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You are here: BAILII >> Databases >> England and Wales High Court (Administrative Court) Decisions >> A-R, R (on the application of) v Secretary of State for the Home Department [2004] EWHC 1999 (Admin) (23 July 2004) URL: http://www.bailii.org/ew/cases/EWHC/Admin/2004/1999.html Cite as: [2004] EWHC 1999 (Admin) |
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QUEEN'S BENCH DIVISION
THE ADMINISTRATIVE COURT
Strand London WC2 |
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B e f o r e :
____________________
THE QUEEN ON THE APPLICATION OF MR A-R | (CLAIMANT) | |
-v- | ||
MENTAL HEALTH REVIEW TRIBUNAL | (DEFENDANT) | |
SECRETARY OF STATE FOR THE HOME DEPARTMENT | (INTERESTED PARTY) |
____________________
Smith Bernal Wordwave Limited
190 Fleet Street London EC4A 2AG
Tel No: 020 7404 1400 Fax No: 020 7831 8838
(Official Shorthand Writers to the Court)
MISS E GREY appeared on behalf of the DEFENDANT
MISS K STERN appeared on behalf of the INTERESTED PARTY
____________________
Crown Copyright ©
"In the opinion of the Tribunal, if subject to a Restriction Order under section 41 Mental Health Act 1983, the patient
"(a) Would not be entitled to be discharged."
"(a) The Tribunal is satisfied that the patient is suffering from mental illness, psychopathic disorder, severe mental impairment or mental impairment or from any of those forms of disorder of a nature or degree which makes it appropriate for him/her to be liable to be detained in a hospital for medical treatment.
"(b) The Tribunal is satisfied that it is necessary for the health or safety of the patient or for the protection of other persons that he/she should receive such treatment."
"8. The Tribunal is therefore satisfied that the patient is now suffering from mental illness of a nature and degree which makes it appropriate for him to be liable to be detained in a hospital for medical treatment. As to whether it is necessary for his health and safety that he should receive such treatment the Tribunal accepted the submission of Miss Stern that this question has to be approached by reference to the practical alternative in the instant case (see Secretary of State for Home Department v Mental Health Review Tribunal (PH) [2002] EWCA Civ 1868; R v Secretary of State for Home Department ex parte IH [2003] UKHL 59)."
"While the patient could, if he were not a prisoner, probably receive the treatment he requires without being detained in a hospital, the fact is that no such regime can at the present time be implemented. If he were discharged he would be returned to prison where, we are satisfied, his mental and physical health would rapidly and seriously deteriorate. Accordingly the Tribunal is satisfied that it is necessary for the patient's health and safety that he should receive such treatment (as a detainee in hospital).
"10. If the above approach were incorrect and the Tribunal was required to proceed on the theoretical hypothesis that the patient could receive the treatment he requires other than as a detainee in hospital, then the Tribunal would have made a recommendation under section 74(1)(b) that the patient should continue to be detained in hospital. The Tribunal would not, however, have (a) made any recommendation in relation to the identity or characteristics of such a hospital, whether by reference to the level of security or otherwise, or (b) specified any conditions which it would have imposed."
"Where application is made to a Mental Health Review Tribunal by or in respect of a patient who is liable to be detained under this Act, the tribunal may in any case direct that the patient be discharged, and --
"(a) the tribunal shall direct the discharge of a patient liable to be detained under section 2 above if they are not satisfied --
"(i) that he is then suffering from mental disorder or from mental disorder of a nature or degree which warrants his detention in a hospital for assessment (or for assessment followed by medical treatment) for at least a limited period; or
"(ii) that his detention as aforesaid is justified in the interests of his own health or safety or with a view to the protection of other persons;
"(b) the tribunal shall direct the discharge of a patient liable to be detained otherwise than under section 2 above if they are not satisfied --
"(i) that he is then suffering from mental illness, psychopathic disorder, severe mental impairment or mental impairment or from any of those forms of disorder of a nature or degree which makes it appropriate for him to be liable to be detained in a hospital for medical treatment; or
"(ii) that it is necessary for the health or safety of the patient or for the protection of other persons that he should receive such treatment."
"(1) Where an application to a Mental Health Review Tribunal is made by a restricted patient who is subject to a restriction order, or where the case of such a patient is referred to such a tribunal, the tribunal shall direct the absolute discharge of the patient if --
"(a) the tribunal are not satisfied as to the matters mentioned in paragraph (b)(i) or (ii) of section 72(1) above; and
"(b) the tribunal are satisfied that it is not appropriate for the patient to remain liable to be recalled to hospital for further treatment.
"(2) Where in the case of any such patient as is mentioned in subsection (1) above --
"(a) paragraph (a) of that subsection applies; but
"(b) paragraph (b) of that subsection does not apply,
"the Tribunal shall direct the conditional discharge of the patient."
"(1) Where an application to a Mental Health Review Tribunal is made by a restricted patient who is subject to [a limitation direction or] restriction direction, or where the case of such a patient is referred to such a tribunal the tribunal --
"(a) shall notify the Secretary of State whether, in their opinion, the patient would, if subject to a restriction order, be entitled to be absolutely or conditionally discharged under section 73 above; and
"(b) if they notify him that the patient would be entitled to be conditionally discharged, may recommend that in the event of his not being discharged under this section he should continue to be detained in hospital."
