Mr Paul R Chambers

: Chiropodist / podiatrist

: CH14684

: Final Hearing

Date and Time of hearing:10:00 25/09/2017 End: 17:00 27/09/2017

: Radisson Blu Hotel, The Gasworks, 3 Cromac Place, Ormeau Road, Belfast, County Antrim, BT7 2JB

: Conduct and Competence Committee
: Struck off

Allegation

As Amended at Final Hearing:

Whilst registered as a Chiropodist:

1. On 9 November 2015 you accepted a Police Caution from Kent Police for theft.

2. In a period before 9 November 2015 you took 17 opened and partially used bottles of phenol belonging to Kent Community Health NHS Foundation Trust for your own use.

3. You did not follow correct procedure for transportation, storage and safe disposal of substance hazardous to health, namely phenol.

4. Your actions described in paragraphs 2 and/or 3 amount to misconduct.

5. By reason of your Caution, your fitness to practise is impaired.

6. By reason of your misconduct, your fitness to practise is impaired.

Finding

Preliminary Matters

Application to Amend

1. Ms Manning-Rees, on behalf of the HCPC, made an application for Particular 2 of the Allegation to be amended, by replacing, ‘Between October and November 2015,’ with, ‘In a period before 9 November 2015’ and by inserting the word ‘approximately’ before the number ‘17’. She also made an application to amend Particular 3 by inserting the words, ‘In relation to the phenol referred to in paragraph 2 above’ in Particular 3 and by deleting the words ‘…of substance hazardous to health, namely phenol.’.

2. The Panel determined that the Particulars 2 and 3 should be amended as requested. The Panel concluded that the amendments:

• provided helpful clarification which more accurately reflects the HCPC case;
• avoids ambiguity;
• did not alter the substance or meaning of the Allegation as originally drafted and did not widen the HCPC’s case.

3. The Panel was satisfied that no injustice would be caused by making these amendments as they were minor and/or more accurately reflected the HCPC case. In forming this view the Panel took into account the fact that apart from the time period in Particular 2, the Registrant had been put on notice of the proposed amendments in a letter, dated 12 December 2016. The Registrant did not object to any of the proposed amendments.

Background

4. The Registrant was employed by Kent Community Health Foundation Trust (the Trust) in a split post as a Band 6 specialist podiatrist and as a Band 7 clinical specialist (Minor Surgery Lead) podiatrist. In addition to his NHS work, the Registrant undertook eight hours of private work, which was declared to the Trust.

5. On 2 November 2015, Witness JO, Production, Improvement and Development Manager for the Trust, discovered two foot impression boxes which were marked, ‘private pts Paul Chambers’. The boxes were stamped with the Trust’s logo which indicated that they belonged to the Trust. Witness PT, a former Counter Fraud Specialist, was instructed to conduct an investigation and as part of his investigation, he attended the Registrant’s home address and his private practice in Sittingbourne. At the Registrant’s private practice four bottles of partially used phenol, belonging to the Trust, were found. The Registrant was arrested and having made full and frank admissions accepted a Police Caution for theft on 9 November 2015.

6. Witness CJ was instructed to conduct a disciplinary investigation on behalf of the Trust and as part of that investigation interviewed the Registrant in person on 18 November 2015 and again on 4 December 2015 by telephone. During the November interview the Registrant stated that in addition to the four bottles of phenol found by Witness PT he had ’20 to 25 still in his private practice.’ In total 13 bottles of phenol were returned to the Head of Service.

7. The Registrant referred himself to the HCPC on January 2016 following his suspension from his NHS post and the Police Caution. He attended a Trust disciplinary hearing on 4 March 2016 and the Trust referred the Registrant to the HCPC on 27 April 2016.

Assessment of Witnesses

8. The Panel heard live oral evidence from the following witnesses:

Witness PT, Former Counter Fraud Specialist

9. On 9 November 2015, Witness PT, with the assistance of Kent police officers, attended the Registrant’s home address and subsequently his private practice in Sittingbourne. He informed the Panel that at the Registrant’s private practice four bottles of phenol were found on top of a counter in the Registrant’s consulting room. He stated that the bottles were not marked as Trust property but the Registrant volunteered that they belonged to the Trust. Witness PT confirmed during the subsequent interview at the police station and throughout the investigative process the Registrant was co-operative.  He stated that the Registrant was remorseful and accepted a Police Caution.

