Legal Assessor who referred to
CHRE v (1) NMC (2) Grant [2011] EWHC 927.

33. The Panel noted that in his written submissions, the Registrant focused upon his feelings of frustration at the internal investigation carried out by SAS, and directs much of his frustration and also criticism towards Person A directly. He also referred to his health issues which resulted from the SAS internal process. The Panel noted that the Registrant does state as follows, which appears to be an explanation for sending the message:

“As I said, I was in a very bad pace and still had all this bouncing about my head and then reacted”

34. However nowhere does the Registrant demonstrate that he understands that he should not have sent the message, and why he should not have done so. The Panel has found no evidence of any insight into the misconduct found proved, why it was inappropriate, and what could be done to avoid it in the future. Nor is there any evidence of reflection upon the misconduct, or any other attempt to remediate his misconduct.

35. The Panel took into account the questions formulated by Dame Janet Smith in the Fifth Shipman report, as set out in the case of CHRE v (1) NMC and (2) Grant [2011] EWHC 927, which are presented in Grant as a test of impairment and ask whether a practitioner:

“a. has in the past acted and/or is liable in the future to act so as to put a patient or patients at unwarranted risk of harm; and/or

b. has in the past brought and/or is liable in the future to bring the medical profession into disrepute; and/or

c. has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession; and/or

d. [this final question relates to dishonesty which is not an issue in this case].

36. The Panel decided that, in respect of the misconduct found proved, the Registrant had not put any patients at an unwarranted risk of harm. However, the Panel decided that the Registrant had brought the profession into disrepute and breached fundamental tenets when he sent the message.

37. In light of the lack of any evidence of insight, of remorse, reflection or remediation shown by the Registrant, the Panel was satisfied that the risk of repetition was real, and therefore the Registrant is liable to bring the profession into disrepute, and to breach fundamental tenets in the future.

38. In light of the Registrant’s past misconduct, the lack of insight and remediation and the ongoing real risk of repetition of such behaviour, the Panel was satisfied that a reasonable, well-informed member of the public, with knowledge of all the facts and circumstances, would be seriously concerned if a finding of impairment were not made in the particular circumstances. The Registrant has not sought at any time to express an understanding of why the message was inappropriate, nor an understanding that it was also threatening and offensive. There has been no expression of regret or remorse, or any apology. He has caused ongoing anxiety to a fellow professional whose personal and professional life has continued to be impacted by his misconduct. In all the circumstances, the Panel was therefore satisfied that the need to uphold proper professional standards of conduct and to maintain public confidence in the profession would be undermined if a finding of impairment were not made.

39. The Panel therefore found the Registrant’s current fitness to practise to be impaired on the basis of both the personal and public components.

Decision on Sanction

40. The Panel heard the submissions of Ms Reid who referred to the HCPC’s Sanctions Policy (SP), and took the position that the kind of sanction to be imposed is a matter for the Panel.

41. The Panel took into account all of the evidence before it, its previous determinations, and the Registrant’s written submissions.

42. The Panel considered the SP and accepted the advice of the Legal Assessor. The Panel was aware that the aim of any sanction is not to be punitive. Rather, the aim is to uphold the public interest. Sanction is a matter for the independent judgment of the Panel. The Panel took into account the principle of proportionality in coming to its decision on sanction.

43. The Panel identified the following mitigating factors:

i. the lack of any previous regulatory findings against the Registrant, and therefore he was previously of good character;

ii. this was an isolated incident.

44. The Panel identified the following aggravating factors:

i. a lack of evidence of insight, remorse or apology and remediation;

ii. the ongoing impact of the message upon Person A;

iii. the sending of the message was a calculated act and it was not sent as an immediate reaction to a situation. The Registrant wrote that he “just wanted to wait until id [sic] left the service before sending this.”

45. The Panel took into account the Registrant’s submissions that he had experienced health issues around the time of the internal investigation, and since, although noted that there was no independent evidence of his health issues.

46. The Panel was of the view that the sending of the message, while it was a single, isolated act, was a serious finding. It was sent some two years after the initial report made about the Registrant to SAS, and it was clear, as the Registrant himself stated in the message, that he had waited until he had left the service before sending it. It therefore had a calculated, premediated nature. Further, it was offensive, and threatening, and there is no evidence of any reflection or insight or remediation, as already set out in the Panel’s determination on impairment.

47. While there is no risk to patients, as has already been decided the decision on impairment, a real risk of repetition of similar behaviour, as set out in that determination, inherently entails an ongoing risk to colleagues.

48. The Panel discounted taking no further action because the misconduct was too serious for such an outcome, and the lack of a sanction would not satisfy the public interest in this case.

49. With regard to a caution, the SP states at para. 101:

“A caution order is likely to be an appropriate sanction for cases in which:

⦁ the issue is isolated, limited, or relatively minor in nature;

⦁ there is a low risk of repetition;

⦁ the registrant has shown good insight; and

⦁ the registrant has undertaken appropriate remediation.”

50. The Panel was of the view that a Caution Order is not appropriate or proportionate because while the misconduct was isolated, it was not relatively minor in nature, and the Panel has already decided that there is a real risk of repetition.

51. The Panel next considered a Conditions of Practice Order but was satisfied that this would not be appropriate, because the Registrant has not attended this hearing, and there is no indication that he would be willing to comply with conditions.

