Anxious scrutiny or boilerplate? Evidence on Transparency Orders

By Celia Kitzinger, 15 September 2023

Introduction: On 21st October 2022, I submitted (at the request of counsel and with the permission of the court) a witness statement to Mrs Justice Lieven, concerning Case no. COP 13180943). I was asked to supply evidence as to how, according to my observations, Transparency Orders are actually working in practice. This came in the wake of Mr Justice Mostyn’s expressed concerns about Transparency Orders in Re EM [2022] EWCOP 31. I’ve reproduced the bulk of that evidence below because I want it be publicly accessible now that I’ve also recently (a) sent it to the ad hoc working group of the Court of Protection Rules Committee working on on Transparency Orders and (b) referred to it in my evidence to the Ministry of Justice on “Open Justice – the Way Forward”. It starts with §6 because I’ve left the numbering as per the witness statement as submitted (and omitted the first 5 paragraphs about me, setting out my personal academic background and experience). The statement is substantially based on an analysis of Transparency Orders at what were then the most recent 50 hearings I’d observed. I have no evidence of any significant change since then. I look forward to developments following the Rules Committee work on how to do transparency better. [Celia Kitzinger]

*****

IN THE COURT OF PROTECTION                                             CASE NO: 13180943

AND IN THE MATTER OF THE MENTAL CAPACITY ACT 2005

AND IN THE MATTER OF COP Rule 4.2

B E T W E E N: 

PM

Applicant

-and-

(1) B CITY COUNCIL

-and-

(2) B INTEGRATED CARE BOARD

-and-

(3) HM

(by his litigation friend, the Official Solicitor) 

Respondents

 FIRST WITNESS STATEMENT OF CELIA KITZINGER 

[Paragraphs 1-5 omitted – they outline my academic qualifications and publications, and the history of the Open Justice Court of Protection Project]

6. I have been asked to provide a statement drawing on my experience, in practice,  about:

(i) the extent to which reporting restrictions in the Court of Protection are the outcome of a balancing exercise weighing the protected party’s Article 8 right to privacy against the public’s Article 10 right to freedom of information; and 

(ii) the extent to which those against whom injunctions are made have the opportunity to ask for reporting restrictions to be varied, making a case for the exercise of our Convention right to freedom of expression.

In summary (each of these points is subsequently evidenced)….

(i) There is rarely evidence of any balancing exercise  

7. In the vast majority of hearings I observe, I do not see any evidence that the court has engaged in anxious scrutiny of competing convention rights in drawing up a Transparency Order (TO) or Reporting Restriction Order (RRO).  

8. I often see evidence that TOs are treated as taken-for-granted, standardised “boilerplate” documents that do not require any balancing exercise from the court. They are sometimes authorised without the judge appearing to know what reporting restrictions they are thereby imposing, since they ask counsel if there is a TO and then re-use (without amendment) one they’re told is in the bundle (often made by a different judge) without appearing to have read it.  Judicial summaries of reporting restrictions in the TO are frequently inaccurate (I would say, more often than not).  

(ii) There is rarely any opportunity for assertion of Article 10 rights from the public (or journalists)

9. Members of the public are very rarely in a position to engage with the reporting restrictions imposed upon us.  Reporting restrictions are usually (with rare and significant exceptions) presented as a fait accompli which we are expected to accept unquestioningly as a condition of entry into the court.  I have noticed that there is a little more latitude for intervention from journalists – but even for journalists there is rarely much opportunity provided for them to question the reporting restrictions.  

10. I do not take a position here on whether such a balancing exercise is required by law, or whether it would be a necessary and proportionate use of court time in every case. I am certain however that the current system for determining and implementing reporting restrictions is not working and needs to be thoroughly overhauled.

Two additional points:

(iii) Injunctions with reporting restrictions are very often not served on observers, so cannot serve their intended function

11. Members of the public very often do not receive any written version of the reporting restrictions: around half of the blog posts published by the Open Justice Court of Protection Project are published without sight of a TO or RRO. Since it is rarely suggested that we have breached reporting restrictions, one implication could be that an injunction against us is not needed. However, the absence of TOs (after their existence has been raised in court) has a chilling effect on transparency because we have no written record of what we are and are not allowed to report, and under those circumstances many members of the public are frightened to say anything at all, and it may be the case that we are over-cautious about what we publish in the blogs – for example there is often anxiety about naming public bodies and expert witnesses.

(iv) The language of the ‘standard’ Transparency Order is incomprehensible to most members of the public

12. Very few observers (except those with legal qualifications) are able to understand the TO and what it does and does not permit them to say. For example, there is a recurrent problem with the standard wording that prevents publication likely to identify that “AB is the subject of these proceedings (and therefore a P as defined in the Court of Protection Rules 2007)” – where AB are the initials a judge has assigned as those to be used in publishing information about P. A typical response:  “If I have to refer to him as AB, and then I can’t say he was in this Court of Protection case, because it says I’m not allowed to say AB is the subject of the proceedings, that means I can’t say anything.” (I could give many more examples of the confusion and resultant chilling effect on transparency occasioned by the ‘standard’ wording).

EVIDENCE BASE

13. I write this statement as a member of the public and as co-director of the Open Justice Court of Protection Project and editor of its blogs[1].  I am not a lawyer or a journalist. I am not a “legal blogger”[2].

14. In preparing this statement, I draw upon: 

  • my experience over the course of the last decade with supporting family members involved in serious medical treatment cases – voluntary work carried out as an offshoot of my work with the Coma and Disorders of Consciousness Research Centre at Cardiff University;
  • my experience over the last two and a half years, with the Open Justice Court of Protection Project, supporting other members of the public to observe hearings and myself observing more than 360 Court of Protection hearings;
  • a systematic analysis (prepared specifically for this statement) of reporting restrictions issues as they arose in the 50 most recent hearings I’ve observed (as of 10th October 2022, listed in Appendix 1), held between 29th April 2022 and 10th October 2022.

THE ‘STANDARD ORDER’

15. The ‘Standard Order’ template for making reporting restrictions in the Court of Protection (the “Transparency Order”) has been used since 29 January 2016 with the introduction of the Transparency Pilot. It was cemented into the practice of the court in 2017 via Practice Direction 4C, which states:

§ 2.1 The court will ordinarily (and so without any application being made)—

(a) make an order under rule 4.3(1)(a) that any attended hearing shall be in public; and 

(b) in the same order, impose restrictions under rule 4.3(2) in relation to the publication of information about the proceedings

§2.3  An order pursuant to paragraph 2.1 will ordinarily be in the terms of the standard order approved by the President of the Court of Protection and published on the judicial website at https://www.judiciary.gov.uk/publication-court/court-of-protection/.[4]

Court of Protection Practice Direction 4C

16. The most salient paragraph of the ‘Standard Order’ for public observers is the list of “material and information (the Information)” covered by the Injunction.  As observers,  we understand that we are “persons bound by the injunction” (#5) and what it prevents us from doing (#7), and the matter of duration (§8)  is rarely at issue.  It is to #6 (or its equivalent in any actual TO) that we turn to check what we are or are not allowed to report.

Remote hearings

17. Until the public health restrictions imposed by the government due to the coronavirus pandemic in March 2020, it was usual for the Court of Protection to sit in public for most  “attended hearings” (i.e. those “where one or more of the parties have been invited to attend the court for the determination of the application” §2.2 Practice Direction 4C). The Vice President notes that “Attended hearings can be remote hearings for these purposes.” (§55 Remote Access to the Court of Protection Guidance, 31 March 2020[5]).  

18. The situation was reversed in the Vice President’s  31st March 2020 Guidance. It states that  PD 4C should be disapplied for remote hearings, and any TOs already in place for established proceedings discharged (§57). In view of the court’s commitment to transparency, however:   “In each case active consideration must be given as to whether any part of any remote hearing can facilitate the attendance of the public, if so Practice Direction 4C may be applied and the transparency order reissued.” (§59).  This is now the usual practice in the Court of Protection for remote hearings (other than hearings in the Royal Court of Justice, which are usually listed as  “in open court” whether they are in person, remote or hybrid)[6].

