Category: Medical


Balancing transparency with ‘secrecy’ in the Court of Protection – Lucy Series

7 March 2011 by

There probably aren’t many people who want to know what ‘goes on’ in the Court of Protection more than me; it’s what I spend much of my time trying to fathom. An outsider would be forgiven for thinking that this branch of Her Majesty’s Court Service doesn’t feel that case law in this tangled and difficult area is anybody’s business but it’s own.

The reasons for this appearance are complex though, and not necessarily the fault of any individuals working within the courts. I think it’s important to draw a distinction between different ways that greater ‘transparency’ could be achieved; some might be more helpful than others.


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Are we truly free?

3 March 2011 by

P and Q by the Official Solicitor, their Litigation Friend v Surrey County Council and Others (Equality and Human Rights Commission, Intervener) [2011] EWCA Civ 190- read judgment

What does it mean to be “deprived of liberty”? This is not an easy question, and there are a wide variety of relevant factors. For instance, the amount of space a person is free to roam in, the degree of supervision and the amount of time away from their main residence are matters which are likely to vary greatly from case to case. There are many borderline cases.

In an important recent case, the Court of Appeal has found that there was no deprivation of liberty, within the meaning of Article 5 of the European Convention on Human Rights, when two people with moderate to severe learning difficulties are cared for in a foster home and a specialist home for adolescents respectively.

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Rights breach council must pay out

7 February 2011 by

G v E & Ors [2010] EWHC 3385 (Fam) (21 December 2010) – Read judgment

Manchester City Council has been ordered to pay the full legal costs of a 20-year-old man with severe learning disabilities who was unlawfully removed from his long-term foster carer. The council demonstrated a “blatant disregard” for mental health law.

The case has wound an interesting route through the courts, with hearings in the Court of Protection, Court of Appeal, and also a successful application by the Press Association to reveal the identity of the offending local council in the interests of transparency. In August, Siobhain Butterworth wrote that the decision to name and shame the council was a “good” one which “marries the need for transparency in the treatment of vulnerable people with the right to a private life“.

Now, Mr Justice Baker has taken the unusual step of ordering that Manchester City Council pay all of E’s family’s legal costs. The general rule in the Court of Protection is that costs should not be awarded, but as the judge ruled it can be broken in certain circumstances:

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States Not Obliged to Assist Persons Wishing to Commit Suicide – Antoine Buyse

23 January 2011 by

Last week, the European Court of Human Rights decided in the case of Haas v. Switzerland (judgment in French only) that the right to private life is not violated when a state refuses to help a person who wishes to commit suicide by enabling that person to obtain a lethal substance.

The applicant in the case, Ernst Haas, had for two decades been suffering from a serious bipolar affective disorder (more commonly known as manic depression). During that time he attempted to commit suicide twice. Later, he tried to obtain a medical prescription for a small amount of sodium pentobarbital, which would have allowed him to end his life without ain or suffering. Not a single psychiatrist, of the around 170 (sic!) he approached, was willing to give him such a prescription. This would have been necessary, under Swiss law, which allowed for assisted suicide if it was not done for selfish motives (in the opposite case, the person assisting could be prosecuted under the criminal code).

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Unlawful mental health detention – who is to blame?

20 January 2011 by

TTM (By his Litigation Friend TM) v London Borough of Hackney, East London NHS Foundation Trust; Secretary of State for Health –  Read judgment

The Court of Appeal has ruled that the local authority, but not the detaining hospital, was liable to pay compensation to a person who had been unlawfully detained under Section 3 of the Mental Health Act  1983.  The case provides important guidance on the liability of mental health and medical professionals in the difficult area of detaining patients, as well as the ability to recover damages where a claimant is unlawfully detained.

The Court held that the patient’s detention had been unlawful from the start when the approved mental health professional [‘AMHP’] erred in whether the patient’s relative objected to admission.  The local authority responsible for the AMHP could not rely on the Section 139(1)of the Mental Health Act 1983 [‘the Act’] statutory protection from civil liability, which had to be read down by virtue of Section 3 of the Human Rights Act 1998 to give effect to the patient’s right to liberty under Article 5 of the ECHR.

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Can release from hospital be a deprivation of liberty?

19 January 2011 by

Secretary of State for Justice v RB [2010] UKUT 454 – Read judgment

In a fascinating recent case, the Upper Tribunal has departed from a line of court authority to decide that where a patient has been detained under the Mental Health Act 1983, conditionally discharging that patient from hospital subject to conditions which might themselves amount to a form of detention is compatible with Article 5 of the European Convention of Human Rights, the right to liberty .

RB, who was aged 75, had been detained under the Mental Health Act on 30 June 1999 following a conviction for indecent assault on a boy aged under 16. He suffered from a persistent delusional disorder, which rendered him a “strongly misogynistic”, lifelong paedophile.

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Not breach of rights to force doctor to disclose patient records

13 January 2011 by

Gillberg v Sweden – 41723/06 [2010] ECHR 1676 (2 November 2010) – Read judgment

A Swedish professor has failed in his European Court of Human Rights challenge to his conviction for disobeying a court order to hand over sensitive information in medical research, despite having promised the participants that the information would be for his use alone.

As reported in a past blog, the fact of their confidentiality does not preclude the medical records of third party patients being disclosed in legal proceedings. So too in relation to sensitive information given confidentially in the context of medical research, in view of the recent Strasbourg case of Gillberg v Sweden (Application no. 41723/06).

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The Redfern Inquiry: the latest investigation into the removal and retention of human tissue

31 December 2010 by

November saw the publication of the report of the Redfern Inquiry into human tissue analysis in UK nuclear facilities (read the report, here).

