2013 03 Health Care

Monday 1 April 2013

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A Local Authority v (1) K (by the Official Solicitor) (2) Mrs K (3) Mr K (4) A NHS Trust [2013] EWHC 242 (COP) (Cobb J): The applicant local authority sought a declaration regarding a best interests' determination in relation to issues of contraception for, and sterilisation of, the first respondent (K). She was 21 years old. She had Down's Syndrome and an associated mild/moderate learning disability and lived with her parents who felt that pregnancy would have a seriously adverse effect on her. They were referred to a consultant gynaecologist for contraceptive advice. On granting the declaration sought the court held that when granting a declaration to a local authority in relation to the best interests of a person lacking the capacity to understand the immediate medical issues surrounding contraceptive treatment and sterilisation, the Court reiterated its role in deciding questions of non-therapeutic sterilisation. (click here for judgment).

R (on the application of Daniel Roque Hall) v (1) University College London Hospitals NHS Foundation Trust (2) Secretary of State for Justice [2013] EWHC 198 (Admin) DC (Hughes LJ, Wyn Williams J, Hickinbottom J): The Claimant suffered from a brain disease which left him seriously disabled and was confined to a wheelchair and needed 24-hour care from two assistants. On return from a holiday with a carer, he was found to have cocaine stashed in his wheelchair and pleaded guilty to importing a Class A drug and, following reports confirming that a prison would have the facilities to provide him with proper care, was sentenced to three years' imprisonment. He commenced his sentence in the hospital wing of a prison for which the secretary of state was responsible. He was transferred to the second Defendant’s hospital for treatment. He issued a claim alleging that the prison regime to which he was subject amounted to inhuman and degrading treatment contrary to the ECHR but in the meantime the second Defendant decided that he was fit to be discharged. The Claimant then issued another claim that to return him to prison would put his life at risk in breach of article 2 of the ECHR, and was granted in injunction restraining the second Defendant from discharging him. He claimed that the prison's treatment of him was such that his life was put at risk and his life expectancy was reduced because it had made him ill such that he needed treatment; and breached his rights under articles 3 and 8 of the ECHR and finally failed to comply with the Equality Act 2010 because of a lack of reasonable adjustments to avoid discriminating against him on disability grounds. On refusing the application the court held that although the level of care received by this severely disabled Claimant whilst in prison was lower than that to which he was accustomed, it did not amount to inhuman and degrading treatment contrary to articles 3 and 8 of the ECHR Further it had not been such that treatment put his life at risk or reduced his life expectancy contrary to article 2 as alleged and although the Claimant had been admitted to hospital, his symptoms were caused by his medical condition, not by the prison's treatment of him. (click here for judgment)

Final Report Of The Independent Inquiry Into Care Provided By Mid Staffordshire NHS Foundation Trust.

The Inquiry Chairman, Robert Francis QC, concluded that patients were routinely neglected by a Trust that was preoccupied with cost cutting, targets and processes and which lost sight of its fundamental responsibility to provide safe care. It has made 18 recommendations for both the Trust and Government. The final report is based on evidence from over 900 patients and families who contacted the Inquiry with their views. The evidence gathered by the Inquiry shows clearly that for many patients the most basic elements of care were neglected. Calls for help to use the bathroom were ignored and patients were left lying in soiled sheeting and sitting on commodes for hours, often feeling ashamed and afraid. Patients were left unwashed, at times for up to a month. Food and drinks were left out of the reach of patients and many were forced to rely on family members for help with feeding. Staff failed to make basic observations and pain relief was provided late or in some cases not at all. Patients were too often discharged before it was appropriate, only to have to be re-admitted shortly afterwards. The standards of hygiene were at times awful, with families forced to remove used bandages and dressings from public areas and clean toilets themselves for fear of catching infections. (click here for full report).

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