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TPC, 'Reply to two Consultations on possible amendments to the HESC Rules regarding proposed changes to the way that the FTT decides cases referred pursuant to s68' (1/8/24)

2024-08-01 TPC Reply to consultations on s68 paper hearings.pdf

Paper reference hearings for hospital-based patients Tribunal rule 35 will be amended to allow mandatory references made under s68, s71(2) and s75(1) in relation to a patient who is not a community (CTO) patient to be decided without a hearing if: (a) he is legally represented; (b) the representative "has stated in writing that the patient does not wish to attend or be represented at a hearing of the reference"; (c) "the patient’s representative has discussed with the patient the contents of any reports and any other documents provided by the responsible clinician and any social supervisor in respect of the patient and is satisfied that the patient has the capacity to decide whether or not to make that decision"; and (d) "the Tribunal is satisfied that the patient has the capacity to make that decision". The TPC must realise that they are weakening the statutory safeguards as, in addition to commenting that if patients seek discharge "they are unlikely to request a paper hearing, nor would they be advised to", the new procedure will not apply if either the patient's case has not previously been considered by the tribunal or the patient's case was last considered by the tribunal without a hearing. The TPC "does not view the proposed change as being made for financial reasons" but notes that paper hearings will "ensure the panel's time is used efficiently when cases come out at short notice or are adjourned on the day". From a Legal Aid perspective, "remuneration will be significantly reduced if there is no hearing, removing the attraction of a paper review" (same £450 for just agreeing to a paper hearing as for full tribunal preparation, additional £294 for tribunal advocacy).

See also

  • Paper reference hearings for hospital-based patients. TPC, 'Reply to Consultation and Further Consultation on possible amendments to the TPR regarding proposed changes to the way that the FTT decides cases referred to the Tribunal pursuant to s.68 MHA' (consultation from 19/12/23 to 13/2/24) — The Tribunal Procedure Committee seem aware that paper hearings are inferior to oral hearings and that their proposal would undermine the important statutory protection provided by automatic tribunal references, so now propose to co-opt legal representatives into the so-called "safeguarding measures". Maybe it is hoped that representatives who object on principle will not bother to respond yet again, and other representatives might be happy to receive the same L1+L2 fixed fee (£450) for advising on a potential paper hearing as for fully preparing for an oral hearing. The proposal is "to allow the Tribunal to make a decision on a reference hearing, in respect of a patient detained in hospital aged 18 or over, with capacity and is legally represented, and who has made a written request that they do not wish to attend or be represented at a hearing of their reference, and the Tribunal is satisfied that the patient has the capacity to make that decision".
  • Paper reference hearings for hospital-based patients. TPC, 'Consultation on possible amendments to the HESC Rules 2008 regarding proposed changes to the way that the FTT decides cases referred to the Tribunal pursuant to s68 MHA 1983' (consultation from 18/7/23 to 29/8/23) — (1) The tribunal wants its rule 35 power to determine reference cases on the papers (where an adult patient does not wish to attend or be represented) to be extended from community patients to hospital-based patients. The tribunal suggests that this would be better for patients: its proposal to the TPC talks of giving patients "the right to determine how they want their case to be considered" and "respect[ing] the autonomy of those in hospital", and the conclusion states that "[t]he most important consideration is to ensure patients in hospital are afforded the same right to privacy and dignity as those in the community". However, resources and finances are major motivations: "it is an inefficient use of the Tribunal’s resources to have an oral hearing", given that "[a] judge can typically dispose of between 4 and 8 automatic references in a single day", especially if the Mental Health Bill 2022 is passed and references triple. (2) The TPC seem aware that the proposal could make matters worse: (a) they suggest "safeguarding measures" (noting that "it may be thought that there is a limit to the number of occasions on which a reference should be dealt with on the papers without providing the opportunity for a hearing which would provide additional scrutiny" and suggesting "a requirement that every second or third reference (depending on the statutory duration of each) must be considered at an oral hearing which would be able to hear the evidence of witnesses or call for additional information as required"); (b) they suggest that the rule change might be premature prior to the Bill's enactment ("it may be considered that the proposed changes may not be appropriate if the references occur only every three years as now"); (c) they note that the Senior President of Tribunals would amend the relevant PD to ensure that, contrary to the tribunal's proposal, these decisions for hospital-based patients would be made by a full panel and not a judge alone.