Karen M Dean

Original Allegation

As a registered Orthoptist (OR03702) your fitness to practise is impaired by reason of misconduct. In that:

1. On 25 August 2019, while at a house party, you:

a. were in possession of a class A drug, namely cocaine;

b. inhaled cocaine;

c. offered and/or supplied cocaine to two other individuals.

2. The matters set out at particulars 1 constitute misconduct

3. By reason of your misconduct your fitness to practise is impaired

Amended Allegation

As a registered Orthoptist (OR03702) your fitness to practise is impaired by reason of misconduct. In that:

1. On or around 25 August 2019, while at a house party, you:

a. were in possession of what you purported to be a controlled drug, namely cocaine;

b. inhaled what you purported to be a controlled drug, namely cocaine; and/or

c. offered and/or supplied what you purported to be a controlled drug, namely cocaine, to Person A and/or Person B

2. The matters set out at particulars 1(a) and/or 1(b) and/or 1(c) constitute misconduct

3. By reason of your misconduct your fitness to practise is impaired

Preliminary Matters

Conflict of interest

1. The Registrant emailed HCPC on 10 November 2023 to express surprise that the Panel that was to decide whether her fitness to practise was impaired included a person who had previously met her. The import of her email was to query whether it was appropriate for someone who knew her from three years at university would be making a judgement about her. The Panel asked HCPC for their view.

2. The HCPC did not consider that knowledge from 20 years ago in the context of a professional relationship necessarily presented a conflict of interest and indicated that the nature and extent of any relationship was relevant to the test of bias. The Panel member in question indicated that while the name of the Registrant was known to him because the profession is a small one, only 1,000 members strong, that he had only known the Registrant in a tutor-student relationship, between 2002-2005 and had had no direct personal or professional encounter with her since to his knowledge. While they did have colleagues in common, he had no knowledge of the Registrant that was external to the papers other than knowing where she had done her degree.

3. The Legal Assessor provided advice on the legal case of Porter v Magill, and referenced the HCPC Conflict of Interest Policy. The latter outlined the situation in which the question of conflict of interest arises: whether a decision maker has an interest which might influence, or be perceived to influence the person’s judgement? In this instance there has been previous interactions with the Registrant whose case needs to be considered, and that interaction was professional rather than personal. The legal test is: whether a fair-minded and properly-informed observer would conclude that there is a real possibility of bias, whether actual or apparent. The nature and duration of any relationship, the length of time that has elapsed in contact, and the reason why a person might have special reason to remember the Registrant or information about her were all relevant.

4. The Panel concluded that given the length of time since any contact had been made between two people who only knew each other in the context of a tutor-student relationship, no conflict of interest existed. It also considered the impact of a mutual colleague but acknowledging that the Registrant was not a topic of conversation and that mutuality only extended to sharing a workplace once a fortnight, it was content that this did not present a conflict of interest either. The Panel member was clear that he did not consider that his historical knowledge of the Registrant was of any relevance of the case, and that he had no special reason to remember her. Applying the test in Porter v Magill, the Panel determined that there was no conflict of interest to prevent the Panel as currently constituted from progressing the case.

Service

5. The HCPC provided information which demonstrated that a Notice of Hearing setting out the time, date and nature of the hearing and that this had been sent to the Registrant’s email address in good time, and the delivery receipt for this. Further, the Registrant had emailed the HCPC to indicate that while she had planned to attend the hearing she had reconsidered her position due to the impact on her mental health. The Panel accepted the advice of the Legal Assessor and determined that good service had been effected.

Proceeding in Absence

6. The Panel was invited by the HCPC to proceed in the absence of the Registrant. The Panel accepted the advice of the Legal Assessor and determined that it was fair and just to proceed in the absence of the Registrant. The rationale for this was:

a. The Registrant via her email to the HCPC acknowledged that she was aware of the hearing;

b. She had provided a reason for her non-attendance citing among other matters, the stress of the hearing on her health;

c. she has made her case clear via correspondence that she does not accept that she voluntarily self-administered cocaine on the day alleged;

d. Any prejudice in non-attendance can be mitigated by action being taken to present the Registrant’s case;

e. That she has not asked for an adjournment or indicated that her non-attendance is limited to this week, meaning that no useful purpose would be served in adjourning.

7. In all the circumstances, the Panel determined that the Registrant had voluntarily absented herself and that it was fair and in the interest of justice to proceed in her absence.