19. An alternative practice for remote hearings has been adopted by some judges whereby PD 4C is disapplied and the hearing remains a private one, to which an observer is admitted, subject to a Reporting Restrictions Order (RRO).  In my experience this is a minority practice.

EMPIRICAL FINDINGS

Boilerplate or “anxious scrutiny”? 

20. There is a small minority of hearings partly, or wholly, devoted to the reporting restrictions themselves in which it is absolutely clear that there is anxious scrutiny of reporting restrictions.  These include (successful) applications from the press to name P (as Laura Wareham [351][7] and Robert Bourn [360]) and a case where the judge invited submissions about an interim RRO he’d imposed at the beginning of the hearing preventing reporting that P was being covertly medicated [362]. These are exceptional cases.

21. In the majority of hearings, the language used by the judiciary and by advocates in court conveys the impression  that reporting restrictions are effectively boilerplate text used from a template and deployed over and over again without making significant changes – that they are routinised and predictable, rather than the outcome of anxious scrutiny of competing convention rights in the individual case in question.

22. Drawing on contemporaneous notes from the last 50 hearings I’ve observed, there are references to:  “the usual Transparency Order” (DJ Glassbrook [240]); “the Transparency Order is in the usual terms” (Arbuthnot, J [345]); “in the usual terms” (HHJ Hildyard KC [327]).  Advocates also talk this way: “it’s the standard order in the standard terms” [357];  “the Transparency Order is in the standard terms” [320];  “Usual transparency orders apply as you know (do not identify family, P, clinicians etc)” [330]. 

23. Judges and advocates who know that I regularly observe court hearings sometimes  display the assumption that I will know – without being told – what is in these “standard” orders: “Professor Kitzinger probably knows the terms of the injunction better than most practitioners” [342]; “Professor Kitzinger is here and understands the reporting restrictions”[338]; “I make the usual order that publication is permitted except that you can publish nothing to disclose P’s name, or the names of P’s family members, or of P’s current placement. I have been over that many times with Professor Kitzinger” [356].  

24. Most of the TOs I am sent are virtually identical except for the initials used for P.

For example:

25. It’s quite common to receive (sealed) TOs that bear clear evidence of a ‘cut and paste’ approach and are insufficiently ‘personalised’ for the particular case (e.g. no initials for P, or the wrong initials, or a template that hasn’t been completed).  I don’t see this level of inattention to detail in other documents before the court:  position statements and substantive orders are usually impressively free of typos etc. and the latter are subject to careful attention by judges.  This contrast between the quality of TOs and other court documents suggests a degree of inattention to the details of TOs

26. The TO from which the first of the extracts above is taken [328] was sent by court staff in advance of the hearing, attached to an email in which the judge was quoted as having said, “requestor is welcome to attend subject ONLY to confirmation that she has received copy of TPO”. I confirmed receipt at the beginning of the hearing – but that didn’t seem the right time to raise the deficiencies of the order I’d been sent. It seems unlikely that the judge can actually have read it. (Another member of the public, Bridget Penhale, Co-editor Journal of Adult Protection, and an elder abuse and adult safeguarding specialist, tells me she also has received a blank template TO for a different hearing.)

27. The same inattention to detail in TOs extends beyond the paragraph concerned with “The subject matter of the Injunction” and is sometimes apparent across the whole document. For example, one TO gives P’s initials as MH and those initials [MH] are used sometimes in the TO, including in the “subject matter of the Injunction” section,  but there are also places where they should have been entered and have not and it instead reads “[the initials chosen to identify P]” [355].  Another TO uses “P” rather than “LD” (the nominated initials) for the person at the centre of this case and there are omissions throughout, e.g. “1) This application be set down for an attended hearing on [missing date]  at [missing time] with a time estimate of [missing time estimate] at which the Court will consider the following issues:…”. (3)  The attended hearing is to be listed as follows: [but nothing follows) [357]

28. Transparency orders are not supposed to have a Confidential Annex – but both [314] and [322] have these, with full postal addresses for P and P’s family in [332].  They do this despite also including a paragraph that instructs them not to add this confidential information and to keep the list of names “separately from other parts of the Information”.  

29. Another member of the public, Ruby Reed-Berendt (academic lawyer) tells me she was also sent a TO with a Confidential Annex. This concerns me because it means that confidential information (often beyond the information revealed in the hearing) is sent in written form to members of the public and hence renders people’s identities vulnerable to exposure (e.g. via a lost laptop, an overseen printed version).

OPPORTUNITIES TO ASSERT RIGHTS TO FREEDOM OF EXPRESSION + ASK FOR THE TRANSPARENCY ORDER TO BE VARIED 

Family members of P 

30. Family members and other lay persons involved in COP proceedings as parties, witnesses, observers, or in other roles (e.g. attorneys, deputies) are also bound by the TO – and it impacts upon their freedom of expression more severely than it does observers , because in speaking about (for example) “my son” or “my mother”, under their own name, in connection with a COP hearing, they are “likely to identify” that person as a P in the Court of Protection.

31. In many cases, family members seem content with these restrictions.  In a significant proportion of cases, they are not.  In hearings I’ve observed, the TO has led to restrictions on family members that they hadn’t understood in advance and do not want.  These restrictions have included: use of fundraising platforms; talking to friends and relatives in search of evidence about P’s former values, wishes, feelings and beliefs; sharing updates about what’s happening with P on closed Facebook pages or their own publicly accessible blog posts; seeking out expert opinions of their own for P; and media, public education and campaigning activities.  Often – even when they are parties to the case – family members do not realise that they are bound by the TO, and that it restricts their freedom of speech.  It seems there is rarely any attempt to explain this to them (until after a breach is seen to have occurred).  

32. Many of the families I’ve supported through serious medical treatment cases find themselves angry about being “silenced” or “gagged”.  They have come to believe that the TO protects clinicians, not P.  Some of the family members who’ve contacted me through the Open Justice Court of Protection Project say similarly that the court is attempting to silence them because of their criticisms of the healthcare or legal systems.  Reporting restrictions are viewed as damaging P, not protecting them. Most have not, in fact, been willing to challenge reporting restrictions – believing it will be another expensive court battle, or that they are bound to lose anyway, or simply because they are too stressed and exhausted by the situation that has led to the court hearing in the first place. Some fear ‘reprisals’ against P if they are seen as ‘difficult’ family members.

33. I am currently supporting two members of the public seeking variations of the TO – neither of whom recalls any discussion at all, at the outset of their relative’s COP case,  about the restrictions it would impose upon their Art.10 rights.  What they remember is being “reassured” by lawyers that their names (and that of their relative) would not be made public, and that the family’s privacy would be protected – but not that they would lose the right to speak out. 

34. It seems that there is no proper explanation or ‘anxious scrutiny’ of reporting restriction orders with family members.  When supporting family members with cases that have not yet reached court, I explain the TO to them, and help them to engage in a balancing exercise, both in relation to their own rights to privacy and freedom of expression, and in relation to P’s.  In a couple of cases, I have recommended publicising as much as possible in advance of the application to the court, such that “the cat is already out of the bag”, in terms of what is publicly available and a TO restrictive of their Art 10 rights is then less likely.  

Public Observers 

35. Most public observers (who are not journalists)  have no idea that they can ask for a variation in the TO (or feel confident to do so, given that they have a very hazy idea of what the TO actually means anyway).   I’m not aware of anyone except me who has done so.

