Mateusz Wyrostkiewicz

Preliminary Matters

Service

1. The Notice of Hearing (Notice) was sent to the Registrant by email on 4 June 2025. The Notice had details of the date and time of the hearing, that it would be conducted remotely by video conference, and a copy of the relevant papers and the powers available to the Panel. The Registrant responded to the Notice on 9 June 2025 and again on 28 June 2025.
The Panel’s decision

2. The Panel noted that the service bundle included a certificate proving the Registrant’s correct registration details and registered email address. The Panel accepted the Legal Assessor’s advice, and having had regard to rule 3 of The Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003 (the rules), the Panel determined that the Notice of Hearing had been served effectively under the rules.

Proceeding in the Registrant’s absence

3. Ms Patel, on behalf of the HCPC, invited the Panel to hear this case in the Registrant’s absence. Ms Patel reminded the Panel of its powers to do so under rule 11 and the guidance from the Court of Appeal in the case GMC v Adeogba [2016] WLR (D) 156. The Panel should prioritise fairness to the Registrant and consider the fair and expeditious disposal of this case to protect the public.

4. Ms Patel reminded the Panel that in his most recent email to the HCPC on 14 July 2025, the Registrant had said:

‘I can confirm that I have no objection to the hearing proceeding in my absence. I do not wish to ask for an adjournment, as the matter has already been ongoing for an extended period—approximately five or six years. I have nothing new to contribute at this stage, and much of the context I have consciously set aside. Additionally, my availability is quite limited; I can only accommodate late afternoons or occasional weekends, as my time is otherwise dedicated to family, pets, and professional commitments.’

5. Ms Patel said that in these circumstances, there was no advantage to the Registrant or the public in delaying the resolution of this matter.

The Panel’s decision

6. The Panel accepted the Legal Assessor’s advice and paid careful regard to the factors set out by the Court of Appeal in GMC v Adeogba. The Panel had no information to suggest that any delay would result in the Registrant’s attendance or participation. The Panel paid close attention to the Practice Note Proceeding in the Absence of the Registrant dated June 2022. It recognised that fairness to the Registrant was a prominent factor in its decision making. However, this matter was in relation to events of over six to seven years ago. Considering all matters, the Panel decided that it would be fair and proper to move forward in the Registrant’s absence.

Application for parts of the hearing to be heard in private

7. Ms Patel invited the Panel to conduct part of the hearing in private. She said that it may be necessary to discuss matters with witnesses in this case which touched on the Registrant’s health and family life. Ms Patel reminded the Panel that, ordinarily, these matters would not be heard in public even where the Registrant had not attended.

8. Ms Patel said that the Registrant had a right for respect to be given to his private and family life, and that could be managed by

• reference to the Panel’s powers to do so under rule 10 and
• the factors set out in the Practice Note Conducting Hearings in Private dated February 2025.

9. Ms Patel submitted that conducting only part of the hearing in private to this limited extent would still conform to the open justice principle as fully as possible. She submitted that conducting the parts of the hearing in private would protect the Registrant’s right to a private life.

The Panel’s decision

10. The Panel accepted the Legal Assessor’s advice and had close regard to the discretion provided to it under rule 10 and the factors set out in the Practice Note referred to by Ms Patel.

11. The Panel was satisfied that the Registrant’s health should be heard in private to maintain the Registrant’s right to respect for his private life. The Panel was satisfied, having considered the matter carefully, that the Registrant may suffer disproportionate damage if it did not hear the parts relating to his health in private. The limited departure necessary from the open justice principle would not result in an unreasonably redacted determination being published.

12. The Panel decided that the matters about the Registrant’s health and family life would be heard in private.

Documents lists

13. The Chair confirmed that the Panel had received the following documentation:

14. Exhibit C1 – Hearing bundle consisting of 276 pages;

15. Exhibit C2 – Service bundle consisting of 13 pages;

16. Exhibit C3 – correspondence bundle 5 pages;

17. Exhibit C4 – Registrant’s response to allegations 3 pages: and

18. Exhibit C5 – further correspondence bundle 6 pages.

Background

19. The Registrant is registered with the HCPC as a Paramedic. From 11 July 2016, he was employed as a band 6 Paramedic with North West Ambulance Service (NWAS) based in West Cumbria, in urgent and emergency care.

20. [Redacted]. He was signed off sick on 15 December 2018.

21. On 17 April 2019, the Registrant was the subject of an internal disciplinary procedure at NWAS because of his conduct while on duty with two colleagues, Colleague A and Colleague B. It was alleged that over time in 2018 and 2019, the Registrant had made unpleasant and unacceptable comments towards his colleagues, some of which were racially offensive and motivated, and others were tainted by references perceived to be terrorism. Later, allegations emerged of his having behaved inappropriately towards patients.

22. NWAS considered that the allegations were matters that should be reported to the police. Cumbria police later interviewed the Registrant, but no police action followed.

23. NWAS suspended the Registrant from duty pending the investigation being completed, after which the Registrant returned to duty.

Witnesses

MG

24. MG affirmed and acknowledged that her sworn statements of truth dated 20 January 2021 and a supplementary statement without exhibits dated 20 September 2022 were correct, complete, and reliable. She adopted them as her evidence-in-chief. The exhibits referenced and authenticated by her in her first statement were incorporated into her evidence.

25. MG explained that in the internal workplace investigation, the Registrant admitted that some of his remarks had been said but were taken outside of the mutually engaged in discussion between Colleague A and himself. The remarks were then reported by Colleague A in an inflated and distorted sense. The Registrant accepted that an incident had occurred where he referred to his preferred society being like that of a white chocolate snack bar. He said however that he intended to focus attention on the other qualities of the bar than simply its white outer layer. He insisted that the bar had multiple-coloured layers and flavours which blended pleasingly, as he preferred.

26. He also accepted that he had discussed a satanic-linked cult figure, the ‘dark lord,’ but did so as part of a genuine and, he thought, mutually interesting course of discussions related to cultures and religions. He denied that he had said anything linked to terrorism but had discussed issues of interest to him related to middle east current affairs.

27. The Registrant denied having said anything racially motivated or intended.

28. In the investigation, other reports emerged that were consistent with the Registrant having behaved as alleged. Colleague B revealed in the workplace investigation that she could not continue working with the Registrant. His remarks had caused her distress. When provided with an opportunity to respond in a meeting with the service’s then acting operations manager MG, the Registrant asserted that he was oppositional and controversialist in nature (‘obstructive’) which reflected his interactions with colleagues and his work seniors.

29. MG was not persuaded by what she perceived to be an unemotional and glibly prepared response. He ’…had an answer for everything.’ She had expected a forceful and emotional response to such appalling allegations which made his answers seem scripted and disingenuous. MG also believed that the Registrant had not engaged meaningfully with the wider context-based reports, which he later explained as the result of the absence of an opportunity to make a written response. However, the record of the interview was sent to the Registrant, and he added his written responses in red type.

30. MG told the Panel that she had formed an unsatisfactory opinion of the Registrant’s responses. He had not reacted to the allegations. The tone of his answers was flat and unemotional, contrary to what might have been expected in a Paramedic who had been accused of, among other things, racially motivated speech. The Registrant’s answers were pre-planned in character in her opinion. He had not reacted as though anything out of the ordinary might have been perceived in his words to his professional colleagues during work. He wished to convey an impression of a cultural or language barrier which he could not overcome, which would account for his having been misunderstood.

31. MG explained that she had taken the Registrant to the workplace policy relating to the expectation that colleagues will know the NHS values of respect for other people’s values and that dignity and respect was to be given to colleagues. She mentioned that the Registrant’s colleagues A and B had been made to feel uncomfortable by his words. The Registrant had merely deflected the discussion to an insistence that his incomplete assimilation into the workplace was the source of an unintended misunderstanding on the occasions mentioned.

32. MG told the Panel that she had considered the possibility that the Registrant’s Central-European cultural and language background favoured directness to the point of bluntness, and that colleagues might not have appreciated that as context. She considered that this was not a satisfactory answer. Many other Polish Paramedics had quickly shown a gradual accommodation and appreciation of the English context in which they were now expected to live and work. They had successfully moderated their tone. The Registrant whose spoken and written English was materially far better than many of his Polish contemporaries, had shown no such softening despite his clear advantages in communication skills.

