SB v South London and Maudsley NHS Foundation Trust  UKUT 33 (AAC)
The following case report was kindly provided by Matthew Seligman of Campbell Taylor Solicitors (solicitor for the claimant):
Keywords: Mental Capacity Act 2005 – Rule 11(7)(b) of the Tribunal Procedure (First-Tier Tribunal) (Health, Education and Social Care) Rules 2008 – appointment of a representative by the Tribunal – Form MH6b – R (oao H) v. SSHM – VS v St. Andrews Healthcare  UKUT 250 (ACC) – Senior President’s Practice Statement on the Delegation of Functions – presumption of capacity remains relevant after appointment
The Appellant was deemed to lack capacity and a representative appointed by the Tribunal under Rule 11(7)(b) – Subsequently he and his mother, who was his Nearest Relative, wished to change the appointed representative and contacted the Tribunal – The Tribunal did not re-consider or rescind the original appointment, giving the reason that the appointed representative objected – That was unlawful – Even after a patient is deemed to lack capacity and a representative appointed under Rule 11(7)(b), he is entitled to have his expressed wish to change the appointed representative lawfully considered – The presumption of capacity in s1(2) MCA 2005 remains relevant, even after the appointment – Further the Form MH6b communicating the appointment decision failed to advise of a right to apply within 14 days for the decision to be considered afresh, which undermined both the process and the decision.
The Appellant SB was detained under s3 of the Mental Health Act 1983 at the Respondent’s Dennis Hill Unit at The Royal Bethlem Hospital in October 2018. At the end of his initial 6 months of detention, on 1 April, 2019, the Respondent referred SB’s case to the Tribunal and stated that they considered he lacked capacity to appoint a representative. On 16 April, the Tribunal therefore issued Form MH3 for an assessment of the Appellant’s capacity and contacted a firm to see if they would be prepared to be appointed to represent SB. On receipt of the completed form, and confirmation of the firm’s availability, the Tribunal the next day appointed a representative for SB under Rule 11(7)(b) of the Tribunal Procedure (First-Tier Tribunal) (Health, Education and Social Care) Rules 2008 (“the HESC Rules”) and subsequently listed the matter to be heard on 15 May, 2019.
Prior to the hearing, SB decided he would prefer his former solicitors to represent him. However, the Tribunal refused on 10 May, 2019 to rescind the appointment, on the basis that the newly appointed solicitors objected to the change. At that point, three working days before the hearing, the former solicitors withdrew to avoid further disruption. The hearing went ahead with SB represented by the appointed solicitors and he was not discharged. The former solicitors then entered an appeal on SB’s behalf.
The Appellant contended that it had been unlawful of the Tribunal to refuse to rescind the appointment simply because the appointed solicitor objected. His former solicitors, whom SB wished to appoint, had visited SB in hospital and on the basis of the lower test for capacity to instruct a representative set out in VS v St. Andrews Healthcare  UKUT 250 (ACC) considered him to have the relevant capacity to do so. He had completed a ‘Change of Solicitor’ form and further his mother, who was both his nearest relative under the Mental Health Act 1983 and his carer and attorney for the purposes of s4(7) of the Mental Capacity Act 2005, had counter-signed and actioned the request. The presumption of capacity in s1(2) of the Mental Capacity Act 2005 also applied. The Tribunal’s failure to take these matters properly into account simply on the basis of an objection by the appointed solicitor was unlawful.
In granting permission to appeal, Judge Gledhill also ordered disclosure and this led to Supplementary Grounds of Appeal being entered, based on criticisms of the Form MH3 which had been completed when SB was initially deemed incapacitous.
In giving Directions in the appeal, Judge Wikeley allowed the Supplementary Grounds and held that the matters complained of did fall within the Upper Tribunal’s appellate jurisdiction, notwithstanding that they related almost entirely to pre-hearing case management decisions by the Tribunal Office. (NOTE 1: Judge Wikely’s exposition in the substantive decision (paras 13-15, 24-25) of the source of Tribunal Officers’ powers under Rule 11(7), which originated from a delegation under Rule 4 of the HESC Rules and the Senior President’s Practice Statement on the Delegation of Functions, sets this in context. Accordingly, a mistaken operation of delegated judicial powers by a Tribunal Officer could amount to a legal error capable of being appealed.) The Respondent took no part in the appeal. In deciding the appeal on the papers, and allowing it in part, Judge Wikeley held:-
- 1. Form MH6b, 17 April, 2019: It was not necessary for the Court to deal with the criticisms of the Form MH3 on this occasion. However, Form MH6b was defective; in failing to notify the relevant 14-day time-limit it “failed to impress on the Appellant the urgency of mounting a challenge to the Rule 11(7)(b) appointment.” That was a material omission as a result of which the decision to appoint a representative was unlawful. (NOTE 2: It would seem to follow from this that appointed solicitors should ensure that the Form MH6b notifying the appointment decision is given to the incapacitous patient and/or his Nearest Relative, so that there is effective notice of the right to apply for a reconsideration within 14 days);
- 2. Tribunal decision of 10 May, 2019: In the absence of oral argument, the Court would not deal with matters raised under the European Convention on Human Rights and the United Nations Convention on the Rights of Persons with Disabilities on this occasion. However, the Tribunal’s refusal to rescind the appointment was held to be unlawful because:-
- The failure properly to notify the right to a review under Rule 4(3) of the HESCR Rules was material, and indicated a lack of due process;
- There was a failure to accord sufficient weight to the presumption of capacity in s1(2) of the Mental Capacity Act 2005;
- The Tribunal’s approach appeared to fail to apply the lower test of capacity set out in the authorities – see R (oao H) v. SSH M and VS v St. Andrews Healthcare  UKUT 250 (ACC);
- The reason given by the Tribunal, that the appointed solicitors objected, was insufficient. “It cannot be right that a prior appointment under Rule 11(7)(b) necessarily trumps any other consideration.” Other important considerations included having regard to the patient’s wishes and feelings and those of his nearest relative under s4 of the Mental Capacity Act 2005 and the requirements of the overriding objective in Rule 2(2)(c) of the HESC Rules: “ensuring, so far as practicable, that the parties are able to participate fully in the proceedings.” Judge Wikeley held that:
- “The effect of the Tribunal’s decision was to abdicate decision-making responsibility and to accept the default position based on the existing solicitors’ assessment of the Appellant’s capacity – the very issue which should have been determinative of the question as to whether the rule 11(7)(b) appointment should remain in place.”
