“This affects my depression because I live very far from friends and family and also the flat is very high up which affects my fear of heights and dizziness.”
“… We have recently been broken in our home, whilst my wife and children was inside. This has been a very traumatic experience for all of us, has left us all scared, anxious and suffering from panic attacks. We all feel very isolated and depressed and suffering from anxiety attacks, and being very nervous and scared living here on the estate.”
“Following treatment your patient was discharged. We have not made arrangements to see your patient again. We have advised them to attend your surgery and would be grateful if you could continue care. Comments for the GP Had a panic attack while on 16th floor. Has had lifelong fear of high buildings. Reassured home.”
“This is to certify that the above mentioned [Mrs El-D] suffers from severe vertigo and fear of heights. She has recently been offered a transfer to a flat on the 19th floor where she is very exposed to this. She went to look at the flat and suffered an anxiety attack with a subsequent faint which needed an attendance to the A&E department at St Mary’s Hospital. Since the event she has been feeling shaky, panicky and fearful. I have treated her with diazepam. Due to the severity of her symptoms I would advise that she be offered alternative accommodation on a lower floor to avoid any further health problems in the form of panic attacks and anxiety.”
“[Mrs El-D] has a long-standing fear of heights. She also suffers from migraines and has recently been diagnosed with sciatica. Stress has been a major trigger for her migraines. [Mrs El-D] first presented with stress and migraines in 2003 but there is no specific mention in her records what the stressors were. The recent viewing of the proposed 16th floor flat caused an acute attack of migraine, dizziness and associated panic attack which necessitated a visit to the local A&E department. At present the family lives on the 8th floor (sic) but in her present accommodation she is less exposed to heights than in the proposed 16th floor flat. [The appellant and his wife] are not receiving any treatment for mental health problems at present and as far as I can see from their records there is no history of having been prescribed medication for such in the past. The only drug received by [Mrs El-D] was diazepam in connection with the acute anxiety she suffered after visiting the 16th floor flat. I would recommend that alternative accommodation should be offered to the family as I that fear the move would exacerbate [Mrs El-D’s] medical condition and also have an unfavourable effect on [the appellant’s] back condition.”
“Are there any restrictions to what floor she can live on e.g. no higher than 2nd floor”]. (4) Her past medical history dating from the beginning of her records in 2004 reveal hay fever, treated with anti-histamine, travel vaccinations … a referral to CBT (Cognitive Behavioural Therapy) in 2006 for a year long history of anxiety and panic attacks, with some symptoms of obsessive compulsive disorder. She was noted not to be depressed. Pregnancy in 2007 … (5) There has not really been any treatment for her condition. (6) She has only attended our surgery on one occasion, on 8/6/10 for her fear of heights and she has not seen us before or since, treatment being diazepam. (7) Please find enclosed the discharge summary from St Mary’s Hospital.”
“The reason for this discrepancy is that I have personally been looking after [Mrs El-D] and her family since they registered with me in 2002. When I saw her in June 2010 she mentioned that she had suffered similar episodes of panic and anxiety when she moved to her current accommodation which is on the 8th floor [sic]. I have always known her as a trustworthy person. I had no reason to doubt this information. I therefore diagnosed her with acute anxiety attacks triggered by exposure to heights. If you have any further queries do not hesitate to contact me.”
“… Our client’s wife can see out of all the windows and balconies down to the ground. Therefore the panic attacks and anxiety will be much more in the new property than before.”
“Over the years I have dealt with numerous cases where clients have complained about their fear of heights. Some medical professionals believe that such a fear of heights is natural as it provides a defence mechanism in the body to ensure that people exercise greater caution when in potentially dangerous situations, for instance when climbing ladders or steep stairs. Nevertheless in dealing with these sorts of cases we are required to distinguish between a general dislike of heights and an irrational fear which would make any property above a certain floor level impractical. To help us determine this issue we have to consider any medical information but also look closely at the facts of the case to enable us to reach an informed decision.”
“In summary although I appreciate that Mrs El-Dinnaoui would definitely have preferred a property on a much lower floor (and did not like heights) I am not satisfied that she would have been unable to or was prevented from living on the 16th floor because of this. This is because the evidence on her file has led me to believe she was able to live on a high floor in spite of her condition. I acknowledge that like many people who are not keen on heights Mrs El-Dinnaoui may have found the property unsettling at first but based on the information available to me it is reasonable to conclude that she would have settled in the property with time. In reaching this conclusion I have taken into account that although Mrs El-Dinnaoui was not keen to live on the 9th floor (when she moved into her current property) she was able to settle in the property and has occupied it for close to 9 years. Furthermore it is not uncommon for people, who live in high rise buildings (whether or not they dislike heights) to use thick nets and curtains or blinds to camouflage the view from the window. I do not feel that this would have been an impractical solution for Mrs El-Dinnaoui. In some of the cases that I have dealt with there is usually a restriction on the floor level that can be offered to a person suffering from a phobia of heights, however we have received no such information in this case. To me this is an indication that Mrs El-Dinnaoui’s case was not sufficiently severe to warrant this.”
“By way of summary, the appellant submits that the judge was wrong to hold that the decision was lawful. It was unlawful for the following overlapping reasons: a. In the light of the medical evidence before her, the Review Officer made insufficient inquiries as to whether Mrs El-Dinnaoui had suffered from an irrational fear or general dislike of heights to enable her properly to answer that question. b. Further or alternatively, the Review Officer failed to answer that question. c. The Review Officer’s conclusion that Mrs El-Dinnaoui suffered a general dislike of heights (if that is the conclusion that was reached) was in the circumstances irrational.” a. In the light of the medical evidence before her, the Review Officer made insufficient inquiries as to whether Mrs El-Dinnaoui had suffered from an irrational fear or general dislike of heights to enable her properly to answer that question. b. Further or alternatively, the Review Officer failed to answer that question. c. The Review Officer’s conclusion that Mrs El-Dinnaoui suffered a general dislike of heights (if that is the conclusion that was reached) was in the circumstances irrational.”
“it was for the council to judge what inquiries were necessary, and it was susceptible to a successful challenge on a point of law if and only if a judge in the county court considered that no reasonable council could have failed to regard as necessary the further inquiries suggested by the appellants' advisers.”
“Accordingly, a benevolent approach should be adopted to the interpretation of review decisions. The court should not take too technical view of the language used, or search for inconsistencies, or adopt a nit-picking approach, when confronted with an appeal against a review decision. That is not to say that the court should approve incomprehensible or misguided reasoning, but it should be realistic and practical in its approach to the interpretation of review decisions.”
“Due to the severity of her symptoms I would advise that she be offered alternative accommodation on a lower floor to avoid any further health problems in the form of panic attacks and anxiety.” (I have added the emphasis). This is a medical opinion, repeated by Dr Mostad, and there is no countervailing evidence from a medical expert to refute it. The Review Officer is simply not entitled to disregard it. Dr Mostad repeats these matters in her report of 13th July. She refers to “a longstanding fear of heights”
“I would recommend that alternative accommodation should be offered to the family as I fear the move would exacerbate Mrs El-Dinnaoui’s medical condition.”