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Table structure:

  • Sentence - Wikitext
  • Summary - Wikitext
  • Detail - Text
  • Subject - List of String
  • Judicial_history - Wikitext
  • Judicial_history_first_page - Page
  • Date - Date
  • Judges - List of String
  • Parties - List of String
  • Court - String
  • NCN - String
  • MHLR - String
  • ICLR - String
  • Essex - String
  • Essex_issue - String
  • Essex_page - String
  • Other_citations - List of String
  • Cites - List of String
  • External_links - Text
  • Judgment - File

This table has 246 rows altogether.

Page Sentence Summary Detail Subject Judicial history Judicial history first page Date Judges Parties Court NCN MHLR ICLR Essex Essex issue Essex page Other citations Cites External links Judgment
A City Council v LS (2019) EWHC 1384 (Fam)

Secure accommodation and inherent jurisdiction

"Does the High Court have power under its inherent jurisdiction, upon the application of a local authority, to authorise the placement in secure accommodation of a 17 year old child who is not looked after by that local authority within the meaning of s 22(1) of the Children Act 1989, whose parent objects to that course of action, but who is demonstrably at grave risk of serious, and possibly fatal harm. I am satisfied that the answer is 'no'."

Inherent jurisdiction cases 2019-06-04 MacDonald A City Council LS RE KS High Court (Family Division) [2019] EWHC 1384 (Fam) [2019] WLR(D) 316 [2019] 3 WLR 475 [2020] Fam 28
A Clinical Commissioning Group v P (2019) EWCOP 18

Withdrawal of CANH

"Having given anxious consideration to this very sad case, and with profound regret, for the reasons set out above I am satisfied this court should declare that P lacks capacity to make decisions regarding CANH. Further, in circumstances where I have concluded that P lacks capacity to decide for herself whether or not to continue to receive CANH, I am satisfied that it is in P's best interests to consent on her behalf to the withdrawal of that treatment, a step that I acknowledge will result in her death. ... In all the circumstances, I am satisfied that the sanctity of P's life should now give way to what I am satisfied was her settled view on the decision before the court prior to the fateful day of her overdose in April 2014."

Medical treatment cases 2019-05-22 MacDonald A Clinical Commissioning Group P TD Court of Protection [2019] EWCOP 18
A Healthcare and B NHS Trust v CC (2020) EWHC 574 (Fam)

Haemodialysis under s63 MHA 1983

"By reason of the above, the Court finds that: (i) The physical condition CC is now in, by which dialysis is critical to keep him alive, is properly described as a manifestation of his mental disorder. There is a very real prospect that if he was not mentally ill he would self-care in a way that would have not led to the need for dialysis. Further, CC's refusal of dialysis is very obviously a manifestation of his mental disorder and dialysis treatment is therefore treatment within the scope of section 63 MHA 1983. (ii) CC's capacity to consent to dialysis treatment fluctuates, however his consent is not required in order to be treated, by way of dialysis treatment, under section 63 MHA 1983. (iii) The decision whether it is in CC's best interests to receive dialysis treatment is a matter for CC's responsible clinician (having consulted clinicians attending to his physical health, including the consultant nephrologist), subject to the supervisory jurisdiction of the Court. (iv) Section 58 has no applicability. Section 62 disapplies section 58 in urgent treatment cases such as this where treatment is immediately necessary to save CC's life, to prevent a serious deterioration of his condition, and to alleviate serious suffering. Section 63 is the appropriate course. (v) As section 63 MHA 1983 can be used as authority to provide medical treatment to CC, including by dialysis treatment and by the use of light physical restraint and chemical restraint (if required), it is unnecessary for the court to exercise its discretion and make a contingent declaration pursuant to section 15(1)(c) MCA 2005 that it is lawful to treat CC in accordance with the proposed dialysis treatment plan in the event that he lacks capacity to make a decision regarding dialysis treatment at the relevant time."

Medical treatment cases 2020-03-11 Lieven A Healthcare B NHS Trust CC High Court (Family Division) [2020] EWHC 574 (Fam) JK v A Local Health Board (2019) EWHC 67 (Fam)
A Local Authority v AT and FE (2017) EWHC 2458 (Fam)

Child, no approved secure accommodation available, deprivation of liberty

"Section 25 of the Children Act 1989 makes express and detailed provision for the making of what are known as secure accommodation orders. Such orders may be made and, indeed, frequently are made by courts, including courts composed of lay magistrates. It is not necessary to apply to the High Court for a secure accommodation order. However, as no approved secure accommodation was available, the local authority required the authorisation of a court for the inevitable deprivation of liberty of the child which would be involved. It appears that currently such authorisation can only be given by the High Court in exercise of its inherent jurisdiction. ... I am increasingly concerned that the device of resort to the inherent jurisdiction of the High Court is operating to by-pass the important safeguard under the regulations of approval by the Secretary of State of establishments used as secure accommodation. ... In my own experience it is most unusual that a secure accommodation order could be made without the attendance of the child if of sufficient age and if he wished to attend, and without the child being properly legally represented. It is true, as Mr Flood says, that this is not an application for a secure accommodation order, but the analogy is a very close one. Indeed, the only reason why a secure accommodation order is not being applied for is because an approved secure accommodation unit is not available. It seems to me, therefore, that the statutory safeguards within section 25 should not be outflanked or sidestepped simply because a local authority have been forced, due to lack of available resources, to apply for the exercise of the inherent jurisdiction of this court rather than the statutory order. ... I propose to order that the child now be joined as a party to these proceedings and Cafcass must forthwith allocate a guardian to act on his behalf. ... In my view it is very important that ordinarily in these situations, which in plain language involve a child being 'locked up', the child concerned should, if he wishes, have an opportunity to attend a court hearing. The exception to that is clearly if the child is so troubled that it would be damaging to his health, wellbeing or emotional stability to do so."

Deprivation of liberty - children 2017-09-14 Holman A Local Authority AT FE High Court (Family Division) [2017] EWHC 2458 (Fam) [2017] MHLO 32
A Local Authority v BF (2018) EWCA Civ 2962

Inherent jurisdiction to authorise DOL of vulnerable adult

An interim order made on 10/12/18 required BF to reside at a care home, over Christmas, and not at his own or his son's home, despite BF's having capacity to make decisions about his residence and wanting to return home. The order was expressed to last until a further hearing to take place no later than 31/1/19 (later fixed for 16/1/19) when the judge could hear full argument on what relief could be granted pursuant to the inherent jurisdiction. The local authority appealed on the basis that the order infringed Article 5. Permission to appeal was refused: (1) BF is a vulnerable adult (old, blind, infirm, in a squalid and dangerous home, with undue influence present in relationship with son) who needs protection despite not lacking capacity. (2) The test of "unsound mind" is different from the test of capacity, and there is prima facie evidence that he may be of unsound mind. (3) In an emergency situation, someone may be deprived of their liberty in the absence of evidence of mental disorder without infringing Article 5 (Winterwerp); even if BF is found not to be of unsound mind, his vulnerability is such that he could not be returned home without careful planning, which is a crucial component of the protection afforded by the inherent jurisdiction.

==Note== This is a surprising decision on both the "unsoundness of mind" and "emergency situation" fronts. This permission judgment of 21/12/18 was published on 21/1/19. The judgments from the 10/12/18 and 16/1/19 hearings have not been published (at the time of writing) but the judgment from a hearing on 4/2/19 is available: [[Southend-On-Sea Borough Council v Meyers (2019) EWHC 399 (Fam)]]. Inherent jurisdiction cases 2018-12-21 Baker A Local Authority BF Court of Appeal [2018] EWCA Civ 2962
A Local Authority v JB (2020) EWCA Civ 735

Capacity and sexual relations

"The issue arising on this appeal is whether a person, in order to have capacity to decide to have sexual relations with another person, needs to understand that the other person must at all times be consenting to sexual relations."

Capacity to consent to sexual relations 2020-06-11 MacFarlane Singh Baker A Local Authority JB Court of Appeal (Civil Division) [2020] EWCA Civ 735
ABC v St George's Healthcare NHS Trust (2015) EWHC 1394 (QB)

Disclosure of patient's medical information

The claimant's father had killed his wife, was detained under s37/41, and refused to allow the Trust to inform his pregnant daughter of his Huntingdon's disease diagnosis. She claimed that the failure to inform her: (a) was negligent and breached Article 8; and (b) had caused psychiatric damage, and (if her daughter also has the disease) additional expense which she would have avoided by an abortion. Her claim was struck out.

Miscellaneous 2015-05-19 Nicol ABC St George's Healthcare NHS Trust South West London and St George's Mental Health NHS Trust Sussex Partnership NHS Foundation Trust High Court (Queen's Bench Division) [2015] EWHC 1394 (QB) [2015] MHLO 39
ABC v St George's Healthcare NHS Trust (2017) EWCA Civ 336

Disclosure of patient's medical information

"The Claimant alleges that the particular circumstances of her case mean that the Defendants owed her a duty of care. She says it was critical that she should be informed of her father's diagnosis, firstly presumed and subsequently confirmed, in the light of her pregnancy. This was her first and only child. It was all along known that she would be a single mother with sole responsibility for the upbringing of the child. If informed of her father's diagnosis she would have sought to be tested for Huntington's Disease. If her own diagnosis was confirmed, she would have terminated the pregnancy rather than run the risk that her child might in due course be dependent on a seriously ill single parent or become an orphan, and the risk that in due course her child might inherit the disease. Her diagnosis would have precluded any subsequent pregnancy. The claim therefore includes a 'wrongful birth' claim in respect of the child. The child has an accepted risk of 50 per cent of contracting the disease, but it is not yet possible to reach a diagnosis in her case, one way or another."

Miscellaneous 2017-05-16 Gloster ABC St George's Healthcare NHS Trust South West London and St George's Mental Health NHS Trust Sussex Partnership NHS Foundation Trust Court of Appeal (Civil Division) [2017] EWCA Civ 336 [2017] MHLO 19
ABC v St George's Healthcare NHS Trust (2020) EWHC 455 (QB)

Disclosure of patient's medical information

"By this claim brought against three NHS trusts, the claimant contends that the defendants breached a duty of care owed to her and/or acted contrary to her rights under Article 8 of the European Convention on Human Rights in failing to alert her to the risk that she had inherited the gene for Huntington's disease in time for her to terminate her pregnancy."

Miscellaneous 2020-02-28 Yip ABC St George's Healthcare NHS Trust South West London and St George's Mental Health NHS Trust Sussex Partnership NHS Foundation Trust High Court (Queen's Bench Division) [2020] EWHC 455 (QB)
AD'A v Cornwall Partnership NHS Foundation Trust (2020) UKUT 110 (AAC)

Change in status - s3 to guardianship

When the patient had been transferred from s3 detention to s7 guardianship, the tribunal had been wrong to strike out her case for want of jurisdiction. The tribunal's jurisdiction arose from the s3 application, and none of the subsequent changes (including a new right to apply to tribunal, different tribunal powers, and different parties) affected that jurisdiction.

==Thanks== Thanks to Ben Conroy (Conroys Solicitors) and Roger Pezzani (Garden Court Chambers) for sending the written judgment. ==Note== The judgment lists the respondent as "Cornwall Partnership NHS Trust". Change of status after application made Upper Tribunal decisions 2020-03-30 Jacobs AD'A Cornwall Partnership NHS Foundation Trust Upper Tribunal [2020] UKUT 110 (AAC) R (SR) v MHRT (2005) EWHC 2923 (Admin)
(2020) UKUT 110 (AAC).pdf
AM (Afghanistan) v SSHD (2017) EWCA Civ 1123

Immigration tribunal - fair hearing, litigation friends

In this judgment the Court of Appeal gave guidance on the general approach to be adopted in FTT and UT immigration and asylum cases to the fair determination of claims for asylum from children, young people and other incapacitated or vulnerable persons whose ability to effectively participate in proceedings may be limited. In relation to litigation friends, despite there being no provision in the tribunal rules for litigation friends, the court decided that: "[T]here is ample flexibility in the tribunal rules to permit a tribunal to appoint a litigation friend in the rare circumstance that the child or incapacitated adult would not be able to represent him/herself and obtain effective access to justice without such a step being taken. In the alternative, even if the tribunal rules are not broad enough to confer that power, the overriding objective in the context of natural justice requires the same conclusion to be reached."

Litigation friend cases Repatriation cases 2017-07-27 Gross Ernest Ryder Underhill AM (Afghanistan) Secretary of State for the Home Department Lord Chancellor Court of Appeal (Civil Division) [2017] EWCA Civ 1123 [2017] WLR(D) 527 [2017] CP Rep 41 [2017] Imm AR 6 [2017] INLR 839 [2018] 2 All ER 350 [2017] Imm AR 1508 [2018] 4 WLR 78
An NHS Foundation Trust v AB (2019) EWCOP 26

Abortion

"This is an application by the NHS Trust for an order in respect of a 24 year old woman AB who is 22 weeks pregnant and, who the Trust say lacks capacity and in whose best interests it is said to have a termination of pregnancy. ... I would like to record my unhappiness about the lateness of this application. AB is now estimated to be 22 weeks pregnant and therefore the cut-off date under the Abortion Act 1967 of 24 weeks is imminent. ... I am acutely conscious of the fact that for the state to order someone to have a termination, where it appears that they do not want it, is immensely intrusive and certainly interferes with her Article 8 rights. ... In my view the balance in terms of AB's best interests lies in her having the termination."

Medical treatment cases 2019-06-21 Lieven An NHS Foundation Trust AB CD A Local Authority Court of Protection [2019] EWCOP 26
Application by Darlington Borough Council in respect of the Adult: AB (2018) ScotSC 4

Scottish capacity case

"The adult, AB, lacks capacity to make decisions as to her care and residence and is subject to Orders made by the Court of Protection in England. During 2017 the Court of Protection decided that it would be in AB’s best interests to move from a care home in Darlington (hereafter referred to as “the English Care Home”) to a care home within the Sheriffdom (hereafter referred to as “the Scottish Care Home”) for a trial period. ... A Summary Application was subsequently submitted to Glasgow Sheriff Court in which the Applicants sought two Orders from the court. Firstly, the Applicants sought an Order under paragraph 7(1) of Schedule 3 to the Adults with Incapacity (Scotland) Act 2000 (hereafter “the 2000 Act”), recognising the Order of the Court of Protection dated 27 April 2017. Secondly, the Applicants sought an Order under paragraph 8(1) of said Schedule 3, directing the Office of the Public Guardian in Scotland to register said Order of the Court of Protection dated 27 April 2017 in the Register of International Measures maintained by the Public Guardian."

Other capacity cases 2018-01-19 A M Mackie Darlington Borough Council AB Scottish Sheriff Court (2018) ScotSC 4 [2018] SC GLA 4 [2018] SC 4
Ardron v Sussex Partnership NHS Foundation Trust (2018) EWHC 3157 (QB)

"The Claimant, Dr. Caroline Ardron, is a very experienced consultant psychiatrist employed by the Defendant [Trust]. The Trust considers it appropriate for Dr. Ardron to face disciplinary proceedings for alleged gross misconduct relating to her work at HMP Lewes in late 2015 and early 2016. At that time, Dr. Ardron was the responsible clinician of a young prisoner known as JO, who committed suicide by hanging himself on 12 February 2016. The proposed disciplinary proceedings relate, almost exclusively, to Dr. Ardron's care of JO including her record-keeping in that respect. Dr. Ardron does not suggest that disciplinary proceedings are inappropriate as a matter of principle, or that there is no case of misconduct that could be brought against her. However, she contends that there is no basis for a charge of gross misconduct; a charge which, if established, could potentially lead to the termination of her contract and serious ramifications for her including her prospects of obtaining subsequent employment. On 18 June 2018, an interlocutory injunction was granted by Mr. Pushpinder Saini QC, sitting as a Deputy Judge of the High Court, which restrained the Trust from proceeding until further order with a disciplinary hearing into gross misconduct. The question for resolution now is whether that injunction should be made permanent. That issue depends upon whether Dr. Ardron can prove that the Trust will breach her contract of employment by holding the proposed disciplinary hearing on a charge of gross misconduct. The Trust's intention to proceed to such a hearing was communicated in its letter to Dr. Ardron dated 20 March 2018, and the issue is therefore whether the Trust should be prevented from operating on the basis of that letter. The resolution of that issue depends principally upon the question of whether the facts found in an investigation into Dr. Ardron's conduct could, taken at their highest, amount to gross misconduct."