The inquiry was the latest in a number of investigations looking at the post mortem removal, retention and disposal of human body parts by medical and other bodies, and the extent to which the families of the deceased knew of and consented to such practices. The Inquiry chairman, Michael Redfern QC, also chaired the Royal Liverpool Children’s Hospital (Alder Hay) Inquiry.

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Ireland must make access to abortion easier in life threatening situations

16 December 2010 by

CASE OF A, B AND C v. IRELAND (Application no. 25579/05) – Read judgment / press release

The Grand Chamber of European Court of Human Rights has ruled unanimously that abortion must be more accessible in Ireland for women whose lives are at risk. It rejected applications that abortion must be more widely available in other circumstances.

The ruling does not represent a significant departure from the current state of Irish law – in that it does not require the state to legalise abortion more than it technically already has done – but the probable changes in the law may result in a general softening towards abortion in general, as, in theory at least, it will be much easier for women in life threatening situations to obtain an abortion. Up until now, the law has made it practically impossible to do so.

Moreover, the recognition that abortion falls under article 8 (the right to private and family life) may also lead in future to more wide-ranging judgments, along the lines of Roe v Wade in the United States.

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Case summary: Cigarette vending machine ban not breach of human rights

6 December 2010 by

Sinclair Collis Limited, The Members of National Association of Cigarette Machine Operators (Interested Party) v Secretary of State for Health [2010] EWHC 3112 (Admin)Read judgment or Rosalind English’s analysis of the decision

The High Court has ruled that the Secretary of State for Health did not breach the human right to peaceful enjoyment of property or European Union law by banning the sale of tobacco products from automatic vending machines.

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Legal aid reforms will be catastrophic for victims of medical negligence

22 November 2010 by

The government’s proposed reforms to legal aid will have a catastrophic effect on those who have suffered as a result of negligent medical treatment.

When Kenneth Clarke informed Parliament on Monday that

Legal aid will still routinely be available in civil and family cases where people’s life or liberty is at stake, or where there is risk of serious physical harm or the immediate loss of their home.

he clearly did not mean that the destruction of a person’s life or the suffering of seriously physical harm through the mismanagement of their medical treatment was to be included within this. If he had meant that he would have proposed at the same time that clinical negligence would continue to be funded by legal aid.

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Legal aid cuts announced, significant reduction in funding of civil and family cases

15 November 2010 by

Updated x 2 | The lord chancellor Ken Clarke has announced plans for significant cuts to the legal aid system, which provides funding for legal representation to those who otherwise cannot afford it. The plans were largely as expected and will be open to consultation.

Update: The MoJ has published full details of the plans:

  • The main documents, including impact assessments are here
  • The proposals can be downloaded here
  • Views on the consultation can be submitted online here
  • A summary of the plans can be found here.
  • The consultation on proposals for reform for civl litigation funding (the Jackson review) is here.

The scale of the cuts is expected to be around £350m out of the £2.2bm budget, which is just over 15%. Some of the plans had been leaked with partial accuracy by the Sunday Telegraph.

 

Update x 2: Read a summary of the reaction to the cuts here and an analysis of the underlying rational here.

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Child protection scheme recommended by Soham murder inquiry ruled unlawful

11 November 2010 by

The Royal College of Nursing & Ors, R (on the application of) v Secretary of State for the Home Department & Anor [2010] EWHC 2761 (Admin) (10 November 2010) – Read judgment

The High Court has ruled that a scheme which prohibits people convicted or cautioned for certain crimes from working with children or vulnerable adults breaches human rights law.

The system of automatically banning those convicted for or who admit certain crimes from working with children and vulnerable adults without allowing them to make representations breached their rights to a fair trial.


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Protecting child claimants from “fortune hunters and thieves”

11 November 2010 by

UpdatedJXF (a child) v York Hospitals NHS Foundation Trust [2010] EWHC 2800 (QB) – Read judgment

Mr Justice Tugendhat has held that the High Court should withhold the identity of a child claimant when approving the settlement of a clinical negligence case.  The decision represents a restatement of the orthodox principle that cases should be heard in public and reported without restrictions, and that anonymity orders should only be granted after careful scrutiny.

His reason for coming to this particular decision was that revealing the name of the claimant would “make him vulnerable to losing the [settlement] money to fortune hunters or thieves.”

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NHS must treat patients despite their personal injury settlements

10 November 2010 by

R (Booker) v NHS Oldham and Direct Line Insurance PLC [2010] EWHC 2593 (Admin)- read judgment

The High Court has held that where a claimant agrees a damages settlement that includes an indemnity to fund private nursing care should existing NHS provision be withdrawn, it was unlawful for a primary care trust to cease its funding of the claimant’s care on the basis that her needs would be met through the settlement.

The claimant, B, was a tetraplegic who had sustained her injuries in a road traffic accident. She had received care from the defendant NHS trust (“the Trust”) over a number of years, and there was no dispute that her medical needs made her eligible for future care. In October 2009, B’s personal injury case was settled on the basis of both a lump sum and periodical payments, the latter due to commence from 15 December 2011. In respect of the period between the settlement date and the first periodical payment, a series of “safety net undertakings” were given by both sides in the litigation, and by DLI, the insurer of the injury claim defendant. These were to the effect that B would use her best endeavours to maintain the NHS funded care that she was receiving, but, should it nonetheless be withdrawn, DLI would indemnify B against the cost of providing replacement care. In June 2010, the Trust informed B that it intended to withdraw its provision of care from her with effect from the autumn, on the basis that B had elected to receive private care and hence no longer required NHS services. B sought judicial review of this decision.

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