33. MG said that she considered, and quickly dismissed, an explanation that the Registrant’s treatment of Patients B and C had been linked to a lack of professional skill or competence. The Registrant had demonstrated no lack of training or competence that would explain his conduct. No-one had ever complained that he had a lack of skills or training and none of the Registrant’s professional colleagues had raised this as an explanation. In common with all Paramedics, the Registrant had been subject to six-month reviews from 2016 to 2018 with no issues being identified.

34. The Registrant was, however, a ‘…difficult character.’ His mental health was not responsible for his choice of words and when he initiated the topics. He had claimed that he was merely exploring cultural differences or personal differences among his colleagues.

Colleague A

35. Colleague A affirmed and acknowledged that his sworn statement of truth dated 10 January 2021 was correct, complete, and reliable. He adopted the statement as his evidence-in-chief.

36. Colleague A told the Panel that he had joined NWAS in September 2018 and had not met the Registrant before that time although he had heard of him. Colleague A knew the Registrant as someone who did not engage with the ambulance crews in the crew room. Instead, he remained in the cab of his ambulance completing highly skilled art on his tablet device.

37. Colleague A recalled that in late 2018 the Registrant had said to him that he liked to cut the heads off cats on his time off. Colleague A recalled that he was driving the ambulance and although the lights and sirens were on but he could hear him. The Registrant had spoken in a flat monotone and matter of fact manner. The remark was unexpected by Colleague A and made him feel uncomfortable.

38. Colleague A worked a shift pattern with the Registrant between 15 to 17 April 2019, which included several increasingly perplexing and then alarming, unprovoked pronouncements by the Registrant. The final remark caused so much concern for Colleague A that as a matter of public safety, he alerted his managers to what he regarded as racist and terrorist speech.

39. On 16 April 2019, the Registrant had stated his wish to drive his car into the local countryside to steal and then sacrifice a lamb, in a troublingly very matter of fact way. Colleague A felt uncomfortable and asked the Registrant how he intended to stop the animal leaping around in the car, the Registrant said that he would tie it up. This abnormal episode was related by the Registrant without any sense of jest or humour but was instead flat and emotionless.

40. This seemed to be linked to an earlier encounter between 15 and 17 April 2019, the Registrant had asked him to counter-sign the controlled drugs book as normal but with the words “…I signed the book of the dark lord, will you sign it as well please?” This had been linked in Colleague A’s mind with the Registrant also stating during that period, ‘I like to sacrifice animals to please the dark lord.’ Colleague A explained to the Panel that nothing had signalled or prefigured the Registrant’s odd and troubling words. He did not accept the explanation put forward by the Registrant in MG’s investigation, that these were part of the exaggerated, grimly morbid ‘cab-humour’ used by colleagues at the end of a shift to decompress from the day’s tensions and strains. The Registrant was not a natural joker; Colleague A told the Panel.

41. Colleague A recalled that on 15 April 2019, the Registrant had been in a bad mood and had been rude to patients. In one incident that day, he, and the Registrant had gone to the home of a patient who had been seen at home by another clinician. The patient’s daughter called for help again as her mother was in a lot of pain and distress. The Registrant had behaved badly by being rude to the patient and constantly leaving the room, giving the impression that the call was a waste of his time and that he did not want to be there.

42. The patient and her daughter became upset by this behaviour and Colleague A had to divert his attention from dealing with the patient’s clinical issues to simultaneously calming down the situation. The patient’s daughter felt failed by the previous clinician and was inflamed by the Registrant’s response. The Registrant’s words to the patient’s daughter included that she had to stop being ‘…childish.’ The situation became chaotic for Colleague A as he was trying attend to the patient. The Registrant’s unhelpful poor behaviour added unwanted external pressure to a situation and only added to the complexity. There had been no need for this conduct. In his opinion the patient was unwell and had acute sepsis and a Modified Early Warning Score (MEWS) that was a cause for concern.

43. The patient was conveyed to hospital. Colleague A stayed with her in the back of the ambulance while the Registrant drove to the hospital. Colleague A told the Registrant not to be so rude. He did not take this well and was bad-tempered for the rest of the shift.

44. Colleague A discussed two further incidents that he linked as connected to racism and possible violence on the Registrant’s part.

45. In an incident in the cab while Colleague A was driving, the Registrant spontaneously began a monotone matter of fact monologue in which he said that he disliked people who were not white. The Registrant said that he had a brother who had been involved in the war in Iraq, and that it was possible to buy rifles and a tank on the internet. The Registrant continued that he would like to buy rifles or a tank and ‘…get some work with…’ his relative, go over there to kill a lot of them. He did not specify the group to which ‘them’ belonged. This was said clearly and without any prompting or context.

46. On 17 April 2019, the Registrant had opened a chocolate bar in the cab while Colleague A was driving. The Registrant held up the bar to show that it was white chocolate. He said to Colleague A ‘See this [Colleague A]? This is how I like my society.’ There was no prompting or encouragement to provoke this remark. It did not appear to Colleague A to be a joke in bad taste or that it had any other explanation than a statement made with racist intent and could be associated with his other remarks regarding not liking any race other than white people.

47. The final event occurred on 17 April 2019, after which Colleague A decided to report the Registrant to his employer for investigation. It was another unprompted, spontaneous, and deeply worrying remark for Colleague A. The Registrant said that he was sorry if he had been ‘…a little off’ over the last few days. The Registrant said that he might get some nicotine (having previously been a smoker) ‘…or maybe when I finish work tonight I’ll murder someone.’ Colleague A said that he remembered this incident intensely. He recalled the precise circumstances of where he was driving the ambulance, pulling out of the Cumbria West Cumberland Hospital (WCH). It was said without emphasis and in an everyday way as though discussing the most ordinary thing. Colleague A was struck deeply by the incident and dwelt on it. He resolved on 19 April 2019, to report this matter to his managers. He felt so concerned that it affected his sleep, worried that the morning papers might have something that the Registrant had done, and Colleague A had not prevented it.

48. Colleague A said that he has wide experience of Polish colleagues as Paramedics. Although many could, at first, be described as abrupt and direct, the Registrant had a far greater knowledge and facility with spoken English. The Registrant’s words were not abrupt bluntness but a chilling everyday conversational tone.

Colleague C

49. Colleague C affirmed and acknowledged that her sworn statements of truth dated 14 April 2021 and 26 August 2022 were correct, complete, and reliable. She adopted the statements as her evidence-in-chief.

Patient A

50. Colleague C told the Panel that she had gone to a call at a country house on 22 June 2018 with the Registrant. The patient was very uncomfortable and in pain. She had suffered a fall and had injured her back and ribs. The Registrant behaved impatiently towards her. He told her she was exaggerating and gave the impression that the visit was a waste of his time. He knelt beside her and the patient expressed being in pain. She screamed. He said to her ‘now I know you are exaggerating; I barely touched you.’ The patient shouted; ‘what did you say’? The patient’s husband was enraged and demanded that the Registrant leave the house.

51. Colleague C confronted the Registrant when they returned to the ambulance. He had been dismissive and had adopted a harsh tone. The Registrant was disgruntled at this, and despite having been in an upbeat mood before this, continued the shift and the succeeding shift over the weekend in a bad temper. He was rude and demeaning towards Colleague C. He corrected her at every turn and left her feeling belittled and upset.

Patient B

52. Patient B had dementia and Alzheimer’s. The call to his house on 22 June 2018, was in response to an infection which had made it necessary for him to be taken to hospital. The Registrant travelled in the back of the ambulance with the patient while Colleague C drove. Colleague C became concerned at what she could overhear in the back of the ambulance. She turned on the internal microphone although she could hear what was being said through the open hatch. Patient B had become distressed. He very much wanted to urinate but because of his condition had become unable to. The Registrant had declined to allow space for this to be facilitated by not allowing the ambulance to pull over and helping the patient to use a urine bottle. He told Patient B he ‘…should have gone before we left.’

