Dr Steven Lovett

: Practitioner psychologist

: PYL15672

: Final Hearing

Date and Time of hearing:10:00 03/04/2017 End: 17:00 04/04/2017

: Health and Care Professions Council, 405 Kennington Road, London, SE11 4PT

: Conduct and Competence Committee
: Struck off

Allegation

Between 2008-2012, whilst practising as a Clinical Psychologist, you:

1. [Stayed]

2. [Stayed / no case to answer]

3. [Stayed]

4. [No case to answer]

5. [Stayed / no case to answer]

6. did not provide:
a) Service User A, her General Practitioner, and/or any other health professional responsible for her care with a copy of Service User A's health records;

b) Service User B, her General Practitioner, and/or any other health professional responsible for her care with a copy of Service User B's health records; and

c. [No case to answer]

7. made false or unjustified statements to Servicer User A's General Practitioner, to the effect that:

a) Service User A has 'underlying psychological problems'; and

b) 'there are numerous safety issues surrounding Service User A's psychopathology to herself and others under her care.'.

8. made a false or unjustified statement to Service User B's General Practitioner, to the effect that the release of Service User B's health records may cause harm;

9. did not provide Service user B with appropriate treatment for Post-Traumatic Stress Disorder in that, you:

a) [no case to answer]

b) [no case to answer]

c) did not provide Service User B with advice in relation to panic attacks and/or refer her elsewhere for such advice.

10. did not refer Service User B and/or Service User A to the respective General Practitioners;

11. did not:

a) set the goals of your therapy session(s) with Service User A;

b) set the goals of your therapy session(s) with Service User B.

12. [No case to answer]

13.[No case to answer]

14..[Stayed]

15. the matters set out in paragraphs […] 6,7,8,[…] amount to misconduct;

16. by reason of that misconduct your fitness to practise is impaired;

17. the matters set out in paragraphs 9,10,11 […] amount to lack of competence and/or misconduct; and

18. by reason of that lack of competence and/or misconduct, your fitness to practise is impaired.

 

Finding

Introduction

1. This history of this case has been most unusual and calls for explanation.

2. On 30 March 2012 a Panel of the Investigating Committee determined that there was a case to answer in relation to the allegations that are set out at the head of this decision document.

3. The final hearing of the allegations referred to the Conduct and Competence Committee by the Investigating Committee did not commence until 25 November 2013, and when it did commence it was envisaged that the hearing would conclude on 10 January 2014. In the event the last day on which evidence was received by the Panel was 12 December 2013 when Dr Lovett was being cross examined by the Presenting Officer on behalf of the HCPC.  Following the hearing that day, and before the case was due to recommence on 16 December 2013, Dr Lovett experienced ill health which resulted in him not attending the hearings. The remaining seven days that had been scheduled saw no further progress in the case.

4. Incapacity has prevented Dr Lovett from attending the hearing since 12 December 2013. Since that date no further oral evidence has been received. There has however, been agreement by the HCPC of expert evidence introduced by Dr Lovett, the HCPC have produced written closing submissions on the issues currently being decided, and on 2 February 2017 written closing submissions on the facts, supplemented orally, were made on behalf of Dr Lovett.

5. Between 12 December 2013 and 2 February 2017 there have been many occasions when the Panel has sat, but these sessions have been to consider when the hearing might reconvene.  On two occasions, namely on 16 March 2016 and 2 February 2017 the Panel has directed that the hearing would continue notwithstanding Dr Lovett’s inability to attend the hearing. It is not necessary for the purposes of this decision to revisit, or explain the reasons for, the decisions made on 16 March 2016 and 2 February 2017, but the full determinations issued on those occasions must be considered for the reasons to be fully understood.

6. On 2 February 2017 it was decided that the Panel would initially make findings of fact in relation to those matters remaining in contention, with the parties having an opportunity to make submissions on the statutory grounds and current impairment of fitness to practise on 3 April 2017, having been informed of the Panel’s findings on the facts in advance of that date.

7. The factual particulars being considered by the Panel are more limited than those than the matters referred by the Investigating Committee in March 2012. On 9 December 2013 the Panel ruled that there was no case for Dr Lovett to answer in relation to particulars 2(a), (b), (d) & (e); 4(a) to (c); 5(a) to (m), (o) & (p); 6(c); 9(a) & (b); 12(a) & (b) and 13 (a) to (c).  Furthermore, on 16 March 2016 the Panel permanently stayed particulars 1(a) to (f); 2(c); 3; 5(n) and 14. Full reasoned decisions for both the “no case to answer” decision and for the “permanent stay” decision were published on the respective dates. It follows that the remaining particulars to be decided are as follows:

Between 2008 – 2012, whilst practising as a Clinical Psychologist, you:

6. did not provide:
(a) Service User A, her General Practitioner, and/or any other health professional responsible for her care with a copy of her health records;
(b) Service User B, her General Practitioner, and/or any other health professional responsible for her care with a copy of her health records;
7. made false or unjustified statements to Service User A’s General Practitioner, to the effect that:
(a) Service User A has “underlying psychological problems”; and,
(b) there are numerous safety issues surrounding Service User A’s psychopathology to herself and others under her care”;

8. made a false or unjustified statement to Service User B’s General Practitioner, to the effect that the release of Service User B’s health records may cause harm;

9. did not provide Service User B with appropriate treatment for Post-Traumatic Stress Disorder in that you did not provide Service User B with advice in relation to panic attacks and/or refer her elsewhere for such advice;

10. did not refer Service User B and/or Service User A to the respective General Practitioners;

11. did not:
(a) set the goals of your therapy session(s) with Service User A;
(b) set the goals of your therapy session(s) with Service User B.

8. Some of the evidence in the case was received by the Panel in 2013 in private sessions, that being necessary to ensure that confidential information relating to service users was not put in the public domain. This is a public determination which is based upon the entirety of the evidence received by the Panel so far as that evidence relates to the remaining factual particulars. Of necessity there is no specific reference in this public determination to evidence that was given during the private sessions.

Background

9. In April 2007 Service User B was injured in an extremely traumatic road traffic incident that had profound consequences for her, other members of her family and for her twin sister, Service User A.  It is not possible to give further details of the incident without risk of identifying Service User B and other family members, and in the judgment of the Panel it is not necessary for further detail to be given for the issues in the case to be properly explained and decided upon.

10. Dr Lovett was a Clinical Psychologist to whom Service User B was referred for treatment following the incident. Her involvement with Dr Lovett commenced in May 2008 and continued until October 2009.  Service User A also received treatment from Dr Lovett at times during this period.

Findings of fact – general factors

11. It is necessary to be clear about the approach the Panel has taken to its decision on the remaining facts:

• The Panel has considered only the evidence relating to the remaining factual particulars. It has wholly excluded from its consideration the evidence relating to those particulars in relation to which it was decided that there was no case to answer, or in relation to which there has been ordered a permanent stay.

• An important element of the Panel’s decision to continue with the case in Dr Lovett’s absence was the fact that he had been offered an opportunity to make a statement in lieu of re-examination, but did not take advantage of that offer. Important though that choice was to the decision to continue with the case, it has no relevance to the factual decisions of this Panel.  The Panel has decided the case on the evidence that has been put before it. It has not drawn any inferences from the absence of evidence that might have been, but was not, given, and it has not speculated as to what any such evidence might have been.

