Mr William Munro

Preliminary Matters

Service

1. A Notice of Hearing letter dated 20 November 2023 was sent to the Registrant’s email address as shown on the HCPC register, informing him of the date and time of the hearing and that it would be conducted by video conference. The Panel had evidence that this email has been successfully delivered.

2. The Panel accordingly found that there had been good service of the Notice of Hearing in accordance with the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003.

Proceeding in the Registrant’s absence

3. The HCPC made an application for the hearing to proceed in the Registrant’s absence in line with the terms of Rule 11 of the HCPC’s Conduct and Competence (Procedure) Rules 2003.

4. In support of that application, the HCPC drew the Panel’s attention to the terms of an email received from the Registrant on Tuesday 21 November 2023, at 05:23 hours. In that email the Registrant states, amongst other things, that he is now 68 years of age, has no intention of practising, and has taken up residency in Australia. This being the case, the Registrant has no intention of attending the hearing.

5. The HCPC submitted that the Registrant had voluntarily absented himself and that there was no evidence that not to proceed today would result in his attending on another occasion. Further, the substantive order will lapse on the 6 January 2024 if there were any delay in undertaking this review today. There is therefore public interest in this review being undertaken today and any disadvantage to Registrant was, in the HCPC’s view, outweighed by that public interest.

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

7. The Panel determined that it was reasonable and in the public interest to proceed with the hearing in the Registrant’s absence for the following reasons:

i. The Panel has found good service in terms of the Notice of Hearing;

ii. The Registrant has stated in his email that he would not be attending the hearing and by implication that there was no point in his attendance now or at a future date as he now lives in Australia and considers himself as retired from professional practice;

iii. The Panel therefore formed the view that the Registrant had voluntarily absented himself from the hearing and was unlikely to attend at a future date even if the Panel adjourned today;

iv. There has been no application to adjourn and as stated above, no indication from the Registrant that he would be willing or able to attend on an alternative date and therefore re-listing the hearing would serve no useful purpose;

v. The Panel noted its duty is to act in a manner which was in the public interest and in order to achieve that aim should act in a fair, economical and expeditious manner.

vi. Therefore, taking all of the aforementioned points into account, and noting that this is a mandatory review of an order due to expire on, 6 January 2024 the Panel considered that the public interest in proceeding with the case outweighed any detriment to the Registrant in not being present.

Background

8. The Registrant was a Paramedic at the time of the alleged incident and had been employed by the Welsh Ambulance Services NHS Trust (WAST) since January 2014.

9. On 28 January 2019, the HCPC received a fitness to practise referral from WAST in respect of the Registrant’s conduct during his attendance to an emergency call on 6 January 2019.

10. On 6 January 2019, two emergency medical technicians, Colleagues A and B (the “first crew”), were attending to Patient A, who was reported to have attempted to end her life by consuming alcohol and medication. When the first crew arrived at the scene Patient A was intoxicated and verbally abusive. Colleagues A and B were unable to persuade Patient A to go to hospital and they contacted ambulance control to request assistance.

11. In response to this request, ambulance control sent a second crew, the Registrant and Colleague C. Colleague C was a Newly Qualified Paramedic undertaking her fourth shift since qualifying. Patient A was transferred from the property to the first crew’s ambulance and taken to hospital.

12. After Patient A had been handed over to hospital staff, Colleagues A and B discussed the events and decided to report the incident to their Clinical Team Leaders. They each completed a DATIX report, a written record of the events.

13. A locality manager, SS was instructed to carry out an investigation into the events reported on the DATIX forms. In SS’s investigation he identified a further concern that the Registrant had not completed a PCR in relation to the incident, but had relied on the PCR completed by Colleague B.

14. On 9 December 2021, a panel of the Conduct and Competence Committee found Paragraphs 1(i) – (iii) and 2 of the Allegation proved. That panel further found that the Registrant’s Fitness to Practise was impaired by reason of his misconduct.

