August 2013 mental health law update

Updates from Mental Health Law Online


Mental Health Act

  • Article 5 case. R (Vowles) v SSJ (2013) EWCA Civ 1086, (2013) MHLO 82The applicant had been given an IPP sentence then transferred to hospital under s47/49. On 12/12/11 the MHT decided she met the criteria for conditional discharge. The dossier reached the Parole Board on 29/3/12, and the hearing was arranged for 12/3/13. She claimed a breach of Article 5(4) during: (a) the period before the dossier was ready, when no judicial body was responsible for supervising her progress and the potentiality for release, and (b) the subsequent long period until the Parole Board met. The Court of Appeal gave permission to apply for judicial review (being simpler than giving permission to appeal the High Court’s refusal of permission to apply for judicial review).
  • MHA/MCA interface case. AM v SLAM NHS Foundation Trust (2013) UKUT 365 (AAC), (2013) MHLO 80 — “This case gives rise to issues relating to the approach to be taken by the First-tier Tribunal (the FTT) and other decision makers under the Mental Health Act 1983 (the MHA) when treatment and authorisation of a deprivation of liberty of the relevant patient might be given under the Mental Capacity Act 1985 (the MCA). … Here, the circumstances do not raise issues relating to (a) treatment for mental and/or physical disorder or problems (as in J v Foundation Trust), or (b) discharge from hospital (as in DN). Rather, they relate to whether the Appellant should be discharged from detention under s. 2 because her assessment in hospital for the purposes identified in s. 2 MHA should be carried out and authorised under the MCA and its DOLS.” [Summary required.]
  • Tribunal case. AM v West London MH NHS Trust (2013) EWCA Civ 1010, (2013) MHLO 73 — “Before the First‑tier Tribunal it was argued by Ms Shah, the solicitor then appearing for M, that the Tribunal should direct a conditional discharge. As part of that case it was said to be necessary to investigate the alternatives to detention. There was relatively little in the social circumstances report about aftercare on discharge. The author of the report did not attend the hearing. The social worker who did attend could not provide any further relevant information. Ms Shah applied twice for an adjournment so that this information could be provided, but the Tribunal refused the applications. The issue is whether the Tribunal thereby fell into legal error… Thus, despite what I acknowledge to have been forceful submissions by Mr Pezzani, I share Sir Stanley Burnton’s view that an appeal would have no real prospect of success.” [Summary required.]
  • Medical case. An NHS Trust v Dr A (2013) EWHC 2442 (COP), (2013) MHLO 69 — “This is an application by a NHS Trust for declaratory relief in respect of a man (whom I shall call ‘Dr. A’) who is on hunger strike in the Trust hospital. The relief sought by the Trust is in short a declaration : (i) that he lacks capacity to litigate and to make decisions in respect of his nutrition and hydration; and (ii) that it is lawful for the Trust to administer artificial nutrition and hydration.” [Summary required.]