• The Panel has remembered throughout that it is for the HCPC to discharge the burden of proof in relation to each disputed factual issue.  When Dr Lovett has raised an issue (as he has in relation to not disclosing his records) the Panel has approached the issue on the basis that, once raised by Dr Lovett, it is for the HCPC to disprove his contention.

• The Panel accepted the submission made on behalf of Dr Lovett that it would not be proper to make a finding against him on an issue unless there were proper and reasonable grounds for rejecting an alternative explanation.

• In reaching its present findings the Panel has had access to all the witness statements and exhibits (in excess of 2,000 pages), a full transcript of the evidence given before it, notes made by Panel members during the hearing and comprehensive written submissions made available by the parties. The Panel has had regard to all these resources in reaching its decisions. Despite the lengthy period between the oral evidence and its deliberations, the Panel is confident that it has been able to fully and fairly consider the evidence.

• In this determination a reference thus: [7/1647] is a reference to page 1647 of hearing bundle 7. If a further number is given after the page number, it is a reference to a numbered paragraph on that page.

• In this determination a reference thus: [T13/69E] is a reference to position E on page 69 of the transcript for day 13 of the case. All transcript references are to public transcripts. These references are accurate for the version of the transcript used by the Panel, one which was printed for them from a pdf format. It has subsequently come to attention that versions prepared in other formats, whilst identical in content, may have variations of up to one page difference in the location of the material referred to.

12. The Panel will start by expressing its views on the witnesses whose evidence it received:

Service Users A and B. They are twin sisters and their presentation to the Panel had many similarities. They were articulate and self-confident. They gave their evidence spontaneously and with a strong air of the correctness of their interpretation of events. It appeared to the Panel that they did their best to recount events to the best of their recollection. However, the reliability of their testimony was compromised in two ways. First, the events in question had occurred over an eighteen month period several years previously. They occurred at a time of great upset and upheaval. Service User A and Service User B had few reliable markers by which to fix particular events and issues and the passage of time had clearly taken its toll on the accuracy of their recollections of many details. They had to accept on occasions that they were mistaken. Second, both Service User A and Service User B had developed significant antipathy towards Dr Lovett. They made no attempt to hide this and made clear that their strongly held view was that Dr Lovett had exploited and cheated them, betraying the trust they had placed in him. Their recollection of interactions with Dr Lovett was coloured by this antipathy and his conduct always liable to a negative interpretation. Accordingly, when assessing their evidence the Panel took great care in considering the extent to which it could be relied upon.

Dr Lovett. In assessing the credibility and reliability of Dr Lovett, the Panel took into account his good character and that he is a well qualified and very experienced clinical psychologist. In the light of that professional background the Panel would have expected a clear, logical and reasoned defence of his professional views and conduct.  In the event he presented quite differently. As will be seen when the Panel turns to explain its particular decisions, his evidence was frequently inconsistent, occasionally evasive and sometimes misleading. His decision making processes were opaque and his explanations for his conduct were confusing and unconvincing. Accordingly the Panel considered that his evidence had to be approached with caution and his explanations carefully scrutinised in terms of their plausibility and credibility.

The expert witnesses. The HCPC called Dr Halari as an expert witness to give evidence before the Panel.  In the event, the expert witness whom Dr Lovett had intended to call as a witness to give evidence before the Panel, namely Professor Powell, did not do so because his report was agreed by the HCPC. In the opinion of the Panel there were few differences between the views expressed by Dr Halari and those contained in Professor Powell’s report, but clearly to the extent that their opinions diverge, the opinions of Professor Powell are to prevail.

Findings of fact

13. In the judgement of the Panel the particulars it is required to decide upon should be taken in the following order: 9(c), 11(a) & (b), 6(a) & (b), 7(a) & (b), 8 and 10.

14. Particular 9(c)  -  “did not provide Service User B with appropriate treatment for Post-Traumatic Stress Disorder in that you did not provide Service User B with advice in relation to panic attacks and/or refer her elsewhere for such advice”.
The evidence to support this particular came from Service User B that Dr Lovett had not given her appropriate advice, or at least she could not remember him having done so. Dr Lovett denied that he failed to advise her regarding panic attacks and claimed that he explained in detail the physiological, psychological and behavioural components of panic attacks and what measures need to be taken to bring them under control. Dr Lovett’s assertion in this regard was corroborated to some extent by his session note dated 11 August 2008 [5&6/1579] which states, “Talked about anxiety issues & managing overwhelming feeling”. The Panel took the view that Service User B’s inability to recall such advice was not a reliable basis on which to conclude that there was none, particularly in the face of the denial by Dr Lovett, supported by his notes. Furthermore, looking at the work that Dr Lovett appears to have engaged in with Service User B, based on both her testimony and that of Dr Lovett, it appeared to the Panel that this was an issue which could be expected to have arisen and it was thus unlikely that Dr Lovett would not have provided her with the sort of advice he claimed to have given.
Particular 9(c) is not proved.

15. Particular 11 – “did not:
(a) set the goals of your therapy session(s) with Service User A;
(b) set the goals of your therapy session(s) with Service User B.
The evidence to support particulars 11(a) and (b) came from the testimony of Service User A and Service User B who stated variously that Dr Lovett did not set any goals or they did not remember him setting any goals.  Dr Lovett asserted that he did set goals for Service User A and Service User B, and in relation to Service User B he claimed to have created a document headed “Some Aims” [8/1924] which clearly set out some goals for the therapy sessions. The Panel noted that the HCPC did not accept the authenticity of that document as it was undated and had not been disclosed at an early stage in the proceedings. The Panel did not consider that the apparent anomaly in relation to its earlier disclosure and the fact that it was undated were sufficient to prove that the document was not what Dr Lovett claimed it to be. Nor did the Panel consider that Service User A’s and Service User B’s inability to remember any goals being set was a sufficient basis on which to conclude that they had not been. In coming to those conclusions the Panel was again influenced by its judgement that the nature of the work on which Dr Lovett was engaged with both Service User A and Service User B, drawn from their descriptions of it, and that of Dr Lovett, made it inherently likely that, consistent with the claim of Dr Lovett, some goals would have been set either explicitly or implicitly.
Particulars 11(a) and (b) are not proved.
Particulars 6, 7 and 8 – general discussion.

16. In dealing with Particulars 6, 7 and 8 the Panel has considered each separately but, to avoid unnecessary repetition, explains its reasoning behind its finding looking at them together, as they are essentially linked.  They are linked because the validity of the reasons put forward by Dr Lovett for not providing the records to the G.P.s (particular 6) are essentially the same as the alleged false or unjustified statements subject of particulars 7 and 8.  Thus it is not possible sensibly to disentangle particular 6 from either particular 7 or particular 8, and whilst it would be possible to deal with matters separately in relation to Service User A and Service User B, the material and issues to be considered are so similar that it would be unhelpfully repetitive to do so.

