In the matter of an application by Margaret Hanna for Judicial Review
| Jurisdiction | Northern Ireland |
| Judge | Coghlin J |
| Judgment Date | 29 July 2003 |
| Neutral Citation | [2003] NIQB 79 |
| Court | Queen's Bench Division (Northern Ireland) |
| Date | 29 July 2003 |
| Year | 2003 |
1
Neutral Citation no. [2003] NIQB 79 Ref:
COGF3936
Judgment: approved by the Court for handing down Delivered:
29/07/03
(subject to editorial corrections)
IN THE HIGH COURT OF JUSTICE IN NORTHERN IRELAND
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QUEEN’S BENCH DIVISION (CROWN SIDE)
________
IN THE MATTER OF AN APPLICATION BY MARGARET HANNA FOR
JUDICIAL REVIEW
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COGHLIN J
[1] The applicant in these proceedings, Margaret Hannah, was at the
institution of the proceedings some 85 years of age and, at that time, residing
in the Elderly Medicine Unit of the Laganvalley Hospital Lisburn. She had
been resident in that unit since admission on 16 November 2000. The
applicant had suffered several strokes associated with brain damage, she was
confused and lacking the legal capacity to institute and conduct proceedings.
Consequently, this application was brought, on behalf of the applicant, by her
son-in-law and next friend John McGowan. However, during the course of
this judgment I shall refer to Margaret Hannah as the applicant. The
applicant was represented by Mr Richard Gordon QC and Mr John Larkin QC
while Mr McCloskey QC appeared with Mr Goode for the Craigavon and
Banbridge Community Health and Social Services Trust (“the Trust”) and
with the Mr McMillan for the Department of Health, Social Services and
Public Safety for Northern Ireland (“the Department”). I am grateful to both
sets of counsel for their detailed skeleton arguments and well constructed oral
submissions.
The factual background
[2] The applicant was originally admitted to Ward 12 of the Laganvalley
Hospital, Elderly Medicine Unit on 16 November 2000 after suffering a stroke
and, at the time of the admissions, the applicant had been living alone in a
warden assessed dwelling receiving meals on wheels one day a week and
other forms of care attendance. Ward 12 is a multi-disciplinary rehabilitation
unit comprising Nursing, Physiotherapy, Occupational Therapy, Social Work,
2
Speech and Language Therapy and Medical Staff. As a result of her stroke,
the applicant’s speech and swallow were affected and she required to be
treated with a Peg tube.
[3] On 25 January 2001 the Trust received a referral for hospital discharge
as a result of which a Level 3 Care Management Meeting was arranged for 8
February 2001, just over 2½ months after the original admission. The purpose
of the Level 3 meeting was to determine whether to recommend the applicant
for discharge and, if so, the appropriate care package that should be provided.
The meeting was attended by a number of relevant personnel concerned with
the nursing and social work aspects of the applicant’s care as well as by her
daughter and son-in-law. The applicant expressed a wish to return home but
it was felt that such an outcome was not feasible given her current levels of
need. While the majority of her functional assessments suggested residential
care it was noted that the requirement for the Peg tube required nursing care.
In the circumstances, after discussion of a number of care options, a decision
was taken to place the applicant’s name on a waiting list for admission to a
community nursing home of her choice. At the time of this assessment the
applicant was 89th on the list of persons waiting for a nursing home place and,
as of 5 July 2001, she was 27th on the list. Since the institution of the
proceedings an appropriate nursing home place has been found for the
applicant and, consequently, the only relief sought is a declaration.
[4] The Trust is almost entirely reliant upon the Southern Health and
Social Services Board (“the Board”), which acts as the agent of the
Department, for the provision of funding required to perform the Trust’s
functions including the provision of places in community nursing homes.
The Trust is also required to comply with relevant policies promulgated by
both the Board and the Department. The problems faced by the Trust in
seeking to implement policies against a background of limited resources have
been set out in detail in the affidavits sworn by Roisin Burns, Director of
Elderly and Primary Care for the Trust, together with the exhibits thereto.
Placements into residential and nursing homes have to be funded by the Trust
and, despite additional funding from the Board in the financial years 1997 to
2000, throughout the 1990s the demand for beds outstripped the funds
available to the Trust to fund such placements. In such circumstances, in
November 1996, the Trust was compelled to devise the “waiting list criteria”
published in the Care Management Manual of December 2000. Essentially,
these criteria provide for patient/clients whose needs qualify them for
transfer to an independent nursing or residential home to be prioritised in
order of the date of the Level 3 care management meeting at which it was
decided to recommend admission to such a facility. As a result of the
restriction of funding provided to the Trust this list has to be managed upon a
“one out one in” basis subject to those whose needs justify immediate priority
as an emergency. It appears that, subsequent to the Level 3 care management
meeting, a place did become available at the home of choice for the applicant,
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Wilson (Eileen) Application for Judicial Review and Kitchen (May) Application for Judicial Review and Eileen Wilson and (1) Department of Health for Northern Ireland (2) South Eastern Health and Social Care Trust (3) The Health and Social Care Board The Commissioner for Older People for Northern Ireland
...in tandem with a corresponding right, crystallize? And if `yes’, what are the contours of the duty? 18 [43] In Re Hanna’s Application [2003] NIQB 79, Coghlin J considered the question of the proper construction of Article 15 of the 1972 Order. On this occasion, in contrast with Judge, Artic......
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JR 139's (A minor) Application
...the Trust in breach of statutory duty. [44] The fall back argument of the Trust derives from the decision of this court in Re Hanna [2003] NIQB 79. In that case Coghlin J held that the Article 15 duty is to provide such facilities as the Trust considers suitable and adequate to meet the pat......