January 2011 update
From Mental Health Law Online
Website and CPD
- The January 2011 CPD questionnaire, which is based on the content of this Update, is now available online. See CPD scheme
- The scheme is primarily aimed at mental health solicitors, and is accredited by the SRA. The course will cover LSC category supervisors for their mandatory MHA- and MCA-related CPD hours. It is also suitable for barristers (established practitioners), psychiatrists, social workers and psychiatric nurses. For £50, you can obtain 12 CPD credits. Multiple-choice tests are published monthly and stay online for 12 months, and can be taken at any time during the 12-month subscription.
- See January 2011 chronology for this month's changes to the website in date order.
- On 31/12/10, the website had 918 categorised cases
- SSJ v RB (2010) UKUT 454 (AAC) — (1) The Tribunal may conditionally discharge with conditions which amount to a regime of detention (deprivation of liberty) to any establishment which is not defined as a 'hospital'. [Caution.] (2) The Upper Tribunal will follow High Court decisions unless it is convinced they are wrong, but where highly specialised issues arise the UT may feel less inhibited than the High Court in revisiting the issues.
- TTM v LB Hackney (2011) EWCA Civ 4 — (1) Where a local authority makes an unlawful application to a hospital for the detention of a patient under the MHA, it can be held liable in damages for false imprisonment when its unlawful act directly causes the detention; (2) although the hospital may act lawfully in detaining such a patient under s6(3) (if the application appeared to be duly made) that does not prevent the detention being held to be unlawful from the outset as against the local authority; (3) an application for detention that is made contrary to s11(4) (in the face of the Nearest Relative's objection) is in breach of Article 5(1); (4) Article 5(5) entitles a person detained in breach of Article 5(1) to compensation, and s139(1) (no liability unless bad faith or lack of reasonable care) can be read down so as to allow such a claim to proceed; (5) the word 'practicable' in s12(2) (requiring a recommendation from a doctor with previous acquaintance of the patient if practicable) should be broadly construed; (6) (obiter) a breach of s12(2) does not go to jurisdiction, but is one made in the exercise of that jurisdiction, and as such is less likely to make detention unlawful; (7) on the facts, the local authority was liable in false imprisonment and breach of Article 5 because of the s11(4) breach, and permission was granted under s139(2) for a compensation claim to be pursued, but there was no s12(2) breach because it had been reasonable to obtain two independent opinions from doctors not acquainted with the patient, given the divergence of views between the treating doctors who were.
- DL v South London and Maudsley NHS Foundation Trust (2010) UKUT 455 (AAC) — The Tribunal failed to explain why it rejected medical and social reports which recommended absolute discharge. Their decision was set aside and the case remitted to the First-tier Tribunal for a rehearing.
- CB v Sussex County Council (2010) UKUT 413 (AAC) — (1) Under s25 TCEA 2007 the Upper Tribunal issued a fine of £500, payable within 28 days, for failure to comply with a witness summons issued by the HESC chamber (education jurisdiction). (2) Under s16(3) Contempt of Court Act 1981 the Upper Tribunal specified a term of imprisonment of 7 days if payment was not made within the specified period.
- Re KM; NCC v KM (2009) COP 1145479102 — Consideration of the legal aid position in relation to deprivation of liberty reviews following final hearing.
- Re P (2010) COP 23/12/10 (Mostyn J) — There was effectively a presumption against deprivation of liberty (pursuant to MCA 2005 s1(6)) and, on the facts, the balance tilted in favour of P returning home pending a final hearing at which full evidence could be considered. [Summary based on counsel's case report.]
- Re JP; DP v JCP (2010) COP 11692737 — DP's application to be appointed financial deputy for her father JP was opposed by her siblings, who also disputed DP's claim to the ownership of their mother's ashes. Guidance was given as to the ownership of the ashes. DP was capable of acting as deputy but did not have the necessary independence so a panel deputy was appointed. [Summary based on Eld LJ case report.]
