Alexander Jones

Preliminary Matters

Application to Amend

1. At the outset of the hearing Mr Foxsmith made an application for the Allegation to be amended as follows:
(i) Insertion of a new particular 1(a)(iv) alleging that the Registrant “Made an inappropriate comment about oral sex”

(ii) Deletion of the words “Encouraged Student A to place” in particular 1(c)(i) and insertion of the words “and said “Maybe I’ll take my top off” or words to that effect”.

(iii) Insertion of the words “If you sleep with me it won’t” in particular 2(b) and deletion of the words “it wouldn’t”.

2. Mr Foxsmith informed the Panel that the Registrant was notified of the proposed amendments well in advance of the hearing. He submitted that the amendments better reflect the evidence and will not cause any injustice to the Registrant.

3. Mr Hockton did not oppose the application to amend.

4. The Panel accepted the advice of the Legal Assessor. She advised the Panel that early notice and minor changes are less likely to cause injustice than late notice and substantial alterations that heighten the seriousness of the Allegation.

5. The Panel was satisfied that the Allegation should be amended as requested as the proposed amendments:
• provide helpful clarification;
• avoid ambiguity; and
• do not alter the substance or meaning of the Allegation or significantly widen the scope of the HCPC’s case as originally drafted.

6. In these circumstances, the Panel concluded that the amendments would cause no injustice to the Registrant as they more accurately reflected the HCPC’s case.

Background

7. The Registrant is a registered Paramedic. The Registrant was employed by the Scottish Ambulance Service (‘the Service’) and was based at Glasgow South Ambulance Station at the time of the allegations.

8. Whilst employed by the Service the Registrant was allocated a mentee, Student A. Student A was a student paramedic and she shadowed the Registrant as part of a week-long placement at the Service, from 21 until 27 January 2019. She worked four shifts with the Registrant during the placement. These shifts took place on:
(i) Monday 21 January 2019;
(ii) Friday 25 January 2019;
(iii) Saturday 26 January 2019; and
(iv) Sunday 27 January 2019.

9. It is alleged that during each of these shifts the Registrant made a number of inappropriate comments and acted in an inappropriate manner towards Student A. It is alleged that the Registrant’s actions towards Student A were sexually motivated.

10. It is further alleged that the Registrant also made a transphobic comment to Student A and a further comment to a colleague which she overheard.

11. On 20 February 2019, the HCPC received a referral from Student A and a representative from her University regarding Student A’s placement with the Registrant.

12. On 25 February 2019, Student A was informally interviewed by the Service. As part of an internal investigation which commenced on 24 July 2020, Student A subsequently attended a formal interview on 31 August 2020 and 15 December 2020 The Registrant was interviewed on 3 February 2021. Other witnesses including Colleague A and Witness AR were also interviewed. On 22 February 2020, the internal investigation report was completed.

Panel’s Approach

13. The Panel was aware that the burden of proving the facts was on the HCPC. The Registrant did not have to prove anything, and the individual particulars of the Allegation could only be found proved, if the Panel was satisfied, on the balance of probabilities.

14. In reaching its decision the Panel took into account:
• the oral evidence of Student A and the Registrant;
• the witness statements contained within the hearing bundle and including the statements of Student A dated 7 July 2020, the Registrant’s Response to Allegations and the witness statements from Colleague A dated 22 June 2020 and Witness AR dated 7 December 2021.
• the documentary evidence contained within the hearing bundle and the Registrant’s bundle;
• the oral submissions made by Mr Foxsmith and Mr Hockton.

15. The Panel accepted the advice from the Legal Assessor. The Panel noted that in the case of Basson v General Medical Council [2018] EWHC 505 (Admin), Mr Justice Mostyn provided the following definition of sexual motivation:
“sexual motive means that the conduct was done either in pursuit of sexual gratification or in pursuit of a future sexual relationship”

Decision on Facts

Introduction

16. The Panel noted that it was inherently unlikely that Student A on her first placement as a paramedic student would make a completely false allegation against a mentor that she had had no previous contact with. However, the Panel also noted that it was inherently unlikely that the Registrant, who has no history of inappropriate behaviour, would make inappropriate comments, and engage in sexual innuendo with a student. Although the Registrant accepted, during his oral evidence, that colleagues would engage in ‘banter’ and dark humour (such as joking about death) he denied that his comments ever “overstepped the mark.” Furthermore, there was no evidence before the Panel that there was a culture of inappropriate sexual comments at the Glasgow South Station. The Panel noted that Colleague A did not witness any inappropriate behaviour. The Panel also took into account the testimonial evidence of Witness GL, an ambulance technician who has known the Registrant since 2016. She stated that:
“[The Registrant]…has also supported me personally when he found me crying after an incident with a colleague being inappropriate, his first concern was for my safety and he offered to find out the reporting procedure and support me if I was to upset to report the incident by myself (sic)”

17. In these circumstances, the Panel carefully assessed the credibility and reliability of the key witness evidence. The Panel noted that the relevant events occurred more than 3 years ago and that due to the passage of time Student A was unable to recall some of the detail or the sequence of some of the events. In assessing the variation in her version of events the Panel took into account the time between the occurrence and the first time she was asked to provide a written account of the incident, the nature and materiality of the variation and the overall context in which the alleged incidents took place.
Particulars 1(a)(i) and 1(a)(ii) – Found Proved
“While employed by the Scottish Ambulance Service, and acting as mentor to Student A, you:
On 21 January 2019:
asked Student A about her use of sex toys;
asked Student A about her sex life;

