Mr Ramon Priess

Profession: Occupational therapist

Registration Number: OT70677

Interim Order: Imposed on 03 Oct 2019

Hearing Type: Review Hearing

Date and Time of hearing: 10:00 22/02/2022 End: 17:00 22/02/2022

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

Panel: Conduct and Competence Committee
Outcome: No further action

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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 24 January 2022 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.

2. The Panel has an email delivery receipt and a Certificate to confirm the Registrant’s email address, and is satisfied that good service of the Notice of Hearing was effected.

Proceeding in the absence of the Registrant

3. The HCPC invited the Panel to proceed in the absence of the Registrant under Rule 11 of the Procedure Rules and to take into account the HCPTS Practice Note on Proceeding in the Absence of the Registrant. The HCPC submits that it is in the public interest for this review hearing to proceed. The Panel must balance the overriding interest of public protection with fairness to the Registrant.

4. The Panel has considered the HCPTS Practice Note, and taken the Legal Assessor’s advice. There is a burden on a Registrant to engage with their regulator and the Registrant is aware of the hearing today. The Registrant has requested an early review of the current Suspension Order. The Registrant has not attended the previous hearings.

5. The Registrant has voluntarily chosen not to attend today’s hearing and it is not likely that he would attend on a future date, if this hearing was adjourned. There has been no request for an adjournment and it is appropriate to proceed in the absence of the Registrant.

Background


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

7. From January 2018, the Registrant provided occupational therapy services to Service User A, a 4-year-old boy, for sensory processing difficulties. Service User A had difficulties with language, communication, and motor skills, and possible Attention Deficit Hyperactivity Disorder (ADHD).

8. On 3 April 2019, during an occupational therapy session the Registrant slapped Service User A’s face on several occasions with an open hand in the presence of the Service User A’s mother. On 8 April 2019 the Registrant was suspended from work and self-referred to the HCPC on 14 April 2019. Service User A’s mother reported the incident to the Police and when interviewed the Registrant stated: “I am a trained Occupational Therapist with over 8 years of experience working with vulnerable and young clients, between a few months and 24 years old. I am specifically qualified and trained to deal with children. I obtained a certificate in sensory integration therapy from the University of Southern California. On 3rd April, I did not slap [A] 10 to 20 times on his face. All of the techniques used during this session were conducted appropriately, in line with recognised standards, in accordance with what I deemed appropriate in light of [A’s] specific needs given his mild neurological impairment.” On 19 September 2019 the Registrant was charged with assault by beating and he pleaded not guilty. On 11 March 2020 he was convicted, and he was sentenced to 12 weeks imprisonment suspended for 12 months on 19 June 2020.

9. The Registrant did not attend the substantive hearing of the Conduct and Competence panel held on 3-4 and 25 June 2021. The panel found the statutory ground of conviction established and that the Registrant’s fitness to practise was impaired, under the public component only. A Suspension Order for 6 months was imposed on the Registrant by the panel. He has been practising as an Occupational Therapist in Germany since at least December 2020.

The substantive hearing

10. The substantive hearing panel stated that the Registrant worked with Service User A once a week in therapy sessions that lasted for around 45 minutes. The session on 3 April 2019 started at about 12.20pm. Service User A was sitting on the Registrant’s lap. He ‘played dead’ or pretended to be asleep. The Registrant then slapped the right cheek of Service User A’s face several times, initially leaving his cheek reddened and causing the child to cry. Before this therapy session, no concerns had been raised. Having witnessed the events that took place at the therapy session at lunchtime that day, Service User A’s mother spoke to the child’s father. At just after 10.09pm on 3 April 2019, the Registrant received an email from Service User A’s father, which stated: “[Service User A] came home today distraught. I am extremely disappointed that [Service User A] was repeatedly slapped in an aggressive manner. This is extremely disappointing and unprofessional. He has been crying hysterically, this is not what I expect from a qualified professional.’ The Registrant sent an email in response at 10.45pm, stating: “Apologies for what has happened today. This wasn't meant to hurt him at all. He complained over pain in his mouth just before as well. There is nothing I can do to justify what happened and I suppose it is probably best if [Service User A] stays with Maximum Potential and does not see me privately. The lines are blurring between my professional relationship/private friendship with [Service User A’s mother] and [Service User A]. They feel like family to me and I handled it in a way I would with my nephews and nieces. Not acceptable from a professional view. I adore [Service User A] and can't tell you in words how sorry I feel.”

