Conduct and Competence Committee Substantive Meeting

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1 Conduct and Competence Committee Substantive Meeting NMC, 20 Old Bailey, London, EC4M 7LN 18 June 2014 Name of Registrant: Mr Matthew Robin Pitts NMC PIN: 93A0777E Part(s) of the register: Registered Nurse Sub part 1 Mental Health Nursing March 1996 Type of Case: Panel Members: Legal Assessor: Conviction Clive Powell (Chair, Lay member) Annie Hitchman (Lay member) Julie Elizabeth Humphreys (Registrant member) John Bromley-Davenport QC Panel Secretary: Facts proved: Facts not proved: Fitness to practise: Sanction: Interim order: Mairead Shenton All, by way of admission N/A Impaired Striking off order Interim suspension order 18 months Details of charges: That you, a registered nurse: 1. Were convicted on 29 th July 2013 at Lewes Crown Court of the following offences: a) Two counts of making an indecent image of a child; b) One count of distributing indecent images of a child; c) One count of possession of extreme pornographic images. And in light of the above your fitness to practise is impaired by reason of your conviction. Page 1 of 6

2 Determination on proof of service: Notice of this meeting was sent to Mr Pitts on 13 May 2014 by recorded delivery and first class post to his address on the register. The panel was satisfied that notice has been served, as advised by the legal assessor, in accordance with Rules 34 and 11A of The Nursing and Midwifery Council (Fitness to Practise) Rules Order of Council 2004 ( the Rules ): 11A. (1) Where a meeting is to be held [ ] the Conduct and Competence Committee or the Health Committee shall send notice of the meeting to the registrant no later than 28 days before the date the meeting is to be held. Determination on the facts: The charges arose whilst Mr Pitts was employed as a registered mental health nurse within Sussex Partnership NHS Foundation Trust ( the Trust ), working at St Anne s Hospital. This matter was referred to the NMC by the Trust in February On 29 July 2013, Mr Pitts was convicted, having pleaded guilty, at Lewes Crown Court of the offences detailed in the charges set out above. The offences involved two level 1 images and one level 4 image (level 5 being the most serious on the Copine Scale). On 27 August 2013, Mr Pitts was sentenced to 3 months imprisonment suspended for 18 months, a Sexual Offences Prevention Order was imposed, and he was ordered to sign the Sex Offenders Register. The panel had sight of Mr Pitts Standard Directions Form, dated 22 May 2014, in which he has ticked the boxes to indicate that he admits all of the charges. The panel therefore found the charges proved by way of admission. Determination on impairment: The panel next went on to decide if, as a result of his conviction, Mr Pitts fitness to practise is currently impaired. The NMC has defined fitness to practise as a registrant s suitability to remain on the register unrestricted. Although the panel noted that Mr Pitts has ticked the box to indicate that he admits his fitness to practise is currently impaired, it bore in mind that impairment of fitness to practise is a matter for the independent judgement of the panel. Page 2 of 6

3 The panel heard and accepted the advice of the legal assessor. The panel had in mind the case of Council for Healthcare Regulatory Excellence v (1) Nursing and Midwifery Council (2) Grant [2011] EWHC 927 (Admin) and the judgment of this case which cites Dame Janet Smith s Fifth Report from Shipman. The panel considered the issue of Mr Pitts current impairment in the terms set out by Dame Janet Smith, specifically the questions of whether he: a) has in the past acted and/or is liable in the future to act so as to put a patient or patients at unwarranted risk of harm; and/or b) has in the past brought and/or is liable in the future to bring the medical profession into disrepute; and/or c) has in the past breached and/or is liable in the future to breach one of the fundamental tenets of the medical profession; [ ] d) [N/A]. The panel also considered paragraph 74 of the judgment in Grant, in which Mrs Justice Cox stated: In determining whether a practitioner s fitness to practise is impaired [ ], the relevant panel should generally consider not only whether the practitioner continues to present a risk to members of the public in his or her current role, but also whether the need to uphold proper professional standards and public confidence in the profession would be undermined if a finding of impairment were not made in the particular circumstances. The panel had regard to the fact that there are no written submissions before it from Mr Pitts, save for the fact that, attached to his Standard Directions Form is a short written statement in which he says that he is not currently working as a nurse and is not providing nursing services of any kind. Consequently, there is nothing before the panel to indicate remorse or insight on his part. Further, the panel noted that Mr Pitts initially denied the allegations, both in correspondence to the NMC, and during the police investigation and criminal proceedings; he only pleaded guilty to the offences at a very late stage. The panel considered that this was indicative of a significant lack of insight on Mr Pitts part. Bearing in mind the case of Yeong v GMC [2009] EWHC 1923 (Admin), the panel also noted that cases of sexual misconduct are difficult to remediate. Having regard to all of the above, the panel could not be satisfied that such conduct would not be repeated, which could place the public at risk of serious harm. The nature of the offences was extremely serious, and Mr Pitts has undoubtedly brought the profession into disrepute. He has also failed to act lawfully, thereby breaching a fundamental tenet of the nursing profession. The panel had regard to the question of whether the need to uphold proper professional standards and public confidence in the profession and the NMC as a regulator would be undermined if a finding of impairment of fitness to practise were not made in the Page 3 of 6