36. It is exceptionally rare for me to be treated by judges, in the course of a hearing,  as someone with Article 10 rights who might wish to vary the TO. This is not provided for in the Transparency Pilot rules (I’m not sure whether it was even considered?).  I am regularly asked whether I have received the TO and sometimes whether I have understood it, but not whether I have concerns about  it.  Since I only receive the TO around 50% of the time (often after the hearing), it’s difficult for me to make any sensible interventions on behalf of my Article 10 rights anyway. The only journalist who regularly attends COP hearings (albeit almost exclusively those in the Royal Courts of Justice and not in the county courts) is Brian Farmer of the Press Association and I’ve noticed that he also finds it very difficult to intervene: I often observe him switching on his camera, or standing up in court towards the end of a hearing to say:  “I’m sorry to interrupt the proceedings but…”  Some judges are more open to inviting a contribution from journalists than others (Hayden J, Theis, J, Francis J, Poole J and Keehan J in particular, Brian Farmer tells me) – and Hayden J, Poole J, Roberts J  and a handful of other judges (including District Judges and Circuit Judges in the county courts) have supported contributions from me about transparency matters when I have been able to indicate that I wish to make them. 

37. I do sometimes have Article 10 concerns which I’ve been unable to address.  For example, I’ve sometimes been told that a “standard” TO is in place, only  subsequently to receive something like [316] below, which prevents me from identifying a public body (the Local Authority). But by then the hearing was over and there was no opportunity to ask why, or to ask for it to be varied.

I was told in court that the TO was “the standard order in the standard terms” but when I received it, it prevented identification of the Local Authority.  Since the hearing was over by then, I was not able to clarify this. [357]

38. When I have Article 10 concerns about a TO and have received it before the end of the hearing, I have usually found it most efficient (in remote hearings)  to write an email to the judge and send it via whoever I have an address for who can pass it on (the judge’s clerk; counsel; whoever sent me the video link). In person, I have simply raised my hand and asked for permission to address the court. I have written blogs about some of these concerns: they have all been carefully considered by judges and resulted in variations to the TO in every case. This suggests that a member of the public (who is not a journalist) can play a part in ensuring the transparency of the court when given the opportunity to do so.

TRANSPARENCY ORDERS ARE OFTEN NOT SENT TO MEMBERS OF THE PUBLIC –  RENDERING ‘ANXIOUS SCRUTINY’ OTIOSE

39. I only ever receive TOs (or written RROs) for about 50% of hearings. Of the last 50, I have no record of having received a written reporting restrictions order for the following (public) hearings: [317] [318] [319] [320] [322] [323] [325][329] [330] 336] [337] [340] [342] [344] [346] [349] [353]  [354] [355] [358][8]

40. In one of these hearings [319], my contemporaneous notes record that the judge asked about TO at the beginning of the hearing, saying  there was “added complexity because of concurrent care proceedings and other young people whose confidentiality needs to be respected.” But I have no record of having received the TO.

41. At some of these hearings (e.g. [320] [349]) the judge made explicit requests for TOs to be sent to observers, but we have no record of receiving them. For example, neither I, nor another observer  (Paige Taylor, a Bar course student) who blogged about this hearing, ever received a TO for [320].  She describes what happened in her blog post:

42. Some other examples: 

  • Three observers from the charity “Compassion in Dying” attended an in-person hearing – on different days – in the Royal Courts of Justice (and blogged about it:  “She is religious and she is a fighter”: Three perspectives on best interests decision-making in the Court of Protection from ‘Compassion in Dying’).  I was also in court for one of these days. None of us received a TO.  
  • I hadn’t received a TO for [318] and checked with another observer, Mollie Heywood who observed a subsequent hearing in the same case She says: “I’ve never had a TO for anything I’ve observed sent to me! They read out instructions but that’s it…. I’ve seen about five [hearings] or so” (Mollie Hayward, social worker + law student).
  • One observer has watched 9 hearings and received only 3 TOs (and one of those came via me) – see Upeka de Silva, Policy Officer or Compassion in Dying, Appendix 2A.
  • Another observer, Georgina Baidoun, former lay COP Deputy, tells me she has observed 10 hearings but received only 4 TOs.
  • A member of the core Open Justice Court of Protection Project group has gone systematically through the 38 hearings (across 32 cases) that she’s observed. She has 14 TOs (=38%) – see Claire Martin Appendix 2B.

43. It does not seem to be anyone’s (agreed) job to send TOs to observers.  When I’ve asked about this, I’ve generally been told that court staff should send them (e.g. ““It is not Counsel’s role to provide orders. This is an HMCTS role.”, HHJ Hilder, Item 8 Minutes of COP User Group meeting, 20 April 2022), but when I’ve asked court staff, I rarely get them (either there’s no response, or I’m advised to ask the judge).  In practice, I mostly receive TOs from counsel.

44. Judges sometimes seem content to provide simply verbal summaries of reporting restrictions, followed by the request to “contact the court if you need a copy of the order” (Theis, J [337]) or “if you want a copy you can ask” [Theis, J [347]).  One judge ran through the TO – she said it was “in the usual terms, nothing to identify [P], her family or where she lives – that would be contempt of court” and seemed surprised – when  she offered me the opportunity to address her – by my request for a TO (‘You are keeping me on my toes’) [327].  Mostly I don’t get an opportunity to address the judge, so cannot make this request.

45. The problem with relying on oral summaries from the judge about what the TO says is that these summaries are often incorrect.  For example:

On discovering that no TO had been prepared, the judge said: “you’re welcome to observe but the identity of the parties to the proceedings must remain confidential”.  She checked with the advocates whether they were content to go ahead on that basis. Francis Hoar (counsel) provided a slightly different version of the TO: “You cannot report anything that may risk identifying any of their parties, or where they live, or who they associate with”.  (The addition of “who they associate with” was new to me.)  The judge asked the observers if we understood, so I was at that point able to ask whether we could identify public bodies, since they were also ‘parties’ to the proceedings. The judge said: “Yes, I meant the family.  Not the public bodies.  I think I need a pro-forma I can read out in these situations”.   When I eventually received the TO, it prohibited identification of the CCG.  I am unclear whether or not what the judge said in court means that she varied the pre-existing TO (made by HHJ Owens on 23rd April 2021).  I’m not sure she meant to.  [364]

46. Most members of the public who receive only oral summaries relating to reporting restrictions (whether these are framed as TOs or RROs, the latter of which are overwhelmingly oral only) do not feel confident to write blog posts about the hearing because they are not sure what the judge said they could and couldn’t report (or – wrongly – believe that there is nothing at all they are allowed to report).  Not sending out TOs has a chilling effect on transparency.

47. In my experience, written versions of TOs (and RROs) are not sent to observers for the following reasons:

  • there is still some confusion between TOs and  “Remote Hearings Order” (even though more recently they are sometimes combined).  I was sent RHOs  for [317] and [353].  These did not include anything equivalent to “the subject matter of the injunction”.
  • nobody knows how to separate out the TO from the rest of the electronic bundle
  • counsel have the TO,  but not the observers’ email addresses
  • court staff have the observers’ email addresses,  but not the TO
  • it’s not clear whose job it is (if anyone’s) to send out TOs – sometimes I’m asked to circulate to other observers

48. Repeated requests for TOs are sometimes unsuccessful.  For example: 

“What sounded like a standard ‘warning’ was read out at the beginning of the hearing, informing me that publishing “the Information” prohibited by the TO could lead to me being sent to prison or having my assets seized etc.  Nothing at all was said at any point during this hearing about what “the Information” was. Nor had I been sent a TO nor was there any attempt to send me a TO during the course of the hearing.  I pursued the TO after the hearing, including via the court staff (on 21/8/22) and then via one of the barristers in the hearing (on 27/8/22) and finally by emailing the court address with an email for the attention of HHJ Howells herself.  On 8/9/22, I receive an email from a Court of Protection Clerk at Cardiff COP saying “Please see attached 2x transparency orders for the hearings that you observed on 19th August”. Two documents were attached. One was a TO for the 9am hearing (which I had already received). The other was a Remote Hearings Order (not a TO) for the 11am hearing  (COP 13802410). It contains NO REFERENCE to “the Information” I am not allowed to publish (i.e. it is not a combined RRO and TO).   I still do not have a Transparency Order for this hearing.” [353]

49. My impression is that I am less likely to receive a TO if the judge requires amendments to the  draft order (or to the order approved by the previous judge).  

