The majority of our patients come from the North West, West Midlands or Wales. Annex 2 to this judgment lists the documents before the Tribunal. Dr Williams had ceased to be H's RMO in 1997. Indeed, the decision of the 1999 Tribunal shows that Dr Croy had expressed to them the view that consideration should be given to H's transfer to a MSU. The cheapest way to get from Club Quarters Hotel, St Paul's, London to Hammersmith Hospital costs only £1, and the quickest way takes just 15 mins. If so, it reveals in my judgment an unreasonable motivation for the decision not to adjourn until it was known what after-care arrangements were in place, or to defer discharge to enable suitable arrangements to be put in place, involving placing immediate and unnecessary pressure on the authorities charged under section 117 with responsibility for after-care. Shocking moment mother with children in her car SPITS at woman's face in parking row at supermarket. https://www.express.co.uk/news/uk/368314/Killer-found-after-hospital-escape In any event, any assumption of powers on the basis of a doctrine of necessity assumes that no appropriate powers are available under the Act: and that begs a large question. Ms Berry summarised her case as follows: H's case was discussed at the most senior levels within Ashworth. It was common ground before the Tribunal, and indeed obvious, that if H were to be discharged successfully into the community, it was essential for his benefit and the safety of others that suitable accommodation was available for him and suitable after-care arrangements were in place. Particularly given the preponderance of that opinion in the written reports, it was inappropriate for the Tribunal to determine the issues before them as if the only significant evidence was the oral evidence, and in any event without giving the Hospital and the local authority the option of calling Dr Heads or Dr Lomax (neither of whom, incidentally, could be said to be other than independent of Ashford), provided that could be done without undue delay. Creating your profile on CaseMine allows you to build your network with fellow lawyers and prospective clients. The penultimate paragraph of the report was as follows: The last psychiatric report was Dr Williams second report, dated 8 March 2001. 3. The conclusions included the following: The independent Psychiatric Report of Dr Burke, dated 5 August 1998, included the following in the section setting out his opinion: Dr Duncan's report, dated 16 November 1999, had been commissioned by H's solicitors for the Mental Health Review Tribunal hearing of November 1999. Dr Croy and Dr Silva made their recommendations for the purpose of section 3 on 28 March and Ms Berry completed her application for his detention under that section on the following day, when it was accepted by the management of the Hospital. The patient's remedy is to apply to the Mental Health Review Tribunal. The reasons did not sufficiently address these matters. That this should be the practice is supported by the guidance from Regional Chairmen of Mental Health Review Tribunals referred to at page 159 of the Leggatt Report on Tribunals and in paragraph 57 of the judgment of Crane J in. General view of Ashworth high-security Hospital, in Maghull, Merseyside. You bet. Independent Psychiatric Report by Dr Alice Duncan of Stockton Hall Psychiatric Hospital. While the Fallon report may take a … It follows from proposition (d) in paragraph 77 above that I reject Mr Walker's submission that a decision to defer discharge, or a decision not to defer discharge in circumstances that suggest that a deferral is appropriate, is outwith the scope of the statutory duty. Contains public sector information licensed under the Open Government Licence v3.0. Not a management problem, and attending therapeutic sessions. In summary, there was a formidable body of written evidence before the Tribunal. A stay may defer the legal consequences of a decision of a tribunal or of the executive, but, in my judgment, it cannot turn the clock back to undo what has already been done. The BBC's Judith Moritz talks to staff and patients. Click here for Mersey Care 24/7 Helpline contact details - online and phone psychological support.. For the sake of completeness, I mention that I reject Mr Walker's submission that a failure by the doctors or the ASW to take reasonable steps to obtain information before sectioning a patient does not justify judicial review unless their failure amounts to perversity or leads to a perverse decision, or there is a failure to take into account something that it is mandatory for them to take into account. Did he get assessed and was classified as insane. Initially admitted to open ward for 2 weeks, then threatening towards nurse and transferred to locked ward (163), Readmitted to locked ward in local hospital Horton Hospital, grandiose and deluded (32), Readmitted to Horton Hospital under section 3 psychotic, after shouting in street and assaulting policeman. Nor is it any answer to say (as does the chairman in his first witness statement) that care plans are put in hand at the last minute: as I stated above, that might justify