Miscellaneous 2018-11-20 Richard Jacobs Dr Caroline Jane Ardron Sussex Partnership NHS Foundation Trust High Court (Queen's Bench Division) [2018] EWHC 3157 (QB)
ARF v SSHD (2017) EWHC 10 (QB), (2017) MHLO 17

Damages for unlawful immigration detention

"In this case the Claimant claims damages for unlawful detention between 31 August 2011 and 22 January 2014 (save for a period when she was in prison on remand between 25 October 2011 and 15 December 2011). She was detained by the Defendant under section 2 (2) and (3) of Schedule 3 to the Immigration Act 1971 throughout this period pending the making and enforcement of a deportation order. She was detained in two psychiatric facilities following her transfer pursuant to section 48 of the Mental Health Act 1983 between 11 October 2012 and 22 January 2014. Although initially disputed, the Defendant now accepts that when she was detained under the mental health legislation the Claimant was simultaneously detained under her immigration powers. The Claimant argues that her total period of detention was unlawful and puts forward four bases for this contention. Firstly, at common law pursuant to the Hardial Singh principles it is argued that: she was detained when there was no reasonable prospect of her deportation; she was detained for longer than necessary; and no steps were taken to expedite her deportation. Secondly, it is argued that there was a public law error in the failure to apply policy properly or at all under Chapter 55.10 (Enforcement Instructions and Guidance) primarily because the Claimant was suffering from a serious mental illness, but also because there was evidence that she had been both trafficked and tortured and so should have been considered suitable for detention only in very exceptional circumstances. Thirdly, it is argued that the circumstances of her detention whilst suffering severe mental illness gave rise to breaches of the Claimant's human rights under Articles 3 and 8. Finally, it is argued that the report of trafficking was not investigated timeously or at all such as to give rise to a breach of Article 4."

Repatriation cases 2017-01-12 Coe ARF Secretary of State for the Home Department High Court (Queen's Bench Division) [2017] EWHC 10 (QB)
Atudorei v Romania 50131/08 (2014) ECHR 947

DOL damages

Breach of Articles 5 and 8, but not Article 8, relating to hospital admission.

Deprivation of liberty 2014-09-16 Josep Casadevall Alvina Gyulumyan Jan Sikuta Luis Lopez Guerra Johannes Silvis Valeriu Gritco Iulia Antoanella Motoc Fatos Araci Atudorei Romania European Court of Human Rights [2014] ECHR 947 [2018] MHLR 1
B v A Local Authority (2019) EWCA Civ 913

(1) Overlap between different decisions; (2) Sex

(1) "The important questions on these appeals are as to the factors relevant to making the determinations of capacity which are under challenge and as to the approach to assessment of capacity when the absence of capacity to make a particular decision would conflict with a conclusion that there is capacity to make some other decision." (2) The Court of Appeal also decided on what is necessary to have capacity to consent to sexual relations.

Capacity to consent to sexual relations 2019-06-11 Etherton King Leggatt B A Local Authority Court of Appeal (Civil Division) [2019] EWCA Civ 913 [2019] WLR (D) 330 [2019] 3 WLR 685 [2020] Fam 105 [2019] Med LR 371
BA v SSHD (2017) UKAITUR IA343212013

Article 3 immigration case

"The Appellant is a citizen of Nigeria born on 26th February 1980. His appeal against a refusal to vary leave was allowed by First-tier Tribunal Judge Abebrese on Article 8 grounds on 23 rd May 2016. ... The Appellant sought permission to appeal against the Article 3 findings only ... On the basis of the factual findings, the opinion in the Amnesty International Report and the opinion of Dr Bell, the Appellant is likely to suffer a breakdown at some point on return to Nigeria whether that be at the airport or some time later. He is likely to come to the attention of the police if he has such a breakdown and he would not be able to access the psychiatric hospital in Lagos because he is unable to afford treatment there. Accordingly, it is likely that he would be held in prison where the conditions for this particular Appellant with his particular condition would result in treatment in breach of Article 3. ... The Applicant would not be at risk of Article 3 treatment because of a heightened risk of suicide. He would, however, be at risk of inhuman and degrading treatment in breach of Article 3 because of the conditions of return. ... The medical evidence indicates that the Appellant is vulnerable to relapse even in the UK and without the threat of removal. His removal to Nigeria is likely to trigger a relapse and his behaviour will draw hostile attention. His treatment by the authorities in detaining him under the Lunacy Act 1958 would amount to inhuman and degrading treatment. There is a reasonable degree of likelihood that he would be detained in a prison, there would be no treatment for his mental health, his situation would deteriorate, the length of detention is indeterminate, there is no right of appeal and there is no requirement for him to consent to treatment. Accordingly, I allow the Appellant's appeal on Article 3 grounds."

Repatriation cases 2017-05-12 Frances BA Secretary of State for the Home Department Upper Tribunal (Immigration and Asylum Chamber) [2017] UKAITUR IA343212013 [2017] MHLO 26
Bassetlaw CCG (19 006 727a) and Nottinghamshire Healthcare NHS Foundation Trust (19 006 727b) (2019) MHLO 67 (LGSCO)

Complaint not upheld by LGSCO

LGSCO summary: "The Ombudsmen found no fault by the Council, Trust or CCG with regards to the care and support they provided to a woman with mental health problems. The Ombudsmen did find fault with a risk assessment the Trust completed. However, we are satisfied this did not have a significant impact on the care the Trust provided."

LGO decisions 2019-12-20 Nottinghamshire Healthcare NHS Foundation Trust Bassetlaw Clinical Commissioning Group Local Government and Social Care Ombudsman
Blavo and Co Solicitors (SRA decision: closure) (2015) MHLO 70

Reasons for closure of Blavo & Co Solicitors

The SRA closed down Blavo & Co Solicitors and suspended John Blavo's practising certificate, giving the following reasons: (a) there is reason to suspect dishonesty of the part of a manager or employee of Blavo & Co Solicitors Limited; (b) there is reason to suspect dishonesty on the part of John Blavo in connection with his practice; (c) to protect the interests of clients of Blavo & Co Solicitors Limited.

SRA decisions 2015-10-14 Solicitors Regulation Authority [2015] MHLO 70
BP v London Borough of Harrow (2019) EWCOP 20

Costs in s21A case

"The relevant circumstances of the adjournment of the January hearing are that the Respondent, the London Borough of Harrow, offered at the hearing a trial of BP returning home. ... For the Applicant, it is submitted that this is a case where it is appropriate to depart from the usual costs rule and to order the costs of the January hearing be paid by the Respondent because of the Respondent's consistent failure to offer a trial period at home before the start of and for the duration of the proceedings, and its decision to do so only after the January hearing had commenced. ... Overall, I can see the basis on which the Applicant considers an application for costs to be justified. However, this was a finely balanced case on the Applicant's own submissions in position statements, in particular that of 15 June 2018. I bear in mind the authorities on which the parties rely, in particular the Applicant's reliance on the comments of Hooper LJ in the Court of Appeal. I note the circumstances of Manchester City Council v. G, E and F [2010] EWHC 3385 were quite different. On balance and considering the circumstances as a whole, I am not persuaded that it is appropriate to depart from the general rule on this occasion. I decide this based on the chronological position of the parties set out above and all the circumstances. The Respondent's conduct falls short, to what degree is immaterial, of the necessary test. This case does not represent a blatant disregard of the processes of the Act and the Respondent's obligation to respect BP's rights under ECHR as in the Manchester case (paraphrased slightly)."

COP costs cases 2019-06-14 Sarah Ellington Court of Protection [2019] EWCOP 20
Buckinghamshire County Council v RT (2018) EWCOP 12

DOL - 17-year-old

"I am concerned with a young man who is now 17 ½ years old and who I shall refer to as RT in this judgement. ... RT's behavioural issues are such that it is no longer safe for him at home with his adoptive parents and siblings. The local authority have therefore applied under the Mental Capacity Act 2005 for an order pursuant to section 4 and 16 of that act to deprive RT of his liberty so that he may be placed at [a place]. The arrangements for his care at that placement involve 2:1 supervision during the day and one to one at night. ... Is clear that the arrangements set out in the care plan amounts to a deprivation of liberty within the 'Storck' and Cheshire West cases. The level of supervision described is far in excess of that which might be applied to even the most unruly 17-year-old in a domestic setting. It clearly amounts to continuous supervision and control. ... It is very clear that it is RT's best interests to remain in an environment in which he can be protected from his own impulsivity and where others are protected. The very high levels of supervision are necessary and proportionate in the particular circumstances of this case. He needs intensive support and therapeutic input in order to reduce the risks he faces. This will not be a short-term recess but is likely to take months if not years. I therefore will make a deprivation of liberty order for one year. RT's 18th birthday is clearly a milestone for any teenager but I think has particular significance for RT. I will therefore list a review shortly before his 18th birthday which in particular will enable him to have a say at that point."

Deprivation of liberty - children 2018-04-23 Wiliams Buckinghamshire County Council RT Court of Protection [2018] EWCOP 12 [2018] EWCOP B12
Cardiff and Vale University Health Board v P (2020) EWCOP 8

Dental treatment - delay

"It might seem, from the above account, that some dental assessment was required quickly and now as long ago as November or early December 2019. Plainly, it was. But the application was only made by the Health Board on 20th February 2020. The proposed inspection and/or treatment is not to take place until early March. For anybody who has had toothache, even delay between now and then looks like an eternity. But this young man, it seems, has been suffering, and significantly so, for nearly five months. This is little short of an outrage. It is indefensible. ... An additional complication arose in November when P was taken to the local A&E by his parents with an obvious bruise to his forehead. They believed that his behaviour was so markedly changed that they feared he had some sort of concussion and may have fractured his skull. It is, to my mind, self-evident that there was an urgent medical emergency that should have been investigated within hours or days, but in fact there has, as yet, been no CT scan at all. ... It is, sadly, yet again, a situation in which there has been a fundamental failure to communicate effectively by those responsible for P's care. This message has now been the conclusion of so many reviews, including serious case reviews, that it has become almost trite. There is no point identifying lessons to be learned if they are not, in fact, learned."

Medical treatment cases 2020-02-21 Hayden Cardiff and Vale University Health Board P Court of Protection [2020] EWCOP 8 102 16
Cash v Court of First Instance, Strasbourg, France (2018) EWHC 579 (Admin)

Extradition

"At the conclusion of the hearing on 13 March 2018 I allowed the Appellant's appeal and quashed the extradition order made by District Judge Grant on 15 March 2017. I did so on the grounds that it would be unjust and oppressive to extradite the Appellant because he is currently unfit to stand trial and is seriously mentally ill with paranoid schizophrenia, and thus the judge should have decided that extradition is barred by s 25 of the Extradition Act 2003."

Repatriation cases 2018-03-21 Julian Knowles Michael Cash Court of First Instance (Strasbourg - France) High Court (Administrative Court) [2018] EWHC 579 (Admin)
CB v Medway Council (2019) EWCOP 5

Unfair summary disposal of DOL/residence case

"The simple issue is whether the Judge had sufficient information before her to discount, at this stage, any real possibility of CB returning to her home, supported by the extensive and expensive care package that is being mooted. The language of the Judgment itself, to my mind, answers this question in phrases such as “I very much doubt…. I am very sceptical…. The practicalities are…. likely to be extremely difficult….” I share the Judge’s scepticism and I also very much doubt that even with an extensive package of support a return home will be in CB’s best interest. I note too that Dr Ajiteru expressed himself in cautious terms (see para 10 above). However, scepticism and “doubt” is not sufficient to discount a proper enquiry in to such a fundamental issue of individual liberty. ... It is easy to see why the Judge took the course she did and I have a good deal of sympathy with her. She will have recognised, as do I, that the effluxion of time has had its own impact on the viability of the options in this case. However, what is involved here is nothing less than CB’s liberty. Curtailing, restricting or depriving any adult of such a fundamental freedom will always require cogent evidence and proper enquiry. I cannot envisage any circumstances where it would be right to determine such issues on the basis of speculation and general experience in other cases."

Deprivation of liberty 2019-03-06 Hayden CB Medway Council CM Court of Protection [2019] EWCOP 5
CB v SSWP (2020) UKUT 15 (AAC)

All-male and all-female panels

(1) It was unlawful of the tribunal to hear the ESA appeal in the applicant's absence; the decision was set aside and the case remitted to a new panel. (2) The judgment contains obiter comments about the request for an all-female panel.

==Thanks== Thanks to Angela Wall of Butler Solicitors for pointing out this case. She recently had a case in which several requests for an all-female panel were declined, but on review the MHT cited this UT decision and accepted that an all-female panel was required in order for the patient fully to participate in the hearing. ==Judicial summary== From Gov.uk website: Employment Support Allowance - tribunal deciding to proceed in absence of appellant - appellant with gynaecological problems and difficulties with bowel movements requesting all-female First-tier Tribunal panel - principles governing composition of tribunal - overriding objective. Miscellaneous 2020-01-09 Wikeley CB Secretary of State for Work and Pensions Upper Tribunal [2020] UKUT 15 (AAC)
CD v London Borough of Croydon (2019) EWHC 2943 (Fam)

Inherent jurisdiction or s48 interim order

(1) Cobb J discussed the inherent jurisdiction, setting out the following summary: (a) first the inherent jurisdiction may be deployed for the protection of vulnerable adults, (b) secondly in some cases a vulnerable adult may not be incapacitated within the meaning of the 2005 Mental Capacity Act but may nevertheless be protected under the inherent jurisdiction; (c) third that in some of those cases capacitous individuals may be of unsound mind within the meaning of article 5(i)(e) of the European Rights Convention; (d) fourth, in exercising my powers under the inherent jurisdiction I am bound by the European Convention and the case law under the convention and must only impose orders that are necessary and proportionate and at all times have proper regard to the personal autonomy of the individual; and (e) fifth and finally, that in certain circumstances it may be appropriate for a court to take or maintain interim protective measures while carrying out all necessary investigations. (2) In the end he made an interim order under MCA 2005 s48 enabling the Local Authority to gain access to CD's accommodation in order to provide appropriate care and make it safe for human habitation. (3) CD was a vulnerable adult but the order was made under the MCA because the judge was "satisfied that it is more appropriate, where statute provides a route, that the statute is used".

Inherent jurisdiction cases 2019-04-14 Cobb London Borough of Croydon CD High Court (Family Division) [2019] EWHC 2943 (Fam)
Clitheroe v Bond (2020) EWHC 1185 (Ch)

Testamentary capacity

"This is a bitter family dispute between the Claimant brother and Defendant sister as to whether their mother, the deceased, had testamentary capacity to make each of her two wills and in addition or in the alternative whether either or both wills resulted from fraudulent calumny."

