Mr Stephen G Lees

: Paramedic

: PA09931

Interim Order: Imposed on 28 Nov 2016

Finding:

Preliminary matters

1. The Registrant, Mr Lees, has neither attended this hearing nor been represented at it.

2. The Panel first considered whether proper notice of the hearing had been sent to the Registrant.  The Panel was satisfied that the letter dated 7 February 2017 sent to the address provided by the Registrant for HCPC Register purposes satisfied the requirement in this regard.

3. The Panel next considered the HCPC’s application that the hearing should proceed in the absence of the Registrant.  In reaching its decision the Panel heeded the guidance contained in the HCPTS Practice Note on the topic and it accepted the advice of the Legal Assessor that great care and caution should be exercised before directing that a hearing should proceed in the absence of the registrant is concerns.  The conclusion of the Panel was that the hearing should proceed in the absence of the Registrant.  The reasons for this decision were as follows:

• All reasonable steps had been taken to notify the Registrant of the hearing.  In addition to the letter dated 7 February 2017 to which reference has already been made, the same information was sent by email on the same day.

• Subsequently, attempts had been made by both post and email to serve the hearing bundle on the Registrant, a bundle that contained details of the hearing.  The posted bundle was not collected and the email not responded to.

• There had been no communication by the Registrant with regard to the hearing.  It follows that there had been no request that the hearing should be adjourned.

• The Panel accepted that the Registrant would be disadvantaged by his case not being considered, but it concluded that that disadvantage arose entirely from his own lack of engagement in the process.

• There were no grounds on which the Panel concluded that the Registrant would engage in the process in the future if the present hearing were to be adjourned.

• It followed from all these factors that there was no merit in adjourning the case.  That being so, the clear public interest in an expeditious disposal of the case outweighed the absence of the Registrant.

4. The Panel next considered the HCPC’s application to amend the wording of particular 1 of the allegation.  Notice of its intention to amend this particular was communicated to the Registrant by a letter dated 9 March 2017, although in the event the wording of the amendment sought at the hearing differed from that communicated in the letter.  Both alternative wordings were solely concerned with the correction of dates concerning the conviction lying at the heart of this case.  The Panel concluded that the amendment sought at the hearing was appropriate in the sense that it properly reflected the case the HCPC intended to present, it was consistent with the case referred to the Panel by the Investigating Committee.  The Panel was also satisfied that there was no risk of prejudice to the Registrant arising from the proposed amendment.  As originally alleged, and as sought by the amendment, the same conviction was relied upon.  In the event of it being factually established that it was the Registrant who was the subject of that conviction, he would be well aware of the particularity of the dates concerned with it.

Background

5. This case arises out of a conviction recorded at the Bristol Magistrates’ Court.  It is the HCPC’s case that on 11 September 2015 the Registrant assaulted his then partner occasioning her actual bodily harm.  The circumstances of the assault were that after a visit to a local public house, an argument during which the Registrant accused his then partner of taking drugs continued when they returned to the partner’s home.  It is alleged that the Registrant assaulted his then partner, grabbing her hair and punching her in the face.  It is contended that he then removed his paramedic bag from a cupboard and filled a syringe with a liquid that he took from the same bag.  He then returned the syringe to the bag and left the room, his partner telephoning the police when he was absent.

6. The sentence imposed by the Court was a Community Order with a requirement to complete various activities within a period of a year.  The obligations included 240 hours of unpaid work.  Additionally, various financial costs and charges totalling £325 were imposed.

7. The HCPC make two allegations against the Registrant, namely:

• An allegation that his fitness to practise is impaired by reason of the conviction.

• An allegation that his fitness to practise is impaired by reason of misconduct, the particulars of the misconduct being that the Registrant did not report the conviction to the HCPC, a failure it is contended was dishonest.


