Dr Steven Lovett (a protected party by his Deputy Mrs Jill Lovett) v Health and Care Professions Council
| Jurisdiction | England & Wales |
| Judge | Mr Justice Ouseley |
| Judgment Date | 10 May 2018 |
| Neutral Citation | [2018] EWHC 1024 (Admin) |
| Court | Queen's Bench Division (Administrative Court) |
| Docket Number | Case No: CO/2092/2017 |
| Date | 10 May 2018 |
Neutral Citation Number: [2018] EWHC 1024 (Admin)
IN THE HIGH COURT OF JUSTICE
QUEEN'S BENCH DIVISION
ADMINISTRATIVE COURT
Royal Courts of Justice
Strand, London, WC2A 2LL
Mr Justice Ouseley
Case No: CO/2092/2017
Mr Marcus Grant (instructed by DICKINSON SOLICITORS) for the Claimants
Miss Jenni Richards QC (instructed by BIRCHAM DYSON BELL LLP) for the Defendant
Hearing dates: 6, 7, 8 & 9 March 2018
Judgment Approved
This is an appeal against the decision of a Panel of the Conduct and Competence Committee of the Health and Care Professions Council, HCPC, given on 4 April 2017. It had found various allegations of misconduct proved against Dr Lovett, a consultant clinical psychologist, that his fitness to practise was impaired, and that the appropriate sanction was that he should be struck off. The appeal concerns the findings of fact by the Panel on the allegations found proved against him.
The HCPC was established under the Health and Social Work Professions Order 2001, as amended. Practitioner psychologists are one of the many professions it regulates for the protection of the public, the maintenance of public confidence in the profession, and the promotion and maintenance of proper professional standards and conduct for the members of those professions, as set out in article 3(4A). The right of appeal to this Court exercised by Dr Lovett against the Panel's decision striking him off the register is contained in article 29(9).
Dr Lovett qualified in 1984, and had a specialist interest in psychological trauma, the subject of his doctorate. He had held many NHS posts, had advised Government on various issues, and had had a number of academic positions. His career, over 30 or so years, was unblemished. He also suffered from scoliosis, from birth, which had required many operations, and for which he had to take pain killers, as he did during the disciplinary proceedings.
The complainants to the HCPC were twin sisters, A and B, who were referred to him, along with their autistic brother C, in May 2008. The referrals arose out of a very serious road traffic offence in April 2007, which had tragic consequences. B, her daughter and mother, were all together on the way to or from visiting A in hospital, where she was to have her first child. The driver of a bus driving dangerously, killed the mother, almost instantly, and injured B's daughter so seriously that she had to have a leg amputated; B herself was badly injured, with serious scarring and significant deformity as a result. The bus driver contested the criminal trial at which B had to give evidence.
Civil proceedings were commenced by A, B and C, though in the end A had to accept that she had no actionable claim for her anguish; she had not witnessed the killing. The solicitor then acting for A, B and C in those proceedings, Ms Kennedy of Anthony Gold, recommended Dr Lovett to them all, as someone she had worked with in the past and trusted. The referral was for assessment of psychological conditions related to the trauma of the dangerous driving offence, primarily actual or potential post-traumatic stress disorder, PTSD. Although Dr Lovett saw C, and C's relationship to the two sisters is relevant to some of what Dr Lovett said, these proceedings do not directly concern him.
A, B and C had a number of sessions of treatment with Dr Lovett in late 2008–2009; in 2009 the relationships with A and B respectively broke down and the relationship with C ended as well. These sessions had included home visits; A and B sought their medical records from him mainly if not wholly for the purpose of checking invoices which they said Dr Lovett had submitted for sessions not done, and his allegedly double counted travel expenses. When the medical records were eventually disclosed, A and B were greatly angered by the content of two documents, one in A's records, and one in B's, variously described as diagnoses or formulations, which referred to A and B as having personality disorders. A and B complained to the HCPC. They also made complaints on behalf of C, but none feature in the appeal.
These various complaints were considered by the HCPC's Investigating Committee. In March 2012, after considering written submissions on behalf of Dr Lovett, it concluded that there was a case for him to answer, and the particulars were referred to the Conduct and Competence Committee.
The particulars and their terms are relevant to the way in which the proceedings were conducted, progressed and to how the case was argued before me. I set them out.