Decision of the final hearing panel (as recorded within the first review panel’s decision)

15. The final hearing panel stated as follows:

‘The panel notes that although the Registrant made no admissions to the HCPC Allegation other than he accepted that he was “out of order”’. He stated:

“I reacted badly and allowed my feelings to get the better of me. I was in the wrong. My language was improper, my manner brusque at best, and I was over assertive with the patient and in my use of equipment. I was also clearly unhappy at the conduct of the crew that my colleague and I were sent to assist”.
The panel considered that this statement demonstrated some insight, but the Registrant then continued in his statement of his position to minimise the seriousness of his conduct. He stated:

“I mean no defiance or denial however, when I state that I also do, and always have done, dispute the extent of my wrongdoing…. I believe that my actions at the event were wrong but not as blameworthy as has been proposed…Overall, I do not believe that any further sanction is either required or necessary. I present no danger to the public and I do cherish my professional registration”.

The panel noted that in all statements the Registrant is critical of Colleague A and Colleague B and their management of Patient A. In his initial interview with SS, the Registrant placed significant emphasis on the fact that he had not received conflict resolution training. The absence of such training has no relevance to the Registrant’s use of unnecessary force or to threat and unacceptable language he used to Patient A [sic]. In the panel’s view, the Registrant deflects responsibility from himself and criticises others. The panel also considered that the Registrant demonstrated little understanding of the role of the regulator and the purpose of professional regulation. He referred to his employer’s disciplinary proceedings and the penalties imposed and submitted that no further sanction is required. There was no evidence before the panel that the Registrant has reflected on the potential impact of his behaviour on the reputation of the profession.

In the panel’s judgment the Registrant has demonstrated limited insight.

The panel considered that the Registrant’s conduct in particular 1 is behavioural and attitudinal in nature, and the panel recognised that such matters are more difficult to remedy. However, the panel considered that the misconduct in this case may be remediable, but that there would only be a prospect of the Registrant demonstrating remediation if he demonstrated a sufficient level of insight and a commitment to engage with the HCPC regulatory process.

In his written submissions, the Registrant chose to provide the panel with information about matters at WAST which did not relate to the HCPC Allegation. It appeared from his submissions that the Registrant is not currently practising as a Paramedic. The Registrant referred in his submissions to a WAST corrective action plan, but he provided no evidence about the content of this plan, or any steps that he had taken as part of that plan.
In his lengthy submissions, the Registrant did not provide the panel with information about what he has learned from the incident, how he might act differently in future, or what he has done to address his past behaviour. The panel concluded that the Registrant has not demonstrated that he has remedied the misconduct.

Having considered the level of the Registrant’s insight and the absence of evidence of remediation the panel decided that there is a real risk that the Registrant would repeat similar behaviour and put patients at risk of harm.

The panel therefore decided that a finding that the Registrant’s fitness to practise is impaired is required to protect service users from the risk of harm.

The panel also considered the wider public interest including the need to uphold the required standards of conduct for Paramedics and to uphold public trust and confidence in the profession. Although the Registrant’s misconduct was a single incident which occurred in a very short space of time, it involved multiple breaches of the Standards of Proficiency for Paramedics and the HCPC Standards of Conduct, Performance, and Ethics. The Registrant failed to treat Patient A with dignity and respect, and put Patient A at serious risk of harm, which is entirely unacceptable. The gravity of the incident is indicated by the impact that it had on Colleagues A and B, both of whom were shocked by the Registrant’s behaviour. Informed members of the public would be particularly concerned by the Registrant’s use of unnecessary physical force and by his language. The panel decided that a finding of current impairment is therefore required in relation to the “public” component of impairment.

The panel therefore concluded that the Registrant’s fitness to practise is currently impaired. He has in the past put a patient at unwarranted risk of harm and is liable to do so in the future, and he has in the past and is liable in the future to bring the profession into disrepute.’

16. In relation to sanction, the final hearing panel found the following:

aggravating features

• ‘Multiple instances of misconduct in one call out;
• No evidence of remediation;
• Limited insight (as described in the panel’s decision on impairment);
• Real risk of repetition;
• The Registrant was the most senior clinician.

mitigating features

• No evidence that the Registrant’s conduct was premeditated;
• Not a pattern of unacceptable behaviour over a stretch of time.