18. Student A, during her oral evidence, affirmed the contents of her witness statement dated 7 July 2020.

19. Student A stated in her witness statement that during the shift that took place on 21 January 2019, she was sitting with the Registrant in the ambulance reviewing an Electronic Patient Report Form (‘ePRF'). She stated that she was sat in the back of the ambulance and the Registrant Alexander was in the front speaking to her through the window that separates the two sections. The Emergency Medical Technician (‘EMT’) (Colleague A) was not present but was due to return to the ambulance. Student A stated that the Registrant brought up the subject of sex toys by asking her if she had ever used any sex toys such as a “wand” vibrator. Student A stated that she was unable to recall her response but believed that she had laughed it off. She stated that the Registrant went on to ask Student A if she had AA batteries for a vibrator and at the end of the shift made the comment “make sure you have those AA’s!” During the conversation, the Registrant asked her if she had used the dating application “Tinder” and whether she had much luck on it.

20. Student A described the incident as making her feel “very uncomfortable.”

21. During cross examination it was put to Student A that her witness statement reads as if the ‘sex toys’ conversation and the ‘sex life’ conversation took place at the same time. However, during her evidence in chief, Student A stated that these were separate conversations. She stated that the ‘sex life’ conversation took place whilst she was in the back of the ambulance and the Registrant was in the front but the ‘sex toys’ conversation occurred when they were both in the back.

22. In the Registrant’s Response to Allegations and during his oral evidence he denied making any reference to sex toys and denied asking Student A about her sex life. He stated that the only reference to sex toys occurred on 25 January 2019. In his Response to Allegation he stated that Student A made the unsolicited comment: “I’ve run out of batteries but it still works,” which he took to be a reference to a “female pleasure aid.” During his oral evidence, the Registrant informed the Panel that this comment was made by Student A whilst he was asking her if she had gone out to celebrate following the end of her exams. She had replied that she had stayed in her room and went on to make the unsolicited comment. Student A denied making this comment.

23. Over and above the inherent unlikelihood that Student A would make a false allegation against the Registrant the Panel concluded that it was inherently unlikely that on her first placement as a paramedic student she would refer to a sex toy during a conversation with her mentor about what she had done to celebrate the end of her exams. Student A accepted that at some point during the placement week, she had used the word ‘vulva,’ as a “play on words” when referring to the uvula. However, the Panel did not accept the submission made by Mr Hockton that this revealed a “different glimpse” of Student A and ‘ties in with the jokey reference to batteries.” The Panel accepted Student A’s account that it was a “play on words” and a “simple joke” and is very different to the suggestion that she implied that she had stayed in her room after her exams in order to use a “female pleasure aid.” She stated that at her jokey comment should have been the end of the matter, but the Registrant kept bringing it up and proceeded to tell other people.

24. The Panel noted that Student A had not initially intended to make a complaint about the Registrant’s behaviour. On 30 January 2019, she spoke to Clare Hastings, her personal tutor at the University, and asked her if it would be possible to have a new mentor. Student A explained to the Panel that she believed that the Registrant was to be her mentor for the full 3 years of her degree course and she did not think that she would be able to put up with his behaviour for that length of time. Student A told Ms Hastings what had happened during her placement with the Registrant and was informed that due to the nature of the concerns it would need to be reported to someone. Student A expressed some concern that the Registrant would know that she had reported him as it was her understanding that he had not previously mentored a student. Ms Hasting’s advised her that if Student A wanted any action to be taken this would be more likely if she made a complaint. Thereafter, Student A spoke to a friend on the same course and came to the conclusion that she would make a complaint because she would not feel comfortable if a “vulnerable or gullible” person became his mentee.

25. The earliest account of what happened was provided in the referral to the HCPC which was submitted on 20 February 2019; less than one month after the placement had come to an end. In the referral, under the heading “About your concern” it states:
“21st January afternoon: he questioned me about my use of sex toys while we were in the back of the ambulance, although this line of questioning stopped as soon as the [Colleague A] came back. He often waited until we were alone to make these sorts of comments.
21st January afternoon: told me stories of other women he had slept with and showed me his dating profile, which then lead on to him questioning me about my own sex life.”
In Student A’s informal interview which took place on 25 February 2020, she referred to the conversation about sex toys and referred to it again in her second formal interview which took place on 3 February 2021. Although there was no mention of sex toys in the first formal interview on 31 August 2020, the Panel, having read the questions and answers in the interview summary, concluded that this was because on that occasion she was not specifically asked about the events which took place on 21 January 2019.

26. In these circumstances, the Panel conclude that Student A’s evidence in relation to the conversation which took place on 21 January 2019 was consistent. Although the Panel noted that Student A was less clear, in the witness statement that she provided to the HCPC on 7 July 2020, about the sequence of these conversations and in which part of the ambulance she was in at the time, the Panel concluded that this did not undermine the reliability of her evidence with regard to the key issues. The Panel was satisfied that the essence of the HCPC’s case was that these comments had been made; the order was much less important.

27. The Panel found Student A’s core evidence to be clear, coherent, and compelling. There was no attempt by her to embellish her evidence and she candidly accepted that she could no longer remember certain detail due to the passage of time, which in the Panel’s view was unsurprising. The Panel found Student A to be an honest witness and was satisfied that her account was reliable. Despite the inherent unlikelihood that the Registrant would make the comments that have been attributed to him the Panel concluded that on 21 January 2019 he did make those comments.