17. It is not disputed that, in the absence of a good reason or lawful excuse, Dr Lovett was under a duty to provide the records requested and the crux of the case in this regard was whether Dr Lovett had, or genuinely believed he had, any good reason or lawful excuse to withhold his notes, or to put conditions on disclosure of them. In determining this issue the Panel took as its basis for consideration, the test set out in the agreed expert opinion of Professor Powell [7/1704]:
“If I were asked whether it was reasonable for Dr Lovett to refuse to disclose records direct to the clients, then I would say that I have never met any of the clients and cannot therefore express an opinion. It is for Dr Lovett to explain why he would only release the notes under supervised circumstances. That was Dr Lovett’s professional view, and it is for the Panel to decide (a) whether it was his genuine professional view and (b) whether they have sufficient evidence to say that his opinion was wrong ….”
18. Accordingly, the Panel first considered “whether it was Dr Lovett’s genuine professional view”, i.e. that he could only release the notes under supervised circumstances, as he told the G.P.s, and whether the reasons, which are the subjects of particulars 7 and 8, represented his genuine opinion.

19. Dr Lovett’s evidence was essentially that he could not unconditionally disclose his notes because to do so would cause harm to the service users.  The reasons it could cause harm were that in both cases the notes contained diagnoses of personality disorder which could cause distress and anger which, particularly in the case of someone with a personality disorder, could cause harm.  He summarised his position in his evidence in chief when he said, “My fear was that these notes would be misunderstood; they would cause significant distress and harm in a situation which was volatile and changeable.  And these particular, or my particular ……. which I call “formulations” needed explanation.” [T11/61B&C] Dr Lovett set out his concerns even more graphically in a letter to Service User B’s GP dated 5 March 2012 [8/1891-1895].  This letter was never sent, but Dr Lovett stood by its contents as explaining his position.  The letter made reference to features of “personality conditions ….. suffering with a mixed personality disorder showing features of both narcissistic personality disorder and borderline personality disorder”, for all of which Dr Lovett claimed in the letter there was substantial evidence, and which he said justified his concerns about disclosure.

20. Dr Lovett also asserted unequivocally in his statement that, “Informing a client or patient they suffer with a form of personality disorder requires specialist skill and knowledge. It is significantly different to diagnosing an anxiety disorder, depression, or for that matter, PTSD. …… Given the circumstances, I had real concern for the impact that the entries in the notes might have on my former clients if they were simply to receive this material in the post without any support or explanation.  …… I did, however, state that I would be prepared to provide them to a suitable healthcare professional …… I had in mind a professional with an expertise in psychological care.  I was anxious about providing them to a non-specialist such as a GP …” [7/1646/150&151]

21. In explaining how he came to this view, Dr Lovett asserted that, despite previously, and for the overwhelming majority of the time that he interacted with Service User A and Service User B, having considered that they were both presenting with issues arising from post traumatic stress, anxiety or adjustment, he was prompted by events to review his opinions and create new formulations [4/949] and [5&6/1606] respectively, each of which included a diagnosis of personality disorder.  Neither formulation was dated, and none of the material included therein had been discussed with either of the service users. Dr Lovett was unsure of when his change of opinion occurred, but suggested that, “It began to click around Spring [2009], and certainly by the June time.” [T11/54F].  In relation to the new formulation for Service User B, he said, “I can’t tell you the date.  I know that it was made between …….. Towards the end of June and July [2009]” [T11/53A]. It certainly appeared that it occurred after 22 April 2009 in relation to which he stated, “Whilst I was increasingly of the opinion that there may be some personality overlay at work with both [Service User A and Service User B], it is one of prioritising really. My view was still that this was the immediate stress and the demands of the environment and the family that was probably generating these problems and therefore that was still the most pressing clinical aspect to focus on”. [T11/48G].

22. In relation to Service User A, Dr Lovett claimed that the most significant event in his change of direction towards personality disorder was a session on 14 May 2009 when she presented as angry and upset by a newspaper article written by her brother-in-law. In relation to Service User B, Dr Lovett did not claim that there was any significant event which prompted his change of opinion towards his formulation and diagnosis of a personality disorder, but he implied that it arose from a review of material already in his possession which he had previously attributed to stress, anxiety or adjustment.

23. In refuting a suggestion, based on the absence of any relevant references in his session notes, that his formulations and diagnoses of personality disorder had been subsequently constructed to justify his refusal to disclose his notes, Dr Lovett referred to a note of a telephone conversation with his Instructing Solicitor, Ms JK.  That call [3/623 & 710] was dated 29 October 2008.  Dr Lovett noted that he, “Explained [to Ms JK] that both [Service User B] and [Service User A] present more like PD’s and that extreme trauma can make underlying personality issues reemerge ….”

24. Dr Lovett’s explanation for not having discussed any of the issues arising from his formulation and diagnosis of personality disorder with either Service User A or Service User B, was that that the former was pregnant, and he considered that raising the issue with either of them could initiate an extreme reaction which could harm Service User A.

25. In support of his diagnoses of personality disorder, Dr Lovett referred to a number of occurrences of which he was aware and which he considered to exemplify the criteria for a diagnosis of personality disorder. These examples were that:

a. Service User A and Service User B had unrealistic expectations of others and failed to understand boundary issues. He referred to complaints from a member of staff at a care management company with which Service User A and Service User B were in dispute regarding its responsibilities towards another family member. He referred also to discussions he had had with his Instructing Solicitor on what appeared to be the same issue.

b. Service User A had expressed anger and resentment over a newspaper article written by her brother-in-law. He suggested that this was significant because it was a direct observation of behaviour that he had not seen before, but had been relayed to him, i.e. that described at a. above.

c. Service User A had emailed him on 8 December 2008 and this revealed that she had left a person for whom she had responsibility, an individual who ‘lacked capacity’, in charge of young children, but was concerned only that the person did not appreciate her needs. This was put forward by Dr Lovett as an example of Service User A showing a serious misunderstanding of a vulnerable person’s needs.

d. Service User B revealed that she had dismissed her housekeeper following an argument over her refusal to undertake wider responsibilities involving occasional childcare. She had become very angry on encountering the former housekeeper working in a charity shop. This was given as an example of “an increasing instability in her presentation”.

e. Service User B had told him she had fond memories of her childhood and being brought up in a mansion. This was suggested as an example of grandiosity.

f. Service User B had told him that she missed her husband who was away during the week at work. This was put forward as an example of ‘a strong element of a sense of being abandoned’.

g. Service User B had expressed her anger regarding an Orthopaedic Consultant whom she saw as responsible for a Disability Living Allowance being disallowed, and that the family may launch a campaign against him. 

h. Service User B experienced distress about her leg which had sustained a serious de-gloving injury in the index incident, and had thoughts of wanting to cut it off.

i. People were very cautious around Service User A at times, wanted to please her and were certainly worried if they antagonised her. This was given as an example of ‘a grandiose sense of self importance’.