a relatively short deferral of discharge, but it does not justify discharge without a care plan. In the present case, however, by the time a stay had been ordered the decision of the Mental Health Review Tribunal had had effect. Read Backpacker leaves hospital latest on ITV News. 33. However, there are additional concerns as to the procedure of the Tribunal. The Court should not deprive a person of liberty by injunction or compel him to submit to treatment, except in the most exceptional cases. I shall consider those orders separately. In my judgment, therefore, the Tribunal's decision was one which no sensible tribunal acting with due appreciation of its responsibilities would have made. The hospital is in the east of Maghull in northeast Merseyside, not far from the M58. However, as mentioned above, I shall consider the lawfulness of H's sectioning on the basis of the facts set out in the contemporaneous documents. Similarly, if the evidence filed by the Tribunal on judicial review of its decision demonstrates that its decision was unlawful, the Court cannot ignore that evidence and may grant relief based on it. Nash v Chelsea College of Art  EWHC Admin 538, State for Education and Science v Tameside MBC. Call 116 123. After belittling and insulting Mick, the two officers give him a speeding ticket and an order to get rid of his truck. * Enter a valid Journal (must If you are in crisis or have thoughts about harming yourself or someone else call 999 for an ambulance or go to your nearest Accident & Emergency department.. Equally, in the circumstances as they appeared to Miss Berry, I find it impossible to find her action unreasonable or irrational. I should not want to leave this case without expressing my appreciation of counsel's comprehensive and informative submissions. La moins chère est en voiture, ce qui coûte £1. There had been therefore limited opportunity to see him interacting with other people. The reports of Doctors Williams, Croy, Duncan, Cole, Lomax and Heads were subsequent to the last tribunal hearing in November 1999. After publication of the report, Paul Lever, the chairman of the Ashworth Hospital Authority for the past three years, resigned. The relevant passage of Mr Lloyd's note is as follows: Mr Simms disputes this: according to his witness statement: The written decision of the Tribunal was produced and given to the parties immediately after the announcement of their decision. I am also troubled by the fact that in his first witness statement the Chairman, Mr Simms, while giving reasons for rejecting the opinions of Dr Croy and Mr Miles, gives none for rejecting those expressed in the written psychiatric reports of the psychiatrists who differed from Dr Williams. There was no recent experience of him in the community. I agree that this Court cannot normally interfere with a tribunal's decision based on its assessment of the evidence before it. Had idea JE's baby not his and had to be killed (32), Returned to locked ward, started on anti-psychotic medication (163), When subject to an unprovoked attack by another patient who was secluded, tried to break into seclusion room with a saw, transferred to St Bernard's hospital and thence to Llanarth Court Hospital. In my judgment, the detention of H under section 3 was lawful. However, as Mr Walker QC pointed out, the statement in paragraph 34(i) of my judgment in that case is too widely expressed, in that it fails to reflect the general rule, as stated in Ermakov, permitting the admission of evidence that merely elucidates original written reasons. It was obvious from the evidence before the Tribunal that there was no accommodation allocated to H in the community and that there were no after-care arrangements in place. H's medical history later in 1997, summarised in the chronology, amply justified the contrary views of other psychiatrists at that date and the refusal of the Tribunal to discharge him in September 1997.) There is no reason to think that the meaning of 'stay of proceedings in Part 54 differs from its meaning in the previous RSC Order 53. He had not had any period of leave of absence under section 17 of the Act, or been the subject of supervised discharge under section 25A ff.. Mr Lloyd's notes are to a similar effect. I have, however, found them troubling, and I mention them because the first two of them may be relevant to Tribunals in future cases. The report recommends that Mr. Paul Lever, chairman of Ashworth hospital authority, should step down. It is also noteworthy that Mr Simms statement makes no mention of this recommendation. Thursday: 08:00 - 17:00. It appears from a number of cases cited to me that it used to be the common practice on applications for the judicial review of their decisions for Mental Health Review Tribunals to supplement the reasons for their decisions in affidavits or witness statements. (32, 163), But when moved to open ward, although he initially appeared calm, he left hospital and assaulted JE. Subject to the matters to which I refer below, the Tribunal was entitled to come to a positive view of the state of H's mental health and his prognostication. Under rule 24 of the Rules, the