MD v Nottinghamshire Health Care NHS Trust [2010] UKUT 59 (AAC)

The Tribunal decided that appropriate treatment was available at Rampton, or alternatively that MD was benefiting from the ward milieu; their reasons were adequate. (1) The detention was not mere containment: (a) treatment could be appropriate even without the possibility of risk reduction; (b) although if there was no prospect of the patient progressing beyond milieu therapy (to engage in psychotherapeutic work) there might come a point at which treatment was no longer appropriate, MD was not at that stage. (2) There was no practical distinction in this case between s72(1)(b)(i) and (iia) so if the tribunal dealt properly with head (iia), its reasoning covered head (ii). (3) The Tribunal was entitled to rely on the evidence, and make the findings of fact, which it did. (4) Although treatment is not defined by reference to its likely effect, as a practical matter, that will have been taken into account in deciding whether the treatment could be given for a permitted purpose. (5) In relation to experts: (a) the duty on parties to co-operate in rule 2(4) must include making their experts available to comply with any directions that are given by the tribunal; (b) the medical examination and expert panel reduce the need for parties to have their own expert evidence.


Decision: 25/2/10

Before: Judge E. Jacobs

Mr Roger Pezzani (instructed by RMNJ) for the patient

Ms Gillian Irving QC (instructed by Mills and Reeve LLP) for the hospital

External links


Transcript on Tribunals website