17. In relation to sanction the panel is recorded as having:

‘……considered the sanctions in ascending order of severity. The panel decided the Registrant’s misconduct is of a nature and gravity that the option of taking no action would be entirely insufficient to protect the public and to maintain public confidence in the profession. The Registrant’s use of unnecessary force might be described as a form of violent behaviour, where a more serious sanction is likely to be appropriate because such behaviour is likely to affect the public’s confidence in the profession (paragraph 93 of the SP).

The panel considered the option of a Caution Order but decided that it would be insufficient. The guidance in paragraph 101 of the SP was not applicable because the panel has found that there is a real risk of repetition, the Registrant has demonstrated limited insight, and has not provided evidence of remediation. A Caution Order would not impose a restriction on the Registrant’s practice as a Paramedic and it would not provide a sufficient measure of protection against the risk of repetition of similar misconduct. A Caution Order would also be insufficient to mark the gravity of the Registrant’s breach of multiple professional standards.
The panel next considered the option of a Conditions of Practice Order. The panel decided that conditions of practice would be insufficient to mitigate the risk of repetition the panel has identified. The panel decided that the Registrant has not demonstrated a sufficient level of insight for conditions of practice to be appropriate. The panel was also of the view that conditions of practice would not currently be workable. Although the Registrant has engaged with the HCPC to some extent, he has not attended the hearing and the panel has little information about his current circumstances. The Registrant described himself as an “ex- Paramedic”.

The panel also decided that a Conditions of Practice Order would be insufficient to mark the gravity of the Registrant’s departure from the required standards for Paramedics. A more serious sanction was necessary to send a clear message to members of the public and the profession that the Registrant’s behaviour on 6 January 2019 was entirely unacceptable.
The panel then considered guidance in the SP on a Suspension Order. The panel considered that this case did not involve all the factors highlighted in paragraph 121 of the SP. The panel considered the Registrant’s submissions to the HCPC and was of the view that it was uncertain whether he may be able to resolve or remedy the misconduct. The Registrant’s recognition that his behaviour on 6 January 2019 was wrong was positive, but for the reasons explained in the panel’s decision on impairment he has demonstrated limited insight. In its decision on impairment the panel was of the view that the Registrant’s conduct might be remediable. Therefore, in these circumstances, given the uncertainty described, the panel decided that it would be disproportionate to impose a Striking Off Order.

In reaching its decision that a Striking Off Order would be disproportionate, the panel had regard to the SP. A Striking Off Order is a sanction of last resort. It is the appropriate sanction for serious misconduct where the Registrant lacks insight and is unwilling to resolve matters. The panel considered that at this stage it is uncertain whether or not the Registrant is willing to resolve matters.

Having decided that a Striking Off Order would be disproportionate, the panel decided that a Suspension Order was the appropriate sanction.

Having decided that a Striking Off Order would be disproportionate, the panel decided that a Suspension Order was the appropriate sanction. The panel considered that a Suspension Order was sufficient to protect the public because the Registrant would not be permitted to practise as a Paramedic, and this protects against the risk of repetition. A Suspension Order was sufficient to maintain public confidence in the profession and to uphold the required standards for Paramedics. A Suspension Order is a serious sanction which sends a very clear message to members of the public and the profession that the misconduct in this case is entirely unacceptable.

The panel decided that the Suspension Order should be for the maximum period of twelve months. The panel considered that any lesser period would not be sufficient to mark the gravity of the Registrant’s misconduct. A twelve- month period would also allow sufficient time for the Registrant to read and reflect on the panel’s decision, begin the process of remediation, and prepare evidence for a review panel.

The panel therefore decided that the appropriate and proportionate sanction is a twelve-month Suspension Order. The panel took into account the Registrant’s interests but decided that they were outweighed by the need to protect the public and the wider public interest.

The Suspension Order will be reviewed before it expires. A future review panel may be assisted by the following evidence:

• A written reflective piece including the Registrant’s learning from the incident on 6 January 2019 and consideration of the impact or potential impact of his conduct on the patient, colleagues and the reputation of the profession;

• Evidence of any remediation (e.g. relevant training courses, personal development plan);

• Evidence that the Registrant has kept his knowledge and skills up to date;

• Testimonials/references from employment paid/unpaid.

