Striking off
We recognise that striking off is a very serious step. A striking-off order will only be imposed in cases where the panel feels that there is no other adequate way to protect the public and maintain public confidence. Circumstances in which a striking-off order may be considered include serious convictions involving violence or sexual misconduct, or where there has been dishonesty or a serious abuse of trust.
Any action the panel takes is intended to protect the public and is not intended as a punishment. The panel will always consider the individual circumstances of a case and take account of what has been said by everyone at the hearing before deciding what to do.
In hearings of the health committee or where the allegation relates to lack of competence, the panel will not have the option to strike off a registrant at the first hearing. This is because we recognise that in cases where ill health has impaired fitness to practise, or where competence has fallen below expected standards, it is possible that the registrant’s health may improve or, in competence cases the registrant may receive extra training or supervised practice.
Showing posts with label Mr M. Show all posts
Showing posts with label Mr M. Show all posts
Friday, 21 November 2008
Striking is not a punishment; Mr M
Holding onto this theme of striking and being struck off, I looked on the web-site to see how the HPC define it. I have copied and pasted the item below, and inked the page to the heading here above, but want to highlight three points in particular. First it is a very serious step. Second, it is not intended as a punishment, but as a last resort to protect the public. Third, it appears to last forever - there is no mention of a time scale. Given the first two statements, the hearing of Mr M seems in breach of the HPC remit. If this were a game, I might point out that the HPC are saying one thing and doing another, which in their terms is grounds for prosecution. But it is not a game, it is a serious business to deprive someone of their livlihood, and I recall that Mr M had been doing this work for 25 years. My question now is, what can and should be done to maintain the possibility of belief in the system of ordinary British justice? Something is clearly out of kilter.
Thursday, 20 November 2008
Interpreting the texts: Mr M
The case against Mr M seems to be entirely built on a particular interpretation of words which doesn't seem possible to put into question.
For example, the first allegation was that Mr M 'failed to immediately' act on the patient. I heard that the unfortunate man had suffered a heart attack in his car, and when the ambulance crew arrived Mr M commenced the procedures when the patient was on the trolley. The lawyer interpreted the guideline's word 'immediately' in a very literal way, and did not consider the context or pose questions about Mr M's decision. The printed word was 'immediately', and this was unambiguous according to the lawyer.
Secondly, a point about responsibility. The crew was made up as follows: Mr M plus one other, not qualified as a paramedic but of long service and experience. Ms J arrived a little later and joined them in the ambulance to the hospital. Mr M was the senior member and filled in forms stating that he took responsibility for this call. Much of the physical action (of resuscitation and so forth) was carried out by the two other members of the team. The question of delegation became transformed into 'abdication' as the fact was established that Mr M's hands had not actually performed the tasks.
The question at the heart of the hearing seemed to be more concerned with the fact that he wrote that he took responsibility whereas 'in fact' the other man pumped the heart while the woman pumped the air. What I'm driving at here is this: from my lay-person's perspective, I am not at all shocked to hear that a senior member of staff takes responsibility for the subordinates' actions. This is every day ordinary life. I didn't hear anyone say that the actions of the subordinates were dangerous or ill-conducted - no-one said that the outcome of this team's work resulted in a disaster for the patient. What seems to be of interest to the lawyers at the HPC was that Mr M was lying! This is a very strange interpretation of the text, but I do believe there's a very good chance that this was indeed the level of the allegation.
Mr M seems to have been severely punished (struck off the register, and his details published on the website) because he took responsibility, delegated to his staff, and made decisions according to the actual circumstances rather than mindlessly following the guidelines. I cannot see anywhere how the public was put in peril by his work.
One other thing. I was struck by Ms J's witness statement. She said she had been doing this work for about 20 years, had seen the other two team members around, and had no doubt whatsoever about their ability to manage the situation that day. She also said that she was someone who 'liked to help out'. I think this is probably why she had agreed to be at the hearing. My guess is she will be shocked at the panel's decision. I don't think it occurred to her that the hearing would be anything other than fair and reasonable. I wonder what she will think of the representation of her words in the report. They have her say that 'she recalled that [Mr M] had taken little part in the direct care of the patient'. I didn't hear her say that, and I didn't interpret her words as in any way damaging to Mr M. The summarising of her position in this way makes me very uneasy indeed.
For example, the first allegation was that Mr M 'failed to immediately' act on the patient. I heard that the unfortunate man had suffered a heart attack in his car, and when the ambulance crew arrived Mr M commenced the procedures when the patient was on the trolley. The lawyer interpreted the guideline's word 'immediately' in a very literal way, and did not consider the context or pose questions about Mr M's decision. The printed word was 'immediately', and this was unambiguous according to the lawyer.
