Ewa Oboho

: Practitioner psychologist

: PYL18455

: Final Hearing

Date and Time of hearing:10:00 04/04/2016 End: 17:00 08/04/2016

: Health and Care Professions Council, Park House, 184 Kennington Park Road, London, SE11 4BU

: Conduct and Competence Committee
: Conditions of Practice

Allegation

Allegation (as amended at the Final Hearing):
During the course of your practice as a Forensic Psychologist:

1. In February 2011 you conducted the following assessments which were not age appropriate for Child A (who was 15 years old at the time of the assessment):
a. Eysenck Personality Scale – Revised;
b. Wechsler Adult Intelligence Scale, (3rd Edition).

2. Within your report you did not explain the limitations of the tests you conducted on Child A, in particular in relation to:
a. the significance of the instruments to the questions that you were asked to address in your report;
b. the use of the EPQ-R which was not appropriate for the child’s age;
c. the usefulness of the EPQ-R as an individual assessment procedure;
d. the use of the WAIS-III Scale which was not appropriate for the child’s age;
e. the fact that the GHQ-28 and HADS assessment were screening instruments and not diagnostic tests;
f. the fact that the GHQ-28 and HADS assessments rely on the person’s self-report of their recent experience;
g. the fact that any interpretation of the GHQ-28 and HADS assessment must be made along with all other information known about that person;
h. the fact that you did not explain the implications of the score obtained in the GHQ-28 and HADS assessments;
i. the fact that you did not explain the implications of all the scores obtained in the EPQ-R assessment.

3. The matters set out in paragraphs 1) and 2) constitute misconduct and/or lack of competence.

4. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.

Finding

Preliminary matters

Application to Adjourn

1. Dr Oboho attended on Day 1 of the hearing without representation. However, he informed the Panel that he had been able to instruct Counsel that morning, his previously instructed Counsel being no longer available, and that his representative would be able to attend in 30 minutes. Dr Oboho requested a short adjournment pending the arrival of Counsel. Mr Orpin-Massey, on behalf of the HCPC, raised no objections to Dr Oboho’s application. However, he made some observations with regards to a previous application to adjourn made on 26 October 2015 which was granted. On that occasion the panel gave Dr Oboho ‘one final opportunity’ to secure legal representation.

2. The Panel was satisfied that it was in the interests of justice to grant a short adjournment.

3. Mr Gloag, of Counsel, attended to represent Dr Oboho and, shortly after his arrival, made an application for a short adjournment to read the bundle and obtain instructions, with a view to Dr Heap (expert witness) commencing his evidence that afternoon. Mr Orpin-Massey raised no objections.

4. The Panel was satisfied that progress was being made and that it was in the interests of justice to grant a short adjournment.

Application to Amend

5. At the outset of the hearing Mr Orpin-Massey made an application for Particulars 1 and 2 of the allegation to be amended. The Registrant had been put on notice of the proposed amendment in December 2013 and no objection had been raised at the time. 

6. Mr Gloag, on behalf of Dr Oboho, made no submission with regard to Particular 1. With regard to Particular 2 he queried whether the stem merely repeated aspects of Particular 1.

7. The Panel determined that Particular 1 should be amended by insertion of ‘In February 2011’ and by deletion of two of the assessments. The Panel was satisfied that the amendment:

• clearly reflected the key issues highlighted by Dr Heap in his expert report and the matters upon which the HCPC intended to rely;

• provided helpful and necessary clarification which would be of assistance.

8. The Panel determined that Particular 2 should be amended by deletion of ‘During the course of your assessment of Child A…’ and insertion of ‘Within your report…’ followed by specific reference to the tests and the interpretation of those tests particularised in 2(a) – 2(i). The Panel was satisfied that the report was the vehicle by which the results of Dr Oboho’s assessments were recorded.

9. The Panel was further satisfied that no injustice would be caused by making these amendments which reflected the key matters highlighted in the expert report. In forming this view the Panel took into account the fact that Dr Oboho had been put on notice of the HCPC’s application for over 2 years and made no representations with regard to the proposed amendments.

10. The Panel also determined of its own volition that Particular 1(a) should be amended by insertion of the word ‘Revised’ as this more accurately reflected the evidence to be adduced. The Panel was satisfied that the amendment was minor and would cause no injustice.