52. The Panel next considered a Suspension Order and considered para. 121 of the SP:

“A suspension order is likely to be appropriate where there are serious concerns which cannot be reasonably addressed by a conditions of practice order, but which do not require the registrant to be struck off the Register. These types of cases will typically exhibit the following factors:

⦁ the concerns represent a serious breach of the Standards of conduct, performance and ethics;

⦁ the registrant has insight;

⦁ the issues are unlikely to be repeated; and

⦁ there is evidence to suggest the registrant is likely to be able to resolve or remedy their failings. “

53. The Registrant’s misconduct represents a serious breach of the relevant standard surrounding appropriate and responsible use of social media. While there is no evidence of insight, and there is a real risk of repetition, the Panel took into account that this was an isolated incident in the career of a Paramedic who had been previously of good character. In applying the principle of proportionality to the individual circumstances of this case, the Panel was satisfied that a Suspension Order was sufficient to protect the public interest in this case and address the ongoing risk of repetition.

54. In light of these factors, the Panel was satisfied that a Suspension Order is appropriate and proportionate. The Panel concluded that a duration of one year is appropriate and proportionate, because it reflects the seriousness of the misconduct, the lack of insight and remediation, and the risk of repetition of such behaviour. In light of the factors which the Panel has taken into account, as set out above, such duration will also sufficiently address the need to maintain public confidence in the profession and the regulatory process, uphold proper standards, and send a clear message that such conduct is unacceptable. The Panel was satisfied that such an outcome is a proportionate result when weighing these various factors in the balance.

55. The Panel considered paragraphs 130 and 131 of the SP:

“A striking off order is a sanction of last resort for serious, persistent, deliberate or reckless acts…

A striking off order is likely to be appropriate where the nature and gravity of the concerns are such that any lesser sanction would be insufficient to protect the public, public confidence in the profession, and public confidence in the regulatory process. In particular where the registrant:

⦁ lacks insight;

⦁ continues to repeat the misconduct…

⦁ is unwilling to resolve matters.”

56. In the Panel’s view, while the Registrant lacks insight, and the misconduct was serious, it was an isolated incident, and in light of the Registrant’s previous good character, the Panel decided that a Striking Off Order would be disproportionate at this stage.

57. In coming to its decision, the Panel took into account the principle of proportionality, and the impact that a Suspension Order will have on the Registrant’s right to practise his profession, as well as the reputational and the financial impact. However, the Panel decided that the need to uphold the public interest meant that a Suspension Order for 1 year is proportionate.

58. The Panel was of the view that a future Panel may be assisted by the following:

i. the Registrant’s attendance at the review of the Suspension Order, whether in person or remotely;

ii. a recent reflective statement written by the Registrant demonstrating an understanding of why the message should not have been sent, and an understanding of its impact on Person A, and the wider public interest;

iii. evidence of undertaking a professional conduct and/ or communication course dealing with the appropriate use of social media.

59. The Panel therefore decided to impose a Suspension Order for a period of one year.

Order

Order: The Registrar is directed to suspend the registration of Mr John Young for a period of 12 months from the date this order comes into effect.

Notes

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 Article 29(10) of the Health Professions Order 2001, any appeal must be made within 28 days of the date when this notice is served on you. The Panel’s order will not take effect until the appeal period has expired or, if you appeal, until that appeal is disposed of or withdrawn.

Application for an interim order to cover the appeal period

1. The Panel heard an application from Ms Reid for a 12 month Interim Suspension Order to cover the appeal period. She submitted that such an order is in the public interest.

2. The Panel considered the HCPTS Practice Note entitled “Interim Orders” as well as Paragraphs 133-5 of the Indicative Sanctions Policy. The Panel accepted the advice of the Legal Assessor.

3. The Panel decided whether or not hear the application for an interim order in the absence of the Registrant. In deciding this issue, the Panel took into account that the Registrant had been informed, in the Notice of hearing dated 7 April 2021, that if this Panel found the case against him is well founded, and imposes a sanction which removes, suspends or restricts his right to practise, the Panel may impose an interim order. In addition, the Panel took into account the reasons set out in its earlier decision to commence the hearing in the absence of the Registrant. In the circumstances, and for the same reasons, the Panel determined that it would also be fair, proportionate and in the interests of justice to proceed in the Registrants absence to hear the application.

4. The Panel took into account its previous findings, and adopting its reasons, the Panel came to the conclusion that an interim order is in the wider public interest in order to maintain public confidence in the profession and to uphold proper standards. The high threshold for such an interim order is met on the basis of the nature of the misconduct, and the impact it had and continues to have on Person A. The Panel also took into account the aggravating features referred to in its decision on sanction, In the circumstances, the misconduct has the capacity to seriously undermine public confidence in the Registrant and the paramedic profession. Public confidence in the profession and the regulatory process would be seriously harmed if the Registrant were not made subject to an interim order during the appeal period.

5. The Panel was mindful of its decision at the sanction stage that Conditions were not appropriate. The Panel considered that not to impose an Interim Suspension Order would be inconsistent with its finding that a substantive sanction of Suspension is required.

6. The Panel recognised that the Panel must take into consideration the impact of such an interim order on the Registrant as part of the principle of proportionality, and must balance the impact on the Registrant with the need to uphold the public interest. The Panel considered those matters; in the circumstances of the case, the Panel was satisfied that the need to uphold the public interest outweighed the Registrant’s interests in this regard.

7. The Panel decided to impose an Interim Suspension Order for a period of 12 months, a duration which is appropriate and proportionate in light of the Panel’s previous decisions, in order to allow any appeal which the Registrant brings, to be concluded.

Hearing History

History of Hearings for Mr John Young

Date Panel Hearing type Outcomes / Status
28/06/2021 Conduct and Competence Committee Final Hearing Suspended