53. Colleague C was distressed to overhear the Registrant decline to allow her to stop and how the Registrant shouted at the patient and was rude to him, despite the proper course being to speak slowly to help the patient to understand. She stopped the vehicle to allow the patient to try to use a urine bottle. The patient was sobbing. He had developed retention and seemed unable to ‘let go.’ The Registrant said to him that ‘if you can’t go we can’t sit here all day.’ Colleague C hear this being said clearly as she sat in the driver’s seat. The Registrant had spoken roughly to Patient B, telling him he did not want to have ‘piss all over his shoes.’ Colleague C told the Registrant that had he spoken to a member of her family like that, she would have been fuming. The patient could hear his comments.

54. However, it was unclear how much if anything that he understood because of his condition and that he was hitting severe infection markers. The Registrant did not receive this comment well. His mood darkened.

55. At hospital there was a verbal exchange between Colleague C and the Registrant in which the Registrant shouted at Colleague C from ten feet away ‘If you put your hands on my neuro deficit patient again then I will report you and you will lose your job.’ He shouted at Colleague C and a matron who had been in the linen cupboard emerged to discover what the commotion was all about.

Patient C

56. Colleague C and the Registrant attended patient C on 22 June 2018, at his GP surgery where an electrocardiogram (ECG) trace had detected a serious and urgent anomaly. The call was to take the patient for urgent care. Colleague C was handed the general practitioner ECG printout, but it was in a different format for Colleague C who is not trained to interpret these printouts. The Registrant agreed to drive the vehicle while Colleague C remained in the back with Patient C who at that point was pain free and was not distressed.

57. On the journey, in the back of the ambulance Patient C said that he could feel the pain returning. He clutched his chest and seemed pale and clammy. The patient was being tracked on a portable ECG. Colleague C could not interpret the results but was concerned to see the trace adopt a ‘tombstone’ appearance indicating to Colleague C that the patient needed urgent and specialist care.

58. Colleague C knew that the Registrant was more qualified and asked him to pull over to allow them to change roles so that he could intervene if clinically necessary. The Registrant refused. He said ‘it’ (the trace) was ‘fine’ and the patient would be ok. Colleague C handed the Registrant the ECG trace to read in order to persuade him to come into the back of the ambulance while she drove instead. However, the Registrant said only that the trace was not urgent. He said that the ambulance was only five minutes from the hospital, and he would switch on the lights and sirens.

59. Colleague C considered the situation to be critical, and it was important to act immediately. The patient’s condition was worsening, and in her opinion a medical crisis was evolving. The Registrant refused and continued towards the A&E unit.

60. On arrival, the Registrant stated that he was the clinical lead and had decided to put the patient in a wheelchair. Colleague C refused to agree and ran into the unit hoping to find someone who would listen to her and instruct that the patient be taken to Carlise. However, the Registrant had also left the vehicle and found a wheelchair to take the patient into the unit. A nurse was concerned that the Registrant had done this because a patient is this condition must avoid any physical stress of any kind. He ought to have been kept flat and remained attached to the portable ECG, which was impossible in a wheelchair. The nurse found a flat trolley for the patient and began an ECG which reinforced the need to take the patient immediately to Carlisle.

61. Patient C was then taken to the specialist heart care facility. Colleague C believed that 45 minutes had been lost by not immediately diverting to the specialist unit when she first asked the Registrant to do so.

62. Colleague C felt that in her experience of other Polish national paramedics, they softened over time as their English language skills became more proficient. They began to attune to the way English is spoken as a Paramedic. This did not apply to the Registrant. His English language skills were already good and far better than any of his Polish contemporaries.

The Registrant’s case

63. The Registrant had not answered the allegations. He had however given the HCPC a written response dated 1 October 2023 which read:

Background

I have been registered Paramedic in England since year 2016, I have been employed by North West ambulance service since July 2016 till march 2022. My employment ended after long period of work-related sickness [Redacted]. Due to the fact I have received little to none support from my employer during my illness and no prospect of alternative role in the Trust I decided to leave. I have begun work for Mountain Healthcare LTD, providing care for detainees in police custody in May 2022, where I'm employed fulltime. Prior to this I was working as a Paramedic in ambulance service and advance care practitioner in emergency department in Poland.

[Redacted]. The form of consent to access my medical records was received by me and returned. If it comes to PREVENT I have never received any official statement in form of document in example. But they have visited one day, and in my short impression, we had a cup of tea, talked a bit had a laugh and said our goodbyes with statement from visiting people that they won’t be coming back.

After the NWAS disciplinary hearing I was immediately reinstated to my post with 6 months of observation period and have not had any negative feedback since, on contrary like before these events I've received couple of recommendation letters for my service quality.

1 i) I have no recollection of such event and words spoken. It is not in my nature to comment on someone behaviour, however. Firstly, because it's not my role to judge, especially not knowing all circumstances to make them behave as they do, secondly people these days are very self-centred and sensitive, thus take offence quite often. I can imagine that in situation when one's relative is ill some people would overreact, behave irrationally to extend, be overcautious and nervous. I would be the same despite being HCP, thus wouldn't judge in such words. Perhaps I have said something that meant to discharge the tension and stress of patients relative, and it wasn't received as intended, but it wouldn't be calling someone childish.

To add to this, I understand that by my colleagues at my current workplace I'm considered calm and composed when dealing with detainees and will rather defuse stressful situations rather than exacerbate them.

1 j) Again I have no recollection of such words spoken, be it time passed. I do however remember we discussed few topics related to witchcraft, magic, and mystery, especially that it was a time when tv series "Salem" last season was released as I recall correctly. There is no denying that I take vivid interest in such things as was raised on fantasy literature and media and I am avid fan of role-playing games like "Dungeon and Dragons" etc. I may have then made a joke or tease like that, what I reflect now would be inappropriate for a person that wouldn’t understand a context, provided such words were said.

And in contrary to what [Colleague A] says I am quite joyful person that does not withheld a joke if one is to be made or told. I am surprised that one that spends 3 days in work environment with someone, with barely any prior acquaintance and little to no engagement in conversations trying to be made is making judgements about a character.

4 a) b) During my employment in North West Ambulance Service (NWAS) I have attended countless episodes of chest pain. Trust policies on any confirmed cardiac events at that time were clear to transport any patients with evident and confirmed acute ischemic changes in ECG to Primary percutaneous coronary intervention (PPCI) unit in Cumberland Infirmary Carlise (CIC), Cumbria. All other cases like pleuritic chest pain, or one of undefined origin to be transferred to WCH in Whiteheaven, Cumbria. On occasion those patients initially brought to WCH would be transferred to CIC either immediately or after some time and assessments, i.e.. After positive troponin tests, or due to, what was common at that time for WCH, lack of appropriate clinician.

I would presume that because we were traveling to WCH there was no clear confirmation of acute ischemic problem. In regards of being in a back or front of ambulance there was no clear guidelines from Trust. It's common sense however that patient that requires or might require Paramedic intervention should travel with Paramedic with them in a back of a truck. This was always left to judgement. Patients haemodynamically stable, with no acute symptoms with mild pain would be often considered safe to travel with technician. Then again, I never said no to a Colleague who said to me they do not feel comfortable or confident enough to travel with given patient in a back of an ambulance on their own.

If patient condition was identified as cardiac and acute, they should be transported on stretcher. That said in my previous statement I have acknowledged that the patient was queried as with Acute Coronary Sympthoms and however in initial assessment they weren’t considered for PPCI according to local guidelines they should have been monitored and transported in comfortable position with no physical stress. Therefore it was an error on my account to transport them otherwise.

Furthermore, I have never received any negative feedback or warnings in regards of my clinical judgement of cardiac events from my superiors.

I can't relate to this event precisely, as simply chest pains are one of more common ambulance responses and there wouldn't be a day without one. What I do recall with that time working with [Redacted] Collegue C is atmosphere of chaos, disorganisation, and uncertainty that she introduced to our work. Asking questions, having doubts, and making considerations is welcomed and good process of learning and development, doing it on every step however even in simplest tasks is undermining and has poor effect on crew morale.

