A paramedic has lost his appeal against a Striking Off Order despite the HCPC taking no part in the appeal.

In the case of Hawker v The Health And Care Professions Council [2022] EWHC 1228 (Admin) (27 May 2022), Paul Hawker was a registered paramedic working as such for the South Western Ambulance Service. By a decision of 6th January 2022 (“the Decision”) the Health and Care Professions Tribunal Service (“the Panel”) sitting as the Conduct and Competence Committee of the Health and Care Professions Council found that by reason of his actions on 24th October 2019 the Appellant’s fitness to practise was impaired by reason of misconduct. It imposed the sanction of striking the Appellant’s name from the Register.

Mr Hawker advanced his appeal on three grounds. First, it was said that the decision to impose the sanction of striking off was disproportionate. Second, it was said that the Panel had wrongly conflated lack of insight with a risk of repetition. Finally, it was said that the Panel had erred in treating as aggravating features matters which were already inherent in the finding of misconduct. In addition, before me it was said that the Panel had erred in its characterisation of the Appellant’s failings on 24th October 2019 and that this error had pervaded the Decision.

The HCPC did not attend the hearing and had taken no part in the appeal process.

The Incident on 24th October 2019.

It was common ground that at the end of his shift on 24th October 2019 the Appellant, Mr Hawker, drove his ambulance onto the forecourt of the Sainsbury’s Service Station in Weymouth in order to refuel the ambulance before returning to the Weymouth Ambulance Station. The Appellant was with a colleague and while the colleague was filling up the tank the Appellant walked towards the store in order to pay. As he was doing so the Appellant was told there were concerns about a person (identified by the Panel as Service User 1 or “SU1”) in a car on the forecourt. The Appellant went towards the car. The CCTV footage of the scene showed that SU1 was in the driver’s seat with the door open and with a female Sainsbury’s employee (identified by the Panel as Witness 1 or “W1”) standing alongside her. The Appellant and spent 48 seconds standing on the side of the door (i.e. nearer the car bonnet and with the door between him and SU1). He then left. SU1 was suffering a stroke. Police officers who were also on the forecourt to refuel their vehicle attended to SU1 after the Appellant had left. An ambulance was called but because of the time it was taking for that to arrive the police officers themselves drove SU1 to hospital where she subsequently died. It was accepted that the Appellant’s action had not contributed in any way to the death of SU1.

Beyond that common ground there was a dispute as to what the Appellant had been told and as to what he had said.

The Appellant’s account was that he had been approached by a male member of the public who said, “I know you’re off duty but there’s a lady over there in a vehicle who’s not feeling very well”. He went across to the car where W1 was speaking to SU1. W1 told him that she thought that SU1 might have had a stroke. The Appellant then introduced himself to SU1 who looked well to him and whose presentation did not cause him any cause for concern. SU1 then replied “no” to his questions as to whether she needed any help, felt any pain, or wanted any further assistance or to go to hospital. He was then told by W1 that a phone call had been made for a relative to come and collect SU1 and that this was confirmed by SU1. He left having said to SU1 “OK that’s fine if you don’t need any help. But if for some reason in the future you need us call 999”.

W1’s account of the incident was markedly different in important respects. She said that her attention had been drawn to SU1 by a customer and that when she went to the car SU1 looked clammy and grey with her face drooping and with her speech becoming increasingly slurred. She thought that SU1 was having a stroke and it she asked her colleagues to call 999 for an ambulance. It was then that the Appellant and his colleague drove on to the forecourt. W1 said that she, rather than a customer, called the Appellant over saying that she thought SU1 was having a stroke and that a 999 call had been made but asking if there was anything which the Appellant could do to help. The Appellant came to the car and stood beside the bonnet. The Appellant did not, W1 said, speak to SU1 at all. Instead he looked towards his wrist saying, “we’ve finished now, we’re clocking off, you’ll have to continue with the 999 call”. The Appellant then went into the store, paid for the fuel, returned straight to the ambulance, and drove off.

The Panel accepted the evidence of W1 which the members found to be clear and reliable. They were critical of the Appellant’s evidence. They found him to be “inconsistent” in his giving of evidence and said that “much of his evidence was inherently implausible” and that it “lacked credibility”.

The Decision said:

“The Panel concluded that a member of the profession would regard the Registrant’s behaviour to be deplorable. His behaviour had fallen far below the standards expected of him as a registered Paramedic. He had failed to conduct an assessment of a vulnerable member of the public, despite significant concern expressed to him by another, engaged, member of the public. The Registrant had conceded in evidence that W1 had told him of her concern that SU1 was having a stroke. Despite this, he had stood at SU1’s car with her and W1 for a mere 48 seconds before choosing to walk away. He conducted no assessment of SU1. He did not speak directly to her. His behaviour amounted to a flagrant disregard of the needs of a member of the public in acute need. Instead, he had chosen to leave SU1 in the care of W1 who was sufficiently concerned to then engage the assistance of a passing police officer…”

Mr Justice Eyre, in refusing the appeal, commented:

 “The striking off was undoubtedly a severe penalty in the light of the Appellant’s otherwise blameless record; his return to work after his initial suspension by his employer and his continuation in work without further incident; and his remorse. However, the gravity of the Appellant’s actions on 24th October 2019 must be borne in mind. The effect of the Panel’s findings of fact was that the Appellant chose to walk away without assessing or assisting a person who was seriously unwell and about whom a member of the public was expressing concern rightly saying that she was suffering a stroke. The Appellant did so moreover on the basis that his shift had come to an end. In addition, regard must be had to the Panel’s findings in respect of a lack of insight and a risk of repetition. My assessment is similar to that which Collins J reached in Bevan. There he was able to have regard to the effect of procedural failings which caused him exceptionally to allow the appeal but in the absence of such failings he would have refused the appeal on the footing that although severe the penalty was neither unreasonable nor disproportionate. Here, as there, the sanction was a severe one and it would have been open to the Panel to impose the lesser sanction of suspension. However, the conclusion that striking off was appropriate and necessary cannot be said to have been in any way unreasonable or outside the range of sanctions which could properly be imposed in these circumstances. In the light of the weight to be given to the specialist judgement of the Panel I am satisfied that the decision as to sanction although severe was not disproportionate. This ground of appeal also fails. “

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