“has a previous diagnosis of paranoid schizophrenia characterised by auditory and visual hallucinations, as well as delusions of reference. Since his admission to Llanarth Court I have seen no evidence of psychotic symptoms.”
“However, we remain cautious about trying to resolve the issue of whether the patient might be found at a later date to have a psychotic illness of a type that might recur in the future. We regard the divergence of expert opinion about this patient to be an important indicator of the difficulty in his diagnosis at any given time, let alone in advance.”
“medical treatment” includes nursing, psychological intervention and specialist mental health habilitation, rehabilitation and care”
“We heard and read no evidence as to any specific form of therapeutic treatment to treat this patient’s anti-social personality disorder that would make it appropriate for him to be detained in hospital for treatment for such purposes.”
“the hospital environment itself is unlikely to be of benefit to [the Appellant] unless he is found at some later date to be suffering from a condition such as a psychotic condition that is amenable to medical treatment, whether it turns out to be drug induced and short lived, or more long lasting and serious such as schizophrenia.”
“(i) First, this Court should exercise restraint and proceed with caution before interfering with decisions of specialist tribunals. Not only do such tribunals have the expertise which the “ordinary” courts may not have but when a specialised statutory scheme has been entrusted by Parliament to tribunals, the Court should not venture too readily into their field. (ii) Second, if a tribunal decision is clearly based on an error of law, then it must be corrected. This Court should not, however, subject such decisions to inappropriate textual analysis so as to discern an error of law when, on a fair reading of the decision as a whole, none existed. It is probable, as Baroness Hale said, that in understanding and applying the law within their area of expertise, specialist tribunals will have got it right. Moreover, the mere fact that an appellate tribunal or a court would have reached a different conclusion, does not constitute a ground for review or for allowing an appeal. (iii) Thirdly, it is of the first importance to identify the tribunal of fact, to keep in mind that it and only it will have heard the evidence and to respect its decisions. When determining whether a question was one of “fact” or “law”, this Court should have regard to context, as I would respectfully express it (“pragmatism”, “expediency” or “policy”, per Jones), so as to ensure both that decisions of tribunals of fact are given proper weight and to provide scope for specialist appellate tribunals to shape the development of law and practice in their field. (iv) Fourthly, it is important to note that these authorities not only address the relationship between the courts and specialist appellate tribunals but also between specialist first-tier tribunals and appellate tribunals.”
“Dr Gamble considered that the patient’s craving for drugs falls short of a mental disorder itself and was certainly not such as to justify detention in hospital in its own right. He reminded us that the patient had in the past abstained from substance misuse for long periods, but he agreed it still represents a significant issue in terms of risk management in the future. In his view the terms of ss. 2 or 3 MHA might suffice to treat such an episode. He warned against a long period in hospital to treat a drug induced psychosis. He was not in favour of there being a power to recall, and he proposed that the patient be granted an absolute discharge.”
“The contribution made by Dr Noir Thomas on the point in his report (para. 44) was in our view the most apt, to the effect that if the patient is not “discharged from his order then he can remain … with a potential for recall in the event that there is a psychotic relapse in the future. It SLL v (1) Priory Health Care and (2) Secretary of State for Justice[2019] UKUT 323 (AAC) 14 HMW/273/2019 would likely be only in these circumstances that [the patient] is again considered for hospital admission. The appropriate level of security will have to be determined if and when this situation ever arises.”
“The conclusion the tribunal arrived at was that the patient had failed to discharge the burden of persuading us to bring the s41 order to an end under s.73(1)(b). We decided on the evidence we heard that the patient should remain liable to be recalled to hospital for treatment.”
“It was accepted that this would have been a conclusion open to him on the evidence and that the defendant’s counsel had given in his closing submissions what would have been valid reasons for the view which the judge took. However, the Court of Appeal held that it could not speculate whether these were indeed the judge’s reasons and that the judgment as it stood was “entirely opaque”
“The further argument as presented to us on behalf of the patient was that he should not be liable to recall, because the setting and the environment of a psychiatric hospital is already positively harmful to the patient and will remain so at any future date. It was argued that the patient is now being “merely contained” and that the situation would re-apply in the future. On careful analysis we found that representation goes further than the evidence. In our view the arguments relating to placement in hospital and the appropriate form of treatment will have to be addressed in the light of whatever evidence there is then available regarding the patient’s mental health. The precise circumstances relating to a potential recall are impossible to predict.”
“41.- (1) The Tribunal may give a decision orally at a hearing. (2) Subject to rule 14(2) (withholding information likely to cause harm), the Tribunal must provide to each party as soon as reasonably practicable after making a decision (other than a decision under Part 5) which finally disposes of all issues in the proceedings or of a preliminary issue dealt with following a direction under rule 5(3)(e)- (a) a decision notice stating the Tribunal’s decision; (b) written reasons for the decision; and (c) notification of any right of appeal against the decision and the time within which, and the manner in which, such right of appeal may be exercised.”
“fairness surely requires that the parties especially the losing party should be left in no doubt why they have won or lost. This is especially so since without reasons the losing party will not know…whether the court has misdirected itself, and thus whether he may have an available appeal on the substance of the case...”