legal briefing :

A case which posed yet another potentially serious threat to health authority budgets has been decided in the HA's favour after a High Court challenge.

A patient in Broadmoor was denied funding for an extracontractual referral to a mediumsecure unit outside her own HA area, Oxfordshire, although her medical team at Broadmoor proposed rehabilitation with her parents in Blackpool as part of the treatment. Doctors had also advised the patient she should not be sent back to Oxfordshire because that was where she had killed her former partner.

The case raises an important question about how far resource constraints can be used to deny access to treatment for patients who are compulsorily detained under the Mental Health Act.

It is established law that the NHS's 'target duty' to provide health services cannot be invoked by an individual to secure treatment. However, the patient's QC, Richard Gordon, argued that the position is different for detained patients, whose treatment is governed by the Mental Health Act.

He contended that the effect of the statutory scheme for detained patients is that the clinical views of a patient's responsible medical officer 'must be accorded virtually determinative weight by those responsible for making funding decisions in respect of a patient's treatment'.

However, Mr Justice Sullivan ruled that a detained patient has no greater right to treatment than someone seeking voluntary treatment.