“Between 2008–2012, whilst practising as a Clinical Psychologist, you:
1. Charged …[A] for treatment sessions on the following dates which did not take place: [6 are listed].
2. Charged…[B] for treatment sessions on the following dates which did not take place: [5 are listed].
3. Charged…[C] for double appointments on several occasions when the session were not double appointments.
4. Arrived late on several occasions for appointments (but on each occasion charged for a full appointment) with [A, B and C].
5. Falsely claimed for travel expenses for visits for purported visits to [B and C] on [16 dates].
6. Did not provide:
[A], her General Practitioner, and/or any other health professional responsible for her care with a copy of her health records;
[B], her General Practitioner, and/or any other health professional responsible for her care with a copy of her health records;
[C-likewise].
7. Made false or unjustified statements to [A's] General Practitioner, to the effect that:
[A] has “underlying psychological problems”; and
“there are numerous safety issues surrounding [A's] psychopathology to herself and others under her care”.
8. Made a false or unjustified statement to [B's] General Practitioner, to the effect that the release of [B's] health records may cause harm.
9. Did not provide [B] with appropriate treatment for post-traumatic stress disorder in that you [did not refer her to a trauma counsellor, or for Cognitive Behaviour Therapy or provide advice in relation to panic attacks].
10. Did not refer [A or B] to the respective General Practitioners.
11. Did not [set the goals of your therapy sessions with A or B].
12. Acted outside the scope of your practice in that, you [provided B with advice in relation to her personal injury claim].
13. Made false or misleading claims in that, you [informed A that you were registered with the GMC, were approved by all major medical insurance company when AXA PPP had revoked recognition, and accused A of making 50 harassing phone calls to you].
14. The matters set out in paragraphs 1,2,3,4,5 and 13a) and b) were dishonest.
15 and 17. [All matters except 9 to 12 amounted to misconduct; 9–12 amounted to lack of competence and/or misconduct].
16 and 18. By reason of that misconduct or lack of competence your fitness to practice is impaired.”
The crucial particulars, upon which this appeal was brought, are particulars 6 to 8.
The Panel found that Dr. Lovett had made statements which he knew to be false in two documents each described as a “diagnosis” or “formulation” of personality disorder, one in respect of A (particular 7) and the other in respect of B (particular 8). He had used those documents as the basis for imposing unjustifiable conditions, unjustifiable because of their falsity, on the disclosure of the medical records of A and B to their GPs (particular 6), in letters of 14 November 2011. One of the themes of Mr Grant, on behalf of Dr. Lovett in this appeal, was the inadequacy of the particulars to convey the actual issues upon which the Panel hearing turned. Mr Grant had not appeared below; there, Dr. Lovett had been represented by three different legal teams, in succession.
It is obvious that, if Dr Lovett, a clinical and treating psychologist, knowingly made false statements about the psychological condition of a patient, in medical records which he had only disclosed, whether to the patient or the General Practitioner, on the basis that care would be taken by other medical professionals in how they were presented to the patient, because of the harm he realised the statements could cause, it was misconduct impairing his fitness to practise, which would inevitably lead to his being struck off.
I shall have to consider how those matters were presented and evolved in the course of recounting the progress of the Panel's hearings and its decision-making. Progress was not smooth. The substantive hearings began on 25 November 2013, after preliminary hearings which had begun a year earlier. On Day 13, 12 December 2013, Dr. Lovett collapsed after the hearing, never to return. His changing medical circumstances led to adjournments, and applications for stays which were partially successful. After a number of adjournments and directions, the final hearing on the facts was on 2 February 2017. The Panel then announced its findings of fact in early March. The further hearings concerned whether the facts found amounted to misconduct, whether fitness to practise was impaired and sanction. Its Final Decision on all issues was dated 4 April 2017. Had it not delivered its decision by July 2017, the process would have had to start all over again, since the retirement of one of its members would have made it inquorate.
Dr Lovett appeals on grounds, which although numbering 32 in the Claim Form, were mostly reformulated by Mr Grant into three very broad main issues. I summarise them as: (1) the Panel's treatment of the psychological evidence about the difference between diagnoses and formulations, the evidence supporting his allegedly fabricated formulations, and the expert evidence about this; (2) the Panel had misunderstood...
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