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You are here: BAILII >> Databases >> England and Wales High Court (Administrative Court) Decisions >> Clarke, R (on the application of) v United Kingdom Central Council for Nursing, Midwifery & Health Visiting [2004] EWHC 1350 (Admin) (27 May 2004) URL: http://www.bailii.org/ew/cases/EWHC/Admin/2004/1350.html Cite as: [2004] EWHC 1350 (Admin) |
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QUEEN'S BENCH DIVISION
THE ADMINISTRATIVE COURT
Strand London WC2 |
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B e f o r e :
____________________
THE QUEEN ON THE APPLICATION OF ARLEY ERLESTER CLARKE | (CLAIMANT) | |
-v- | ||
UNITED KINGDOM CENTRAL COUNCIL FOR NURSING, MIDWIFERY AND HEALTH VISITING | (DEFENDANT) |
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Smith Bernal Wordwave Limited
190 Fleet Street London EC4A 2AG
Tel No: 020 7404 1400 Fax No: 020 7831 8838
(Official Shorthand Writers to the Court)
MR ROBERT LAWSON (instructed by penningtons) appeared on behalf of the DEFENDANT
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Crown Copyright ©
Legal framework
The facts
"That you, whilst employed as an RMN at Havelock Court Nursing Centre:
1a on an unknown date between 1 April 2001 and 1 August 2001, failed to safeguard and promote the interest and well-being of patient A, in that you:
(i) said words to the effect of, 'Go back to your fucking room, we don't have time to give you tea and a fag now', after 'A' had asked for an early morning cigarette and a cup of tea;
(ii) pushed 'A' towards his bedroom; and
b that having so failed to safeguard and promote the interests and well-being of a patient, you are guilty of misconduct.
2a on an unknown date between 1 April 2001 and 1 August 2001, pushed Patient B after he refused to leave his wife's bedroom; and
b that having so pushed a patient, you are guilty of misconduct.
3a on an unknown date between 1 April 2001 and 1 August 2001, failed to safeguard and promote the interests and well-being of Patient C after he had urinated on the dining room floor, in that you:
(i) slapped Patient C on the back;
(ii) said words to the effect of, 'What the fuck are you doing?', to 'C';
(iii) Pushed patient C towards his bedroom; and
b that having so failed to safeguard and promote the interests and well-being of a patient, you are guilty of misconduct.
4a on an unknown date between 1 April 2001 and 1 August 2001 failed to safeguard and promote the interests and well-being of Patient C after he had urinated on his bedroom floor, in that you:
(i) said words to the effect of, 'What the fuck are you doing?' to 'C';
(ii) slapped patient C on his back;
(iii) said words to the effect of, 'Go to your fucking bed', to 'C'; and
b that having so failed to safeguard and promote the interests and well-being of a patient, you are guilty of misconduct.
5a on an unknown date between 1 April 2001 and 1 August 2001, were verbally abusive to Patient D, more particularly you said words to the effect of, 'If you speak to me like that I will break your hands'; and
b that having so verbally abused a patient you are guilty of misconduct.
6a on an unknown date between 1 April 2001 and 1 August 2001 slapped Patient E after he had urinated in the bathroom sink; and
b that having so slapped a patient you are guilty of misconduct.
7a on an unknown date between 1 April 2001 and 1 August 2001 pulled Patient E along the floor from the dining room to his bedroom; and
b that having so pulled a patient along the floor you are guilty of misconduct."
"Madam, for reasons which it would be prejudicial for me to go into, it is unlikely that Mrs Haynes is going to be attending here today. For that reason, madam, the position of the Council in relation to three of the charges which were previously denied by Mr Clarke is that the Council would offer no evidence in relation to those ..."
"... the Professional Conduct Committee find that the facts alleged in charge 1a(i) are proved, in 1a(ii) are proved, in 2a are proved, in 3a(i) are proved, in 3a(ii) are proved, and in 7a are proved.
The reasons for this are: the Professional Conduct Committee have considered the evidence very carefully and are satisfied that the facts alleged in the charges are proved. The reasons are that the Committee have found Mrs Hall to be a credible and reliable witness. They are sure beyond reasonable doubt that she is telling the truth."
"The reasons for this are that as a registered nurse you should act always in such a manner as to promote and safeguard the interests and well-being of patients and clients. The patients in your care, as we have heard, were particularly helpless and vulnerable, their behaviour was part of their condition. Your actions at slapping, pushing and shouting at patients were seriously detrimental to them and the committee have therefore found your actions to be conduct unworthy of a registered nurse."
"Mr Clarke, the committee has considered your case very carefully. First, we considered whether to postpone judgment and we decided that postponement was not appropriate in your case.
The committee has decided to remove your name from the register with immediate effect. We considered whether to specify that removal should be for a particular period of time and decided that it would not be appropriate to specify any period.
The reasons for this are the charges which have been found proved are extremely serious. You were the only qualified nurse on duty caring for extremely vulnerable patients and you abused that position of trust. This was not just one isolated incident but several abusive acts against patients in your care. We have considered all the mitigation points raised on your behalf, including the verbal character reference from Mr Cyrus and the fact that you have had a long period of nursing. However, you have not demonstrated today that you are aware of the seriousness of your actions. You have not presented before the committee today evidence that would mitigate against such serious charges. The committee note in particular that you failed to produce any up-to-date references from your current or previous employer. The Committee therefore feel that your name should be removed from the register in the interests of public protection."
