Poppy Sprague

Preliminary Matters
1. On behalf of the HCPC Mr Keating made an application to amend Particulars 1(a), 1(b) and 1(d) of the Allegation to substitute the word “including” for the word “namely”. Mr Keating stated that the purpose of the proposed amendment was to permit the HCPC to rely on evidence contained in the hearing bundle which supported the Allegation in the stem of Particular 1 that the Registrant “engaged in inappropriate and/or unprofessional conduct via social media” in addition to the specific incidents relied on in Particulars 1(a)(i), 1(b)((i) and 1(b)(ii) and 1(d)(i) and (1)(d)(ii).

2. The Legal Assessor advised the Panel that it had a discretion to amend the Allegation at any time before making findings of fact. However, he advised the Panel that the HCPC had relied on specific incidents and that evidence not relating to those specific incidents was irrelevant. The HCPC could have relied on a list or schedule of other incidents supported by other evidence contained in the hearing bundle but had chosen not to do so. The Legal Assessor invited the Panel to consider whether in these circumstances it would be fair to the Registrant to allow the amendment when its purpose was to enable to HCPC to rely on evidence which was prejudicial without being probative of the specific allegations on which the HCPC relied.

3. The Registrant having heard the legal advice, expressed an objection to the application.

4. The Panel determined to refuse the proposed amendments on the grounds that it would be unfair to the Registrant to admit evidence which was not relevant to the Particulars of Allegation.

Background
5. The Registrant is registered with the HCPC as a Practitioner Psychologist and at all material times practised in that capacity on a self-employed basis.

6. It is alleged that between August 2020 and March 2021 the Registrant engaged in inappropriate and/or unprofessional conduct via social media by sharing and/or posting content via a public Facebook Profile which identified her as a Practitioner Psychologist registered with the HCPC.

7. Concerns about the content of the Registrant’s posts on social media were reported by a member of the public to the HCPC, resulting in an investigation culminating in these proceedings.

The evidence
8. In support of the Allegation the HCPC relied on the witness statement of AM, who exhibited screenshots of the relevant material.

9. The Registrant did not dispute that she had posted this material on social media but claimed that she was justified in so doing because her comments were backed up by research which she had conducted.

Decision on the Facts
10. The Panel was mindful that the burden of proof in relation to the facts is on the HCPC and the standard of proof is on the balance of probabilities.

11. The Panel found the facts set out in Particulars 1(a)(i), 1(b)(i) and 1(b)(ii), 1(c)(ii), 1(c)(iii), 1(d)(i) and 1(d)(ii) proved on the basis of the screenshots from her Facebook page and the Registrant’s admissions that she had posted the material in question.

12. The screenshot relied on by the HCPC in support of Particular 1(c)(i) was not sufficiently legible to establish that it “questioned the validity of information provided by governments on the Covid 19 virus and/or death rate” as alleged. Accordingly, Particular 1(c)(i) was not proved.

13. In relation to Particulars 1(a)(i), 1(b)(i) and 1(b)(ii), the Panel was satisfied that the content of the Registrant’s messaging was “contrary to government advice and guidelines” as alleged in the stem to those Particulars. Evidence in support was provided by the statement of AM, which was not disputed by the Registrant.

14. In relation to Particulars 1(c)(ii) and 1(c)(iii), the Panel was satisfied that that the statements and/or content contained therein “were deemed by Facebook to contain partly false or false information” as alleged in the stem to Particular 1(c). This appeared on the face of the relevant screenshots and was not disputed by the Registrant.

15. With regard to Particulars 1(d)(i) and 1(d)(ii), the Panel was satisfied that the Registrant’s statements referred to the NHS “in an inaccurate and/or damaging manner” as alleged in the stem to Particular 1(d).

16. The Panel was further satisfied in relation to Particulars 1(a)(i), 1(b)(i), 1(b)(ii), 1(c)(ii), 1(c)(iii), 1(d)(i) and 1(d)(ii) that the Registrant thereby “engaged in inappropriate and unprofessional conduct via social media” as alleged in the stem to Particular 1. In this context the Panel noted that the Registrant’s Facebook profile page identified her as an “HCPC Practitioner Psychologist”, and that her account was followed at the time by 3989 people. The Registrant acknowledged that her postings on Facebook were accessible by any member of the public who searched for or encountered them.

17. The Registrant relied on her right to freedom of speech enshrined in Article 10 of the ECHR. In this context the Panel was referred by Mr Keating to the case of Adil v GMC [2023] EWHC 797 (Admin), which concerned a consultant surgeon who had publicly expressed views in his capacity as a doctor that the Covid-19 pandemic was a conspiracy created by the UK, Israel and America, and a scam being run by various pharmaceutical companies. In rejecting the doctor’s defence that his pronouncements were protected by his right to freedom of speech, the court stated that the Article 10 right is a “qualified right” and that “Exercise of the right to freedom of expression may be restricted when necessary in the interests of public safety, and for the protection of public health, and for the protection of the rights of others”.