Secondly, a point about responsibility. The crew was made up as follows: Mr M plus one other, not qualified as a paramedic but of long service and experience. Ms J arrived a little later and joined them in the ambulance to the hospital. Mr M was the senior member and filled in forms stating that he took responsibility for this call. Much of the physical action (of resuscitation and so forth) was carried out by the two other members of the team. The question of delegation became transformed into 'abdication' as the fact was established that Mr M's hands had not actually performed the tasks.
The question at the heart of the hearing seemed to be more concerned with the fact that he wrote that he took responsibility whereas 'in fact' the other man pumped the heart while the woman pumped the air. What I'm driving at here is this: from my lay-person's perspective, I am not at all shocked to hear that a senior member of staff takes responsibility for the subordinates' actions. This is every day ordinary life. I didn't hear anyone say that the actions of the subordinates were dangerous or ill-conducted - no-one said that the outcome of this team's work resulted in a disaster for the patient. What seems to be of interest to the lawyers at the HPC was that Mr M was lying! This is a very strange interpretation of the text, but I do believe there's a very good chance that this was indeed the level of the allegation.
Mr M seems to have been severely punished (struck off the register, and his details published on the website) because he took responsibility, delegated to his staff, and made decisions according to the actual circumstances rather than mindlessly following the guidelines. I cannot see anywhere how the public was put in peril by his work.
One other thing. I was struck by Ms J's witness statement. She said she had been doing this work for about 20 years, had seen the other two team members around, and had no doubt whatsoever about their ability to manage the situation that day. She also said that she was someone who 'liked to help out'. I think this is probably why she had agreed to be at the hearing. My guess is she will be shocked at the panel's decision. I don't think it occurred to her that the hearing would be anything other than fair and reasonable. I wonder what she will think of the representation of her words in the report. They have her say that 'she recalled that [Mr M] had taken little part in the direct care of the patient'. I didn't hear her say that, and I didn't interpret her words as in any way damaging to Mr M. The summarising of her position in this way makes me very uneasy indeed.
Tuesday, 18 November 2008
Mr M, paramedic, ambulance driver.
Mr M, had written to the HPC last year telling them that he had stopped working as a paramedic and asking to be removed from the register. It did not respond. He wrote again this year reminding it, again without success. He wrote to the law firm acting on behalf of the HPC in today’s fitness to practice hearing pointing out that to proceed with the hearing against him was a waste of time and money. In a rather touching move he added ‘I know the ball is rolling now, and that you say it is impossible to stop’, but again stressed the waste of time, and of tax payers’ money.
Nevertheless, the HPC takes its duty seriously. Its public, apparently, deserves its pound of flesh.
In the little bit of time that emerged as the system waited for the actors to show up, the HPC solicitor bantered with the legal adviser. She read out: " It says "Mr M has been working for 25 years without a single incident" she smirked as she added the word ‘reported’. It seemed pretty clear that she interpreted his absence and his letter as an admission of his guilt and an attempt to worm his way out of the humiliation. From the public benches it seemed at least equally likely that he had no faith in the fairness of the system and wanted not to become grist to this mill.
The complaint about Mr P’s work was made by Mr D: an instructor and sectional training manager and 'responsible', as he pointed out, ‘for Mr P being up to date’. He happened to be at the scene when the ambulance arrived, and he saw that Mr P was driving it.
Of course, it is not a crime for an ambulance driver to drive an ambulance. The crime this time was in delegating responsibility to the two other workers who remained in the back of the ambulance during the 6 minute journey to the hospital. One of these workers was a witness at this morning’s hearing.
She has worked for the service for 20 years, and is an emergency medicine technician. She had no doubts whatsoever about her team’s competence to work safely with the patient that day. But it was also her opinion that a paramedic on the team should stay with the patient and delegate the driving to a non-paramedic. This was her opinion, she repeated, though she knew that everyone had their own ideas.
It was her opinion and not that of the man in charge at the scene. Nevertheless her opinion is matched by that also written in some rule-books. It is written in a liaison committee’s guidelines, and appears in the European Resuscitation Council’s guidelines. These ‘guidelines’, however, are not open for discussion. Which is surprising, for guidelines.
The process appears to proceed like a giant unstoppable machine, yet the machinery is made up of people and bits of paper. Many of the people concerned would call themselves ‘professionals’, which implies that they are trusted to exercise their personal judgement. Their judgement and their actions can surely be subject to debate.