Tribunal is under a statutory duty to communicate its decision, including the reasons, to all the parties. First, according to Mr Lloyd's note, the Tribunal did not at any time give any indication that it was proposing to reject the evidence of the psychiatrists who had given written reports on H but were not at the Tribunal hearing. Hammersmith Hospital, Imperial College London. A short video of the inside of the former Ashworth Hospital, Maghull. It appears from a number of cases cited to me that it used to be the common practice on applications for the judicial review of their decisions for Mental Health Review Tribunals to supplement the reasons for their decisions in affidavits or witness statements. Before confirming, please ensure that you have thoroughly read and verified the judgment. Indeed, it is clear that there was consternation on the part of the Hospital and the local authority, and subsequently the local health authority, none of whom believed that the immediate discharge of H was justified under the Act or in his or the public interest. 1.33.0 Ashworth Hospital and the Criminal Justice System 1.34.0 Personality Disordered Prisoners within the Prison System 1.35.0 The Services 1.36.0 The Role of the Home Ofﬁce Mental Health Unit 1.37.0 The Use of Hospitals as "Quasi-Prisons" 1.38.0 Directing Prisoners to Unwilling Hospitals 1.39.0 Recall to Hospital At the conclusion of the evidence and submissions, the Tribunal asked the parties to retire. As appears from my judgment, there were reasonable grounds for such advice to have been given. The reasons given by the Tribunal do not refer to after-care, and in my judgment the alleged misapprehension of the tribunal is neither explicit nor implicit in their reasons. It was felt that if the original decision of the Tribunal to discharge from Ashworth was upheld, after-care arrangements were of paramount importance. Furthermore, I do not consider it appropriate to assume that the Tribunal had reason to believe that immediate discharge was necessary to ensure that arrangements were put in place. (32), JE applied for discharge as nearest relative: given improvement, H was discharged and returned to London for follow up at Horton Hospital rapid deterioration, readmission on section 3 briefly (32), Abandoned depot medication, and later, oral medication also, mental state began to deteriorate (32, 38, 163), Readmitted to Horton Hospital with threatening behaviour, thought disorder, and paranoia s. 4 then s. 3 MHA (38), Leave rescinded because failed to comply with medication, Mental state improved with further medication (33), While out of hospital on leave broke down JE's door and threatened to kill her threatening her with a kitchen knife in presence of the children no criminal proceedings brought (33, 38), In Horton Hospital abused and assaulted social worker, kicked down 2 se cure doors, threatened to kill a civilian worker, damaged property and assaulted a junior psychiatrist (punching him 20 to 30 times in the head) and his secretary when tried to telephone for help; (33) (38) (163), Following the incident H was secluded and after 2 weeks transferred to Ashworth (38) Hostile to medication (45), At Ashworth re-commenced on depot anti-psychotic medication: weekly Clopixol started 300 mgs weekly (45), Alleged that H tried to strangle another patient - strenuously denied by H (42), Noted that he has a tendency to become uncommunicative at times and to stay up all night (166), MHRT application: No discharge, transfer recommended (unspecified) (241), Incidents of abuse to staff, agitated and aggressive; physical threats to and spat at other patients; verbal abuse and intimidation, Seen by an independent psychiatrist on his behalf, Dr Burke for MHRT; considered well enough for discharge by him but MHRT recommended transfer to lesser security (33), Paranoid, agitated, crying and wailing; acute psychosis, over aroused and angry (45) (166), MHRT adjourned for a 117 meeting, full definite aftercare plans needed to be in place before any decision regarding a section 3 discharge (160), Section 117 case conference recorded a high level of concern amongst the community authorities at the risks of H's discharge to the community and advised a referral should be made to 3 Bridges regional secure unit where a more gradual rehabilitation into the community might be possible (160), MHRT sat again, and refused discharge but made a recommendation for transfer to 3 Bridges if no transfer by 1st December then the MHRT stated it would re-convene (155-157), Seen by Horton Hospital Dr Alcock for referral to Three Bridges (because Horton closing), Report of Dr Baxter and Atkins of 3 Bridges: illness partially treated, poor insight, and limited engagement with clinical team; should remain in hospital prior to discharge to community via an MSU. The only doctors present, who gave evidence orally were Doctors Croy and Williams. Secondly, and this is to some extent connected with the first, H and those representing him accept that all those concerned in these cases have at all times acted in good faith. The reason he had not been transferred to a MSU was that Dr Heads, from Three