10. Witness PT’s evidence was limited in scope but the Panel found him to be a credible and reliable witness. His oral evidence was consistent with his written witness statement and the Panel had no reason to doubt that his recollection of events was true to the best of his knowledge and belief.

Witness FM, Podiatry Manager, South Locality

11. Witness FM was the Registrant’s former line manager. She informed the Panel that she had face to face meetings with the Registrant at least monthly and confirmed that he was a good employee. She stated that she had confidence in the Registrant’s knowledge and informed the Panel that as a Band 7 Lead he was required to develop guidelines and standard operating procedures. Witness FM stated that phenol is a controlled substance used in nail surgery and is sometimes referred to as carbolic acid. She outlined some of the harmful consequences of exposure to phenol, including burns, headaches and transmission to the milk of nursing mothers. Witness FM informed the Panel that phenol should only be kept open for limited periods and should be transported in a sealed plastic box. However, she also stated that phenol is transported, from the pharmacy to the Trust, in a white container. She informed the Panel that transportation in the white container does not pose as great a risk as simply transporting the glass bottle of phenol.

12. The Panel formed the view that Witness FM’s evidence was confused and conflicting. She provided the Panel with a conflicting account of the transportation of phenol. She appeared to be reluctant to answer certain questions and seemed unclear as to what matters were outside her knowledge. Although Witness FM tried to be helpful, her evidence was of limited assistance to the Panel. Due to the conflicting nature of the information that she provided, on the transportation of phenol, the Panel attributed little weight to this aspect of her evidence.

Witness CJ – Deputy Head of Service of Community Chronic Pain

13. Witness CJ conducted the Trust’s internal disciplinary investigation. She relied on her investigation report and the documentary evidence relating to the internal investigation. Witness CJ was careful not to overstate her evidence and was clear about the limits of her knowledge and experience as she is not a podiatrist. She informed that Panel that the Registrant had a managerial role, was responsible for writing and updating departmental policies and was expected to be a role model for junior members of staff.

14. The Panel found Witness CJ to be of considerable assistance to the Panel. Her oral evidence was clear and consistent with her written statement. The Panel formed the view that she had conducted a robust and thorough investigation and had no reason to doubt that she was anything other than a credible and reliable witness.

The Registrant

15. The Registrant chose to give evidence under oath with regard to the factual particulars only at this stage. The Registrant outlined his background and qualifications. He informed the Panel that he had taken phenol from the Trust once a month for a period of 18 months, he explained his motivation for doing so, and his assessment of the risks his actions posed.

16. The Panel made allowances for the passage of time and the inherent stress associated with giving evidence, but concluded that key aspects of the Registrant’s evidence were inconsistent and contradictory. For example, the Registrant stated in his internal disciplinary interview that the key to the red cabinet in his private practice was already in the lock when it was searched by Witness PT and the police. However, in oral evidence he stated that the key was in a drawer in his consulting room. Furthermore, during his oral evidence the Registrant stated that the four bottles of phenol found in his drawer were inert, but when questioned further, he acknowledged that he had not checked the content of the bottles and could not confirm when they were first opened. Therefore, the Registrant was not in a position to know whether the liquid within the bottles was still potent.  These inconsistencies adversely affected the Registrant’s overall credibility and reliability.

Decision on Facts

Panel’s Approach

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

18. In reaching its decision the Panel took into account the oral and documentary evidence. The Panel also took into account the HCPTS Practice Note entitled ‘Conviction and Caution Allegations’. The Panel was aware that it could not go behind the Police Caution and was required to accept the certification from Kent Police as conclusive proof of the caution itself and the underlying facts.

19. The Panel noted that the Registrant admitted the factual particulars in their entirety at the outset of the hearing. Notwithstanding the admissions the Panel proceeded on the basis that the HCPC was required to prove all of the particulars of the Allegation.


Decision

Particular 1  – Found Proved

‘On 9 November 2015, you accepted a Police Caution from Kent Police for theft.’

20. The Panel was provided with a copy of the Registrant’s transcript of interview which was conducted at Medway Police Station on 9 November 2015. The Panel noted that during the police interview the Registrant admitted taking partially used bottles of phenol from the Trust for use within his private practice in addition to two impression boxes and record cards. The Panel was also provided with a copy of the Simple Adult Caution form in the name of the Registrant. The Panel took into account the Registrant’s formal admission of Particular 1 and accepted the documentation as conclusive evidence that the Registrant received a Police Caution for Theft by Employee on 9 November 2015, having made a clear and reliable admission to the offence.