- Re J (2010) COP 6/12/10 — Under MCA 2005 s22(3) ('Powers of court in relation to validity of lasting powers of attorney') the court can consider any past behaviour or apparent prospective behaviour by the attorney (not just behaviour as P's attorney); depending on the circumstances and gravity of any offending behaviour found, it can then take whatever steps it regards as appropriate in P’s best interests (this only arising if P lacks capacity) whether by revoking the power or by taking some other course.
- Re RK; YB v BCC (2010) EWHC 3355 (COP) — (1) Given the terms of s20(8) Children Act 1989 (that any person with parental responsibility may at any time remove the child) the provision of accommodation to a child under s20(1), (3), (4) or (5) will not ever give rise to a deprivation of liberty within the terms of Article 5. If the child is being accommodated under the auspices of a care order, interim or full, or if the child has been placed in secure accommodation under s25, then the position might be different. (2) In any event: (a) the objective element of deprivation of liberty was not remotely close to being met on the facts; (b) the subjective element was not met, as the parents had consented on RK's behalf; (c) RK's placement was at the behest of her parents and could not be imputed to the state. [Detailed summary to follow.]
- R v Inglis (2010) EWCA Crim 2269 — Appeal allowed and retrial ordered on the basis of fresh evidence which showed that the appellant suffered at the time of the killing from bipolar affective disorder and supported a defence of diminished responsibility.
- Salisu v SSH (2011) UKFTT 1 (HESC) — The Applicant was guilty of misconduct within the meaning of Section 86(7)(a) Care Standards Act 2000 (convicted of ill-treatment under s127 MHA 1983) but was not unsuitable to work with vulnerable adults and children under s86(7)(b).
- Francis v GSCC (2010) UKFTT 434 (HESC) — The GSCC had refused to register Francis as a social worker under s58 Care Standards Act 2000 because (a) he had from 2005 to 2006 failed to register as a social worker but continued to act as such, (b) during the same period he had continued to act as an AMHP; (c) he had failed to inform his employer of his personal difficulties, (d) there was no adequate endorsement of his application. His appeal under s68 was dismissed.
- GSCC conduct committee decision: Philip Julian Davies 10/12/10 — Social worker suspended for misconduct for 12 months. Two of the proven allegations were: '(4) Without authority, on or around 18th July 2008, you requested service user Mrs Z to sign financial papers after she had been diagnosed by a consultant psychiatrist as having a lack of mental capacity. (5) Between 20th May 2008 and 30th October 2009, you failed to ensure that an application for a Court of Protection order in respect of a service user Mr Z, was made expeditiously, or at all.'
- TW v A City Council (2011) EWCA Civ 17 — The Court of Appeal issued a reminder of the following: (a) that the bundle of authorities should be agreed; (b) that it should be filed at least seven days before the hearing; (c) that it should not contain more than ten authorities unless the scale of the appeal warrants more extensive citation; (d) that the relevant authorities should be copied from the official law reports, and only if not should reports from the All England Law Reports (All ER) or a specialist law report series be included. In addition, if a case is reported in volume 1 of the Weekly Law Reports that report should be used in preference to the report in the All ER. BAILII judgments (with neutral citation numbers) should only be used if no other recognised reports were available and the case really needs to be cited; and (e) that the passages in the authorities which were relevant and on which counsel sought to rely must be marked.
Case summaries - OPG
- Re Scott (2011) COP 11/1/11 — The donor made an LPA for property and financial affairs, appointing A and B to act jointly and severally. She then imposed the following restriction: "In the event of there being any disagreement between A and B (as the attorneys for property and financial affairs) and C (as the attorney for health and welfare) over expenditure on my health or welfare then C's decision is to prevail." The Public Guardian applied for this restriction to be severed on the basis that Re Reading (above) showed that a donor could not require that a person who was not an attorney under the instrument should join in the making of decisions by the attorneys. The court dismissed the Public Guardian's application, considering that there was no reason in law why the donor of two seperate LPAs should not be able to provide that, in the event of a disagreement between the attorneys for property and financial affairs and the attorney for health and welfare, the decision of the attorney for health and welfare should prevail. [OPG summary - LPA case.]