26. However, as Dr Lovett developed his evidence and attempted to clarify his reasoning he contradicted himself on a number of critical points. Significant examples in this respect occurred in both his examination in chief and in his cross-examination. The most significant contradiction was his subsequent assertion that in relation to Service User B, the material which he had previously referred to as a diagnosis was not a diagnosis, but only a formulation. (See Dr Lovett’s witness statement, [7/1647/156] and [T11/56].  In relation to his formulation for Service User B [5&6/1606] Dr Lovett said in his examination in chief, “This was written as a reminder to me. It was me thinking out loud but writing it on the page to make a file note. In many respects I never saw this as actually part of Service User B’s notes, but once a problem had arisen, I simply couldn’t remove it. It left me with an ethical dilemma.” [T11/53D] He was further asked in relation to that material, “Were you certain when you wrote those words down that that was what was fundamentally at issue with [Service User B]?” His answer was, “Not at all ….. this was not a diagnosis of any kind …. and certainly I have never conceptualised [Service User B] or [Service User A] as experiencing any more than a mild or moderate type of personality dysfunction.” [T11/56A-B]  The issues previously put forward as a diagnosis of a personality disorder were then described on his behalf as “your tentative views on the traits in play.” [T11/56E]

27. These contradictions developed further in the evidence Dr Lovett gave under cross-examination when he retreated almost completely from his earlier assertions that he had good reasons for believing that both Service User A and Service User B had personality disorders.  In relation to whether Service User B could properly be said to have this “formulation NPD/Borderline mixed”, he said [T13/42F-H], “I don’t make the claim that necessarily they can be properly described ….. I had no intention of actually working with [Service User B] or [Service User A] in terms of treatment of personality traits particularly because I’d got a relationship, I tried to do some initial assessment I think, and I think I would have needed to review matters at that point.  The formulation …… is very much a note to me because I knew that in fact I wouldn’t be seeing [Service User A] for a while ….. And for [Service User B] the same in many respects because it would’ve been very, very difficult to have started to discuss such issues with [Service User B].  Again, I’d never conceptualised these problems as really anything more than mild or moderate …..” [T13/43B] He then went on to describe the formulation in respect of Service User B which had previously underpinned his “diagnosis” of narcissistic/borderline personality disorder as, “….. it was actually a note to me that really wasn’t a clinical note at all. It really was just my mental thoughts, my ideas put down that had we gone on I would’ve actually confirmed or disconfirmed.  It wasn’t a diagnosis and it wasn’t a fixed formulation.”  He continued, “It wasn’t an assessment, it was just some ideas.  It was thoughts really that I was putting down on paper.” [T13/43D]

28. In the light of this shift in Dr Lovett’s evidence about the nature of the material previously described by him as diagnoses of personality disorders, but subsequently described as just some thoughts or ideas put down on paper and, “not a clinical note at all”. The Panel then examined Dr Lovett’s explanations of why he had believed that a disclosure of his notes had required the inclusion of this material.

29. In his witness statement Dr Lovett suggests, “What I could, and probably should, have done was to separate the notes from the diagnosis. In truth it was the diagnosis that was likely to be the part that would cause difficulty for [Service User B] and [Service User A] and it would have been possible to have disclose (sic) the notes but not the diagnosis. I believe that the notes (because they are my aide memoire to what was actually said) with some interpretation from me may have been upsetting but not such a focussed (sic) manner as the diagnosis itself.”  [7/1647/156]  However, in his evidence in chief, referring to this material as it related to Service User B he asserted, “In many respects, I never saw this as actually part of [Service User B]’s clinical notes, but once a problem had arisen I simply couldn’t remove it.  It left me with an ethical dilemma.” [T11/53D] In cross-examination when it was pointed out in relation to the same material that he had appeared to have treated similar material differently and removed it from his notes, Dr Lovett said, “I put this into the clinical notes, it was written, it wasn’t an assessment, these were my thoughts and, therefore, when this case ……… When we actually started to get the complaints I just felt ethically I couldn’t remove it. I couldn’t remove it.  I just put it into the assessment part of my file.  It wasn’t an assessment, it was just some ideas.  It was thoughts really that I was putting down on paper.” [T13/43D]

30. At another juncture of his cross-examination, Dr Lovett stated, “It has never been my practice to disclose information about my assessments of individuals, either to G.P.s or, for that matter, in legal matters …” [T13/5B]  He continued, in relation to not disclosing a visual formulation but considering that he had a duty to disclose a narrative formulation, “Because I actually saw this as distinct, and maybe incorrectly I saw this distinct and part of my assessment process and distinct from my clinical records as such ….”. [T13/5F]

31. The Panel then considered whether in the light of all this evidence, it was Dr Lovett’s genuine professional view that he was justified in not providing his notes to the service users and/or to their G.P.s for the reasons he gave.  In coming to its decision on this question the Panel noted in particular the following points:

a. When his purported diagnoses of personality disorder in relation to both service users were examined, Dr Lovett denied that they were diagnoses and claimed that they were formulations, works in progress, potentially an alternative way of interpreting evidence which he had hitherto considered to be features of other psychological issues, such as adjustment to the aftermath of a traumatic event.

b. When his formulation in relation to Service User B was challenged, Dr Lovett retreated further, describing it variously as, “actually a note to me that really wasn’t really a clinical note at all”, and,  “…. it was just some ideas” and more in the same vein.

c. The evidence put forward by Dr Lovett to support his contention that he was justified in either diagnosing or even formulating any form of personality disorder in relation to either Service User A or Service User B was entirely unconvincing.  It appeared to the Panel that without gross exaggerations of the nature of the incidents to which he referred, those matters were all much more reasonably to be considered referable to the impact of the trauma and stress on the service users, in relation to which Dr Lovett’s services had been engaged. The way in which it appeared to the Panel that Dr Lovett was prepared to exaggerate and distort what seemed to be relatively trivial matters was well illustrated by the matters referred to in paragraph 25 of this determination.  Furthermore, the Panel took the view that Dr Lovett’s evidence was misleading on occasions, such as when asked if any of the examples he was using were “enduring” or “pervasive” in nature, as would be required to raise a concern about a personality disorder, he said, “……. I thought that that may be the case, but I have no ….. I have no conclusive evidence by any means that that was the case.” [T13/69A] This was clearly misleading as he was implying that he had some, albeit not conclusive, evidence, and he must have known that he had no evidence at all.

d. Dr Lovett’s evidence in relation to what, out of his records, he ought to disclose was incoherent and made no sense. He variously implied that he could have withheld the potentially harmful material even when he described it as diagnoses, but also indicated that, even when it qualified as no more than a few ideas and not necessarily even a clinical record, he felt it had to be disclosed.

e. When originally asked for the clinical notes for Service User B and Service User A, albeit not by their G.P.s or other medical professionals, Dr Lovett raised none of the concerns that he subsequently expressed.  In fact, he stated in a letter that he would be pleased to provide them when his outstanding invoices were paid [2/143]. He then entered into further correspondence to explain what he claimed he was owed.  Although Dr Lovett claims that this response was made on legal advice it begged the question of what information from Dr Lovett any such purported advice was based on. In any event, had there been genuine reasons for believing that service users would be exposed to the risk of harm by the disclosure of records relating to them, Dr Lovett would have been under a professional duty not to disclose the records whatever legal advice he was given.