21. Therefore, the Panel found the facts and grounds proved.
Particular 2 – Found Proved
‘In a period before 9 November 2015 you took approximately 17 opened and/or partially opened bottles of phenol belonging to Kent Community Health NHS Foundation Trust for your own use.’

22. The Panel accepted the evidence of Witness CJ. She formally interviewed the Registrant as part of her internal disciplinary investigation on 18 November 2015 and 4 December 2015. In her written and oral evidence she informed the Panel that the Registrant admitted that according to Trust policy,  at the end of nail surgery the bottles of phenol should be placed in the Trust’s cytotoxic waste disposal, even if the bottles are not empty, but rather than waste the contents he took them to use in his private practice. The Panel noted that the record of interview was not a verbatim transcript of the Registrant’s responses to the questions that were put to him. However, the accuracy of the typed notes of interview were not challenged by the Registrant and therefore the Panel accepted that the Registrant stated, ‘I would not use them if they were more than 3-4 weeks old so would only use the latest bottle, and would only take them once or twice a month. The rest are at my private practice awaiting disposal. They found them in either the big red cabinet or small desk drawer. I have about 20-25 altogether but they only found and seized 4. I have used very little.’

23. The Panel accepted the evidence of Witness CJ that 13 bottles of phenol were subsequently returned to the Head of Service. Together with the four bottles found by Witness PT and the police on 9 November 2015, the Panel accepted that the Registrant had taken approximately 17 partially used bottles of phenol from the Trust prior to 9 November 2015.

24. The Panel took into account the admission made by the Registrant and together with the evidence of Witness CJ found Particular 2 proved.

Particular 3(i) – Found Not Proved

In relation to the phenol referred to in paragraph 2 above, you did not follow correct procedures for:

i. transportation;

25. The Panel was provided with the Trust’s Standard Operating Procedure for nail surgery, Control of Substances Hazardous to Health Policy and Procedures, Medical Waste Policy and the Standard Operating Procedures for the disposal of Medicinal Waste. The Panel accepted the evidence of Witnesses FM and CJ that phenol is classified as a hazardous substance. However, Witness CJ stated in her witness statement that she was not aware of any specific guidance on the transportation of phenol. The Panel noted that paragraph 8.1.1 of the Medicinal Waste Policy states: ‘Infrequently, a transfer of medicinal waste from one location to another may be necessary by staff.’ The Panel also noted that paragraph 8.2.4 of the Medicinal Waste Policy states: ‘The pharmaceuticals should be placed in an outer rigid, leak proof container in case of spillage of any liquid during transportation.’

26. The Registrant stated during his interview with Witness CJ that he transported the opened phenol bottles in a white plastic container. The Panel accepted that transporting phenol in a plastic container placed within a pharmacy bag may be the optimum method. However, the Panel could not rule out the possibility that transportation of the glass bottle of phenol within the white plastic container would be sufficient in the light of the Trust procedures.  In these circumstances, the Panel concluded that, notwithstanding the Registrant’s admission, Particular 3(i) could not be found proved.
Particular 3(ii) – Found Proved

In relation to the phenol referred to in paragraph 2 above, you did not follow correct procedures for:

ii. storage;

27. The Panel noted that neither the Trust’s Standard Operating Procedure for nail surgery, the Control of Substances Hazardous to Health Policy and Procedures, the Medical Waste Policy nor the Standard Operating Procedure for the disposal of Medicinal Waste contained any guidance on the storage of phenol other than as medicinal waste. The Panel accepted that this was because once opened a bottle of phenol was required to be disposed of in accordance with the Medical Waste Policy. The policy recommends purple lidded bulk waste containers for cytotoxic medical waste and that when ready for collection the container should be securely closed. The policy also states, ‘It is recommended that waste is dealt with promptly to avoid accumulation. Containers containing bulk medicines must be held in a locked cupboard or room (both during fill and when finally full), until just prior to collection by the Waste Contractor.’

28. The Panel noted that the Registrant informed Witness CJ during the Trust’s internal disciplinary interview that the four bottles of phenol that were seized were in his desk drawer and were not in their plastic cases. He also stated that the other bottles had been stored in a lockable red cabinet inside their plastic covers.

