Ghulam, R. v

Under section 4 of the Criminal Procedure (Insanity) Act 1964, the requirement for evidence from two registered medical practitioners, including an approved practitioner, applies to a determination that an accused is unfit to plead. It does not prevent the trial judge from determining that the accused is fit to plead when that statutory medical evidence is absent.

Where fitness is raised late in a trial, the judge may assess the evidence and the accused’s observed ability to participate, instruct counsel and give evidence. The judge may reject unsupported or inconsistent medical opinion and permit the trial to continue.

The appellant was convicted of burglary at St Albans Crown Court and sentenced to two years’ imprisonment. At the beginning of the trial, counsel sought an adjournment relying on a brief psychiatric letter, but the letter did not sensibly raise unfitness to plead and the application was refused.

Near the end of the trial, after the appellant had given evidence, counsel relied on a further letter from the same doctor and applied for the jury to be discharged. The letter asserted that the appellant did not satisfy the Pritchard criteria. The trial judge, having observed the appellant’s participation, refused the application and allowed the trial to conclude.

The appeal concerned the construction and application of section 4 of the Criminal Procedure (Insanity) Act 1964, particularly the medical-evidence requirement for a determination of fitness to be tried.

1. Appeal dismissed. The judge was entitled to refuse to discharge the jury and to permit the trial to be completed.

2. Section 4(4) of the Criminal Procedure (Insanity) Act 1964 requires the question of fitness to be tried to be determined as soon as it properly arises, subject to section 4(2) and (3). The first, brief medical letter did not sensibly raise that question. The issue was effectively raised only near the end of the trial.

3. Section 4(5) permits the court to determine fitness without a jury. Properly construed, section 4(6) requires evidence from two or more registered medical practitioners, at least one duly approved, only before the court may determine that an accused is unfit to plead. It does not preclude a determination that the accused is fit in the absence of that evidence.

4. That construction avoids requiring the trial to stop whenever unfitness is asserted on inadequate material. It also accords with the statutory safeguards for compulsory hospital detention, for which substantial supporting medical evidence is required.

5. The judge could consider the late opinion of a single doctor against his own observations of the appellant. The appellant had instructed counsel about a possible juror challenge, given evidence and shown no inability to answer questions. The judge was entitled to find those observations inconsistent with the medical opinion, to determine implicitly that the appellant was fit to plead, and to refuse the application.

• Court of Appeal (Criminal Division): Appeal against conviction dismissed: [2009] EWCA Crim 2285.

• Crown Court at St Albans: The appellant was convicted of burglary on 7 April 2009 and sentenced to two years’ imprisonment.