Amendment of the Allegation

8. The HCPC applied to amend the Allegation in the terms set out above:

a. inserting “or around” at the stem after the date;

b. in a) replacing “a class A drug” with “what you purported to be a controlled drug”;

c. in b) inserting “what you purported to be a controlled drug, namely” between the words “inhaled” and “cocaine”;

d. in c) inserting what you purported to be a controlled drug, namely before the word “cocaine” and replacing the words, “two other individuals” with “Person A and/or Person B”;

e. in particular 2, making clear that 1a and/or b and/or c, could constitute misconduct.

9. The Panel accepted the advice of the Legal Assessor. It took into account that the Registrant had been put on notice of this amendment since April 2023 and had not objected to the amendment. It considered that it was fair to make this amendment, as it was the more accurate allegation in the circumstances, bearing in mind its overarching objective of public protection, and its role of helping maintain public confidence in the profession.

Background

10. The HCPC opened the case on the basis that the Registrant took a substance that she purported to be cocaine at a house-party. This party was held at her house and it was said that she supplied the substance that she and others inhaled.

11. The HCPC case is that it rejects the Registrant’s contention that the substance ground and inhaled was an anti-histamine. While the HCPC does not have scientific evidence of the substance’s composition, it contends that inferences may be made and that such behaviour was not consistent with required standards of conduct.

Decision on Facts

12. The Panel first heard from the HCPC witness EB. EB adopted her statement. This was supplemented with additional information. She indicated that four adults were at the Registrant’s party and five to eight children were playing amongst themselves unsupervised simultaneously. She said she could not remember why she took videos but it was her habit to take lots of photos and videos as other people did. She said that she was open about the fact that she was filming and that while she had deleted some of the photos and videos that she had taken to free up space in her phone she had kept some photos and videos of this party, without editing either of the videos.

13. She was asked about the possibility that the Registrant was making a joke but she could not recall what it was. She said the Registrant and Person A and B may have made a joke before her filming started but she did not recall the subject matter. However, she could say that it was definitely not about the substance being Benadryl and that the substance was definitely cocaine. She said that the Registrant did have an allergy to horses but was not suffering from an allergy at the time.

14. There was exploration of dates, and with the assistance of her telephone which was checked, EB confirmed that the relevant party was in August 2019, but by the end of that month she had fallen out with the Registrant. Her statement set out the nature of this falling out, when she indicated that the Registrant attempted to blackmail her about a personal matter and would not stop.

15. Panel questions related to a number of different matters and elicited the following information:

a. EB explained that the Registrant was in the kitchen when she announced that her dealer was coming to the house and that she was going to buy cocaine. She clearly said this and was offering to get some for Person A or B. This was not the first time that she had made this offer to them. She said that they provided £15-20 each, sometimes in cash and sometimes via bank transfer. She saw notes being placed on the table.

b. The dealer’s car was a dark BMW, one series, it contained a male with dark hair. She said that she was holding open the front door as the Registrant would be locked out if the door closed. EB indicated that there is a gate and wall in front of house, with a drive that allows for four cars to park. There is a 15 ft gate that obscures the view from the street. This occurred in the daytime, approximately noon in August. She said that the road is not a busy one but quite secluded but the gate, large shrubs, and tall gate would block the view from the street to the house. She said that she was no more than two-three feet away from the driver, and was not obstructed in her view. She saw the Registrant hand over cash and receive a white substance which she understood to be cocaine. There was a small matchbox size amount of white powder, within a bag that could comfortably contain that amount.

c. She indicated that the Registrant called out: “got it, got it,” “got the coke,” “got the lemo,” once she returned to the house. EB said that the Registrant referred to cocaine as lemo often. The Registrant didn’t offer it to her because she was aware that EB does not take drugs. She tried it herself before offering it to Person A and B. They said it was “good lemo and not cut with much”.

d. Para 28: She said that her threat to send the video to the Registrant’s employers followed the Registrant’s threat to her and that the Registrant would not leave her alone. She set out how the blackmail attempts continued and the timeline was established after she checked her telephone. The two friends fell out at the end of August 2019 and by April 2020 were not talking.

e. She explained how the Registrant had tried the cocaine straight way and had a “quick one” declaring it to be good. However, the children came into the kitchen, so it was put away. She saw Person A, Person B and the Registrant attempt to use the downstairs bathroom but because a child was in there all four adults went to the family bathroom upstairs as she did not want to be the only adult alone. She at different times saw the bag in the Registrant’s hand, watched her put it into her pocket and later removed and take cocaine from it. She was content that the bag was the same one each time, as it had stripes across it with a K for Karen on it. She said that she knew it was the same bag, with a K on it, because the Registrant was in her sight at all times.

