Mr Julian Maher

Preliminary Matters

Service

1. The Registrant was not present at the hearing and was not represented.
2. The Panel was satisfied that the notice of hearing had been sent to the Registrant by email and by post on 25 August 2022, giving notice of the hearing date, details of how to join the virtual hearing, and of his right to attend and be represented.
3. The Panel had sight of confirmation of the Registrant’s email and postal addresses held by the HCPC to which the notice of hearing was sent, and confirmation of sending of the notice.
4. The Panel was satisfied that there had been proper service of the notice of the hearing in accordance with the HCPC (Conduct and Competence Committee) (Procedure) Rules 2003 (‘the Rules’), as amended by the (Coronavirus Amendment) Rules 2021.

Application to proceed in the Registrant’s absence

5. Mr Keating, on behalf of the HCPC, referred to an email from the Registrant dated 25 October 2022. Mr Keating submitted this confirmed that the Registrant was fully aware of the hearing taking place today and indicated a deliberate intention on his part not to attend. There was no request for an adjournment. Mr Keating’s submission was that an adjournment would not ensure the Registrant’s attendance on a future date and that it was in the public interest that the hearing should proceed today.
6. The Panel considered the submissions on behalf of the HCPC and accepted the advice of the Legal Assessor. The Panel was referred to the HCPTS Practice Note, Proceeding in Absence, which sets out guidance from the cases of R v Jones (Anthony) [2004] 1 AC 1HL and GMC v Adeogba and GMC v Visvardis [2016] EWCA Civ 162. Applying that guidance, the Panel was careful to remember that its discretion to proceed in absence is not unfettered and must be exercised with the utmost caution and with the fairness of the hearing at the forefront of its mind.
7. The Panel was satisfied from the email from the Registrant that he did not intend to be present at this hearing. There was no indication that he was unable to attend for any reason, or that he sought an adjournment. The Panel noted that the Notice of Hearing informed the Registrant of his right to seek a postponement of the hearing, that the Panel could decide to proceed in his absence, and of the powers available to the Panel at this hearing.
8. The Panel concluded that the Registrant had voluntarily waived his right to attend and that an adjournment was unlikely to secure his attendance on a future date. The Panel was further mindful of the public interest in ensuring that HCPC cases are dealt with as expeditiously as possible.
9. The Panel was mindful that it may not be in the interests of the Registrant for the hearing to proceed in his absence, but was satisfied that any prejudice to him was outweighed by the public interest in proceeding to deal with the criminal conviction allegations in this case.
10. The Panel was mindful of its duty to ensure that, in the Registrant’s absence, the hearing should be as fair as circumstances permit and to consider any points in the Registrant’s favour which reasonably appeared from the evidence.
11. The Panel was satisfied it was fair and in the public interest to proceed with the hearing today.

Amendment of the allegation

12. Mr Keating applied to amend the allegations as set out below, by deleting the struck-through text and adding the bold text:
“As a registered Paramedic (PA27498) your fitness to practise is impaired by reason of a conviction. In that:

1. On 11 January 2022 at Sheffield Crown Court you, upon your own
confession, were convicted on indictment of:

a. Between 13 November 2005 and 4 January 2007 mMadeking indecent photographs of children at category A, contrary to section 1(1)(a) of the Protection of Children Act 1978;

b. Between 13 November 2005 and 4 January 2007 mMadeking indecent photographs of children at category B, contrary to section 1(1)(a) of the Protection of Children Act 1978;

c. Between 13 November 2005 and 4 January 2007 mMadeking indecent photographs of children at category C, contrary to section 1(1)(a) of the Protection of Children Act 1978;

d. On 21 March 2017 was in pPossession of a prohibited image of a child,contrary to sections 62(1) and 66(2) of the Coroners and Justice Act 2009.

2. By reason of your conviction your fitness to practise is impaired.”

13. Mr Keating submitted that no prejudice would be caused to the Registrant by the amendments. The Registrant had been informed of the HCPC’s intention to apply to amend the allegation in its letter of 15 July 2022 and he had not commented upon, or objected to, the proposed amendments.
14. The Panel took advice from the Legal Assessor. The Panel accepted that the proposed changes were not substantive but amended the particulars to improve their clarity and accuracy. No new issues were added to the allegations and the Panel concluded that the amendments sought would cause no prejudice to the Registrant. The Panel was satisfied that it was fair and in the interests of justice for the amendments sought by the HCPC to be made.