29. The Panel concluded that as the phenol belonged to the Trust the Registrant was required to store it in accordance with Trust policy. The Panel was satisfied that the phenol had not been stored in accordance with the Trust’s policy and accordingly, found Particular 3(ii) proved.
Particular 3(iii) – Found Proved
‘In relation to the phenol referred to in paragraph 2 above, you did not follow correct procedures for:
iii. safe disposal.’

30. The Panel noted that medical waste is defined within the Trust’s Standard Operating Procedure as ‘expired, unused, spilt and contaminated pharmaceutical products…that are no longer required and need to be disposed of appropriately.’ The policy states that the waste must be disposed of on-site. The Panel also noted that the Registrant confirmed in his interview with Witness CJ that phenol should be disposed of as cytotoxic waste.

31. The Panel accepted the evidence of Witness CJ that phenol requires safe and effective disposal to avoid it getting into the waterways. The Panel concluded that the phenol belonged to the Trust and should have been disposed of in accordance with the Trust’s policy. The Panel was satisfied that the phenol had not been disposed of in accordance with the Trust’s policy and accordingly, found Particular 3(iii) proved.


Decision on grounds

32. Having found Particulars 2, 3(ii) and 3(iii) proved, the Panel went on to consider whether the Registrant’s conduct amounted to misconduct. The Panel considered each particular of the Allegation in turn. As Particular 3(i) was not found proved, it did not form part of the Panel’s consideration.

33. The Panel took into account the submissions made by both parties and accepted the advice of the Legal Assessor.

34. In considering the issue of misconduct, the Panel bore in mind the explanation of that term given by the Privy Council in the case of Roylance v GMC (No.2) [2000] 1 AC 311 where it was stated that:
“Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required to be followed by a … 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.”

35. Particular 2: The Registrant took approximately 17 bottles of opened or partially used bottles of phenol belonging to the Trust without permission. Although the Panel accepted that the Registrant did not take unopened bottles of phenol for use in his private practice and therefore only took bottles of phenol that were destined for disposal, the hazardous fluid remained at all times the property of the Trust.  The Panel considered the HCPC Standards of Conduct, Performance and Ethics and was satisfied that the Registrant’s conduct breached Standard 13 which states:

“You must behave with…integrity and make sure your behaviour does not damage the public’s confidence in you or your profession.”

36. The Panel was aware that breach of the standards alone does not necessarily constitute misconduct. However, the Panel was satisfied that the Registrant’s conduct and behaviour fell far below the standards expected of a registered practitioner as his actions represented a significant breach of his employers’ Trust and constituted a criminal offence. The Registrant’s behaviour cannot be described as a momentary failure or a temporary lapse of judgement as, by his own admission, it formed part of a pattern of behaviour over an 18 month period. The Registrant was aware that he did not have permission to take the bottles of phenol and the Panel concluded that the Registrant’s acts and omissions amounted to serious misconduct.

37. Particular 3: The Registrant did not follow the Trust’s policy and procedures relating to the storage and safe disposal of the bottles of phenol. The Panel noted that as a Band 7 Lead it was the Registrant’s role to review the Standard Operating Procedures. The Registrant had a professional duty to not only be aware of the Trust’s policy, but to ensure that he complied with it.  Therefore, the Panel was satisfied that the Registrant’s failure to ensure compliance with the policy and procedures relating to the storage and disposal of unused phenol was serious. The Panel considered the HCPC Standards of Conduct, Performance and Ethics and was satisfied that the Registrant’s conduct breached the following standards:
• 13 – You must behave with…integrity and make sure your behaviour does not damage the public’s confidence in you or your profession.

38. The Panel was satisfied that the Registrant’s conduct and behaviour fell far below the standards expected of a registered practitioner, as storage and disposal outside of Trust policy has the potential to expose members of the public to an unwarranted risk of harm. The Panel was satisfied that the Registrant’s behaviour was so serious as to amount to misconduct.


Decision on Impairment

Panel’s Approach

39. Having found that the Registrant accepted a Police Caution and having found misconduct in respect of the additional bottles of Phenol that the Registrant took from the Trust without permission, the Panel went on to consider whether the Registrant’s fitness to practise is currently impaired. The Panel took into account the HCPTS Practice Note: “Finding that Fitness to Practise is Impaired”. The Panel also took into account the submissions made by both parties and accepted the advice of the Legal Assessor. The Legal Assessor advised that in determining current impairment the Panel should have regard to the following aspects of the public interest:
i) The ‘personal’ component: the current behaviour of the individual Registrant; and

ii) 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

40. The Panel took the view that the factual findings raise significant concerns. The Registrant abused his position of trust with his employer and demonstrated a persistent lack of judgment for a significant period of time.