16. Person B gave evidence under affirmation and also adopted her written statement. She agreed that she was good friends with the Registrant and that she worked at Alder Hey hospital. She admitted that she had discussed this matter, what had happened at the party and this case with the Registrant at length. She also acknowledged that taking illegal drugs could have professional consequences for herself.

17. Person B indicated that she quickly became intoxicated at the party on 25 August 2019 and was under the influence of alcohol in the two videos. However, she said that although the three adults depicted in the video, who she identified as the Registrant, Person A, and Person B (herself), were acting as if they were taking cocaine, that each knew it was crushed up anti-histamine tablets. She said that she had seen a box of an own brand Asda anti-histamine tablets on a shelf in the bathroom and that the tablets had come from them. She said that either the Registrant or Person A had crushed them up and she could not remember which.

18. The Investigation Officer, LM, gave oral evidence under affirmation. She adopted her written statement and confirmed her investigation report and the interview summaries post a referral to HCPC on 9 November 2020. She set out that many interviews were undertaken by her with different people including the Registrant’s employers at the time. She said that the Registrant had provided an independent drug test that covered the period May-August 2020. The Trust did not supply a drug test which covered the relevant period of August 2019. She did not know why this was. Supplementary information was provided by the Registrant through her investigation.

HCPC submissions

19. Ms Bennathan, on behalf of the HCPC acknowledged that the Registrant has provided additional material, by way of email, but queried both its admissibility, and even if admissible, whether any weight should be given to it. She submitted that there is no dispute that the party occurred, and that the Panel has been able to view two videos. One depicts the Registrant placing a white powder under her nose, passing to Person A and Person B white powder from a £20 bank note on her fingernail which both snort. In the second video, the Registrant again offers a fingernail on which she has white powder to Person B who puts her nose to it. She asked the Panel to consider whether it was likely that this was crushed up anti-histamine tablets and whether it was realistic to consider that this video simply reflected an extended pretence and was a joke of which everyone was aware. She submitted that there was not a cadence of a joke about the video with no exaggerated pretence of snorting lines and laughing. Instead, the
Registrant is seen holding up drugs to be inhaled, she provides this to Person A who is already slumped on a toilet in an undignified pose, and Person B who is intoxicated.

20. Ms Bennathan reminded the Panel that the Registrant was seen to purchase drugs from a dealer, and that the Registrant’s habits were known to Person B. Further, that the evidence of witness EB is that the Registrant had no issues with her allergy at the party. She submitted that Person B had acknowledged that she was a good friend of the Registrant and that an admission to taking drugs could have professional consequences for herself. She invited the Panel to draw inferences of the actual video itself.

21. Ms Bennathan invited the Panel to consider the primary evidence of the videos and the inference that the Panel can draw from hem and set this against the plausibility of Person B’s account. Further, she highlighted that the negative drug test did not cover August 2019 and that the Trust did not undertake an independent test. She asked that although the Registrant has suggested that she had allergies and a sleep disorder, that made taking illegal drugs exceptionally dangerous, that she had not provided independent medical evidence of this. Lastly, she reminded the Panel that all those who take illegal drugs of uncertain provenance take risks willingly. Her submission was that the Panel had sufficient material before it to find the matters alleged proved given the burden and standard of proof.

22. The Panel accepted the advice of the Legal Assessor and bore in mind the burden and standard of proof in reaching its decision on facts. It applied care to its assessment of witness evidence and did not base any assessment of credibility on vivid or confident recollection alone. It considered where inferences could properly be drawn as commonsense deductions as opposed to mere conjecture.

23. The Panel first considered the additional emails provided by the Registrant. One set of correspondence was undated and purported to be WhatsApp messages between two people. The Registrant asked for these to be put before the Panel but not to be shared with witness EB They did not allude to the 25 August 2019. While the Panel regarded these as an attempt to undermine the credibility of witness EB via unsubstantiated speculation, it did not consider them directly relevant to the Allegation. Further, given that the material had been provided at a late stage the working day before the hearing, and the Registrant did not attend the hearing, the Panel was not able to verify through questioning the provenance of any messages. This was further complicated by the indication that these messages should not be shared with EB. Given the absence of details such as date or identity of provenance, any verification or the indication that these should not be shared with EB, the Panel considered that even if the material was admitted, that it could credit little, if any, weight to it, in all the circumstances.