50. For example:

I never received a TO for the case before Lieven J on 27 January 2021 (COP 13703893).  My contemporaneous notes from that hearing record that the judge referred at the beginning of the hearing to the draft TO and said she could see no reason for anonymising the hospital or the treating clinicians – and in fact she then referred to the clinicians by name in the published judgment.  It subsequently transpired that the amendments had never been made – leading to considerable confusion for the BBC (and the court) in their application to name P a year and a half later, since there was a discrepancy between the still-extant TO (which said the treating clinicians could not be named) and the published judgment, which named them. The judge (Francis J) hearing the case brought by the BBC ruled that they could not now be named and ordered that Lieven J’s   judgment should be taken down and redacted to remove the names of the treating clinicians (see BAILII  (The Newcastle Upon Tyne Hospitals NHS Foundation Trust v Bourn (Rev1) [2021] EWCOP 11). For reasons not discussed in court, the name of the independent expert was also redacted. A temporary restriction on publishing anything about the case was imposed until the redacted judgment was in place.  This whole process of seeking a variation to the TO was messier and more complicated than it need have been had the judicially approved version of the TO been available in the first place.  (I blogged about the hearing: Medical treatment for people with learning disabilities: Telling Robert Bourn’s story and the challenges of ‘transparency’.) 

51. I have emails from counsel in other cases saying that they will send me the revised TO once they have made the revisions and the judge has approved them – but then there is no record that I’ve ever received these revised TOs.

REPORTING RESTRICTION PROCEDURES ARE NOT WORKING WELL 

52. In sum, there is strong evidence that the current procedures in place with the aim of protecting P’s privacy while at the same time protecting the public’s right to freedom of information and freedom of expression are  not working well.  I understand that, following the concerns expressed by Mostyn in Re EM [2022] EWCOP 31, aspects of TOs are being reviewed by the Rules Committee. Pragmatically, requiring a full-scale Re S analysis and notification of the press before any Transparency Order is made would cause a level of delay and complexity that would be impossible to manage – but it would be worth exploring how to address the current problems created by reporting restrictions and to build in mechanisms to allow the court more effectively to address the concerns participants (including family members) and observers often have about the way things are working (and failing to work) at present.

STATEMENT OF TRUTH

I believe that the facts stated in this witness statement are true. I understand that proceedings for contempt of Court may be brought against anyone who makes, or causes to be made a false statement in a document verified by a statement of truth without an honest belief in its truth

Celia Kitzinger

Dated 21st October 2022

Appendix 1. List of hearings 50 most recently observed hearings (on 10 October 2022)

by Celia Kitzinger in date order. 

Ref.        CASE NO.   DATE       JUDGE                                         TO?

[314] COP 13755775 (29.04.22) Cobb J RCJ                                    Y

[315] COP 13744224 (03.05.22) DJ Beckley FAH                           N (Private)

[316] COP 13801482 (04.05.22) DJ Woodburn Bristol                    Y

[317] COP 13053463 (17.05.22) DJ Porter-Bryant Cardiff               N

[318] COP 13861341 (08.05.22) Francis J RCJ                                 N

[319] COP 13630800 (20.05.22) HHJ Edwards Cardiff                    N

[320] COP 13585739 (23.05.22) Lieven, J                                        N

[321] COP 1388671T (23.05.22) DJ Birk                                          Y

[322] COP 1378613T (24.05.22) Moor J RCJ                                   N

[323] COP 13930317 (25.05.22) MacDonald J RCJ                          N

[324] COP 1393210T (07.05.22) DJ Charnock-Neal Newcastle       Y

[325] COP 13776756 (13.05.22) DJ Keller Cardiff                           N

[326] COP 13744224 (30.05.22) DJ Beckley FAH                           N (Private)

[327] COP 13899903 (07.06.22) HHJ Hildyard Reading                  Y

[328] COP 13719647 (09.06.22) DJ Searl Newcastle                        Y

[329] COP 13861341  (13.06.22) Francis J RCJ                                N

[330] COP 13933678 (15.06.22) Hayden J RCJ                                N

[331] COP 13662687 (17.06.22) HHJ Hilder FAH                           Y

[332] COP  13862920 (20.06.22) Cobb J RCJ                                   Y

[333] COP 13861341 (27.06.22) Francis J RCJ                                 Y

[334] COP 1393108T (01.07.22) HHJ Cove (Medway)                    N (Private – RRO)

[335] COP 13452747 (06.07.22) DJ Beckley FAH                           Y

[336] COP 13667357 (05.07.22) Hayden J RCJ                                N

[337] COP 133883671 (06.07.22) Theis J RCJ                                  N

[338] COP 13744224 (07.07.22) DJ Beckley FAH                           N (Private)

[339] COP 13955023 (06.07.22) Arbuthnot J RCJ                            Y

[340] COP 13627568 (08.07.22) DJ Glassbrook Birmingham          N

[341] COP 13796227 (13.07.22) DJ Beckley FAH                           N (Private)

[342] COP 13890570 (13.07.22) Poole J RCJ                                   N

[343] COP 13609965 (09.07.22) Hayden J RCJ                                Y

[344] COP 13710982 (18.07.22) Lieven J  RCJ                                N

[345] COP 139622855 (19.07-22) Arbuthnot J RCJ                          Y

[346] COP 13961662 (22.07.22) Arbuthnot J RCJ                            N

[347] COP 1394451 [22.07.22] Theis J RCJ                                      Y

[348] COP 13755775 (25.07.22) Cobb J RCJ                                    N

[349] COP 13969520 (02.08.22) Lieven J, RCJ                                N

[350] COP 13627568 (03.08.22) DJ Glassbrook Birmingham          N

[351] COP 13977747T (18.08.22) Cobb J RCJ                                 Y

[352] COP 13710521 (19.08.22) HHJ Howells Cardiff                     Y

[353] COP 13802410 (19.08.22) HHJ Howells Cardiff                     N

[354] COP 13407956 (19.08.22) Keehan J RCJ                                N

[355] COP 13488785 (30.08.22) HHJ Mitchell Bristol                     Y

[356] COP 13887142 (30.08.22) DJ Beckley FAH                           N (Private)

[357] COP 13971098 (31.08.22) DDJ Morrill (Huddersfield)          Y

[358] COP 13777736 (02.09.22) DJ Foster Leeds                             N

[359] COP 13936808 (15.09.22) DJ Matharu Manchester                Y

[360] COP 13703893 (16.09.22) Francis J RCJ                                 N

[361] COP 12174660  (20.09.22) DJ Ellington FAH                         Y

[362] COP 13236134 (20.09.22) Poole J RCJ                                   Y (also RRO)

[363] COP 13180943 (05.10.22) Lieven, J (Northampton)               Y

[364] COP 12219141  (6-10-22) HHJ Brown Reading                      Y

Appendix 2 Other observers don’t get TOs either

A. Upeka de Silva (Policy Officer for the charity Compassion in Dying) 

TOs for 3/9 = 33% (Note: one came from me)

B. Dr Claire Martin, Consultant Clinical Psychologist, leads Older People’s Psychology Team, Gateshead

TOs for 14/38 cases = 37% (Note: one came via me; and she watched 2 hearings in 6 cases so second opportunities were missed to send TOs in some cases)