f. Dr Lovett maintains that the risk of harm in disclosing his notes could only be properly addressed by providing them to “a suitable healthcare professional …… I had in mind a professional with expertise in psychological care.” [2/161]. This only makes sense if his notes included not only a diagnosis of a personality disorder, but some reasoned basis for such a diagnosis.  It appeared to the Panel that even the best qualified professional with expertise in psychological care would not be able to provide any support or assistance to either Service User A or Service User B or their respective G.P.s if presented with simply with “really just my mental thoughts, my ideas put down that had we gone on I would’ve actually confirmed or disconfirmed ….”.  Dr Lovett’s assertion that this material needed to be released in a “safe and controlled manner” makes no sense in the light of his contentions that it did not amount to diagnoses and, in any event, had not been worked on, thought through, exemplified, or referenced to any of the session notes. This point is underlined, particularly with regard to Service User B, by Dr Lovett’s agreement in cross-examination [T13/69C-E] that his contemporaneous written notes do not support in any way the formulation.

g. If Dr Lovett’s claim is correct that his note of a telephone conversation with his Instructing Solicitor in October 2008 shows that he was already considering issues of personality disorder at that stage, and that, therefore, they could not simply be a device to justify non-disclosure, then he must be wrong to say that these issues only “clicked” around Spring or Summer 2009.  He would also have no basis on which to claim either that he felt it was inappropriate to broach the subject with either of the service users (Service User A was not pregnant then), or that he had no real opportunity to start to try to “confirm or disconfirm” his “ideas”. 

h. It was noted that although in his statement Dr Lovett says, “…… it appears to be [Service User A]’s belief that she only ever saw me on four (or possibly five) occasions ….. my records show that I met with her on many more occasions than she recalls” [7/1617/37], in a letter to Service User A’s Solicitor on 11 October 2010 he states, “Whilst I saw [Service User A] at her sister’s house on many occasions, it is my opinion that there are only three appointments the (sic) represent clinical sessions with her.” [2/145] In that respect the opinion of Dr Halari is relevant when she suggested that Dr Lovett’s contact with Service User A was so limited that it would be “difficult” to come to his formulation of personality disorder. [T7/43A]  Dr Halari was referring, of course, to the formulation as described in his statement rather than the significantly reduced version settled on by Dr Lovett at the end of his oral evidence.

i. Dr Lovett’s claimed concerns about personality disorders affecting either Service User A or Service User B are not supported by any of their health records gleaned from other professionals involved in their care, which were produced as a result of disclosure applications made by Dr Lovett in advance of the commencement of the hearing. This lack of support is particularly apparent in relation to Service User B, who appears to have been dealt with by a significant number of health professionals over the period before and after the tragedy at the root of this case. The only mention of personality issues comes from Dr Cleare, a Psychiatrist whose report of his first assessment of Service User B dated 28 December 2007 notes, “a degree of histrionic overlay, which likely relates to [Service User B]’s pre-morbid personality” but who diagnosed a combination of Post Traumatic Stress Disorder and Major Depression. [6/1394]

32. Having carefully considered all those points the Panel has been persuaded that it was not Dr Lovett’s genuine professional view that he was justified in not providing his notes to Service User A and Service User B and/or to their G.P.’s as alleged at Particulars 6(a) and 6(b).  It was clear to the Panel that on his own evidence there was no justifiable basis on which he could have come to a diagnosis of any kind of a personality disorder in relation to either Service User A or Service User B.  As such there was no justifiable basis on which he could have considered himself under an obligation to provide any information or documentation which included or implied such a diagnosis in any health records he had a duty to disclose.  Having accepted that the formulations he provided were only ideas to explore, he must have known they could not make sense to any third party.  They were effectively inexplicable and had no place in records to be shared with any other health professional.  Thus Dr Lovett had no good reason or lawful excuse not to provide the health records as requested.

Particulars 6(a) and 6(b) are both proved.

33. On the same basis, and for the same reasons, the Panel also found proved the particulars at 7(a), 7(b) and 8 in so far as they relate to the allegation that Dr Lovett’s statements to the G.P.s. were unjustified. The Panel has interpreted the wording of the allegation in 7(a) as linked to failure to provide the health records subject to particular 6 as that is clearly its import, that is how it has been presented and that is how it has been defended. To do otherwise would make a nonsense of particular 7(a) as it would be trite to suggest that a service user has “underlying psychological problems” if they are engaged in therapy with a Clinical Psychologist.

34. In further considering particulars 7(a), 7(b) and 8 as to whether the statements were false, i.e. whether Dr Lovett knew they were not true when he made them, the Panel considered whether there could be some other explanation for his conduct, such as simply a mistaken belief in the validity of his formulation of personality disorder.  However, the Panel rejected that possibility for several reasons. First, it is very difficult to reconcile with Dr Lovett’s initial response to the request for his records which was to say that he would be pleased to disclose them subject to payment of his outstanding invoices. Second, it is impossible to reconcile with the content of his draft letter to Dr Cross of 5 March 2012, which although not sent was adopted by Dr Lovett as valid when he gave his evidence in chief.  In that letter Dr Lovett makes extensive claims about the presentation of Service User B which involve gross distortions of relatively trivial matters so as to exemplify his claimed diagnosis of personality disorder. This was no accident or oversight but a clearly false picture. Third, Dr Lovett is a highly qualified and very experienced Clinical Psychologist for whom such a mistake is simply not credible.

Particulars 7(a), 7(b) and 8 are proved in relation to making false and unjustified statements.

35. In the light of its findings on particulars 6, 7 and 8 the Panel then considered the allegation at particular 10 “did not refer Service User B and/or Service User A to the respective G.P.s”.  The Panel found this particular not proved on the basis that, as there were no genuine concerns about risks of harm by Service User A or Service User B to themselves or others, there was no reason why they should have been referred to their G.P.s.

Particular 10 is not proved.

36. For the avoidance of doubt the Panel has considered the submission made on behalf of Dr Lovett that there was no clear motive for him to have acted in the manner the Panel has found he did.  Any attempt to identify a motive for his conduct would be purely speculative and entirely inappropriate.  The absence of an identified motive has little or no impact when set against the other clear evidence in this case.

Preliminary Matters
37. On 3 April 2017 the hearing resumed. At the outset of the hearing Mrs Lovett, on behalf of Dr Lovett, provided the Panel with a four page written submission entitled ‘Registrant’s Applications for Orders and Directions’ and accompanying documents relating to a personal injury claim.

38. The written submission included general criticisms of the Panel’s findings of fact and conduct of the hearing. It also included a number of overlapping applications. The Panel took the view that the application for the case to be ‘discontinued’ was a repetition of a previous application for the whole hearing to be stayed which had been refused by this Panel in March 2016, a decision upheld by the High Court on an application for Judicial Review in July 2016. The new applications related to recusal of the Panel on the grounds of bias or apparent bias, referral to the Health Committee and the fact that the previous Legal Assessor did not hold a practising certificate.

Recusal Application
39. Mrs Lovett, on behalf of Dr Lovett, submitted that the Panel should recuse itself on the grounds of bias in that:

(i) Two of the Panel members are former police officers who both attained the rank of Assistant Chief Constable. It was suggested on behalf of Dr Lovett that police officers ‘by habit treat every person they come into contact with suspicion with the presumption that those persons will lie to them and that it is a habit which is in all probability impossible to break.’

