Mrs Edna Pool
(The following allegation was considered by a Panel of the Conduct and Competence and Committee at the substantive hearing on 07 June 2016)
On 23 June 2015 at Dumfries Sheriff Court, you:
1. Were convicted of an offence of failure to provide a specimen of breath for analysis upon request, contrary to Section 7(6) of the Road Traffic Act 1988.
2. By reason of your conviction as set out at paragraph 1 your fitness to practise as a Paramedic is impaired.
1. The Notice of today’s hearing was sent to the Registrant at her address in the register on 4 May 2017 by first class post. The Notice contained the date, time and venue of today’s hearing. The Panel accepted the advice of the Legal Assessor and is satisfied that service has been proper and effective.
Proceeding in the absence of the Registrant
2. Mrs Hamilton submitted that the HCPC is seeking that the Panel proceed in the absence of the Registrant. She submitted that the Registrant has not sought an adjournment and that she has received notice of the hearing and responded by letter of 22 May 2017 indicating that she would not attend today due to being on holiday. Mrs Hamilton submitted that the Panel can be satisfied that the Registrant’s absence today is voluntary and she has waived her right to attend or be represented. She submitted that an adjournment would serve no useful purpose and there was a public interest in this matter being dealt with expeditiously. This was a mandatory review.
3. The Panel heard and accepted the advice of the Legal Assessor. He advised that if the Panel is satisfied that all reasonable efforts have been made to notify the Registrant of the hearing then the Panel has the discretion to proceed in the absence of the Registrant. He reminded the Panel that it should exercise that discretion with care and referred the Panel to the HCPC Guidance Note on “Proceeding in the Absence of the Registrant” and to Adeogba v GMC  EWCA Civ 62. This case makes clear that the first question the Panel should ask is whether all reasonable efforts have been made to serve the Registrant with notice. Thereafter, if the Panel is satisfied that proper notice has been given, the discretion whether or not to proceed must be exercised having regard to all the circumstances of which the Panel is aware, with fairness to the Registrant being a prime consideration, but fairness to the HCPC and with the interests of the public also taken into account.
4. The Panel agreed to proceed in the Registrant’s absence as it is satisfied that it is both in the public interest and in the Registrant’s interest to do so. In reaching this decision, the Panel has noted there has been no request for an adjournment. It balanced fairness to the Registrant with fairness to the HCPC and the public interest. The Panel is of the view that the Registrant has voluntarily absented herself and no useful purpose would be served by adjourning the hearing. The Panel has also taken account of the fact that this is a mandatory review. The Panel weighed its responsibilities for public protection and the expeditious disposal of the case with the Registrant’s right to be present at the hearing. In these circumstances the Panel is satisfied that it is appropriate to proceed in his absence.
5. The Registrant was a paramedic who worked for the Scottish Ambulance Service for over 25 years until she was dismissed on the grounds of gross misconduct on 15 January 2015. On 23 June 2015, the Registrant was convicted of failing to provide a specimen of breath contrary to Section 7(6) of the Road Traffic Act 1988. The Registrant had pleaded guilty. The Registrant provided her account of the circumstances leading to the conviction as part of an investigatory interview with her employer. She did not attend the HCPC final hearing and the panel concluded she was impaired and imposed a 12 month Suspension Order.
6. Mrs Hamilton referred the Panel to the decision of the panel at the final hearing. She told the Panel that there is a letter from the Registrant explaining her non-attendance today. The Registrant did not attend the final hearing. The Panel today have not been provided with any reflective piece as suggested by the panel at the final hearing nor any current health information or information on coping strategies. There is no information on whether the Registrant has kept her practice up to date. Mrs Hamilton submitted that the Registrant appears to have limited insight or remorse and the Panel may have some difficulty in assessing the issue of impairment.
7. The Panel accepted the advice of the Legal Assessor who reminded the Panel that its purpose today was to conduct a comprehensive appraisal of the Registrant’s fitness to return to unrestricted practice. Its role is not to conduct a rehearing of the allegations or go behind the previous findings. The Legal Assessor advised that, in carrying out this assessment, the Panel must exercise its own independent judgement and its determination should be based on the evidence before it.
8. The Legal Assessor advised the Panel that if it determined that the Registrant’s fitness to practise remained impaired all the options under Article 30 of the Health and Social Work Professions Order 2001 could be exercised by the Panel. He advised the Panel that it should bear in mind the principles of fairness and proportionality and have regard to the HCPC’s Indicative Sanctions Policy. He reminded the Panel that any order that it makes under Article 30 should not be punitive in purpose, and that it should be the least restrictive order that would suffice to protect the public and/or is otherwise in the public interest.
Decision on impairment
9. The Panel first considered whether the Registrant’s fitness to practise is currently impaired. The Panel took into consideration all the documentation before it, the submissions of Mrs Hamilton and the advice of the Legal Assessor. It noted that the panel at the final hearing had suggested a number of issues that the Registrant may want to consider and provide evidence in respect of.
10. The Panel carefully considered the letter from the Registrant and the limited information she has provided. There is no information regarding how she has kept her practice up to date or developed coping strategies, to deal with stress. The Registrant has provided no reflective piece and there is very limited evidence of insight or remorse. The Registrant’s engagement with the HCPC process has been limited.
11. In these circumstances, the Panel has determined that the Registrant’s fitness to practise remains impaired.
Decision on sanction
12. The Panel then went on to consider what action, if any, it should take in light of its finding of current impairment. In doing so, it had careful regard to the HCPC Indicative Sanctions Policy. The Panel is concerned that the Registrant has not fully engaged with the HCPC.
13. The Panel first considered whether it would be appropriate to take no further action and to allow the current order to lapse at its expiry. The Panel is of the view, given the nature and gravity of the conviction, the very limited information from the Registrant and the lack of evidence of full insight, remorse and remediation that it would not be appropriate to allow the order to lapse. Similarly, as regards a Caution Order, the Panel concluded that such an order would not be sufficient or proportionate and neither would it be in the public interest.
14. The Panel next considered whether a Conditions of Practice Order would be appropriate. It has determined that given the limited information from the Registrant and her limited engagement with the HCPC, that it would not be possible to formulate appropriate, proportionate or workable Conditions of Practice Order. Further, it would not be in the public interest to impose such an order.
15. The Panel carefully considered a Suspension Order. It noted that there has already been a period of suspension. However, the Registrant has not taken up the opportunity to engage fully and meaningfully with her regulator during the period of suspension. She has not provided adequate evidence of remediation or of having fully developed insight into her actions and the impact of her actions on service users, her profession and the public interest.
16. The Panel next considered Striking-Off Order. It has noted the limited information the Registrant has chosen to provide. However, it considers that at this stage a Striking-Off Order would be disproportionate. On balance, the Panel has determined that, at this time, a further brief period of suspension might allow the Registrant an opportunity to fully reflect and to provide evidence of her fitness to practise on an unrestricted basis to a future panel. The Panel consider that the following may assist a future reviewing panel:-
a. Any relevant, up to date medical information on health issues
b. The development of coping strategies for dealing with stress
c. An indication of her future intentions in respect of her profession
d. Details of steps taken to keep her knowledge and skills up to date
17. The Panel is also mindful of the need to protect the public and the wider public interest in maintaining confidence in the profession and upholding proper standards. In all the circumstances of this case, the Panel has reached the view that a further period of six months suspension is the proportionate and appropriate sanction.
The order imposed today will apply from 05 July 2017.
This order will be reviewed again before its expiry on 5 January 2018.