The real nature of the scene in question again seemed un-interesting to the HPC. The nitty gritty business of driving an ambulance, intervening in real life traumas and crises, and of making decisions about another man’s life is reduced to what is written in a few pre-printed books. What is at stake is whether the man’s character can be read from the way he relates to the administration. From this distance, it looks very much as if the HPC is a very heavy sledge hammer used to force a centralised rule book into the bodies and minds of local ambulance drivers.
It was Karl Popper who remarked that ‘you can centralise all power, but you cannot centralise all knowledge’. He knew, however, that sometimes, and especially in bad times, some people like to try.
Perhaps Mr P was a dangerous man, perhaps it is right that after 20 years of unblemished service, he should no longer be paid to save people’s lives. Perhaps. But the way that the case is being pursued is running roughshod over important questions and values and leaves a lot of useful knowledge and insight stumbling around in the dark.
My question, as before, is what kind of public is being imagined in order to justify this work of the HPC? It is not one that I am familiar with. And what kind of peril is it being saved from. From an ordinary, yet educated point of view available in the public benches, what can be seen as taking shape is quite a different danger. It is this that needs to be brought to light if we are serious about protecting a real public from the real danger - of creating something pernicious.
I await the publication of the panel’s conclusion, and will report on it tomorrow
Nevertheless, the HPC takes its duty seriously. Its public, apparently, deserves its pound of flesh.
In the little bit of time that emerged as the system waited for the actors to show up, the HPC solicitor bantered with the legal adviser. She read out: " It says "Mr M has been working for 25 years without a single incident" she smirked as she added the word ‘reported’. It seemed pretty clear that she interpreted his absence and his letter as an admission of his guilt and an attempt to worm his way out of the humiliation. From the public benches it seemed at least equally likely that he had no faith in the fairness of the system and wanted not to become grist to this mill.
The complaint about Mr P’s work was made by Mr D: an instructor and sectional training manager and 'responsible', as he pointed out, ‘for Mr P being up to date’. He happened to be at the scene when the ambulance arrived, and he saw that Mr P was driving it.
Of course, it is not a crime for an ambulance driver to drive an ambulance. The crime this time was in delegating responsibility to the two other workers who remained in the back of the ambulance during the 6 minute journey to the hospital. One of these workers was a witness at this morning’s hearing.
She has worked for the service for 20 years, and is an emergency medicine technician. She had no doubts whatsoever about her team’s competence to work safely with the patient that day. But it was also her opinion that a paramedic on the team should stay with the patient and delegate the driving to a non-paramedic. This was her opinion, she repeated, though she knew that everyone had their own ideas.
It was her opinion and not that of the man in charge at the scene. Nevertheless her opinion is matched by that also written in some rule-books. It is written in a liaison committee’s guidelines, and appears in the European Resuscitation Council’s guidelines. These ‘guidelines’, however, are not open for discussion. Which is surprising, for guidelines.
The process appears to proceed like a giant unstoppable machine, yet the machinery is made up of people and bits of paper. Many of the people concerned would call themselves ‘professionals’, which implies that they are trusted to exercise their personal judgement. Their judgement and their actions can surely be subject to debate.
The real nature of the scene in question again seemed un-interesting to the HPC. The nitty gritty business of driving an ambulance, intervening in real life traumas and crises, and of making decisions about another man’s life is reduced to what is written in a few pre-printed books. What is at stake is whether the man’s character can be read from the way he relates to the administration. From this distance, it looks very much as if the HPC is a very heavy sledge hammer used to force a centralised rule book into the bodies and minds of local ambulance drivers.
It was Karl Popper who remarked that ‘you can centralise all power, but you cannot centralise all knowledge’. He knew, however, that sometimes, and especially in bad times, some people like to try.
Perhaps Mr P was a dangerous man, perhaps it is right that after 20 years of unblemished service, he should no longer be paid to save people’s lives. Perhaps. But the way that the case is being pursued is running roughshod over important questions and values and leaves a lot of useful knowledge and insight stumbling around in the dark.
My question, as before, is what kind of public is being imagined in order to justify this work of the HPC? It is not one that I am familiar with. And what kind of peril is it being saved from. From an ordinary, yet educated point of view available in the public benches, what can be seen as taking shape is quite a different danger. It is this that needs to be brought to light if we are serious about protecting a real public from the real danger - of creating something pernicious.
I await the publication of the panel’s conclusion, and will report on it tomorrow
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