28. Accordingly, particulars 1(a)(i) and 1(a)(ii) were found proved.

Particulars 1(a)(iii) – Found Proved

“On 21 January 2019:
told Student A about your previous sexual partners;”

29. Student A stated in her witness statement that the Registrant was talking about different women on Tinder and showed her their photographs. She also stated that he went on to make comments about meeting and engaging in sexual activity with women he had met on Tinder. However, she was unable to recall any specific comments.

30. The Registrant acknowledged that at that time (January 2019) he was a Tinder subscriber. He denied that he had discussed this with Student A. However, he stated that he had not made any secret of the fact that he used Tinder and so it was likely that Student A heard him being ‘ribbed’ by his colleagues in the Mess about his lack of success.

31. The Panel noted that Student A also referred to the Registrant’s sexual exploits with women in the HCPC referral and in her subsequent informal and informal interviews. For the reasons stated in paragraph 26 above, the Panel found Student A’s evidence to be compelling. The Panel had no reason to doubt that her recollection was accurate and concluded that her evidence was reliable.

32. Accordingly, particular 1(a)(iii) was found proved.
Particulars 1(a)(iv) – Found Not Proved
“On 21 January 2019:
Made an inappropriate comment about oral sex;”

33. Student A stated in her witness statement that throughout the week the Registrant frequently make sexual jokes and innuendoes. She stated that on one occasion, which she believed to be 21 January 2019, she was eating a sandwich and bit off more than she could chew. The Registrant then made a joke about oral sex and choking. Student A was unable to recall the Registrant’s exact phraseology.

34. The Registrant denied making any reference to oral sex.

35. The Panel had no reason to doubt Student A’s account that the Registrant made a comment after she appeared to choke on her sandwich. She referred to it in the HCPC referral and in her first formal interview. During the formal interview she stated:
“I bit into my sandwich and took too big a bite. Alex made jokes about my mouth being full…choking...blow job”
When she was asked as a follow up question whether the Registrant had used the words ‘blow job,’ Student A said that she could not remember the exact wording because it was such a long time ago.

36. There were said to have been others present, but Colleague A did not remember the incident and nor did Witness AR who is a Trainee Advanced Paramedic Practitioner. Witness AR stated during his formal interview and in the witness statement that he provided to the HCPC that if the comment had been made in his presence, he would have remembered it and he would not have tolerated such behaviour.

37. The Panel was mindful that comments can be made in the presence of others without being registered, as it depends on many factors such as how it was said, how loudly and where the other person’s focus was at the time. Therefore, the Panel concluded that the absence of corroboration even by those who were likely to have been present did not undermine Student A’s account. However, the Panel was concerned by the lack of detail. The Panel accepted that this was due to the passage of time but concluded that without clarity with regard to the nature of the comment it was unable to determine if it was inappropriate and as a consequence whether it was a reference to oral sex or if Student A had drawn that inference because of the context or because of other things that the Registrant had said that day.

38. Accordingly, particular 1(a)(iv) was found not proved.
Particulars 1(b)(i) and 1(b)(ii) – Found Proved
“On 25 January 2019:
asked Student A about shaving her body;
told Student A about your previous sexual partners.

39. Student A stated in her HCPC witness statement that during her shift with the Registrant on 25 January 2019, he began speaking to her about a woman he had met on Tinder. He stated that he would not meet up with one particular girl again because she did not shave or groom her genital area. The Registrant said that the person he had met up with did not shave and that he thought this was gross because he preferred people who shaved. Student A believe that this was a reference to genital and body hair. Student A also stated that the Registrant asked her how high up she shaves, and whether she waxed or shaved her genitals. Student A was unable to recall how she had responded, but she believed that she had tried to divert the conversation away from herself. She stated that she felt extremely uncomfortable and embarrassed that the Registrant had asked her such a personal question.

40. Student A stated that this conversation took place in the front of the ambulance whilst Colleague A was in the back with a patient and the patient’s family member. She also stated that the Registrant had closed the window between the front and the back of the ambulance and so no one in the back would have been able to hear the conversation.

41. The Registrant denied that he had asked Student A about her personal grooming habits and denied that he had discussed his previous sexual partners.

42. The Panel accepted Student A’s evidence that the Registrant closed the window between the front and back of the ambulance. The Panel did not accept the suggestion that it was unlikely that Student A would be sitting in the front of the ambulance. On the contrary the Panel concluded that this was highly likely in circumstances where Colleague A was in the back with a patient and the patient’s family member and there was bags/equipment on the third seat in the back of the ambulance.

43. The Panel noted that Student A stated in the HCPC referral that the Registrant had referred to women that he had slept during their conversations. She also mentioned it in her second formal interview. When asked in the second formal interview she also confirmed that the Registrant had asked about her shaving habits. For the reasons stated in paragraph 26 above, the Panel found Student A’s evidence to be compelling. The Panel had no reason to doubt that her recollection was accurate and concluded that her evidence was reliable.

44. Accordingly, particular 1(b)(i) and 1(b)(ii) were found proved.
Particulars 1(c)(i) – Found Proved
“On 26 January 2019:
Placed ECG leads on your body rather than on a training dummy and said “Maybe I’ll take my top off” or words to that effect;”

45. Student A stated in her witness statement that on 25 January 2019 the Registrant attended to a patient who required an Electrocardiogram (‘ECG’). Whilst on shift the following day (26 January 2019) she told him that she had felt useless during that call because she did not know how to administer an ECG. She asked if there was anything she could do to help in the future and the Registrant said that he would show her what to do. The Registrant then started to put the ECG leads on himself. He placed the leads on his own arms and legs, and then said, ‘maybe I’ll take my top off.’ At this point, Student A and the Registrant were in the back of the ambulance alone. Student A stated that this comment made her feel uncomfortable and that she believed that the Registrant was trying to make the scenario sexual when she simply wanted to learn. Student A could not recall her response but thought it was likely that she had made a jovial response.