Bridges, did not consider that he had made enough progress for transfer there. Ashworth, the top-security hospital at the centre of paedophilia allegations that have prompted an immediate government inquiry, is no stranger to controversy. It is far from clear that the Tribunal would have directed discharge in the face of the concerns and difficulties to which they would have been alerted. John Jarratt as Mick Taylor in the film wields a high-powered rifle to subdue backpackers in the desert, True life killer: Ivan Milat was an intelligent, gun-obsessed psychopath who took his victims to a deserted forest, where he chased them as 'prey', taunting them, before their inevitable, merciless end, German backpackers Katarina and Rutger visit a desert grave in the Australian outback in Wolf Creek 2, An unmarked cross and stone cairn mark the site near where Peter Falconio was murdered in July, 2001, his body later disposed of by Bradley Murdoch, but never found. Neither of them considered that H was suitable for discharge into the community. Mar 2003 – Present 16 years 8 months. The delay before accommodation other than bed and breakfast or hostel accommodation could be made available, and the concerns of the section 117 authorities, could and should have been taken into account by the Tribunal before discharge was made effective. Threatening but showed rapid improvement with medication. It follows that the detention of H pursuant to section 3 on 29 March 2001 was lawful. Dr Williams set out under 7 heads H's progress at the Hospital over the past two years. I am strongly of the view that such a hearing would have been shorter than a hearing of an application for judicial review. It was a short report, opining that H's aggressive behaviour was due to poor impulse control rather than his mental illness, but giving no reason for this view. It focussed, necessarily, on the tribunal hearing, the evidence before it, its reasons, and the actions of Doctors Croy and Silva and Miss Berry on 28 and 29 March 2001. According to Dr Croy's witness statement of 28 March 2001, the chairman, Mr Simms, said that the Tribunal were not minded to defer H's discharge as, in his experience, it did not matter how long matters were deferred, nothing ever happened. Paul Hammersmith is the main protagonist in Wolf Creek 2 and one of the survivors to escape from Mick Taylor.He is a British tourist that went to visit austraila, until he came across a girl named Katarina on the Middle of the road who was injured by Mick. (c) Where, as in the case of Mental Health Review Tribunals, Parliament has required that a decision be given with written reasons, those reasons have to be adequate. Man who survived deadly Milat attack talks for the first time. Dr Croy's second report, dated 26 February 2001, did not add substantially to her earlier report. change. Ashworth accepted section 3 application (paragraph 12, H's witness statement dated 3/5/2001). The case will again be in the public eye, with Bradley John Murdoch launching an appeal against his conviction, claiming lawyers 'groomed' Ms Lees for the evidence she gave at his 2005 murder trial. In addition, in my judgment the Tribunal did not properly take into account the evidence of Miss Ariola. However, when they make their decisions the ASW and the doctors cannot know whether the decision of the Tribunal will subsequently be held to be unlawful. No one in the Hospital had considered H's discharge a realistic possibility. However, that practice must now be reconsidered in the light of the decision of the Court of Appeal in, (g) In assessing the adequacy of reasons, one must bear in mind that the decision will be considered by parties who know what the issues were (, Secondly, it appears from Mr Lloyd's note that at no stage of the hearing before the Tribunal announced their decision were the parties before the Tribunal informed of the findings of Dr Cashman as a result of his interview with H. The parties should be given the opportunity to address and to comment on any significant findings of the medical member, both because fairness so requires and because they may have comments or evidence to put before the Tribunal that may lead it to depart from the provisional opinion formed by the medical member. Lastly, by letter dated 11 October 2001, Mr Worth informed H that the local authority was holding a one-bedroom sixth floor flat in Hammersmith available for him as temporary accommodation as an alternative to bed and breakfast or hostel accommodation. Or, to put it differently (see Secretary of State for Education and Science v Tameside MBC  AC 1015, 1064E), was the Tribunal's decision one which no sensible tribunal acting with due appreciation of its responsibilities would have made? Mr Walker submitted that the Tribunal was entitled to form its own view of H, he having been interviewed by the medical member and all of them having seen and heard him give evidence and been subject to cross-examination. While traffic and air pollution exposure is associated with increased mortality in numerous diseases, its association with disease severity and outcomes in pulmonary arterial hypertension (PAH) remains