Daughter wins legal battle over mother's suicide
http://www.independent.co.uk/news/uk/home-news/daughter-wins-legal-battle-over-mothers-suicide-1060287.html
The daughter of a mentally-ill woman who walked out of a hospital and threw herself under a train has won the final round of her battle for the right to sue the local health trust for damages.
Anna Savage claims the hospital allowed her mother to escape and kill herself and should be held liable for violating her "right to life" under Article 2 of the European Convention on Human Rights.
Today, five Law Lords rejected argument by South Essex Partnership NHS Foundation Trust that, in the absence of gross negligence, it could not be held liable.
Lord Walker said the Trust was under a general obligation to take precautions to prevent suicides by employing competent properly-trained staff and running a safe system at the hospital.
Health authorities also had an obligation, if staff knew or ought to know that a patient presented a "real and immediate" risk of suicide, to do all they could to prevent it.
Carol Savage, 50, who had a history of mental illness, absconded from Runwell Hospital in Wickford, Essex, where she was being treated for paranoid schizophrenia as a detained patient in an open acute psychiatric ward, in July 2004.
After walking two miles to Wickford station, she jumped in front of a train.
Her daughter sought compensation, claiming that as a result of her mother's death she suffered distress, anxiety, vexation, bereavement, loss and damage.
She argued that the Trust took insufficient care to protect her mother and, as a public authority, was liable for a breach of her mother's right to life.
Her mother had made a number of attempts to leave the hospital before succeeding, it was alleged. Staff at the hospital failed properly to appreciate the "acute risk" she presented and failed to ensure adequate measures were put in place to protect her life.
In December 2006, a High Court judge blocked the claim on the basis that it would need to be proved there was "gross negligence" on the part of the hospital authorities, not merely negligence or something less.
But a year ago, the Court of Appeal held that the case could go ahead.
The court upheld argument by the daughter's lawyers that, in a case where the deceased was compulsorily detained in a mental hospital, the authority owed the same human rights obligations as were owed by the State to someone detained in prison or a prison hospital.
The Trust's appeal against that ruling was dismissed today by Lords Scott, Rodger, Walker and Neuberger and Baroness Hale.
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House of Lords - Savage (Respondent) v South Essex Partnership NHS ...Judgments - Savage (Respondent) v South Essex Partnership NHS Foundation ..... Anna Savage, has brought the present proceedings alleging that the South ...
ReplyDeletewww.publications.parliament.uk/pa/ld200809/ldjudgmt/jd081210/savage-1.htm
Jeremy
also @ http://health.groups.yahoo.com/group/SSRI-Crusaders/message/33383
If trusts are removing people from their homes and families against their will then the very least they should do is see that the people removed are being watched and protected. After all people are removed if they are a risk to themselves or others and that risk whould be monitored. I know watchign someone all the time is costly and time consuming and prob a pain the ass for nurses, but it is their job and these are people's lives. I hope they win their case and set a positive precedent.
ReplyDeleteSometimes, just sometimes, the Law gets things right. This is a GOOD ruling. thanks for bring it to my attention.
ReplyDeleteBest wishes...
More coverage in the Times to-day
ReplyDeleteJeremy
http://business.timesonline.co.uk/tol/business/law/reports/article5321111.ece
Duty to prevent suicidal patients from succeeding
House of Lords
Published December 11, 2008
Savage v South Essex Partnership NHS Foundation Trust
Before Lord Scott of Foscote, Lord Rodger of Earslferry, Lord Walker of Gestingthorpe, Baroness Hale of Richmond and Lord Neuberger of Abbotsbury
Speeches December 10, 2008
The right to life protected by article 2 of the European Convention on Human Rights imposed an operational obligation on medical authorities to do all that could reasonably be expected of them to prevent a patient detained in a mental hospital who was known to be at a real and immediate risk of committing suicide from doing so.
The House of Lords so held in dismissing an appeal by the defendant, South Essex Partnership NHS Foundation Trust, from the Court of Appeal (Sir Anthony Clarke, Master of the Rolls, Lord Justice Waller and Lord Justice Sedley) (The Times January 9, 2008; [2008] 1 WLR 1667) who allowed an appeal by the claimant, Anna Savage, from Mrs Justice Swift (The Times February 16, 2007) who had given summary judgment for the defendant.
Mr Edward Faulks, QC and Mr Angus McCullough for the defendant; Mr Nigel Giffin, QC and Ms Cecilia Ivimy for the Secretary of State for Health, intervening; Mr Philip Havers, QC and Ms Jenni Richards for Ms Savage; Ms Dinah Rose, QC, Mr Richard Hermer and Mr Paul Bowen for Inquest, Justice, Liberty and MIND, intervening.