CaseDateCOP numberTO yes/no Who sent?Topic/Blog
129 June 202013330649No First blog – 2 hearings
2July 202013392405No Capacity/residence
36 July 202013375644No Covert meds
430 July 202013620235YesCourt staff – Judge’s clerk& Barrister Bridget Dolan & Solicitor Peter  MerchantPhone hearing – no blog
526 Oct 202020 Jan 202113551368YesCourt staff – Judge’s clerkWhen Expert Evidence Fails
611 Feb 20216-7 May 202114 July 202113575520YesCourt staff – Judge’s clerkVideo Monitoring
722 March 2021[1]13712176No Life sustaining Rx following attempted suicide. Blog by Brown & Power. 
829 March 202111919290YesBarrister – Sophia RoperBringing Lucy Home blog
929 March 202113585866YesDJ Searl emailed me to inform that the TO would be being sent. Sent by court staff – Judge’s clerkBI and contact with Mother. No blog
1013 April 202113416239No S21A challenge. No blog
1123 April 202130 April 202113718293No – notes from Celia say not received either Celia/Claire blog – Court Enforced Amputation or Patient Autonomy? 
1216 May 202113655419No Capacity for sex. No blog
137 June 2021[2]13751629No You Can’t Ask I High Court Judge to Turn a Blind Eye to Illegal Detention, blog
1414 June 202113751175No No blog
15 5 July 202113418695YesEmma SuttonDental Clearance blog with Eloise Crang and Meg Aitken
168 July 202113503831No Predatory Marriage & Coercive Control – Celia blog
179 August 202113773522No DoLs
1812 August 20211324896TYesCourt staff – Listing TeamShould P Go to Live with Her Family in her Country of Birth?
1917-19 Aug 202113783897YesCelia (sent to her from Katie Gollop)BI in a Contested End of Life Case blog
2013 Sept 2021[3]13787443No No blog
2121 Sept 202113339015YesCourt staff – COP Admin Officer Eight Litigants in Person
2219 Oct 202113364813No Covid Vax – aspiring med student blog
2329 Nov 202113816452No 3 politics of the pandemic blogs
2417 Jan 202213860597No Cross-examining a GP – Celia Covid blog
2527 Jan 2022[4]13607901  No Why members of the public don’t ask earlier to observe hearings. 
2631 Jan 202213817461No No blog
277 Feb 20221354439TNo Blogs by Gaby Parker, Jen O’Neill, Celia/Gaby, Celia, Eleanor Tallon, & ‘Four Commentaries’
2814 Feb 202211 May 202213866679YesBarrister – Ulele BurnhamPrader-Willi case.2 Blogs Celia and B FarmerBamber
2924 Feb 202213883671YesBarrister – Ulele Burnham3 blogs – Mr MCelia – 11 FebClaire – 24 FebCelia -19 July
3025 April 202225 July 2022 (removed from listing)22 Sept 2022 13236134YesCourt staff on two occasions (April & Sept)A Baffling Case
3113 June 202212611795YesSolicitor – Kirsty Stuartand Court StaffMicro-management blog
3218 July 20221396281TYesBarrister – Conrad HallinCourt Authorised C-section blog
      
      

Total number of hearings = 38

Total cases observed = 32


[1] 13712176 – from my notes: 

Reference made to TO, but not sent to me (not sure I requested). Mungo Wenban-Smith mentioned the ‘previous draft order on 9 March included a TO regarding anonymity. Said the aim was to ‘preserve the anonymity of CD’. The judge (Williams J) reinforced that P would be referred to by name during the hearing and that ‘others’ must adhere to the TO, and added that in the TO it also says family members’ names also not to be disclosed. 

[2] Lieven J said ‘TO will be sent. Nobody is to publish information that could lead to the identification of the claimant or P’. Did not receive TO. 

[3] From my notes: HHJ Hilder – I had to confirm that I understood the hearing was in private and I could not identify anything about P etc.

[4] From my notes: Judge mentioned observers – “welcome of course, but may I say … the court office is only open from 9-5 and communications received outside of those hours … a lot for staff to do… so Dr M if you wd be kind enough the earlier you can give notice the easier it will be.” Asked if I had received the TO [No] – asked for ‘someone’ to send it to me. Never rec’d. No summary. Don’t know who respondents are …..


[1] https://openjusticecourtofprotection.org/about/

[2] The Family Procedure Rule 27.11 (which applies only to private proceedings in the Family courts, and not to the Court of Protection) permits observation and blogging from “legal bloggers”, defined as  “duly authorised lawyers” who meet the criteria specified in Practice Direction 27B. 

[3] https://cdoc.org.uk

[4] I couldn’t find it on that website, but it is available as a downloadable pdf from this page, where Charles J (then VP of the COP) explains the new approach: https://www.judiciary.uk/guidance-and-resources/the-transparency-pilot-a-note-from-the-vice-president-of-the-court-of-protection/

[5] https://www.judiciary.uk/wp-content/uploads/2020/04/20200331-Court-of-Protection-Remote-Hearings.pdf

[6] For a full account of the changing situation vs. observer access to Court of Protection hearings, see my Transparency Project blog post: “Why are so many Court of Protection hearings labelled ‘private’?”

[7] Numbers in square brackets refer to the number I’ve given the 50 court hearings I’ve observed, listed in Appendix 1.

[8] In preparing this witness statement, I have searched through my emails for the TOs missing from my files using (a) the case number; (b) the date of the hearing; (c) the names of counsel.  It is just possible that I have in fact been sent TOs for one or more of these hearings but, if so, I have been unable to locate them.

Moving towards transition from children’s to adult services

By Claire Martin, 14 September 2023

John (not his real name) is 17 and will be 18 in three months’ time. He used to live with his adoptive mother but (since 2021) has been living in a Gateshead Local Authority placement where he is supervised 2:1 by carers. 

I didn’t find out anything about John’s difficulties or diagnoses during the hearing (but filled in some gaps in my understanding when I read the Position Statement from the OS) other than that he can present with ‘challenging behaviour’, but he is said to be very happy at his home. He has to move out though, because the home is for children and he will become an adult soon. 

This case (COP 14067800) has been before the Court of Protection since 12th May 2023, but the first hearing I observed (remotely) was before HHJ Burrows on 17th August 2023. This is how it was listed. 

It was a case management hearing, which means current issues are reviewed, parties’ positions are submitted to the judge, orders are made and plans for future or final hearings are decided. 

A Note on Accessing the Court

This was one of the best organised hearings I have observed. HHJ Burrows was sitting at First Avenue House, the home of the Court of Protection, in London. The hearing was remote, via MS Teams at 10am. I received the link, and the Transparency Order, at 9.40am. 

Both counsel (Sophie Hurst for John, via his Litigation Friend the Official Solicitor; and Stephen Williams for Gateshead Council) were on the link when I was admitted. The court clerk checked with counsel whether any other people were expected (John’s Social Worker joined by telephone some time later) and then checked that I could hear and that I had received the Transparency Order. He said the judge had asked whether I wished to stay on for his 11am hearing. I couldn’t stay on as I had a prior commitment, though I was pleased to have been asked. 

John

When HHJ Burrows joined the video-platform, he checked with counsel whether others would be joining and then said: “Dr Martin is very welcome to join us. I haven’t received a Position Statement from the Local Authority. I have one from Ms Hurst. …. For my benefit and also for Dr Martin please outline what this case is about”.

Counsel for the local authority explained: 

“This case concerns [John] a 17-year-old, 18 on [X December 2023]. He was previously living with his adoptive parents and then due to […] rising aggression and behaviours […] he was detained under Section 2 of the Mental Health Act and then in March 2021 detained under Section 3. Care proceedings in 2021 resulted in [John] residing in his current placement – he is the sole resident at the placement since 2021, [which is] a registered children’s home. The Local Authority has blocked out the other vacancies – it can cater for 3 or 4 [children] – but he’s the sole resident presently. He turns 18 in December. He will need to leave then or shortly thereafter. I have been informed that he can remain for a very short period of time, but the Local Authority is taking steps to identify a placement for him before he turns 18. He is supervised 2:1 in the current placement and to and from school. He attends year 13 [and] he’ll be there until 2024, July. [He has] reduced supervision of 1:1 […] staff have had to restrain him on occasion […] they are trained in NAPPI training […] have had to administer PRN [‘as needed’] Methazine medications. He is restricted in using computer equipment, to aid good sleep and a good routine. There are restrictions in place, the doors and windows are locked.”

Counsel for John via the Official Solicitor helpfully sought permission to share her client’s Position Statement with me, which has enhanced my understanding of John’s needs. Counsel for the local authority likewise sought permission to share their Position Statement, but I have not received it to date. 