Facts

1. On or around 25 August 2019, while at a house party, you:

a. were in possession of what you purported to be a controlled drug, namely cocaine;

24. The Panel relied the evidence of the video, HCPC witness EB, and the Registrant’s interview with HCPC during its investigation for this particular of the Allegation.

25. The Panel found from watching the video that there was white powder placed on a bank note that the Registrant held. The video has been shown to the Registrant. EB gave evidence that the Registrant said that it was ‘good lemo’. The Registrant herself in interview indicated that:

“We were drunk; I had a bag that looked like a drugs bag on my bikini with spare parts in it. There were saying that it looked like a bag thing for drugs and laughing because I said I was taking my drugs. I said I'm going to take my drugs, do you want some? - we were all having a laugh. I came in saying "here you are, do you want some", as if I was a dealer.”

26. The Panel considered that the video of the white substance, its placement on a banknote, the way that the Registrant acted in relation to it, scooping it up in small amounts, all suggest that Person A, Person B, and herself were treating the substance as the controlled drug cocaine. Accordingly, the Panel find this Particular of the Allegation proved.

27. The Panel went onto consider the evidence of both witness EB and Person B, along with the Registrant’s amendment to her interview record.

28. EB provided a consistent account of a person she recognised as the Registrant’s drug dealer, saw the transaction in which cash and a bag of white powder were exchanged. She had an unimpeded view of this and when the Registrant re-entered the house, watched her sampling it, heard the Registrant indicating that this was good lemo before offering it to Person A and B. She was able to describe the bag in detail, and the drugs, and from her past long friendship with the Registrant could indicate that their behaviour was consistent with what she knew to be true about the Registrant, Person A and Person B as drug users.

29. EB amended her interview summary by adding:

“Prior to the start of this video and immediately after the video "ended" - you would have heard the girls joking about my allergies, commenting on the fact that I have to take antihistamines every time we have a BBQ and saying how they felt "so much better" after taking my benadryl (something I say very regularly; in hindsight, this was a silly, drunken joke amongst the girls”

30. This account is supported by Person B who indicated that it was a joke that the three women were treating the white substance as cocaine, on the basis that it was really only crushed anti-histamine tablets.

31. The Panel considered both what EB and Person B had said, acknowledging that Witness EB and the Registrant were no longer friends. However, it was mindful that the Registrant was undergoing an investigation by her regulatory body for drug-taking when faced with videos of her behaviour. Further, it bore in mind that Person B had given evidence that she had not really snorted crushed up anti-histamine tablets and had suggested that the video had been edited so that the laughter and the fact that it was clearly a joke was not apparent without sound.

32. The Panel watched the videos multiple times. It was of the view that none of the women are laughing or even smiling in the videos. There is little exaggerated behaviour consistent with a joke. Rather, it is clear that Person B does snort the white powder offered to her by the Registrant and that the Registrant then scoops up more white powder to offer it to Person A.

33. The Panel did consider that a video could present a distorted picture and the passage of time could dull the memories of individuals. However, the Panel has found the most obvious interpretation of the video to be the true one: that it depicts drug taking, with the drug in question cocaine. It noted that the Registrant holds herself out as being familiar with what a drugs bag looks like: I had a bag that looked like a drugs bag, and that Person A and B were similarly aware of this: There were saying that it looked like a bag thing for drugs.

34. The video is consistent with the oral evidence of witness EB, notwithstanding her admission that she only made the video public after she stopped being friends with the Registrant. This is distinguished from the evidence of Person B, who has acknowledged that admitting to taking an illegal drug could have consequences for herself. Person B was unable to provide details of how the tablets were crushed, or who undertook this task. She admitted that she had discussed this case with the Registrant at length and that the two of them were good friends. In all the circumstances, the motivation for Person B to be less than frank is obvious.

35. Accordingly, the Panel find that the Registrant did purport the white powder to be cocaine, and that while there was no scientific analysis of the substance possible, because it had not been tested, and the Registrant had not been tested for drugs consumed during August 2025, that it is more likely than not that the drug in question was in fact cocaine.