(ii) The Panel are parties in a personal injury claim made on behalf of Dr Lovett, where it is alleged that through their negligence he has become physically and mentally disabled. It was suggested on behalf of Dr Lovett that this has created a ‘conflict of interest’.
HCPC Submission
40. Ms Hill, on behalf of the HCPC, opposed the application. Ms Hill submitted that the application was an attempt to delay the proceedings. She also informed the Panel that the claim has been amended and HCPC is the only respondent to the personal injury claim. The Panel members are now witnesses only. 
Decision

41. The Panel took into account the submissions made by both parties and the advice of the Legal Assessor. The Panel noted that there is no test for actual bias but in relation to apparent bias applied the well-established test as set out in Porter v Magill [2002] 2 AC 357: ‘Would the fair-minded and informed observer, having considered the facts, conclude that there was a real possibility that the tribunal was biased?’

42. The Panel noted that the ‘fair minded and informed observer’ can be assumed to have access to all of the relevant facts which are capable of being known to members of the public and that a reasonable member of the public is neither complacent, nor unduly sensitive or suspicious.

43. The Panel concluded that the ‘fair minded and informed observer’ would take the view that there is no merit in the assertion that the professional background of two members of the Panel renders them incapable of reaching a fair and objective decision or specifically incapable of reaching an impartial decision in this case. Bold general assertions were made, on behalf of Dr Lovett, but these were not substantiated by reference to any issues that have arisen during this case other than non-acceptance of the Panel’s findings. Similarly, the Panel also concluded that the ‘fair minded and informed observer’ would take the view that the outstanding personal injury claim is irrelevant to the Panel’s determination of the remaining issues in this case. Mrs Lovett, on behalf of Dr Lovett, chose to bring the detail of the claim to the Panel’s attention. However, the Panel, having determined that the claim is irrelevant concluded that the claim and documents in support of it should be disregarded.

44. Mrs Lovett, on behalf of Dr Lovett, did not identify any basis upon which the Panel could conclude that it had demonstrated actual bias.The Panel took the view that general dissatisfaction with the factual findings and the conduct of the hearing was insufficient.

45. For the above reasons the application for the Panel to recuse itself was refused.
 Application for Referral to the Health Committee

46. Mrs Lovett, on behalf of Dr Lovett, submitted that the hearing should be referred to the Health Committee. Mrs Lovett submitted that there was no public interest in pursuing a ‘sick and injured man’. She further submitted that the purpose of these proceedings should not be to punish.
HCPC Submission

47. Ms Hill, on behalf of the HCPC, opposed the application and referred the Panel to the HCPC Practice Note on Health Allegations.
Decision

48. The Panel noted that the discretionary power to refer Dr Lovett’s case to the Health Committee is set out in Rule 4(1), which states: ‘Where it appears to the Committee that an allegation which it is considering would be better dealt with by the Health Committee, the Committee may refer the allegation to the Health Committee for consideration and shall suspend its consideration of the allegation.’ The Panel also took into account the case of R (on the application of Toth) v GMC [2003] which concerned the ‘cross referral’ of an allegation to the Health Committee. In the Toth case the court held that: “whilst the possibility of [striking off order] remains, the [Committee] cannot lawfully refer the case to the Health Committee. That Committee cannot impose a sanction of [striking off order] and it is one that the [Committee] may have to impose in the public interest. Whilst that remains a possibility, [it] should retain jurisdiction.”

49. The Panel concluded that the alleged misconduct was unrelated to Dr Lovett’s health conditions. In addition there is no evidence that Dr Lovett’s health raises any issue of fitness to practise or poses a risk to service users. The Panel was also satisfied that the factual findings are of a sufficiently serious nature that the option of a striking off order should be retained.

50. For these reasons the Panel took the view that Dr Lovett’s case would not ‘be better dealt with by the Health Committee’ and concluded that it should retain jurisdiction.
Application to Adjourn

51. Mrs Lovett, on behalf of Dr Lovett, made an application for the hearing to be adjourned. Mrs Lovett informed the Panel that on 31 March 2017, Dr Lovett’s legal representatives indicated that they would refuse an instruction to advance the legal arguments contained within her written submissions. On that basis instructions were withdrawn. Mrs Lovett submitted that she had not had time over the weekend to instruct new legal representatives and requested an adjournment in order to do so.
HCPC Submission

52. Ms Hill, on behalf of the HCPC, opposed the application to adjourn. Ms Hill submitted that there is no unrestricted right to instruct a new legal team. She invited the Panel to take into account the circumstances which led to the breakdown of the relationship between Mrs Lovett and Dr Lovett’s former legal representatives.
Decision

53. The Panel refused the application to adjourn. In reaching this decision the Panel took into account the fact that Dr Lovett does not have an unfettered right to insist on instructing new legal representation regardless of the consequences for the public interest and for the regulatory process.

54. The Panel refused the application to adjourn for the following reasons:
(i) The substantive hearing of Dr Lovett’s case has been ongoing since November 2013 and there is a significant public interest in ensuring that it concludes. There is a real risk that this case will not conclude if the hearing is adjourned, as one Panel member has to demit in June 2017.
(ii) If the case were to be adjourned it is not possible to estimate the likely length of such an adjournment. As Mrs Lovett, on behalf of Dr Lovett does not accept the Panel’s findings nor the Panel’s authority, she may encounter similar difficulties in persuading a new legal team to accept her instructions. The Panel further noted that this was not the first time that the services of a legal team had been dispensed with by or on behalf of Dr Lovett and on the previous occasion there had been a significant delay to allow his new legal team to familiarise itself with the case. 
(iii) There is no significant disadvantage to Dr Lovett in not being represented at this stage of the proceedings. The Panel had regard to the fact that the factual findings had been determined and the remaining issues are not beyond the competence of a non-lawyer. Previous Legal Assessor’s Advice. Mrs Lovett had been provided with the Panel’s decision on the facts more than four weeks previously and, as it appeared at that stage that she was unrepresented, she had been sent guidance on what would be expected at the next stages of the hearing. It appeared to the Panel that Mrs Lovett was perfectly capable of making submissions on the outstanding issues.
55. Mrs Lovett submitted that as the previous Legal Assessor did not have a practising certificate this called into question the status of the advice that he provided to the Panel. She also submitted that his advice had been negligent and the case should be adjourned for further enquiries to be made.

56. The Panel took the view that the matters raised by Mrs Lovett are not for this Panel to determine. Mrs Lovett can appeal the Panel’s decisions on behalf of Dr Lovett. If the right to appeal is exercised the advice the Panel received can be included as a ground of appeal.

Proceeding in Absence

57. Mrs Lovett refused to make submissions on grounds and impairment. She repeated her criticisms of the Panel’s fact finding decision and conduct of the hearing. The Panel gave Mrs Lovett the opportunity to reconsider her position. Mr Dickinson, the lawyer instructed on the personal injury case, attended and the Panel gave Mrs Lovett extra time to consult with him. When the hearing resumed Mrs Lovett once again repeated her denunciations of the Panel and the process. She left the hearing without making any submissions on grounds and impairment.

