Clarke, R (on the application of) v United Kingdom Central Council for Nursing, Midwifery & Health Visiting

On a statutory appeal from a professional disciplinary committee, the court must conduct a genuine rehearing but should respect the committee’s assessment of witness credibility and its expertise in professional standards and public protection. There is no general duty to give detailed reasons for findings of fact based principally on credibility, although fairness may exceptionally require reasons. A committee may proceed to penalty without an adjournment where the practitioner has had a fair opportunity to provide mitigation and has not sought more time. In assessing sanction, the committee may consider insight, the absence of current references and the seriousness of abuse towards vulnerable patients. Removal from the register may be proportionate even without a fixed period, particularly where restoration remains legally available.

The claimant, a registered mental nurse, appealed against findings of misconduct and his removal from the register by the respondent’s Professional Conduct Committee. Seven charges arose from alleged verbal and physical abuse of vulnerable patients. Four charges were initially found proved, but three were withdrawn when a witness did not attend. The Committee relied on the evidence of one witness, found the remaining charges proved beyond reasonable doubt, and ordered immediate removal without specifying a period.

The appeal challenged the factual findings, the adequacy of the Committee’s reasons, the decision to proceed to penalty without an adjournment, and the proportionality of the sanction.

1. Appeal dismissed. The Committee’s factual findings were reasonably open to it. The evidence involved a direct conflict between the claimant and a witness whom the Committee had seen and heard. The court therefore accorded appropriate respect to the Committee’s assessment of credibility and reliability, while recognising that its appellate jurisdiction remained full: [2001] 1 WLR 1915; [2002] 1 WLR 1691.
2. There was no general duty to give detailed reasons for findings of fact substantially dependent on credibility. The Committee had stated that it found the witness credible and reliable and was sure of the truth of her evidence. The circumstances did not make further reasons necessary for fairness.
3. The Committee acted fairly in proceeding to penalty without an adjournment. The claimant had been able to call evidence, make submissions and raise mitigation. Neither he nor his representative sought time to obtain further material. The Committee was entitled to take the absence of up-to-date references into account.
4. It was also entitled to consider whether the claimant had demonstrated insight into the seriousness of his misconduct. The misconduct involved verbal and physical abuse of particularly vulnerable patients and was properly viewed as serious.
5. Removal from the register without a specified period was not excessive or disproportionate. The court gave appropriate weight to the Committee’s professional expertise but did not defer beyond what the circumstances warranted. The availability of a future application for restoration under Rule 22 was a relevant, though secondary, consideration. The claimant was ordered to pay the respondent’s costs, summarily assessed at £6,293.30.

• Professional Conduct Committee of the Nursing and Midwifery Council: found four charges of misconduct proved and ordered immediate removal from the register without specifying a period.
• High Court (Administrative Court): dismissed the statutory appeal and ordered the claimant to pay the respondent’s costs.