Allegation 1a: found proved

1. On or around 25 August 2019, while at a house party, you:

b. inhaled what you purported to be a controlled drug, namely cocaine;

36. The Panel watched the video of the Registrant with the cocaine on a bank note. It showed the Registrant, as identified by Person B, scoop up with a fingernail a quantity of the powder and move it towards her nose. When her hand moves away from her nose, there is no white powder on the fingernail. This is evident from the manner in which she immediately refuels her fingernail, by scooping up more white powder from the bank note.

37. The Panel considered this evidence to be compelling. It does not consider it credible that the Registrant would consume an anti-histamine medication in this way. Nor that this was simply acting out a joke for the purpose of filming. In such circumstances, the pose struck by Person A, who is slumped on the toilet and who has her underwear lowered appears unlikely.

Allegation 1b, found proved.

1. On or around 25 August 2019, while at a house party, you:

c. offered and/or supplied what you purported to be a controlled drug, namely cocaine, to Person A and/or Person B

38. The Panel watched both videos. On the first video the Registrant scoops up the white powder, found to be cocaine, and passes it to Person A and Person B in turn. Both snorted the cocaine. This is apparent from their body language and the fact that Person B goes as far as closing one nostril, the better to use the other, and concentrate the effort of inhalation more efficaciously.

39. In the next video, while the Registrant’s face is not visible, her arm and hand is. This is identifiable because she has a large tattoo of a seahorse which can be clearly seen. Once again, her hand is very close to Person’s B face which is turned towards it. While at this angle Person B’s full face cannot be seen, the body language of the two is telling, and the Registrant holds the banknote on which cocaine is placed in her other hand.

40. The longer video shows a clear view of Person B inhaling the cocaine offered to her by the Registrant. It also shows Person A inhaling the cocaine offered to her by the Registrant although this depiction is less clear. In both instances, the Panel was clear, given the burden and standard of proof, that the Registrant has supplied cocaine to both Person A and Person B.

Particular 1c, found proved.

41. Having found the facts found proved, the Panel went onto consider misconduct.

Decision on Grounds

42. It was submitted on behalf of the HCPC that the Standard 9.1 of the HCPC’s Standards of Conduct Performance and Ethics:

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

43. Ms Bennathan submitted that giving drugs to people who were already intoxicated was particularly serious, with her agreeing to the filming of the incident throws her judgement into question further. Accordingly she invited the Panel to consider that the ground of misconduct was made out.

44. The Panel accepted the advice of the Legal Assessor and considered whether the facts it had found proved demonstrated that the Registrant had fallen short in her conduct, by way of “omission or commission” of the standards of conduct expected. Further, they weighed up whether the wrongdoing they had found proved was “serious” by reference to conduct that fellow practitioners would find “deplorable”. It considered the Registrant’s conduct against the relevant objective professional standards.

45. The Panel was of the view that Particular 1a did amount to misconduct. While the Registrant was in her home and entitled to a private life, she was acting in a way that is contrary to the law. Her role as a healthcare professional means that she is expected to operate within the confines of the law. Possessing an illegal drug for recreational use when a person is a professional is a serious matter.

46. The Panel was of the view that Particular 1b also amounted to misconduct. The Registrant inhaled cocaine without regard to her safety or the law. By her own admission she was already intoxicated at the time. Her position as a healthcare professional did not appear to feature in her assessment of what was appropriate behaviour in front of other members of the public.

47. The Panel was of the view that Particular 1c also amounted to misconduct. The supplying of cocaine to others, particularly those who were already intoxicated is dangerous and irresponsible. While supplying illegal drugs, even socially to friends, is against the law, and contains risks due to the unknown provenance of the goods, the Panel had been able to see that Person A did not appear to be able to hold herself upright and was slumped against the toilet. Further, the Registrant herself acknowledged in her HCPC interview, that she herself was already concerned about Person A’s behaviour by this time. This did not prevent her from providing Person A with cocaine. Person B also appears to be intoxicated and by her own admission quickly fell under the influence of alcohol during the party.

48. The Panel found that Standard 9.1 of the HCPC Standards on Conduct, Performance and Ethics had been breached by the facts found proved. The Registrant had failed to act in a way that was expected of her by not behaving as a law-abiding citizen. Further, her conduct did not justify the trust and confidence that the public is entitled to place in registered healthcare professionals.

