RD, R (on the application of) v Mental Health Review Tribunal

A medical member of a Mental Health Review Tribunal may express a provisional view on the case, including the ultimate question of discharge, before or at the hearing. Rule 11 of the Mental Health Review Tribunal Rules 1983 does not confine the member to an opinion on the patient’s mental condition. The requirement of due impartiality is met provided the view is provisional, the member remains open-minded, and the other members understand that they may disagree. A tribunal’s reasons are adequate if they intelligibly identify and explain its central findings and conclusions on the statutory detention criteria.

The claimant was a restricted patient detained at Broadmoor following a conviction for manslaughter on the grounds of diminished responsibility. A Mental Health Review Tribunal decided that he should not be discharged, although it recommended transfer to a medium secure unit.

He renewed an application for permission to seek judicial review. He alleged that the medical member had acted beyond rule 11 by communicating a view on discharge before the hearing, and that the Tribunal had failed to give adequate reasons, particularly on whether conditional discharge would make continued detention unnecessary or disproportionate.

1. Provisional view of the medical member. The renewed application failed on this ground. Rule 11 of the Mental Health Review Tribunal Rules 1983 permits the medical member to examine the patient and form an opinion of the patient’s mental condition. It does not prevent that member, like the other members, from discussing the case and expressing a provisional view on the case as a whole or on any issue, including whether discharge is appropriate.
2. The test is whether the member has a concluded or preconceived opinion, or has expressed matters so as to create a reasonable apprehension of a closed mind. A provisional view that is expressly subject to the evidence and submissions is not objectionable. The view communicated here was expressly described as very preliminary and was plainly consistent with Article 5.4 of the Convention, rule 11, and the guidance in R (S) v The Mental Health Review Tribunal, [2002] EWHC 2522 (Admin), DN v Switzerland, (2001) 63 BMLR 221, and In the Matter of an Application by Laurence McGrady for Judicial Review, [2003] NIQB 15.
3. Adequacy of reasons. The Tribunal’s reasons were adequate and intelligible. They explained why the nature and degree of the claimant’s illness continued to satisfy the first statutory criterion, including the limited period of stability, deterioration during drug-free trials, and the risk of relapse and harm if medication were discontinued.
4. The reasons also explained why conditional discharge into the community was inappropriate at that stage. The Tribunal concluded that safe rehabilitation required a phased and monitored transfer to a secure unit, having regard to the risks associated with the index offence, new relationships, drug abstinence and the need for medication. That conclusion was the converse of finding that conditions made detention unnecessary. The renewed application for permission was dismissed.

First-instance judicial review application. Permission had previously been refused on the papers by Ouseley J on 30 August 2006. The renewed application was dismissed by the Administrative Court.