Testamentary capacity cases 2020-05-21 Linwood John Clitheroe Susan Bond High Court (Chancery Division) [2020] EWHC 1185 (Ch)
CM v Derbyshire Healthcare NHS Foundation Trust (2011) UKUT 129 (AAC)

Nature and degree

(1) The Tribunal's decision not to discharge was made in error of law, and was set aside, (a) because there was no real evidence to support its view that non-compliance with medication and the risk of consequent relapse in the near future would probably occur, (b) because it did not establish that in these circumstances it had complied with the 'least restriction principle', (c) because of the irrationality in paragraph 21 of its decision (in that as the risk was of what might eventually happen it was hard to see how the envisaged leave regime could test that risk), and (d) because continued detention for the purposes of avoiding a chaotic lifestyle or drug taking or the absence of drug counselling is not permitted by law on the facts of this case. (2) The judgment contains a discussion of the 'nature' and 'degree' tests.

==Extract from judgment== '''“Nature or Degree”''' 9. The words “nature” and “degree” in section 72(1)(b)(i) are to be read separately so that, for example, even if the degree of mental disorder does not make it appropriate for the patient to be liable to be detained for treatment, the nature of the disorder might make such detention appropriate (R v MHRT ex parte Smith [1998] EWHC 832 Admin). 10. The Code of Practice (2008) suggests (in paragraph 4.3): :“4.3 The criteria require consideration of both the nature and degree of a patient’s mental disorder. Nature refers to the particular mental disorder from which the patient is suffering, its chronicity, its prognosis, and the patient’s previous response to receiving treatment for the disorder. Degree refers to the current manifestations of the patient’s disorder”. 11. This does not quite reflect what I understand these ordinary words of the English language to mean but I accept this as the basis on which the parties, the expert witnesses and the First-tier Tribunal have dealt with the matter. 12. If the nature of a patient’s illness is such that it will relapse in the absence of medication, then whether the nature is such as to make it appropriate for him to be liable to be detained in hospital for medical treatment depends on an assessment of the probability that he will relapse in the near future if he were free in the community and on whether the evidence is that without being detained in hospital he will not take the medication (Smirek v Williams (200) 1 MHLR 38 – CA; R v MHRT ex parte Moyle [2000] Lloyd’s LR 143 – High Court). [[test]] Reasons Upper Tribunal decisions 2011-03-23 Levenson CM Derbyshire Healthcare NHS Foundation Trust Secretary of State for Justice Upper Tribunal [2011] UKUT 129 (AAC)
CQC v Hillgreen Care Ltd (2018) MHLO 50

Prosecution of care home provider

(1) The care home provider charged with failing between 1/4/15 and 1/12/15 to comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 by failing to provide care and treatment in a safe way for service users (reg 12) and failing to put in place, and operate effectively, systems and processes to protect service users from abuse, including sexual abuse (reg 13). The provider had known since 2004 that its resident XX posed risk a of causing sexual abuse. Following an allegation of anal rape of a woman in 2008 his care plan stated that he "identifies with both male and female around his sexual orientation" and that he "needs to be supported at all times and not to be left alone unsupervised when around other service users and when in the community". XX admitted to having sex with two other residents, neither of whom had capacity to consent: a female resident AA in April 2015 and a male resident YY on 1/11/18. The provider had not followed the care plan and the district judge concluded that "[t]he incident with YY could not have happened had there been an extra member of staff on duty to watch XX and where he went." It was found guilty of both charges and was fined £300,000. (2) The judgement states that the CQC's inspection of the care home and seizure of documents took place on 27/7/17: this is the same day as a critical article in the Times (Andrew Norfolk, 'CQC covered up suspected rape in care home' (Times, 27/7/17)). Information about the chronology can be found in the CQC's subsequent report (CQC, 'CQC publishes independent investigation into its regulation of 14 Colne Road' (press release, 13/6/18)).

==CQC summary== <div class="perm"> A care home provider has been fined £300,000 for allowing a man in its care with a history of sexual assaults the freedom to prey on vulnerable people. The Care Quality Commission brought the case against Hillgreen Care Limited for not providing the constant, one-to-one supervision required for the man, who was described in court as XX. CQC prosecuted Hillgreen Care Limited for failing in its duty to protect people in its care, exposing them to the risk of sexual abuse. District Judge Susan Williams also awarded CQC £141,000 in costs. The judge ruled that residents at the care home must not be identified. She added: “There was a failure to provide appropriate care and a high level of culpability because the risks were well known to the company.” She said there was a “woefully inadequate system of care” in place. The judge said that although Hillgreen was subject to insolvency proceedings, this should not affect the sentence and that the “fine would serve to mark society’s condemnation” of Hillgreen’s failure to protect vulnerable people in its care. The CQC brought the case against Hillgreen Care Limited, for failing in its duty to protect people in its care, exposing them to the risk of sexual abuse. Hillgreen Care Limited was not present in court at any time during the proceedings. Highbury Corner Magistrates’ Court was told that on 1 November 2015, an autistic man was assaulted at Hillgreen’s care home at Colne Road, in Enfield, north London. At the time there were only two care staff on duty to look after six people. One of the residents, who was described as non-verbal, with limited mental capacity, was followed up to his room by XX, and, allegedly, raped. The incident was eventually reported to the police, but partly because of the alleged victim’s mental capacity and a lack of evidence, no prosecution ensued. The alleged perpetrator had been under the care of Hillgreen Limited for 10 years. Mr Paul Greaney QC, representing CQC said that: “XX is a predatory and opportunistic sex offender” and was a risk to both sexes. Numerous allegations involving vulnerable adults and children had been made against XX dating back to his childhood. The court heard from expert witness, Chartered Clinical Psychologist, Dr Neil Sinclair, who said that it should have been apparent to Hillgreen Care Limited that there was an extremely high risk of XX committing sexual offences. XX needed to be monitored at all times. Dr Sinclair said that if that monitoring been carried out, the alleged attack would probably never have happened. Residents at Colne Road were exposed to potential and actual harm. A number of care workers who had worked at Colne Road gave evidence - although nobody from the senior Hillgreen management team. A support care worker, who said she had not been given any instructions about watching XX, said that she walked in on XX while he was assaulting another service user, described as YY, on 1 November 2015. Following the alleged sexual assault Colne Road Home Manager, said that the home was no longer a place he wanted to work after the incident. He said that staffing levels were inadequate and that he had raised the matter with senior Hillgreen management, but that nothing had been done about it. A statement was read out in court from YY’s mother in which she said she had no doubt that YY would have been incapable of providing informed consent to sexual activity, given the nature and extent of his disabilities. Paul Greaney QC said: “YY plainly needed to be protected from abuse. One only needs to think for a moment about the situation that existed in that care home, a vulnerable man, in an environment in which a predatory sexual offender was largely free to roam, to realise that YY needed protection.” CQC began the process to cancel the registration of the Colne Road service in February 2016. The registration of Hillgreen Care Ltd was cancelled altogether in September 2017. Andrea Sutcliffe, CQC's Chief Inspector of Adult Social Care, welcomed the judgment and sentence: "As the judge has made clear, Hillgreen Care Limited utterly failed in their duty of care for the people they were responsible for supporting. YY should never have been exposed to the potential of sexual abuse from XX and the impact on him and his family is heartbreaking. My thoughts are with them today. "It has taken a long time to bring this prosecution to a conclusion but the outcome proves that it has been worth the effort and dedication of CQC's inspection and legal teams. Providers should be clear that if people are exposed to harm through their failure of care we will take every step we can to hold them to account." </div> ==Note== Transcript supplied by the CQC on request on 19/11/18. Miscellaneous 2018-11-15 Susan F Williams Care Quality Commission Hillgreen Care Ltd Magistrates' Court
CQC v Hillgreen Care Ltd (2018) MHLO 50.pdf
CS v FB (2020) EWHC 1474 (Fam)

Capacity in family case

The judge in this international children law case made an interim declaration that the mother lacked capacity to litigate, to enable the Official Solicitor to be appointed as litigation friend and, with the benefit of legal aid, to investigate for final determination the mother's capacity to conduct these proceedings.

Other capacity cases 2020-05-20 Mostyn CS FB VC High Court (Family Division) [2020] EWHC 1474 (Fam)
CS v SBH (2019) EWHC 634 (Fam)

Whether child had "sufficient understanding" to conduct appeal without Guardian

"Thus in determining whether the child has sufficient understanding to give instructions to pursue an appeal and to conduct the appeal I need to consider a range of factors including: (i) The level of intelligence of the child. (ii) The emotional maturity of the child. (iii) Factors which might undermine their understanding such as issues arising from their emotional, psychological, psychiatric or emotional state. (iv) Their reasons for wishing to instruct a solicitor directly or to act without a guardian and the strength of feeling accompanying the wish to play a direct role. (v) Their understanding of the issues in the case and their desired outcome any matter which sheds light on the extent to which those are authentically their own or are mere parroting of one parents position. ... (vi) Their understanding of the process of litigation including the function of their lawyer, the role of the judge, the role they might play and the law that is applied and some of the consequences of involvement in litigation. ... (vii) The court's assessment of the risk of harm to the child of direct participation for the risk of harm arising from excluding the child from direct participation and the child's appreciation of the risks of harm."

Litigation capacity cases 2019-03-18 Williams CS SBH FS Andreea Juravle High Court (Family Division) [2019] EWHC 634 (Fam) [2019] WLR(D) 216
DA v DJ (2017) EWHC 3904 (Fam)

Interim declarations under s48 MCA 2005

In this case Parker J followed the approach of HHJ Marshall QC in Re F [2009] EWHC B30 (Fam)M rather than the approach of Hayden J in Wandsworth LBC v A McC [2017] EWHC 2435 (Fam)B in relation to the correct approach to the threshold test for making an interim order under MCA 2005 s48 (which requires that there is "reason to believe that P lacks capacity in relation to the matter"). There is no need for the the purpose and extent of the capacity assessment to be explained to the person concerned, and the evidence does not need to go so far as to rebut the presumption of capacity.

==Note== Appeared on BAILII on 17/3/20. This case has wrongly been given a "Fam" neutral citation and will probably end up with the following citation: [2017] EWHC 3904 (COP). Other capacity cases 2017-11-29 Parker DA DJ Court of Protection [2017] EWHC 3904 (Fam)
DA v Kent and Medway NHS and Social Care Partnership Trust (2019) UKUT 348 (AAC)

Proceeding in absence of solicitor and patient

The tribunal refused to adjourn the case of a CTO patient who had not attended the hearing, then the solicitor left the hearing because she felt unable to represent the patient in those circumstances. (1) The tribunal's initial decision to proceed in the patient's absence referred to rule 39(1) (whether the party had been notified of the hearing or reasonable steps had been taken to notify the party of the hearing, and whether it was in the interests of justice to proceed with the hearing) and rule 39(2)(a) (whether the patient had decided not to attend the hearing or was unable to attend the hearing for reasons of ill health) but not rule 39(2)(b) (whether a rule 34 medical examination of the patient been carried out or was impractical or unnecessary). However, given the assumption that, as an expert tribunal, it will have got the law right, it was more likely than not that the tribunal decided it was impractical to carry out an examination. (2) The tribunal had not considered making an appointment under rule 11(7), but this was unnecessary as there was no indication that the patient had withdrawn her instructions or lacked capacity. (3) When the solicitor departed, it was incumbent upon the tribunal to make a fresh assessment under rule 39(1) as to whether it was in the interests of justice to proceed with the hearing. Its reasons did not mention the departure and it was unlikely that the tribunal had carried out such an assessment; even if it had done so, the lack of any explanation would have rendered the reasons inadequate. (4) The matter was remitted to the First-tier Tribunal for a re-hearing by a differently-constituted panel.

==Thanks== The judgment was provided by Karen Wolton of Wolton & Co (solicitors for the patient). Powers Upper Tribunal decisions 2019-11-11 Thomas Church DA Kent and Medway NHS and Social Care Partnership Trust Upper Tribunal [2019] UKUT 348 (AAC)
(2019) UKUT 348 (AAC).pdf
DB (as executor of the estate of OE) v SSWP (2018) UKUT 46 (AAC)

Social security appointeeship

"The main grievance of Mr B, who brings this appeal in his capacity as executor of his late Aunt Miss E’s estate, is the Secretary of State’s decision to make Birmingham City Council Miss E’s social security appointee. When the council were made Miss E’s appointee, Mr B held an enduring power of attorney authorising him to deal with her financial affairs. Appointment decisions do not attract a right of appeal to the First-tier Tribunal. Neither that tribunal, nor the Upper Tribunal, has jurisdiction to entertain an ‘appeal’ against an appointment decision. However, I do have some concerns about the way in which the council’s appointment application was handled. I decide to express some views on that subject. My purpose in simply to provide some assistance to the DWP and local authorities in their efforts to operate the appointee system effectively and properly."

Other capacity cases Welfare benefits cases 2018-02-04 Mitchell DB Secretary of State for Work and Pensions Birmingham City Council Upper Tribunal [2018] UKUT 46 (AAC)
DCC v NLH (2019) EWCOP 9

Retrospective authorisation of DNA swab sample

"I concluded it would be appropriate to make a declaration (1) that NLH lacked capacity (a) to make decisions as to the provision of buccal swab samples, the testing of such samples and the profiling of his DNA and (b) to conduct these proceedings, and further (2) that it was lawful for the local authority to arrange for the taking of buccal swabs from NLH for the purposes of performing DNA paternity testing in respect of the child. I further concluded it would be appropriate to make an order, by consent, that the court consented on NLH's behalf for the swab sample to be taken and tested and so that his DNA could be profiled to establish whether he was the father of the child. Shortly before the order was made, however, it emerged that a member of staff from the DNA testing company, Lextox, had already attended at the nursing home and taken the sample, with the agreement of NLH's family, but without either the formal consent of NLH (who lack capacity to provide consent) or the approval of the court. ... I therefore agreed to prepare this short judgment to remind practitioners, carers and those involved in taking samples in these circumstances that, where the patient lacks capacity and an application has been made to the Court of Protection for an order authorising the taking of a sample, it will be unlawful for the sample to be taken without the Court's permission. All practitioners and professionals working in this field ought to be aware that there is always a judge of the Family Division on duty available to sit in the Court of Protection twenty-four hours a day, seven days a week, every day of the year, to deal with urgent applications, usually by telephone. Consequently, there is no excuse for any failure to comply with the obligations to obtain the court's permission in circumstances such as these. As stated, no harm arose on this occasion, but any infringement in future will run the risk not only of attracting severe criticism from the Court but also potentially incurring liability for damages if a breach of human rights were to be established."

Medical treatment cases 2019-03-19 Baker DCC NLH Court of Protection [2019] EWCOP 9
Derby Teaching Hospitals NHS Foundation Trust v Derby City Council (2019) EWHC 3436 (Ch)

Charitable status of foundation trusts

Seventeen NHS foundation trusts argued that, as foundation trusts, they were entitled under s43(5) Local Government Finance Act 1988 to the four-fifths reduction in non-domestic rates because they were charities and the relevant properties were wholly or mainly used for charitable purposes. The High Court answered the preliminary question "Whether the Lead Claimant is a charity for the purposes of section 43(6) of the Local Government Finance Act 1988?" in the negative.

Miscellaneous 2019-12-12 Morgan Derby Teaching Hospitals NHS Foundation Trust Derby City Council High Court (Chancery Division) [2019] EWHC 3436 (Ch) [2020] 2 WLR 390
Derbyshire Healthcare NHS Foundation Trust (17 012 839a) (2019) MHLO 44 (LGSCO)

Complaint about community care delay

LGSCO's summary: "The Ombudsmen do not consider Derbyshire County Council and Derbyshire Healthcare NHS Foundation Trust delayed providing support for Mrs X’s mental health needs. We have not found fault with the way the Council decided what support she needed. The Ombudsmen consider Derbyshire County Council delayed completing Mr X’s carer assessment and should have considered carrying out an integrated assessment with Mrs X. However, it has remedied the distress Mr X suffered."

