Categorized | Case Law, Civil Law

Blood on our hands – part 2

Blood on our hands –  part 2

Sir Justice James Munby, who sits as president of the High Court’s family division, in his judgment of 3 August said he felt “ashamed and embarrassed” that no hospital place had been found that could take proper care of an unnamed 17-year-old known as X when she was due to be released from youth custody in 11 days’ time.

The judicial intervention drew attention to the state of mental health provision in the UK. The judge said it demonstrated the “disgraceful and utterly shaming lack of proper provision in this country of the clinical, residential and other support services.” He ordered his judgment in the private case be made public and sent to NHS England and senior Government ministers to expose the “outrage” that is the “lack of proper provision for X – and, one fears, too many like her.”

His judgment explained that the girl has made a large number of “determined attempts” on her life. She is due to be released from a secure unit, referred to as ZX for legal reasons, and doctors believe she needs to be placed in further care for her own protection. But, so far, none had been found.

None of England’s 124 places in low secure units were currently available and there was a six-month waiting list even though X was due to be released within days. Judge Munby wrote: “If, when in 11 days’ time she is released from ZX, we, the system, society, the state, are unable to provide X with the supportive and safe placement she so desperately needs, and if, in consequence, she is enabled to make another attempt on her life, then I can only say, with bleak emphasis: we will have blood on our hands.”

One can imagine the reaction at senior levels in the Department of Health to this judgment, along the lines of “get this judge of our backs – fast.” And, surprise surprise, on Monday morning NHS England finally submitted a detailed plan to keep her in a low secure unit, by creating new beds from those in a psychiatric intensive care unit, instead of trying to care for her in the community. The NHS plan is now to move X this Thursday into the unit. Munby has now approved the plan which also includes new funding for her care, which requires a three-to-one staff ratio.

Sir James has no doubt that this is not a matter for congratulation. He was scathing that the decision to find her a bed only followed his outspoken warnings that a failure to do so could result in her taking her own life. He said that without his intervention last week, NHS England would not have acted as effectively or speedily.

The case of X has proved an embarrassment to the NHS in revealing the lack of resources to cope with the most extreme mental health cases. Munby himself wondered who else might be at risk as the country’s mental health system strains to deal with rising demand from young patients at a time when the supply of beds as not been able to keep up. Away from public sight some other poor patient will probably have slipped down a place to make room for patient X.

Judge Munby wrote: “We are, even in these times of austerity, one of the richest countries in the world. Our children and young people are our future. X is part of our future. It is a disgrace to any country with pretensions to civilisation, compassion and, dare one say it, basic human decency, that a judge in 2017 should be faced with the problems thrown up by this case and should have to express himself in such terms.”

Nationally we stagger under the burden of four major projects of questionable value – HS 2, Heathrow, Trident replacement and a Nuclear Power station. They will each consume trillions of pounds. No wonder there is nothing to spare for the humanitarian programmes required for people like X.

And down the side of the Treasury sofa can be found £1.5 billion to persuade the DUP to support the government. How’s that for priorities.

This post was written by:

- who has written 462 posts on Upper Case – The Anya Legal Journal.

Mike Gribbin is a retired Civil Servant with wide experience, including the drafting and implementation of Parliamentary legislation and regulations. He is the editor of “Criminal Offences Handbook”, a uniquely comprehensive guide to more than one thousand ways to fall foul of UK criminal law. He is Editor of the Upper Case Legal Journal and has been writing blog posts for the past eight years.

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