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You are here: BAILII >> Databases >> England and Wales High Court (Administrative Court) Decisions >> Council for the Regulation of Health Care Professionals, R (on the application of) v Nursing And Midwifery Council & Anor [2007] EWHC 1806 (Admin) (04 July 2007) URL: https://www.bailii.org/ew/cases/EWHC/Admin/2007/1806.html Cite as: [2007] EWHC 1806 (Admin) |
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QUEEN'S BENCH DIVISION
THE ADMINISTRATIVE COURT
Strand London WC2A 2LL |
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B e f o r e :
____________________
| THE QUEEN ON THE APPLICATION OF THE COUNCIL FOR THE REGULATION OF HEALTH CARE PROFESSIONALS | Claimant | |
| v | ||
(1) THE NURSING AND MIDWIFERY COUNCIL |
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(2) MICHELLE KINGDOM | Defendants |
____________________
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Miss Claire Strickland (instructed by NMC) appeared on behalf of the First Defendant
Mr Simon Wilton (instructed by RCN Legal Services) appeared on behalf of the Second Defendant
____________________
Crown Copyright ©
Nursing
and Midwifery Council concerning Ms
Kingdom,
a registered
nurse,
who at the relevant time was working at the Great Ormond Street Children's Hospital.
Kingdom
in 2003 concerned false documentation regarding her qualifications. They are set out at length in the charge, but can usefully be summarised from the skeleton argument of Mr Chamberlain, who appeared on behalf of the Council in this appeal. The charges relate to a letter Ms
Kingdom
she had shown her line manager concerning a course taken at South Bank University on "Special and Intensive Care of the Newborn". The first charge was that she produced a result letter showing that she had passed a unit from the course on "Special and Intensive Care of a Newborn" when she had not. The second charge was that she told her line manager she had passed the unit when she had not. The third charge was that she produced false documentation regarding her qualifications to a member of staff at South Bank University.
Kingdom
began working at the hospital in May 2000 and started the course in 2001. The course consisted of four units. She passed three of them on her first attempt, but failed the unit on "Physiological Basis of Care", a non-clinical unit. She was permitted to resit the unit. In a letter dated 17 August 2001, the Chair of the Examination Board informed her of this. The letter stated that, as she had been referred in this subject, she would have to resit the exam, and referred work could only carry a pass mark of 40 per cent.
Kingdom's
ward manager, received an anonymous e-mail informing her that two members of staff had failed the course. Ms
Kingdom
had already told Miss Singer that she had scraped through it after a resit. Miss Singer asked all staff to confirm that they had passed the course. Ms
Kingdom
produced letters on university note paper purporting to show that she had passed all four units. One of the letters, dated 17 October 2001, purported to show that she had received the mark of 45 per cent in the unit of "Physiological Basis of Care". That letter also stated that the Examination Board had met on 14 October 2001. In fact, the Board had met, according to a copy of the letter on the university's records, on 17 October. The letter Ms
Kingdom
produced purported to be the original of the letter concerning the unit in question, and suspicions were aroused.
Kingdom
and found proved by the Committee. The Committee heard evidence for a further two days as to the circumstances in which the conduct had been committed. They were entitled to do so under the rules.
Kingdom
would need in order to progress up the career structure. She stated that, after Ms
Kingdom
had told her that she passed the course, steps had been taken to start developing Ms
Kingdom
to take on more responsibility within the unit.
nurse's
ability to get promotion, the Committee also heard evidence about the nature of the document shown to Miss Singer and to a university official. The evidence was given by Anne Garvey, the deputy dean of South Bank University. She said that the university did not believe the letter that she had shown the hospital could have been generated in the university's system. She thought the letter had been forged because the paper was different, and the logo on the paper was different in colour and appearance. Moreover, the document looked brand new whereas it was purported to have been written in 2001. She also referred to the fact that the letter stated a pass mark of 45 per cent which was not possible, and gave the wrong day for the Examine Board meeting. She said that she had asked Ms
Kingdom
for the letter, but Ms
Kingdom
had refused to let her keep it.