==Note== Added to LGSCO website on 28/8/19. Community care LGO decisions 2019-05-24 Derbyshire Healthcare NHS Foundation Trust North Derbyshire Clinical Commissioning Group Local Government and Social Care Ombudsman
Djaba v West London Mental Health NHS Trust (2017) EWCA Civ 436

ECHR and tribunal criteria

"[T]he appeal is concerned with the narrow issue whether the statutory tests within ss. 72, 73 and 145 of the Mental Health Act 1983 require a 'proportionality assessment' to be conducted, pursuant to articles 5 and/or 8 of the European Convention of Human Rights and Fundamental Freedoms and the Human Rights Act 1998, taking into account the conditions of the appellant's detention. ... The position established by these cases is that, where the question whether the detention complies with the European Convention on Human Rights is not expressly within the powers of the tribunals but can be heard in other proceedings, section 3 of the Human Rights Act 1998 does not require the powers of the tribunals to be interpreted by reference to the Convention to give them the powers to consider Convention-compliance as well. The same principle applies here too. In this case, the appellant must apply for judicial review to the Administrative Court if he considers that the conditions of his detention are disproportionate and do not comply with the Convention. That Court is able to carry out a sufficient review on the merits to meet the requirements of the Convention."

Powers Upper Tribunal decisions 2017-06-28 Arden McCombe Sales Jasmin Djaba West London Mental Health NHS Trust Secretary of State for Justice Court of Appeal (Civil Division) [2017] EWCA Civ 436 [2017] WLR(D) 429 [2018] 1 WLR 1333 [2018] WLR 1333 (2017) 20 CCL Rep 264 [2017] MHLR 345 [2017] MHLO 23
Djaba v West London Mental Health NHS Trust (2018) MHLO 76 (SC)

ECHR and tribunal criteria

On 15/3/18 the Supreme Court (Lady Hale, Lord Hodge, Lord Lloyd-Jones) refused Jasmin Djaba permission to appeal, giving brief reasons.

==Thanks== Court order provided by Djaba's solicitor, Kate Luscombe of Abbotstone Law. Powers Upper Tribunal decisions 2018-03-15 Hale Hodge Lloyd-Jones Jasmin Djaba West London Mental Health NHS Trust Secretary of State for Justice Supreme Court
2018-03-15 Djaba Supreme Court permission decision.pdf
DL-H v West London MH NHS Trust (2017) UKUT 387 (AAC)

Religious beliefs and tribunal expertise

Judicial summary from Gov.uk website: (1) "In deciding whether a patient is manifesting religious beliefs or mental disorder, a tribunal is entitled to take account of evidence from both religious and medical experts." (2) "A tribunal is entitled to use its own expertise to make a different diagnosis from those of the medical witnesses, provided it allows the parties a chance to make submissions and explains its decision."

==Mind== The summary below is reproduced from [[Mind, 'Legal Newsletter' (March 2018)]]. <div class="perm"> A patient was detained on a section 37/41 since 2006. He had been diagnosed with schizophrenia and personality disorder. He applied to the First-tier Tribunal who decided that he should remain in hospital. The patient appealed to the Upper Tribunal but it was dismissed. The patient said that he was expressing religious beliefs which weren’t a mental disorder and the hospital chaplain was a witness to support his case. The Upper Tribunal said that when they are deciding whether a patient is expressing religious beliefs or mental disorder, a tribunal can consider evidence from both religious and medical experts. The Upper Tribunal can only consider whether there is an error on a point of law but this assessment of evidence and finding of fact was a matter for the First Tier Tribunal. The judge confirmed that there is no rule of evidence that only a religious expert’s evidence is admissible on issues of religion. A tribunal doesn’t have to agree with all of the evidence but it must have good reason not to. It is allowed to use its own expertise to make a different diagnosis from those of the medical witnesses, provided it allows the parties a chance to make submissions and explains its decision. </div> [[Category:Mind summary]] Reasons Upper Tribunal decisions 2017-09-28 Jacobs DL-H West London Mental Health NHS Trust Secretary of State for Justice Upper Tribunal [2017] UKUT 387 (AAC) [2017] MHLO 33
DM v Dorset County Council (2019) EWCOP 4

Litigation capacity

Unsuccessful challenge to a finding that DM lacked litigation capacity.

Litigation capacity cases 2019-02-11 Roberts DM Dorset County Council Court of Protection [2019] EWCOP 4
DXW v PXL (2019) EWHC 2579 (QB)

Claimant not told value of settlement

"In the Application Notice seeking approval of the settlement, the Claimant also sought what has been called an "EXB Order" after the judgment of Foskett J in EXB v FDZ and others [2018] EWHC 3456 (QB)M. In that case, Foskett J made what was a novel form of order to the effect that it was not in the best interests of the claimant to know the amount of a settlement of his personal injuries action in circumstances where the court had also determined that the claimant lacked capacity to decide whether or not he should know the amount of the settlement."

Other capacity cases 2019-10-04 Pushpinder Saini DXW PXL High Court (Queen's Bench Division) [2019] EWHC 2579 (QB) EXB v FDZ (2018) EWHC 3456 (QB)
East Lancashire Hospitals NHS Trust v PW (2019) EWCOP 10

Amputation

"This is an application by East Lancashire NHS Trust for orders under the Mental Capacity Act 2005 that PW lacks capacity "to make a decision regarding whether to undergo the leg amputation surgery to address his high risk of sepsis"; and that it is lawful to carry out that surgery having regard to his best interests. Before dealing with the substantive issues in this case I will deal with the timing of the application."

Medical treatment cases 2019-03-21 Lieven East Lancashire Hospitals NHS Trust PW Court of Protection [2019] EWCOP 10
Esegbona v King’s College Hospital NHS Foundation Trust (2019) EWHC 77 (QB)

Aggravated damages following MCA breaches

"The claimant, Dr Gloria Esegbona, brings this claim as administrator of the estate of the deceased, her mother, Christiana Esegbona. The action is brought in negligence and false imprisonment. The amended claim form states that the claimant's claim is a claim in clinical negligence and/or pursuant to the Fatal Accidents Act 1976 and/or the Law Reform (Miscellaneous Provisions) Act 1934. The claimant claims damages for pain, suffering and loss of amenity as well as damages, including aggravated damages, for false imprisonment. It is the claimant's case not only that the medical, nursing and other staff at the defendant’s hospital owed her mother a duty to treat her with reasonable care and skill but also that the defendant had duties under the Mental Capacity Act 2005: to take reasonable steps to establish whether Mrs Esegbona lacked capacity before doing any act in connection with her care or treatment; and further that if the defendant reasonably believed that Mrs Esegbona lacked capacity whether it would be in her best interests for any act in connection with her care or treatment to be done; and to take steps to obtain a court order or the relevant authorisation under schedule A1 to the Act before depriving Mrs Esegbona of her liberty. The claimant says the defendant acted in breach of these duties."

==See also== *'"`UNIQ--item-481--QINU`"'[[1 Crown Office Row, 'Alasdair Henderson secures award of damages for false imprisonment in a hospital setting' (30/1/19)]] — '"`UNIQ--item-482--QINU`"' Unlawful detention cases 2019-01-22 Coe Gloria Esegbona King's College Hospital NHS Foundation Trust High Court (Queen's Bench Division) [2019] EWHC 77 (QB)
(2019) EWHC 77 (QB).pdf
ET v JP (2018) EWHC 685 (Ch)

Variation of Trusts Act

"This judgment deals with one point which arose in the course of an application for the court's approval to a variation of a trust pursuant to the Variation of Trusts Act 1958. ... The way in which section 1 of the 1958 Act operates can be summarised as follows: (1) In the case of an adult beneficiary who has capacity within section 2(1) of the 2005 Act, the adult can decide for himself whether to agree to a proposed variation of a trust and the court has no power to give approval on his behalf; (2) In the case of an adult beneficiary who does not have capacity within section 2(1) of the 2005 Act to agree to the variation of a trust, the court has power to give approval on his behalf but the question as to whether the variation is for his benefit is decided by the Court of Protection rather than by the High Court; (3) In the case of a minor beneficiary, the minor does not have capacity (by reason of being a minor) to decide for himself whether to agree a proposed variation of a trust and the court has power to give approval on his behalf. The question then arises: what is the position of a minor beneficiary who, by reason of an impairment of, or a disturbance in the functioning of, the mind or brain would not have capacity for the purposes of section 2(1) of the 2005 Act to make decisions for himself in relation to certain matters? Is such a minor within section 1(3) of the 1958 Act so that the question as to whether a variation of a trust would be for his benefit is to be determined by the Court of Protection rather than by the High Court? If that question had to be referred to the Court of Protection and that court determined that the variation was for the benefit of the minor, the matter would then have to return to the High Court for it to give its approval to the variation under section 1 of the 1958 Act."

Other capacity cases 2018-03-28 Morgan ET JP High Court (Chancery Division) [2018] EWHC 685 (Ch) [2018] 3 WLR 44 [2018] 3 All ER 469 [2018] WTLR 109 [2018] 2 P &CR DG8
EXB v FDZ (2018) EWHC 3456 (QB)

"This case came before me on 23 April 2018 for the purpose of considering whether to approve the proposed settlement of a personal injuries action reached between the Claimant's Litigation Friend (his mother) and the Third and Fourth Defendants. The settlement required the approval of the court pursuant to CPR Part 21.10 because the Claimant was (and remains) a protected party. I gave my approval to the settlement. [I]t was thought by those who knew him best ... that it would be in the Claimant's best interests not to be told the amount at which the settlement had been achieved. ... The primary question, however, is whether I can conclude, on the balance of probabilities, that the Claimant cannot make for himself the decision about whether he should be told the value of the award. As Ms Butler-Cole says, this is difficult in the present case because 'by definition, the Claimant cannot be presented with the information relevant to the decision in order to assess his capacity, as that would make the entire exercise redundant.' Nonetheless, the Claimant has expressed his views on the matter without the exact figure being known to him and there is evidence (particularly in his comment after he left the videoconference room after giving his evidence) that his ability to make this decision is variable and that he could not necessarily sustain over any meaningful period the making of such a decision given his inability to control his impulses and weigh up all the relevant considerations. In those circumstances a declaration as to incapacity in relation to this specific decision is justified. ... This case is the first I can recall when an issue such as that which has arisen has occurred. ... I will send a copy of this judgment to the Deputy Head of Civil Justice and to the Vice-President of the Court of Protection so that they can consider whether any consultation on this issue is required and whether any action needs to be taken as a result." The draft order included the following declarations: "(1) The Claimant lacks the capacity to decide whether or not he should know the amount of the Settlement. (2) It is in the Claimant's best interests that he does not know the amount of the Settlement. (3) It shall be unlawful for any person (whether the Claimant's deputy or any other person who has knowledge of the amount of the Settlement) to convey by any means to the Claimant information about the amount of the Settlement, save that this declaration does not make unlawful the conveyance of descriptive information to the Claimant to the effect that the Settlement is sufficient to meet his reasonable needs for life."

Other capacity cases 2018-12-13 Foskett EXB FDZ Motor Insurers' Bureau GHM UK Insurance Ltd High Court (Queen's Bench Division) [2018] EWHC 3456 (QB)
Gilchrist v Greater Manchester Police (2019) EWHC 1233 (QB)

Police use of force

"I recognise that this was a challenging situation for the police officers. They were faced with an individual who presented as very angry, covered in blood and with whom they were unable to communicate. Prior to Andrew Gilchrist's explanation, their assumption that Michael Gilchrist was an aggressor who, probably, had assaulted someone and needed to be detained, was reasonable. In those circumstances, their initial actions to attempt to bring him under control using CS gas and Taser were justified, reasonable and proportionate. However, once they were appraised of his vulnerability as an autistic man, and his behaviour suggested that he was defensive rather than aggressive, a more cautious approach should have been adopted. The further use of Taser, which had already proved to be ineffective, and following the use of CS gas, was inappropriate. The alternative course mandated by PS Morris, namely, using the force of the officers available to take Mr Gilchrist to the ground and restrain him without using weapons was a reasonable and proportionate response."

Miscellaneous 2019-05-15 O'Farrell Michael Gilchrist Chief Constable of Greater Manchester Police High Court (Queen's Bench Division) [2019] EWHC 1233 (QB)
GM v Dorset Healthcare University NHS Foundation Trust (2020) UKUT 152 (AAC)

Change from s3 to s37 during tribunal proceedings

The First-tier Tribunal had been right to strike out proceedings arising from a s3 reference when the patient was subsequently made subject to a s37 hospital order. It would be contrary to statutory policy if the tribunal were to retain jurisdiction under an application or reference that was made before the date of the hospital order.

==Summary on Gov.uk website== When a patient who was detained pursuant to section 3 of the Mental Health Act 1983 is made subject to a hospital order without a restriction order, the First-tier Tribunal has no jurisdiction on any application or reference that was lodged before the order was made. ==Note== The judgment calls it "Dorset Healthcare NHS Trust". First published on 25/6/20, on the Gov.uk website. Change of status after application made 2020-05-04 Jacobs GM Dorset Healthcare University NHS Foundation Trust Secretary of State for Justice Upper Tribunal [2020] UKUT 152 (AAC)
Greater Manchester Mental Health NHS Foundation Trust (18 018 548a) (2019) MHLO 66 (LGSCO)

Carer's assessment failures

LGSCO summary: "The Ombudsmen have upheld Mrs G’s complaint about the way her carer’s assessments were carried out. We have not found fault with the way the Trust, Council and CCG arranged Mr H’s accommodation under s117 of the Mental Health Act or how the Trust communicated with Mrs G and Mr H about this."

LGO decisions 2019-10-03 Greater Manchester Mental Health NHS Foundation Trust Local Government and Social Care Ombudsman
Griffiths v Chief Constable of Suffolk Police, and Norfolk and Suffolk NHSFT (2018) EWHC 2538 (QB)

Claim following decision not to admit under MHA

"This case arises out of the murder of Mary Griffiths by John McFarlane on 6 May 2009 in Bury St Edmunds, Suffolk. The Claimants are her three daughters, suing by their father and litigation friend. They seek damages from the Chief Constable of the Suffolk Police, the 'Suffolk Police', and North and Suffolk NHS Foundation Trust, the 'NHS Trust', the first and second Defendants. ... The claim, put very shortly, is that the NHS Trust assessment under the Mental Health Act, MHA, was flawed in a number of respects, and that Mr McFarlane ought to have been admitted to hospital, voluntarily or compulsorily, on 3 May 2009, which would have prevented him being in a position to murder Ms Griffiths on 6 May. In any event, the NHS Trust should have warned her that Mr McFarlane was a danger to her, and they ought also to have communicated with the Suffolk Police. This would have affected the way in which they, in turn, addressed Ms Griffiths' concerns when she telephoned them on 5 May 2009. The Suffolk Police, in any event, ought to have graded Ms Griffiths' call as more serious than they did, and ought to have sent someone round that night. That person would have realised that the situation was more threatening than had the call-taker, and steps would have been taken to protect Ms Griffiths, who faced a real and immediate risk from Mr McFarlane, to remove her from danger, or to warn or detain Mr McFarlane."

Miscellaneous 2018-10-10 Ouseley Jessica Griffiths Hannah Griffiths Sophie Griffiths Chief Constable of the Suffolk Police Norfolk and Suffolk NHS Foundation Trust High Court (Queen's Bench Division) [2018] EWHC 2538 (QB) E90-24
Guy's and St Thomas' NHS Foundation Trust v R (2020) EWCOP 4

Contingent/anticipatory declarations - MCA/inherent jurisdiction - Caesarean section

R had capacity to make decisions as to her ante-natal and obstetric care but there was a risk that she would lose capacity during labour and refuse a Caesarean section. (1) MCA 2005 s16 (Powers to make decisions and appoint deputies: general) applies only to those who currently lack capacity. (2) MCA 2005 s15 (Power to make declarations) is not so limited and so can authorise contingent declarations. (3) Deprivation of liberty cannot be authorised by s15 but the inherent jurisdiction may be utilised to fill that lacuna which would otherwise render the s15 power nugatory.