First review of the Substantive Suspension Order

18. The decision of the first review hearing records that the Registrant had emailed the HCPC on 27 November 2022 and 2 December 2022. In those emails he stated that he was travelling in South East Asia on ‘a voyage of discovery.’ He expressed regret and apologised for his actions. He further stated that he had sought counselling which ‘had a very positive outcome’; he had attended classes; and he had also read profusely on behaviour in the workplace.

19. At the first review the HCPC maintained that in the absence of evidence from the Registrant of having undertaken steps to address his conduct failings, as recommended by the final hearing panel, the order should be extended. The HCPC also submitted that the Registrant was still required to provide more evidence of his remorse and insight including a reflective piece, evidence of work undertaken and a report from his supervisor.

20. At that review hearing the HCPC told the panel that it was for the Registrant to demonstrate that he had acknowledged the deficiencies identified by the final hearing panel and had appropriately addressed them. Without such evidence of remediation his fitness to practise remained impaired.

21. The HCPC had accepted that the Registrant in his recent emails to the HCPC had further expressed regret and remorse in relation to what had occurred. The HCPC however noted that in those emails the Registrant had referred to volunteering at St John Ambulance for a short time whilst in the UK, and ‘shadowing medics’ whilst abroad. The Registrant had failed to provide any details of this or documents evidencing it. The HCPC had further submitted that whilst the Registrant had also referred in his emails to counselling, he had again failed to provide any details of this counselling or how it had assisted him in relation to the regulatory concerns identified by the final hearing panel.

22. The reviewing panel had concluded that the Registrant’s fitness to practise remained impaired on both the personal and the public components of its decision. In reaching that decision it stated that:

‘In relation to the personal component, the Panel noted that the substantive Panel had concluded that the Registrant had demonstrated limited insight. The substantive panel further concluded that the Registrant’s conduct was in particular 1 was behavioural and attitudinal. That Panel considered that the Registrant’s conduct ‘may be remediable, but that there would only be a prospect of the Registrant demonstrating remediation if he demonstrated a sufficient level of insight and a commitment to engage with the HCPC regulatory process.’

The Panel considered that there had been limited engagement by the Registrant since the substantive hearing.

The Panel further considered that the Registrant had continued to show some regret and remorse for his actions. However, the Registrant had failed to engage and attend this hearing. The Panel further considered that the Registrant’s overall engagement with the HCPC since the substantive hearing was limited.

Having considered the recent emails from the Registrant, the Panel determined that the Registrant had failed to demonstrate any significant development in his insight since the substantive hearing and that the Registrant’s insight therefore remains limited. The Panel also determined that, whilst the Registrant has referred to volunteering for St John Ambulance and ‘shadowing medics’ he had not provided any evidence of the nature and extent or results of his volunteering or shadowing, or any reports or references from those supervising his volunteering or shadowing. The Panel did, however, note that in his email of 2 December 2022 to the HCPC the Registrant had stated that he was trying to “reconnect” with the several companies he had worked with and would “endeavour to write a reflective piece”.
Similarly, the Registrant in his emails has referred to seeking counselling but has failed to specify what counselling he may have undertaken and how this may have assisted him in addressing the concerns identified by the substantive panel”.

23. The reviewing panel noted that the Registrant had failed to provide this information for this hearing as recommended by the final hearing panel. It also concluded that in respect of the personal component:

‘….the Registrant has currently failed to demonstrate appropriate insight into the full nature and extent of his misconduct on patients, colleagues – particularly the example set to junior colleagues and the public confidence in the profession and the HCPC as a Regulator. The Panel further determined that the Registrant had currently failed to demonstrate any remediation.’

24. The reviewing panel considered that there remained a risk of potential harm due to the Registrant’s misconduct. That panel was satisfied that a member of the public, appraised of all of the circumstances of this case, would have their confidence in the profession, and the regulator, undermined if a finding of current impairment was not made on public interest grounds.

