Doctors 'cannot be forced to treat mentally ill'

The high court ruling

Doctors cannot be forced to provide care in the community to mentally ill patients they believe might pose a safety risk, the High Court has ruled.

The ruling was made in the case of a schizophrenic female patient who is still being detained in a hospital even though a tribunal has said she should be freed under supervision.

No doctor will accept the risk of treating the woman - who has a conviction for violence - in the community.

Mr Justice Burton defended the right of doctors to exercise their professional judgement.

He said the failure to offer supervision did not unlawfully "thwart" the tribunal's decision.

The judge rejected an application for judicial review by the patient, known for legal reasons as Miss K, against Camden and Islington Health Authority.

Miss K was sectioned under the 1983 Mental Health Act after conviction in February 1988 conviction for causing grievous bodily harm with intent.

She was initially held at a medium secure unit in Hampshire, and is now detained in north London.

The tribunal ruled last August she should be free to live with her parents, provided she co-operated with her case social worker and complied with treatment prescribed for her by a supervising forensic consultant psychiatrist.

Controlled by medication

The tribunal said it was satisfied that Miss K's symptoms were being fully controlled by medication and was well enough to be discharged "under psychiatric and social supervision".

Her discharge was deferred for a consultant to be appointed to supervise her.

But, said the judge, those approached were only prepared to take on the case if she remained in "supported accommodation" and not allowed back to her family.

Her lawyers argued in court that the authority's failure to provide her with psychiatric supervision was unlawfully preventing her discharge from hospital.

But the judge ruled there was no absolute duty for the health authority to comply with the tribunal's ruling and provide the supervision which would allow Miss K to stay at home.

He also said the health authority was under no obligation to instruct doctors to act.

The judge said the fact that there was an impasse, or it was impossible to comply with conditions, did not deprive Miss K of her "entitlement" to be discharged.

The case has been referred to the Home Office.