GENERAL PHARMACEUTICAL COUNCIL FITNESS TO PRACTISE ...

GENERAL PHARMACEUTICAL COUNCILFITNESS TO PRACTISE COMMITTEE129 Lambeth Road, London SE1 7BTThursday 31 May 2012Chairman:Mr Douglas ReadingsCommittee Members:Committee Secretary:Mrs Jillian AlderwickMr Aamer NaeemMr Mark MallinsonCASE OF:SMITH, Christopher Adrian(Registration Number: 2074490)DETERMINATIONSIN PUBLIC__________________________MR MARK MILLIN, Solicitor Advocate, appeared on behalf of the GeneralPharmaceutical Council.MR GRAHAM SOUTHALL-EDWARDS, of PDA, appeared on behalf of MrSmith, who was present.__________________________Transcript of the shorthand notes of T A Reed & Co LtdTel No: 01992 465900___________________________

INDEXPageDetermination on Fact 1Determination on Impairment 1Determination on Sanction 5Determination on Interim Measures 8________________________PLEASE NOTE: Copies printed from email may differ in formatting and/orpage numbering from hard copies

A(The hearing commenced at 09.35 am)DETERMINATION ON FACTBTHE CHAIRMAN: That is very helpful from Mr Edwards. I am required by the Rules toannounce, therefore, that all the facts alleged in the particulars of allegation are proved, and wenow move on to the second stage of the proceedings, which is to consider whether theRegistrant's fitness to practise is impaired.DETERMINATION ON FITNESS TO PRACTISECTHE CHAIRMAN: This is our determination concerning impairment of fitness topractise. The allegation against Mr Christopher Adrian Smith, the Registrant, is setout in the amended particulars of allegation as follows:DEF"That being first registered as a pharmacist on 23 August 2010:1. On unknown dates between 1 July 2008 and 31 July 2009, while employedas a pre-registration pharmacist at St Mary’s Hospital, Isle of Wight, you stolean unknown quantity of Oxycodone, a Schedule 2 Controlled Drug.2. On unknown dates between 1 August 2009 and 14 September 2010, whileemployed as a pre-registration pharmacist with Prior Pharmacy, 2 PrioryRoad, High Wycombe, HP13 6SE you stole an unknown quantity ofControlled Drugs including:(i) Dihydrocodeine tablets;(ii) Buprenorphine tablets;G(iii) Codeine;(iv) Morphine Sulphate ampoules;H(v) Subutex tablets;T A REED& CO LTD01992-4659001

A(vi) Morphine;(vii) Benzodiazepines;B(viii) Methadone.C3. On unknown dates between 1 August 2009 and 14 September 2010, whileemployed as a pre-registration pharmacist with Prior Pharmacy, 2 PrioryRoad, High Wycombe, HP13 6SE you stole an unknown quantity ofGabapentin capsules, a Prescription Only Medicines.D4. On an initial assessment by Dr Sarma on 27 August 2010 Mr Smith testedpositive for:(i) Benzodiazepines;E(ii) Opiates;(iii) Methadone;(iv) Buprenorphine;F(v) Cannabis.5. Your actions as described at 1, 2 and 3 above were:G(i) Inappropriate; and/or(ii) Contrary to Principle 6.5 of the Code of Ethics; and/orH(iii) Dishonest.T A REED& CO LTD01992-4659002

ABy reason of the matter set out above, individually or cumulatively, yourfitness to practise is impaired by reason of (a) misconduct and (b) adversephysical or mental health."BIn a Statement of Defence Case for the Respondent, and formally today through hisrepresentative Mr Southall-Edwards, Mr Smith has made admissions in respect of allthe allegations of fact. I have already announced that the facts alleged are foundproved.CDMr Smith also admits that his fitness to practise is currently impaired by reason ofboth misconduct and adverse health. However, the Committee has heard evidenceand considered that question itself separately in respect of misconduct and adversehealth, because the question whether a Registrant’s fitness to practise is impaired isnot a matter of proof, but is a matter of judgment. It has had regard to the criteriaidentified in Rule 5(2) of the General Pharmaceutical Council (Fitness to PractiseDisqualification etc., Rules) Order of Council 2010.EFMr Smith has admitted that he regularly stole controlled drugs from his employerswhile he was a pre-registration pharmacist. That is plainly misconduct, in the sense ofserious professional misconduct. The Committee considers that by his misconduct MrSmith has brought the profession into disrepute and has demonstrated that hisintegrity cannot be relied upon. He has also breached one of the fundamental tenetsof the profession of pharmacy, which is that a pharmacy professional “must be honestand trustworthy”. That fundamental tenet is embodied in the Sixth Principle of theStandards of Conduct, Ethics and Performance published by the GeneralPharmaceutical Council.GMisconduct which involves dishonesty is not easily susceptible to remediation, andthe Committee has borne in mind the words of Mrs Justice Cox in the case of CHRE vNursing and Midwifery Council and Grant [2011] EWHC 927 (Admin):HT A REED& CO LTD01992-465900“In determining whether a practitioner’s fitness to practise is impaired byreason of misconduct, the relevant Committee should generally consider not3

