Title: Mr G -v- Medical Director of the Mater Hospital, Mental Health Tribunal, notice party HIGH COURTJudgment delivered by Mr Justice Peart on November 29th 2007
JUDGMENTThere may be situations where some deviations from the provisions of the Mental Health Act 2001 are permissible in the best interests of a patient, Mr Justice Peart ruled.
Such circumstances could be where a person detained in a psychiatric institution under an admission order suddenly suffers an acute illness which requires an immediate transfer to a hospital.
BACKGROUNDThe case was brought on behalf of a man, Mr G, who suffered from a mental illness and was a resident of St Aloysius Ward in the Mater Hospital, a psychiatric ward. This was an approved centre under Section 22 of the Mental Health Act 2001.
He suffered from both a psychiatric and a medical condition, and his medical condition worsened. Mr G was moved to St Teresa's Ward, a medical ward in the same hospital, in order to have his medical condition investigated. His removal was not arranged by the clinical director of an approved centre, as required by the 2001 Act.
During a hearing before the Mental Health Tribunal Dr Sheehan, a psychiatrist in the hospital, confirmed that the clinical director of this ward was in fact based in St Vincent's hospital, and had not been asked to give approval for the transfer. Despite the fact that the terms of the 2001 Act were not complied with, the Tribunal approved his continued detention in St Teresa's ward.
Mr Adrian Mannering, SC, for the applicant, accepted that Mr G suffers from a mental disorder and that he is also in need of medical treatment requiring him to be in the medical ward. He also accepted that all those caring for both his psychiatric and medical needs were concerned with his best interests. However, he said this did not in any way dilute their obligations to adhere strictly to the procedures laid down by the Act, otherwise a person was not detained in accordance with law.
Donal McGuinness, BL, for the Mental Health Tribunal, said that Section 22 should be viewed simply as a section enabling a person to be transferred to a hospital for medical treatment, and that other sections of the Act deal with the legality of a person's detention, and these had been complied with.
DECISIONMr Justice Peart said there was no doubt that Mr G was very sick both mentally and physically and he needed to be detained wherever necessary so that he could be treated properly. No-one was seeking to impugn the admission order under which he was detained initially, or the renewal order.
However, he said it was appropriate for Mr G's solicitor to ask the court to inquire into the legality of his detention, which carried the possibility that this could lead to his release.
But, he added: "It cannot have been the intention of the Oireachtas when it enacted this piece of legislation that its provisions would have to be acted upon in such a literal way that the best interests of the patient would take second place to those best interests.
"In my view . . . the transfer of the applicant to St Teresa's Ward, a step deemed essential by those looking after the applicant, has not rendered his continued detention there for treatment purposes to be unlawful, in spite of the fact that it was not the clinical director of the approved centre who arranged it."
His view would have been entirely different had the transfer been for any other than strictly medical reasons, he added.
The full text of this judgment is available on www.courts.ie