Documentation

15. The Panel received the HCPC hearing bundle of 202 pages, a service bundle of 8 pages, and an email from the Registrant dated 25 October 2022.

Background

16. The Registrant, Julian Maher (‘the Registrant’), is registered with the HCPC as a Paramedic. He commenced his employment at Yorkshire Ambulance Service NHS Trust (‘the Trust’) on 16 August 2004 and at the relevant time was in the role of Acting Clinical Supervisor/Paramedic.
17. On 11 January 2022, the Registrant appeared at Sheffield Crown Court and was convicted upon his own confession on three counts of making indecent photographs of children contrary to Section 1(1)(a) of the Protection of Children Act 1978 and one count of possession of a prohibited image of a child, contrary to Sections 62(1) and 66(2) of the Coroners and Justice Act 2009.
18. On 9 February 2022, the Registrant was sentenced by His Honour Judge Kelson QC to ten months imprisonment concurrent on all four counts, suspended for two years; to 40 days’ rehabilitation activity, 200 hours of unpaid work, a Sexual Harm Prevention Order for ten years and a notification requirement of ten years under the Sexual Offences Act 2003.

Response of the Registrant to the allegation

19. The Registrant was not in attendance. The Panel took into account his email of 25 October 2022.

The HCPC’s submission on facts

20. On behalf of the HCPC, Mr Keating set out the background facts in the case. Mr Keating referred to the Certificate of Conviction from Sheffield Crown Court dated 1 February 2022 which confirmed details of the Registrant’s conviction on 11 January 2022. He also drew the attention of the Panel to the transcript of the Judge’s sentencing remarks at the sentencing hearing on 9 February 2022.
21. It was the HCPC’s case that the fact of the conviction was proved by the Certificate of Conviction, as provided for by Rule 10(1)(d) of the Rules.
22. Mr Keating referred to the case of Achina v General Pharmaceutical Council [2011] EWHC 415 (Admin) which provides that the sentencing remarks indicate the factual matrix on which the convicted person has been sentenced.

Panel decision on Facts

23. The Panel considered the submissions of Mr Keating and the advice of the Legal Assessor. The Panel considered whether the facts were proved according to the civil standard of proof, that is the balance of probabilities, and proceeded on the basis that the burden of proving the facts rested upon the HCPC throughout.

Particulars 1a, b, c and d

24. The Panel had sight of a copy of the Certificate of Conviction dated 1 February 2022 which confirmed that the Registrant pleaded guilty to, and was convicted of, the offences on 11 January 2022 at Sheffield Crown Court.
25. The Panel accepted the certificate as proof of the conviction and of the findings of fact upon it was based, as provided for by Rule 10(1)(d) of the Rules. The Panel also had regard to the transcript of the sentencing remarks of HHJ Kelson QC.
26. The Panel was satisfied that the facts alleged in particulars 1a, b, c, and d were proved.

The HCPC’s submissions on ground and impairment of fitness to practise

27. Mr Keating submitted that the ground of conviction was proved by the Certificate of Conviction and in accordance with Rule 10(1)(d) of the Rules.
28. Mr Keating referred to the serious nature of the criminal offences of which the Registrant had been convicted. The HCPC’s submission was that the fitness to practise of the Registrant was impaired on both the personal and public components of current impairment. It was submitted that public confidence in the profession would be undermined were such a finding not made.
29. Mr Keating drew the attention of the Panel to the guidance in the HCPTS Practice Note, Fitness to Practise Impairment, and referred to a number of matters, including that the period of the offending extended over some twelve years and so indicated that the Registrant had a long-term interest in indecent images of children. Mr Keating also noted that the Registrant had maintained a denial, and a defence which sought to place the blame on another person for the duration of the police investigation until he finally pleaded guilty at his trial.
30. Mr Keating submitted that little weight could be placed upon the contentions in the Registrant’s email of 25 October 2022. The Registrant had provided the Panel with no evidence of insight, remorse or remediation
31. Mr Keating said that given the long period of the offending behaviour and the lack of any remediation, there was a significant risk of repetition and of future harm. The HCPC’s position was that the Registrant’s fitness to practise was currently impaired in relation to both the personal and public components of current impairment.
32. Mr Keating reminded the Panel that in respect of the conviction, the Registrant remained subject to the suspended custodial sentence of the criminal court and had been registered as a sex offender. He referred to the authority in the case of CRHP v GDC & Fleischmann [2005] EWHC 87 Admin to the effect that a practitioner who has not completed their criminal sentence should not usually be allowed to return to practice without restriction. He reminded the Panel that the period of the suspended custodial sentence is not yet concluded and that the Registrant will remain subject to the sex offender notification requirement and the Sexual Harm Prevention Order for the remainder of the ten-year period.