Deprivation of liberty Inherent jurisdiction cases Medical treatment cases 2020-01-29 Hayden Guy's and St Thomas' NHS Foundation Trust South London and Maudsley NHS Foundation Trust Court of Protection [2020] EWCOP 4 101 29
Guy's and St Thomas' NHS Foundation Trust v X (2019) EWCOP 35

Pregnancy - OS out-of-hours representation

(1) Official Solicitor's lack of out-of-hours service: "... I invite the Official Solicitor to urgently review this position and consider putting in place arrangements that will ensure appropriate representation out of normal court hours for those individuals who are the subject of urgent applications that potentially involve serious medical treatment. ... [E]very effort must be made to issue such applications during normal court hours." (2) Pregnancy: "Having considered the submissions of the parties there is, in my judgment, in accordance with s 48 Mental Capacity Act 2005, reason to believe that X lacks capacity in relation to the matter, namely the medical intervention that may be necessary for X to give birth to a baby who is safe and well. On the evidence the court has from Dr Y, which I accept, his assessment is X is unable to reconcile her conflicting beliefs (on the one hand of wanting a natural birth and also wanting a live, well and safely born baby) in a way that she is able to balance the pros and cons. Additionally, there is, in my judgment, a real risk the position is unlikely to change and is more likely to deteriorate. He concluded X showed limited insight in relation to her previous mental ill- health. I have carefully considered the submissions on behalf of the Official Solicitor regarding capacity but looking at all the evidence and information available to the court I am satisfied the interim declaration should be made."

Litigation friend cases Medical treatment cases 2019-07-25 Theis Guy's and St Thomas' NHS Foundation Trust X Court of Protection [2019] EWCOP 35
Harrow CCG v IPJ (2018) EWCOP 44

Residence and care

"The Court is asked to determine where AJ should live and how he should be cared for. The applicant CCG has proposed an extensive package of care at the family home, with (most of) the financial arrangements managed by a third party broker. JA's parents, who are the Second and Third Respondents, do not agree the proposals and seek the dismissal of the application.

==Thanks== Thanks to Will Whitaker of Bindmans (solicitor for AJ) for providing the judgment. Best interests 2019-04-30 Hilder Harrow Clinical Commissioning Group IPJ IJJ AJ Court of Protection [2018] EWCOP 44
(2018) EWCOP 44.pdf
Hertfordshire CC v K (2020) EWHC 139 (Fam)

Inherent jurisdiction and DOL

"In this matter, the question before the court is whether it should grant a deprivation of liberty order (hereafter a DOL order) under the inherent jurisdiction of the High Court in respect of AK, born in 2003 and now aged 16."

Deprivation of liberty Inherent jurisdiction cases 2020-01-23 MacDonald Hertfordshire County Council NK AK High Court (Family Division) [2020] EWHC 139 (Fam)
Hinduja v Hinduja (2020) EWHC 1533 (Ch)

Protected party - litigation friend

(1) Medical evidence on capacity to conduct proceedings is not required under the CPR, and in this case to require it would not be necessary or in accordance with the overriding objective. The court decided that SP was a protected party. (2) The defendants argued that the proposed litigation friend failed both limbs of the relevant test (ability fairly and competently to conduct proceedings and having no adverse interest). Having considered the tests (including noting that "[w]hether the existence of a financial interest on the part of the litigation friend should debar [her] from acting will depend on the nature of the interest, and whether it is in fact adverse or whether it otherwise prevents the litigation friend conducting the proceedings fairly and competently on the protected party's behalf") the court made the appointment sought.

Litigation capacity cases Litigation friend cases 2020-06-23 Falk Srichand Parmanand Hinduja Gopichand Parmanand Hinduja Prakash Parmanand Hinduja Ashok Parmanand Hinduja High Court (Chancery Division) [2020] EWHC 1533 (Ch)
Hounslow Clinical Commissioning Group v RW (2019) EWCOP 12

Death

"This is an application brought by the Hounslow Clinical Commissioning Group concerning RW a 78-year-old man, suffering from vascular dementia. ... I would very much have liked to have been able to endorse a plan which permitted RW to return home. There is no doubt at all, as the history of this case shows, that RW would want to die at home. I do not know whether he would survive the transition but I should have been prepared to take that risk. However, PT would, in my judgement, continue to try to give his father food and water. As I speak these words he indicates to me that this is precisely what he would do. I have been told by Ms I that, at this stage, if PT were to attempt to feed his father there is a real risk that he would asphyxiate on any food given. I cannot permit RW to be exposed to the risk of ending his life in this way and, if I may say so, I would not be prepared to take that risk for PT either, especially having regard to all the loving care he has provided for his father. I endorse the applicant's plan. I indicate that it is in RW's best interest to have his sons with him as much as possible. I am not prepared to be prescriptive of the times and the circumstances in which the sons may visit. In this I reject the applicant's proposals in this respect."

Best interests 2019-03-29 Hayden Hounslow Clinical Commissioning Group RW PT PW MW BW Court of Protection [2019] EWCOP 12
James v James (2018) EWHC 43 (Ch)

Banks v Goodfellow test for testamentary capacity survives MCA

"There is a preliminary question of law as to the test to be applied for testamentary capacity in a case like this, where the testator has made a will, died, and then the question of capacity has arisen. The traditional test for such a case is that laid down in Banks v Goodfellow (1870) LR 5 QB 549, 565, per Cockburn CJ: 'It is essential … that a testator shall understand the nature of his act and its effects; shall understand the extent of the property of which he is disposing; shall be able to comprehend and appreciate the claims to which he ought to give effect, and, with a view to the latter object, that no disorder of the mind shall poison his affections, avert his sense of right, or prevent the exercise of his natural faculties, that no insane delusion shall influence his will in disposing of his property and bring about a disposal of it which, if his mind had been sound, would not have been made.' ... More recently the Mental Capacity Act 2005 has made fresh provision for the law of mental capacity in certain situations. What is unfortunately not made express in that legislation is the extent to which this fresh provision affects the test for capacity to make a will when that question is being judged retrospectively (typically, though not necessarily, post mortem). ... The general rule of precedent, as applied in the High Court, is that that court is not strictly bound by decisions of co-ordinate jurisdiction, but will follow them as a matter of comity unless convinced they are wrong ... As it happens, I think the decision in Walker v Badmin [2014] EWHC 71 (Ch)Not on Bailii! [that the test in Banks v Goodfellow not only had survived the enactment of the 2005 Act, but that it, rather than anything in the Act, was still the sole test of capacity for judging will-making capacity in retrospect] is right, and for the reasons given by the deputy judge. ... Whilst it is a complication to have two tests for mental capacity in making wills, one prospective and the other retrospective, it is a complication created by the decision of Parliament to legislate as it has, a decision that the courts must respect."

Testamentary capacity cases 2018-01-19 Paul Matthews Raymond Allen James Karen James Serena Underwood Sandra James High Court (Chancery Division) [2018] EWHC 43 (Ch)
JD v West London Mental Health NHS Trust (2016) UKUT 496 (AAC)

ECHR and tribunal criteria

"The patient in this case is held in conditions of exclusion and restraint that are exceptional and perhaps unique. He occupies a ‘super seclusion suite’ consisting of a room with a partition that can divide it into two. No one is allowed to enter without the partition in place, except nursing staff wearing personal protective equipment in order to administer his depot injections. He is only allowed out of the suite in physical restraints that restrict his circulation and under escort by a number of members of staff. ... The Secretary of State referred the patient’s case to the First-tier Tribunal on 28 July 2015. The hearing took place on 19 and 20 November 2015; the tribunal’s reasons are dated 23 November 2015. ... What the tribunal did not do was to deal expressly with the human rights argument put by Ms Bretherton on the patient’s behalf. On 7 January 2016, the tribunal gave permission to appeal to the Upper Tribunal identifying as the issue: 'to what extent should the circumstances of the patient’s detention, and any possible breach of the European Convention as a result thereof, have any bearing on the First-tier Tribunal’s exercise of considering sections 72 and 73? Following from that, if the Tribunal is satisfied that the circumstances of a patient’s detention are a breach of the European Convention on Human Rights, how should that be reflected in the decisions that the First-tier Tribunal can lawfully make?'"

Powers Upper Tribunal decisions 2016-07-19 Jacobs JD Jasmin Djaba West London Mental Health NHS Trust Secretary of State for Justice Upper Tribunal [2016] UKUT 496 (AAC) [2016] MHLO 46
JG v Kent and Medway NHS and Social Care Partnership Trust (2019) UKUT 187 (AAC)

Non-legal research by judge

Judicial summary from gov.uk website: "Mental Health First-tier Tribunal - Judicial Bias - Apparent bias - Breach of Natural Justice - Procedural Irregularity. Where a First-tier Tribunal judge undertook non-legal research by accessing a court of appeal judgment in respect of the appellant, did this lead to a presumption of bias and automatic disqualification? Did it lead to a conclusion of a real possibility of bias? Whether so doing amounts to a procedural irregularity leading to a breach of natural justice in that it rendered the hearing unfair. In the circumstances appertaining there can be no presumption of bias leading to automatic disqualification. On the facts of the case there was no real possibility of bias. Undertaking the non-legal research was a procedural irregularity but on the facts the hearing was not unfair."

==Thanks== Thanks to the patient's solicitor for sending the judgment ages ago (and sorry for not uploading it earlier) Bias 2019-06-11 Ramshaw JG Kent and Medway NHS and Social Care Partnership Trust Upper Tribunal [2019] UKUT 187 (AAC)
Jhuti v Royal Mail Group Ltd (Practice and Procedure) (2017) UKEAT 0062/17

Litigation friend under employment tribunal rules

Summary from judgment: "While there is no express power provided by the ETA 1996 or the 2013 Rules made under it, the appointment of a litigation friend is within the power to make a case management order in the 2013 Rules as a procedural matter in a case where otherwise a litigant who lacks capacity to conduct litigation would have no means of accessing justice or achieving a remedy for a legal wrong."

Litigation friend cases Powers 2017-07-31 Simler Royal Mail Group Ltd Law Society Secretary of State for Business Energy and Industrial Strategy Employment Appeal Tribunal [2017] UKEAT 0062_17_3107 [2017] WLR(D) 613 [2018] ICR 1077
JK v A Local Health Board (2019) EWHC 67 (Fam)

Force feeding under s63 MHA 1983

"In my view his refusal to contemplate any alternative paths, and his rigid belief that refusing to eat is his only way forward, is a consequence of his autism and as such falls within s.63. The proposed force feeding is therefore certainly capable of being treatment for the manifestation of his mental disorder. However, that does not mean that I by any means accept that force feeding JK would be in his best interests, or critically would be "treatment" that falls within the definition in s.145(4) of the MHA, as being "to alleviate or prevent a worsening of the disorder…". It is apparent that force feeding is a highly intrusive process, which involves sedating the patient whilst the naso-gastric tube is inserted and potentially having to restrain the patient for fairly prolonged periods. This process would be extremely upsetting for any patient, but for JK with his ASD and his aversion to eating in front of other people, the process would be even more traumatic. JK said in oral evidence that he viewed the possibility as abhorrent, and it was clear from that response how incredibly upsetting for all concerned having to go through that process would be. If it came to that stage close consideration would necessarily have to be given to the terms of article 3 ECHR and the caselaw such as Herczegfalvy v Austria [1993] 15 EHRR 437 and the test of medical necessity."

Medical treatment cases 2019-11-13 Lieven JK A Local Health Board High Court (Family Division) [2019] EWHC 67 (Fam)
JMcG v Devon Partnership NHS Trust (2017) UKUT 348 (AAC), (2017) MHLO 28

Deferred discharge beyond current authority for detention

"The principal issue in this appeal is whether the First-tier Tribunal (Mental Health) erred in law in its belief that, pursuant to s.72(3) of the Mental Health Act 1983, it could not defer the discharge of a detained patient beyond the date of the order authorising detention. The Appellant patient criticised the tribunal for (a) refusing to defer his discharge until a date after the authority for his detention had expired and (b) failing to give adequate reasons for its decision overall. I have concluded that the tribunal did not err in law with respect to the effect of section 72(3) since its reasons did not assert that a deferred discharge could not exceed the date of the order authorising detention. Though strictly obiter, I have concluded that a deferred discharge cannot exceed the date of the order authorising detention and explain why I have reached that view below. I also concluded that the tribunal’s reasoning in this case was adequate."

==Note== The decision in relation to deferred discharge was obiter (not binding) and I think wrongly decided. ==Judicial summary== The following is from the Gov.uk website (see external link below): <div class="perm"> Mental Health – detention under Mental Health Act – section 72(3) – whether tribunal had power to defer the discharge of a detained patient beyond the date of the order authorising detention The appellant, a prisoner, was transferred to hospital for treatment after he became psychotic and paranoid. His condition eventually improved after he was transferred to a hospital closer to his home and had received anti-psychotic medication. On 9 December 2016, he applied to the First-tier Tribunal (F-tT) for discharge from detention. The appellant recognised that immediate discharge would be inappropriate and the tribunal was invited to defer discharge to allow the care team sufficient time in which to arrange for appropriate accommodation. The F-tT refused the application having found that such deferment would be for a short period as the appellant’s section was due to expire in early February 2017. The appellant appealed to the Upper Tribunal (UT) on the basis that the F-tT had erred in its belief that, pursuant to section 72(3) Mental Health Act 1983, it could not defer the discharge of a detained patient beyond the date of the order authorising detention and had failed to give adequate reasons for its decision overall. Held, allowing the appeal, that: #a tribunal when exercising its power pursuant to section 72(3) to direct a discharge on a future specified date, cannot specify a future date for discharge after that on which the authority for the patient’s detention expires (paragraph 32); #once the tribunal had made a direction pursuant to section 72(3) liability to be detained, either pursuant to sections 2 or 3 or indeed to a Community Treatment Order, came to an end on the date specified for discharge. A date set beyond the date of the order authorising detention would be as invalid as the continuation of the Community Treatment Order in MP v Mersey Care NHS Trust [2011] UKUT 107 (AAC) since the necessary underpinning of the order authorising detention would be lacking (paragraph 34); #there was no basis to intervene with the F-tT’s decision as it had carried out its fact-finding role rationally and its written reasons accorded with the UT’s guidance in MS v North East London Foundation Trust [2013] UKUT 92 (AAC) - the F-tT had (a) stated what facts it had found; (b) explained how and why it made them; and (c) showed how it applied the law to those facts (paragraphs 41 to 46). </div> ==Mind== The summary below is reproduced from [[Mind, 'Legal Newsletter' (March 2018)]]. <div class="perm"> The mental health tribunal cannot defer a patient’s discharge to a date after their renewal. JMcG was transferred from prison to hospital under section 47 of the Mental Health Act 1983 (MHA). After the expiry of his sentence he applied to the tribunal for discharge. He requested that his discharge be deferred under section 72(3) to allow an appropriate aftercare package to be put in place, including the suitable accommodation. JMcG’s application was refused, the tribunal finding that the statutory criteria for detention were met. The tribunal noted in the decision that JMcG’s detention period was due to expire 3 weeks after the hearing (absent being renewed by his Responsible Clinician) and that that period ‘would not be long enough to wean him from Diazepam and nor would it be enough time to give the best opportunity of finding appropriate discharge accommodation nor to reintroduce him to the community by way of controlled leave’. JMcG appealed to the Upper Tribunal on the grounds that: The tribunal had misinterpreted the law by holding itself as being unable to defer a patient’s discharge at a date beyond the date of renewal The tribunal had failed to give adequate reasons for why the statutory criteria for detention were met. The Upper Tribunal held that the tribunal did not in fact assert that discharge could not be deferred beyond the date of expiration, but that, though obiter, it could not. To order discharge at a later date would effectively extend the period of authorisation: a power which the Act does not provide the tribunal. Judge Knowles QC noted that the power to defer a discharge is usually used where the tribunal considers that the patient ought to be discharged but that adequate aftercare arrangements have not been made. In such cases an application for an adjournment could be made instead. The Upper Tribunal cited the following passage from R (Ashworth Hospital) v MHRT [2002] EWCA Civ 923: "If the tribunal had any doubt as to whether such services would be available, they should have adjourned to obtain any necessary information. I regard the alternative of a deferral…as less satisfactory … if the tribunal is in doubt as to whether suitable after-care arrangements will be available, it is difficult to see how they can specify a particular date for discharge. In cases of doubt, the safer course is to adjourn…" Patients whose hearings are scheduled relatively close before their renewal date will need to consider whether they are in a position to argue for their immediate discharge or whether they will need to apply for their hearing to be adjourned beyond that date. Applications should be made in advance of the hearing where possible and specify directions sought in relation to aftercare arrangements. </div> [[Category:Mind summary]] Powers Upper Tribunal decisions 2017-04-23 Gwynneth Knowles JMcG Devon Partnership NHS Trust Upper Tribunal [2017] UKUT 348 (AAC) [2018] AACR 11
John Blavo v Law Society (2017) EWHC 561 (Ch)

Statutory demands set aside

"In November 2015 the Law Society served a statutory demand on Mr Blavo claiming that he owed it £151,816.27. In February 2016 the Law Society served a second statutory demand on Mr Blavo claiming that he owed it a further £643,489.20. On 14 December 2015 Mr Blavo applied to set aside the first statutory demand. On 11 March 2016 Mr Blavo applied to set aside the second statutory demand. ... It is the costs of the intervention, from 15 October 2015 to 20 January 2016, into the company and Mr Blavo's practice which are the underlying subject matter of the statutory demands. ... It follows from all I have said that I have concluded that the statutory demands in this case should be set aside because the debts in question are not for liquidated sums."