- Re Stevens (2011) COP 11/1/11 — The donor made an EPA including the following provision: "The word "seasonal" in section 3(5) of the Enduring Powers of Attorney Act 1985 includes the end of one tax year and the beginning of another." On the application of the attorneys the court severed the provision as being ineffective as part of an EPA. [OPG summary - EPA case.]
- Re Harris (2011) COP 6/1/11 — The donor made an EPA purporting to authorise the Attorneys to do the following: "Making a choice on my behalf for any nursing/residential care needed for me in the future." On the application of the Attorneys the court severed the provision on the ground that it would be ineffective as part of an EPA, because it sought to authorise Personal Welfare decision making. [OPG summary - EPA case.]
- Re Donegan (2011) COP 6/1/11 — The donor made an EPA including the following provision: "All the while that I am practically and financially able to remain in my own home my Attorneys should ensure that I remain there. My Attorneys do not have power to sell my home." On the application of the Attorneys the court severed the restriction on the ground that it was ineffective as part of an EPA because it sought to confer Personal Welfare decision making powers on the Attorneys. [OPG summary - EPA case.]
- Re Berg (2010) COP 31/12/10 — The donor made an EPA appointing A and B to act jointly. He then added: "so long as neither Attorney dies or is incapacitated in which eventuality the other Attorney is empowered to act on his own". On the application of the attorneys the court severed the restriction as being incompatible with a joint appointment. [OPG summary - EPA case.]
- Re Haworth (2010) COP 20/12/10 — The donor made an EPA appointing A and B to act jointly and severally. He then imposed the following restriction: "B shall not, while A is alive and mentally capable, without A's consent (a) sell, mortgage, charge, lease, or otherwise dispose of any asset of mine or (b) enter into any transaction with a value of more than £2,000." On the attorneys' application the court severed the restriction as being incompatible with a joint and several appointment. [OPG summary - EPA case.]
- Re Warren (2010) COP 10/12/10 — The donor appointed four attorneys, A, B , C and D, to act jointly for some decisions and jointly and severally for others. She imposed the following restriction: "All decisions will be made by my first attorney A unless and until such time that he no longer has the mental capacity to do so. Should A no longer have the mental capacity to make decisions the remaining attorneys will jointly make decisions regarding the house and property and jointly and severally make decisions concerning finance." On the application of the Public Guardian the words preceding "attorneys will jointly" were severed on the ground that, where attorneys were appointed to act jointly in some matters and jointly and severally in others, it was not open to the donor to provide that one attorney should act alone for so long as he was able to do so. The Senior Judge added that, to have achieved the desired objective, the donor should have appointed A as the sole attorney and the three others as replacement attorneys. [OPG summary - LPA case.]
- Re Weyell (2010) COP 2/12/10 — The donor appointed three attorneys, A, B and C, to act jointly for some decisions and jointly and severally for others. He then imposed the following restrictions: (1) "Two out of three of my attorneys must act jointly in relation to any transaction with a value in excess of £5,000 and my attorneys may act jointly and severally in relation to everything else." (2) "I direct that when acting jointly and severally where possible my attorneys are to act in the following order of priority: firstly A, then B and then C." On the application of the Public Guardian the first restriction was severed as being incompatible with the joint aspect of the appointment. In the application the Public Guardian submitted that, while a direction that attorneys appointed to act jointly and severally must act in an order of priority would normally be regarded as incompatible with a joint and several appointment, the addition of the words "where possible" made the direction in effect a statement of wishes only. The court accepted this submission and did not sever the second restriction. [OPG summary - LPA case.]