Panel decision on the grounds

33. The Panel considered the evidence and submissions and accepted the advice of the Legal Assessor.
34. In respect of particular 1, the Panel was advised that a criminal conviction is a statutory ground of impairment under Article 22(1)(a)(iii) of the Health Professions Order 2001. As the Panel had found the conviction proved at the facts stage, the Panel was satisfied that this ground was therefore established.

Panel decision on impairment of fitness to practise

35. The Panel next considered the issue of current impairment of fitness to practise. The Panel was mindful that this was a matter for its own judgment. In reaching its decision, the Panel had regard to the conduct of the Registrant, the nature, circumstances and gravity of the findings and the critically important public policy issues. It also had regard for the particular need to maintain public confidence in the profession and to declare and uphold the proper standards of conduct and behaviour which the public expects.
36. The Panel referred to the HCPTS Practice Notes, Fitness to Practise Impairment and Conviction and Caution Allegations.
37. In relation to the details of the criminal convictions, the Panel noted that the sentencing transcript provided details of the number of images concerned in counts 1a, b and c as follows:
- Count 1 related to 132 images in Category A (images showing penetrative sexual activity, sexual activity with an animal or sadism);
- Count 2 related to 143 images in Category B (images showing non-penetrative sexual activity);
- Count 3 related to 512 images in Category C (indecent images not in categories A or B).
38. Count 4 related to the offence of possession of a prohibited image of a child.
39. The Panel also noted from the criminal indictment that the period of offending was from November 2005 to January 2017, when the offences came to the attention of the police and an investigation was commenced.
40. The Panel’s starting point was that a conviction for the offences of making or possessing indecent photographs of children is an extremely serious matter, as ultimately it involves the exploitation and abuse of vulnerable children. The Panel was of the view that an HCPC registrant who is convicted of such offences undermines public confidence in the profession and in the HCPC as its regulator.
41. In the Registrant’s absence, the Panel took account of his email of 25 October 2022, in which the Registrant stated that he accepted full responsibility for his past behaviour and was “fully engaged in the process of punishment and rehabilitation”. The Registrant had not submitted any evidence of rehabilitation or remediation nor any character evidence in support of the information in his email.
42. In respect of the personal component of current impairment, the Panel took the view that the Registrant’s offending behaviour might be capable of remedy. However, the Panel was concerned that the long period of the offending, from 2005 to 2017, showed a long-term interest in indecent images of children on the part of the Registrant and may therefore indicate that there is a deep-seated attitudinal issue which would be difficult to remedy. In any event, the Registrant had not provided any information beyond his short email, nor any evidence to support that he had attempted any remediation. The Panel took account of the Registrant’s acknowledgment of his past actions, but concluded it was able to give little weight to the submission in his email.
43. Further, the Panel concluded that the limited remorse demonstrated in the Registrant’s email focussed on his own interests and did not acknowledge the impact of his offences on the victims, or upon his colleagues, his profession and the HCPC as regulator.
44. The Panel concluded that the insight shown by the Registrant was minimal. He ultimately pleaded guilty at his criminal trial but prior to that, during the period of the police investigation, he had maintained a denial and had actively put forward a defence which sought to blame another person for the criminal behaviour, incurring additional costs and time in the criminal proceedings, as noted by HHJ Kelson QC in his sentencing remarks.
45. The Panel further concluded that the Registrant showed no insight or understanding of the impact of his criminal behaviour; that these offences are not victimless crimes: they involve the abuse and exploitation of vulnerable children and perpetuate the market for illegal indecent material.
46. In the light of these circumstances, the absence of any significant insight and the indication of a long-standing interest in indecent images of children, the Panel considered there remained a risk of future repetition. The Panel therefore concluded that the Registrant’s fitness to practise is impaired in respect of the personal component of current impairment.
47. The Panel was also mindful of the guidance from the case of Fleischmann to the effect that a registrant who holds a conviction of this nature should not normally be permitted to return to unrestricted practice while they are still subject to the sentence of the criminal court.
48. In relation to the public component of current impairment, the Panel was of the view that a registrant who has a criminal conviction for the offences of making and possessing indecent images of children undermines public confidence in the profession and in the HCPC as its regulator.
49. The Panel took into account that there was no information before it to suggest that the offending behaviour took place in the Registrant’s workplace. However, the Panel was mindful that during the long period of the offences, the Registrant was practising as a Paramedic and was also during this time responsible for the supervision of other Paramedics. The Panel concluded that members of the public would be horrified to learn that that a practising paramedic with access to vulnerable patients held a such a conviction and that public confidence in the profession, and in the HCPC as its regulator, would be undermined in this case if a finding of current impairment were not made. The Panel therefore concluded that the Registrant’s fitness to practise is also impaired in respect of the public component
50. The Panel concluded that the Registrant’s conviction has brought the profession into disrepute. He has breached a fundamental tenet of the profession, the requirement to be honest and trustworthy. The Panel further considered that the Registrant has acted in such a way that his integrity can no longer be relied upon.
51. The Panel reached the conclusion in the light of all the above that there is a risk of future harm to potential victims, and to public confidence, were the offending behaviour to be repeated in the future.