64. The Registrant had also made an initial answer to what became the allegations in his self-report to the HCPC in May 2019 which in part read:

On the 18th April 2019 I was suspended from duty due to concerns raised that I have allegedly made comments inconsistent with Trust values. On 26th April 2019 meeting was held where I had my chance to make verbal statement, written document have yet to be composed.

Nature of concerns was to my beliefs and religious stances and my alleged racial prejudice. The concerns were raised by my work Colleague whom I was working for consecutive days and discussed different geopolitical and religious topics. Its worth stating that my crew mate was actively participating in discussion and never stated that some topics make him feel uncomfortable or would not discuss them. Afterwards he constructed report filled whit statements that I have made but cut out of context or deformed thus changing they initial meaning. As well as put statements that I never made or would make regarding racial prejudice, that made me feel uncomfortable and sad.

Written report of this meeting has not yet been delivered to me. I'm not aware of any outcomes of this situation yet. I will forward this documents as soon as will receive them.

65. Ms Patel closed the case on behalf of the HCPC and said that it was unnecessary for her to recall MG as a witness. The Panel conferred and agreed that they had no further questions for MG and so did not ask that she be recalled.

66. Ms Patel invited the Panel to find all of the facts proved, partly by reference to the Registrant’s written responses and largely by relying on the evidence of the three witnesses she had called.

67. Ms Patel said that all three witnesses had given persuasive and in certain instances vividly compelling testimony, which all accorded with the contemporary written records. Ms Patel submitted that all of the facts could be established based on the witness testimony which had comprehensively covered the matters alleged.

68. Ms Patel took the Panel to each succeeding head of allegation and methodically explained where, in her submission, the Panel could find the evidence in the Panel’s own notes of the live evidence, the statements, and in the schedule of evidence which formed part of the statement of case in the hearing bundle Exhibit C1.

69. Ms Patel invited the Panel to find that allegation 4 was proved on balance of probabilities. Support for the finding of racial motivation could be found in the case of Lambert-Simpson v HCPC [2023] EWHC 481 (Admin), where the judge framed a two-part test:

i) that the act in question (here, the posting of the content) had a purpose behind it which at least in significant part was referable to race; and

ii) that the act was done in a way showing hostility or a discriminatory attitude to the relevant racial group.”

70. Ms Patel said that, the Registrant’s speech had a purpose behind it that was substantially linked to race because he identified that all people who were non-white were the ‘other’ who were the object of his words, and that the only realistic way to understand his speech was that he intended hostility and a discriminatory attitude towards non-whites.

Decision on the Facts

71. The Panel accepted the Legal Assessor’s advice. The Panel had regard to the Practice Note Making decisions on a Registrant’s state of mind dated January 2025. In particular the Practice Note reminded the Panel that the state of a person’s mind is not something that can be proved by direct observation. A person's state of mind can only be proved by inference or deduction from the surrounding evidence. The Panel must examine all the evidence and the circumstances, including the facts, the history, the Registrant’s explanation, and any evidence as to character, and then consider whether the alleged state of mind can reasonably be inferred from the evidence.

72. The Panel recognised that the Council had the burden of proving disputed facts to the civil law standard of balance of probabilities. The Registrant had no burden of proof.

73. The Panel began by carefully considering what few contemporary records existed as recommended in the case of R (Dutta) v GMC [2020] EWHC 1974 (Admin). Care had to be taken when considering the early records that they were not influenced by the developing NWAS investigation. However, there was nothing in the records to suggest that there had been any deliberate filtering or contamination of the reports made by Colleague A, Colleague C or Colleague B although that person was not a formal witness in this process.

74. The Panel considered therefore that it was appropriate to assess the impression made by each witness regarding their credibility and reliability.

75. The Panel was satisfied that MG, Colleague A, and Colleague C, were each honest and reliable witnesses. The Panel was satisfied that each witness was careful to limit their evidence to factual, unemotional matters, even when recalling the events that had an emotional impact on them (in particular Colleague C). In the Panel’s assessment, the witnesses had not tried to elaborate on their evidence in an artificial, unrestrained way. Rather, they were careful to make sure they provided only evidence they could accurately remember. Their accounts in their written statements and in their later oral evidence closely corelated to the earliest accounts of events in April and May 2019 for Colleague A and July 2018 for Colleague C.

76. The Panel was satisfied that the witnesses had not allowed imagination to fill gaps as their memory of events faded with time. Colleague A had recalled striking details linked to the incidents which had made an immediate and lasting impression on him. He remembered the location of the vehicle he was driving at the relevant point, and why the sudden pronouncements made by the Registrant had made the events memorable. Colleague C was equally vivid in her recall, remembering the distress endured by Patient B and the reactions to the Registrant’s words by Patient A and her husband. In respect of Patient B, she recalled incidental factual details, such as the sudden appearance of a Matron to see what was going on when the Registrant had shouted at her in the hospital. None of this recall appeared to be embellishments. Colleague C described the Registrant as having been jovial and in good humour at the start of their shift, only changing in demeanour after she had challenged him regarding his words said to Patient A.

77. The Panel considered that it was important that while both Colleague A and Colleague C had experienced the Registrant as a person who did not mix readily with other crew members and who kept to himself, they rarely criticised his clinical skills outside of the patient reports they made. They seemed to accept him for who he was. There was no appearance of ill-will towards him or of any intention to inflate their accounts to be rid of him.

78. The Registrant’s written responses and statement were of less assistance to the Panel. He had not addressed the allegations in the detail that it would have expected had there been a substantial answer. Instead, the Registrant said that he could not recall many events having occurred or that the attributed speech was not characteristic of him. The Registrant persisted in his assertion that a cultural or linguistic misunderstanding might explain things. That was not an easy explanation to accept from a person whose linguistic skills in English extend to using words such as ‘…interlocutor.’ The Panel could accept the Registrant’s perception of himself as a provocative cab-mate. However, that did not fit closely with a picture of a speaker who raised potentially troubling matters in a spirit of enquiry. Rather it matched the image of someone who made outrageous or worrying declaratory statements, expressing his own embedded beliefs.

79. The Panel found all of the sub-particulars in Allegation 1 proved.

80. 1.a) Colleague A had satisfied the Panel that he had accurately recalled the words said by the Registrant. The fact that they were said with no connection to anything else being said or done and said in a flat, monotone matter of fact way all made the words memorable for Colleague A. It became a characteristic of the Registrant’s manner of delivery. The content of the words related to what appeared to be emerging themes in the Registrant’s monologues, the violent killing of animals for pleasure or in sacrifice to a malign entity. The Registrant referred to his religious beliefs in his responses to the Allegations, without enlarging on the substance of his beliefs, as might be expected if they were sinister in nature.

81. 1.b) The Registrant did not deny saying these words. He recalled that they resulted from a TV show he had been following. The Registrant’s strained explanation was contrived to suggest that he was engaged in a lively discussion about an interesting production with cultural and historical significance. That was not in agreement with Colleague A’s memory of the troublingly flat monotone of the Registrant’s delivery.

82. 1.c) As stated, the Panel accepted Colleague A’s account. It was supported by his recollection of trying to make light of the ideas to close the discussion, but the Registrant was not deflected. He explained to Colleague A how he would tie up a stolen lamb to ensure it was controlled on the way to the sacrifice. The Registrant later tried to assert that he was ‘having fun’ presumably at Colleague A’s expense. He also said however that it was appropriate to raise the topic in case Colleague A was interested. He said that Colleague A might have misinterpreted his words but that did not sit with the Registrant referring to Colleague A as his ‘…interlocutor,’ a polished and advanced word that is unlikely to be in the vocabulary of a person easily misunderstood.

83. 1.d) The Panel was satisfied that Colleague A had accurately recalled the Registrant’s expressed desire to commit mass murder with weapons. The Registrant’s assertion of only trying to discuss current affairs was, in the Panel’s view, no more than smoke and mirrors. The Registrant’s responses came close to ‘gas-lighting.’ The Registrant talked about his internet searches which revealed that such weapons are available for purchase. He did not wholly distance himself as the speaker of those words. There was context for the Registrant’s expressed desire to commit indiscriminate killing. He had explained to NWAS in his ‘prevent’ interview [Redacted] that he himself could not deny having killed people already on active duty for fear of somehow being prosecuted for treason.