41. The Panel considered the Registrant’s current fitness to practise firstly from the personal perspective and then from the wider public perspective.

42. The Panel demonstrated only limited insight. In particular, the Registrant did not demonstrate that he fully appreciated that his actions breached a fundamental tenet of the profession, brought the profession into disrepute and that as a consequence of his actions there was likely to be an ongoing concern that his integrity could not be relied upon. The Registrant’s premeditated and persistent theft suggests a failure to understand and take seriously his professional obligation to be trustworthy at all times. There was also no evidence before the Panel that the Registrant had properly reflected on the impact of his behaviour on colleagues, patients and the profession.

43. The Panel recognised that demonstrating remediation following a finding involving dishonesty is particularly difficult, as probity issues are reliant on attitude, which can often only be inferred from conduct. The Registrant’s dishonest conduct relates to a discrete set of circumstances, which may be capable of remediation, however the Panel was not satisfied that there was sufficient evidence of insight and therefore it concluded that there is a risk of repetition. The Panel concluded that for these reasons the Registrant’s fitness to practise is currently impaired based on the personal component.

44. 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.

45. In the Panel’s view the dishonest conduct which resulted in a Police Caution for theft from his employer and blatant disregard of the Trust’s policies and procedures are serious. Members of the public would be concerned by the prospect of a registered professional flouting these policies and procedures for his own advantage. It is critically important that health and safety polices and procedures have integrity and full compliance by senior clinical professionals with management responsibilities are a vital part of that process.

46. A significant aspect of the public component is upholding proper standards of behaviour. The Registrant’s conduct fell far below the standard expected of a registered practitioner and the Panel take the opportunity to declare that it is not acceptable for a registered professional to take Trust property for his own use without permission and to disregard health and safety policies for financial gain or for any other reason. The Panel concluded that public confidence would be undermined if a finding of fitness to practise was not made, given the seriousness of the Registrant’s dishonest conduct and behaviour.
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.

Sanction

Registrant’s Evidence

48. The Registrant chose to give evidence under oath for a second time, with regards to sanction. The Panel had been provided with the following documents immediately prior to the Registrant’s evidence:

(i) A copy of a HCPC Final Hearing determination that resulted in the Registrant being made subject to a 3 year Caution Order in 2009 for treating patients with equipment that had not been properly sterilised on two occasions (16 January 2008 and 17 January 2008) and for not reading the instrument cleaning policy.

(ii) A redacted copy of a HCPTS Interim Order Application determination, dated 21 August 2017, that resulted in the Registrant being made subject to an 18 month Interim Suspension Order in relation to the following concerns:

• A medical condition impacting upon the Registrant’s professional practice and personal behaviour;
• Misappropriation of stock from the Practice;
• Violent behaviour, potentially related to his medical condition (In August 2010 the Registrant received a Police Caution for battery pursuant to s39 Criminal Justices Act 1988);
• On or around 29 May 2017 the Registrant was arrested by Kent Police Force for criminal damage in relation to a domestic incident between the Registrant and his partner at that time. The Registrant was not formally charged in respect of this incident.

(iii) Positive character references from two former colleagues; a junior colleague and a GP that referred patients to his podiatry service.
 
49. The Registrant informed the Panel that he was sacked by the Trust for gross misconduct in April 2016. He stated that he maintained his small private practice and subsequently started to work for Physiotherapy2fit.

50. The Registrant admitted that a series of incidents happened between April 2016 and May 2017 culminating in the breakdown of his long term relationship. He informed the Panel that he is currently subject to a Non-Molestation Order and that on one occasion he breached that order by contacting his ex-partner by text. The Registrant stated that he moved to Northern Ireland in June 2017 and has not worked since. He stated that he is not eligible for Job Seekers Allowance, has lost his home, his career and the relationship he had with his step-children. He accepted that the Final Hearing determination from 2009 and the Interim Order Application determination are accurate records of the proceedings that took place.