Admissibility of Dr Heap’s Addendum Report

11. During Dr Heap’s evidence in chief, Mr Gloag, on behalf of Dr Oboho, objected to the HCPC’s reliance on Dr Heap’s addendum report dated 27 January 2016, as no formal application had been made to rely on it at the Case Directions Hearing on 23 May 2014 or at the adjourned Final Hearing on 26 October 2014. Mr Orpin-Masey submitted that the addendum report was a supplement to the original report, dated 19 July 2013. It was based on Dr Oboho’s response to the Allegation and  the HCPC was entitled to ascertain whether this had any impact on Dr Heap’s opinion. Mr Orpin-Masey made a formal application for the addendum to be admitted.

12. Having invited enquiries to be made, the Panel was informed that the addendum report was sent to Dr Oboho as part of the Final Hearing bundle on 16 February 2016. The Panel accepted the advice of the Legal Assessor. The Panel determined that it was appropriate to permit the HCPC to rely on the addendum report as it was relevant to the issues in the case. The Panel was satisfied that Dr Oboho had been given sufficient notice of its contents and that no injustice would be caused.

Background

13. The Registrant is a Registered and Chartered Forensic Psychologist. He has been practising as a Consultant Psychologist at Rabamarcs Associates, Harley Street, since 1998.

14. On 18 March 2011 the Registrant prepared a report in relation to Child A. Child A was 15 years old at the time and due to appear before a Youth Court as a defendant in respect of criminal allegations of assault and the possession of an offensive weapon. The Registrant was instructed by Child A’s solicitors to prepare a report on Child A’s fitness to plead.
 
15. Later in 2011 another psychologist,  (Person 2), was instructed to undertake a report on Child A, who this time was the complainant in a criminal trial. When completing his report (Person 2) had sight of the Registrant’s report and a further report completed by another psychologist on the same child. He recommended to the solicitors that had instructed him that they make a complaint to the HCPC about both reports. They did so.
 
16. The complaint against the other psychologist was investigated by the HCPC but was subsequently discontinued.

17. The HCPC appointed an expert, Dr Michael Heap, to review the Registrant’s report of 18 March 2011. The HCPC relied solely on Dr Heap’s observations. It was Dr Heap’s analysis alone that formed the basis for the allegation. No reliance was placed on the concerns raised initially by (Person 2). However, his complaint was included in the bundle as context and background information.

18. Mr Gloag was instructed on the basis that he could only attend the first two days of the hearing. By the end of Day 2 Dr Heap and Dr Oboho had both given evidence. Mr Gloag made observations with regard to the evidence at the close of the defence case, as he was unavailable to attend the hearing on Day 3 for formal submissions with regard to facts, grounds and impairment.

Assessment of Witnesses

Dr Heap

19. Dr Heap presented as a credible witness given his many years of experience and expertise as a Chartered Clinical Forensic Psychologist. However, on occasion, the Panel found his evidence to be unstructured and at times he appeared insufficiently prepared and not immediately familiar with the relevant material. Dr Heap did his best to assist the Panel and overall his evidence was reliable.

Dr Oboho

20. Dr Oboho chose to give oral evidence. His responses to the questions put to him were brief. At times his answers lacked sufficient detail and required further clarification. During his evidence Dr Oboho made a number of admissions.

Decision on facts

Panel’s Approach

21. The Panel was aware that the burden of proving the facts was on the HCPC. The Registrant did not have to prove anything and the individual particulars of the Allegation could only be found proved if the Panel was satisfied on the balance of probabilities.

22. In reaching its decision the Panel took into account the written evidence which included the original bundle and the additional documents disclosed during the hearing. The Panel was clear that the only material evidence for its consideration, with specific regard to the allegation, was Dr Oboho’s report of 18 March 2011 and Dr Heap’s expert opinion. The Panel also took into account the submissions from both parties and accepted the advice from the Legal Assessor.

Particular 1

23. The stem of this particular alleges that ‘In February 2011 you conducted the following assessments which were not age appropriate for Child A (who was 15 years old at the time of the assessment) …’ The individual particulars (1(a) and 1(b)) allege specific assessments. As there was no dispute that the Registrant assessed Child A in February 2011 who was 15 years old at the time, the Panel considered each assessment in turn.
 
Particular 1(a) – Found Proved
‘Eysenck Personality Scale- Revised’
24. The Panel was satisfied, based on the evidence presented by Dr Heap and by Dr Oboho’s own admission, that the use of this test in these circumstances was not appropriate. The lowest age for which scores are given in the manual for the EPQ-R is 16 years. As Child A was 15 years 7 months at the time of the assessment, there were no test norms in the manual for his age group. Dr Oboho accepted that he should have used another age appropriate test.