: Final Hearing

Date and Time of hearing:10:00 12/05/2017 End: 17:00 12/05/2017

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

: Conduct and Competence Committee
: Struck off

Allegation

Allegation as amended

While registered as a Paramedic, you:


1. Between 14 September 2015 and 6 October 2015 at Bristol Magistrates Court, were convicted of assaulting Person A, thereby occasioning her actual bodily harm, on 11 September 2015. 

2. Did not declare the conviction at paragraph 1 to the Health and Care Professions Council.

3. Your actions at paragraph 2 were dishonest.

4. The matters at paragraphs 2 and 3 amount to misconduct

5. By reason of your conviction as set out at paragraph 1, your fitness to practise as a Paramedic is impaired.

6. By reason of your misconduct your fitness to practise as a Paramedic is impaired.

Finding

Decision

Particular 1 – the conviction.

8. The Panel has been provided with a Memorandum relating to the records of the Bristol Magistrates’ Court for 6 October 2015.  It was on that date that sentence was passed.

9. The Panel finds that the HCPC has discharged the burden of proving that it was the Registrant who was convicted in relation to this offence.  In particular the Panel was shown the un-redacted Pre-Sentence Report dated 1 October 2015 on which both the date of birth and address of the person in respect of whom it was written corresponded with the details of the Registrant held by the HCPC.

10. The Memorandum states that a plea of guilty was “indicated” on 14 September 2015, three days after the incident, but the HCPC could not advance a positive case as to whether the actual plea of guilty was entered on 14 September 2015 or merely intimated.  The Panel is satisfied that the Registrant appeared in Court on both 14 September 2015 and 6 October 2015 and that it was on one of those dates that he pleaded guilty.  Accordingly, the Panel permitted the HCPC to amend the particular to allege its case to reflect this fact.  The Panel also finds it proved on that basis being satisfied that nothing turns on the precise date of the conviction.

11. It follows that particular 1 is proved.

Particular 5 – impairment of fitness to practise arising from the conviction.

12. The Panel reached its decision on the allegation that the conviction was currently impairing the Registrant’s fitness to practise before turning to consider the issues relevant to the misconduct allegation.

13. The Panel found the Pre-Sentence Report dated 1 October 2015 prepared by a Probation Officer to be relevant in considering this issue.  There are three passages in particular that are important for present purposes, namely:
In elaborating the statement that the Registrant had difficulty understanding other people’s points of view, it was stated:

“[The Registrant] made significant admissions at interview, he accepts what he has done and understands why he stands before the Court today, however beyond such declarations, he has a profound lack of insight into why he committed this matter and at interview there appeared to be a discord between what [the Registrant] says and his emotions, not cold responses but more a sense of detachment.”
In a section of the report headed, “Risk of Serious Harm and Likelihood of Reconviction”, the following was written:

“[The Registrant] exhibited a profound lack of insight into why he committed this offence or an appreciation of how his own insecurities and suspicions undoubtedly influenced his violence on that night.”

and,

“Considering his case as a whole, I believe that there was and there is a potential for a high risk of harm, however given that the couple have separated he is assessed as Medium risk of serious harm specific to his partner.  This would need to be closely monitored.”

14. The Panel finds that on the basis of the information with which it has been provided there is a profound lack of insight on the part of the Registrant.  There is no evidence of remediation, and beyond his plea of guilty and completion of the requirement imposed under the Community Order, no evidence of remorse.  These factors result in the Panel concluding that there is clear residual risk of repetition of inappropriate behaviour.  Furthermore, the Registrant breached the fundamental tenet of his profession to keep high standards of personal conduct and brought his profession into disrepute.  All of these factors require a finding that the conviction is currently impairing the Registrant’s fitness to practise.

15. It follows that the conviction allegation is well founded.

16. The Panel accepts the evidence of Ms A O-A, an employee of the HCPC, that the Registrant did not notify the HCPC of the conviction.  It also accepts the evidence that it was not until 25 May 2016 that the HCPC became aware of the conviction when it was reported by a Probation Officer.

17. Particular 2 is therefore proved.

Particular 3 – dishonesty.