John has a condition called Fragile X of a type that is associated with learning disability, ADHD and global developmental delay. He has been deprived of his liberty since December 2021, when he first moved from living with his adoptive mother, and a care order was made for him to live in his current home. By all accounts (according to his counsel), John likes living where he is, is very sociable, gets on well with his carers and is happy and settled. This was clearly important, given that John’s life will be changed completely not long after he turns 18. 

What was the court being asked to do?

It wasn’t clear to me at first, what the court was being asked to consider. HHJ Burrows needed to clarify this point:

Judge[to Stephen Williams, counsel for LA] What are you asking the court to do?

Counsel for the LA  described issues to do with identifying an appropriate place for John to move to. 

Judge Does he have to leave the placement when he’s 18?

Counsel for LA: There is no issue in terms of registration. […] The Local Authority is effectively booking out the entire placement, which could cater for more than one resident. Equally, and more importantly, the Local Authority acknowledges that remaining in a children’s placement is not in [John’s] best interests in the long term. We are taking appropriate steps to identify properties.

So, it seemed the main issue, from the Local Authority’s perspective, was finding somewhere for John to live. All parties agreed that John lacked capacity to make this decision himself, as well as decisions about his care needs. However, the Official Solicitor requested that the Local Authority provide capacity assessments for financial decisions (John’s mother currently acts as appointee, but wishes to be removed from this role), as well as use of social media and the internet (which are subject to restrictions in John’s care plan).

John’s Mother

I was wondering why, given that she had been mentioned a few times, John’s mother was not at the hearing, or a party to proceedings. HHJ Burrows asked about this during the hearing: 

Judge[John’s] mother is not present today and you said she’s not indicated a wish to be involved in proceedings. How much has she been involved in the early stages of the planning?
Counsel for the LA: I don’t have instructions on that … [he passed the query to John’s Social Worker, who had joined the hearing by telephone] 
Social Worker: My understanding is that she DOES want to be involved in all aspects of planning and I thought she would be joining today.
Judge: Have efforts been made to involve her?
Social Worker: I was in touch with her last week. Apologies if that hasn’t filtered through.
Judge: I am rather glad now that I didn’t just make the order in the absence of a hearing. It’s vital that this lady is involved, not only in care planning but in these proceedings and she needs to know about these things for his future life. I am surprised she’s not here. This is perhaps an oversight by somebody who should have put her in touch. Let’s carry on and see where we get to. 

Counsel for the LA later addressed the lack of planning to ensure John’s mother was part of the court process. He said that ‘urgent enquiries’ would be made of John’s mother, ‘as to whether she wishes to be a party’. I thought that HHJ Burrows’ response to this was heartening: 

Judge: I’m not talking about her being a party [….] obviously we can consider that, but she obviously wants to be involved. It’s very common for parents and close relatives having access to all of the papers and having access to me, as if she were a party. Sometimes parents are a bit cautious about the court, as if we are adjudicating about their parenting. She’s been through care proceedings which must be AWFUL and I want her reassured that the purpose is not to judge her and we will benefit from her knowledge and experience. [Judge’s emphasis]

Counsel for the LA: Yes, we will contact her. You will see she’s submitted evidence.

Judge: Yes I have read it.

Counsel for the LA: You have my apologies that I haven’t granted her permission to submit [further statements.] I would suggest giving her two weeks to respond [about proposed properties for John to move to]. 

Judge: No doubt the Official Solicitor will wish to respond, but they will wish to see what the mother has to say. When you say ‘statement’ it can just be a letter to me, it doesn’t have to be formal, if she wants to talk to me at the hearing that is fine. I want to make it more user-friendly for someone who might be intimidated by the court. 

That felt like a breath of fresh air. I wondered how many other parents and relatives are afforded this sort of compassionate understanding of what it’s like to be faced with engaging with the judicial system, and efforts made to adjust the ‘intimidating’ processes and etiquette. 

Capacity for Sex

A brief but interesting discussion took place about John’s age, sexual development, current situation and decision-making capacity in relation to sex. 

Counsel for the Local Authority was discussing the ‘PBS Plan’ [Positive Behaviour Support Plan] in relation to John’s ongoing care needs. His current plan was devised in 2021, by CYPS (NHS Children’s & Young People’s Service). 

Counsel for LA: CYPS will confirm with [care provider] that the plan is sufficient and whether the school [has addressed] sexual relationships, he has had some….

Judge: What? Sexual relationships?

Counsel for LA: No apologies. Education about this. He’ll be 18, he’s looking forward to going to clubs and bars, ‘picking up chicks’ in his language….

Judge: Is there evidence he doesn’t have capacity for sexual relationships?

Counsel for LA: It’s not yet assessed. There’s no suggestion of an assessment about capacity for this yet [this was also agreed by the Official Solicitor]. We are more looking to see what the school can provide, and also to see if he is even indicating an interest in this …. [Counsel’s emphasis]

Judge: But presumably it’s an important part of care planning. He’s expressing an interest in women … he may want to have sex with a woman today. What would you do? [Judge’s emphasis] 

Counsel for LA: Well, it’s not been expressed as present. It’s been described as bravado. He’s expressed a wish to meet girls. The Local Authority is keeping it under close review.

Judge: Yes, but he’s entirely under the care of the Local Authority and any development needs to be [….] sexual relationships should be moving towards the top, if not occupying the top, of the agenda. 

I was thinking the same thing, really. The judge was anticipating a situation that could change rapidly.  It didn’t sound as if the Local Authority knew what sexual and relationship education John had received, yet he was talking about going to clubs and ‘picking up chicks’. An aspect of life that is not restricted for John is contact with others (confirmed by the Official Solicitor’s Position Statement). 

Counsel for John later addressed this issue in her submissions: 

“Sexual relationships. This something we sought to explore in the round table meeting, given he is interested. On exploring further, we were told he has never acted on any comments – he has a favourite character in Coronation Street who says things like this [‘picking up chicks’]. We understand his needs are more sensory than looking for a partner. We understand that this is to be kept under review, see what happens over the next year. It isn’t the case he hasn’t had the opportunity to explore this if he wants to – he’s a very social young man. The Official Solicitor is satisfied about the plan over the next year.”

Both the Local Authority and Official Solicitor are therefore in agreement that a capacity assessment for sexual relations is not currently needed and will be kept under review.

The Outcome

HHJ Burrows invited final submissions from both counsel and asked whether (by the end of November) the court would ‘likely be in a position to formulate, approve or see enactment of a transition plan?’. 

The Occupational Therapist is visiting potential properties and will whittle this down to two or three appropriate places, which John will then be invited to visit. A statement of John’s wishes and feelings will be drawn up for the court. Then there will be a further (remote) hearing, with HHJ Burrows who will be sitting in Manchester, on 30th November at 10am to decide whether further evidence is needed. 

A note on transparency 

It seems to be increasingly common for statutory bodies to request that their identities are kept secret. As members of the Open Justice Court of Protection Project, we often ask for this reporting restriction to be ‘varied’ (i.e. changed), to enable us to name them. See, for example: Is he deprived of his liberty? (Plus a request to vary the reporting restrictions – again); Varying reporting restrictions to name Kent County Council in “shocking” delay case).

I had received the Transparency Order (which is the court injunction stipulating what can and cannot be reported) and it did indeed prevent identifying where John lives – but not (explicitly) the name of the local authority.

The public listing – see the start of this blogpost – for this case had named Gateshead Council (which is why I was interested in observing the hearing, because I work in Gateshead). 

HHJ Burrows took the bull by the horns (for which I felt very relieved): 

“The second question – to both of you [counsel] – the Local Authority is identified in the list. We have an observer today – I can see no conceivable reason she should be prohibited from mentioning that Gateshead is the applicant in this case. There’s no reason for that is there?”

Counsel for LA: I have no instructions otherwise.

Judge: It’s on the public list. The horse has bolted in this case. For Dr Martin’s benefit, there is controversy at the moment about identifying public bodies. I can see no reason why not to identify in this case. 

The judge asked that he receive the Order ‘by tomorrow please’.