SRA decisions 2017-03-29 Klein John Blavo Law Society High Court (Chancery Division) [2017] EWHC 561 (Ch) [2017] WLR(D) 254
John Blavo v Law Society (2018) EWCA Civ 2250

Intervention costs statutory demands

The Law Society successfully appealed against a decision to set aside two statutory demands (of £151,816.27 and £643,489.20) which had been served on John Blavo in relation to costs incurred in respect of the intervention into his practice.

Miscellaneous 2018-10-16 Patten Lewison Moylan John Blavo Law Society Court of Appeal [2018] EWCA Civ 2250 [2018] WLR(D) 637
Joseph, Application for Reconsideration by (2019) PBRA 43

Reconsideration of Parole Board decision

Unsuccessful application by prisoner with mental health background for reconsideration on basis of irrationality and procedural unfairness of Parole Board oral hearing panel's decision not to direct release on licence.

==Note== Appeared on BAILII on 19/2/20. Prison law cases 2019-10-22 Jeremy Roberts Joseph Secretary of State for Justice Parole Board [2019] PBRA 43
JS v SLAM NHS Foundation Trust (2019) UKUT 172 (AAC)

Reinstatement

(1) Reinstatement: "As there is no right to reinstatement, the tribunal has a discretion whether or not to reinstate the party’s ‘case’. It must, like all discretions, be exercised judicially and that involves complying with the overriding objective of the tribunal’s rules of procedure, which is ‘to enable the Tribunal to deal with cases fairly and justly’ (rule 2(1)). ... Considered methodically, the factors that the tribunal should take into account neatly divide into three. First, the tribunal should consider whether there is anything to undermine either the patient’s application to withdraw or the tribunal’s consent. Just to give some examples, the application may have been based on a misunderstanding of the facts or the law. Or there may be an issue whether the patient had capacity or gave informed consent. Or the tribunal’s reasons for consenting may have been defective. Second, there may have been a change of circumstances that makes it appropriate to agree to reinstatement. Third, the tribunal will have to consider any other factors that may be relevant under the overriding objective. These will include: (a) the reasons given in support of the application, whatever they may be; (b) any prejudice to the patient in refusing consent; (c) any detriment to the other parties if consent is given; (d) any prejudice to other patients if consent is given; and (d) any impact that reinstatement might have on the operation of the tribunal’s mental health jurisdiction system as a whole." (2) Respondent status: "[T]he Trust was properly named as a respondent on the appeal to the Upper Tribunal ... The Trust was the responsible authority and, as such, a party to the proceedings in the First-tier Tribunal ... On appeal by the patient to the Upper Tribunal, everyone else who was a party before the First-tier Tribunal became a respondent ... That is standard procedure in appeal generally. The Trust’s letter shows a confusion between an appeal and a judicial review. In the latter, the tribunal is the respondent, and others may be interested parties."

==Note== In paragraph 3, UTJ Jacobs stated: "The tribunal gave its consent on 20 August 2018. That decision was made by an authorised member of staff purporting to act under the authority of the Senior President’s Practice Statement on Delegation of Functions to Staff and Registrars of 10 June 2014. In fact, that Statement had been replaced by one of 27 April 2015." In fact, ''that'' statement had been replaced by [[Practice Statement: Delegation of Functions to Registrars, Tribunal Case Workers and Authorised Tribunal Staff on or after 8 July 2016 (7/7/16)]]. Powers Upper Tribunal decisions 2019-05-30 Jacobs JS South London and Maudsley NHS Foundation Trust Secretary of State for Justice Upper Tribunal [2019] UKUT 172 (AAC)
King's College Hospital NHS Foundation Trust v FG (2019) EWCOP 7

Medical treatment case

"[T]he King's College Hospital NHS Foundation Trust seeks an order in the following terms in relation to FG: (a) a declaration that FG lacks capacity to make decisions regarding the medical treatment for his physical health conditions; (b) that it is lawful and in FG's best interests for him to undergo an operation to repair his right shoulder fracture/dislocation; and (c) that it is in his best interests to receive any sedation and anaesthesia his clinicians think necessary to allow the operation to be done. The matter has come in front of me today as urgent applications judge."

Deprivation of liberty Medical treatment cases 2019-01-29 Francis King's College Hospital NHS Foundation Trust FG South London and Maudsley NHS Foundation Trust Court of Protection [2019] EWCOP 7
LB Islington v AA (2018) EWCOP 24

Residence, wishes and feelings

"These proceedings began with three applications, all dated 27th July 2017. One application was made on form DLA in respect of an Urgent Authorisation of deprivation of liberty at C Lodge granted on 24th July 2017. The other applications were made on forms COP1 and COP9, and sought orders for the return of AA to C Lodge."

Best interests 2018-07-05 Hilder London Borough of Islington Court of Protection [2018] EWCOP 24 E90-10
LCN v KF (2019) EWCOP 1

Settlement of property on trust

"This is an application under section 18(1)(h) of the Mental Capacity Act 2005 for the settlement of CJF's property on trust. ... By the time of the hearing it was expected that CJF would die in a matter of days. As noted earlier in this judgement, CJF died the following week. ... LCN [CJF's deputy] made an application on 20th November 2018 for the settlement of CJF's assets including his property at 1AY on revocable trust for himself during his lifetime and thereafter for 1AY to pass to EH [CFJ's daughter] and AH [EH's husband] and the residue of CJF's estate to pass to KF [CFJ's mother]. ... By the rules of intestacy, CJF's estate would be divided equally between KF and CJF's biological father, stated by KF to be BJF. This is subject to section 18 of the Family Law Reform Act 1987 which raises a rebuttable presumption that BJF pre-deceased CJF as his name did not appear on CJF's birth certificate. KF was able to contact BJF, but only through social media. That contact was sufficient, in my view, to rebut the presumption. If the court did not approve the settlement of CJF's property, it would be divided equally between KF and BJF with nothing passing to EH and AH. It would be open to EH and AH to make an application under the Inheritance (Provision for Family and Dependants) Act 1975, but the outcome of such an application was uncertain. ... In this case, I consider that there were exceptional circumstance justifying proceeding without BJF being notified. These circumstances were his complete lack of involvement in CJF's life and care and his denial of paternity. There was a genuine urgency and balancing the prejudice of proceeding in the absence of BJF with the prejudice to EH and AH of not proceeding, I considered that the hearing had to take place despite the lack of service on BJF. It was agreed between the parties, and I ordered, that attempts should be made after the hearing to locate BJF and serve him with a copy of the final order so that it would be open to him to apply to set aside or vary it. ... The parties agree, and I find, that the authorities on the making of a statutory will apply to the settlement of CJF's estate in this case. I was advised by Miss Hughes that between 1925 and 1959 the Court had no power to make a statutory will and so would have approved settlement trusts as an alternative. ... All agreed that 1AY should pass to EH and AH and that the residue of the estate should pass to KF. I take that agreement into account and see no reason to depart from it. ... The question remains whether AH and EH should be effectively liable for some of the Inheritance Tax liability or whether the liability should all be borne by the estate, and in effect KF. ... I do not consider that it would be in CJF's best interests for there to be any risk to the security and stability of EH's and AH's home and therefore I consider that they should inherit 1AY effectively free of Inheritance Tax."

Statutory will cases 2019-01-03 Beckley LCN CJF Court of Protection [2019] EWCOP 1
Leeds Teaching Hospitals NHS Trust v JF (2018) EWCOP 32

Tracheostomy tube, escalation, morphine

"... N suffered a cardiac arrest in the taxi as she was arriving at Leeds General Infirmary and as a result for some 20 minutes or so ceased breathing and suffered a severe hypoxic injury. In consequence she has suffered a very significant and severe brain injury. The position now and since then has remained that she is essentially unconscious. ... The issues before me have been threefold. First, whether or not the tracheostomy tube should be removed. ... The second issue has rather retreated in significance. I have to consider whether or not N should receive an escalation of invasive care or treatment, in particular vasoactive drugs, renal replacement therapy, ventilation treatment that requires central venous action or CPR. ... That brings me on to morphine, and that is a difficult issue."

Medical treatment cases 2018-07-20 Cohen Leeds Teaching Hospitals NHS Trust JF CH Court of Protection [2018] EWCOP 32 E90-08
LJ v Mercouris (2019) EWHC 1746 (QB)

Litigation friend

"The essential questions are: (1) Does Mr [J] lack capacity within the meaning of the Mental Capacity Act 2005. (2) Is the court satisfied that Mrs [J] satisfies the conditions in Rule 21.4 (3). This requirement is incorporated by Rule 21.6 (5). The main function of a litigation friend appears to be to carry on the litigation on behalf of the Claimant and in his best interests. However, part of the reasoning for imposing a requirement for a litigation friend appears also to be for the benefit of the other parties. This is not just so that there is a person answerable to the opposing party for costs."

Litigation capacity cases Other capacity cases 2019-07-05 Stewart Alexander Mercouris LJ High Court (Queen's Bench Division) [2019] EWHC 1746 (QB)
LMN v Government of Turkey (2018) EWHC 210 (Admin)

Extradition

"It would be unlawful for this country to extradite the appellant to Turkey if he would there face a real risk of being treated in a manner which breached his Article 3 right not to be "subjected to torture or to inhuman or degrading treatment or punishment": see R (Ullah) v Special Immigration Adjudicator [2004] 2 AC 323B. It is for the appellant to establish that there are substantial grounds for believing that, if extradited, he will face such a risk; and the ill-treatment must reach a minimum level of severity before Article 3 would be breached. Given that Turkey is a member of the Council of Europe and a signatory to the European Convention on the Prevention of Torture, the respondent is entitled to rely on the presumption that the Turkish authorities will protect prisoners against breaches of their Article 3 rights. Mr Josse has not invited this court to decide the appeal on the basis of findings about the Turkish prison system as a whole, and in any event there is no evidence which would enable the court to do so. ... There are in my judgment two key aspects of the evidence relating to the Article 3 issue: the expert evidence as to the appellant's mental health; and the expert evidence as to prison conditions in Turkey following the attempted coup. ... In those circumstances, I accept the expert evidence now available as establishing that the appellant is presently suffering from a recognised medical condition, namely severe depressive episode; that he also presents some features of PTSD; that he is currently prescribed antidepressant medication, and in receipt of regular psychological counselling; that there is a continuing need for coordinated care management; and that there is a high risk of suicide in the event of extradition. ... The further evidence now before the court shows, as I have indicated, a continuing need for medication and healthcare. The appellant has very plainly raised the issues of whether his healthcare needs would in fact be met, and whether the healthcare which is in principle available in Turkish prisons would in fact be available to the appellant in the context of the greatly-increased prison population. There is simply no evidence that such care will be available to him. ... In my judgment, taking into account the risk of suicide, a failure to meet the mental healthcare needs of the appellant would in the circumstances of this case attain the minimum standard of severity necessary to breach his Article 3 rights. ... It follows that his extradition would not be compatible with Article 3 or with section 87 of the 2003 Act."

Repatriation cases 2018-02-09 Holroyde Jay LMN Government of Turkey High Court (Administrative Court) [2018] EWHC 210 (Admin)
Loake v CPS (2017) EWHC 2855 (Admin)

Insanity

"For the purposes of this appeal we shall assume that the Appellant pursued a course of conduct which objectively amounted to harassment. The real issue is the question whether the defence of insanity is available on a charge of harassment contrary to Section 2(1) of the PFHA given the terms of Section 1(1)(b). ... It follows that we answer 'Yes' to the question posed in the stated case: 'Is the defence of insanity available for a defendant charged with an offence of harassment, contrary to Section 2(1) PFHA?' ... Finally, we add this. Although in this judgment we have held that the M'Naghten Rules apply to the offence of harassment contrary to Section 2 of the PFHA just as they do to all other criminal offences, this should not be regarded as any encouragement to frequent recourse to a plea of insanity. M'Naghten's Case makes clear that every person is presumed to be sane. The burden lies on a defendant to prove on a balance of probabilities that he or she falls within the M'Naghten Rules. The offences in the PFHA generally require a "course of conduct", that is, conduct on more than one occasion (see Section 7). In practice, prosecutions are generally brought in respect of conduct repeated many times over a significant period. We do not anticipate that someone who has engaged in such conduct will readily be able to show that throughout that period they did not know the nature and quality of their act, or that throughout that time they did not know what they were doing was wrong, in the necessary sense. If the defence is to be relied upon, it will require psychiatric evidence of great cogency addressing the specific questions contained in the M'Naghten Rules. In the Crown Court, by Section 1 of the 1991 Act, the special verdict may not be returned except on the evidence of two registered medical practitioners. In the absence of cogent psychiatric evidence about the specific relevant aspects of a defendant's mental state throughout his alleged course of conduct, we would expect magistrates and judges to deal robustly with claimed defences of insanity."

Unfitness and insanity cases 2017-11-16 Irwin Julian Knowles Alice Loake Crown Prosecution Service High Court (Administrative Court) [2017] EWHC 2855 (Admin) [2017] WLR(D) 763 [2018] Crim LR 336 [2018] 1 Cr App R 16 [2018] QB 998 [2018] MHLR 81 [2018] 2 WLR 1159
London Borough of Hackney v SJF (2019) EWCOP 8

Residence, contact, tenancy

"SJF is a 56 year old woman with a complicated matrix of physical and mental health issues. Apart from frequent hospital admissions, she is presently living in a residential placement. She wants to go home to live in her rented flat with her son. The Court is asked to determine: (a) Whether she has capacity to make decisions about where she lives, how she is cared for, the contact she has with others (notably her son) and whether to terminate and enter into tenancy agreements; and (b) If she lacks capacity in the relevant domains, where she should live, whether her contact with her son should be restricted and whether tenancy agreements should be terminated/entered into."