84. 1.e) The Panel was convinced by Colleague A’s testimony that the Registrant had used a white chocolate bar to state his preference for an all-white society. There was no room for doubt having heard and accepted the context and delivery recalled by Colleague A. There was no attempt at the time by the Registrant to say that the white coloured bar was a metaphor for a blended society in which the other coloured layers and flavours blend positively. That artifice was another example of the Registrant’s gas-lighting and distraction from the clear and obvious point he had expressed. There was no need for the Registrant to explain further to Colleague A in the cab of the ambulance. The point was made simply and fully in the few words chosen by the Registrant to express his true beliefs. Colleague A immediately grasped the Registrant’s meaning. His preference was for an all-white society.

85. 1.f) Colleague A recalled the Registrant’s chilling words. It struck home with him so powerfully that it was the catalyst for Colleague A’s report to NWAS. The flat, monotone delivery, coupled with the earlier troubling words used by the Registrant left Colleague A feeling he had to act as he could not live with the consequences of having done nothing had the Registrant made good on his declared openness to commit murder as a relief from his mood.

86. 1.g) The Panel were persuaded by Colleague A’s testimony that the Registrant had voiced a wish to find work that would licence him to kill people who did not meet his all-white society preference. There was no room for doubt in the Panel’s mind that the Registrant might have been misunderstood for the commonplace expression ‘…kill for a cigarette’ sometimes used by ex-smokers. The link between this incident and the others was equally clear. It formed part of a thread of seriously intended declarations which revealed a theme, and a central part of the theme was the Registrant’s preference for an all-white society. The Registrant’s advanced skill in his second language revealed his efforts to explain away the remarks as smoke and mirrors.

87. 1.h) The Panel was satisfied that Colleague A heard the Registrant use these words and in the way described. There was no room for error or mistranslation. Colleague A remembered the incident in vivid and memorable details including the Registrant being told by the patient’s husband to leave the house.

88. 1.i) Colleague A recalled that the Registrant had said the words when being handed the controlled drugs book to counter-sign. Colleague A did not hear it as a joke because of the now routine flat monotone delivery. In the context of the other sinister and unwholesome remarks made with no connection to the situation by the Registrant, there was no error on Colleague A’s part in the Panel’s view.

89. The Panel found all of the sub-particulars in Allegation 2 proved.

90. 2.a) The Panel was satisfied that Colleague C had accurately recalled the incident. The Registrant had behaved in an unprofessional way by not attending to Patient A with empathy and compassion. Her perception of pain was important. The Registrant’s impatience with her was not. The patient’s husband had been so provoked by the incident that he demanded that the Registrant leave right away.

91. 2.b) Colleague C described an extended and unprofessional series of events regarding the Registrant’s care of Patient B who was vulnerable. Patient B was vulnerable. He could not communicate clearly, and his mental state left him vulnerable to feeling frightened and unable to understand what was happening to him. The Panel accepted this was compounded by his potential sepsis infection and his inability to urinate freely despite his keenly felt urge to do so. The Panel was satisfied that the Registrant had spoken to Patient B abruptly and rudely on several occasions. He had not adjusted his tone and communication to meet the patient’s needs. It was unprofessional behaviour.

92. 2.c) Colleague C had said that she had become so concerned by the Registrant’s angry and aggressive manner while he was with Patient B in the back of the ambulance that she had switched on the microphone to track the situation. She heard the Registrant shout at Patient B who was distressed. The Registrant had advanced an inadequate response; he had required to raise his voice to be heard over the ambulance sirens. The Panel was satisfied that Colleague C’s account of events was true.

93. 2.d) The Panel was satisfied that Colleague C had correctly and truthfully reported the Registrant’s unprofessional words said to patient B.

94. 2.e) The Panel was satisfied that Colleague C had correctly and truthfully reported the Registrant’s angry and loud words said to her in the hospital after transporting Patient B. He said it in such a way that a senior matron who chanced to be nearby came out to see what was going on. Colleague C’s testimony was credible and illustrated the emotional response to having been shouted at in this way. The Registrant had acted unprofessionally. Colleague C did no more than to advocate for her patient. The Registrant’s seeming sense of superiority overcame his professionalism.

95. The Panel found all of the sub-particulars in Allegation 3 proved.

96. 3.a) The Panel was satisfied that Colleague C had correctly identified the building crisis in relation to Patient C. Colleague C reported to the Registrant the accelerating signs of heart distress in Patient C including his ‘tombstone’ ECG trace. She correctly identified that she should be the driver to allow her more clinically qualified Colleague, the Registrant, to intervene if necessary and perform more advanced emergency care procedures. The Panel accepted Colleague C’s testimony that the Registrant had refused to stop and change places with her. He had instead performatively read the ECG trace while driving at speed before dismissing Colleague C’s concerns with ‘he’ll be fine.’

97. 3.b) The Panel was satisfied that Colleague C had correctly recalled that at on arrival at the hospital it was essential not to stress Patient C by requiring him to change from a semi recumbent position. Patient C was having a ‘…full-blown heart attack,’ as Colleague C put it. The additional strain of requiring him to adopt a seated position, as the Registrant was determined to do, was precisely the wrong thing to do.

98. Patient C should have been kept still on the stretcher and continuously tracked by the ECG machine, which was all impossible because of the Registrant’s insistence faced with Colleague C’s desperate entreaties not to and her search for someone at the hospital who would listen to her, Patient C was presented to staff by the Registrant in a wheelchair. The nurse’s alarmed and immediate reaction should have shocked the Registrant out of his stubbornness. He had made a life-threatening situation unmeasurably more perilous, deliberately, and knowingly, despite all of his training and experience.

99. The Panel found Allegation 4 proved in relation to sub-particulars 1.e) and 1.g).

100. The Panel applied the test for racial motivation set out as above in the case of Lambert-Simpson. The reasons for the Panel’s conclusion on each limb of that test were:

Referable to race:

• The Registrant’s unambiguous and direct reference to the white colour of the snack bar was an intentional reference to his preference for an all-white society

• The Registrant had a history of expressing racially motivated remarks such as those directed at and shut down by Colleague B

• The ‘them’ that the Registrant expressed a desire to kill were again an explicitly non-white racial group

• The element referable to race in the Registrant’s case is to all races that are non-white

Hostility or discriminatory attitude to non-whites:

• The Registrant’s unmistakable expression for an all-white society showed hostility to and discriminatory attitudes against non-whites

• The Registrant’s desire to place himself in a position to kill non-whites showed clear hostility and discriminatory attitudes to non-white races.

101. The Panel was satisfied that each of the sub-particulars were connected by the Registrant’s antipathy for non-whites just as other sub-particulars were linked by his unnatural interest in the occult. Violence was a recurring element in each part. The Panel was satisfied that the Registrant’s speech had a purpose behind it that was substantially linked to race because he identified that all people who were non-white were the ‘other.’ As in other contexts, the Registrant expressed violent hostility towards non-whites in these words and a clear discriminatory attitude against non-whites. His preference was for a society where there were no non-whites. He wished an opportunity to kill ‘them.’

102. The Registrant’s gas-lighting attempted obfuscation by referencing the zone of combat in Syria and Iraq was only an expedient cover for him to express his violent antipathy for non-whites.

Decision on Grounds

103. Having found all of the facts to be true, the Panel went onto consider particular 5; whether misconduct as the statutory ground of impairment under Article 22.(1)(a) of the Health and Care Professions Order 2001is made out.

5. Your conduct above at paragraphs 1 - 4 above constitutes misconduct.

Submissions

104. Ms Patel submitted that the facts found proved by the Panel were serious. She referred the Panel to the principles in the cases of

• Roylance v GMC [2000] 1 AC 311,

• Nandi v GMC [2004] EWHC 2317 (Admin), and

• Calheam v GMV [2007] EWHC 2606.

