The case of James Rice v Health Professions Council was an appeal to the High Court against the decision of the Conduct and Competence Committee (CCC) of the Health Professions Council (HPC) made on 7 May 2010, by which it directed that Mr Rice, a registered paramedic, be struck off the HPC register.

The case centred on Mr Rice who provided, upon request, out-of-date Diamorphine to a friend (SR) for pain relief. SR subsequently died. On 18 April 2008, Mr Rice was charged with supplying a quantity of Diamorphine, a class A drug, and tried in the Crown Court. A jury found Mr Rice not guilty and he was acquitted. The decision before the CCC however, was that Mr Rice’s fitness to practise was impaired by reason of his misconduct and that the allegation was well-founded. They struck him off the register.

Mr Rice challenged the conclusions of misconduct and impairment of fitness to practice and also the decision as to sanction. Mr Rice argued firstly that the panel misread and misunderstood the information put forward on his behalf; secondly that the panel did not consider all the evidence that was supplied to it at the hearing; and thirdly that it misunderstood the explanation that he gave for his actions.

Mr Justice Lindblom rejected the appeal and in his judgment highlighted key reasons for doing so. Although Mr Rice was acquitted in the criminal court, this did not automatically exonerate him in front of the CCC, and in fact the CCC had a duty to form its own view in deciding whether the allegation was well-founded. Further, the standard of proof was a factor being on the balance of probabilities compared to the higher criminal standard of beyond reasonable doubt. Further, the court must show deference to the CCC panel because they are the specialist tribunal, they had the advantage of hearing from material witnesses on either side and they are better placed to understand the professional standards required of individuals practising within the health professions. Finally, Mr Justice Lindblom was satisfied that the panel’s process in reaching its decisions was sound and there was no reason to question or overturn them.

In short, the purpose of fitness to practice panel proceedings such as these is not to punish the practitioner for past misdoings but to protect the public against the acts and omissions of those who are deemed fit for practice. In this case, factors of public confidence assumed a significant importance in the disciplinary process. Mr Rice failed to understand how serious his actions had been and had failed to appreciate what the consequences of those actions might be. This can only have led the CCC to decide that Mr Rice’s behaviour was fundamentally incompatible with his remaining on the register of paramedics and severe as that might be it was both appropriate and proportionate.