Particular 1(b) – Found Proved
‘Wechsler Adult Intelligence Scale, (3rd Edition)’
25. The Panel was satisfied, based on the evidence presented by Dr Heap and by Dr Oboho’s own admission, that the use of this test in these circumstances was not appropriate. The lowest age for which scores are given in the manual for the WAIS-III is 16 years. As Child A was 15 years 7 months at the time of the assessment, there were no test norms in the manual for his age group. Dr Oboho accepted that he should have used another age appropriate test.

Particular 2
26. The stem of this particular alleges that ‘Within your report you did not explain the limitations of the tests you conducted on Child A, in particular in relation to …’ The individual particulars (1(a) -1(i)) allege specific criticisms. As there was no dispute that the Registrant produced a report based on his assessment of Child A, the Panel considered each assessment in turn.

Particular 2(a) – Found Proved
‘the significance of the instruments to the questions that you were asked to address in your report’’
27. The Panel was satisfied, based on the expert evidence of Dr Heap, that Dr Oboho’s report should have explained the significance of the tests selected for the assessment of Child A, and their limitations. The Panel noted that Dr Oboho’s report includes no such reference and provides no professional context as to the tests used.

Particular 2(b) – Found Proved
‘the use of the EPQ-R which was not appropriate for the child’s age’
28. The Panel took into account its finding with regard to Particular 1(a).  The Panel was satisfied, based on the evidence presented by Dr Heap and by Dr Oboho’s own admission, that the use of this test in these circumstances was not appropriate and that no explanation as to its limitations was included in Dr Oboho’s report.

Particular 2(c) – Found Not Proved
‘the usefulness of the EPQ-R as an individual assessment procedure’
29. While it is the case that Dr Oboho provided no explanation in his report as to the usefulness of the EPQ-R as an individual assessment, the premise of this particular is that the test can only be used on a group basis. It was established, however, through Dr Heap’s evidence that it can be used in both an individual or group context. It is a matter for the individual practitioner to determine on what basis the assessment is used. The Panel determined that in these circumstances there was no obligation to further explain or provide rationale for its use as an individual assessment tool.

Particular 2(d) – Found Proved
‘the use of the WAIS-III scale which was not appropriate for the child’s age’
30. The Panel took into account its finding in relation to particular 1(b) and was satisfied, based on the evidence presented by Dr Heap and by Dr Oboho’s own admission, that the use of this test in these circumstances was not appropriate and that no explanation as to its limitations was included in Dr Oboho’s report.

Particular 2(e) – Found Proved
‘the fact that the GHQ-28 and HADS assessments were screening instruments and not diagnostic tests’’
31. The Panel was satisfied, based on the expert evidence of Dr Heap, that Dr Oboho’s report should have explained the limitations of the tests he conducted on Child A. However, there was no such explanation in his report which the Panel would have expected to see in a report of this type. In the Panel’s view there was no good reason for omitting such an explanation.

Particular 2(f) – Found Proved
‘the fact that the GHQ-R and HADS assessments rely on the person’s self-report of their recent experience’
32. The Panel was satisfied, based on the expert evidence of Dr Heap, that Dr Oboho’s report should have explained the limitations of the tests he conducted on Child A. However, there was no such explanation in his report which the Panel would have expected to see in a report of this type. In the Panel’s view there was no good reason for omitting such an explanation.

Particular 2(g) – Found Proved
‘the fact that any interpretation of the GHQ-28 and HADS assessments must be made along with all the other information known about that person’
33. The Panel was satisfied, based on the expert evidence of Dr Heap, that Dr Oboho’s report should have explained the relationship of the tests with other appropriate information about Child A. However, there was no such explanation in his report which the Panel would have expected to see in a report of this type. In the Panel’s view there was no good reason for omitting such an explanation.

Particular 2(h) – Found Not Proved
‘the fact that you did not explain the implications of the scores obtained in the GHQ-28 and HADS assessments’
34. The Panel noted that in Dr Oboho’s report there was some description as to the significance of the GHQ-28 and the HADS assessments and that he did provide some, albeit limited, explanation of the results and implications.

Particular 2(i) – Found Proved
‘the fact that you did not explain the implications of all the scores obtained in the EPQ-R assessment’’
35. By his own admission, Dr Oboho adopted a formula of his own devising to overcome, as he saw it, the error in not administering an age appropriate test. This would have required an explanation. The lack of such an explanation by Dr Oboho in his report and his representation of the results as being valid, were major failings on his part.

Decision on grounds

36. Having found particulars 1(a), 1(b), 2(a), 2(b), 2(d), 2(e), 2(f), 2(g), 2)(i)    proved, the Panel went on to consider whether the Registrant’s conduct amounted to misconduct and/or lack of competence. At this stage, in view of its findings in relation to Particulars 2(c) and 2(h), those sections of the allegation did not form part of the Panel’s consideration. The Panel accepted the advice of the Legal Assessor.