- Re Williams (2010) COP 1/12/10 — The donor appointed three attorneys to act jointly. She then added: "The attorneys are only to make decisions jointly and should any of the attorneys die within my lifetime I wish for their personal representative to take over as my attorney in their place." On the application of the Public Guardian the court severed this provision on the ground that section 10(8)(a) of the MCA provided that an LPA instrument could not give the attorney power to appoint a substitute or successor. [Note: The provision could also be viewed as incompatible with the nature of a joint appointment.] [OPG summary - LPA case.]
- Summary already on website: An NHS Foundation Trust v D (2010) EWHC 2535 (COP) — (1) D lacked the capacity to decide on medical treatment for her prolapsed uterus, as she held the delusional belief that her condition was normal and did not require treatment. (2) It was in D's best interests to receive surgery, as if untreated her condition could be life-threatening. (3) The proposed restraint and deprivation of liberty (including a general aesthetic six days before the surgery) was authorised, if absolutely necessary, as being in her best interests. (Summary based on press articles.)
- Summary already on website: R (SP) v SSJ (2010) EWCA Civ 1590 — The Secretary of State for Justice was entitled to rely on a medical recommendation under s47 which did not explicitly address the new 'appropriate treatment' test: (1) his case workers are not concerned to pursue medical reasoning, but only to see whether the expert had given some reasons which they considered adequate and did not conflict with the facts known or the statutory requirements; (2) he was entitled to give the reports a sensible meaning, and to satisfy himself that the 'appropriate treatment' test was met by reference to matters which had been in the report by necessary implication. [Summary based on All ER (D) report of ex tempore judgment]
- Court order added: Public Interest Lawyers v LSC (2010) EWHC 3277 (Admin) — (1) The verification process following the LSC's public law and mental health tendering process fell short of what was required by the Public Contract Regulations 2006. No objection was taken, nor could it be, to self-certification. But the self-certification supervisor forms did not require supervisors to confirm specifically the nature of the employment arrangements between them and the organisation or whether they had complied with the supervision standards set out in the contract, in particular the supervision experience or training course requirement (clause 2.28) and the 1:6 supervisor ratio requirement (clause 2.35). There may therefore be a number of firms with contracts who did not meet the supervision criteria, for example who have an external non-employed supervisor, or a part-time supervisor who is not employed for sufficient hours. The LSC must ensure, within a limited period, that all firms currently comply with the supervision standards; those who do not must have their contracts removed and the matter starts redistributed pro rata. (2) The disability equality duty challenge to the HSH contract under s49A Disability Discrimination Act 1995, as originally raised, was essentially a challenge to the consultation and the formulation of the tender proposals; as it was brought eight months after the proposals were available, it was out of time. However, the outcome of the of the tender exercise was only recently known: in particular, senior psychiatrists had given evidence of the distress changing solicitors would cause to a considerable number of patients in the light of the reduction in number of solicitors with contracts (of 98 existing providers, 43 did not bid; of those who bid, six firms were successful at Ashworth, and five at each of Broadmoor and Rampton). The outcome engaged the s49A duty so the LSC must gather information, consult with interested stakeholders, and have due regard to whether they need to take steps to ameliorate the result of ..→
- R (Guntrip) v SSJ (2010) EWHC 3188 (Admin) — Parole Board Article 5(4) delay case. [Summary required.]
- Re AVS; AVS v A NHS Foundation Trust (2011) EWCA Civ 7 — Court of Appeal refuse permission to appeal from Court of Protection decision in medical treatment case. [Official summary available.]
- Re HM; PM v KH (2010) EWHC 3279 (Fam) — PM sentenced to 4 months' imprisonment for contempt of court. [Summary required.]
- Re HM; PM v KH (2010) EWHC 2107 (Fam) — Costs orders against PM. [Summary required.]