Best interests Other capacity cases 2019-03-12 Hilder London Borough of Hackney SJF JJF Court of Protection [2019] EWCOP 8
London Borough of Hounslow v A Father & A Mother (2018) EWCOP 23

Disproportionate litigation - legal costs, and LIP costs

Judge's headnote: "Costs in the Court of Protection - Disproportionate litigation - Whether a litigant in person is entitled to recover costs including loss of earnings"

COP costs cases 2018-09-21 Eldergill London Borough of Hounslow A Father A Mother Court of Protection [2018] EWCOP 23
London Borough of Tower Hamlets v A (2020) EWCOP 21

Residence and care capacity

(1) Residence and care decisions are usually considered as individual domains of capacity, in keeping with the MCA's "issue-specific" approach; residence and care decisions involve overlapping information and are not made in separate "silos"; overlap does not mean that a residence decision incorporates a care decision: it is not necessary to make a capacitous decision about care in order to make a capacitous decision about residence. What was required for A to make a capacitous decision about where she lives is a broad understanding of the sort of care which would be provided in each of the two places of residence potentially available to her. Although it was agreed that A lacked capacity to decide how she was cared for, it was decided that she had capacity to decide whether to continue to live in residential care or return to live in her own flat with a care package. (2) Legal Aid would have ended had the DOLS standard authorisation ended: in a postscript the judge decided that, as A had no choice until the home care package was available, "the determination that A lacks capacity to determine the care that she should receive necessarily means that she lacks capacity within the meaning of paragraph 15 of Schedule A1 (that "[t]he relevant person meets the mental capacity requirement if he lacks capacity in relation to the question whether or not he should be accommodated in the relevant hospital or care home for the purpose of being given the relevant care or treatment").

Deprivation of liberty Other capacity cases 2020-04-23 Hilder London Borough of Tower Hamlets A KF Court of Protection [2020] EWCOP 21 104 10
London Borough of Tower Hamlets v NB (2019) EWCOP 17

Capacity to consent to sex with husband

"There is also evidence that indicates that NB very much enjoys the status of marriage, is affectionate to her husband [AU] and, on occasion, initiates sexual relations. This appears consistent with Ms Wilson's observations as long ago as 1996. The primary issue before the Court is whether NB truly has the capacity to consent to sexual relations. ... Unfortunately, the case attracted a great deal of media coverage, this notwithstanding that no argument had been heard and no Judgment delivered. A great deal of the comment was sententious and, in some instances, irresponsible. It is considered, by the Official Solicitor and the applicant Local Authority, that the impact of that publicity frightened AU very considerably, leading him to believe that he was likely to be sent to prison. He has left the party's flat and disengaged with these proceedings. ... [Mr Bagchi for the OS] submits it is a 'general' or 'issue-specific' test rather than a partner-specific one. If Mr Bagchi is correct, the difficulty that presents in this case is that there is only one individual with whom it is really contemplated that NB is likely to have a sexual relationship i.e. her husband of 27 years. It seems entirely artificial therefore to be assessing her capacity in general terms when the reality is entirely specific. ... As I said on the last occasion, these issues are integral to the couple's basic human rights. There is a crucial social, ethical and moral principle in focus. It is important that the relevant test is not framed in such a restrictive way that it serves to discriminate against those with disabilities, in particular those with low intelligence or border line capacity. ... Mr Bagchi has accepted that if a person-specific test were applied here then the outcome, in terms of assessment of NB's capacity may be different. ... I do not necessarily consider that the applicable test in the Court of Protection necessarily excludes the 'person specific approach'. I am reserving my Judgment ..."

Capacity to consent to sexual relations 2019-05-07 Hayden London Borough of Tower Hamlets NB AU Court of Protection [2019] EWCOP 17 IM v LM (2014) EWCA Civ 37, (2014) MHLO 1
Lord Chancellor v Blavo and Co Solictors Ltd (2018) EWHC 3556 (QB)

John Blavo personally ordered to repay Legal Aid claims

The High Court gave judgment for the Lord Chancellor against John Blavo in the sum of £22,136,001.71 following the allegation that Blavo & Co made dishonest claims for payment on the legal aid fund for thousands of cases where it was not entitled to any fee.

Miscellaneous 2018-12-21 Pepperall Lord Chancellor Blavo and Co Solictors Ltd John Blavo High Court (Queen's Bench Division) [2018] EWHC 3556 (QB)
Lord Chancellor v John Blavo (2016) EWHC 126 (QB), (2016) MHLO 6

Freezing order continued

There was a strongly arguable case that John Blavo was party to an arrangement whereby false claims were submitted to the LAA in many thousands of cases, there was evidence of a less than scrupulous approach to his duty of disclosure to the Court, and evidence of a recent attempt improperly to put property beyond the reach of the Lord Chancellor. Taking these matters together there was a real risk that any judgment would go unsatisfied because of disposal of assets. Given the sums of money involved and the admitted financial difficulties it was just and convenient in all the circumstances to continue the freezing order. (The precursor to the official investigation was an audit during which 49 files were passed to the LAA's counter-fraud team, whose conclusions included: "In respect of 42 of these 49 files HMCTS have confirmed that they have no record of there having been tribunal proceedings either in respect of the individual client or on the date when the file indicates...Following this, the LAA made inquiries of the NHS on a selection of files among the 42 that had no tribunal hearing and the NHS confirmed that they have no records relating to 16 of the clients... After completing this analysis the Applicant undertook a further comparison of all mental health tribunal claims against the HMCTS system. As a result of this analysis, it was found that the Company had submitted a total of 24,658 claims for attendance at tribunals of which 1485 (6%) tribunals were recorded by HMCTS as having taken place... After visiting the Company's Head Office and requesting documentation from the Company and the Respondent, the LAA team used an electronic sampling tool to randomly select 144 cases for further investigation, across the last three complete financial years. Only 3% could be evidenced from HMCTS records...")

Miscellaneous 2016-01-28 Garnham Lord Chancellor John Blavo MSP Capital High Court (Queen's Bench Division) [2016] EWHC 126 (QB)
Lord Chancellor v John Blavo (2016) EWHC 126 (QB), (2016) MHLO 6.pdf
LV v UK 50718/16 (2018) MHLO 22

MHT/Parole Board delay

"Complaint: The applicant complains under Article 5(4) of the Convention that she did not have a speedy review of the legality of her detention. In particular, she contends that her right to a speedy review was violated both by delays on the part of the Public Protection Casework Section and the Parole Board, and from the unnecessary two-stage Tribunal/Parole Board process. Question to the Parties: Was the review of the applicant’s detention which commenced on 24 May 2011 and concluded on 21 March 2013 conducted 'speedily' within the meaning of Article 5(4) of the Convention?" (The first paragraph of the decision is wrong as the applicant's solicitor works for Campbell Law Solicitors.)

ECHR deprivation of liberty cases Prison law cases 2018-03-12 LV United Kingdom European Court of Human Rights [2018] MHLO 22
LV v UK 50718/16 (2019) MHLO 32 (ECHR)

MHT/Parole Board delay

LV, a s47/49 patient, had argued that there had been a delay, in breach of Article 5(4), in securing her release, in particular because of the two-stage process involving both the Mental Health Tribunal and Parole Board. She accepted the government's offer of £2,500 in settlement of her claim.

Deprivation of liberty 2019-06-06 Ales Pejchal Tim Eicke Raffaele Sabato LV United Kingdom European Court of Human Rights [2019] MHLO 32 (ECHR)
LW v Cornwall Partnership NHS Foundation Trust (2018) UKUT 408 (AAC)

Meaning of "nature" in discharge criteria

(1) Having considered the statutory framework of CTOs and the legislative purposes behind them the UT concluded, primarily on that basis, that in cases where there is a risk of a relapse which might necessitate recall, how soon that such a relapse is likely to occur is a relevant consideration. However, other factors, including the risk to the patient and/or others if a relapse were to occur, may also be relevant, and there is no requirement for likely relapse to be "soon", "in the near future" or within the permitted duration of a CTO. (2) Addressing the claimants' arguments on the analogy between detention and CTO cases, the judge stated that while there are some parallels between the s3 regime and CTOs they are not such that the same principles necessarily apply to both, and (to the extent necessary to reach a view on the detention cases) neither of the previous judgments cited in CM v Derbyshire Healthcare NHS Foundation Trust [2011] UKUT 129 (AAC) provided an authoritative basis for the view that imminence of relapse is the only factor or need be in the near future.

==Judicial Summary== From Gov.uk website (link below): <div class="perm"> Is a defined degree of imminence of likely relapse required in order to justify not discharging a patient from a CTO? What is to be expected of the FtT’s reasons in such a case? </div> ==Note== The judgment lists the respondent as "Cornwall Partnership NHS Trust". Upper Tribunal decisions 2018-11-29 Jacobs LW Cornwall Partnership NHS Foundation Trust SE Devon Partnership NHS Trust TS Birmingham and Solihull Mental Health NHS Trust Upper Tribunal [2018] UKUT 408 (AAC) CM v Derbyshire Healthcare NHS Foundation Trust (2011) UKUT 129 (AAC)
M v A Hospital (2017) EWCOP 19

Withdrawal of CANH

"This judgment is given: (a) To explain why CANH was withdrawn from M, a person in a minimally conscious state (MCS). (b) In response to the request of the parties for clarification of whether legal proceedings were necessary or not when there was agreement between M's family and her clinicians that CANH was no longer in her best interests. (c) To explain why the court appointed M's mother, Mrs B, as her litigation friend, rather than the Official Solicitor. The short answer to these questions is that: (a) CANH was withdrawn because it was not in M's best interests for it to be continued. The evidence showed that it had not been beneficial for the previous year. (b) In my view, it was not necessary as a matter of law for this case to have been brought to court, but given the terms of Practice Direction 9E and the state of the affairs before the very recent decision of the Court of Appeal on 31 July in the case of Briggs [2017] EWCA Civ 1169B, it is understandable that the application was made. (c) Mrs B was appointed as litigation friend because she was a proper person to act in that role: the fact that she supported the withdrawal of her daughter's treatment did not show that she had an adverse interest to her."

Medical treatment cases 2017-09-20 Peter Jackson M A Hospital Court of Protection [2017] EWCOP 19 [2017] WLR(D) 615 [2018] 2 All ER 551 [2017] Med LR 558 [2018] 1 WLR 465 [2017] COPLR 398
M v Abertawe Bro Morgannwg University Health Board (2018) UKUT 120 (AAC)

Covert medication and MHT

The tribunal had failed to turn its mind to the extent to which (despite his lack of capacity to conduct proceedings) the patient was capable of participating in proceedings before addressing the test for non-disclosure. The appeal was allowed and the matter remitted to the tribunal to re-make its decision.

==Citation== On Bailii as: M v ABM University Health Board (Mental health) MHT capacity cases Upper Tribunal decisions 2018-03-27 Mitchell M Abertawe Bro Morgannwg University Health Board ABM University Health Board Upper Tribunal [2018] UKUT 120 (AAC) RM v St Andrew's Healthcare (2010) UKUT 119 (AAC)
M v An NHS Trust (2017) MHLO 39 (UT)

Tribunal reasons

"[T]he tribunal's decision was made in error of law, but not [set aside]. In my grant of permission, I identified two possible errors of law. ... One of those errors was that the tribunal's reasons might be inadequate for being 'long on history and evidence but short on discussion.' ... There is, in truth, only one thing that really has to be said about the quality of reasons, which is that they must be adequate. Everything else is merely application of that principle to the circumstances of a particular case. ... [T]he second possible error [is] that the 'tribunal's reasoning shows that it was confused about its role and the [relevance] of a community treatment order'. ... [T]he reasons at least leave open the possibility that the tribunal may have strayed outside its proper remit. ... The first three sentences read: 'A cardinal issue of this application is whether the patient should be discharged from hospital by a CTO. This issue involves knowledge of the nature of a CTO. A CTO may only be imposed by the patient's RC ...' It may be that the judge did not express himself clearly, but that passage appears to begin by suggesting, and to continue by denying, that the tribunal had power to make Mr M subject to an order or was being asked to approve that course. The judge did then make a distinction between discharge from hospital and discharge from the liability to be detained. So it is possible that his reference to 'discharge from hospital by a CTO' may have been intended, not as a direction about the tribunal's powers on the application, but as a statement of how the responsible clinician envisaged Mr M's eventual progress. This interpretation would be consistent with what the tribunal said later ... In view of Mr M's current status [he had been discharged], I do not have to decide whether those reasons do or do not show that the tribunal misdirected itself. I limit myself to saying that it is risky if reasons can be read in a way that indicates a misdirection. ... Given that Mr M is no longer liable to be detained, I can see no need to venture outside the appropriate role of the Upper Tribunal in mental health cases and state, even in the form of a narrative declaration, that the tribunal should have exercised its power to discharge him. That is why I have exercised my power to refuse to set aside the tribunal's decision regardless of any error of law that it may have made."

==Note== Transcript provided by Richard Jones (solicitor for the Trust) Reasons Upper Tribunal decisions 2017-04-28 Jacobs M An NHS Trust Upper Tribunal
(2017) MHLO 39 (UT).pdf
MacDonald v Burton (2020) EWHC 906 (QB)

Audio recording of neuropsychological testing

(1) The defendant was allowed to carry its neuropsychological examination of the claimant without being subjected to any kind of recording of that examination: a level playing field could not be achieved where the claimant had not recorded the examination and testing by his own expert but where the examination testing by the defendant's expert was so recorded. (2) The judge discussed the question of any privilege which may exist in any recordings that are made. (3) The judge hoped that the forthcoming British Psychological Association guidance would recognise the competing interests and would not merely state that psychological examinations and testing should never be recorded.

Miscellaneous 2020-03-13 Martin Spencer Rory MacDonald Simon Burton High Court (Queen's Bench Division) [2020] EWHC 906 (QB)
Maitland-Hudson v SRA (2019) EWHC 67 (Admin)

Dishonest solicitor

"The Appellant appeals against findings of misconduct and dishonesty made against him by ... the Solicitors Disciplinary Tribunal ... Pursuant to those findings, on 2 May 2018 the Appellant was struck off the Roll of Solicitors and ordered to pay the SRA's costs, including £300,000 by way of interim payment. The Tribunal found the Appellant to have been guilty of misconduct "at the highest level", characterised as "deliberate, calculated and repeated… over a number of years". It was aggravated by the Appellant's dishonesty and attempts to defend his conduct. The appeal is based on grounds of alleged procedural unfairness, specifically that the Appellant, a litigant in person, was substantially impaired in his ability to defend himself, to the extent that he admitted himself to hospital. Despite the fact that consultant psychiatrist experts on both sides found that the Appellant was unable to represent himself, the Tribunal refused to dismiss the proceedings on the basis of "incurable unfairness" or even to stay or adjourn their remainder."

SRA decisions 2019-01-24 Green Carr Alexis Maitland-Hudson Solicitors Regulation Authority High Court (Administrative Court) [2019] EWHC 67 (Admin)
Manchester City Council Legal Services v LC (2018) EWCOP 30

Sexual exploitation, restrictions where adults have capacity

After a circuit judge endorsed a care plan which led to the repeated sexual exploitation by strangers of a young woman with autism and significant learning disabilities (who had capacity to consent to sexual relations but lacked capacity to make decisions on her contact with men), Hayden J provided guidance that 'where issues arise that may necessitate restrictions in areas where adults have capacity, these should be heard by a High Court Judge in the Court of Protection'.