49. Accordingly, the Panel found that the facts proved did amount to misconduct that was serious. Further that given the Registrant is a healthcare professional this it impacts on the reputation of her profession.

50. The statutory ground of misconduct was made out.

Decision on Impairment

51. Ms Bennathan, on behalf of the HCPC, submitted that impairment is current so the passage of time since August 2019 is relevant, especially in light of a clean drug test covering a six month period since then.

52. Insofar as the personal element of impairment was concerned, she invited the Panel to consider that the Registrant’s responses in this case shows a lack of insight or interest in remediation. While Ms Bennathan was careful to submit that simply denying an allegation does not equate with not having insight, the Registrant dismissing the instance as a joke does not represent real engagement she suggested.

53. Insofar as the public element of impairment was concerned, Ms Bennathan submitted that while this is not an incident that engaged service users, it did impact Person A, and B, who are members of the public. Supplying drugs to them caused harm, which the Registrant has not acknowledged. She said that the risk extended beyond the individuals present on or around the 25 August, given that the Registrant’s response had not acknowledged the importance of maintaining professional standards for the public good.

54. The Panel took into account the submissions of Ms Bennathan. The Panel accepted the advice of the Legal Assessor.

55. The Panel has approached its decision on impairment by looking at the situation as it is today. It has had regard to the HCPTS Practice Note “Fitness to Practise Impairment”.

56. The Panel’s primary objective is the protection of the public, the maintenance of public confidence in the profession, and the declaring and upholding of proper standards of conduct and behaviour.

57. In reaching a decision on impairment, the Panel has considered all of the evidence and the submissions and has exercised its’ own judgment on impairment.

58. Whilst there is no statutory definition of impairment, the Panel was assisted by the guidance provided by Dame Janet Smith in the Fifth Shipman Report, as adopted by the High Court in CHRE v NMC & Grant [2011]. In particular, the Panel considered whether its findings of fact showed that the Registrant’s fitness to practise is impaired in that she:

a. Has in the past acted and/or is liable in the future to act so as to put a patient at unwarranted risk of harm; and/or

b. Has in the past brought and/or is liable in the future to bring the medical profession into disrepute; and/or

c. Has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession; and/or

d. Has acted in such a way that her integrity can no longer be relied upon.

59. The Panel noted there was no character evidence or submission of references on behalf of the Registrant. The Panel did accept that there had been no information before it to suggest that there had been any previous regulatory findings against the Registrant.

60. In determining whether the Registrant’s fitness to practise is currently impaired, the Panel took into account both the “personal” and “public” components of impairment referred to in the case of Grant. The “personal” component relates to the Registrant’s evidence of insight and remorse and efforts towards remediation (whether it is remediable, whether the Registrant has taken remedial action and if there is a risk of repetition). 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.

61. With regard to the “personal” component of impairment, the Panel considered that the Registrant’s misconduct was remediable but was less confident that remedial action had been taken. While the Panel was alive to the six-month clean drug test that the Registrant put forward, it noted that this was the only such test before it. Further, it noted that this was a test that the Registrant had undertaken privately.

62. It considered that there was a risk of repetition due to the lack of evidence on insight. There has been nothing before the Panel which evidences an understanding of the harm done.

63. The Registrant had been interviewed by the Trust in relation to the incident reflected in proven Particular 1a-c. At the time of the interview, in 2021, the Registrant characterised her behaviour as “silly” and “drunken”. This in part, could be because she did not admit that it was cocaine that was being snorted by her friends and her.

64. The Panel was mindful that the Registrant is entitled to run the defence of her choice. However, it did not believe that the white powder being snorted by the three women was crushed anti-histamines. There is nothing about the conduct of the Registrant, Person A or Person B in the video recording that supports such a contention the Panel found, even without the evidence of witness EB.

65. The Panel considered that the demonstrated behavioural issues of the Registrant have been compounded by a lack of insight being demonstrated. While the Registrant had a right rather than an obligation to be present and engage in this hearing, it has not been possible to test her evidence via cross-examination.

66. The Panel did not have any updated information to take into account as to whether the Registrant had reflected and whether she had developed any insight. This meant that a risk of repetition remained.

67. Accordingly, the Panel therefore found the Registrant’s fitness to practise to be impaired having regard to the “personal” component.

