Secretary Of State For Home Department, R (on the application of) v Mental Health Review Tribunal

Factual and Procedural Background

The claimant seeks to quash a decision made by the defendants on 11 June 2004, which provisionally decided that the patient, referred to as MP, should be discharged subject to various conditions. However, the discharge was deferred until the Tribunal was satisfied that the necessary arrangements were in place to meet these conditions. The claimant argues that the conditions effectively amount to detention by reason of deprivation of liberty and that the Tribunal lacked power to impose such conditions. The Tribunal took a neutral stance on the merits, viewing the claim as premature, and scheduled a further hearing for 15 October 2004 to consider the appropriateness of MP's conditional discharge. MP also submits that the claim is premature but contends the conditions do not inevitably amount to deprivation of liberty and are lawful, especially as he consents to them.

MP is a 69-year-old restricted patient who was convicted of manslaughter in 1976 and has a history of serious sexual offences. He was committed to hospital under sections 37 and 41 of the Mental Health Act 1983 without limitation of time. The Tribunal's powers regarding restricted patients are governed by sections 72 and 73 of the Act, requiring discharge if the patient is no longer suffering from a qualifying mental disorder or if detention is not necessary for treatment or protection of others. Conditional discharge may be directed but can be deferred until necessary arrangements are confirmed.

The Tribunal considered extensive evidence from medical and social work professionals, including oral and written testimony, regarding MP's psychopathic disorder and risk to others. While acknowledging the risk MP poses, the Tribunal reached a provisional conclusion that discharge on stringent conditions was appropriate. The conditions included medication compliance, residence in secure accommodation with qualified staff, escorted community leave, and regular supervision.

The claimant challenges the conditions concerning residence and escorting, arguing they inevitably constitute a deprivation of liberty.

Legal Issues Presented

1. Whether the Tribunal had the power to impose conditions on MP's conditional discharge that inevitably amount to a deprivation of liberty.
2. Whether the claim challenging the Tribunal's provisional decision is premature.
3. Whether consent by the patient can render conditions lawful even if they amount to a deprivation of liberty.
4. Whether the Tribunal's decision was irrational in light of the evidence.

Arguments of the Parties

Claimant's Arguments

• The conditions imposed by the Tribunal, particularly those requiring residence in secure accommodation and continuous escorting, inevitably amount to a deprivation of liberty and thus exceed the Tribunal’s powers.
• The claim is not premature because the deprivation of liberty is inevitable, and early challenge avoids unnecessary preparation of care plans under unlawful conditions.
• The Tribunal’s decision was irrational given the evidence presented.

Tribunal's Position

• The Tribunal adopts a neutral stance on the merits of the claim, considering it premature since the decision to defer discharge is provisional.
• A further hearing is scheduled to consider whether conditional discharge is appropriate once arrangements are in place.

MP's Arguments

• The claim is premature.
• The conditions do not inevitably amount to a deprivation of liberty and are lawful.
• Even if the conditions amount to a deprivation of liberty, MP’s consent renders them lawful.

Table of Precedents Cited

Court's Reasoning and Analysis

The court began by acknowledging the provisional nature of the Tribunal’s decision to defer conditional discharge pending arrangements. It recognized the legal principle that a decision to defer is subject to change upon material changes in circumstances, referencing established case law.

The court examined the evidence before the Tribunal, which included extensive professional testimony indicating MP’s ongoing risk to others, particularly young boys, and the necessity for stringent conditions to mitigate that risk. The Tribunal’s conclusion was that discharge on strict conditions was appropriate, given that treatment and supervision could be provided effectively in the community setting.

The court analyzed the specific conditions imposed—residence in secure accommodation with qualified staff and constant escorting—and concluded these conditions inevitably amount to a deprivation of liberty. It distinguished the PH case, where similar conditions were imposed for the patient’s benefit and in the context of advanced age and poor health, from the present case where the conditions are aimed at protecting others from a continuing risk.

The court rejected the argument that MP’s consent could render conditions lawful if they amount to deprivation of liberty, referencing prior reasoning in related cases. It also found no necessity to declare the Tribunal’s decision irrational, although it expressed surprise at the Tribunal’s conclusions given the evidence.

Ultimately, the court agreed with the claimant that the challenge was not premature because the deprivation of liberty was inevitable, making it appropriate to resolve the issue promptly.

Holding and Implications

The court held that the claimant is entitled to succeed in quashing the Tribunal’s decision imposing the challenged conditions.

Holding: The conditions imposed by the Tribunal, specifically those requiring residence in secure accommodation and continuous escorting, inevitably amount to a deprivation of liberty and are beyond the Tribunal’s power to impose.

Implications: This decision directly affects the parties by invalidating the Tribunal’s provisional decision to defer conditional discharge on the challenged conditions. No broader precedent is established beyond the facts of this case, and the court will determine the precise relief after hearing counsel.