Mental Capacity Act

  • Medical case. Re K (cancer) (2013) MHLO 83 (COP)The press has reported this case as follows: (1) It was suspected that K had cancer of the womb, but she was took frightened to undergo an diagnostic examination. (2) Moylan J decided that (a) K lacked capacity to take decisions about medical treatment; (b) it was in her best interests to undergo a hysteroscopy, which is more detailed and invasive than the normal ultrasound, on the basis that her fear meant she would be under general anaesthetic anyway.
  • Best interests case. MK v JK (2013) EWHC 4334 (COP), (2013) MHLO 81 — “MK made an application to the court to be appointed Personal Welfare Deputy for JK and that is how these proceedings commenced. However, all parties accept that the one issue is residence and that it is to be determined by a court … it is in his best interests to move to the CNC Home on the basis that his placement at the Home will be retained for eight weeks so that he has somewhere to return should the move to the CNC Home fail… I think it would be very rare for the court to consider it right to delegate its issue-resolving function to a Deputy on any significant issue of principle such as residence, type of care, treatment and such like … Article 8 of the Convention rights … I do think that putting in place a State-appointed decision-maker – which is what a Deputy is – is a considerable interference with family life and would therefore have to justify the twin requirements of legitimate aim and proportionality. One can never say never, but it is hard at the moment to envisage how in most cases a Personal Welfare Deputy could ever be so justified.” [Summary required.]
  • Best interests/DOL case. A Local Authority v WMA (2013) EWHC 2580 (COP), (2013) MHLO 79 — “The case concerns the future of a twenty five year old man, WMA, and where he should live plus what help should be given to him. It raises complex issues about best interests and deprivation of liberty. … there is no doubt in my mind it is WMA’s best interests to move to B … if one looks at WMA’s isolation, the refusal to engage with outside agencies, the poor conditions in the home and the absence of friends, save one for MA, of both mother and son and contrasts them with the opportunities for WMA at B then the opportunity for a higher quality private life is clear. … I confess for my part it is not easy to follow the reasoning of the Cheshire West decision. That said, I agree strongly with the Official Solicitor that moving WMA to B would be a deprivation of liberty … The local authority now concedes there will be a deprivation of liberty, at least because the move will be involuntary. I would go further and note that WMA at least in the short term objects to the arrangements for him and he may seek to leave. We simply do not know. So being in B may in itself be a deprivation of liberty. I will not delve into the meaning of ‘restraint’ and ‘deprivation of liberty’ as analysed in the Cheshire West and Chester case. …” [Summary required.]
  • Medical case. An NHS Trust v DE (2013) EWHC 2562 (Fam), (2013) MHLO 78 (COP) — “In my judgment it is overwhelmingly in DE’s best interests to have a vasectomy. That being said the court does not make such an order lightly, conscious as it is that for the court to make an order permitting the lifelong removal of a person’s fertility for non-medical reasons requires strong justification.” [Summary required.]
  • Medical case. An NHS Trust v L (2012) EWHC 4313 (Fam), (2012) MHLO 180 (COP) — “By application made on 6 August 2012 an NHS Trust seeks a declaration that in the event of a patient, called “Mr L” for the purposes of these proceedings, suffering a cardiac arrest and/or a respiratory arrest and/or other serious deterioration in his condition, it would not be in his best interests for active resuscitation and/or other similar treatment to be provided. … I am persuaded that the balance comes down firmly against the provision of active resuscitation and/or other similar treatment and in favour of granting the Trust’s application. … Harsh though it will sound, in my judgment to take the opposite course would indeed be, as was said in the evidence, to prolong Mr L’s death and not to prolong, in any meaningful way, his life. I repeat Dr Bell’s powerful analysis – It would result in Mr L’s death being characterised by a series of harmful interventions without any realistic prospect of such treatment producing any benefit.” [Summary required.]
  • Capacity case. Harrison v South Tyneside Council (2013) EWLandRA 2012 0866, (2013) MHLO 72 — “For some years prior to his death, Mr. Jackson suffered from dementia… By the middle of 2007, Mr. Jackson was no longer able to live alone at his home and he was placed by the council in residential accommodation… In doing so, the council was acting under Part III of the National Assistance Act 1948. Under section 21(1) of that Act, it was required it to make arrangements for providing residential accommodation for persons aged 18 or over who by reason of age, illness, disability or any other circumstances are in need of care and attention which is not otherwise available to them. In my judgment, Mr. Jackson did avail himself of the accommodation despite his lack of capacity. It was accommodation which he required to receive the necessary care and attention not otherwise available to him and the fact that he lacked capacity to understand that does not mean that he did not avail himself of it within the meaning of the statute. I would add that if that were not the case, then the provision of the accommodation would in the circumstances have been a necessary either at common law or under section 7 of the Mental Capacity Act 2005, and he would have been obliged to pay a reasonable price for it, which would have been recoverable from his estate (Wychavon District Council v EM [2012] UKUT 12 (AAC)). Mr. Harrison, like others before him in similar cases, has sought to contend that the council was not in fact acting under those powers but was acting unlawfully both because Mr. Jackson’s dementia was so severe that he required to be provided for by the NHS, and indeed ought to have been sectioned under the Mental Health Act, because he lacked capacity to consent to being admitted to the care home, and because he had no need of accommodation because he already had his own home. These points are misconceived and self-contradictory.” [Summary required; detailed external summary available.]
