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AM v Health Service Executive
Factual and Procedural Background
On 7 November 2016 the Appellant applied ex parte to the High Court for orders that the Respondent be made a ward of court and detained in The Hospital. The Respondent – a prisoner with a documented history of paranoid schizophrenia and serious violence – was due for release four days later. Affidavits from treating psychiatrists warned that, if released, he would pose a grave threat to his own life and to others. At interlocutory hearings counsel for the Respondent argued that continued detention could only occur under the Mental Health Acts 1945-2001 (“the 2001 Act”), which contain specific safeguards. The High Court nonetheless made interim orders, later issuing a full judgment on 27 March 2017 ([2017] IEHC 184) declaring the Respondent a ward and directing his detention in The Hospital.
The Supreme Court granted a direct appeal ([2017] IESCDET 126) to decide whether the wardship route was lawful when the Respondent admittedly met the statutory criteria for detention under the 2001 Act.
Legal Issues Presented
- Can a person who satisfies the 2001 Act criteria for involuntary detention instead be detained through the wardship jurisdiction of the High Court?
- Did the High Court err in declaring the Respondent a ward of court and ordering his detention?
- How do the historic wardship jurisdiction and the statutory code in the 2001 Act interact, and when may they overlap?
Arguments of the Parties
Appellant's Arguments
- The situation was an emergency: the Respondent would imminently be released, and the statutory admission pathway under the 2001 Act was impossible to complete in time because no other approved centre would accept him.
- The evidence satisfied the wardship tests of “necessity” and “appropriateness”; therefore the High Court could invoke wardship to protect the Respondent and the public.
- Wardship afforded flexibility to impose protective conditions while also permitting “mirror” procedural safeguards.
Respondent's Arguments
- The Appellant was attempting to “circumvent” the 2001 Act and deprive the Respondent of its safeguards, including independent tribunal review and periodic renewal orders.
- Where the legislature has created a comprehensive statutory code, wardship should not be used.
- The High Court could have used inherent jurisdiction to facilitate compliance with the 2001 Act instead of resorting to wardship.
Table of Precedents Cited
| Precedent | Rule or Principle Cited For | Application by the Court |
|---|---|---|
| In re a Ward of Court [1996] 2 I.R. 79 | Wardship has constitutional foundations and must protect personal rights. | Confirmed breadth of wardship jurisdiction subject to constitutional limits. |
| In re D [1987] 1 I.R. 449 | Wardship orders require that detention be “necessary” and “appropriate”. | Supreme Court applied these twin tests to uphold the order. |
| AB v. Clinical Director of St Loman’s Hospital [2018] IECA 123 | Struck down s.15(3) 2001 Act for lack of timely review. | Illustrated deficiencies within the statutory code. |
| In re FD [2015] IESC 83 | Inherent jurisdiction cannot replace a complete statutory scheme absent constitutional necessity. | Distinguished; the present case involved fundamental rights. |
| DG v. Eastern Health Board [1997] 3 I.R. 511 | Courts retain inherent powers to protect personal rights in emergencies. | Supported availability of a “back-stop” jurisdiction. |
| The State (Quinn) v. Ryan [1965] 1 I.R. 70 | Courts’ duty to vindicate personal rights. | Underpinned protective rationale for detention. |
| Attorney General v. X [1992] 1 I.R. 1 | Welfare interests may override strict liberty concerns. | Referenced in proportionality analysis. |
| HSE v. J.O'B [2011] IEHC 73 | Inherent jurisdiction used where statutory lacuna exists. | Showed practice inconsistent with claim that inherent powers are obsolete. |
| HSE v. VF [2014] IEHC 628 | Safeguards required when exercising inherent jurisdiction. | Guided High Court’s “mirror” protections. |
| SS (a minor) v. HSE [2007] IEHC 189 | Further articulation of procedural protections. | Cited in same context. |
| PM v. DC & the HSE [2013] IEHC 425 | Recent use of inherent jurisdiction by the Appellant itself. | Contradicted argument that only statutory powers remain. |
| Winterwerp v. The Netherlands (1979) 2 EHRR 387 | ECHR requires periodic review of detention. | High Court’s six-monthly review order complied with this standard. |
| HL v. The United Kingdom (2005) 40 EHRR 32 | Law authorising deprivation of liberty must be clear and foreseeable. | Informed analysis of safeguards. |
| Eastern Health Board v. MK [1999] 2 I.R. 99 | Fair procedures where liberty is restricted. | Cited to affirm procedural fairness. |
| DPP v. Shaw [1982] 1 I.R. 1 | Article 40.3.1 duties to vindicate rights. | Supported protective jurisdiction exercised. |
| Mogul v. Tipperary County Council [1976] 1 I.R. 260 | General precedent on judicial restraint. | Referenced in inherent-jurisdiction discussion. |
| G McG v. DW (No. 2) [2000] 4 I.R. 1 | Express statutory jurisdiction normally excludes parallel inherent powers. | Discussed and distinguished. |
| Mavior v. Zerko Ltd [2013] IESC 15 | Court should not create parallel inherent jurisdiction if rules exist. | Used to delineate limits of inherent jurisdiction. |
| In re Birch (1892) 29 L.R. Ir. 274 | Historic scope of parens patriae powers. | Cited to trace origins of modern wardship. |
| In re Godfrey (1892) 29 L.R. Ir. 278 | Historical confirmation of broad wardship powers. | Same purpose as In re Birch. |
Court's Reasoning and Analysis
The Court examined the statutory schemes and held that s.283 of the Mental Treatment Act 1945 expressly preserves the wardship jurisdiction. While the Respondent plainly met the 2001 Act criteria, sections 10 and 21 prevented his direct admission to The Hospital; no other approved centre would take him even temporarily. Given that impasse, the High Court faced an imminent risk to life and public safety.
Re-affirming In re D, the Supreme Court reasoned that wardship could be invoked when “necessary and appropriate” and where fundamental constitutional rights – life and bodily integrity – were at stake. The decision in In re FD was distinguished because that case involved property management, not deprivation of liberty. Inherent jurisdiction remains a “back-stop”, but here the High Court acted within its express wardship powers, supplementing them with “mirror” safeguards to satisfy constitutional and ECHR standards (e.g., six-monthly reviews, legal representation, independent medical input, liberty to apply on short notice).
Holding and Implications
Appeal dismissed. The High Court lawfully made the Respondent a ward of court and ordered his detention in The Hospital.
Immediate consequence: the Respondent remains detained under wardship, subject to ongoing judicial review. Broader implication: wardship continues to operate as an exceptional but lawful mechanism for involuntary detention where the statutory pathway in the 2001 Act proves unworkable, provided that orders are both necessary and appropriate and accompanied by robust safeguards. No new precedent was set, but the judgment clarifies the permissible overlap between the two regimes.
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