Ms Linda Joyce

Preliminary Matters

1. At the commencement of the hearing, the Panel was asked to conduct the hearing partly in private. The application was based on the fact that it was known that evidence concerning the Registrant’s health would be received by the Panel. The direction was sought by both the HCPC and the Registrant, and the Panel decided that the direction was necessary to protect the Registrant’s private life.

2. When invited to respond to the allegation, the Registrant admitted the fact of the conviction. In relation to the contention that her fitness to practise is impaired as a consequence of that conviction, the Registrant responded that she accepted that the conviction impaired her fitness to practise in 2021, but that she did not believe that it was impairing her fitness to practise at the present time.

Background

3. The Registrant is a Speech and Language Therapist (“SLT”) registered with the HCPC. She qualified as a SLT in 1998. At the time of the events underpinning the allegation, the Registrant was employed by York and Scarborough Teaching Hospital NHS Foundation Trust (“the Trust”), and that employment had commenced on 1 July 2007.

4. On 11 May 2021, the Registrant referred herself to the HCPC. She stated that she had been convicted of the offence of drink driving. She described the offence thus: “drink driving whilst over the limit (the morning after the night before) and crashed into a lamppost on 28/02/21”.

5. Subsequent investigations by the HCPC confirmed further details of the conviction. The incident occurred mid-morning on Sunday, 28 February 2021. The tyre marks left by the Registrant’s car disclosed that it had mounted the grass island and driven in a straight line across it, making no deviation or attempt to navigate the roundabout. A lamp post had been struck and dragged under the vehicle. No other person or vehicle had been involved in the incident, but the Registrant’s car was extensively damaged and the Registrant received minor injuries in respect of which she declined treatment. When the Police arrived, the Registrant cooperated fully, admitting that she had been driving the car and providing a specimen of breath. The breath test at the scene having provided a reading that was over the legal limit, the Registrant was arrested and taken to a Police Station. A further test conducted at the Police Station on an Intoximeter breathalyser produced a reading of 99 micrograms of alcohol in 100 millilitres of breath. This represented a fail, as the lawful limit is 35 micrograms of alcohol in 100 millilitres of breath. The Registrant was subsequently charged with the offence with which this hearing is concerned.

6. The Registrant appeared before the Humber Magistrates’ Court on 21 April 2021. She pleaded guilty to the offence. The sentence imposed was a fine of £800.00, disqualification from driving for 25 months (a period that could be reduced by 25 weeks upon completion of an approved course), and some consequential costs orders.

Decision on Facts and Ground

7. As the HCPC’s allegation against the Registrant is that her fitness to practise is impaired by reason of the conviction, the sole fact to be decided is whether the Registrant was convicted as alleged. If that fact is proven, the statutory ground of conviction is necessarily established.

8. It has already been recorded that when invited to respond to the allegation, the Registrant admitted the conviction. The Panel was provided with a copy of the authenticated Memorandum of Entry in the Register of the Magistrates’ Court for 21 April 2021, and it is apparent from that document that the Registrant’s admission was appropriately made.

9. It follows that the Panel is satisfied that the particular 1 of the allegation is proven and the statutory ground of conviction is made out.

Decision on Impairment

10. After summarising the circumstances of the incident on 28 February 2021 and the conviction resulting from it, the Presenting Officer made his submissions on impairment of fitness to practise. In relation to the Registrant’s fitness to return to practise, he referred to the opinion of [the Medical Consultant] in paragraph 99 of his report to which the Panel will return below. However, the focus of the Presenting Officer’s submissions focused on the public component of impairment of fitness to practise. In this regard, he submitted that the seriousness of the offence has the consequence that fully informed members of the public would expect a finding of impairment of fitness to practise, and that the confidence of such people in the SLT profession and the regulation of it would be diminished were that finding not to be made.