68. With regard to the “public” component of impairment, the Panel considered that a finding of current impairment is necessary to uphold professional standards. In relation to the facts found proved and which amounted to misconduct, an informed member of the public would be shocked that a medical professional had possessed illegal drugs, inhaled these and supplied these to other members of the public. The Panel determined that public confidence in the profession and in the HCPC as its regulator would be seriously undermined if there were no finding of impairment.

69. Accordingly, the Panel found that the Registrant’s fitness to practise is impaired having regard to both the “personal” and “public” components of impairment. The Panel found that all three limbs of impairment were engaged in covering public protection, the public interest, and the upholding of appropriate standards.

Decision on Sanction

70. The Panel heard submissions from Ms Bennathan on behalf of the HCPC. She did not seek any particular sanction and left it as a matter for the Panel’s discretion. She reminded the Panel on its findings of facts.

71. In relation to mitigating factors, she indicated that the Allegation concerned a single day. In relation to aggravating factors, she indicated that the Panel should consider a lack of insight, remorse or remediation. She confirmed that she had no instructions concerning any previous fitness to practise findings.

72. The Panel accepted the advice of the Legal Assessor and has reached its decision on sanction by following the guidance in the HCPC Sanctions Policy.

73. The Panel has had regard to all the evidence presented. It reminded itself that a sanction is not intended to be punitive although it may have a punitive effect. The Panel bore in mind the principles of fairness and proportionality and that a sanction should consider both the position of the Registrant and the wider public.

74. The Panel acknowledged that any sanction should be no more restrictive than required, and that the primary function of any sanction is to address public safety from the perspective of the risk which the Registrant may pose to patients and to the wider public interest. It bore in mind the deterrent effect on other Registrants, the reputation of the profession and public confidence in the regulatory process.

75. 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.

76. The Panel began its deliberations on sanction by considering the mitigating factors. The Panel acknowledged that the Registrant had practised for many years and had no previous regulatory findings recorded against her.

77. The Panel next considered aggravating factors and reminded itself of its finding at the impairment stage; the misconduct was considered remediable, but limited evidence that any remedial action had been taken was put before it, as this was confined to a single drug test result. The Panel did not have any updated information to take into account as to whether the Registrant had reflected and whether she had further developed any insight. This meant that a risk of repetition remained. The Panel considered that the Registrant appears to have been less than frank in her communication and there is evidence of potential harm to other members of the public. Further although the Allegation is drafted to reflect the video evidence on a single day, there is more than one instance of the Registrant supplying drugs, and this involved both Person A and B. Children were present in the house at this time and unsupervised. The Registrant has not expressed remorse.

78. The Panel next considered the sanctions in ascending order of gravity.

79. The Panel found that it is not appropriate to make no order because of the serious nature of the Allegation found as well as its findings on facts, misconduct and impairment.

80. A Caution Order is not appropriate because the conduct found proved was serious and not minor in nature. There also remained a risk of repetition as there was lack of insight. There was no evidence of what the Registrant had done since this incident and limited evidence of remediation.

81. The Panel next considered a Conditions of Practice Order. Whilst the misconduct was capable of being remediated, the Registrant had not engaged to the extent that she had provided evidence of what steps she had taken and her attitude and approach to the Panel’s findings. Accordingly, the Panel could not be confident that the Registrant would comply with any conditions formulated. The Panel had also found a lack of insight. The Registrant’s misconduct was serious and there was a risk of repetition. The Panel did not consider there were any conditions that could be formulated that would be proportionate, appropriate and workable. In the circumstances, the Panel determined that a Conditions of Practice Order was inappropriate.

82. The Panel next considered a Suspension Order. The Panel noted the serious breach of a professional standard, the lack of insight and thus the risk of repetition.

83. The Panel noted the potential risk to members of the public and the reputation of the profession caused by the Registrant’s failure to adhere to Standard 9.1. When looking at the circumstances of the case, the Panel noted that the Registrant sought to deny any wrongdoing. The Panel determined that notwithstanding the risk of repetition, there was a possibility of the Registrant being able to remediate and demonstrate insight to address the risk of possible repetition.

84. The Panel was mindful that a Suspension Order deprived the Registrant of the opportunity to practise in her chosen profession, but considered that no lesser sanction was sufficient to mark the seriousness of the breach and reinforce the need to engage with and maintain the regulatory requirements.