 And that was the end of what was a very efficient (44 minutes’ long), and very human hearing, which (although I did not – yet – learn a great deal about John as a person or his wishes and feelings) did keep ‘P’, and his mother, at the centre of the court’s focus. I formed the impression that this was entirely because HHJ Burrows made sure of it. 

Claire Martin is a Consultant Clinical Psychologist, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Older People’s Clinical Psychology Department, Gateshead. She is a member of the core group of the Open Justice Court of Protection Project and has published several blog posts for the Project about hearings she’s observed (e.g. here and here). She tweets @DocCMartin

How we get there: Conveyance plans in the Court of Protection

By Ian Brownhill, 13 September 2023

The focus of many Court of Protection cases is where someone will live, what care and support they will receive, or what medical treatment they should be provided. Once that substantive decision has been made, the Court’s attention will often turn to what is described as “conveyance planning”.

A “conveyance plan” is, in the simplest sense, a plan which provides how a person will get from one place to another. However, conveyance is often one of the most complex areas legally and logistically in a case. 

Sometimes “conveyance plans” are an integral part of a “transition plan”. The two terms are often used interchangeably but that misunderstands the difference between the two things. A “transition plan” is not simply about how somebody gets somewhere (that is conveyance). Rather, a “transition plan” should be focused on how P’s care, support or treatment will be delivered in a different setting. The idea behind transition planning is that P is not overly impacted by a sudden change of surroundings or care/treating team. 

There are some examples of cases involving conveyance issues which can be found on the Open Justice Court of Protection Blog:

The legal challenges in respect of conveyance planning

Sometimes a conveyance plan is simply presented as a logistical nicety. That fundamentally ignores the legal complexity which is involved and often indicates a misunderstanding of core aspects of the Mental Capacity Act 2005 (and other statutory frameworks).

There are three legal issues that frequently arise in cases involving conveyance planning:

  • Powers of entry. Lawful entry into a person’s home is strictly limited by statute, even in circumstances where a person lacks the mental capacity to make certain decisions for themselves. There is no power of entry contained within the Care Act 2014, and this was a conscious decision on the part of Parliament. There is no explicit power of entry contained within the Mental Capacity Act 2005. However, a court may authorise entry using the provisions contained with sections 15 and 16 of the Act. In some cases, public bodies have argued that entry should be secured using section 135 of the Mental Health Act 1983, put simply, that approach is unlikely to be necessary in the context of Court of Protection cases. Nor should public bodies expect the police to use powers under section 17(1)(e) of the Police and Criminal Evidence Act 1984 to secure entry to a private property save in emergency circumstances.
  • Who is responsible for conveyance? One of the most surprising debates that has become common in complex conveyance cases is who is responsible for arranging the conveyance. Likewise, there is sometimes a presumption that the police will assist in respect of conveyance when no such obligation exists in law. It is impossible to distil a universal rule as to who is responsible for organising the conveyance, but the basic principle is that it will fall on the party seeking the order. 
  • Restraint. In too many cases, conveyance has taken place without any authorisation of the deprivation of liberty which arises from the conveyance arrangements. Active thought needs to be given to whether the proposed restraint will go beyond the parameters set out in sections 5 and 6 Mental Capacity Act 2005 and amount to a deprivation of liberty?

What a good conveyance plan looks like

In my experience, good conveyance plans consider the following issues:

  • P: Who is P, what is their prior experience of medical treatment, what are their future needs likely to be, how can we prevent their needs intensifying? What does P want?
  • Property: Where does P live? How do we extract them from that property? What is our lawful ability to enter? How do we physically enter?
  • People: Who do we need to be part of the conveyance? Is this a case where we need to use sedation (or even general anesthesia) in someone’s living room, or is it a case where P will be driven to hospital in a family member’s car? Do we need other parties (perhaps a fifth P) to be involved?
  • Passing it on: Who do we need to share P’s experience with for the future? What can we learn from this case that we can pass on so that other professionals might learn from it?

Failures in conveyance planning have consequences

Conveyance planning is not a luxury or a nicety. It is a means of properly protecting P’s rights and sometimes protecting them from harm. The failure to properly plan someone being conveyed to hospital can imperil their physical health. Shortcomings in planning how P will be extracted from an address can cause them to be subject to excessive physical restraint or to be injured during their extraction. Ultimately, conveyance plans that don’t properly consider P’s experience, may have longstanding implications for their care and treatment: they may become fearful of hospital or changes in care settings.

A considered conveyance plan is positive for all involved. In the most basic sense, it avoids the risk of something going wrong during the transfer of location. But it also can give the change of location or care/treatment arrangements the best chance of success.  The most human way of explaining this is our own experience of travel: we are always much happier when we reach our destination if we have had a positive journey without delays, lost luggage and plenty of opportunities to use the loo, to eat and drink.  

Ian Brownhill is a barrister at 39 Essex Chambers and HM Assistant Coroner for Kent. Ian tweets @CounselTweets and is a member of the Advisory Team for the Open Justice Court of Protection Project. 


Evidence for Ministry of Justice Consultation on “Open Justice: The way forward”

By Celia Kitzinger, 10 September 2023

Drawing on my experience with the Open Justice Court of Protection Project – and with some helpful input from other core team members – I submitted my views about open justice to the Ministry of Justice consultation, just before the deadline at 11.59 on 7th September 2023. I’ve reproduced what I sent below (with typos corrected- why do I only see those after pressing ‘send’?).

As I think is clear from the document itself, I’m slightly embarrassed about the very basic nature of my suggestions for “the way forward”. The twenty Key Performance Indicators (KPIs) I’ve developed to assess whether or not the Court of Protection is meeting the requirements of open justice seem to me to be entirely self-evident – as I expect they are for anyone who reads the document. It’s awkward to have to spell them out because obviously the Ministry of Justice must already know that open justice requires that the public is informed about hearings – including when and where they’re taking place, and what the hearing is about; that it must include making clear that we can observe a hearing and how (remotely or in person); that it’s necessary to tell us how to contact the court for information or to obtain a video-link for remote hearings. But those requirements (KPIs 1-5) often aren’t met – so until they are, it does actually seem necessary to keep mentioning them in any plan for “the way forward”. Equally, it’s really obvious that court staff should be able to tell us what courtroom a hearing is in (but in practice they often can’t) and that there shouldn’t be a big sign on the courtroom door saying “PRIVATE” when the hearing isn’t intended to be private (but in practice these signs are common) (KPIs 9 and 10). It’s also glaringly obvious that open justice is defeated if nobody replies, in a timely manner, to our emails requesting remote access (KPI 13): but that too is a daily experience. Since these are the daily barriers we confront in seeking to observe court hearings, that’s what I’ve written about.

I look forward to seeing what evidence has been contributed by other people and to the outcome of the consultation.

**********

Open Justice – The Way Forward 

Response to Call for Evidence

 Celia Kitzinger, 7 September 2023

Index to contents

  1. About the Open Justice Court of Protection Project
  2. Questions on open justice
  3. Listings
  4. Accessing courts and tribunals
  5. Remote observation and live-streaming
  6. Public access to judgments
  7. Access to court documents
  8. Public legal education
  9. Closing Summary

A. About the Open Justice Court of Protection Project

The Open Justice Court of Protection Project (OJCOP) is an unfunded voluntary project, independent of any public body, initially launched by Celia Kitzinger and Gillian Loomes-Quinn on 15th June 2020 with the aim of encouraging members of the public to observe Court of Protection (COP) hearings and to blog about them.  

As a direct consequence of our Project, thousands of people have observed COP hearings over the last 3 years and several hundred people have contributed blog posts reflecting on the experience. 

The Project does not seek to promote a particular perspective on the Court of Protection, but through its work aims to give people the information they need to access court hearings, to read about court hearings observed by others, and to form their own views (see our Project policy, available as a downloadable pdf from our “About the Project” webpage). 

