By Richard Digard
LIKE many of you, I’ve been reading with increasing amounts of concern the unfolding case of the conviction, sentencing and probably appeal of two experienced ambulance paramedics for failing to give adequate treatment to a dying man. Unlike most of you, I suspect, my disquiet is that John Sutherland and Tom Le Sauteur are now being treated as martyred heroes.
As things stand, they are neither. Unless or until any appeal hearing clears them (which I think is unlikely, but we’ll come on to that), they have been convicted of pretty substantial failures of care towards a vulnerable patient.
To be very clear, I’m not being judgmental here – the court had that unenviable task – and I sympathise completely with the men, their families and their colleagues. This is an appalling situation that none of them wanted and no doubt bitterly regret.
Stand back a bit, however, remove the emotion and what do you have? A patient who claimed to have taken an overdose, calls an ambulance for medical assistance and dies despite being attended by the two paramedics and two police officers, who were called as back-up.
In such circumstances, an obvious course of action is to have a reflective review of the treatment the patient received, whether it was adequate, if the death could have been prevented and whether anything could be taken away to improve performance in future similar cases.
Instead, the Royal Court of Jersey, its Commissioner and two Jurats now find themselves vilified, virtually accused of operating a kangaroo court and themselves being guilty of committing a gross miscarriage of justice. Well, it’s possible they have done so I suppose, but that may now come out at any appeal court hearing.
Meanwhile, what the facts show so far is quite the reverse. I don’t often find myself writing in support of the judicial system, but the backlash to this case is disturbingly Trumpian – we didn’t get the result we wanted, so it’s wrong and must be overturned.
What I can say with some certainty, having known a couple of Jersey Jurats and many more in Guernsey, is that they undertake their duties with meticulous conscientiousness and would have been well aware of the sensitivities in this particular case.
And even if they were not, the Commissioner, Sir John Saunders, would have been. He became a KC in 1991, a High Court Judge in 2007 and his career has involved many high-profile cases, particularly in the terrorist arena. He chairs the public inquiry into the Manchester Arena Bombing and from November 2016 to January 2020 was vice-chair of the Parole Board of England and Wales, no easy gig that one, and has been very involved in the issues arising from the John Worboys – better known as the black cab rapist – case.
So it is no coincidence that he used the sentencing court last week to provide a fuller explanation, even though none was required, to explain the guilty verdict simply because the court was well aware of the depth of feeling this was likely to provoke, at least in certain areas. As indeed it has.
The other thing to note is that the hearing took place over eight days. It was not treated lightly. I won’t go through the evidence in any detail. To do so and pick up on the elements that led the court to its decision would be distressing for the family and friends of the patient who died because there were multiple points of failure to comment on.
Suffice, however, to repeat Sir John’s words: “At the very least…” he said, “the two defendants should have cleared the [patient’s] airways.”
Pretty standard stuff for trained ambulance officers, you’d think.
In general terms, to secure a conviction requires the prosecution to prove a defendant’s guilt beyond reasonable doubt, ensuring a high level of certainty about the defendant’s culpability while protecting against wrongful convictions. In this case in Jersey, the court had no hesitation in finding there was no reasonable doubt the paramedics failed to take appropriate care.
Well, we’ll see whether an appeal hearing agrees. My expectation that it will is based on courts of appeal generally overturning convictions only if there are substantial reasons to believe a miscarriage of justice has actually occurred, whether that’s due to legal errors, procedural irregularities, new evidence coming to light, or other significant factors affecting the fairness of the earlier hearing. In other words, the bar is pretty high.
I do also see this from the medical profession’s point of view. That using health-and-safety legislation is wrong, that it sets a dangerous precedent – but it also begs a wider question: who polices the paramedics?
My own hands-on experiences in Guernsey show they are not infallible and that the organisation’s first instinct on challenge is aggressive defence. Yes, we have a different set-up to Jersey’s but I assume the training and professional standards are broadly similar – and I wonder whether the cultural outlook is the same as well.
More to the point, users of the system have to have confidence that if something does go wrong, those responsible are held to account and that any deficiencies are swiftly identified and rectified for future users.
This, I think, is the essential paradox of the case. A man dies when, with better, quicker intervention, he might have lived. Yet, as his mum said in a later statement, it felt like it was her son who was on trial.
“One of the overriding feelings was one of intimidation, with the court being packed every day by paramedics in uniform who seemed oblivious to the facts or who were not willing to listen to the facts,” she said. Unsurprisingly, she hopes that some of those attending in support of the paramedics would “reflect on the verdict and agree that the care was totally inadequate”.
Jersey’s chief ambulance officer appeared to acknowledge some of that when he said: “I would like to publicly apologise to Mr Irvine’s family for what happened while he was in our care.” Thereafter, however, his statement was more about supporting his own officers than discussing whether lessons had been learned from what he said was an extremely rare case.
I think that’s unfortunate, especially since the Social Security Minister has announced that there will be a review of health-and-safety legislation in the light of this case, presumably to prevent a similar prosecution in future.
If so, that too is perverse. As I asked earlier, who polices the paramedics? From the response to date, it rather looks like the establishment will move to protect its own while leaving anyone with serious concerns or who was genuinely failed by the system treated as voiceless victims.