Ms Patel submitted that the Registrant’s behaviour individually and taken together was sufficiently serious to amount to misconduct and so met the statutory ground for a decision on impairment to follow. He acted in such a way which fell far short of what would be proper in the circumstances and what the public would expect of a HCPC registered Paramedic.

105. Ms Patel submitted that the Registrant had breached a fundamental principle of the profession in failing to treat his colleagues in a professional manner showing them respect and consideration and failing to treat service users with respect. Further the Registrant had acted in a way that was motivated by racism.

106. The Registrant had breached standards 1,2,6 and 9 of the HCPC Standards of Conduct, Performance and Ethics 2016 (the 2016 Standards) which were in force at the relevant time, Ms Patel said.

107. Ms Patel also submitted that the Registrant had breached the Paramedics Standards of Proficiency 2014, which was also in force at the relevant time, in respect of Standards 1, 2, 4, 6, 8, 9, 14 and 15.

108. Ms Patel reminded the Panel that Colleague C’s evidence had referred to her reaction to the Registrant’s treatment of Patient B. Colleague C had taken the Registrant to task over his conduct and described his behaviour as ‘…nasty.’ She told the Panel in her evidence that the Registrant’s actions were not in keeping with how Paramedics should treat patients. ‘We are here to care for people’ she told the Panel. In these circumstances, Ms Patel said that the Panel could find that that other Paramedics would consider the Registrant’s actions to have been deplorable.

The Panel’s decision

109. The Panel accepted the advice of the Legal Assessor. In considering grounds, the Panel took into account the submissions of Ms Patel and the Registrant’s written responses in advance of this hearing, all other relevant evidence, and its prior Findings on Facts.

110. The Panel was aware that in respect of misconduct there was no standard or burden of proof and that it was a matter for the Panel’s own professional judgement.

111. The Panel accepted the Legal Assessor’s advice. The Panel understood that a finding of misconduct was a matter for the Panel’s independent professional judgement. There is no statutory definition of misconduct, but the Panel had regard to the guidance of Lord Clyde in the case of Roylance v GMC (No2) [2001] 1 AC 311:

"Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a… practitioner in the particular circumstances.”

112. The conduct must be serious in that it falls well below the required standards. The Panel recognised that breaches of standards in and of themselves might not necessarily amount to misconduct.

113. The Panel considered that the Registrant had breached the following 2016 Standards:

1. Promote and protect the interests of

service users and carers

Treat service users and carers with respect

1.1 You must treat service users and carers as individuals, respecting their privacy and dignity.

2. Communicate appropriately and effectively

Communicate with service users and carers

2.1 You must be polite and considerate.

2.2 You must listen to service users and carers and take account of their needs and wishes. Work with colleagues

2.5 You must work in partnership with colleagues, sharing your skills, knowledge, and experience where appropriate, for the benefit of service users and carers.

6. Manage risk

Identify and minimise risk

6.1 You must take all reasonable steps to reduce the risk of harm to service users, carers, and colleagues as far as possible.

6.2 You must not do anything, or allow someone else to do anything, which could put the health or safety of a service user, carer, or colleague at unacceptable risk.

9 Be honest and trustworthy

Personal and professional behaviour

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

114. The Panel considered that the Registrant had breached the following 2014 Standards of Proficiency:

1. be able to practise safely and effectively within their scope of practice

1.4 be able to work safely in challenging and unpredictable environments, including being able to take appropriate action to assess and
manage risk

2.4 recognise that relationships with service users should be based on mutual respect and trust, and be able to maintain high standards of care even in situations of personal incompatibility

4 be able to practise as an autonomous professional, exercising their own professional judgement

4.1 be able to assess a professional situation, determine the nature and severity of the problem and call upon the required knowledge and experience to deal with the problem

4.8 be able to make a decision about the most appropriate care pathway for a patient and refer patients appropriately

6 be able to practise in a non-discriminatory manner

8 be able to communicate effectively

8.1 be able to demonstrate effective and appropriate verbal and non-verbal skills in communicating information, advice, instruction and professional opinion to service users, colleagues, and others.

8.3 understand how communication skills affect assessment of, and engagement with, service users and how the means of communication should be modified to address and take account of factors such as age, capacity, learning ability and physical ability

8.4 be able to identify anxiety and stress in patients, carers and others and recognise the potential impact upon communication

8.5 be able to select, move between and use appropriate forms of verbal and non-verbal communication with service users and others

9 be able to work appropriately with others

9.1 be able to work, where appropriate, in partnership with service users, other professionals, support staff and others

9.2 understand the need to build and sustain professional relationships as both an independent practitioner and collaboratively as a member of a team

14 be able to draw on appropriate knowledge and skills to
inform practice

14.4 know how to position or immobilise patients correctly for safe and effective interventions

14.22 be able to use information and communication technologies appropriate to their practice

15.6 understand and be able to apply appropriate moving and handling techniques

115. The Panel considered that not every breach identified would be serious on its own to justify a finding of misconduct. However, taken together with other very serious breaches, the conduct overall was very serious and fell far short of what was expected of the Registrant. The Registrant had breached multiple aspects of the 2014 and 2016 Standards and had acted in a way that any reasonable Paramedic would immediately consider to be deplorable.

116. Colleague C had said that the Registrant's conduct had been disgraceful and uncaring. Colleague A had been left deeply troubled by the Registrants violent and racially motivated words. His actions towards both colleagues had not fostered an appropriate spirit of trust and cooperation in order to secure the best outcomes for the patients in the Registrant’s care. The Registrant had been the most qualified when working with Colleague A and Colleague C. He had failed to show leadership. He had acted instead in pursuit of his private pleasure in the ‘…game’ (as the Registrant described it in his response) of deliberately provoking colleagues.

117. The Registrant had put patients at risk of having significantly worse clinical outcomes than might have been the case had the Registrant acted in a caring patient centred way and exercised his skills appropriately and for their benefit. He had allowed his self-importance and abrasive personality (which he was well aware of) to interrupt the ordinary course of caring for patients in some very high-risk situations. His racially motivated and violent speech was utterly at odds with the safe care of patients whatever their racial characteristics.

118. Taking all of these matters into account, the Panel determined that both individually and cumulatively, the Registrant’s acts and omissions found proved in the particulars Allegations 1, 2, 3, and 4 fell seriously short of the standards to be expected of a registered Paramedic and amounted to misconduct.

Decision on Impairment

119. Having found that the statutory ground of misconduct had been made out, the Panel moved on to consider the question of impairment.

120. Ms Patel had again provided the Panel with submissions in which she referred the Panel to the HCPTS Practice Note Fitness to Practise Impairment updated in February 2025. She reminded the Panel that whether the Registrant’s fitness to practise was impaired was a matter for the Panel’s professional judgement.

121. Ms Patel referred the Panel to the approach formulated by Dame Janet Smith in the Fifth Shipman Report and adopted as a test for current impairment in the case of CHRE v NMC & Grant [2011] EWHC 927. She reminded the Panel that impairment is decided based on the present and is a forward-looking exercise. However, where impairment in the past can be identified, the focus can be on what current information is available to displace or lessen impairment. Ms Patel submitted that it was clear that the Registrant’s fitness to practise was impaired in April 2019, on both the personal and the public components. Since then, the Registrant has failed to demonstrate any real insight or remediation that would allow a panel to consider that his fitness to practise is no longer impaired.

122. Ms Patel referred the Panel to the Grant case mentioned above and to the case of Cohen v GMC [2008] EWHC 581 (Admin). She reminded the Panel that guidance is provided on both the personal and public components of impairment in the HCPTS Practice Note Fitness to Practise Impairment dated February 2025.

123. Ms Patel invited the Panel to find the Registrant’s fitness to practise was currently impaired because, among other considerations, the need to support public trust and confidence in the profession of Paramedic and in its regulator. An informed member of the public would be troubled to learn that no finding of impairment had been made in a case like this in which racially motivated speech had been proved.