Kingdom's
dishonesty and whether she was dishonest in what she had done with the document, the charge did not specify dishonesty. The charge alleged misconduct by Ms
Kingdom
in producing a false document, advising Miss Singer that she had passed the unit, and producing the document to Miss Garvey.
Kingdom's
representative had earlier accepted that dishonesty was before the Council, and that the factual background would be integral to whether or not misconduct took place because it is an allegation of dishonesty. In the light of the advice of its legal assessor, the Committee decided that it was not appropriate for it to consider whether Miss
Kingdom
had been dishonest because dishonesty had not been expressly alleged. The Committee remarked that:
"We should add that we regret that we have felt obliged to reach this decision. Much of the evidence which was given in this case related to the alleged dishonesty of the Registrant, but this did not form part of the charges. We were not therefore able to fully explore the issues of the Registrant's alleged dishonesty."
Having so directed itself, the Committee made no finding of misconduct in relation to any of the charges.
Nursing
and Midwifery Council. One of its functions is to bring cases in which there has been undue lenience, either in the charge or in the penalty, to the attention of this court in order to ensure the protection of the public.
nurse
or midwife. Section 29(2) applies to decisions not to take any disciplinary measure, and section 29(2)(b), applying that to decisions in relation to
nurses
or midwives.
"(4) If the Council considers that-
(a) a relevant decision falling within subsection (1) has been unduly lenient, whether as to any finding of professional misconduct or fitness to practise on the part of the practitioner concerned (or lack of such a finding), or as to any penalty imposed, or both, or
(b) a relevant decision falling within subsection (2) should not have been made
and that it would be desirable for the protection of members of the public for the Council to take action under this section, the Council may refer the case to the relevant court."
The relevant court is the High Court, and cases brought pursuant to section 29 are brought to the Administrative Court.
"(7) If the Council does so refer a case-
(a) the case is to be treated by the court to which it has been referred as an appeal by the Council against the relevant decision (even though the Council was not a party to the proceedings resulting in the relevant decision), and
(b) the body which made the relevant decision is to be a respondent."
In the present case, the first respondent is the
Nursing
and Midwifery Council, who is represented in court by Miss Strickland. The Council do not oppose the relief sought, and Miss Strickland was here to assist the court by her presence.
"(8) The court may-
(a) dismiss the appeal,
(b) allow the appeal and quash the relevant decision,
(c) substitute for the relevant decision any other decision which could have been made by the committee or other person concerned, or
(d) remit the case to the committee or other person concerned to dispose of the case in accordance with the directions of the court..."
It is the power under section 29(8)(d) which the appellant invites the court to exercise.
Nursing
and Midwifery Council are contained in the
Nurses,
Midwives and Health Visitors (Professional Conduct) Rules 1993; Approval Order 1998 (SI 1993/893). The key provisions for present purposes are Regulation 14, entitled "Postponement or Cancellation of the Hearing". Regulation 14(3) provides:
"Where before the hearing begins it appears to the chairman of the Conduct Committee, or at any stage during the hearing it appears to the Conduct Committee, that a Notice of Inquiry is defective, she or it shall cause the Notice to be amended unless it appears that the required amendment cannot be made without injustice, or if she or it considers that the circumstances in which an amendment is made so require, she or it may direct that the hearing shall be postponed or shall not take place."
"The role of the Court when a case is referred is to consider whether the disciplinary tribunal has properly performed that task so as to reach a correct decision as to the imposition of a penalty. Is that any different from the role of the Council in considering whether a relevant decision has been 'unduly lenient'? We do not consider that it is. The test of undue leniency in this context must, we think, involve considering whether, having regard to the material facts, the decision reached has due regard for the safety of the public and the reputation of the profession."
"The procedures for disciplinary proceedings under the various statutes referred to in section 29(1) of the Act are not identical. In general they involve a preliminary investigation of conduct of the practitioner of which complaint has been made. If it is decided to bring disciplinary proceedings, a charge will be proffered which alleges the facts relied upon as demonstrating professional misconduct ... The disciplinary tribunal should play a more proactive role than a judge presiding over a criminal trial in making sure that the case is properly presented and that the relevant evidence is placed before it."