46. The Registrant accepted in his Response to Allegation that he may have demonstrated how to place the ECG leads on a patient by placing the leads on himself. During his oral evidence he denied that he said the words that had been attributed to him by Student A or that he had done anything inappropriate.

47. The Panel note that there was no mention of the Registrant’s suggestion that he take his top off in the informal interview, but it was mentioned in the first formal interview. Although there was no mention of the comment in the HCPC referral or in the second formal interview the Panel concluded that this did not undermine Student A’s credibility. The HCPC was a summary of Student A’s concerns and in the second formal interview she was not specifically asked about the “take my top off’” comment.

48. For the reasons stated in paragraph 26 above, the Panel found Student A’s evidence to be compelling. The Panel had no reason to doubt that her recollection was accurate and concluded that her evidence was reliable.

49. Accordingly, particular 1(c)(i) was found proved.
Particulars 1(c)(ii) – Found Proved
“On 26 January 2019:
When she reached to pick up a tablet device, said to Student A “Oh, you’d better watch where your hand is” or words to that effect.”

50. Student A stated in her witness statement that in every ambulance there is a tablet on which the ePRF is completed. Whilst on shift with the Registrant on 26 January 2019, she stated that he was standing next to her in the back of the ambulance completing the ePRF whilst she was sitting down. There was also a patient in the back of the ambulance. Student A stated that when the ambulance drove over a bump in the road, the Registrant dropped the tablet. Student A caught it and paused for a moment to ensure that she had hold of it securely, and her hand accidently touched the Registrant’s trousers near to his groin area. She stated that the Registrant said ‘oh, you’d better watch where your hand is.’ Student A stated that she felt very embarrassed by the Registrant’s remark as her actions had been unintentional. She stated that the Registrant made a point of laughing and joking about her embarrassment.

51. The Registrant could not recall this incident and denied that he had made the comment that had been attributed to him by Student A.

52. The Panel did not accept the suggestion that it was unlikely that the Registrant would be standing in the back of the ambulance. The Panel accepted Student A’s account that he was standing and for the reasons stated in paragraph 26 above found her account of this incident to be compelling.

53. Accordingly, particular 1(c)(ii) was found proved.
Particulars 2)(a), (b), (c), (d) and (e) – Found Proved
“On 27 January 2019, while driving Student A home:
Suggested that she should sleep with you;
Said to Student A “So long as you didn’t tell anyone it would be fine” or words to that effect;
Said to Student A “If you sleep with me it won’t affect your grades” or words to that effect;
Asked Student A about anal sex;
Suggested to Student A that she should invite you into her flat for coffee.”

54. Student A stated in her witness statement that on 27 January 2019, she accepted the Registrant’s offer of a lift home after their shift. She stated that his was because it was a cold and rainy evening, and she did not know the area they had been working in very well. She also stated that she was tired and just wanted to get home.

55. Student A stated that during the drive, the Registrant began to veer the conversation towards sexual matters by talking about his sex life. She stated that he told her the names of people he had slept with and showed her their profiles on a dating site. One particular profile was of a person that was interested in having anal sex. The Registrant then asked Student A if she had ever had anal sex or whether it was something that she was interested in doing. Student A stated that she did not answer this question. The Registrant then said ‘if you sleep with me it won’t affect your grades’ or works to that effect. Student A stated that it would be unethical for a lecturer and a student to sleep together, so why would it not be unethical for a mentor and a student to do the same. The Registrant’s response was that if they did not tell anyone it would be fine. Student A stated that she laughed at this comment but avoided saying no as she did not want to hurt his ego. The Registrant then accidentally drove over a kerb whilst turning a corner. He said that if he had busted a tyre he would have to come up for a “cup of coffee.” Student A stated that the comment was said jokingly but was also suggestive as he held eye contact with her and she caught him staring at her breasts, which is something that happened several times throughout her placement.

56. The Registrant denied that he had made these comments.

57. The Panel accepted Student A’s reasons for accepting a lift from the Registrant despite feeling uncomfortable in his presence due to the inappropriate comments and sexual innuendo. The Panel noted that there was no evidence that she feared for her safety. Therefore, the Panel accepted that she weighed up the inconvenience of the inappropriate comments with the inconvenience of working out how to travel home by public transport. She informed the Panel that after the first two shifts she got a taxi home but after that she could no longer afford that mode of transport.

58. For the reasons stated in paragraph 26 above, the Panel accepted Student A’s evidence.

59. Accordingly, particulars 2(a) – (e) were found proved.
Particulars 3(a) and (b) – Found Proved
“On 25 January 2019, you:
Said to Student A “Oh, so it actually talked to you?” or words to that effect when referring to a transgender medical professional;
Said to Colleague A within Student A’s hearing “I don’t think I’m homophobic, but I am transphobic” or words to that effect.”

60. Student A stated in her witness statement that during their lunch break on 25 January 2019, she overheard part of a conversation between the Registrant Alexander Jones and Colleague A. She heard the Registrant say, “I don’t think I’m homophobic, but I’m transphobic’” or words to that effect. Student A stated that she took herself away from the conversation and sat elsewhere in the mess room to eat her lunch as she has transgender friends and is an avid supporter of LBGTQ+ rights. She stated that she felt angry about the comment that had been made.