The Panel’s decision

124. The Panel accepted the advice of the Legal Assessor and had regard to the Practice Note Fitness to Practise Impairment. The Panel took into account what was said by the court in the case of Meadow v General Medical Council [2006] EWCA Civ 1390 that the Panel is entitled to form a view of the likelihood of repetition of misconduct by having regard to what had been done in the past.

125. The Panel also referred to what was said by Silber J in the Cohen case already referred to, that any

“…approach to the issue of whether a doctor's fitness to practise should be regarded as ‘impaired’ must take account of ‘the need to protect the individual patient, and the collective need to maintain confidence [in the] profession as well as declaring and upholding proper standards of conduct and behaviour of the public in their doctors and that public interest includes amongst other things the protection of patients, maintenance of public confidence in the profession".

The judge went there on to say that

“it must be highly relevant in determining if a [practitioner’s] fitness to practise is impaired that first his or her conduct which led to the charge is easily remediable, second that it has been remedied and third that it is highly unlikely to be repeated.”

126. The Panel recognised that the public interest in maintaining trust and confidence in the profession of Paramedic was a centrally important element of any determination of current fitness to practise.

127. The Panel also held in mind the test for current impairment that was formulated by Cox, J in the Grant case was for a panel to consider:

“Do our findings of fact in respect of the doctor's misconduct, deficient professional performance, adverse health, conviction, caution, or determination show that his/her fitness to practise is impaired in the sense that s/he:

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

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

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
…”.

128. The Panel first considered whether anything written by the Registrant in advance of this hearing would support any real measure of insight on his part. The Panel held in mind that in paragraph 116 of the Grant case, the court had said that insight was a critical factor in determining current fitness to practise. The Panel considered that the Registrant has not provided the Panel with any material to demonstrate any insight that his actions may have had on

• the safety of patients and the public including his professional colleagues,

• public trust and confidence in the profession, and on,

• the need to declare and uphold standards for the Paramedic profession.

129. The Registrant had said to the Panel that his personal and work commitments did not allow him to find time to attend this hearing during the working week. He had left the Paramedic profession and was now employed in a non-registered role. His only interest in maintaining his registration was to allow the possibility of future professional development and advancement where he now worked.

130. The Registrant had said nothing to recognise the harm that his actions had caused in creating a difficult working environment for his professional colleagues with whom he was supposed to work collaboratively to assist the public.

131. Nothing had been said by the Registrant that recognised the distress caused to Patient A. Likewise there was no evidence of any appreciation of the hurt and confusion that must have been endured by Patient B. Patient C had been placed at a risk of a much worse outcome because of the Registrant’s stubborn refusal to attend to him while Colleague C drove, and his insistence on placing him in a wheelchair to transport him into the A&E department.

132. The Registrant appeared not to have understood the impact on his colleagues and on the public’s trust and confidence in the profession of Paramedic, stemming from his

• disturbing and upsetting references to animal sacrifices and the occult in the workplace, or in

• his violently expressed and racially motivated speech.

The Registrant had not undertaken any course in any form of further education or training, in areas such as:

• equality and diversity

• working collaboratively with professional colleagues

• refreshers in clinical decision-making including patients in danger of a cardiac arrest

133. The Registrant had explained that when he returned to work for six months in 2019, no further complaint of any kind had been made regarding his behaviour of clinical decision making. The Registrant deserves full credit for that. However, he was also on sick leave for a portion of that time. The Panel had not been told how long the Registrant had returned to full capacity without any adverse reports being made.

134. The Panel observed that racially motivated speech suggested an attitude of mind that was deep-rooted and difficult to remediate. The Panel had no reason to doubt that, although it may be difficult to remediate, it cannot be impossible. However, the Panel had no information to suggest that the Registrant had any appreciation of the harmfulness of his speech, and nothing in regard to the need to address and correct it so that there was no possibility of any repetition.

135. The Panel was alive to the issue that an unremediated disposition towards racially motivated speech was contrary to the central tenets of the Paramedic profession and of anyone registered with the HCPC. Accordingly, a finding of impairment is required to maintain public confidence in the profession and in order to promote and maintain proper professional standards for the Paramedic profession.

136. In all of the circumstances, the Panel found that there was a real risk of repetition by the Registrant of his harmful misconduct.

137. The Panel considered that the absence of any further reports of misconduct since 2019 was not a reliable indicator of any sustained positive improvement by the Registrant. He has failed to take ownership of his failings and has taken no action to address them such that there is no likelihood of any repetition and that the public and colleagues are safe in his care.

138. There was an absence of appropriate remediation which identified the harm caused to the colleagues, patients, and the reputation of the profession of Paramedic. There was no commitment to avoiding any such failings in the future. The Registrant had never identified the impact that his misconduct had on the public’s trust and confidence in the profession or for the declaring and upholding of standards, far less taken positive steps to act on such recognition.

139. For all of these reasons, the Panel found that the Registrant was impaired on the public component.

140. The Panel also found that the Registrant had acted in a way which engaged the first three of the four limbs of the test set out by the High Court in the Grant case. In the absence of constructive and positive insight put forward by the Registrant, the Panel could not find that there was no risk of repetition. The opposite appeared to be more likely.

141. For all of these reasons, the Panel found that the Registrant’s fitness to practise was impaired on the public component. 

142. The Panel also considered that the public would be troubled and concerned if no finding of impairment were made in the circumstances. Accordingly it was necessary to make a finding of current impairment for reasons of the wider public interest.

143. For all of these reasons, the Panel found that the Registrant’s fitness to practise is currently impaired.

Decision on Sanction

144. Ms Patel, on behalf of the HCPC invited the Panel to move on to consideration of imposing a sanction. Ms Patel did not suggest a particular sanction, but she referred to the Panel to the guidance issued by the HCPC in its Indicative Sanctions Policy (ISP) and highlighted the need for proportionality.

145. Ms Patel pointed out paragraph 29 of the ISP which reminded panels to take account, where appropriate, of the potential for Registrants to be unfairly disadvantaged as a result of communicating in English where this is not the Registrant’s first language. Cultural difference, Ms Patel reminded the Panel, might create the conditions for expressions of remorse and apology to be misunderstood or misread.

146. Ms Patel also asked the Panel to take into account the guidance in the ISP relating to serious cases, including instances of potentially unlawful conduct implicit in acts of discrimination.

147. Ms Patel also asked the Panel to refer to the guidance in relation to instances of failures to work in partnership. Ms Patel said that this could apply in this case because of a perceived pattern of inappropriate behaviour towards colleagues and patients. This was another factor that pointed to this being a serious case.

148. Ms Patel also said that the Panel could take into account the increased risks of harm to the patients identified in this case. This was another factor pointing to this being a serious case. Ms Patel identified the aggravating and mitigating factors that she considered were important in this case.

The Panel’s decision

149. The Panel accepted the advice of the Legal Assessor. In reaching its decision on sanction, the Panel took into account the submissions made by Ms Patel on behalf of the HCPC. There were no submissions by or on behalf of the Registrant. However, the Panel reconsidered all of the submissions already made by him in order to ensure that anything relevant to sanction was fully taken into account.

150. The Panel also referred to the ISP and held in mind that the purpose of sanctions was not to punish the Registrant, but to protect the public, maintain public confidence in the profession and to maintain proper standards of conduct and performance. The Panel was also aware of the need to ensure that any sanction is proportionate.

151. The Panel found the following mitigating factors:

• Prior to this matter no previous disciplinary history with the HCPC;

• The Registrant had engaged earlier in the process and had corresponded with the HCPC regarding his current circumstances and decision not to actively participate in the hearing;

• The Registrant had made some admissions of facts, although limited to the less serious issues in this case.

152. The Panel found the following aggravating factors:

• These were serious departures from the standards expected of a Registered Paramedic.

• The incidents occurred in two defined periods which were 10 months apart and were sustained across a number of days whilst working with Colleague A and Colleague C.

• The Registrant had engaged in racially motivated speech on more than one occasion.

• The Registrant had been subject to a workplace mediation process in June 2018 to resolve the kinds of conflict which he had created.
Despite this, instances of overbearing and offensive/oppressive speech had recurred in 2019.