4 circumstances of this case. The panel had no doubt that it would, given the gravity of Mr Pitts conviction. For all the reasons outlined above, the panel determined that Mr Pitts fitness to practise is currently impaired by reason of his conviction. Determination on sanction: The panel considered this case very carefully and has decided to make a striking off order. The effect of this order is that Mr Pitts will be removed from the nursing register, and he may not apply for restoration until five years after the date that this decision takes effect. In determining the issue of sanction, the panel noted that Mr Pitts is currently subject to a sentence of imprisonment, albeit suspended for 18 months. In relation to this, it had in mind the case of Council for the Regulation of Healthcare Professionals v (1) General Dental Council (2) Alexander Fleischmann [2005] EWHC 87 (Admin), in which Mr Justice Newman stated: As a general principle, where a practitioner has been convicted of a serious criminal offence or offences he should not be permitted to resume his practice until he has satisfactorily completed his sentence. Only circumstances which plainly justify a different course should permit otherwise. Such circumstances could arise in connection with a period of disqualification from driving or time allowed by the court for the payment of a fine. The rationale for the principle is not that it can serve to punish the practitioner whilst serving his sentence, but that good standing in a profession must be earned if the reputation of the profession is to be maintained. The panel first considered whether to take no action but concluded that this would be manifestly inappropriate in view of the grave nature of the conviction, and in the light of the panel s duty to uphold proper professional standards. The panel decided that it would be neither proportionate nor in the public interest to take no further action; a conviction of this nature demands a sanction. Next, in considering whether a caution order would be appropriate in the circumstances, the panel took into account the Indicative Sanctions Guidance, which states that a caution order may be appropriate where the case is at the lower end of the spectrum of impaired fitness to practise and the panel wishes to mark that the behaviour was unacceptable and must not happen again. A caution order would not be proportionate given the seriousness of the conviction, nor would it sufficiently protect the public. Page 4 of 6

5 The panel next considered a conditions of practice order. The panel was unable to formulate practicable conditions given the nature of the criminal offences. Further, the panel determined that the placing of conditions on Mr Pitts registration would not address the seriousness of the conviction and would not adequately protect the public. The panel then went on to consider a suspension order. Paragraph 71 of the Indicative Sanctions Guidance indicates that a suspension order may be appropriate where: 71.2: The misconduct is not fundamentally incompatible with continuing to be a registered nurse or midwife in that the public interest can be satisfied by a less severe outcome than permanent removal from the register. The panel determined that Mr Pitts conduct was a serious departure from the standards expected of a registered nurse and, in the panel s judgement, his behaviour was fundamentally incompatible with his remaining on the register. Bearing in mind its duty to protect the public, and uphold proper standards of conduct and behaviour, the panel decided that a suspension order would not be an appropriate or proportionate sanction. The panel also took account of paragraphs 45 to 47 of the Indicative Sanctions Guidance, which state: Panels should be aware that any conviction relating to child pornography will lead to registration as a sex offender and possible disqualification from working with children. The criminal courts identify degrees of seriousness in relation to child pornography offences. However, panels will wish to give careful regard to the proposition that any conviction for child pornography is a matter of serious concern because it involves such a fundamental breach of trust and damages the reputation of the professions. In all cases of serious sexual misconduct, it will be highly likely that the only proportionate sanction will be a striking-off order. Given the gravity of the criminal offences in this case, involving as they did the making and distributing of indecent images of children, the panel concluded that nothing short of a striking off order would be sufficient in this case, both in terms of public protection and satisfying the public interest. The panel considered that such an order was necessary to mark the importance of maintaining public confidence in the nursing profession, and in the NMC as a regulator, and to send to the public and the profession a clear message about the standard of behaviour required of a registered nurse. Determination on interim order: The panel accepted the advice of the legal assessor. The panel took account of the guidance issued to panels by the NMC when considering interim orders and the appropriate test as set out at Page 5 of 6

6 Article 31 of The Nursing and Midwifery Order It may only make an interim order if it is satisfied that it is necessary for the protection of the public, is otherwise in the public interest or in Mr Pitts own interest. The panel was satisfied that an interim suspension order was necessary to protect the public and was otherwise in the public interest. The panel had regard to the seriousness of the facts found proved and the reasons set out in its decision for the substantive order in reaching the decision to impose an interim order. To do otherwise would be inconsistent with its earlier findings. Not to impose an interim suspension order in these circumstances may undermine public confidence in the regulatory process. The period of this order is for 18 months to allow for the possibility of an appeal to be made and determined. If no appeal is made then the interim suspension order will be replaced by the striking off order 28 days after Mr Pitts is sent the decision of this meeting in writing. That concludes this determination. Page 6 of 6

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