61. Student A stated that after their lunch break, she and the Registrant took a patient to the hospital. Once they arrived, the Registrant told her to remain in the hospital and to observe what she could whilst he returned to the ambulance to complete the ePRF. Student A stated that she tried to understand what was going on, so she asked the doctor what they were doing and had a discussion with them about the patient. When Student A spoke to the Registrant about the call, he asked if she had spoken to the transgender doctor who was treating the patient. She said that she had and that they were nice. The Registrant replied; “I can’t believe it actually talks to you.” Student A took ‘it’ to be a derogatory reference to the transgender doctor.

62. The Registrant denied that he had made the comments that had been attributed to him. He stated that he has transgender friends and although the church he attends has strong views on transgender issues he said that he believes that all human beings have “ultimate dignity” and some people believe that they have been born in the wrong body.

63. The Panel noted that Student A became confused during her evidence with regard to the sequence of the events. In her witness statement she stated that the transphobic comment was said first, and it was after lunch that the conversation about the transgender doctor took place. However, during her oral evidence Student A initially suggested it was the other way around before conceding that her memory with regard to the chronology was “hazy”. The Panel concluded that this did not undermine the reliability of her evidence with regard to the key issues. Student A could recall where the incidents took place, and the Panel was satisfied that the essence of the HCPC’s case was that these comments had been made; the order in which they were said was much less important.

64. The Panel acknowledged that the reference to being transphobic followed by the conversation with the transgender doctor may appear to be coincidental. However, the Panel considered that this would be more coincidental if the Registrant had not known that there was a transgender doctor that worked at that particular hospital. The Panel was satisfied, based on the evidence of Student A, that the Registrant did know there was a transgender doctor at that hospital. In any event, Student A referred to the transphobic comment in the HCPC referral, in the informal interview and in her second formal interview on 15 December 2020. The Panel concluded that the core elements of Student A’s evidence was consistent and for the reasons stated in paragraph 26 above, the Panel accepted her evidence.

65. Accordingly, particulars 3(a) and 3(b) were found proved.

Particular 4 (sexually motivated) – Found Proved

66. The Panel, having determined that particulars 1 and 2 had been found proved in their entirety (save for particular 1(a)(iv)) went on to consider whether the Registrant’s comments and behaviour was sexually motivated

67. The Panel noted that the HCPC’s case was that the Registrant’s conduct was motivated by an intent to pursue a sexual relationship with Student A.

68. The Panel was satisfied that the Registrant’s comments and conduct gradually escalated during the placement week. He was interested in having sexual relations with Student A and overstepped the boundaries of his professional relationship as her mentor in order to create the environment in which a sexual relationship could develop.

69. Accordingly, the Panel concluded that particular 4 in relation to particulars 1 and 2 (save for particular 1(a)(iv)) was found proved.

Decision on Grounds

Panel’s Approach

70. In view of the factual findings the Panel went on to consider the issue of grounds but only in relation to the particulars that were found proved. No further consideration was given to the particular 1(a)(iv) which was not found proved. The Panel was aware that determining the issue of misconduct is a matter of judgement; there is no standard of proof.

71. The Panel took into account the submissions from Mr Foxsmith and Mr Hockton and accepted the Legal Assessor’s advice.

72. The Panel was aware that breach of the standards alone does not necessarily constitute misconduct and that negligence may amount to misconduct if it is sufficiently serious. The Panel also bore in mind that in the Privy Council case of Roylance v GMC (No.2) [2000] 1 AC 311 it was stated that:
“Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a … practitioner in the particular circumstances. The misconduct is qualified in two respects. First, it is qualified by the word ‘professional’ which links the misconduct to the profession ... Secondly, the misconduct is qualified by the word ‘serious’. It is not any professional misconduct which will qualify. The professional misconduct must be serious.”

Misconduct

73. The Registrant had a professional duty to observe and maintain appropriate professional boundaries when interacting with his colleagues. He also had a duty to treat his colleagues with dignity and respect. Student A, as a paramedic student on placement, was a very junior colleague. The Registrant was Student A’s mentor and knew or ought to have known that high standards of conduct and behaviour was expected of him at all times. As a consequence of his role, he was in a position of trust and there was an inherent imbalance of power between himself and Student A. The Registrant exploited that power to further his own interests.

74. Student A stated in her witness statement and during her oral evidence that she felt very uncomfortable in the Registrant’s presence because of the frequent sexual innuendo and towards the end of the placement had become exhausted by it. Although there was no evidence of physical harm the Panel concluded that there was a risk of emotional harm. Student A, described during her oral evidence, the concern she had that if she spoke out about the Registrant’s inappropriate comments it might affect her grades and the progress of her paramedic career. A more vulnerable student may not have had the courage to speak out which is likely to have had an impact on their mental well-being. Although the Registrant’s inappropriate behaviour relates to a single student over the course of a week there were multiple examples of improper comments and therefore a degree of persistence. The Panel viewed the Registrant’s individual comments as a course of conduct which culminated in him suggesting to Student A that it would be ok for her to have sex with him.

75. The Panel noted that colleagues, employers, universities that provide work placement programmes as part of their courses, and the public are entitled to expect registered paramedics to be trusted to behave appropriately. The Registrant’s sexually motivated behaviour towards Student A demonstrates an unwillingness, on those occasions, to adhere to the high standards of behaviour which are fundamental to effective practice as a registered paramedic.

76. The Panel considered the HCPC Standards of Conduct, Performance and Ethics (‘the Standards’) and concluded that the Registrant’s conduct breached Standard 9.1 which states:
9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession.