  • Capacity case. Loughlin v Singh (2013) EWHC 1641 (QB), (2013) MHLO 71 — “On 28 October 2002, when he was 12 years old, the Claimant was seriously injured in a road traffic accident. He was riding his bicycle when he was struck by a vehicle driven by the First Defendant. This was a trial for an assessment of damages, in which a number of contested issues fell to be resolved. … The parties are in dispute as to whether the Claimant has capacity to conduct litigation and manage his property and affairs. … Therefore, I conclude, notwithstanding the legal presumption in favour of capacity, that the Claimant does not have capacity within the relevant legal definition. … Annex: Professor Barnes’ evidence is so unreliable that it should be rejected for the following reasons… District Judge Eldergill was unaware, when he made the order on 28 April 2010 appointing Mr Hugh Jones as the Claimant’s deputy, that there was any medical evidence to the effect that the Claimant had capacity. He was not told about Dr Huddy’s report, nor did he have any inkling of the circumstances, set out in detail above, in which Professor Barnes came to give his “revised” opinion, nor that no-one at Pannone had shown the report of Dr Huddy to Professor Barnes. … All I need add is that the lamentable failures that occurred here, and the invidious position in which the judge in the Court of Protection was unwittingly placed, must never be repeated. The issue of capacity is of very great importance, and all involved must ensure that the Court of Protection has all the material which, on proper reflection, is necessary for a just and accurate decision.” [Summary required.]
  • Ian Slater, ‘Loughlin v Singh & Ors: assessment of capacity – conflict of interest?’ (DWF, 19/6/13). This article includes the following comment: ‘In this particular case in question Parker J ultimately concluded that the Claimant lacked capacity so, on one level, it could be argued that no harm had been done. The evidence was, however, very finely balanced and – by the date of the trial – there was a weight of expert evidence on both sides. Consider this, however: had Parker J not reached the conclusion that he did then difficult questions would have arisen as to the £40,000 worth of fees which the Court of Protection team had incurred since their instruction.’
  • Ian Slater, ‘Loughlin v Singh & Ors: the duty of experts’ (DWF, 19/6/13). This article includes the following comment: ‘This raises important considerations both as to the duty of experts but also – given the particular U-turn performed by Professor Barnes – as to the Mental Capacity Act 2005. The Act provides at Section 1(2) that a “person must be assumed to have capacity unless it is established that he lacks capacity.” It is surely somewhat concerning that Professor Barnes felt it appropriate to deprive an individual of his autonomy based, apparently, on nothing more than a conversation with his instructing solicitor.’
  • Section 44 MCA 2005. R v Turbill (2013) EWCA Crim 1422, (2013) MHLO 70 — “Four members of staff at a care home in Bromsgrove were charged with wilfully neglecting one of their residents, contrary to [section 44] of the Mental Capacity Act 2005. … Even if the agreed formula was sufficient to give the jury the kind of clear directions they needed (about which we have our doubts) the judge’s directions strayed beyond them. In some of the passages to which we have referred, he appears to equate carelessness or negligence with wilful neglect. They are not the same. … For all those reasons, we have no option, as it seems to us, but to quash the convictions.” [Summary required; detailed external summary available.]
  • Capacity case. RC v CC (2013) EWHC 1424 (COP), (2013) MHLO 68 — “The main application before the court is in fact not by CC but by her birth Mother RC. There was indirect contact between CC and RC until 2010/11 at a rate of 6 or 12 monthly letters, drawings, photographs and cards organised by the adoption agency [Birmingham City Council] through the adoptive Mother. That indirect contact stopped when the adoptive parents separated. By her application dated 2nd October 2012 to the Court of Protection RC applies to reintroduce such indirect contact. I suspect [but have not been formally told] that she would of course like direct contact in due course were it feasible. The case is highly unusual in that ordinarily a birth parent cannot by application to a court reintroduce herself to a birth child after adoption. It is only CC’s incapacity that enables an application to be made.” [Summary required.]
  • Medical case. An NHS Foundation Trust v M and K (2013) EWHC 2402 (COP), (2013) MHLO 67 — “The painful and difficult issues now to be faced by M’s family, the medical team that have cared for him so diligently over many years, and ultimately this court, is to what extent should M be treated in Intensive Care or be given cardio-pulmonary resuscitation in the event that there is a further deterioration in his condition.” [Summary required.]
  • Testamentary capacity. Pearce v Beverley (2013) EW Misc 10 (CC), (2013) MHLO 77 — “This is a claim by the Claimant, Colette Pearce following the death of her father, John Pearce on 23rd July 2008. Colette Pearce seeks to challenge a number of transactions made by her father which are said to be subject to the undue influence of the Defendant, Elizabeth Beverley or are otherwise voidable. She also challenges the validity of the will he purported to make on 20th June 2007. … In the circumstances Elizabeth Beverley has not satisfied me that John Pearce had the capacity to make a will on 20th June 2007.” [Summary required.]