58. Ms Hill, on behalf of the HCPC, made an application for the hearing to proceed in Mrs Lovett’s absence.

Decision

59. The Panel determined that it was reasonable and in the public interest to proceed with the hearing as it was clear that Mrs Lovett had voluntarily absented herself and from what she had said there was no reason to believe that she would be likely to re-engage. The Panel also had regard to the matters set out in paragraph 52. Although Mrs Lovett was unwilling to make submissions on grounds and impairment, she was more than capable of doing so. 

Decision on Grounds

Panel’s Approach

60. In light of the Panel findings of fact in respect of Particulars 6(a), 6(b), 7(a), 7(b) and 8, the Panel went on to consider whether, by not providing the health records and by making false statements, Dr Lovett’s acts and omissions amount to  misconduct. The Panel wholly excluded from its consideration the particulars that were found not proved and the issue of lack of competence as it does not have any bearing on the matters found proved.

61. 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 31, 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 … practitioner in the particular circumstances. The misconduct is qualified in two respects. First, it is qualified by the word ‘professional’ which links the misconduct to the profession ... Secondly, the misconduct is qualified by the word ‘serious’. It is not any professional misconduct which will qualify. The professional misconduct must be serious.”

62. The Panel took into account the oral submissions made by Ms Hill, on behalf of the HCPC and followed the advice of the Legal Assessor.
Panel’s decision

63. The Panel first considered the matters dealt with in Particulars 6(a) and 6(b), the failures to provide the Service Users and their GP’s with copies of their health records. The Panel has found that Dr Lovett had no good reason not to provide the records as requested, he had no basis on which to set the conditions he laid down for their provision, and it was apparent from the evidence of both Service Users that his failure to provide the records caused them significant concern. Whatever the basis for the Service Users’ earlier concerns about Dr Lovett’s conduct, his prevarication over the provision of their health records further undermined their trust in him. Even without the seriously aggravating feature of the false and unjustified statements Dr Lovett made in the context of his refusal to provide the records, it is the Panel’s view that his failures to provide the records as requested were serious professional failings and breaches of the following standards of the HCPC Standards of Conduct, performance and Ethics:
Standard 1 – You must act in the best interests of service users.
Standard 7 – You must communicate properly and effectively with service users and other practitioners.
The Panel was aware that breach of the standards alone does not necessarily constitute misconduct. However, the Panel was satisfied that Dr Lovett’s conduct and behaviour fell far below the standards expected of a registered Practitioner Psychologist. Whatever Dr Lovett’s motive for his refusal to provide the records, it caused upset to the Service Users and was clearly not in their best interests. In compliance with the requirement to communicate properly and effectively with service users and other practitioners, Dr Lovett should have promptly provided the health records as requested, having exercised appropriate professional judgement in relation to what he should responsibly include therein.

64. Dr Lovett’s failings in this regard were serious and would be regarded as deplorable by fellow professionals. The matters found proved at Particulars 6(a) and 6(b) amount to misconduct.

65. The Panel then gave consideration to the same question in relation to its findings on Particulars 7 and 8. These findings are that Dr Lovett made the relevant statements without justification and knowing them to be wrong. The mischief of these statements was not simply what was said on the face of the documents but that they directed the reader to purported diagnoses on which they were based. These purported diagnoses of personality disorder, narcissistic/borderline/mixed, were inevitably extremely distressing to the Service Users to whom they related. Dr Lovett’s conduct was deliberate and it is apparent that it caused considerable anguish to both Service Users. Dr Lovett had a good knowledge of these Service Users, he knew of their vulnerabilities and he must have known what sort of impact on them his statements were likely to have. It is the view of the Panel that his conduct in this regard and in relation to each particular amounts to a very serious breach of Standards 1 and 7 (above) of the HCPC Standards of Conduct, Performance and Ethics and:

Standard 13 - You must behave with…integrity and make sure your behaviour does not damage the public’s confidence in you or your profession.
It is difficult to overstate the impact of Dr Lovett’s behaviour on the public’s trust in him and his profession. The Panel considers that someone in Dr Lovett’s position who has so seriously breached the trust reposed in him by his clients would find it difficult to be trusted ever again by them or by anyone who knew of his conduct.

66. Dr Lovett’s failings in respect of Particulars 7 and 8 are extremely serious and in the view of the Panel clearly amount to misconduct.
Decision on Impairment 

Panel’s Approach

67. Having found misconduct the Panel went on to consider whether Dr Lovett’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.

68. In determining current impairment the Panel had regard to the following aspects of the public interest:
• The ‘personal’ component: the current competence, behaviour etc. of the individual registrant; and
• The ‘public’ component: the need to protect service users, declare and uphold proper standards of behaviour and maintain public confidence in the profession.

Panel’s Decision
69. The Panel took the view that Dr Lovett’s misconduct raises significant concerns. The Registrant abused his position of trust, demonstrated a persistent lack of judgment and a disregard for the best interests of Service User A and Service User B.
 
70. The Panel considered the Registrant’s current fitness to practise firstly from the personal perspective and then from the wider public perspective.

71. The Panel asked itself whether misconduct of this nature is remediable and if so, whether it has been remediated so as to preclude a significant risk of repetition. In doing so, the Panel noted that Dr Lovett has never admitted or acknowledged his behaviour. Throughout the very lengthy period during which this case must have been present in his mind, he has denied his responsibility and from the outset attempted to raise what the Panel judges to be baseless justifications for his purported diagnoses in an attempt to exculpate himself. The Panel noted that for at least the last six months Dr Lovett has not been in a position to further reflect on his conduct in this case but even when given the chance to make a statement in lieu of re-examination, in March 2016, over two years after acknowledging that his ‘diagnoses’ were nothing of the sort, the opportunity was still not taken to accept responsibility. Dr Lovett has shown no insight whatsoever into his conduct and, even if conduct of this nature could be regarded as potentially remediable, there is no basis on which the Panel could conclude that any form of remediation has even begun. As a consequence the Panel considered that there remains a serious and ongoing risk of repetition.

72. The Panel concluded that for these reasons the Registrant’s fitness to practise is currently impaired based on the personal component.

73. For the avoidance of doubt the Panel noted that it was said on behalf of Dr Lovett that not only does he have no intention of returning to practice but his health would not allow him ever to do so. The Panel did not consider that it could or should make assumptions about either of these issues and proceeded on the basis that a return to practice is possible.

74. In considering the public component the Panel had regard to the important public policy issues which include the need to maintain confidence in the profession and declare and uphold proper standards of conduct and behaviour. It is critically important that professional colleagues can rely on the integrity of a Practitioner Psychologist at all times. Equally members of the public would be extremely concerned by Dr Lovett’s conduct and behaviour. The Panel took the view that the public would regard his behaviour as thoroughly unprofessional and in the judgement of the Panel a finding of no impairment would fail to declare and uphold proper standards, would undermine confidence in the profession of Clinical Psychology and would undermine public confidence in the HCPC as a professional regulator.

75. The Panel concluded that the Registrant’s current fitness to practise is impaired on the basis of both the personal component and the wider public interest and therefore the HCPC’s case is well-founded.