The Panel noted that the Standards are mainly directed towards conduct which relates to the health, safety, and well-being of patients. However, the Panel was satisfied that the spirit of the standards in relation to maintaining appropriate boundaries, respect and dignity and communication equally apply to colleagues.

77. The Panel was aware that breach of the Standards alone does not necessarily constitute misconduct. However, the Panel was satisfied that the Registrant’s conduct failed to meet the high standards expected of a registered paramedic. Furthermore, the Panel took the view that fellow practitioners and the public would be appalled by the Registrant’s failure to behave in a professional manner whilst interacting with Student A.

78. The Panel noted that the Registrant’s sexually motivated behaviour towards Student A is towards the lower end of the scale for conduct of this type. However, for the reasons stated above, the Panel concluded that the Registrant’s conduct and behaviour fell far below the standards expected of him and is sufficiently serious to be characterised as misconduct.

79. The Panel separately considered the transphobic comments that were made to Student A and overheard by her.

80. The Panel noted that the comments were not made directly to anyone with a protected characteristic and the comment regarding the Registrant’s views was made in the Mess Room. However, the Panel was mindful that these comments were capable of causing offence in and of themselves. The Panel noted that paramedics serve the public and there is a legitimate expectation that everyone is treated with dignity and respect. Declarations of transphobia and derogatory comments communicated to colleagues has the potential to undermine the trust and confidence of the public.

81. It is in this context that the Panel concluded that the transphobic comments fell far below the standards expected of a registered paramedic and are sufficiently serious to be characterised as misconduct.

Decision on Impairment

Panel’s approach

82. In considering whether the Registrant’s fitness to practise is currently impaired, the Panel took into account its findings in relation to misconduct and the oral submissions of Mr Foxsmith and Mr Hockton.

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

84. In determining current impairment, the Panel had regard to the following aspects of the public interest:
• The extent to which the Registrant has the skills, knowledge, and character to practise his profession safely and effectively without restriction; and
• The wider public interest which includes the need to promote and maintain public confidence in paramedics and the need to promote and maintain proper professional standards for these paramedics.

Impairment

85. The Panel considered the Registrant’s current fitness to practise firstly from the perspective of his ability to work safely and effectively as a paramedic and then from the perspective of the wider public interest.

86. The Panel noted that there is no suggestion that the Registrant is clinically incompetent. However, his sexually motivated misconduct undermined his professional standing as a registered paramedic. His inappropriate behaviour was sustained for a period of four days and significantly breached the high standards expected of him.

87. The Panel recognised that the Registrant’s misconduct is capable of being remediated provided there is evidence of meaningful reflection and a willingness to take appropriate steps to ensure that the risk of repetition is sufficiently low.

88. The Panel noted that the Registrant, in the reflective statement he provided to the Panel after the findings of fact, stated under the heading ‘Evaluation’ that:
“Whilst I have always endeavoured to maintain clinical practice this incident has made me realise that there is always more that can be done in relation to professionalism. Professionalism includes a combination of behaviours, values and attitudes and the way a paramedic presents themselves to colleagues and the public (Gallagher, et al., 2016). Students’ perception of their mentors is extremely important, and any inappropriate behaviour might make a student reluctant to approach their mentor and might lead to a poor learning experience. (Sibson & Murcell, 2010).
Reflective practice is useful in understanding any shortcomings and especially in understanding things from the perspective of others, this helps to identify common behaviours which threaten working relationships (Bulman, 2013) (Richardson, 2012).”
Under the heading ‘Action Plan’ the Registrant stated:
“Since this incident I have avoided any discussion of my personal life and am more conscious of my use of humour and behaviour at work, open discussion of my personal life is inappropriate in the workplace and I endeavour to avoid such conversations at work. I recognise the importance of taking into account individual colleague’s and student’s backgrounds, personalities and sensibilities when having conversations in the messroom.
If it is determined that I have acted in any way inappropriately I would like to offer my apology to the complainant and the HCPC. I recognise the distress that this will have caused her. I also recognise that matters like this have the potential to affect the reputation of the profession with the public and that is to my regret. I hope that the Panel will accept that any inappropriate conduct found proven is wholly out of character and would not occur in the future. Going through this process has been a very salutary lesson for me, regardless of outcome.”

89. The Panel noted that the reflective statement demonstrates some insight as there is a recognition by the Registrant of the importance of professionalism and the potential impact of inappropriate behaviour in the workplace. However, the Panel noted that because the reflective statement had been prepared in advance of the hearing it did not reflect a deep and meaningful understanding of the factual findings. Furthermore, as the Registrant denied the allegations his apology was a qualified expression of remorse and the overall tenor of his statement lacked depth and a considered analysis of what went wrong. In these circumstances, although the Panel acknowledged that the Registrant had demonstrated some insight it concluded that the degree of insight was insufficient to demonstrate that the Registrant had remediated his previous misconduct.

90. The Panel acknowledged that these proceedings are likely to have had a salutary effect on the Registrant which may have reduced the risk of repetition. However, the Panel concluded that in the absence of meaningful reflection and evidence that the attitudinal failings have been fully addressed, the Panel was not satisfied that the risk of repetition was sufficiently low. Although there is no evidence that there has been any repetition in the 3 years since the relevant events occurred the Panel concluded that a real risk of repetition remains.

91. In these circumstances, the Panel concluded that the Registrant’s ability to practise effectively as a paramedic is currently impaired.

92. In considering the wider public interest the Panel had regard to the need to promote and maintain public confidence in the profession and to promote and maintain proper standards of conduct and behaviour.