18. Under cross-examination the Registrant acknowledged that she was not a qualified expert on public health matters, or the transmission or prevention of diseases. She nevertheless purported to give advice in her Facebook messages in her capacity as a Practitioner Psychologist on public health matters in which she had no expertise.

19. The Registrant sought to justify the views which she expressed on the basis that she had undertaken extensive research on the subject from which she considered that members of the public should benefit. The Panel considered that the views which she expressed lacked any balance and were uniformly hostile to government advice and guidelines. Her reference to the “progressively and ironically sick and sadistic NHS” and her association of the NHS with “indecency, harassment & genocide” belied her claim to benefit the public with the fruits of her research.

20. In the Panel’s judgement, the Registrant’s posts on social media were “inappropriate and unprofessional” as alleged in the stem to Particular 1 of the Allegation and were in breach of the following standards of the HCPC Standards of Conduct, Performance and Ethics (2016), namely:

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

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

Decision on Grounds
21. The Panel went on to consider whether the facts found proved in Particular 1 amounted to misconduct as alleged in Particular 2.

22. The Panel was mindful that this is a matter for the Panel’s professional judgment, there being no standard or burden of proof.

23. Misconduct was defined in Roylance v GMC (No 2) [2000] 1 A.C. 311 as:

“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 medical practitioner in the particular circumstances. The misconduct is qualified in two respects. First, it is qualified by the word ‘professional’ which links the conduct to the profession of medicine. Secondly, the misconduct is qualified by the word ‘serious’. It is not any professional misconduct which will qualify. The professional misconduct must be serious …”

24. In the case of Nandi v GMC [2004] EWHC 2317 (Admin), the court stated that:

“The adjective ‘serious’ must be given its proper weight, and in other contexts there has been reference to conduct which would be regarded as deplorable by fellow practitioners”.

25. The Registrant used her Facebook account to publish material which contradicted and undermined government advice and guidelines on medical issues where she had no relevant expertise and to attack and denigrate the NHS. Her Facebook account identified her as a Practitioner Psychologist registered with the HCPC and as such a member of the Healthcare Professions, who could be expected to speak with some authority. At the relevant time she had approximately 4,000 followers on Facebook and her postings were freely available to members of the public.

26. As stated above, the Panel found the Registrant to have been in breach of standards 2.9 and 9.1 of the HCPC Standards of Conduct, Performance and Ethics.
27. The Panel considered that the Registrant’s conduct in posting inflammatory images and remarks on medical issues outside of her area of expertise and qualifications would be regarded by fellow practitioners as deplorable and a serious departure from the standards to be expected of a member of her profession. It follows that the proven Particulars of the Allegation amounted to misconduct.

Decision on Impairment
28. The Panel carefully considered the submissions on behalf of the HCPC and the submissions of the Registrant. The Panel had regard to the HCPTS Practice Note on “Fitness to Practise Impairment” and accepted the advice of the Legal Assessor.

29. In determining whether the Registrant’s fitness to practise is impaired, the Panel took into account both the “personal” and “public” components of impairment of fitness to practise. The “personal” component relates to the Registrant’s own practice as a Practitioner Psychologist, including any evidence of insight and remorse and efforts towards remediation. The “public” component includes the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession and the Regulator.

30. The Panel found that the Registrant’s fitness to practise was and remains impaired having regard to the “personal” component. The Registrant maintained that she saw it as her duty to provide members of the public with the fruits of her research. She demonstrated no insight into the possibility that the content of her postings on social media might have been wrong or that her opinions and advice, if adopted by others, had the potential to cause them significant harm. She had little, if any, awareness that her postings could cause damage to the reputation of her profession. The only regret she expressed concerned the manner in which she had presented her views, stating that she would not communicate in that way again and would now do so differently. She did not provide any evidence of changes that she had made. It did not appear to occur to her that it was inappropriate for her to make pronouncements on medical issues in which she had no relevant expertise. She said that she would continue to post material on her Facebook account, under the banner of the HCPC, which identified her as a Practitioner Psychologist and on matters relevant to “informed consent”. She asserted that it would be unprofessional not to express her views in matters where she could assist others in achieving informed consent. She stated her “inalienable right of freedom of speech” and that she followed, in effect, her own guidelines. In the circumstances, the Panel could have no confidence that the Registrant would not engage in inappropriate and unprofessional conduct via social media in the future, if she were permitted to practise without restriction.