25. The reviewing panel considered in ascending order the sanction options open to it, which being a matter of misconduct, included the sanction of strike off. The reviewing panel considered that a caution order would not provide adequate protection given the wide-ranging failings and ongoing risk to the public identified by the final hearing panel. The reviewing panel also considered that due to the Registrant’s ongoing failure to demonstrate insight and remediation prohibited the imposition of conditions of practice, as it would not be proportionate, appropriate or workable in such circumstances.

26. The panel next considered suspension and in this regard noted:

‘The Panel took into account the SP and particularly the factors set out in paragraph 121 in relation to when a suspension order might be appropriate. The Panel considered that the concerns identified by the substantive panel represented a serious breach of the HCPC’s Standards of Conduct, Performance and Ethics. The Panel considered that the Registrant has demonstrated regret and remorse for his actions. The Panel further considered that, although it has determined that the Registrant has still not demonstrated an appropriate level of insight and remediation, that his most recent communications demonstrate that he continues to take steps in this process. As such the Panel considered that, at the current time, there is evidence to suggest that the Registrant may be able to resolve or remedy his failings.’

27. The panel did consider a Striking Off Order, but determined that, at the current time, this would be disproportionate. The panel made the observation that should the Registrant make no further efforts to address his failings this option of a strike off may become a reality. The reviewing panel therefore extended the current Suspension Order for the maximum period of 12 months ‘which was sufficient time for the Registrant to return to the United Kingdom and undertake further reflection and remediation prior to the next review hearing’.

28. This reviewing panel extended the Substantive Suspension Order and observed that before it expired a future reviewing panel may be assisted by the following:

• A written reflective piece including the Registrant’s learning from the incident on 6 January 2019 and consideration of the impact or potential impact of his conduct on the patient, colleagues and the reputation of the profession. The reflective piece should also include any learning that the Registrant has taken from counselling in relation to his actions and reference any learning that he has taken from his travels and ‘voyage of discovery’.

• Details of the Registrant’s intentions with regard to returning to work as a Paramedic and how he considers this would occur.

• Evidence of any remediation (e.g. relevant training courses, personal development plan);

• Evidence that the Registrant has kept his knowledge and skills up to date;

• Testimonials/references from employment paid/unpaid.

Information received since the last Substantive Review

29. The Registrant has not provided any of the further evidence requested by the reviewing panel.

30. On 18 June 2023, the Registrant emailed the HCPC to request that his registration be cancelled.

31. On 21 November 2023, the Registrant emailed the HCPTS and stated that he had “deregistered several months ago”. The Registrant further stated that he was 68 and had retired to Australia and has “no intention of seeking employment again in any form”. The Registrant advised the HCPTS to “accept my apologies as I shall not be appearing at the meeting”.

Today’s Substantive Review Hearing

Documentation

32. This Panel, in advance of the hearing today, received the adjournment decision and the Final Hearing determination. It also had a copy of the recent email correspondence from the Registrant. Immediately before the hearing the Panel received a copy of the first review decision and a short addendum bundle which reflected the addition of some further redaction.

33. The Panel noted that the Registrant may not have been sent a copy of the last review with the bundle of documentation for this hearing but took into account the fact that the Registrant would have been sent a copy of this documentation soon after that review hearing. In the Panel’s view the Registrant will not have been caused any prejudice by this omission from today’s bundle of documentation and in any event, it is a document that was readily available to him and was also on the HCPC website.

HCPC submissions

34. The HCPC had helpfully provided a written skeleton argument and within that its submissions were set out and relied on the hearing. Those are set out as provided to the Panel below.

35. The HCPC submitted that notwithstanding the fact that the Registrant is ineligible for a Voluntary Removal Agreement following the substantive decision, the HCPC submits that the Registrant should be allowed to leave the Register and be struck off.

36. Under Article 30(4)(d) of the Health Professions Order 2001, the Panel are not bound by the substantive decision and are able to replace the original Suspension Order with “any order which it could have made at the time it made the order being reviewed”.