• The Registrant’s admissions were based on the supposed misapprehensions by him of the willing participation of Colleague A and Colleague C. They were not meaningful, forthright or genuinely remorseful.

• There was no true insight into the harmful effect his actions had on the service users and on the damage he had caused to the necessary trust and confidence held by the public in the profession.

• There was no recognition of the impact that his actions had on working in partnership with colleagues, and the associated risks for patients.

• There was no evidence of attempted remediation.

153. The Panel considered that this was a serious case as set out in the ISP. The Registrant had failed to work in partnership with colleagues A and C. In those instances, he had placed patients A, B, and C, at unwarranted and unnecessary increased risk of harm. The Registrant’s seeming innate sense of superiority, and his demeaning and belittling attitude towards Colleague C had all placed unnecessary burdens on them. This did not, but had the potential to, impact adversely on patients care.

154. There was a pattern of repetition by the Registrant of his racially motivated speech which was at odds with HCPC standards and values of inclusiveness and welcoming of diversity. As discussed more fully below, a workplace mediation had evidently failed.
155. In all of these circumstances, the Panel did not consider this was an appropriate case in which either mediation or taking no further action had any merit.

156. The Panel next considered whether a Caution Order would adequately reflect the seriousness of the conviction. The Panel’s role, as indicated by the ISP, was not to punish the Registrant, but solely to

• protect the public,

• to maintain high standards amongst registrants and

• to maintain public confidence in the profession.
For all of the reasons already set out, the Panel did not consider that such an Order would adequately mark the seriousness of the Registrant’s behaviour.

157. The Panel gave careful consideration to the potential for a Conditions of Practice Order. There had been some instances of conduct which the Registrant had recognised as being clinically wrong, such as the decision to remove Patient C from the ambulance in a wheelchair and not a stretcher. Conditions of practice can be a valuable means to protect the public where there are identifiable and remediable failings in clinical practice and decision making. However, the Registrant’s insight in this regard was very limited.

158. The Registrant had, in any event, shown no ability to identify what deficiencies could be addressed in this way and he had not shown a willingness to abide by and work within conditions of practice. There had been a workplace mediation process in 2018. Despite that, the Registrant’s failures to work in partnership had resurfaced. He had persisted in the ‘…game’ over several shifts in 2019 despite, having been made aware in the mediation process of the impact on and consequences for his professional colleagues.

159. Further, the Panel considered that some of the Registrant’s very serious failings are non-clinical in nature. They are more probably linked to an ingrained attitude held by the Registrant, which is difficult to address with conditions. There are courses available in diversity and equality which are accessible generally. However, in the many years that have elapsed since these incidents, the Registrant had not sought to gain from them, preferring instead to leave the workplace, the profession, and his critics behind. The Registrant had not shown any willingness to engage meaningfully with conditions which would help him.

160. Some of the most serious failings related to;

• a seemingly deep-seated and unacknowledged sense of superiority over his professional colleagues, and

• most seriously, an appalling antipathy to non-white races.

The Registrant had not shown any willingness to confront and challenge his own predisposition, which was contrary to professional standards and inclusive values.

161. The Panel considered that a Conditions of Practice Order would not sufficiently protect the public, would not meet the concerns for the wider public interest, and would not adequately reflect the seriousness of the Registrant’s offensive behaviour.

162. The Panel next considered whether to make a Suspension Order.

163. The ISP states that,

“A suspension order is likely to be appropriate where there are serious concerns which cannot be reasonably addressed by a Conditions of Practice Order, but which do not require the Registrant to be struck off the Register. These types of cases will typically exhibit the following factors:
the concerns represent a serious breach of the Standards of conduct, performance, and ethics;
the Registrant has insight;
the issues are unlikely to be repeated; and
there is evidence to suggest the Registrant is likely to be able to resolve or remedy their failings.”
The Panel considered all these factors were relevant, and apart from the seriousness of the case, were otherwise not reflected in the Registrant’s correspondence with the HCPC."

164. The Registrant’s actions represented a serious breach of the Standards. He does not have the insight necessary to permit a suspension order to do more than merely remove him from having access to patients for a period of time. That would be a valuable thing to protect patients from unnecessary risks of harm and to protect colleagues from his ‘game.’ However, the Panel had no information to suggest that such a period of suspension would be likely to direct him to the means of remediation and training necessary. There is nothing to foster the view that a period of suspension would allow the Registrant to improve on his very limited insight and that the conduct would be unlikely to be repeated in the future. There was no evidence to indicate that the Registrant has even appreciated that he must resolve his failings, far less that he has begun to do so.

165. The Panel considered that if it were to impose a suspension order in all of these circumstances, it would itself create the risk of damage to the reputation of the profession and its regulator in the minds of the public.

166. The Panel then turned to consider the guidance at paragraph 130 in relation to a Striking Off Order. The ISP guidance states that,

‘A striking off order is a sanction of last resort for serious, persistent, deliberate, or reckless acts involving:

• failure to work in partnership

• discrimination

• abuse of professional position’

167. At paragraph 131, the guidance further states that:

"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. In particular where the Registrant:

• lacks insight;

• continues to repeat the misconduct, or

• is unwilling to resolve matters."

168. The Panel had already referred to the Registrant’s absence of insight and his seeming unwillingness to address his pattern of misconduct and other failings. He appears to be unwilling to resolve matters. The only purpose for him in retaining his registration is solely related to his own professional development and career outside of the profession of Paramedic.

169. The Panel considered that the public would be in no doubt regarding the seriousness of the misconduct in this case. As referred to above, it is not this Panel’s role to punish the Registrant, but rather to ensure that the public is fully protected when engaging and trusting in the services of Paramedic at some of the most vulnerable times in their lives. For that reason alone, a clear marker must be set down to act as a deterrent to other who may consider taking up such a course of misconduct.

170. Further, public trust and confidence in the profession and in its regulator must be maintained. The Panel wished to be clear that the Registrant’s inexcusable behaviour must be marked so as to send out a message to the Registrant, the profession, and to the public about how seriously the Panel views this misconduct.

171. Taking into account the specific circumstances of this case and the almost complete absence of any mitigation that the Panel could find, the Panel considered that the Registrant’s conduct could only be regarded as being fundamentally incompatible with continued registration. He had demonstrated no meaningful insight and was clearly unable or unwilling to take any steps to resolve matters.

172. The Panel concluded that there could be no other appropriate and proportionate sanction than to remove the Registrant from the Register.

173. Accordingly, the sanction in this case will be one of Striking Off from the Register to reflect the gravity of the Registrant’s misconduct and the need to protect the public in all aspects of the overarching objective.

 

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

Interim Order

Application

1. Ms Patel, on behalf of the HCPC, asked the Panel to impose an Interim Suspension Order on the grounds that it is necessary for the protection of the public and that it is otherwise in the public interest. Ms Patel submitted that having regard to the determination in this case and the Striking Off Order that the Panel has imposed, an Interim Suspension Order is required for the reasons set out above in order to protect the public and the public interest until such time as any appeal has been decided or alternatively, until the appeal period has expired without an appeal being lodged.

2. There were no submissions for or on behalf of the Registrant.

3. The Panel accepted the Legal Assessor’s advice. The Panel recognised that an interim must be truly necessary in all of the circumstances. The Panel was satisfied that, for all of the reasons set out in the determination above, the public would be placed at an unacceptable risk of harm if no order was in place pending the substantive order coming into effect.

4. The Panel approached the issue proportionately. However, for the same reasons as before, the panel was unable to identify conditions of practice which were workable, measurable, or likely to be effective in protecting the public. The Panel concluded that the only appropriate and proportionate interim order was one of suspension. Accordingly, an Interim Suspension Order is necessary for the protection of the public and is otherwise in the public interest. The Panel determined that the Interim Suspension Order will remain in force for the period set out below.

Decision

5. The Panel makes an Interim Suspension Order for 18 months 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.

6. 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 Mateusz Wyrostkiewicz

Date	Panel	Hearing type	Outcomes / Status
21/07/2025	Conduct and Competence Committee	Final Hearing	Struck off