Other cases

  • 30/08/13 (5): Scottish smoking ban. Re CM (Judicial Review) (2013) CSOH 143, (2013) MHLO 84 — “The petitioner asks the court to declare that the respondents’ “policy of a complete smoking ban and prohibition of possession of tobacco products by patients at the State Hospital” is unlawful; and also to declare that the respondents’ policy has breached the petitioner’s human rights, specifically article 8 of the European Convention on Human Rights [ECHR] (right to respect for private life and home) as a stand‑alone claim and in combination with article 14 ECHR (enjoyment of Convention rights without discrimination) and the first protocol, article 1 ECHR (right not to be deprived of property) as a stand-alone claim and in combination with article 14 ECHR (enjoyment of Convention rights without discrimination). … I have come to the view, though with reluctance, that the decision to compel the petitioner to stop smoking was flawed in every possible way. In that it relied on compulsion, the decision was contrary to the national policy which it purported to implement. The decision should have been made with reference to the section 1 principles of the 2003 Act but was not, and was in contravention of the obligations imposed by section 1 on the respondents. The respondents did not, for example, take account of the petitioner’s wishes, or provide him with the requisite information; and on no reasonable view could they have reached the conclusion that the smoking ban, to the extent that it was necessary, was implemented in “the manner that involves the minimum restriction on the freedom of” the petitioner. Whether or not consultation is a legal requirement, if it is embarked on it must be carried out properly. I am satisfied that the compulsory “comprehensive smoke‑free” regime was a foregone conclusion and that the consultation exercise was not a meaningful one… If article 8 ECHR is engaged, and I hold that it is, it is for the respondents to justify interfering with the petitioner’s right to make his own decision about smoking. They have failed to do so ..→


  • BBC, ‘Katie Thorpe’s mother to renew hysterectomy bid’ (29/8/13). See BBC website *
  • Community Care, ‘Legal challenge over “discriminatory” system for investigating mental health detention deaths’ (24/7/13). See Community Care website *
  • Jonathan Rayner, ‘MPs condemn ‘complacent’ approach to deprivation of liberty’ (Law Society Gazette, 19/8/13). See Mental Health Act 2007
  • Amanda Keeling, ‘The right to review of a deprivation of liberty’ (Nottingham Institute of Mental Health Blog, 16/8/13). See IMH Blog website *
  • Mithran Samuel, ‘Research into improving the use of mental capacity advocates in adult safeguarding’ (Community Care, 15/8/13). See Community Care website *
  • Community Care, ‘Hunt warned CAMHS shortfalls are risking Mental Health Act “breaches”‘ (13/8/13). See Community Care website *
  • Singh S et al, ‘Ethnicity as a predictor of detention under the Mental Health Act’ (2013) Psychological Medicine, ‘FirstView’ article, available on Cambridge Journals Online (subscription required). See Statistics#Ethnicity


  • 37 Park Square, ‘COP E-lerter’ (issue 9, 12/8/13). See Newsletters


  • Consultation. Scottish Government consultation in relation to section 268 appeals against conditions of excessive security (from 2/8/13 to 25/10/13). “A consultation seeking views on the way forward in respect of appeals against excessive security for mental health patients following the Supreme Court decision of M v Scottish Ministers.” See Consultations#Scotland


  • Panel course. The Mental Health Lawyers Association will be running their successful two-day course for membership of the Law Society’s Mental Health Accreditation Scheme (formerly the MHRT panel) in Preston on Tuesday 8/10/13 and Wednesday 9/10/13 and in London on Monday 14/10/13 and Tueday 15/10/13. Price: £300 (members); £390 (non-members); £250 (for third and subsequent members in a group). CPD: 12 SRA-accredited hours. See MHLA website for further details and online booking form. See Events
  • Event. Northumbria University are hosting the Mental Disorder and Criminal Justice Conference on Saturday 12/10/13 from 10.00am to 6.00pm. The three main sessions are: Unfitness to Plead (Diversion/Disposal); Insanity/Automatism; Partial Responsibility. Price: £60; £55 (SLS/SLSA members); £35 (postgraduate students); free (current Northumbria and Sunderland University Postgraduate students). For further information and to book your place, see flyer and visit the conference website. See Events


  • House of Commons Health Committee, ‘Post-legislative scrutiny of the Mental Health Act 2007: First Report of Session 2013–14’ (HC 584, 14/8/13). Chapter headings are: (1) Introduction; (2) The Appropriate Treatment Test, Community Treatment Orders and detention; (3) Independent Mental Health Advocates; (4) Places of safety; (5) Supervised Community Treatment; (6) Interaction with the Mental Capacity Act 2005; (7) Ethnicity and the use of the Mental Health Act; (8) Conclusions and recommendations. See Mental Health Act 2007

Book review

  • Richard Charlton, ‘Book review: Mental Health Tribunals: Law, Policy and Practice’ (Law Society Gazette, 13/5/13). See Gazette website


  • Asterisks. To help clear a backlog of updates, some news items will be added to the Updates page without being added anywhere else on the website, and (for now) will be marked with asterisks.