Misconduct

37. The Panel determined that Dr Oboho failed to apply age appropriate tests as a result of not having checked Child A’s age and did not take immediate corrective action when he realised his error. Instead, Dr Oboho chose to continue to report the assessment findings as being accurate, notwithstanding that he had used his own devised formula to present the findings as valid. Dr Heap was firm in his view that the report was of a poor standard and furthermore described it as ‘awful’. The Panel shared the view that the report was not of an acceptable standard.

38. Dr Oboho’s assessment and report had the potential to mislead his instructing solicitor, Child A, the Court and all other interested parties. The fact that other professionals reached the same conclusions as to Child A’s fitness to plead is not relevant.

39. In considering the issue of misconduct, the Panel bore in mind the explanation of that term given by the Privy Council in the case of Roylance v GMC (No.2) [2000] 1 AC 311 where it was stated that:
“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 [medical] practitioner in the particular circumstances.”

40. In the Panel’s view Dr Oboho’s actions fell into the category of serious misconduct as described in the Roylance case, and furthermore, taking note of the judgment in Nandi v GMC [2004] EWHC 2317 [Admin], his conduct would be regarded as deplorable by fellow practitioners.

41. The Panel considered the HCPC Standards of Conduct, Performance and Ethics. The Panel took the view that the Registrant breached the following standards:
• 1 You must act in the best interests of service users
• 7 You must communicate properly and effectively with service users and other practitioners.

42. The Panel also considered the Standards of Proficiency for Practitioner Psychologists and took the view that the Registrant’s actions breached the following standards which state that Registrants must:
• 1a.6 be able to practise as an autonomous professional, exercising their own professional judgement
• 1b.1 be able to work, where appropriate, in partnership with other professionals, support staff, service users and their relatives and carers
• 2a.1 be able to gather appropriate information
• 2a.2 be able to select and use appropriate assessment techniques
• 2a.3 be able to undertake or arrange investigations as appropriate
• 2a.4 be able to analyse and critically evaluate the information collected
• 2b.1 be able to use research, reasoning and problem solving skills to determine appropriate actions
• 2b.2 be able to draw on appropriate knowledge and skills in order to make professional judgements
• 3a.1 know and understand the key concepts of the bodies of knowledge which are relevant to their profession-specific practice.

Lack of Competence

43. The Panel went on to consider the ground of lack of competence. It noted that no other concerns had been raised (save those detailed above) with regard to the standard of the Registrant’s work. In addition, the Panel noted that it only had one example of substandard practice relating to one instruction. In these circumstances the Panel concluded that this did not represent a fair sample upon which the Panel could make a judgment as to Dr Oboho’s overall competence. Therefore, taking all of these factors into account, the Panel concluded that Dr Oboho’s acts and omissions did not establish a lack of competence.

Decision on impairment 

44. Having found misconduct the Panel went on to consider whether the Registrant’s fitness to practise is currently impaired. The Panel took into account the HCPC Practice Note: “Finding that Fitness to Practise is Impaired” and accepted the advice of the Legal Assessor.

45. In assessing the extent of the Registrant’s insight and remediation, the Panel considered that it would have expected at least an acknowledgement that he had made a serious error of judgement, an explanation as to how he would act differently in the future, and a credible assurance that such mistakes would not be repeated.

46. The Panel recognised that Dr Oboho had admitted his error in applying a non age appropriate test on this occasion in his written response to the Allegation. In the course of giving evidence, Dr Oboho referred to this as a mistake. Dr Oboho acknowledged that he had been wrong to manipulate the test results by devising his own formula. The Panel considered that Dr Oboho demonstrated very little insight, limited remorse and no evidence of reflection. The Panel noted that Dr Oboho’s admissions were late, having previously contested the expert evidence, and that there was no evidence of the steps he had taken to improve his practice other than using electronic scoring packages of the WAIS and WISC assessment tools which would, he advised, automatically ensure the correct age was entered and the correct test administered. The Panel determined Dr Oboho’s current fitness to practise is impaired on the basis of the ‘personal component’.

47. The Panel concluded that Dr Oboho’s actions represented potential harm to Child A, as it would to any other service user to whom he applied an inappropriate test. The wider public would also expect a regulatory body to address professional conduct which falls short in this magnitude, and reflect that in an impairment finding. Notwithstanding Dr Oboho’s assurances, the Panel could not be satisfied, given the lack of sufficient insight and remediation, that there would be no risk of repetition.