Nursing
and Midwifery Council at the preliminary stages of the case, the only proper conclusion was to include a charge of dishonesty, and that the failure to do so was a serious procedural irregularity. He submits that that was so at that stage, and it was certainly so by the time the proceedings before the Committee opened.
Kingdom,
contrasts the present case with Rajeshwar's case. He submits that in the present case there were no witness statements, and this court cannot say that at that early stage it was clear, as it had been in Rajeshwar's case, that the only correct procedure was to amend the charges. Mr Chamberlain responded that the evidence upon which he relied from the transcript of the hearing was largely evidence-in-chief. The Council would have had witness statements from the witnesses, and this court is able to see what evidence was adduced. It is clear from that evidence that, by the commencement of the hearing, the evidence was amply sufficient to require the prosecuting authority to include a charge of dishonesty. He also relied on the terms of Regulation 14(3) and the fact that it empowered an amendment to the charge "at any stage during the hearing". Mr Wilton submitted that, apart from the absence of clear evidence as to the position before the outset of the proceedings, the fact that Ms
Kingdom
admitted the facts alleged in the charges meant that thereafter the power to amend the charges could not be exercised without injustice. He submitted that once she admitted the facts, while further evidence might be led as to the circumstances leading up to the facts in the charge or charges, because there is no power to re-open the findings of fact or the facts that had been announced as proved, adding an allegation of dishonesty could not be done without injustice to her. He relied in particular on the very structured nature of the procedure laid down in the regulations. While initially submitting that there was jurisdictionally no power to order an amendment after the facts were found to be proved, as I have indicated, he accepted that while there might be power to do so given the width of the words "at any stage during the hearing" in Regulation 14. He submitted that it would often -- indeed inevitably -- be unfair to do so and that, in this case, the amendment could not be made without injustice.
Kingdom
what was being alleged. After the facts were found to have been proved, it was too late to amend the charge without unfairness.
Kingdom
had been denied the opportunity to prepare for the case in the full knowledge of what was alleged against her as far as her knowledge was concerned. He submitted that remitting would be a recipe for confusion. There was a real danger that the charge would be amended to suit the way the evidence had come out. There was a possibility of bringing the procedure into disrepute because of the potential for the proceedings to take a self-contradictory course. These submissions were made to show that the court should not regard any failure to consider amending the charges as serious procedure irregularity. In addition, he argued that if I did so regard this failure, it should be regarded as a matter which justified the exercise of discretion not to remit. In the context of the exercise of discretion, he also made the submission that the course in question was of a theoretical nature. He argued that Ms
Kingdom's
competence would not have been affected by the fact that she had not passed it even had she gone on to assume the further responsibilities which passing the course was designed to enable her to assume.
Kingdom
was a serious procedural error. As to the consequences, I bear in mind the judgment of the Court of Appeal as to the criteria of undue leniency, and have regard to the safety of the public and the reputation of the profession. I have concluded that if, applying Sullivan J's test in Rajeshwar's case, the issue of dishonesty had been on the charge sheet and been considered by the Committee and had been resolved against Ms
Kingdom,
the finding in this case that there had been no misconduct would undoubtedly have been unduly lenient.
nurse
used a forged document in support of her career advancement. It may be the case that her practical competence was not affected by the fact that she had not passed the non-clinical unit. The idea that a dishonest person, or a person against whom there is a serious prima facie case of dishonesty, is to be placed in a responsible position caring for ill and vulnerable people is, however, an extremely unattractive one. Dishonesty of this sort in relation to qualifications is a matter which does potentially affect the safety of the public. The issue is not whether this particular dishonesty affected the safety of those for whom Ms
Kingdom
happened to be caring. It is the implication of having a professional who has engaged in dishonesty in the course of the exercise of his or her profession continue in it without at least a finding of misconduct. I put it in that way, but as Mr Chamberlain fairly said, it is not the case that Ms
Kingdom
has been found to be dishonest. The issue is whether, on the material available to the Council, there was a serious prima facie case of dishonesty for her to answer.
Kingdom
has reason for not wanting it to press on -- but delay is put here and I respond to it in that way.
Kingdom
has chosen to resist and so she should pay the remainder of the appellant's costs.
nurse, obviously it is highly important to know what the NMC is going to say before considering --