11. The Registrant left the UK in December 2019 and started work in a paediatric occupational health practice in Berlin. In a reflective statement dated 17 February 2021, the Registrant stated: “From the beginning my current boss was aware of my circumstances and provided support. She had insight into evidence provided by the Police. Every session was therefore monitored, reflected and improved by questioning certain aspects of the intervention but also making sure that practice is safe. For the past year I have not practiced [sic] without close supervision and it’s been a very helpful process in developing my skills and ensuring I only practice [sic] with the appropriate support system in place.’

12. The testimonials provided showed that the Registrant had worked under supervision in a structured manner to address the deficiencies in his professional practice. The panel decided that in view of all those matters, the risk of repetition was low and the Registrant’s fitness to practise was not currently impaired under the personal component but he was impaired under the public component. His actions constituted a criminal assault on a 4-year-old child who had a number of developmental difficulties. The child was in the care of the Registrant and he undermined that trust. The Court imposed a sentence of imprisonment of 12 weeks, suspended for 12 months and the Registrant failed to comply with Standard 9 of the HCPC’s “Standards of Conduct, Performance, and Ethics”. He brought the profession into disrepute and breached fundamental tenets of the profession by assaulting a vulnerable child placed in his care.

13. The mitigating factors were that the Registrant made a prompt apology for his actions to the father of Service User A. He also showed remorse for what he did, there is no evidence of intent to cause harm and he has shown substantial insight by seeking structured support through supervision in his work. He engaged in considerable remediation by putting in place, and pursuing, a plan of structured improvement in the relevant areas of his practice; there has been no reported repetition and there have been no other adverse fitness to practise matters. He also co-operated with the Police, self-referred to the HCPC and engaged with the HCPC, although he did not attend the substantive hearing.

14. The panel considered that only a Suspension Order would adequately protect the public interest to reflect the gravity of the Registrant’s conviction and the resulting blemish on the reputation of the profession. The panel was not addressed in relation to the Registrant’s ability to work in Germany and the Registrant had not made representations on this point. The panel concentrated on the Registrant’s ability to work as a registered Occupational Therapist in the UK.

15. The Panel considered the case of Council for the Regulation of Health Care Professionals v. General Dental Council and Fleischmann [2005] EWHC 87 (Admin), which stated where a practitioner has been convicted of a serious criminal offence or offences, they should not be permitted to resume practice until they have satisfactorily completed their sentence. The 12 month period of the suspended sentence ended on 19 June 2021.

The previous Review hearing

16. At the previous review hearing the HCPC adopted a neutral stance, in relation to whether the Suspension Order should lapse on expiry. The Registrant had not provided any representations for the panel other than testimonials. The substantive hearing panel found that the Registrant had shown insight and he was not impaired on the personal component. The reviewing panel considered the public component only. The Registrant had been working in Berlin. This was not a breach of the Suspension Order, which apparently only applied in the UK.

17. The Registrant had provided testimonials from his current employer and from supervising occupational therapists. The panel was satisfied that the Registrant had notified his employer of his conviction but could not be confident that his employer was aware of his Suspension. The panel was concerned at the lack of evidence that he had reflected at all on his Suspension or the impact his conduct would have had on the public perception of his profession.