93. The Panel was mindful of the duty to uphold proper standards of conduct and behaviour and maintain public trust and confidence in the profession. The Registrant’s sexually motivated misconduct put Student A at risk of emotional harm, breached a fundamental tenet of the profession and, in so doing, brought the profession into disrepute. The Panel concluded that a reasonable and well-informed member of the public would be extremely concerned by the Registrant’s sexually motivated behaviour and by his transphobic comments. In these circumstances, the Panel concluded that a finding of impairment is required to publicly declare that it is unacceptable for a registered paramedic to disregard his professional responsibility to act professionally at all times.

94. The Panel took the view that public trust and confidence in the profession would be significantly undermined if a finding of impairment of fitness to practise was not made, given the nature and seriousness of the Registrant’s failure to uphold the high standards of behaviour expected of him and in the absence of any remediation.

95. Therefore, the Panel concluded that the Registrant’s current fitness to practise is also impaired based on the wider public interest.

96. The Panel, having determined that the Registrant’s current fitness to practise is impaired on the basis of both the personal and public component of the public interest, concluded that the HCPC’s case is well-founded.
Decision on sanction

97. Having determined that the Registrant’s fitness to practise is impaired by reason of his misconduct, the Panel next had to decide on the appropriate sanction, if any, to impose.
The Evidence

98. The Panel took into account evidence received during the earlier stages of the hearing where relevant to reaching a decision on sanction.

99. The Panel received further evidence, in the form of additional testimonials, an additional reflective statement and a certificate of attendance at a Professional Boundaries course attended by the Registrant.

Submissions

On behalf of the HCPC

100. On behalf of the HCPC, Mr Foxsmith submitted that the decision on sanction was a matter for the Panel.

101. He drew the Panel’s attention to several paragraphs of the HCPC Sanctions Policy in setting out its responsibility and the approach it should take when making a decision on the appropriate sanction, balancing the interests of the public against those of the Registrant.

On behalf of the Registrant

102. On behalf of the Registrant, Mr Hockton submitted that good mitigation has been put forward since the Panel determination. He adopted his earlier submissions and asked the Panel to be mindful of the earlier material produced on behalf of the Registrant.

103. Mr Hockton submitted that the Panel could see that the Registrant had remediated, had developed insight and provided an apology. He indicated that these were mitigating factors for the Panel to include in its assessment as to what sanction was appropriate. Further, he took the Panel through other mitigating factors that he submitted existed.

104. While he accepted that there were no exceptional circumstances, he submitted that the Registrant’s conduct placed him at the lower scale of possible sexually motivated behaviour and asked that this be reflected in the Panel’s determination.

105. He reminded the Tribunal of the principle that there is a public interest in not depriving the public of good caring individuals, as confirmed by the case of Giele v GMC [2005] EWHC 2084. Also, in relation to proportionality he indicated that there would be financial detriment to the Registrant were he to be suspended for a lengthy period and that he was currently working as a Rapid Response Driver reflecting that his employers continued to be willing to employ him.

The Panel Approach

106. The decision as to the appropriate sanction, if any, to impose in this case is a matter for the Panel exercising its own judgment. In reaching its decision, the Panel has taken into account the legal advice it has received, the HCPC Sanctions Policy and borne in mind the overarching objective.

107. The Panel reminded itself that the main reason for imposing any sanction is to protect the public and that sanctions are not imposed to punish or discipline registrants, although they may have a punitive effect.

108. Throughout its deliberations, the Panel has applied the principle of proportionality, balancing the Registrant’s interests with the public interest.
The Panel’s Determination on Sanction
Aggravating and mitigating factors

109. The Panel first identified the aggravating and mitigating factors in this case.

110. The Panel found the following aggravating factors:

• That this was not an isolated incident, but involved separate instances which continued over four days;
• There was breach of trust, given that the Registrant was acting as mentor to Student A, and the two were often alone in 1:1 situations which the Registrant took advantage of;
• There was also an imbalance of power between the Registrant and Student A
• Insight, apology and remediation have only commenced relatively recently;
• Student A was at an early stage of her career and described the negative impact of the Registrant’s behaviour on her; having her evidence challenged robustly because the Registrant did not accept that he had done anything wrong when he gave oral evidence;

111. The Tribunal found the following mitigating factors:

• That the Registrant has reflected on the Panel’s determinations to date, and sought to incorporate his developing insight and acceptance of the Panel decision in his Reflective Statement;
• That the Registrant has apologised in writing to this Panel for Student A’s distress;
• That the Registrant has attended a one-day case on Professional Boundaries and learnt the dangers of informality at work which can lead to overstepping professional boundaries;
• No previous or subsequent regulatory concerns;
• Testimonials attest to these actions being out of character for the Registrant.

No action

112. The Panel determined that there were no exceptional circumstances to justify taking no action in this case. It considered that taking no action would neither be appropriate, proportionate nor in the public interest bearing in mind the seriousness of sexually motivated behaviour of the kind demonstrated by the Registrant.

Caution Order

113. The Panel did not consider that this was a case where a caution would sufficiently address the seriousness of sexually motivated behaviour of the kind demonstrated by the Registrant. It was necessary for additional action to be taken to mark the gravity of the wrongdoing and to promote and maintain public confidence in the profession and to uphold proper standards and conduct for paramedics.

Conditions of Practise

114. The Panel next considered whether it would be appropriate to impose conditions on the Registrant in this case.

115. The Panel reminded itself that conditions needed to be appropriate, proportionate, workable and measurable.

116. The Panel determined that in cases of sexual motivated misconduct, conditions would be inappropriate and would not serve to address the seriousness of what the Registrant had done. Further, restrictions on working with colleagues and patients of the opposite gender was impractical and tantamount to suspension.

