Simpson, R. v

In choosing between a life sentence and a hospital order with an unrestricted restriction order, public protection remains crucial. A court must give appropriate weight to the different release and recall regimes. It should not assume that a hospital order necessarily gives materially less protection than life imprisonment.

Where the danger arises substantially from serious mental disorder, the evidence may show that secure hospital treatment offers the best prospect of reducing risk and safely rehabilitating the offender. If the statutory criteria are met, a hospital order may therefore be the most suitable disposal. Special restrictions without limit of time may be necessary where protection of the public from serious harm requires them.

The appellant pleaded guilty at Exeter Crown Court to attempted murder after a planned and sustained attack upon the wife of a former colleague. He had a persistent delusional disorder centred on the colleague and had no previous convictions.

Both psychiatrists recommended a hospital order under the Mental Health Act 1983, accompanied by an indefinite restriction order. The sentencing judge instead imposed life imprisonment with a six-year minimum term, considering that it afforded greater public protection. The challenge to the minimum term was not pursued.

The appeal concerned whether the judge was wrong to reject the recommended hospital disposal on public-protection grounds.

1. Appeal allowed. The life sentence was quashed and replaced by a hospital order, with special restrictions without limit of time.

2. Public protection was a crucial consideration because the appellant’s disorder created a grave risk of potentially lethal violence if he again acted on his delusions. The sentencing judge was entitled to treat that protection as paramount. However, he had not clearly explained why imprisonment would protect the public better than a hospital order with an indefinite restriction.

3. The court applied the guidance in R v IA [2006] 1 Cr App R(S) 521 and R v Offen [2001] 1 WLR 253. A court must give weight to the differing release and recall regimes for life prisoners and restricted patients. It must not assume that a hospital order necessarily provides significantly less protection.

4. The psychiatric evidence established that secure hospital treatment would better detect any malign development in the appellant’s mental state, reduce risk through medication and specialist therapy, and permit safer assessment and rehabilitation. The security at the proposed unit was stringent and effective. In these circumstances, treatment for the underlying mental illness in secure conditions gave the best prospect of minimising danger.

5. The court found that the conditions for a hospital order under s 37 of the Mental Health Act 1983 were met and that it was the most suitable disposal. Given the offence, antecedents and risk of further offending if at large, restrictions under s 41 without limit of time were necessary for protection of the public from serious harm. A place was available at the Reaside Clinic.

• Court of Appeal (Criminal Division): Allowed the appeal and quashed the life sentence: [2007] EWCA Crim 2666.
• Crown Court at Exeter: Following a guilty plea to attempted murder, imposed life imprisonment with a minimum term of six years. No citation was stated.