- G v E (2010) EWHC 3385 (Fam) — Costs judgment. "In all the circumstances, I conclude that this is a case for departing from the general rule set out in rule 157 of the Court of Protection rules, and I make an order in the following terms: (1) That the local authority should pay the costs of G, F and E, including pre-litigation costs, up to and including the first day of the hearing before me on 14th January 2010 on an indemnity basis. (2) The local authority shall pay one third of the costs of G, F and E from that date up to and including the hearing on 6 May 2010 on a standard basis. (3) All costs will be subject to a detailed assessment, if not agreed." [Summary required.]
- Health and Social Care Bill 2010-11 — This Bill received Royal Assent on 27/3/12 and is now the Health and Social Care Act 2012. Summary from Parliament website: 'To establish and make provision about a National Health Service Commissioning Board and commissioning consortia and to make other provision about the National Health Service in England; to make provision about public health in the United Kingdom; to make provision about regulating health and adult social care services; to make provision about public involvement in health and social care matters, scrutiny of health matters by local authorities and co-operation between local authorities and commissioners of health care services; to make provision about regulating health and social care workers; to establish and make provision about a National Institute for Health and Care Excellence; to establish and make provision about a Health and Social Care Information Centre and to make other provision about information relating to health or social care matters; to abolish certain public bodies involved in health or social care; to make other provision about health care; and for connected purposes.'
- Practice Direction (Upper Tribunal: Judicial Review Jurisdiction) (2009) 1 WLR 327 — This Practice Direction sets out the JR jurisdiction of the Upper Tribunal.
- Guidance in cases involving protected parties in which the Official Solicitor is being invited to act as guardian ad litem or litigation friend — In relation to Court of Protection welfare (including medical) cases, the guidance states that: (1) consideration should be given to excusing the OS from attendance at directions hearings, particularly where there is a written position statement; (2) unnecessary expert assessments must be avoided; and (3) focussed brevity in report writing is to be preferred over discussion. There is separate guidance for public and private law children’s cases.
- NHS Information Centre, 'Mental Health Bulletin - Fourth report from Mental Health Minimum Dataset (MHMDS) annual returns, 2010' (11/1/11). Two of the key facts are that (1) 'The number of people who spent time in a mental health hospital rose by 5.1 per cent - the first increase in five years'; and (2) 'This rise was due to a 30.1 per cent rise in the number of people being compulsorily detained in hospital under the Mental Health Act, from 32,649 in 2008/9 to 42,479 in 2009/10. Some part of this increase was due to improved recording between 2008/09 and 2009/10, because a small number of trusts failed to provide MHA information in 2008/09. On a like for like basis, excluding the data for trusts that failed to return information in 2008/09, there was an estimated increase of about 17.5 per cent in the number of people being detained under the MHA - from 32,649 to 38,369.' See Statistics
- NHS Information Centre, 'Quarterly analysis of Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) Quarter 2 2010/11', 22/12/10. The summary states that these statistics provide the first official information about authorisations using the legislation. Key facts listed are: (1) the number of authorisations completed was 2,333 in quarter 2; (2) of the total assessments completed in this quarter, a higher proportion were for females than for males; (3) in quarter 2, 76 per cent of assessments were made by local authorities while the rest were made by primary care trusts; (4) the percentage of authorisations granted which led to someone being deprived of their liberty was 54 per cent in quarter 2; (5) at 30 September 2010 1,436 people were subject to such authorisations. See Statistics
Legal Services Commission