11. The Registrant gave evidence under affirmation before the Panel, was cross-examined by the Presenting Officer and answered questions by the Panel. She told the Panel that [redacted] in the period before the incident in 2021 different factors had adversely affected her. [Redacted] the Covid-19 pandemic arose. The Registrant was working in a hospital setting, working in acute wards and intensive care. She told the Panel that she had lost the confidence, that she had previously enjoyed, that she could do her job. [Redacted].

12. The Panel was also provided with documents submitted by the Registrant. They included:

• A statement made by the Registrant;
• a testimonial dated 6 March 2023, prepared by a Registered Nurse;
• a letter dated 15 March 2023, [redacted].
• a letter dated 15 April 2021, [redacted].
• a certificate dated 21 April 2022, confirming satisfactory completion of the course that would entitle the Registrant to a reduction of 25 weeks in the length of her disqualification from driving.

13. Included in the hearing bundle provided by the HCPC was a report on the Registrant prepared by a [Medical Consultant]. The report is dated 14 September 2023, the same day [the Medical Consultant] interviewed the Registrant by video conferencing. This report was obtained when an earlier panel of the Conduct and Competence Committee had adjourned the hearing of the conviction allegation, suggesting that medical evidence be obtained in order to ascertain whether the case should be transferred to the Health Committee. In the event, the case was not transferred to the Health Committee, but the HCPC made the report available to the present Panel for its assistance in deciding the conviction allegation. In the view of the Panel the report was of assistance, and the respects in which that was so can be best demonstrated by reproducing various paragraphs of [the Medical Consultant]’s report:

(81) [Redacted].

(82) [Redacted].

(83) [Redacted].

(84) [Redacted].

(85) [Redacted].

…

(90) [Redacted].

(91) [Redacted].

(92) [Redacted].

(93) [Redacted].

(94) [Redacted].

(95) [Redacted].

(96) [Redacted].

(97) MY OPINION AS TO WHETHER I CONSIDER THE REGISTRANT’S MEDICAL CONDITION TO AFFECT HER ABILITY TO PRACTICE

(98) [Redacted].

(99) If she chose to return to work as a Speech and Language Therapist, in my opinion at the current time she would be able to do so. [The Panel adds that this view by [the Medical Consultant] was clearly based on the medical issues he was considering; it did not purport to take account of any de-skilling arising from the Registrant being away from practice for a considerable period.] She would need a phased return to work with appropriate regular supervision to monitor her own wellbeing and make sure she had adequate support. [Redacted].

14. The Panel’s view of the Registrant was that she was an honest witness who did her utmost to answer the Panel’s questions as fully and as candidly as she was able. From a person who had practically no awareness of the state she had got herself into at the time of the incident in early 2021, she is now a person who has considerable awareness of, and insight into, her past behaviour. She is remorseful and embarrassed. The assessment of [the Medical Consultant] expressed nearly four months ago is consistent with the assessment of the Panel.

15. [Redacted]. When the risk is expressed in these terms the Panel shares the opinion of [the Medical Consultant] that the degree of insight reached by the Registrant is such that there is not an appreciable risk.

16. The assessment of the Panel that the Registrant does not present an appreciable risk of repetition of behaviour of the sort that resulted in the conviction has the consequence that the Panel does not consider that the Registrant’s fitness to practise is impaired upon the personal component.

17. Very different considerations apply to the public component of impairment of fitness to practise. It is true that the Panel is concerned with a single incident, but it was an incident of the utmost seriousness. The Registrant was not marginally over the legal limit; the level of alcohol in her system was very nearly three times the legal limit. She drove for approximately a mile on a public road. That behaviour created a very real risk that she could have caused life-changing injuries or death to other road users, and it is purely fortuitous that that did not occur. In the judgement of the Panel, fully informed and fair-minded members of the public would be appalled by that behaviour on the part of a health professional. The Panel is of the clear view that it would be failing in its duty to mark the seriousness of what occurred were it not to reach a finding of impairment of fitness to practice. In addition to the public losing confidence in the SLT profession and the regulation of it by the HCPC, proper professional standards would not be declared and upheld and there would not be a sufficient deterrent effect on other registrants.