85. The Panel did discuss a Striking Off Order and considered paragraph 131 of the HCPC’s Sanction Guidance, which stated as follows; “A striking off order is likely to be appropriate where the nature and gravity of the concerns are such that any lesser sanction would be insufficient to protect the public, public confidence in the profession, and public confidence in the regulatory process.”

86. The Panel was fully aware that a Striking Off Order “is a sanction of last resort for serious, persistent, deliberate, or reckless acts” (paragraph 129 of the HCPC’s Sanction Guidance). The Panel was satisfied that a lesser sanction would suffice, namely a Suspension Order. The Panel considered it would be disproportionate to issue a Striking Off Order as the misconduct concerns a single day insofar as the Allegation is drafted. The Registrant also had a long unblemished career without any fitness to practise concerns being raised.

87. The Panel determined that a Suspension Order was the more appropriate and proportionate outcome. It would protect the public and the reputation of the profession sufficiently until such point that the misconduct was remedied. It would also serve to allow the Registrant an opportunity to attend a future review hearing and engage, demonstrating the development of insight.

88. In considering the length of any period of suspension, the Panel determined that the Suspension Order should last for 12-months given the seriousness of the matter and the need to protect the public. This would give the Registrant time, should she wish, to develop insight and evidence the same.

89. A review would take place shortly before the expiry of the Suspension Order. The Panel considered a future reviewing panel may be assisted, but are not bound, by the following:

• Evidence that the Registrant has not taken illegal drugs, which may include drug test results;

• A reflective piece from the Registrant, which includes reflections on what illegal drug taking and supply means for others and the reputation of the profession;

• Any testimonials from colleagues in relation to conduct and working relationships, which may be from paid or unpaid roles;

• Evidence of continuous professional development; and

• Any other information that the Registrant considers would assist the reviewing panel.Order: The Registrar is directed to suspend Ms Karen M Dean from the register for a period of 12 months.

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.

The Registrar is directed to suspend Ms Karen M Dean from the register for a period of 12 months.

Interim Order
Application for an Interim Order

1. Ms Bennathan submitted that an interim order was necessary to protect members of the public and was otherwise in the public interest because the Panel had found the Registrant’s fitness to practise to be impaired and imposed a 12-month Suspension Order.

2. The Panel accepted the legal advice of the Legal Assessor. The Registrant was clearly on notice by virtue of the Notice of Hearing email sent as dealt with at the service stage that an application for an Interim Order may be made in the event of the Panel determining a sanction of Conditions of Practice, Suspension Order or Strike Off. The Panel was directed to the relevant paragraph on the Notice of Hearing within the Service Bundle. The Panel also determined that it should proceed in the absence of the Registrant. For the reasons set out earlier, the Panel determined it would be fair, proportionate and in the interest of justice to consider this application in the Registrant’s absence.

3. The Panel had careful regard to Paragraphs 133-135 of the Sanction Policy and to Paragraph 3.4 of the HCPTS Practice Note on Interim Orders, which offer guidance on interim orders imposed at final hearings after a sanction has been imposed.

4. The Panel recognised that its powers to impose an Interim Order are discretionary and that imposition of such an order is not an automatic outcome of fitness to practise proceedings in which a Suspension Order has been imposed. The Panel took into consideration the impact of such an order on the Registrant.

5. The Panel decided to impose an Interim Order under Article 31(2) of the Health Professions Order 2001. The Panel was satisfied on the basis and requirement of an Interim Order given the facts found proved. In the judgment of the Panel, the risk of repetition identified in the substantive decision and the associated risk of harm that could result from repetition mean that an Interim Order is necessary to protect members of the public.

6. It is also required in the wider public interest as public confidence in the profession and the regulatory process would be seriously undermined if the Registrant was allowed to continue unrestricted practice, after the substantive determination, during the appeal period.

7. The Panel first considered whether an Interim Conditions of Practice Order should be imposed. For the same reasons as the sanctions stage, the Panel did not consider that such an order was appropriate or workable. The Panel considered an Interim Suspension Order would be appropriate.

8. The Panel determined that the interim order should last for an 18-month period to cover any appeal period, notwithstanding that the substantive period was for a 12-month period. This was to take account of the time that may be necessary to deal with any appeal.

9. If no appeal is made, then the Interim Suspension Order will be replaced by the 12-month Suspension Order, 28 days after the Registrant is sent the decision of this hearing in writing.

Decision on 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 Karen M Dean