Submissions

51. Ms Manning-Rees, on behalf of the HCPC, referred the Panel to the Indicative Sanctions Policy. She reminded the Panel that its primary function is to protect the public and the wider public interest. She submitted that the Registrant’s theft from his employer, the potentially serious consequences of disregarding the storage and transportation guidance and the information within the determinations of previous Final Hearing and Interim Order Panel are aggravating features. Although Ms Manning-Rees made no positive submission with regard to the sanction that should be imposed she reminded the Panel that due to the Registrant’s current circumstances the available options are limited.

52. Mr Hamill, on behalf of the Registrant, submitted that the appropriate sanction in this case is a substantive 12 month Suspension Order. He further submitted that the 3 year Caution Order was imposed for matters dating back to 2008 and is of a different nature to the current matters. He reminded the Panel that despite the admissions that the Registrant made with regards to the misappropriation of stock from the Physiotherapy2fit practice, the interim Suspension Order has been imposed for matters that have not been found proved. He referred the Panel to the positive character references and invited the Panel to conclude that the Registrant’s conduct should be characterised as ‘reckless’ rather than a blatant disregard for policies and procedures. Mr Hamill also referred the Panel to the case of HK v General Pharmaceutical Council [2014] CSIH 61 and reminded the Panel that if a Suspension Order was imposed at a review hearing, a further period of suspension could be imposed.


Panel’s Approach

53. The Panel accepted the advice of the Legal Assessor. The Panel was mindful that the purpose of any sanction is not to punish the Registrant, but to protect the public and the wider public interest. The 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 the Registrant’s interests with the public interest and by considering each available sanction in ascending order of severity.

54. The Panel took into account the Final Hearing and the Interim Order Application determination provided on behalf of the HCPC and the testimonials and judgement in the case of HK provided on behalf of the Registrant. The Panel was aware that interim order panels made no findings of fact and that in due course the allegations may not prove to be well-founded. The Panel was also aware that the 3 year Caution Order expired approximately five years ago.

55. The Panel had regard to its findings in relation to impairment of the Registrant’s fitness to practise. The Panel also took into account the Indicative Sanctions Policy (ISP) and the submissions made by both parties.


Decision

56. 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:

• The Registrant made full admissions to the relevant factual particulars (Particular 1, 2, 3(ii) and 3(iii));
• The Registrant admitted that the facts amounted to misconduct and impairment of his current fitness to practise;
• The Registrant has fully engaged with the regulatory process.

57. The Panel identified the following aggravating factors:
• The Registrant’s theft of Trust property was premeditated, deliberate and persisted for approximately 18 months;
• The Registrant’s misappropriation of the bottles of phenol represented a breach of his employer’s trust and a flagrant disregard for the Trust’s policies and procedures;
• The Registrant, having been made subject to a 3 year Caution Order in 2009, for similar matters, and a Police Caution for battery in August 2010 does not have an unblemished record;
• The Registrant has demonstrated no insight.

58. The Panel first considered taking no action. The Panel concluded that, in view of the nature and seriousness of the Registrant’s Police Caution for theft from his employer and misconduct to take no action on his registration would be inappropriate. Furthermore, in the absence of exceptional circumstances the Panel concluded that taking no action would be insufficient to maintain public confidence and uphold the reputation of the profession and the regulatory process.

59. The Panel then considered a Caution Order.  The Panel noted paragraph 28 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 remedial 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.”

60. The Panel took the view that a Police Caution for theft in breach of an employer’s trust and blatantly disregarding policies and procedures implemented in order to protect the health and safety of patients and healthcare professionals, requires a public declaration that such behaviour is unacceptable. The Panel was satisfied that the finding of impairment, in itself, was not sufficient to act as a deterrent to other registrants and would not be sufficient to publically re-affirm the standards expected of a registered practitioner. The Panel concluded that the Registrant’s misconduct and the facts underlying his Police Caution could not be described as limited or minor in nature. On the contrary, the Panel determined that the Registrant’s dishonest behaviour and lack of integrity persisted for approximately 18 months and exposed others to an unwarranted risk of harm. The Panel noted that a Caution Order would impose no restriction on the Registrant’s practice and therefore concluded that it would not provide any protection from the risk of repetition. Furthermore, the Registrant has demonstrated no meaningful insight and the current matters are similar to the 2009 matters in that the Registrant put his own interests above his professional duties and disregarded health and safety policies and regulations. The Panel noted that the 2009 matters amounted to lack of competence, whilst the current matters amount to misconduct. However, the Panel was satisfied that the underlying shortcomings are similar in nature. 