18. For these reasons the Panel has concluded that the Registrant’s fitness to practise is impaired upon consideration of the public component. It will be necessary to proceed to consider the issue of sanction.

Decision on Sanction

19. After the Panel handed down the written determination explaining that the allegation is well founded, the parties were allowed time to consider the document before making submissions on sanction.

20. On behalf of the HCPC, the Presenting Officer stated that he did not intend to submit that the Panel should impose any particular sanction. After identifying some aggravating and mitigating factors, he referred the Panel to the HCPC’s Sanctions Policy. The Presenting Officer submitted that the Panel should work its way through the sanction range, and, in that context, he submitted that the Panel might consider that a sanction at the bottom of the available range might not be appropriate. He also submitted that the Panel might consider that this is not a case in which conditions of practice would be appropriate. After drawing the Panel’s attention to paragraph 121 of the Sanctions Policy in which a Suspension Order is discussed, he reminded the Panel that striking off is the sanction of last resort and one that might not be appropriate in this case.

21. When offered the opportunity to address the Panel on sanction, the Registrant again stated that she did not wish to practise as an SLT.

22. The Panel began its discussion by considering the aggravating factors and those matters that it would be appropriate to take into account in favour of the Registrant.

23. Although they do not all bear directly upon the circumstances of the offence, the Panel considered the following should properly be taken into account as mitigating factors in favour of the Registrant:

• the stress factors to which reference has already been made that preceded the offence and undoubtedly contributed to the Registrant’s inappropriate use of alcohol;
• the Registrant pleaded guilty to the charge in the Magistrates’ Court, has engaged in these fitness to practise proceedings and admitted the fact of the conviction at this hearing;
• the Registrant has demonstrated genuine remorse;
• the Registrant has made real efforts to address the underlying causes [redacted].

24. In the judgement of the Panel, the aggravating factors were the circumstances of the drink driving; it was driving with a level of alcohol that massively exceeded the legal limit, and driving that exposed members of the public (and the Registrant herself) to a very real risk of physical harm. The Panel was of the clear view that such was the seriousness of these factors that they outweigh the mitigating factors.

25. With these factors in mind, the Panel first addressed the question whether this is a case in which a sanction is required. The conclusion reached was that the circumstances of the case are far too serious to result in no sanction being imposed. Accordingly, the Panel considered the available sanctions in an ascending order of seriousness.

26. Paragraph 101 of the Sanctions Policy suggests the type of case in which a Caution Order will be appropriate. It is in these terms:

A caution order is likely to be an appropriate sanction for cases in which:

• the issue is isolated, limited, or relatively minor in nature;
• there is a low risk of repetition;
• the registrant has shown good insight;
• and the registrant has undertaken appropriate remediation.

27. The Panel has already stated in its decision on impairment of fitness to practise that there is a low risk of repetition, the Registrant has shown good insight and, to the extent that a conviction can be remediated, has taken positive and commendable steps to remediate the issue. However, despite the fact that the issue was isolated in the sense that the Panel is concerned with a single conviction, it was a conviction that was very emphatically not minor in nature. Indeed, it was a conviction for an offence of the utmost seriousness. In the judgement of the Panel the seriousness of the offence renders a Caution Order insufficient to mark the gravity of the matter.

28. The Panel next considered whether a Conditions of Practice Order should be made, and in that context considered paragraph 106 of the Sanctions Policy. The conclusion of the Panel is that given the seriousness of the conviction conditions of practice would not be appropriate, and that would be so even were the Registrant practising as a SLT or proposing to do so in the future.

29. The Panel therefore next considered whether a Suspension Order should be made, and in that regard considered the terms of paragraph 121 of the Sanctions Policy, which is written thus:

A suspension order is likely to be appropriate where there are serious concerns which cannot be reasonably addressed by a conditions of practice order, but which do not require the registrant to be struck off the Register. These types of cases will typically exhibit the following factors:

• the concerns represent a serious breach of the Standards of conduct, performance and ethics;
• the registrant has insight;
• the issues are unlikely to be repeated; and
• there is evidence to suggest the registrant is likely to be able to resolve or remedy their failings.