Submissions on Sanction

52. Mr Keating submitted on behalf of the HCPC that the conviction which the Panel had found proved concerned very serious criminal offences. He referred the Panel to the relevant sections of the HCPC Sanctions Policy (March 2019). He reminded the Panel of the appropriate approach to its consideration of sanction.
53. Mr Keating, as a matter of fairness to the Registrant in his absence, identified the mitigating circumstances, including the comments of the Registrant’s counsel at his trial relating to mitigation and the sentencing comments of HHJ Kelson QC. Mr Keating suggested that the Panel may feel able to give only limited credit to the Registrant for his late guilty plea at the criminal trial and for the expressions of remorse in the Registrant’s email to the HCPC of 25 October 2022.
54. Mr Keating identified those issues which the HCPC considered to be aggravating factors, referring in particular to the lengthy pattern of offending behaviour over twelve years and the defence the Registrant had maintained throughout the police investigation until the trial. He submitted there was very limited evidence that the Registrant had insight and consequently, there was a risk of repetition.

Decision on Sanction

55. The Panel accepted the advice of the Legal Assessor and referred to the HCPC Sanctions Policy in reaching its decision on sanction. The Panel took account of the submissions of Mr Keating and the points put forward by the Registrant in his email of 25 October 2022.
56. In considering sanction, the Panel was mindful that a sanction is not intended to be punitive, although a sanction may have that effect. The Panel must consider the risk the Registrant may pose in the future and determine what degree of public protection is required. The Panel must also give appropriate weight to the wider public interest which includes the deterrent effect on other registrants, the reputation of the profession and the maintenance of public confidence in the regulatory process.
57. The Panel referred to the Sanctions Policy and applied the guidance concerning serious cases. The Panel considered and applied the sections on sexual abuse of children, criminal convictions and cautions, sex offenders and offences related to indecent images of children (paragraphs 78-92).
58. The Panel considered the following mitigating factors were present:
a. The Panel took account of the Registrant’s plea of guilty at his trial. This could be attributed only limited weight, given its late stage and the denial which the Registrant had maintained up until that point;
b. The Panel noted the positive information about the Registrant’s professional history as a Paramedic. It noted the Registrant’s counsel’s comments in the sentencing transcript when he referred to the Registrant having “saved a lot of lives as a paramedic for fifteen years” and that “he’s delivered, he thinks, fifteen babies that might not have been safely delivered without him. He’s helped a lot of people, to put it frankly, that would have died if it hadn’t been for him”;
c. The Panel also took account of the comments of HHJ Kelson QC which demonstrated how the Judge weighed the Registrant’s professional history against the criminal offences:
“It must be said on your behalf, and has been very well said on your behalf, that you are fifty-five years of age and are of good character, and I have had that very much in mind in imposing the sentence that I have imposed. And I do not take lightly the fact that you have in your career saved a lot of lives as a paramedic, and that is highly significant and I have taken that into account in fixing this sentence. You are a fifty-five-year-old man of good character, with a dazzling character reference. But all these offences are so serious that, in my view, a prison sentence was, and is, inevitable.”
d. The Panel took into account the Registrant’s email of 25 October 2022 in which he said that he accepted full responsibility for his actions. However, the Panel took the view that this showed very limited insight into his past actions or understanding of their wider impact.