Issues
1. Whether it was unreasonable for the Committee to find proven the factual charges that it did.
2. Whether the Committee gave adequate reasons in respect of its decision on the facts.
3. Whether the Committee acted in a procedurally unfair manner in relation to its decision on penalty.
4. Whether the Committee's decision to remove the appellant's name from the register for an unspecified period of time was excessive and disproportionate.
First issue
"The decisions in Ghosh and Preiss are a reminder of the scope of the jurisdiction of this Board in appeals from professional conduct or practices committees. They do indeed emphasise that the Board's role is truly appellate, but they also draw attention to the obvious fact that the appeals are conducted on the basis of the transcript of the hearing and that, unless exceptionally, witnesses are not recalled. In this respect these appeals are similar to many other appeals in both civil and criminal cases from a judge, jury or other body who has seen and heard the witnesses. In all such cases the appeal court readily acknowledges that the first instance body enjoys an advantage which the appeal court does not have, precisely because that body is in a better position to judge the credibility and reliability of the evidence given by the witnesses. In some appeals that advantage may not be significant since the witnesses' credibility and reliability are not in issue. But in many cases the advantage is very significant and the appeal court recognises that it should accordingly be slow to interfere with the decisions on matters of fact taken by the first instance body. This reluctance to interfere is not due to any lack of jurisdiction to do so. Rather, in exercising its full jurisdiction, the appeal court acknowledges that, if the first instance body has observed the witnesses and weighed their evidence, its decision on such matters is more likely to be correct than any decision of a court which cannot deploy those factors when assessing the position. In considering appeals on matters of fact from the various professional conduct committees, the Board must inevitably follow the same general approach. Which means that, where acute issues arise as to the credibility or reliability of the evidence given before such a committee, the Board, duly exercising its appellate function, will tend to be unable properly to differ from the decisions as to fact reached by the committee ... "
Second issue
"14. Their Lordships would add this. They have rejected the submission that there is a general duty to give reasons in cases where the essential issue is one of the credibility or reliability of the evidence in the case. Nonetheless, while bearing in mind the potential pitfalls highlighted by Lord Mustill, the Committee can always give reasons, if it considers it appropriate to do so in a particular case. Their Lordships would go further: there may indeed be cases where the principle of fairness may require the Committee to give reasons for their decision even on matters of fact ... "
Third issue
Fourth issue
"The principles upon which this Board acts in reviewing sentences passed by the Professional Conduct Committee are well settled. It has been said time and again that a disciplinary committee are the best possible people for weighing the seriousness of professional misconduct, and that the Board will be very slow to interfere with the exercise of the discretion of such a committee ... The Committee are familiar with the whole gradation of seriousness of the cases of various types which come before them, and are peculiarly well qualified to say at what point on that gradation erasure becomes the appropriate sentence. This Board does not have that advantage nor can it have the same capacity for judging what measures are from time to time required for the purpose of maintaining professional standards."
"For these reasons the Board will accord an appropriate measure of respect to the judgment of the Committee whether the practitioner's failings amount to serious professional misconduct and on the measures necessary to maintain professional standards and provide adequate protection to the public. But the Board will not defer to the Committee's judgment more than is warranted by the circumstances. The Council conceded, and their Lordships accept, that it is open to them to consider all the matters raised by Dr Ghosh in her appeal; to decide whether the sanction of erasure was appropriate and necessary in the public interest or was excessive and disproportionate; and in the latter event either to substitute some other penalty or to remit the case to the Committee for reconsideration."
In my judgment, it was plainly entitled to view that conduct seriously. Given that, and the other matters taken into account by the Committee -- matters that, as I have held, were properly taken into account -- it does not seem to me that the penalty imposed can be said to have been excessive or disproportionate.
I bear in mind the advantages enjoyed by an expert professional committee in assessing the gravity of misconduct, but I stress that I reach my conclusion without deferring to the judgment of the Committee to a greater extent than is warranted.
I have also borne in mind that it remains open to the appellant to apply in due course under Rule 22 of the 1993 Rules for restoration to the register. No doubt such an application would have no realistic prospect of success if matters remained as they appeared to the Committee when imposing the penalty it did. But if for example the appellant was able to produce fresh evidence to show that he had achieved a proper insight into his offending behaviour, together with evidence such as the additional references that have been produced to this court, it may be that his application would be viewed more favourably. What matters for present purposes, however, is that the procedure exists for making such an application, and that any such application can be expected to be given proper consideration. Therefore, although the penalty imposed is one of removal from the register without specifying any period of time, that penalty does not represent an absolute bar to the appellant returning to the profession in the future. It would be open to him to return to the profession if the view were taken that, in all the circumstances, he was now a fit person to be re-admitted. That is of some relevance to the question of proportionality, though I rely on it very much as a secondary factor in my reasons for upholding the Committee's decision on penalty.
Conclusion