48. The Panel determined that on the basis of the ‘public component’ a finding of current impairment was necessary to uphold public confidence in the profession and maintain proper standards of conduct and behaviour.

49. In conclusion, the Panel found that the Registrant’s fitness to practise is currently impaired with regards to both the ‘personal and public components’, and therefore the HCPC’s case is well-founded.

Decision on sanction

Panel’s Approach
50. The Panel accepted the advice of the Legal Assessor. The Panel was mindful that the purpose of any sanction was not to punish Dr Oboho, but to protect the public interest. The public interest includes protecting the public, upholding public confidence in the profession and the HCPC as its regulator and by maintaining proper standards of conduct and behaviour. The Panel applied the principle of proportionality by weighing Dr Oboho’s interests with the public interest and by considering each available sanction in ascending order of seriousness.

51. The Panel had regard to the Indicative Sanctions Policy and took into account the submissions made by Mr Orpin-Massey, on behalf of the HCPC, and those of Mr Gloag, on behalf of Dr Oboho.

52. The Panel was mindful that this was a single event that dated back five years and that Dr Oboho testified that he had not been the subject of any other complaint either before or since. He had continued to accept instructions to assess fitness to plead including for young persons under the age of 16. He advised the Panel that he now always checked the age of the client and selected the appropriate assessment tool. However, in the absence of meaningful insight and reflection, particularly on the fundamental inappropriateness of seeking to pass off the test results as valid when that could never be the case, the Panel could not be satisfied that the misconduct had been remediated.

53. This was too serious a matter not to attract a sanction and the Panel therefore considered the available sanctions in ascending order taking note of the principle of proportionality. This was not a matter that lent itself to mediation and a caution order would not adequately reflect the seriousness of Dr Oboho’s misconduct, nor provide a means by which he could demonstrate the degree of learning and remediation necessary to ensure that the risk of repetition of any like conduct was minimal. Dr Oboho has been in settled employment as a private practitioner for nearly 20 years. The Panel was assisted by the information Dr Oboho provided on the breakdown of his work activities in determining that a conditions of practice order could be applied and would be appropriate, proportionate, realistic and verifiable.

54. In deciding upon a conditions of practice order the Panel is of the view that the serious lapse in conduct is capable of being remedied and is not indicative of a more general and deep-seated deficiency on the Registrant’s part.  The Panel further determined that a conditions of practice order for 12 months would allow sufficient time for Dr Oboho to reflect on his failings and, through compliance with the conditions, demonstrate the insight, learning and self-discipline that would signal full remediation. A suspension order would not offer the same opportunity for active remediation and would be punitive in effect.

Order

ORDER: The Registrar is directed to annotate the Register to show that, for 12 months from the date that this Order comes into effect (“the operative date”) you, Dr Ewa Oboho, must comply with the following conditions of practice:

1. For the consideration of a future review panel you must:

A. provide a reflective statement which fully addresses the shortcomings in your conduct that have been found proved, the implications of such shortcomings for clients, service users and professional colleagues, and the steps you have taken to improve your practice as a consequence.

B. provide evidence of your continuing professional development with particular emphasis on the areas of your practice that were the subject of these proceedings eg. evidence of  current formal training on psychometric testing and report writing.

2. You must identify a Practitioner Psychologist registered with the HCPC who is appropriately expert and experienced in the areas of psychometric testing, fitness to plead assessment and report writing, to act as a mentor. The mentor should be made known to the HCPC and you should provide a report from your mentor on your ongoing performance for consideration by a future review panel.

3. You must promptly inform the HCPC of any change in your employment arrangements, providing details of any new employer and your role. 

4. You must inform the following parties that your registration is subject to these conditions:

A any organisation or person employing or contracting with you to undertake professional work
 
B any agency you are registered with or apply to be registered with (at the time of the application); and  
 
C any prospective employer (at the time of your application).

This order will be reviewed shortly before its expiry on 5 May 2017. You may request an early review if you consider that you have fulfilled the terms of this order.

Interim Order:
The Panel makes an Interim Conditions of Practice Order under Article 31(2) of the Health and Social Work 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 13 months.

 

 


 

Notes

 

Hearing history

History of Hearings for Ewa Oboho

Date Panel Hearing type Outcomes / Status
05/10/2017 Conduct and Competence Committee Review Hearing Struck off
10/04/2017 Conduct and Competence Committee Review Hearing Conditions of Practice
04/04/2016 Conduct and Competence Committee Final Hearing Conditions of Practice