Control over Patients – Implicit Powers – Whether Power to Prevent Publication of Book by Patient - Broadmoor Hospital Authority & Another v R  MHLR 186 CA
Points Arising: A High Secure hospital has a duty to treat patients, maintain security and provide a therapeutic environment; and implicit rights and powers to secure these objectives, including seeking to control events outside the hospital that might impact upon its duties.
Facts and Outcome: R, a patient in a high secure hospital, wrote a book relating to his offence (a homicide), including the justification for it, and gave some details about other patients, their offences and some medical information. The care team was concerned that publication of the book would undermine R’s mental state, cause distress to the family of his victim and the other patients mentioned (who would recognise themselves from the information provided) and might expose R to the risk of assault. The Court of Appeal held, by a majority, that the high secure hospitals had, as part of the duty to treat patients, maintain security and provide a therapeutic environment, certain implicit statutory rights or powers, including the power to seek to restrain activity taking place outside the hospital which is having a sufficiently significant impact on the hospital’s duties, including security or the treatment of a patient (though that would not extend to protecting the privacy of other patients). (Morritt LJ dissented, holding that a power to restrain a fundamental right such as the freedom of speech of R required an express statutory provision.) However, as the test for an injunction was not made out, the High Court judge’s decision to lift an ex parte injunction was upheld: the factors included the lack of evidence that the hospital’s powers would be prejudiced.