unknown.Exposure to particulate matter with a 50% cut-off aerodynamic diameter ≤2.5 μm (PM 2.5 … The last paragraph of her witness statement is as follows: The hospital clinical notes for 26 March 2001, taken by Nurse Jordan and Mr Miles, bear out Dr Croy's evidence that on 26 March 2001 H stated that he would leave Ashworth and go to B and B, as do their witness statements. Anne Marie Nelson, former chairman of the Special Hospitals Service Authority and present chairman of the High Security Psychiatric Services Commissioning Board has also resigned, in accordance with the principles of public accountability. Morning; relevant documents assembled for Sefton social worker (Lorraine Berry)'s visit to carry out potential admission interview (345), Arrangements discussed in the event that no section 3 application is made, noting that as there has yet to be proper involvement by the London authority this cannot be construed as effective aftercare (346). In the sequel, the character of Taylor, played by veteran Australian actor, John Jarratt, returns to menace a new batch of victims, British traveller Paul Hammersmith (played by Ryan Corr) and Germans Rutger Enqvist (Philippe Klaus) and Katarina Schmidt (Shannon Ashlyn). H gave evidence, and was cross-examined extensively by Mr Mulrooney. Given H's past violence and the previous failures of discharge into the community, it was necessary to know that suitable arrangements would be in place when H was discharged. At least somebody's happy to see them! Mr Walker and Ms Richards submitted that the Tribunal was indeed entitled to assume that the local authority and the local health authority would comply with their duties under section 117, that in due course suitable after-care arrangements and accommodation would be put in place, and on the basis of their findings as to H's mental health to believe that he would behave sensibly and not leave Ashworth until they were in place. I can dispose of certain of Ashworth's contentions immediately. Ashworth whistleblower gives evidence The Personality Disorder Unit at Ashworth Hospital on Merseyside is the focus of the inquiry. As it was, the Tribunal had no information as to the after-care arrangements that could be made. She thought that he remained appropriately detained in hospital for continued treatment of his mental illness. The Court of Appeal held that, although those consequences were stipulated by statute, the Court could by granting a stay defer them until the review proceedings were concluded. The Tribunal gave reasons for their being satisfied that the discharge criteria were met. According to the witness statement of Dr James, Ashworth's Medical Director: Dr James statement explains the reasons for the admission of (H) under Section 5(2). An appellate tribunal, the members of which would include a judge and a psychiatrist of appropriate qualifications, would have been able to focus on H's mental health at the date of the hearing before it, to have determined the issues as to H's mental health, and could hear medical evidence for that purpose; and it could have taken into account the evidence of the section 117 authorities. However, I am concerned that the Tribunal misunderstood Dr Williams report of 8 March 2001. Ashworth, the top-security hospital at the centre of paedophilia allegations that have prompted an immediate government inquiry, is no stranger to controversy. He summarises the reports of Doctors Lomax, Burke and Heads, but does not mention the report of Dr Duncan. (b) Reasons must be sufficient for the parties to know whether the tribunal made any error of law: Alexander Machinery Ltd v Crabtree  ICR 120. If it considers that to be inappropriate (and it should be borne in mind that the previous unwillingness of an RMO to make an application may not persist in the face of the Tribunal's views) or unnecessary, and there is uncertainty as to the putting in place of the after-care arrangements on which satisfaction of the discharge criteria depends, the tribunal should adjourn pursuant to rule 16 to enable them to be put in place, indicating their views and giving appropriate directions: c.f. Part of the Daily Mail, The Mail on Sunday & Metro Media Group, At least somebody's happy to see them! The procedure of a Mental Health Review Tribunal is to a significant extent inquisitorial. H's solicitor's (Mr Lloyd's) note of the hearing is in evidence before me. A number of general points need to be made at this stage. Dr Williams recommendation of supervised discharge itself implied that there would be a substantial risk of serious harm to the health or safety of the patient or the safety of other persons or of the patient being seriously exploited, if he were not to receive the after-care services to be provided under section 117 : see section 25A(4)(b). For Joanne Lees and her murdered boyfriend, Peter Falconio, from Huddersfield, UK, it happened on their tour of the Australian outback when a psychotic drifter flagged down their Kombi van on a remote highway. Information whatsoever as to what after-care arrangements were not Ashworth 's, filmed. 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