"If, in the case of a patient who is subject to a transfer direction under section 48 above, the tribunal notify the Secretary of State that the patient would be entitled to be absolutely or conditionally discharged, the Secretary of State shall, unless the tribunal have made a recommendation under subsection 1(b) above, by warrant direct that the patient be remitted to a prison or other institution in which he might have been detained if he had not been removed to hospital, there to be dealt with as if he had not been so removed."
"(i) The tribunal must, if not satisfied either that the patient is suffering from a mental disorder of a nature or degree which makes it appropriate for him to be liable to be detained in a hospital for medical treatment or that it is necessary for the health and safety of the patient or the protection of others that he continue to receive medical treatment in hospital, make a recommendation for discharge under section 74(1)(a)."
"(ii) If the tribunal is satisfied that it is not appropriate for the patient to remain liable to be recalled to hospital, they must recommend the patient's absolute discharge; if they are not so satisfied, they must recommend the patient's conditional discharge (section 73(1)(b) and 73(2))."
"(iii) If the tribunal recommends the patient's conditional discharge then it may also make a recommendation under section 74(1)(b) that, in the event of his not being discharged under section 74, the patient should continue to be detained in hospital. If the Secretary of State accepts that recommendation the patient remains in hospital notwithstanding he no longer satisfies the criteria for detention under the Act (or under Article 5(1(e)).
"(iv) by virtue of section 74(4) a patient subject to a transfer direction under section 48 cannot be discharged by the Secretary of State under section 74, either absolutely or conditionally. His discharge powers under section 74(2) only apply to serving prisoners transferred under section 47. The patient will automatically be remitted back to the place of his former detention if the recommendation is for absolute discharge or if a recommendation for conditional discharge has been made but without a recommendation under section 74(1)(b). If a recommendation has been made under section 74(1)(b) the patient is not automatically remitted back to their former place of detention and he will remain detained until remitted back to prison by the Secretary of State under section 53, discharged by the Secretary of State under section 42(2) or the justification for his underlying detention expires."
"... if subject to a restriction order..."
"Where a tribunal considers that it is necessary for the health or safety of the patient or the safety of others that the patient continues to receive psychiatric treatment, and that it is reasonable for such treatment to be provided in the community, but the psychiatrists who would have to provide such treatment refuse to do so because they disagree with the tribunal's view that the patient can safely be treated in the community."
"We consider that in a case such as the present the provisions of section 73 of the Act operate as follows. Where a tribunal decides (i) that a restricted patient is suffering from mental illness for which psychiatric treatment is necessary for the health or safety of the patient or the protection of other persons and (ii) that detention in hospital for that treatment is not necessary if, but only if, psychiatric treatment is provided in the community, the tribunal can properly make a provisional decision to direct a conditional discharge, but defer giving that direction to enable arrangements to be made for providing psychiatric treatment in the community. The health authority subject to section 117 duty will then be bound to use its best endeavours to put in place the necessary after-care. If it fails to use its best endeavours it will be subject to judicial review. If, despite its best endeavours, the health authority is unable to provide the necessary services, the tribunal must think again. If, as is likely in those circumstances, it concludes that it is necessary for the patient to remain detained in hospital in order to receive the treatment, it should record that decision."
"It will not normally be appropriate for a tribunal to direct a conditional discharge on conditions with which the patient will be unable to comply because it has not proved possible to make the necessary arrangements."
"There was no time between 3rd February 2000 and 25th March 2002 when the appellant was, in my opinion, unlawfully detained, and there was thus no breach of article 5(1)(e). There is a categorical difference, not a difference of degree, between this case and that of Johnson. Mr Johnson was a patient in whose case the Winterwerp criteria were found not to be satisfied from June 1989 onwards. While, therefore, it was reasonable to try and ease the patient's reintegration into the community by the imposition of conditions, the alternative, if those conditions proved impossible to meet, was not continued detention but discharge, either absolutely or subject only to a condition of liability to recall. His detention became unlawful shortly after June 1989 because there were, as all the doctors agreed, no grounds for continuing to detain him. The present case is quite different. There was never a medical consensus, nor did the tribunal find, that the Winterwerp criteria were not satisfied. The tribunal considered that the appellant could be satisfactorily treated and supervised in the community if its conditions were met, as it expected, but the alternative, if these conditions proved impossible to meet, was not discharge, either absolutely or subject only to a condition of recall, but continued detention. The appellant was never detained when there were no grounds for detaining him. To the extent that Buxton and Sedley LJJ differed from the Master of the Rolls on this point in K, the opinion of the latter is to be preferred."
"If he were discharged he would be returned to prison ..."
"The claimant is detained as a 'suspected international terrorist' under section 21 of the Anti-terrorism, Crime and Security Act 2001. He has been transferred to Broadmoor Special Hospital under sections 48 and 49 of the Mental Health Act 1983. His application to the Mental Health Review Tribunal for a recommendation that he be released from detention under the Mental Health Act was dismissed on 9th January 2004. Unless and until he is discharged from detention under the Mental Health Act he cannot make an application to the Special Immigration Appeals Commission for release on bail. For that reason it is requested that this application be considered expeditiously."
(11.50 am)
"...the identity of any party or witness must not be disclosed if it considers non-disclosure necessary in order to protect the interests of that party or witness."