- 0n 22/12/10 the LSC published revised Key Performance Indicators which are enforceable under the 2010 Civil Contract. The three KPI aims are (1) quality, (2) access, and (3) cost. The following KPIs apply to mental health: KPI 2A: 'Assessment reductions to be no more than 10% (exceptional cases)', KPI 2B: 'Assessment reductions to be no more than 15% (licensed work)', KPI 2D: 'Fixed Fee Margin 20%', KPI 3: 'NMS usage - providers must use either the minimum contract allocation or at least 85% of their current allocation' (whichever is the greater). The following KPIs do not apply to mental health: KPI 1A: 'Substantive Benefit: Legal Help', KPI 1B: 'Substantive Benefit: CLR and Licensed Work', KPI 1C: 'Post-investigation of proceedings', KPI 1D: 'ADR to be proposed/accepted in no less than 10% of a providers civil representation cases where appropriate', KPI 2C: 'Damages vs. Costs: Damages to be 2:1 the level of costs (net of any costs recovered)'. See the CLS news item, the guidance document and the summary chart. See Legal Aid News
- Bruce Calderwood, Director of Mental Health and Disability, 'Mental Health Act 1983 - proposed amendments in the Health and Social Care Bill 2011' (Dept of Health Dear Colleague Letter, gateway ref 15451, 19/1/11). This sets out changes resulting from: (1) the proposed abolition of PCTs and SHAs; (2) the proposed transfer of the regulation of social workers in England from the General Social Care Council (GSCC) to the Health Professions Council (which is to be renamed the Health and Care Professions Council); (3) the proposed removal of the SOAD requirement for consenting capacitous community patients. See Dept of Health
- 39 Essex Street, 'Court of Protection Newsletter' (issue 5, January 2011). See Court of Protection
- Private Eye, 'Mental Health: Catch 22' (Eye 1277, 10-23 December 2010). This article refers to the situation where Article 5 prevented patients from being discharged from hospital to conditions which amounted to a deprivation of liberty (which is no longer the case following SSJ v RB (2010) UKUT 454 (AAC)). See Mental health law in the media
- Department of Health, 'Reporting the death of a person subject to an authorisation under the Mental Capacity Act Deprivation of Liberty Safeguards' (Gateway ref 15453, 19/1/11). See DOLS
- BBC, 'Care workers use glove puppet to bully elderly women', 6/1/11. This article involves a prosecution under MCA 2005 s44. See Mental health law in the media
- Sally Bradley, 'Court of Protection Update (January 2011)' (Family Law Week, 7/1/11). See Court of Protection
- On 15/12/10 the Dept of Health published 'Liberating the NHS: Legislative framework and next steps' (Cm 7993, 2010). Para 2.53 states: 'Responsibility for commissioning independent mental health advocacy under the Mental Health Act will also move from PCTs to local authorities, together with the role of the supervisory body in respect of hospitals under the Mental Capacity Act deprivation of liberty safeguards. However, owing to its highly specialised nature, mental health advocacy will not be a part of the NHS complaints advocacy services that local authorities will be able to commission from HealthWatch.' See Independent Mental Health Advocate service
- On 23/12/10 the SCIE published the following document: David Thompson, 'Good practice guidance for the commissioning and monitoring of Independent Mental Capacity Advocate services', Social Care Institute for Excellence, October 2009 (updated December 2010). This good practice guide contains: (1) issues to consider when reviewing IMCA contracts; (2) a revised example service specification; (3) suggestions for assessing quality; (4) an example engagement protocol; and (5) suggested tender requirements. See Independent Mental Capacity Advocate service
Courses and conferences
- Northumbria University are running a seminar entitled 'Mental Capacity Act and the Court of Protection' on Wednesday 13/4/11 from 9.30am to 4.00pm. The speakers are DJ Gordon Ashton, DJ Anselm Eldergill, David Hewitt and Helen Kingston. Price £150. See Courses and conferences for brochure.
- Northumbria University are hosting 'The Sixth North East Mental Health Law Conference 2011' on Friday 10/6/11 from 9.00am to 4.30pm. The speakers are Prof Phil Fennell, Kris Gledhill, Judge Edward Jacobs, Mat Kinton, Dr Jorun Rugkasa and Dr Simon Wood. Price £220 (£180 before 21/4/10; £170 for two or more from same company). See Courses and conferences for brochure.