59. The Panel considered that the following aggravating factors were present:
a. The grave nature of the criminal conviction, which concerned the exploitation and abuse of vulnerable children;
b. The offending behaviour was not an isolated incident but was a pattern of behaviour which extended over twelve years, from 2005 to 2017;
c. Throughout the period of the police investigation until his trial, the Registrant maintained a defence which was untrue and sought to place the blame on another person and, as acknowledged by his counsel on his behalf, incurred substantial costs and time;
d. There was no evidence of any attempt by the Registrant to remedy his offending behaviour;
e. In his only submission for this hearing, his email of 25 October 2022, the Registrant had demonstrated no real insight into his actions and their impact on victims and his profession.
60. The Panel was mindful that mitigating factors carry considerably less weight in regulatory proceedings where public protection is the overarching primary consideration. In this case which concerns a criminal offence of such a serious nature, the Panel could give only limited weight to the mitigating factors.
61. The Panel also bore in mind paragraph 82 of the HCPC Sanctions Policy, which reflects the guidance given in the Fleischmann case that, as a general principle, where a registrant has been convicted of a serious criminal offence and is still serving the sentence a panel should not normally allow the registrant to return to unrestricted practice until the sentence has been satisfactorily completed. The Panel had been informed that the Registrant will be subject to the suspended ten-month custodial sentence for a further eighteen months. He will also be subject to the sex offender notification requirement and a Sexual Harm Prevention Order for the remainder of 10 year period. The Panel bore in mind as per the Sanctions Policy (paragraph 85) that where a registrant remains on the sex offender database this is normally incompatible with continuing in unrestricted practice.
62. Taking all these factors into account, the Panel considered whether it was necessary to impose a sanction. The Panel had in mind the gravity of a criminal conviction relating to indecent illegal images of children and that such a conviction undermines public trust and confidence in the profession. The Panel concluded that in this case, neither mediation nor taking no action would address the important public protection and public interest concerns. The Panel concluded that a sanction was necessary for the protection of the public and in the public interest.
63. The Panel considered the sanctions available to it in ascending order of severity. The Panel first considered the factors in the Sanctions Policy in relation to a Caution Order. It concluded that the issues in this case were not minor in nature. This was not an isolated matter: it concerned accessing indecent images of children over a period of twelve years, during which the Registrant was a practising Paramedic who in his work was dealing with members of the public, a number of whom would have been children.
64. The only information provided by the Registrant showed no real insight or evidence of attempts to remedy his past behaviour. The Panel could not be reassured that the risk of repetition in the future was low. The Panel concluded that a Caution Order was not appropriate in this case.
65. The Panel also considered that a Conditions of Practice Order would not be appropriate given the serious nature of its findings. The Panel was not satisfied that conditions could address the issues of public protection or the wider public interest concerns. Moreover, in the absence of full engagement by the Registrant with this process the Panel could not have any confidence that the Registrant would be willing to comply with conditions of practice.
66. The Panel carefully considered whether a period of suspension would be the proportionate and appropriate sanction, applying the factors in the Sanctions Policy. The breach of standards in this case was serious. The Registrant had demonstrated little insight. The Panel could not have confidence that the behaviour was unlikely to be repeated and had no evidence that the Registrant had attempted to remedy his failings. The Panel concluded this was not a case where a period of suspension could achieve the necessary public protection or maintain public confidence in the profession.
67. The Panel concluded that the factors indicating a Striking Off order were present. The case involved sexual misconduct in that it concerned the offence of making indecent images of children. There was a lack of insight and an absence of evidence of any action taken by the Registrant to remedy the issues. The Panel had concluded there was a risk of repetition. Further, the Registrant will be subject to the sex offender notification requirement for the remainder of 10 year period which is incompatible with continued registration. For all these reasons, the Panel concluded that only a Striking Off order would be sufficient to protect the public, to maintain public confidence in the profession and in the regulatory process, and to declare and uphold proper standards of conduct in the Paramedic profession.