37. In light of the gravity of the allegations, lack of insight and remorse, the HCPC submits that a second extension of the Suspension Order would not be proportionate. There has been no substantive change in the year since the last Substantive Review that would warrant a further extension. It is submitted that a further extension of the Suspension Order would not result in any improvements to the registrant’s fitness to practise.

38. The HCPC submits that a strike off order would be both necessary for the protection of the public and it is otherwise in the public interest.

39. The HCPTS Practice Note ‘Review of Article 30 Sanction Orders’ details the factors to be taken into account when assessing what, if anything, has changed since the current order was imposed or last reviewed:

a. the steps which the Registrant has taken to address any specific failing or other issues identified in the previous decision;

b. the degree of insight shown and whether this has changed;

c. the steps which the Registrant has taken to maintain or improve his or her professional knowledge and skills;

d. whether any other fitness to practise issues have arisen;

e. whether the Registrant has complied with the existing order and, if it is a condition of practice order, has practise safely and effectively within the terms of that order.

40. The reviewing Panel’s task “is to consider whether all the concerns raised in the original finding of impairment…[have] been sufficiently addressed” (Abrahaem v GMC).

41. The Practice Note also states that the “persuasive burden” falls on the Registrant if they wish to have a substantive order varied or revoked.

42. The HCPC invites the Panel to note that the Registrant has not provided any of the evidence requested of him by the CCC Panel. The Registrant has not discharged his persuasive burden. In doing so, the Registrant has also shown that he does not demonstrate the level of insight or remorse to improve his fitness to practise. The Registrant has not provided any other evidence of insight.

43. The Registrant is no longer working in any capacity, which would suggest that he has not maintained or improved his professional knowledge or skills.

44. Furthermore, the Registrant has explicitly refused to engage in the Substantive Review process. The Registrant has stated that he would not attend the second Substantive Order Review and has retired to Australia.

45. The HCPC submits that the Registrant’s fitness to practise remains impaired and that a strike off order would protect, promote and maintain the health, safety and well-being of the public, promote and maintain public confidence in the professions, and promote and maintain proper professional standards and conduct.

46. Accordingly, the HCPC invites the Panel to impose a strike off order to take effect at the end of the current Suspension Order.

Legal Advice

47. This is a mandatory review under Article 30(1) of the 2001 Order (as amended) of an existing Substantive Suspension Order imposed for a period of twelve months. The ground on which it was imposed was based upon a finding of misconduct. This being the case, the full range of sanctions referred to in Article 29 of the Order are available to this reviewing Panel.

48. The Legal Assessor reminded the Panel that its purpose today was to conduct a comprehensive review to determine if the Registrant is fit to return to unrestricted practice.

49. She reminded the Panel that its role was not to conduct a rehearing of the allegations nor was it to go behind the previous findings, decisions, and review. She advised that in carrying out this assessment, the Panel must exercise its own independent judgment.

50. The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired, then the Panel must go on to consider what sanction, if any, should be imposed. She also advised the Panel that it should bear in mind the principles of fairness and proportionality and have regard to the Sanctions Policy document issued by the HCPC. She reminded the Panel that any order that it makes under Article 30 should not be punitive in purpose, and that it should be the least restrictive order that would suffice to protect the public and/or would otherwise be in the public interest.

Decision

51. The Panel accepted the advice of the Legal Assessor. The Panel has also had regard to the HCPTS’s Practice Note on ‘Fitness to Practise Impairment’. The Panel first considered whether the Registrant’s fitness to practise is currently impaired. The Panel took into consideration all the documentation before it, and the submissions of the HCPC. From that evidence, the Panel considered that the Registrant was required to demonstrate that he had both developed insight and remediation of his failings before he could be considered suitable for return to unrestricted practice.

52. There is no evidence or new information before the Panel today that could satisfy it that the Registrant’s fitness to practise is no longer impaired. There is no evidence to support a finding that the Registrant has developed a programme of remediation nor that he has undertaken any further reflection on his past failings or by taking any of the steps suggested by the previous reviewing panel. In the circumstances, this Panel concluded that the Registrant’s fitness to practise is currently impaired on the personal component of impairment.