- The cumulative effect of the above was that the Tribunal decision of 10 May, 2019 was tainted by fundamental unfairness.
- 3. Tribunal decision of 15 May, 2019: None of the above rendered the Tribunal’s decision at the hearing on 15 May, 2019 unlawful.
The Appellant SB had subsequently been discharged and returned to live with his mother. It was not therefore necessary as a matter of discretion to set any of the above decisions aside, events long since having overtaken them.
Finally, the Upper Tribunal has no power to award damages. Such a remedy would have to be sought elsewhere.
Case-Report: Matthew Seligman
Appellant’s Solicitors: Campbell-Taylor Solicitors, London
Incident Dates: 17 April, 10 May, 15 May, 2019
Judgment Date: 30 January, 2020
The summary below is reproduced from Mind, 'Legal Newsletter' (March 2020).
Judge finds that patients feelings should always be taken into account.
SB was a 43-year old man admitted to the Maudsley hospital under S 3 of the MHA 1983. He had been administered 22 sessions of ECT, but had not appealed to a Tribunal by the end of his first period of detention. Consequently, the detaining hospital made a referral to the Mental Health Tribunal after the first six months of treatment had, elapsed and added an application to appoint a solicitor for SB under rule 11b on the grounds he lacked litigation capacity. The Tribunal granted the application and appointed ADJ Law Solicitors to act for SB via standard form MH6b on the 7th April 2019.
Three weeks later SB’s mother (and nearest relative) helped him call the Tribunal to say that he wished Campbell-Taylor Solicitors, who had represented him previously, to represent him on this occasion. The Tribunal, in turn asked ADJ if they objected to a transfer of authority to Campbell-Taylor and they did, on the grounds that their appointment was under rule 11(b) and in their view, SB still lacked capacity.
Campbell-Taylor persisted and sent in a transfer of authority form signed by SB but also counter signed by his mother. The Tribunal adopted ADJ Law’s grounds of refusing transfer and stated if there was a question of SB regaining capacity then a new capacity statement would be needed. As the tribunal was now imminent, Campbell-Taylor did not pursue the matter further, SB was not discharged at the Tribunal, but not long afterwards was discharged home to live with his mother.
However, Campbell-Taylor went on and appealed the decision stating that it was unlawful for the Tribunal to have refused to have rescinded the appointment on the grounds that the rule 11b appointed solicitor objected. They pointed out that they had represented the clients previously and on their visit to him had applied the lower test for capacity to instruct a solicitor in VS v St Andrew’s HealthcareM and as a result considered him capacitous. They also cited that both he and his Mother and Nearest Relative, and attorney for the purposes of s4(7) of the Mental Capacity Act (MCA) 2005 had signed the change of solicitor form and a failure to take into account the ‘presumption of capacity in s 1(2) of the MCA 2005.
Judge Gledhill granted permission to appeal and after the document disclosure, another ground of appeal was formulated, and accepted. This arose from the original capacity report furnished by the detaining authority on the prescribed form MH3 and form MH6b a notification of the Tribunal’s decision based on judicial authority delegated to Tribunal officers.
The appeal was allowed in part. Namely that the Form MH6b was defective as it did not contain the notice of the 14 day time-limit to challenge the Rule 11b appointment and this meant such an appointment was unlawful.
- Further that the failure to notify the patient of a right of review under Rule 4(3) of the Tribunal rules was material and indicated a lack of due process.
- There was a failure to accord the proper weight to the presumption of capacity in s 1(2) of the MCA 2005.
- The Tribunal had failed to apply the lower test of capacity in either R on the Application of H v SSH UKHL or VS.
- The Tribunal’s grounds for refusing to accede to the patient’s, that the rule 11(b) solicitor objected to the appointment was unlawful. Judge Weikley held that the Tribunal should have considered the patient’s wishes and feelings and those of his mother and nearest relative and the Tribunal should have applied one of its’ overriding objectives in Rule 2(2)(c) in ensuring as far as practicable that the parties are able to participate fully in the proceedings.
- Therefore the Tribunal’s hearing had been fundamentally unfair and therefore unlawful.
The Tribunal did not order discharge or remit the matter to another Tribunal as the SB had now been discharged and therefore the matter was academic.
This will be welcome news for patients and nearest relatives who should now have more of a say in Rule 11(b). It has long been recognised in the Court of Protection that those who may lack capacity to manage their affairs and need a Deputy, may nonetheless retain capacity to choose the Deputy’s identity or their wishes and feelings in regard to this, should in any event be taken into account.
This will also be of some relief to those who practice in the Mental Health Tribunal who have faced delegated decisions from tribunal caseworkers who may not have sufficient legal training to properly consider. This case will highlight such situations and lead to better training and better decision making.
You can read the full judgement here: SB v South London and Maudsley NHS Foundation TrustB