LORD RODGER said that the decisions of the European Court of Justice in Powell v United Kingdom (Application No 45305/99) ((2000) 30 EHRR CD 362) and Osman v United Kingdom (Application No 23452/94) ((1998) 29 EHRR 245) related to different aspects of the article 2 obligations of health authorities and their staff to protect life. The obligations were not alternative but complementary.
In terms of article 2, health authorities were under an overarching obligation to protect the lives of patients in their hospitals. In order to fulfil that obligation, and depending on the circumstances, they might require to fulfil a number of complementary obligations.
In the first place, health authorities were required to ensure that the hospitals for which they were responsible employed competent staff and that they were trained to a high professional standard. In addition, the authorities had to ensure that the hospitals adopted systems of work which would protect the lives of patients. Failure to perform those general obligations might result in a violation of article 2.
If, for example, a health authority failed to ensure that a hospital put in place a proper system for supervising mentally ill patients and, as a result, a patient was able to commit suicide, the health authority would have violated the patient’s right to life under article 2.
Even though a health authority employed competent staff and ensured that they were trained to a high professional standard, a doctor, for example, might still treat a patient negligently and the patient might die as a result. In that situation, there would be no violation of article 2 since the health authority would have done all that the article required of it to protect the patient’s life.
Nevertheless, the doctor would be personally liable in damages for the death and the health authority would be vicariously liable for her negligence. That was the situation envisaged by Powell.
The same approach would apply if a mental hospital had established an appropriate system for supervising patients and all that happened was that, on a particular occasion, a nurse negligently left his post and a patient took the opportunity to commit suicide.
There would be no violation of any obligation under article 2, since the health authority would have done all that the article required of it. But, again, the nurse would be personally liable in damages for the death and the health authority would be vicariously liable too. Again, that was just an application of Powell.
Finally, article 2 imposed a further operational obligation on health authorities and their hospital staff. That obligation was distinct from, and additional to the authorities’ more general obligations.
The operational obligation arose only if members of staff knew or ought to have known that a particular patient presented a real and immediate risk of suicide. In those circumstances article 2 required them to do all that could reasonably be expected to prevent the patient from committing suicide.
If they failed to do that, not only would they and the health authorities be liable in negligence, but there would be a violation of the operational obligation under article 2 to protect the patient’s life. That was comparable to the position in Osman.
Lord Scott and Baroness Hale delivered concurring opinions. Lord Walker and Lord Neuberger agreed.
Solicitors: Bevan Brittan LLP; Solicitor, Department of Works and Pensions; Bindmans LLP; Bhatt Murphy
Hello Mandy
ReplyDeleteHope you are well - Wrote a long reply to this post but deleted it as it was me spouting forth on your blog - I just think this is such a complicated matter in it broadest sense.
As the South London and Maudsley NHS Trust has , through its solicitors Bevan Brittan presented me with a bill for £15,000 for daring to take legal action against the Trust in the small claims Court I think the Chief Executive and senior managers of South Essex Partnership should be held personally liable for their Trust's and Anna Savages legal costs and any future compensation she may be awarded as at the moment patients and the public are in a Lose-Lose situation with corporately driven Trusts being prepared to waste millions of pounds of public money trivially defending actions no other professional real world business would waste their time trying to defend.
ReplyDeleteThat Anna Savage lost her mother in the way she did is bad enough , that those responsible for looking after her mother at the time of her death , the South Essex Partnership NHS Foundation Trust, defied logic and common human decency to force this woman all the way to the House of Lords to make them professionally accountable is quite frankly evil.
Bevan Brittan also represented the South Essex Partnership NHS Foundation Trust in the savage case .
I am not legally represented in my ongoing legal action against the South London and Maudsley NHS Foundation Trust.
Hi Jeremy
ReplyDeleteThis part really struck me:
"In terms of article 2, health authorities were under an overarching obligation to protect the lives of patients in their hospitals. In order to fulfil that obligation, and depending on the circumstances, they might require to fulfil a number of complementary obligations.
In the first place, health authorities were required to ensure that the hospitals for which they were responsible employed competent staff and that they were trained to a high professional standard. In addition, the authorities had to ensure that the hospitals adopted systems of work which would protect the lives of patients. Failure to perform those general obligations might result in a violation of article 2."
I think there are constant reminders that services are falling short of the above.
I was going to put a post up, not long back, about my perspective on someone who recently hung themselves in a Bedfordshire acute unit. That post didn't materialise because, as happens in life, I got caught up in other things.
However, I think it is important that that was not a one off tragedy. Over the last year or so I believe 4 people have taken their lives, whilst either in acute care, or under the care of community mental health teams. All of these people warranted crisis care and their deaths are a reflection of the lack of appropriate care being available to them (even in a hospital environment where people are supposed to be being monitored).
So when I hear NHS organisations saying "There are lessons to be learnt", I can't stop myself screaming "WHEN?".