18. The panel found the Registrant had been working in Germany despite a conviction for a serious offence against a vulnerable Service User committed within the context of clinical practice in the UK. The Suspension Order had seemingly had no impact on the Registrant. The panel concluded that the Registrant remained impaired under the Public Component. In considering the HCPC Sanctions Policy the panel decided it was not appropriate or proportionate to take no further action or to impose a Caution Order. The Registrant had not attended the review hearing. He was unable to persuade the panel that he would comply with Conditions of Practice. Furthermore, they would not reflect the seriousness of the conduct underlying the conviction, would not be sufficient to maintain public confidence in the profession and its regulation, or to declare and uphold professional standards or 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 was that the Registrant was at liberty to practise, albeit subject to Conditions of Practice.

19. The panel decided that a Suspension Order for 3 months was appropriate to enable the Registrant to provide some documentation and/or attend the next review hearing. Also, 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. The panel directed the HCPC to inform the German regulator and the Registrant’s employer that the Registrant is Suspended from practising for a further period of 3 months, upon the expiry of the existing Order.

Legal Assessor’s advice

20. The Legal Assessor advised the Panel to conduct a comprehensive review to determine if the Registrant is fit to return to unrestricted practice. The Panel’s role is not to conduct a rehearing of the allegations or go behind the previous findings. The Panel should take into account the HCPTS Practice Notes on Article 30 Reviews and Finding that Fitness to Practice is Impaired. If the Registrant’s fitness to practise remains impaired, then the Panel must go on to consider what restriction should be imposed and have regard to the HCPC Sanctions Policy. Any Order under Article 30 should be the least restrictive bearing in mind the need to protect the public and the public interest.

21. The Panel’s powers under Article 30(2) of the Health Professions Order 2001 include all the sanction options including a Striking-off Order. The case of Abrahaem v GMC [2008] EWHC 183 (Admin) states there is a “persuasive burden” on the Registrant, to demonstrate at a review hearing that he has fully acknowledged the deficiencies which led to the original finding of impairment and has addressed that finding sufficiently “through insight, application, education, supervision or other achievement...”

22. The Panel’s decision today must be proportionate and strike a fair balance between interfering with the Registrant’s ability to practise and the overarching objective of public protection.


Decision

23. The Panel accepted the advice of the Legal Assessor. The Panel has made an assessment of the Registrant’s fitness to practise. The Panel has taken into account the HCPTS Practice Note on Finding that Fitness to Practise is Impaired, which emphasises that the fitness to practise process is about public protection. The Panel has considered the public component only, in view of the findings at the substantive hearing. This includes protecting service users, declaring and upholding proper standards of behaviour and maintaining public confidence in the profession.

24. This review process requires a Registrant to demonstrate both developed insight and remediation before returning to unrestricted practice. There is a persuasive burden on the Registrant. The Panel has made an assessment today of the Registrant’s fitness to practise. The Panel took into consideration all the documentation before it and the submissions made by the HCPC which has taken a neutral view in relation to the outcome of this Review hearing.

25. The Panel finds that there has been a significant change in the Registrant’s circumstances since the last Review hearing. There is new evidence available today which was not before the previous panel, as regards reflection and insight. He has taken the steps suggested by that panel by engaging with the HCPC and providing a reflective piece covering his insight, remorse and reflection on the impact of his actions on the reputation of the profession. He also stated his desire to comply with the appropriate guidelines. He demonstrated further education, supervision, and skills development. His current employer has no concerns about the Registrant. He has supplied impressive references and has been supported by his employer in requesting this early Review of the current Order.

26. The Panel finds the Registrant’s fitness to practise is no longer impaired because he has addressed his failings, shown insight, and the public interest issues have been resolved. In addition, the HCPC has taken steps to inform the appropriate German authorities about his Suspension. There was a serious conviction in this case but it has been marked by the imposition of two Suspension Orders and it is no longer in the public interest for a Suspension Order to continue. The Panel is satisfied that it is now appropriate to revoke the current Suspension Order with immediate effect.

Order

The Registrar is directed to revoke the Suspension Order against the registration of Ramon Priess with immediate effect.

 

Notes

No notes available

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