ORDER: The Registrar is directed to strike the name of Mr Julian Maher from the Register on the date this Order comes into effect.

Interim Order

Application to proceed in absence to consider an Interim Order

1. Mr Keating applied for the Panel to proceed in the absence of the Registrant in order to hear his application for an interim order. Mr Keating referred to the Panel’s powers and the guidance in the Practice Note relating to proceeding in absence.
2. Mr Keating referred to the Notice of Hearing dated 25 August 2022 which gave the Registrant notice that the HCPC may apply for such an order. He reminded the Panel of its decision of the previous day to proceed with the substantive hearing in the Registrant’s absence and asked the Panel to proceed today on the same basis. He submitted that it was in the public interest that an interim order application should be heard, given the substantive findings of the Panel in this case.
3. The Panel took advice from the Legal Assessor and took account of the guidance in the Practice Note. The Panel was satisfied there was no change in circumstances of the Registrant’s non-attendance since its decision to proceed in absence at the beginning of the substantive hearing.
4. The Panel was satisfied from the Registrant’s email of 25 October 2022 that he had made a deliberate decision not to participate in the hearing. There was no new information today indicating any change in that position. The Panel was mindful that notice of a potential interim order application had been given to the Registrant in the Notice of Hearing of 25 August 2022. In the circumstances, the Panel was satisfied it was appropriate and in the public interest to hear the HCPC’s application in the Registrant’s absence.

Interim order application

5. Mr Keating submitted that in the light of the Panel’s substantive decision to impose a striking off order, the HCPC sought an interim suspension order for a period of eighteen months to cover the appeal period. The basis upon which the order was sought was the nature of the Panel’s findings and the grounds were that such an order was necessary for the protection of the public, as there would be a real risk to patients and children if the Registrant were permitted to practise pending the coming into effect of the substantive order. Mr Keating submitted that an interim order was also required in the public interest.
6. Mr Keating submitted that the appropriate duration of the interim suspension order was 18 months, as an interim order would continue to be required pending the resolution of any appeal in the event of the Registrant giving notice of an appeal within the 28-day period. It could not be known when any such appeal might be heard by the Court.
7. The Panel accepted the advice of the Legal Assessor. It bore in mind that an interim order in these circumstances is discretionary. The Panel must consider whether an interim order is required, applying the test set out in Article 31(2) of the Health Professions Order 2001, and if it so decides, must act proportionately. This means balancing the public interest with the interests of the Registrant and imposing the lowest order which will adequately protect the public.
8. The Panel was referred to the guidance in respect of immediate interim orders in the Sanctions Policy and to the HCPTS Practice Note on interim orders.
9. The Panel was satisfied in the light of the serious findings it had made that an interim order was necessary to protect the public from the continuing risk of harm which would be posed by the Registrant being able to practise as a Paramedic without restriction. Such an order was also required in the public interest to maintain public confidence in the profession and in the HCPC.
10. The Panel considered the issue of proportionality and balanced the interests of the Registrant with the risks in this case. The Panel had determined to impose a substantive striking off order on the basis of the need for public protection, that it is otherwise in the public interest and in order to maintain public confidence in the profession. Given the gravity of the criminal offences involved and the sanction imposed, the Panel considered it would be inconsistent not to impose an immediate interim order to address the residual risk and public interest issues. The Panel was satisfied that the impact on the Registrant’s interests was clearly outweighed by the need to protect the public from risk in this case.
11. The Panel considered whether interim conditions of practice would be appropriate, but concluded, for the same reasons as identified in its substantive decision, that conditions which would address the Panel’s concerns were not appropriate.
12. Accordingly, the Panel determined that an interim order of suspension was necessary in order to protect the public and in the wider public interest.
13. The Panel concluded that the appropriate and proportionate duration of the interim suspension order was 18 months, as the interim order would continue to be required pending the resolution of an appeal in the event of the Registrant giving notice of an appeal with the 28-day period.

Interim Order:

The Panel makes an Interim Suspension Order under Article 31(2) of the Health Professions Order 2001, the same being necessary to protect members of the public and being otherwise in the public interest. This order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

History of Hearings for Mr Julian Maher