61. In these circumstances the Panel concluded that although the 3 year Caution Order imposed in 2009 expired more than five years ago, escalation to a higher sanction is required to adequately protect the wider public interest. The Panel concluded that a further Caution Order, even for the maximum period of five years, would fall well short of declaring and upholding proper standards or maintain public confidence in the profession.

62. The Panel went on to consider a Conditions of Practice Order.  The Panel noted that paragraph 34 of the ISP states:

‘Where an allegation relates to dishonesty, breach of trust…, conditions of practice are unlikely to be appropriate unless the Panel is satisfied that the registrant’s conduct was minor, out of character, capable of remediation and unlikely to be repeated.’

63. The Panel concluded that theft is not amenable to conditions, as the basis for this type of behaviour, is an attitudinal failing and by its very nature cannot be described as minor. Furthermore, as the Registrant failed to comply with the policies and procedures within the Trust, and has demonstrated no meaningful insight into his failings, the Panel had no confidence that conditions are currently workable or appropriate. In reaching this conclusion the Panel took into account the fact that the Registrant is currently unable to practise as he is subject to an 18 month Interim Suspension Order. In any event, the Panel concluded that conditions would not adequately address the serious nature of the Registrant’s misconduct and the facts underlying his Police Caution and so would undermine public confidence in the profession and the need to uphold standards of conduct and behaviour.

64. The Panel next considered a Suspension Order. A Suspension Order would send a signal to the Registrant, the profession and the public re-affirming the standards expected of a registered practitioner. The Panel noted that a Suspension Order would prevent the Registrant from practising during the suspension period, which would therefore temporarily protect 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. The Panel took the view that that would depend, on the extent to which the Registrant’s misconduct could be regarded as remediable. In considering this issue the Panel had regard to paragraph 41 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.’

65. The Panel concluded that the Registrant’s theft from his employer and lack of integrity, as evidenced by his willingness to misappropriate property belonging to the Trust for a significant period of time, is inherently difficult to remediate.  In the absence of evidence of a willingness or ability to demonstrate meaningful insight, the Panel concluded that there is no realistic prospect that the Registrant would be able to develop the necessary insight in the future. In the Panel’s view the Registrant’s history of disregarding policies and procedures, his criminal record which includes two Police Cautions for theft and assault and his admitted breach of a Non-Molestation Order suggests that the Registrant is either unwilling or unable to remedy his failings and therefore a Striking Off Order may be the most appropriate option.

66. In relation to a Striking Off Order the Panel noted that the ISP states at paragraph 47 and 41:

‘Striking off is a sanction of last resort for serious, deliberate or reckless acts involving abuse of trust such as…dishonesty 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... A registrant’s inability or unwillingness to resolve matters will suggest that a lower sanction may not be appropriate.’

67. It is the Panel’s view that the above paragraphs of the ISP apply to the Registrant. His misconduct involved a gross breach of trust and despite the passage of time he has shown no evidence of meaningful insight or reflection with regards to the impact on patients, colleagues or the reputation of the profession as a whole. Instead, during his oral evidence at the sanction stage, he focused on the impact of the criminal and regulatory proceedings on himself.  The Panel took the view that, in the absence of meaningful insight and reflection, and in light of the Registrant’s history of breaching policies and procedures and committing criminal offences in 2009 and 2010, and more recently breaching the terms of a Non-Molestation Order the risk of repetition is extremely high. The Panel concluded that in these circumstances the only way to protect the public is through a Striking Off Order.

68. Furthermore, it is the Panel’s view that the public would consider the Registrant’s Police Caution for theft and misconduct to be betrayals of the trust placed in him by his employer, colleagues and the wider public. Therefore, they are matters which would need to be marked by the most severe sanction, particularly as there is no evidence before the Panel that he has learnt any lessons from his previous experiences. 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.

69.In reaching this decision, the Panel considered the Registrant’s personal, financial and professional interests, but concluded that his interests were outweighed by the Panel’s duty to give priority to the significant public interest concerns raised by this case.

70. 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 Mr Paul R Chambers from the Register on the date this order comes into effect.

Notes

The Order imposed today will apply from 25 October 2017.

A Interim Suspension Order for a period of 18 months was imposed to cover the appeal period. 

Hearing history

History of Hearings for Mr Paul R Chambers

Date Panel Hearing type Outcomes / Status
25/09/2017 Conduct and Competence Committee Final Hearing Struck off
21/08/2017 Investigating committee Interim Order Application Hearing has not yet been held