==Citation== Originally on Bailii with the neutral citation number [2018] EWHC 2849 (Fam). Capacity to consent to sexual relations 2018-10-24 Hayden Manchester CIty Council Legal Services LC KR Court of Protection [2018] EWCOP 30 E90-04
Manchester University NHS Foundation Trust v DE (2019) EWCOP 19

Jehovah's Witness - blood transfusion

"The only issue during the hearing was the degree to which DE's wishes and feelings would be overborne by a decision to allow a blood transfusion, in the light of her being a Jehovah's Witness; and therefore whether there was a disproportionate interference in DE's article 8 rights. However, the evidence even at the oral hearing was that although DE described herself as a Jehovah's Witness she was not someone for whom those beliefs were central to her personality or sense of identity. During the oral hearing I did not get any sense that she would feel deeply upset if an order was made in the form sought, or that she would feel a deep conflict with her religious beliefs. As such she was someone who was in a quite different decision from B in Jackson J's decision, where his religious beliefs were fundamental to B's sense of who he was. The other stark contrast with that case is that DE had been completely clear that she did not want to die. She is also significantly younger than was B."

Medical treatment cases 2019-04-19 Lieven Manchester University NHS Foundation Trust DE Court of Protection [2019] EWCOP 19 Wye Valley NHS Trust v B (2015) EWCOP 60
Mazhar v Lord Chancellor (2017) EWHC 2536 (Fam)

Inherent jurisdiction

"This is a claim brought under sections 6, 7(1)(a), 8(1) and 9(1)(c) of the Human Rights Act 1998 against the Lord Chancellor in respect of a judicial act. The act in question is an order made by a High Court judge, Mr Justice Mostyn, who was the Family Division out of hours applications judge on the late evening of Friday, 22 April 2016. The order was made on the application of Birmingham Community Healthcare NHS Foundation Trust. It was an urgent, without notice, out of hours application made in respect of the claimant, Mr Aamir Mazhar. ... Mr Mazhar seeks to argue that the inherent jurisdiction cannot be used to detain a person who is not of unsound mind for the purposes of article 5(1)(e) of the Convention and that a vulnerable person's alleged incapacity as a result of duress or undue influence is not a basis to make orders in that jurisdiction that are other than facilitative of the person recovering, retaining or exercising his capacity. His removal and detention were accordingly unlawful and in breach of article 5. He also seeks to argue that his article 6 rights were engaged such that the absence of any challenge by the judge to his capacity and/or the evidence of the NHS Trust and the absence of any opportunity to challenge those matters himself or though his family or representatives before the order was executed was an unfair process. He says that his article 8 right to respect for family and private life was engaged and that the order was neither necessary nor in accordance with the law. ... The consequence is that I have come to the conclusion that there is nothing in the HRA (taken together with either the CPR or the FPR) that provides a power in a court or tribunal to make a declaration against the Crown in respect of a judicial act. Furthermore, the HRA has not modified the constitutional principle of judicial immunity. Likewise, the Crown is not to be held to vicariously liable for the acts of the judiciary with the consequence that the claim for a declaration is not justiciable in the Courts of England and Wales. A claim for damages against the Crown is available to Mr Mazhar for the limited purpose of compensating him for an article 5(5) breach but the forum for such a claim where the judicial act is that of a judge of the High Court cannot be a court of co-ordinate jurisdiction. On the facts of this case, the only court that can consider a damages claim is the Court of Appeal. If Mr Mazhar wants to pursue his challenge to the order of Mostyn J he must do so on appeal."

Inherent jurisdiction cases 2017-10-12 Ernest Ryder Aamir Mazhar Lord Chancellor High Court (Family Division) [2017] EWHC 2536 (Fam) [2017] WLR(D) 680 [2018] Fam 257 [2018] 2 WLR 1304
McCann v State Hospitals Board for Scotland (2014) CSIH 71

Scottish smoking ban

The smoking ban at Carstairs Hospital, which at first instance had been declared to be unlawful, was decided on appeal to be lawful.

==Note== Judicial history: see [[Re CM (Judicial Review) (2013) CSOH 143]] Miscellaneous 2014-08-12 Carloway McCann Scottish Court of Session [2014] ScotCS CSIH_71 2014 SCLR 817 2015 SC 112 [2014] CSIH 71 [2014] MHLO 93
McCann v State Hospitals Board for Scotland (2017) UKSC 31

Scottish smoking ban

"This is a challenge by application for judicial review to the legality of the comprehensive ban on smoking at the State Hospital at Carstairs which the State Hospitals Board for Scotland adopted by a decision taken at a meeting on 25 August 2011 and implemented on 5 December 2011. The appellant, Mr McCann, does not challenge the ban on smoking indoors. His challenge relates only to the ban on smoking in the grounds of the State Hospital and on home visits, which, by creating a comprehensive ban, prevents detained patients from smoking anywhere. ... Mr McCann raises three principal issues in his challenge. First, he argues that the impugned decision is invalid at common law on the ground of ultra vires because, when so deciding, it did not adhere to the principles laid down in section 1 of the Mental Health (Care and Treatment) (Scotland) Act 2003 (which I set out in para 22 below) or comply with the requirements of subordinate legislation made under the 2003 Act. Secondly, he submits that the impugned decision was unlawful because it unjustifiably interfered with his private life and thereby infringed his right to respect for his private life under article 8 of the European Convention on Human Rights and Fundamental Freedoms. Thirdly, founding on article 14 of ECHR in combination with article 8, he argues that the Board, by implementing the comprehensive smoking ban, has treated him in a discriminatory manner which cannot be objectively justified when compared with (i) people detained in prison, (ii) patients in other hospitals (whether detained or not) or (iii) members of the public who remain at liberty. ... [T]he prohibition on having tobacco products and the related powers to search and confiscate are in my view illegal and fall to be annulled. ... [B]ut for the illegality under our domestic law of the prohibition of possession of tobacco products, the searches and the confiscation of tobacco products which are part of the impugned decision, I would have held that the decision was not contrary to Mr McCann’s article 8 right to respect for his private life. ... The article 14 challenge ... fails."

==Note== Judicial history: see [[Re CM (Judicial Review) (2013) CSOH 143]] Miscellaneous 2017-04-11 Hale Mance Wilson Reed Hodge McCann State Hospitals Board for Scotland Supreme Court [2017] UKSC 31 [2017] WLR(D) 268 2017 GWD 12-169 (2017) 156 BMLR 35 [2017] WLR 4575 [2017] 1 WLR 1455 2017 SLT 451 :[2017] 4 All ER 449 [2017] MHLO 22
Miller v DPP (2018) EWHC 262 (Admin)

Appropriate adult

"This is an appeal by way of case stated from a pre-trial ruling of the Black Country Magistrates' Court sitting at Dudley on 13 October 2016 in respect of an information preferred against the Appellant for failing to provide a specimen of blood in breach of section 7 of the Road Traffic Act 1988, not to exercise its discretion under section 78 of the Police and Criminal Evidence Act 1984 to exclude evidence of the drug drive procedure at Oldbury Police Station that led to the charge being made. ... On 24 June 2016, the Appellant was stopped by the police on suspicion of driving under the influence of drugs. When arrested and taken into custody, he behaved erratically and aggressively. It appears that he was known to the police as a person who had learning difficulties and autism. ... As Mr Scott submitted, the presence of an appropriate adult (whilst not being able to provide technical, legal or medical advice) would have provided the Appellant with the opportunity not only to have the question as to whether or not to provide a sample explained to him, but also to obtain an appreciation of the consequences of failing to do so. He points out that the offence of failing to provide a blood sample is predicated not only on the person's comprehension of the requirement to provide a sample, but also of the consequences of failing to do so in terms of criminal liability. The Appellant was clearly very exercised whilst being detained, and there is a very real possibility that the presence of an appropriate adult would have calmed him, and led him to behave differently and make different choices from those he in fact made. ... [H]aving found there to have been a breach of Code C in failing to inform and summon an appropriate adult to the police station, we do not consider that the magistrates did properly exercise their discretion under section 78 of PACE not to exclude the evidence of the drug drive procedure. Their reasoning was, unfortunately, fundamentally flawed; and, had they exercised their discretion properly, they would have been bound to have excluded the evidence of the drug drive procedure."

Other criminal law cases 2018-02-15 Hickinbottom Dove Christopher James Miller Director of Public Prosecutions High Court (Administrative Court) [2018] EWHC 262 (Admin)
Milton Keynes CCG (17 018 823e) (2019) MHLO 61 (LGSCO)

Section 117 complaint

"Whilst the Trust was acting on behalf of the CCG in carrying out the s117 actions, the CCG is ultimately responsible for s.117 provision, along with the Council. ... The CCG, Trust and the Council should, by 23 December: (a) Write to Mrs B apologising for the impact of the fault in relation to not refunding the care fees relating to the supported living placement. (b) Confirm with Mrs B and refund the supported living fees which have not already been reimbursed. Mrs B may need to provide additional information to the organisations about fees paid as part of this. (c) Write to Miss A and Mrs B personally and apologise for the impact the lack of s.117 planning had on both of them individually due to the length of time Miss A went without adequate support. They should also apologise for the uncertainty caused by not knowing whether the incidents outlined above could have been avoided. (d) Pay Miss A £1500 and Mrs B £1000 each in recognition of the impact of the and length of time Miss A had a lack of s.117 support. By 20 February 2020, the Council, CCG and Trust should create an action plan of how they will notify and cooperate with each other to ensure patients are assessed promptly and s.117 care put in place in line with the MHA Code of Practice. This action plan should include a review of progress and the impact of any changes following implementation of the plan."

After-care LGO decisions 2019-11-26 Milton Keynes Clinical Commissioning Group Central and North West London NHS Foundation Trust Milton Keynes Council Local Government and Social Care Ombudsman
NHS Cumbria CCG v Rushton (2018) EWCOP 41

Withdrawal of CANH; advance decision

"This is an application regarding the proposed withdrawal of clinically assisted nutrition and hydration in respect of Mrs Jillian Rushton, who is now 85 years of age. Since sustaining a traumatic head injury in December 2015, Mrs Rushton has suffered from a prolonged period of disorder of consciousness. Insofar as a label is relevant, the consensus of medical opinion, in respect of which there is no dissent at all, is that she is in a persistent vegetative state (PVS). In their recent guidance, ‘Clinically-assisted nutrition and hydration (CANH) and adults who lack the capacity to consent’, the Royal College of Physicians and the British Medical Association have noted that the importance of obtaining a precise and definitive diagnosis has reduced. It is recognised by the Courts and clinicians that drawing a firm distinction between vegetative state and minimally conscious state is frequently both artificial and unnecessary. In practice, when assessing best interests, information about the patient’s current condition and prognosis for functional recovery and the level of confidence with which these can be evaluated is invariably of greater importance than a precise diagnosis. ... It perhaps requires to be said, though in my view it should be regarded as axiomatic, that the medical profession must give these advanced decisions the utmost care, attention and scrutiny. I am confident the profession does but I regret to say that I do not think sufficient care and scrutiny took place here. The lesson is an obvious one and needs no amplification. Where advanced decisions have been drawn up and placed with GP records there is an onerous burden on the GP to ensure, wherever possible, that they are made available to clinicians in hospital. By this I mean a copy of the decision should be made available and placed within the hospital records with the objective that the document should follow the patient. It need hardly be said that it will rarely, if ever, be sufficient to summarise an advance decision in a telephone conversation. ... The family have ... made it clear to me that she would not have regarded her present situation as tolerable. Whilst I have no doubt that she would understand the commitment of her son, Tim and his profound resistance to letting her go, I have equally no doubt that she would want to be let go and I have no hesitation in concluding that it is my responsibility to respect this."

Advance decision cases Medical treatment cases 2018-12-21 Hayden NHS Cumbria CCG Jillian Rushton Tim Rushton Court of Protection [2018] EWCOP 41
NHS Dorset CCG v LB (2018) EWCOP 7

COP costs

"In 2017, the NHS Dorset Clinical Commissioning Group launched what were intended to be four test cases seeking clarification of the law concerning the deprivation of liberty of mentally capacitated adults. For various reasons, however, all of those applications, or in some cases that part of the application relating to the deprivation of liberty issue, were withdrawn, but not before the Official Solicitor had agreed to act for two of the respondents with the benefit of publicly-funded certificates and had incurred some legal costs. Subsequently, the Official Solicitor has applied for all or part of those costs to be paid by the applicant. This judgment sets out my decision on that costs application and the reasons for that decision."

COP costs cases 2018-03-28 Baker NHS Dorset CCG LB SHC Court of Protection [2018] EWCOP 7
NHS Guilford and Waverley CCG (18 007 431a) (2019) MHLO 60 (LGSCO)

Section 117 complaint

"(1) Within one month of my final decision, the Council and CCG will: (a) Write to Miss X and Mr Y, acknowledging the fault identified in this decision and offering meaningful apologies; (b) Jointly pay Mr Y £500 for failure to provide support as outlined on his s117 aftercare plan, delayed care planning, loss of opportunity to re-engage him and distress as a result of poor communication around his care plan and eviction; (c) Jointly pay Miss X £150 for poor complaint handling, stress and inconvenience. (2) Within three months of my final decision, the Council and CCG will ensure that Cherrytrees and all other providers acting on their behalf under s117 review their policies and procedures to ensure compliance with the relevant parts of the Code of Practice: Mental Health Act Code 1983, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Act 2014, in relation to: (a) Care planning; (b) Daily record keeping; (c) Complaint handling, including ensuring all points are responded to adequately and complainants are properly signposted should they wish to escalate their complaint."

==Note== Paragraphs and bullet points in extract converted to numbers and letters. After-care LGO decisions 2019-11-29 NHS Guilford and Waverley Clinical Commission Group Local Government and Social Care Ombudsman
NHS Trust v Y (2017) EWHC 2866 (QB)

Withdrawal of CANH

"This is a claim for a declaration under CPR Part 8 that it is not mandatory to bring before the Court the withdrawal of Clinically Assisted Nutrition and Hydration ("CANH") from a patient who has a prolonged disorder of consciousness in circumstances where the clinical team and the patient's family are agreed that it is not in the patient's best interests that he continues to receive that treatment, and that no civil or criminal liability will result if CANH is withdrawn."

Medical treatment cases 2017-11-13 O'Farrell An NHS Trust Mr Y Mrs Y High Court (Queen's Bench Division) [2017] EWHC 2866 (QB) [2017] WLR(D) 771
NHS Trust v Y (2018) UKSC 46

Court order not always necessary for withdrawal of CANH

"The question that arises in this appeal is whether a court order must always be obtained before clinically assisted nutrition and hydration, which is keeping alive a person with a prolonged disorder of consciousness, can be withdrawn, or whether, in some circumstances, this can occur without court involvement. ... In conclusion, having looked at the issue in its wider context as well as from a narrower legal perspective, I do not consider that it has been established that the common law or the ECHR, in combination or separately, give rise to the mandatory requirement, for which the Official Solicitor contends, to involve the court to decide upon the best interests of every patient with a prolonged disorder of consciousness before CANH can be withdrawn. If the provisions of the MCA 2005 are followed and the relevant guidance observed, and if there is agreement upon what is in the best interests of the patient, the patient may be treated in accordance with that agreement without application to the court. I would therefore dismiss the appeal. In so doing, however, I would emphasise that, although application to court is not necessary in every case, there will undoubtedly be cases in which an application will be required (or desirable) because of the particular circumstances that appertain, and there should be no reticence about involving the court in such cases."

Medical treatment cases 2018-01-30 Hale Mance Wilson Hodge Black An NHS Trust Mr Y Mrs Y Supreme Court [2018] UKSC 46 [2018] WLR(D) 490

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