18. Before turning to consider the issue of dishonesty the Panel considered it to be necessary to decide the circumstances surrounding the Registrant’s non-disclosure of the conviction to the HCPC.  Apart from the obligation very clearly expressed in Standard 4 of the HCPC’s Standards of Conduct, Performance and Ethics which requires all registrants to let the HCPC know straight away if they are convicted of a criminal offence, there was a matter specific to this particular Registrant.  This was the fact that, by a letter dated 24 June 2014, when told that a Panel of the Investigating Committee had decided that there was not a case for him to answer in relation to an earlier conviction for driving under the influence of alcohol, he was told that the matter might be taken into account if another complaint were to be made within three years.  It follows from this that not only did the Registrant know the HCPC would consider fitness to practise issues arising from convictions, but also that he had a motive to keep the HCPC in the dark concerning the 2015 conviction.

19. The Panel finds on the balance of probabilities that the Registrant’s non-reporting of the conviction was deliberate and an omission on his part with the intention of seeking to prevent the HCPC from discovering it.

20. The Panel accepted the advice it received that it should consider the dishonesty issue by applying the well-known two stage test, the first element of which was to decide whether the Registrant acted dishonestly by the standards of ordinary and honest members of the Paramedic profession.  The Panel would not hold that in all cases of non-reporting the answer to that first question would be that it would be considered to be dishonest.  It is possible to imagine cases where an important matter, even a conviction, might not be reported by an unthinking, careless attitude towards professional responsibilities.

21. However, in the particular circumstances of this case, the Panel’s finding that the Registrant’s failure to disclose was deliberate and arose from a desire to keep the HCPC ignorant of the conviction, the Panel finds that ordinary and honest Paramedics would categorise his behaviour as dishonest.  Further, the same findings as to the Registrant’s motives leads the Panel to conclude that he appreciated that his omission was dishonest by reference to those standards.  It follows that particular 3 is proved.

Particular 4 – misconduct.

22. It is necessary for the Panel to decide if the facts included in particulars 2 and 3 amount to misconduct.  The Panel is of the view that the breaches are very serious.  They amount to a breach of Standard 3 (“You must keep high standards of personal conduct”) and Standard 13 (“You must behave with honesty and integrity and make sure that your behaviour does not damage the public’s confidence in you or your profession”).  The Panel has not overlooked the fact that the breach is a single omission, but it nevertheless has no hesitation in finding that fellow professionals would regard it as deplorable.  The Panel finds that they do amount to misconduct which is serious, with the consequence that particular 4 is proved.

Particular 6 – impairment of fitness to practise arising from the misconduct.

23. It is necessary to consider the issue of current impairment of fitness to practise arising from the misconduct as an issue distinct from that of the impairment relating to the conviction.  Quite apart from the fact that dishonesty is conceptually difficult to remediate, there is no evidence that the Registrant has attempted to do so.  There is no information at all as to his attitude towards the dishonesty the Panel finds he displayed in failing to report the conviction to the HCPC.  There is inevitably a risk of repetition of behaviour demonstrating a lack of integrity.  Furthermore, all of the concerns arising from the wider public interest considerations that were identified in relation to the conviction apply with just as much force to the issue of misconduct.

24. It follows that the misconduct is currently impairing the Registrant’s fitness to practise.

25. The result of these findings is that both the conviction and the misconduct allegation are well founded.  The Panel must proceed to consider the issue of sanction.

Order

Decision on Sanction

26. After handing down the decision on the allegations the Panel heard further submissions from the Presenting Officer in relation to the sanction.  In connection with the submissions she made, the Presenting Officer introduced a further small bundle of documents.  The documents included in this bundle related to two earlier fitness to practise concerns relating to the Registrant.  One of those matters was a final hearing held in May 2011 when the hearing Panel found misconduct but no current impairment of fitness to practise in relation to allowing a member of the public to accompany him on six emergency calls in 2010 and breaching patient confidentiality in the same period.  The other concern related to the conviction for driving a vehicle under the influence of alcohol in January 2014 which resulted in the finding of the Investigating Committee which was communicated to the Registrant by the letter dated 24 June 2014 to which reference was made by the Panel in relation to its finding of dishonesty.  The Presenting Officer submitted that these earlier matters were relevant because they put the 2015 conviction and misconduct findings in context as they demonstrated that the Registrant did not comply with proper professional standards notwithstanding his earlier referrals to the HCPC.