30. When the Panel considered the factors set out in the bulleted sub-paragraphs of paragraph 121, it was of the view that the circumstances of this case met them. The view that a Suspension Order appeared to be the appropriate sanction was bolstered by the terms of paragraph 124 of the Sanctions Policy, “Short-term suspensions can also be appropriate in cases where there is no ongoing risk of harm, but where further action is required in order to maintain public confidence in our professions.”

31. Before confirming that a Suspension Order was appropriate, the Panel considered whether a Striking off Order should be made. The view of the Panel, confirmed by the bulleted points in paragraph 131 of the Sanctions Policy, was that a Striking off Order would be disproportionately severe.

32. Accordingly, the Panel has determined that a Suspension Order is the appropriate sanction in this case. It is necessary for the Panel to make clear its reasons for that decision. It is imposed not because it expects the Registrant to take active steps during the period of suspension to address the consequences of the conviction. Rather, a Suspension Order is imposed (as paragraph 124 of the Sanctions Policy makes clear it can be) because no lesser sanction would reflect the seriousness of the conviction, and therefore no lesser sanction would serve to maintain the required degree of confidence in the SLT profession or the regulation of it. In all the circumstances, the Panel considers that the appropriate duration of the Suspension Order is 6 months.

33. The Panel is satisfied that a Suspension Order for 6 months represents a proportionate response to the allegation, being a necessary but sufficient sanction.

ORDER: The Registrar is directed to suspend the registration of Linda Joyce for a period of 6 months from the date this Order comes into effect.

Interim Order

Application

1. After the Panel announced its decision that a Suspension Order for 6 months would be imposed, the Presenting Officer applied for an Interim Suspension Order to cover the appeal period. He confined the application to the ground of otherwise in the public interest, submitting that an order made on either of the other grounds that can support an Interim Order would conflict with the decision of the Panel on the substantive issues. He submitted that confidence would be undermined were there to be no restriction while the Registrant’s appeal rights remain outstanding.

2. The Registrant stated that she did not wish to oppose the application.

Decision

3. The Panel accepted the advice it received from the Legal Assessor that the default position established by the legislation governing these proceedings is that when a substantive sanction is imposed there should be no restriction on the registrant’s ability to practise unless and until that registrant’s appeal rights are exhausted. It follows that positive reasons are required to justify departure from this default position. Those reasons are to be measured against the grounds that can justify the imposition of an Interim Order, namely that it is (i) necessary for protection of members of the public, (ii) otherwise in the public interest, or (iii) in the interests of the Registrant.

4. The Panel determined that an Interim Order is required in the public interest. The Panel was satisfied that the proven is so serious that public confidence would be diminished were the Registrant to be able to practise pending the commencement of the substantive Suspension Order.

5. An Interim Order being necessary, the Panel next considered whether the factors requiring it could be satisfactorily addressed by the imposition of interim conditions of practice. The conclusion of the Panel was that they could not. The reason for this decision is the same reason why substantive conditions of practice are not appropriate.

6. For these reasons an Interim Suspension Order is required.

7. As to the duration of the Interim Suspension Order, the Panel determined that it should be for the maximum period of 18 months. If the Registrant does not appeal against the substantive decision and Order there will be no prejudice to her because the Interim Suspension Order will simply fall away when the Suspension Order takes effect. However, if the Registrant does appeal within the 28 day period she has to take that step, the final determination of that appeal could well take 18 months, and for the reasons already expressed, her ability to practise should be restricted pending that final determination.

The Panel makes an Interim Suspension under Article 31(2) of the Health Professions Order 2001, the same being otherwise in the public interest.

This Order will expire: (if no appeal is made against the Panel’s decision and Order) upon the expiry of the period during which such an appeal could be made; (if an appeal is made against the Panel’s decision and Order) the final determination of that appeal, subject to a maximum period of 18 months.

History of Hearings for Ms Linda Joyce