ABConly whether the practitioner continues to present a risk to members of thepublic in his or her current role, but also whether the need to uphold properprofessional standards and public confidence in the profession would beundermined if a finding of impairment were not made in the particularcircumstances.”The Committee is satisfied that there is a continuing risk to public confidence in theprofession, and there is a continuing need to uphold proper professional standards,and has determined that Mr Smith’s fitness to practise is currently impaired by reasonof misconduct.XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX (Redacted)DThat determines the question of impairment, and we must now go on to considerwhether any, and if so, what sanction is appropriate.EDETERMINATION ON SANCTIONTHE CHAIRMAN: Mr Smith, I see Mr Edwards has gone. I knew about that; I sawhim before he left, and I am sorry it has taken so long.FGHT A REED& CO LTD01992-465900May I tell you immediately that the order we have decided to make is an order for 12months suspension, but it will be reviewed at the end of that time, and at the end ofthat time the Panel has all the powers to do whatever we could have done today. Tobe on the safe side, I had better tell you that one of the things it could do is to removeyou from the Register next time; so, literally all the powers that we have today. Inany event I will now read the determination on sanction which we have come to.The Committee has had regard to the General Pharmaceutical Council’s publishedIndicative Sanctions Guidance. It has borne in mind that the purpose of any sanctionis not to punish the Registrant but to protect the public, to maintain public confidencein the profession and to declare and uphold proper standards of behaviour by membersof the profession.4

ABThe Committee has taken into account the submissions made on behalf of the GeneralPharmaceutical Council and on behalf of Mr Smith. It has had the advantage ofhearing evidence from the Registrant himself, and reading testimonials. It has notedhis admission of the allegations, and expressions of remorse.XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX (Redacted)CDEFThe Committee is concerned about Mr Smith’s failure to be open and honest.XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX (Redacted)He breached the trust of his employers by stealing from them.XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX (Redacted)As the Registrant’s representative has acknowledged, a warning by itself would not besufficient. It is necessary to send a message to the profession and to the public that aprofessional registered pharmacist must be honest and trustworthy, particularly inrelation to controlled drugs.It is not possible to devise any form of conditional registration directed to theRegistrant’s misconduct, which would be appropriate to maintain public confidence inthe profession and adequately uphold proper standards of conduct. Again, MrSouthall-Edwards on behalf of Mr Smith has acknowledged that a conditions ordermight well be insufficient to send to the public and to the profession a sufficientmessage of disapproval.GHT A REED& CO LTD01992-465900The Committee next considered the possibility of a suspension order. Mitigatingfactors which have been advanced are that there is no evidence of actual harm topatients, and there is no criticism of Mr Smith’s clinical competence. There is noprevious disciplinary history in his relatively short professional career, and themisconduct in question has not led to a criminal conviction or a caution.5

ABMr Smith has told the Committee that he has changed his life completely since he wasadmitted to the Register in September 2010, XXXXXXXXXXXXXXX (Redacted)His misconduct and his health condition came to the attention of the Council onlybecause of his decision to seek professional help. That decision demonstrates someinsight into his failings, and the Committee recognises that it is in the public interestthat a professional should not be deterred from seeking professional help by fear ofthe consequences for his livelihood.CDThe Committee has anxiously considered whether the Registrant’s conduct isfundamentally incompatible with continued registration.XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX (Redacted)Accordingly, on balance, the Committee has found that Mr Smith’s misconduct is notfundamentally incompatible with remaining on the Register, and that it is notnecessary or proportionate that he should be removed from the Register.EThe Committee has therefore determined to direct that Mr Smith’s registration shallbe suspended for a period of 12 months. This order will be reviewed by another Panelof the Fitness to Practise Committee before the end of that period. The Panel thenconsidering the case will be assisted by having evidence from Mr Smith:FXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX; (Redacted)GEvidence that he has maintained his knowledge of professional practice;Reports from any employers, whether within the pharmaceutical profession ornot.HT A REED& CO LTD01992-4659006

ABCDI am now going to go into private to read a very short addendum to this. This partwill not be published, and thank you member of the public in question who has kindlyretired.(The hearing went into private session - see separate transcript)RULING ON INTERIM MEASURESTHE CHAIRMAN: That is very helpful, Mr Millin. If he were here, I have no doubtthat Mr Edwards would have said what I have hear him say on other occasions, whichis that there is a statutory right to appeal, and we should keep in mind that the effect ofmaking an order by way of interim measures is to deprive the Registrant of the benefitof the statutory period during which the order is stayed pending appeal. We havediscussed this amongst ourselves, but of course without making any decision in caseyou had anything to say that might take us by surprise. I will just check with themembers whether anything has. No. Very well then.EThis is a determination on the question of an interim order. The Council has appliedfor an order for an interim measure which will cover the period between now and thetime when the period for appealing expires. The Committee has taken into accountthat there is a statutory provision for an appeal.FGHT A REED& CO LTD01992-465900In this case the matter is too grave for there to be any thought of the Registrantreturning to practise during the interim period. The Committee is satisfied that it isnecessary for the protection of members of the public, and is otherwise in the publicinterest, to make an interim order. XXXXXXXXXXXXXXXXXXXXXX (Redacted)it is also in the interests of the Registrant himself.Therefore the Committee will make an order under Article 60, sub-rule (2) of thePharmacy Order 2010, for suspension from the Register forthwith. Mr Smith, thismeans that you cannot practise, and you are suspended as from today. I do not thinkthere is anything else I need to add. You will be notified of all of this in writing, inany event.7

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