27. The Presenting Officer reminded the Panel of the proper approach to the imposition of a sanction and urged the Panel to have regard to the HCPC’s Indicative Sanctions Policy.  She did not, however, urge the Panel to impose any particular sanction.

28. The Panel has accepted the advice of the Legal Assessor in relation to the proper approach to the imposition of a sanction and it has heeded the guidance contained in the HCPC’s Indicative Sanctions Policy.  A sanction is not to be imposed to punish a registrant against whom findings have been made.  Rather, a sanction should only be imposed to the extent that it is required to protect the public and service users and to maintain a proper degree of confidence in the registered profession and the regulation of that profession by the HCPC. Accordingly, a Panel must first consider whether the findings it has made require the imposition of any sanction.  If a sanction is required, the available sanctions must be considered in an ascending order of seriousness until one that satisfactorily addresses public protection and the wider public interest is reached.  In the present case the whole sanction range up to, and including, striking-off is available in relation to both allegations.

29. The Panel does not intend to repeat everything that has been stated earlier in this determination in explaining why the Registrant’s current fitness to practise is still impaired by reason of both the conviction and the misconduct.  It is, however, necessary to underline the lack of insight identified by the Probation Officer and the Panel’s findings that there was a risk of repetition in relation to both aspects of the findings made today.

30. In the judgement of the Panel the seriousness of the findings made requires the imposition of a sanction.  Further, the imposition of a Caution Order would not reflect the seriousness of the findings as it would neither protect the public from the risk of repetition the Panel has identified nor would it satisfy public concern over the findings.

31. The Panel therefore considered whether the imposition of a Conditions of Practice Order would meet the circumstances of the case.  The Panel concluded that it would not.  First, the finding of dishonesty represents a finding of an attitudinal deficit in relation to which it would not be possible to find appropriate and workable conditions of practice, particularly when there is a finding of a risk of repetition.  Secondly, even if conditions could be formulated, there would need to be confidence that the Registrant would comply with the conditions, and his lack of engagement in the process means that the Panel does not have any degree of confidence that he would.

32. The Panel next considered the making of a Suspension Order.  The Panel accepted the guidance contained in paragraph 41 of the Indicative Sanctions Policy that where there is evidence that a registrant will be unable to resolve or remedy his or her failings, the making of such an order might not be appropriate.  In the present case, the views of the Probation Officer, coupled with the Panel’s findings of lack of insight and remediation, risk of repetition and lack of engagement in the process are all relevant.  All of these factors lead the Panel to conclude that there are no grounds for believing that if a Suspension Order were to be made that the position at the end of the period of suspension would be any different to the position at the present time.  For these reasons, the Panel has concluded that a Suspension Order is not appropriate.

33. The Panel has accordingly decided that the appropriate order in this case is a Striking Off Order.  This is a conclusion reached not only by the decisions that all lesser sanctions are not sufficient, but also by the positive decision of the Panel that the totality of the findings made are incompatible with the Registrant’s name remaining on the HCPC Register.  The Panel is satisfied that the making of a striking-off order is a proportionate response to its findings.

Notes

Order

The Registrar is directed to strike the name of Stephen G Lees from the Register on the date this order comes into effect.

The order imposed today will apply from 9 June 2017 (the operative date)

Hearing history

History of Hearings for Mr Stephen G Lees

Date Panel Hearing type Outcomes / Status
12/05/2017 Conduct and Competence Committee Final Hearing Struck off