31. With regard to the “public” component of impairment, the Panel considered that there is a real risk that the Registrant will continue to post potentially harmful material on her Facebook account which identifies her as a Practitioner Psychologist registered with the HCPC. It follows that a finding of current impairment is necessary to protect the public. In addition, the Panel was mindful of the need to maintain public confidence in the profession and to declare and uphold proper standards of conduct and behaviour. The Panel considered that the Registrant’s misconduct represented a serious departure from the standards to be expected of a member of her profession. In the Panel’s judgement, public confidence in the profession and in the HCPC as its Regulator would be undermined if there were no finding of impairment.

32. Accordingly, the Panel found he Registrant’s fitness to practise to be impaired having regard to both the personal and public components.

Decision on Sanction
33. The Panel took into account the submissions on behalf of the HCPC and the Registrant.

34. The Panel was guided by the HCPC’s Sanctions Policy (2019) and accepted the advice of the Legal Assessor. The Panel was mindful that the purpose of a sanction is not to punish the Registrant but to protect the public and the wider public interest in upholding proper standards and maintaining public confidence in the profession and the regulatory process. The Panel applied the principle of proportionality, balancing the interests of the Registrant with those of the public and considered the available sanctions in ascending order.

35. By way of mitigation:
• The Registrant has practised as a Practitioner Psychologist for 25 years without any previous findings against her.

• She expressed regret as to the manner in which she had presented herself on social media, which she attributed to her reaction to the extreme and unprecedented circumstances and pressures on her arising from the pandemic. The weight given by the Panel to this aspect of her mitigation was limited by the fact that her postings on social media were not an isolated incident but continued over a prolonged period

• She provided the Panel with a large number of supportive testimonials from patients and service users who said that they had benefitted from her services as a Psychologist.

36. By way of aggravating factors:

• The Registrant’s postings on social media had the potential to cause harm to members of the public and, in particular, to vulnerable service users and patients who might have followed her advice and opinions

• The Registrant’s postings on social media followed a pattern and continued over a prolonged period

• The Registrant has demonstrated little if any insight into the potential harm that her postings on social media, under the banner of the HCPC, could cause to members of the public or to the reputation of her profession

• The Registrant has asserted that in continuing to post material on social media she recognises no limits other than those dictated by her own conscience and irrespective of any guidelines of the HCPC

37. The case is too serious for the Panel to take no further action.

38. A Caution Order would not reflect the seriousness of the Registrant’s misconduct or provide any protection to members of the public. There is a risk of repetition, and the Registrant has shown very little insight or remediation.

39. A Conditions of Practice Order would not be appropriate because the misconduct does not relate to the Registrant’s practice as a clinician and the Panel could not formulate any conditions which would address the underlying concerns regarding the Registrant’s use of social media.

40. The Panel decided to impose a Suspension Order for a period of 12 months. This should allow the Registrant sufficient time and opportunity to reflect on the Panel’s findings and address any outstanding concerns.

41. The Panel considered whether to impose a Striking Off Order but decided that to do so would be disproportionate at this time.

42. At the review of this order, the reviewing panel is likely to be assisted by:

• a reflective statement by the Registrant demonstrating what she has learned from the Panel’s findings concerning her misconduct and impairment of fitness to practise, the potential harm to members of the public caused by her misconduct and the damage to the reputation of her profession

• evidence that she has reflected on and adopted the HCPC Standards of Conduct, Performance and Ethics in relation to the use of social media and undertaken training on how to communicate appropriately and responsibly on social media in her capacity as a registered HCPC practitioner

• her attendance at the review hearing

That the Registrar is directed to suspend the name of Miss Poppy Sprague from the Register for a period of 12 months from the date this order comes into effect

Right of Appeal:
You may appeal to the appropriate court against the decision of the Panel and the order it has made against you. In this case the appropriate court is the High Court in England and Wales.

Under Articles 29 and 38 of the Health and Social Work Professions Order 2001, an appeal must be made to the court not more than 28 days after the date when this notice is served on you. The Order made against you will not take effect until that appeal period has expired or, if you appeal during that period, until that appeal is disposed of or withdrawn.

Interim Order
1. Mr Keating on behalf of the HCPC made an application for an Interim Suspension Order for a period of 18 months to cover the appeal period or until any appeal lodged has been determined. The Registrant did not oppose that application.

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

3. Given the Panel’s findings and its decision to impose a Suspension Order, it would be inconsistent with that need for public protection and the wider public interest not to impose some form of interim order. The Panel, for the same reasons it identified above, came to the conclusion that it is impracticable and inappropriate to formulate interim conditions of practice in this instance.

4. The Panel therefore makes an Interim Suspension Order under Article 31(2) of the Health Professions Order 2001, the same being in the public interest, having regard to the Panel’s findings of fact and determination as to impairment and sanction.

5. 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. This Interim Suspension is for a period of 18 months.

History of Hearings for Poppy Sprague