Suspension

117. The Panel reminded itself that it had found the Registrant to be impaired because of repeated sexually motivated utterances. It acknowledged that these involved Student A alone, and took place over the course of a week. However, it determined that these actions were serious and fell far below the standards required, and had not been remediated fully given his incomplete insight.

118. The Panel considered the background to the case, particularly with respect to the Registrant acknowledging his own relative youth and inexperience as a Paramedic but considers he is accountable to the same standards of conduct and behaviour in respect of not acting on sexual motivation, as any other paramedic in his position. It was heartened that the Registrant recognised this.

119. The Panel recognised that multiple professionals have provided testimonials for the Registrant, some who have known him for a number of years working in a professional capacity. The Panel accepted that attending a Professional Boundaries Course was a step in the right direction to the Registrant remedying his conduct. The Panel was mindful that it had found the Registrant’s insight to be incomplete, in that he had not provided either strategies that he would employ to prevent any repetition or examples of where he had been in a situation where there might have been repetition, but he averted this. The Panel accepts the Registrant had put effort into gaining further insight, even if specific steps to create safeguards have not been identified.

120. The Panel considers that these proceedings will have been a salutary lesson for the Registrant. The Panel considers the evidence before it. There has been some reflection and the attendance on an appropriate one-day course to assist in preventing a duplication of events, however, there is still a risk of repetition given the incomplete insight exhibited by the Registrant and his failure to acknowledge throughout the majority of the hearing how his behaviour could have impacted the student with whom he had a specific mentoring relationship.

121. The Panel was mindful that Student A had only been at university for a few months, and had been allocated the Registrant as her Mentor for three years. It is only because of her efforts to change mentor that the facts of this case emerged because she was loathe to make a complaint. The Panel considered that young women at work have a right to go about their professional lives without being subject to language and conversation that is sexually motivated and distressing to them. The Panel heard of the impact of the Registrant’s behaviour on Student A and was mindful that trust between paramedic colleagues is important, not least because of the emergency situations that paramedics may need to cover, and the knock-on effect this could have on patient care.

122. The Panel accepts that there was no clinical failing or patient harm caused in this case. In balancing the interests of the public against those of the Registrant, the Panel was of the view that there is significant public interest in retaining the skills of a competent professional in the healthcare system. Given the Registrant’s very recent reflections, apology and attendance on a course, it considers that further time may allow this to be evidenced more fully.

123. Accordingly, the Panel was satisfied that a period of suspension would appropriately mark the seriousness of this sexually motivated behaviour and would send a clear signal to the public and the wider profession that such behaviour is not acceptable.

124. The Panel was of the view that a fully informed member of the public would not wish to end the career of a paramedic who is trusted and respected by his employers in circumstances where there has been no repetition, and in view of the mitigating factors detailed above.

125. The Panel did consider the ultimate sanction of striking off from the Register. It determined that this sanction would be disproportionate in all the circumstances of this case. It was of the view that public safety, the public interest, including confidence in the profession and upholding standards of acceptable behaviour for the profession can be satisfied by imposing a period of suspension and that this would be sufficient.

126. In determining the length of suspension, the Panel noted that it could impose a period up to 12 months. The Panel noted that the Registrant’s conduct was short-lived, over a period of no more than a week and that it appears to be out of character, with no previous or subsequent complaints made. It took into account that the sexually motivated conduct stopped at words spoken, rather than any physical contact and that the Registrant appeared to behave in an opportunistic rather than a planned and predatory way.

127. The Panel was of the view that a three-month period of suspension should be long enough for the Registrant to fully reflect on his misconduct, and to develop further insight.

128. The Panel determined to suspend the Registrant’s registration for a period of three months.

129. The Panel wishes to clarify that at a review hearing, the onus will be on the Registrant to evidence:

• how his insight has developed further following the course attended;
• steps taken to ensure that the risk of repetition of similar instances is reduced;
• that he has maintained relevant Continuing Professional Development.

130. The Registrant will also be able to provide any other information that he considers will assist the reviewing Panel.

That the Registrar is directed to suspend the registration of Alexander Jones for a period of 3 months from the date this order comes into 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 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

1. After the Panel handed down its decision on sanction, it addressed the question of whether an interim order was required pending the substantive sanction coming into force.
2. The HCPC’s application for an interim order was based upon the Panel’s substantive decision being based on public interest considerations. The Presenting Officer submitted that a decision not to make an interim order would be inconsistent with the Panel’s reasoning leading to the imposition of a substantive suspension order.
3. It was submitted on behalf of the Registrant that an interim order should not be considered as automatic in public interest cases. Given that there was no evidence of repetition or risk, it was submitted that it was neither appropriate or necessary for there to be such an order.
4. The Panel accepted the advice of the Legal Assessor and the guidance within the HCPC Sanctions Policy at paragraphs 134 and 135. The Panel considered whether the circumstances merited the imposition of an interim order. It did not consider that an interim order is the default position where a substantive order is imposed restricting the Registrant’s practice.
5. While the Panel does consider the allegation is serious, it is of the opinion that having made a finding on facts, impairment and sanction, an interim order is not required. The Panel made this decision in recognition that the Registrant has continued to work as a paramedic for the Trust without restriction over the last three years throughout these proceedings. Accordingly, the Panel was of the view that public confidence would not be seriously harmed if the Registrant were allowed to remain in unrestricted practice pending the substantive sanction coming into effect.
The Panel makes no interim order in this case.

History of Hearings for Alexander Jones