53. The Panel concluded that there was no information before it that could lead it to conclude that there was not an ongoing need for a restriction on the Registrant’s practice. In those circumstances, it considered that public confidence in the profession and in the regulatory process would be undermined if the Registrant were able to practise without restriction.

54. In the light of all of the above, the Panel determined that the Registrant’s fitness to practise also remains impaired on the public component.

55. The Panel then went on to consider what the appropriate and proportionate sanction should be, starting with the least restrictive. It bore in mind that the purpose of a sanction was not to be punitive, although a sanction may have that effect. In doing so, it took into account the HCPC’s Sanctions Policy.

56. In doing so the Panel bore in mind that its over-arching objective is:

• to protect, promote and maintain the health, safety and wellbeing of the public;

• to promote and maintain public confidence in the profession; and

• to promote and maintain proper professional standards and conduct for members of the profession.

57. The Panel first considered taking no action but was satisfied that the Registrant’s failings were so serious that the public interest considerations could not be met by such an outcome. The Panel was not satisfied that there would be no risk to the public, or to public confidence in the profession by taking no action.

58. Given the Panel’s findings, it was also not satisfied that mediation was an appropriate sanction given that the particular circumstances of this case make such an outcome irrelevant.

59. The Panel next considered whether to impose a Caution Order in light of the advice set out in paragraph 101 of the Sanctions Policy which states that such an order is appropriate where:

• The issues are isolated, limited, or relatively minor in nature;

• There is a low risk of repetition;

• The registrant has shown good insight; and

• The registrant has undertaken appropriate remediation

However, it concluded such an order would not be sufficient to protect the public, nor would either be in the public interest given that there remained a risk of repetition in the absence of evidence of good insight and appropriate remediation. The Panel has concluded that such this sanction would not adequately protect the public or safeguard the public interest.

60. The Panel next considered whether to impose a Conditions of Practice Order. It had regard to paragraph 106 of the Sanctions Policy which states (amongst other things) that this level of sanction is appropriate where:

• The Registrant has insight;

• The panel is confident that the registrant will comply with the conditions;

61. The Panel considers that there is only little evidence of the Registrant having gained insight into his former misconduct and there has been nothing further since the last review to support the argument that it has continued to develop.

62. The Panel also noted from his emails of the 18 June 2023 and 21 November 2023, that the Registrant had taken steps to remove himself from the Register and considered himself no longer a member of the profession. This supports his statement that he now considers himself retired and settled living abroad. These factors make it clear that the Registrant is unlikely to wish to fulfil any conditions should they be imposed.

63. The Panel next considered extending the existing Suspension Order. In doing so, it has had regard to paragraph 121 of the Sanctions Policy. The Panel noted that the Registrant has not fully engaged in the regulatory process to date and has not availed himself of the opportunity of attending the final hearing, the first review or this hearing. His action of attempting to deregister demonstrates an intention not to return to practice in this country.

64. At this point the Panel took into account that at the last review hearing there was some indication that the Registrant may have been using his professional skills whilst in the UK and also when on his travels in the Far East. There was no evidence whether this was in a paid capacity or required his registration however it raised concern that the Registrant may not been adhering completely with the terms of his suspension. Similarly there is no information as to whether this use of professional skills and qualifications is being utilised by him whilst now resident in Australia. The Panel would therefore have little confidence nor comfort from imposing a further period of suspension in such circumstances.

65. This Panel notes that the last reviewing panel had stated that:

‘However, the Panel considered that any further reviewing panel might give serious consideration to imposing a Striking Off Order if the Registrant does not fully engage and demonstrate insight and remediation in the future.’

66. This Panel has considered the arguments advanced by the HCPC, all the information before it and has come to the conclusion that there would be nothing gained in granting another period of suspension. It appeared to not be in the Registrant’s interest, given his stated position, and it would not be in the public interest nor that of service users to continue with a further review in twelve months’ time. This being the case, the Panel impose a Striking Off Order.

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

The Order imposed today will apply from 6 January 2024.

History of Hearings for Mr William Munro