Decision on sanction

Panel’s Approach

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

77. The Panel had regard to its findings in relation to misconduct and impairment of Dr Lovett’s fitness to practise. The Panel also had regard to the Indicative Sanctions Policy (ISP) and took into account the submissions made by Ms Hill, on behalf of the HCPC.

Decision

78. In determining the appropriate sanction, if any, to impose the Panel first identified what it considered to be the mitigating and aggravating features of the case. The Panel identified the following mitigating factors:

• Previous unblemished career;
• There are no other regulatory findings against Dr Lovett.
The Panel identified the following aggravating factors:
• Dr Lovett’s misconduct included knowingly making false statements;
• The false statements caused great distress to the Service Users;
• The Service Users were both vulnerable individuals whose vulnerabilities would have been well known to Dr Lovett;
• Dr Lovett has never acknowledged his misconduct or expressed any remorse.
• The only apology he has offered was for the shortcomings in his invoicing which led the Service Users to question the integrity of that aspect of his service.
• There is no evidence that Dr Lovett has any insight into his misconduct.

79. The Panel first considered taking no action.The Panel concluded that, in view of the nature and seriousness of Dr Lovett’s misconduct, to take no action on his registration would be wholly inappropriate. Furthermore, in the absence of exceptional circumstances the Panel concluded that taking no action would be insufficient to protect the public, maintain public confidence in and uphold the reputation of the profession.

80. The Panel then considered a Caution Order. The Panel noted paragraph 22 of the ISP which states:

‘A caution order is an appropriate sanction for cases, where the lapse is isolated, limited or relatively minor in nature, there is a low risk of recurrence, the registrant has shown insight and taken appropriate action. A caution order should also be considered in cases where the nature of the allegation means that meaningful practice restrictions cannot be imposed but where the registrant has shown insight, the conduct concerned is out of character, the risk of repetition is low and thus suspension from practice would be disproportionate.  A caution order is unlikely to be appropriate in cases where the registrant lacks insight.’

81. In view of the Panel’s findings that Dr Lovett demonstrated no insight when he had the opportunity to do so, the Panel concluded that a Caution Order was not appropriate. The Panel also took the view that Dr Lovett’s misconduct could not be described as limited or minor in nature. The Panel noted that a Caution Order would impose no restriction on Dr Lovett’s practice and therefore concluded that it would not provide any protection from the risk of repetition. In these circumstances a Caution Order would fall well short of meeting the wider public interest in terms of declaring and upholding proper standards or maintain public confidence in the profession.

82. The Panel went on to consider a Conditions of Practice Order. The Panel noted that the ISP states at paragraph 28:

‘Whilst conditions can be drafted so that they are verifiable, including providing mechanisms for verifying compliance…to a large extent the registrant will be trusted to adhere to those conditions. Where the allegation before the Panel is based upon actions which constitute… a breach of trust, conditions of practice are unlikely to be appropriate...’

83. Dr Lovett’s false statements demonstrated a lack of integrity and such behaviour is not amenable to conditions, as the basis for this type of misconduct is an attitudinal failing. Furthermore, such failings undermine the trust and confidence the public are entitled to expect from all professional clinical psychologists. As a consequence the Panel concluded that conditions would not adequately meet the wider public interest.

84. The Panel next considered a Suspension Order. The Panel noted that paragraph 32 of the ISP states:

‘Suspension should be considered where the Panel considers that a caution or conditions of practice would provide insufficient public protection or where the allegation is of a serious nature but unlikely to be repeated and, thus, that striking off is not merited’

85. Clearly a Suspension Order would prevent Dr Lovett from practising during the suspension period, which would therefore provide temporary protection to the public and the wider public interest. However, the question then arises as to what assurance there would be when the suspension came to an end, that the risk to the public would be sufficiently reduced. That would depend, of course, on the extent to which Dr Lovett’s misconduct could be regarded as remediable. In considering this issue the Panel had regard to paragraph 34 of the ISP which states:
‘If the evidence suggests that the registrant will be unable to resolve or remedy his or her failings then striking off may be the more appropriate option. However, where the registrant has no psychological or other difficulties preventing him or her from understanding and seeking to remedy the failings then suspension may be appropriate.’

86. In this case the Panel considered that not only is Dr Lovett’s lack of integrity, evidenced by a willingness to make false statements to the detriment of the vulnerable Service Users, inherently difficult to remediate, but in the absence of any progress in that respect over the last five years, it did not consider there was any realistic prospect that Dr Lovett would remedy his conduct in the future. In the Panel’s view the evidence suggests that Dr Lovett will be unable to remedy his failings and therefore a Striking Off Order may be the more appropriate option.

87. The Panel noted that it had been presented on behalf of Dr Lovett that he has no intention of returning to practice and that, in any event, his health would not allow him to do so. However, the Panel did not consider that it could or should make assumptions about either of these issues and proceeded on the basis that a return to practice is possible and therefore public protection considerations needed to be given priority.

88. In relation to a Striking Off Order the Panel noted that the ISP states at paragraph 40 and 41:

‘Striking Off is a sanction of last resort for serious, deliberate or reckless acts involving abusive of trust…or persistent failure.’
‘Striking Off should be used where there is no other way to protect the public, for example, where there is a lack of insight, continuing problems or denial. A registrant’s inability or unwillingness to resolve matters will suggest that a lower sanction may not be appropriate.’
89. It is the Panel’s view that this is such a case. Dr Lovett’s misconduct has involved a gross breach of trust, has continued for a period of years and during all that time has continued to cause anguish to the vulnerable Service Users who placed their trust in him. He has shown no evidence of insight or a willingness to acknowledge his failings. The Panel does not consider that there is any way to protect the public other than through a Striking Off Order.

90. Furthermore, it is the Panel’s view that the public would consider Dr Lovett’s misconduct to be a betrayal of trust to the two Service Users already the victims of a family tragedy and thus a matter which would need to be marked by the most severe sanction. Any sanction short of a Striking Off Order would fail to declare and uphold proper standards and would fail to maintain public confidence in the profession and the HCPC as its regulator.

91. Accordingly, it is the Panel’s decision that a Striking Off Order is the appropriate, necessary and proportionate sanction in this case.

Order

Order: That the Registrar is directed to Strike the name of Dr Steven Lovett from the Register on the date this order comes into effect.

The order imposed today will apply from 2 May 2017 (the operative date).

Interim Order:

The Panel makes an Interim Suspension 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. The Panel reached this decision having concluded that there is a serious and on-going risk to service users and having concluded that Dr Lovett's misconduct is so serious that public confidence would be undermined if he were permitted to remain in practice even on a restricted basis. 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.

Notes

The hearing which commenced on 25 November 2013 was adjourned on 8 January 2014. Evidence was heard during this period but the hearing did not conclude. 

Further hearing dates took place on: 19 March 2014, 3 July 2014, 3-5 November 2014, 17 December 2014, 20 April 2015, 31 July 2015, 4 December 2015 and 14-15 March 2016, 16 December 2016, 01-02 February 2017 and 3-4 April 2017.

 

Hearing history

History of Hearings for Dr Steven Lovett

Date Panel Hearing type Outcomes / Status
03/04/2017 Conduct and Competence Committee Final Hearing Struck off
01/02/2017 Conduct and Competence Committee Final Hearing Hearing has not yet been held