The current Project team has five core members – none of us lawyers or journalists:

  • Celia Kitzinger, retired academic
  • Gill Loomes-Quinn, disability rights scholar-activist
  • Claire Martin, NHS consultant clinical psychologist
  • Daniel Clark, paid carer and politics PhD student
  • Amanda Hill, PhD student

We are supported by an Advisory Group composed of two COP barristers (Victoria Butler-Cole KC and Ian Brownhill) and a COP solicitor (Kirsty Stuart). For more information see our “Meet the Team” webpage.  

The Project was launched as a direct response to the exigencies of the COVID-19 pandemic. With the first announcement of restrictions on contact, the (then) Vice President of the Court of Protection, Mr Justice Hayden, closed down access to the physical courtroom and directed that all COP hearings should be heard remotely unless there was a “genuine urgency” and it was “not possible to conduct a remote hearing”.   He also said that Practice Direction 4C (permitting the attendance of members of the public and journalists) was “unworkable at present” and disapplied it (“Remote Access to the Court of Protection Guidance”, 31st March 2020).  We saw the move to remote hearings as posing a direct threat to transparency and open justice in the Court of Protection.

Access to members of the public (and journalists) had previously been permitted by virtue of the Court of Protection’s own “Transparency Pilot”, initiated four years earlier, in 2016.  Having previously held almost all hearings in private (“serious medical treatment” hearings were a significant exception), the “Transparency Pilot” created a situation where hearings were, by default and unless otherwise directed, open to members of the public (and journalists).  We could observe hearings, and write about them, subject to reporting restrictions (known as “Transparency Orders”) – usually limited to anything identifying the vulnerable person at the centre of the case (commonly known as “P” for “protected party”) or their family, and where they live.  The Pilot was subsequently integrated into ordinary Court of Protection practice – with all hearings listed as “Public” by default. By the beginning of the COVID-19 pandemic, both Gillian Loomes-Quinn and I had observed dozens of Court of Protection hearings, and published material about them (including live-tweeting a Court of Protection hearing back in 2017).[1]

The public nature of Court of Protection proceedings was effectively reversed at the beginning of the pandemic.  Although the (then) Vice President had stated that “In each case active consideration must be given as to whether any part of any remote hearing can facilitate the attendance of the public, if so Practice Direction 4C may be applied and the transparency order reissued” (§59 (“Remote Access to the Court of Protection Guidance”, 31st March 2020), there was very little evidence of any such consideration in practice.  All remote hearings were now listed as “Private”, albeit with a footnote stating that we could nonetheless apply to observe them via video-link or telephone conference call.  We quickly discovered that most such applications were unsuccessful. Either we were told that we couldn’t be sent the link because the hearing was “private”, or we simply got no response to our enquiries.  The threat to transparency was real and obvious.  

It did not occur to us to “ask permission” of anyone to create our Project and we chose not to apply for funding since we wanted to remain independent of any particular backers.  We simply came up with a Project name, created a social media presence for it and started to provide information about upcoming hearings via our website, our Twitter handle (@OpenJustice COP) and other social media. We also offered support, based on our own experience, to would-be observers seeking to navigate access. Those activities remain central to the Project.

From the outset, the uptake exceeded our expectations. Within the first two weeks after our website went live in June 2020, more than 70 people had contacted us for help with observing hearings and we’d published six blog posts by members of the public.  By the end of the first year, we’d published 139 blog posts with 97 different authors, and today it’s nearly 400 blog posts, written by around 200 different authors.  They’re written by social workers, best interests assessors, case managers, psychologists, nurses, doctors, midwives, medical ethicists, policy officers, academics, journalists, third-sector workers, law students, paralegals, lawyers, birth rights activists, a care worker, a speech and language therapist, a court interpreter, an intermediary, a police officer, school students wanting work experience in relation to medicine and law, and family members of potential or actual “P”s – and observers have watched remote hearings from Europe, Japan, and the USA (including this medical-ethicist blogger, Resolving End-of-Life Treatment Conflicts: Comparing the COP in England to Analogous Mechanisms in Ontario, California, and Texas). The Project has opened up public awareness of the Court of Protection as never before.

Today, despite the arguably ‘niche’ nature of our Project, we have nearly 6k followers on Twitter, and 233k unique visitors to our website from more than 150 countries. We’ve supported thousands of people to observe hearings – and I’ve personally observed more than 470 COP hearings in the Court of Protection since 1 May 2020 (most remote, around 15-20 in person).

The Court of Protection has been broadly positive about and supportive of our Project.  The former Vice President, Hayden J,  has said publicly that he is “very grateful” for the work that we do, and Poole J has said: “… the Open Justice Court of Protection Project is an important project that makes a significant contribution to transparency and public understanding of the workings of the Court of Protection” (§68, Re A [2022] EWCOP 44).

In responding to this Call for Evidence, I’ve answered those of your questions to which I feel I can best contribute – and my answers come directly from experience with the Open Justice Court of Protection Project, and are specific to it. Your questions are very broad and very ambitious.  By contrast, the evidence I’m sending you is rooted in my ordinary everyday experience of observation in the Court of Protection at a hands-on level over more than three years and we have rather modest proposals for improving open justice (see our 20 Key Performance Indicators). I suspect they may sound rather mundane and prosaic – even as though I am labouring the self-evident.  But what I have learnt over the last few years is that the high ideals and lofty principles of open justice depend upon – and can only be realised through – the ordinary, daily, taken-for-granted practices of the court.  “Fine words butter no parsnips”.  If I sound acerbic or frustrated at times, that is because I struggle, daily, to bridge the gap between the court’s stated commitment to transparency and its repetitive, predictable, seemingly intractable failures to achieve it.  I am impressed with the level of commitment and hard work shown by judges and lawyers at all levels of the Court of Protection – but it is glaringly apparent that they are working within a system that doesn’t support them adequately.  I agree with the view that “You have got to recognise the system is broken and needs to have proper financing’. Townend, J. and Prasad, A. (2023) Courts and Tribunals Access and Observation Workshop Report. Oxford: Sheila Kitzinger Programme, Green Templeton College, University of Oxford.  Better resourcing is fundamental to promoting open justice and transparency in the justice system.

B. Questions on open justice

The principle of open justice means that the public (not just journalists or designated categories of accredited observers) should be able to observe hearings; that we should be able to communicate about what we’ve seen and heard in court, our views about it, and our experience of the justice system; and the principle best translates into practice as a collaborative – not a confrontational – enterprise.  I expand on this below.

1.1 The public (not just journalists or designated categories of accredited observers) should be able to observe hearings

Open justice means that the public (not just journalists or designated categories of accredited observers) should be able to observe hearings. This is because there aren’t enough journalists covering court hearings, and because members of the public have both personal and professional investments in the Mental Capacity Act 2005 and in the Court of Protection, which journalists can’t be expected to address.  Despite the claim that journalists are “the eyes and ears of the public”,  there are, as evidenced below, significant differences between what journalists ‘see’, ‘hear’ and report about court hearings, and what members of the public ‘see’, ‘hear’ and report. Open justice requires that we have direct access to the court and are able to observe for ourselves the process whereby judges and lawyers are “doing justice” with our own eyes and our own ears.

Open justice is too important to delegate to journalists alone, for the following reasons.

(i) There aren’t enough journalists to cover all the hearings

There’s very rarely a journalist in court. The PA journalist Brian Farmer is the only member of the press who regularly attends COP hearings, and he virtually never attends hearings outside of the Royal Courts of Justice – which means that about 95% of COP hearings (held at First Avenue House or in regional courts across England and Wales) simply never have a journalist in attendance.  If the public couldn’t attend either, there’d be nobody watching and  ‘open justice’ would be simply an abstract ideal.

Unlike court journalists, the majority of the hearings I observe are hearings before district judges and circuit judges in regional courts.  These hearings are often perceived as ‘routine’ or ‘mundane’ in their content: they rarely raise issues of life and death or novel points of law.  But they do engage human rights principles (especially deprivation of liberty, and the right to private and family life) which are of fundamental importance to the people involved in them, and for all of us who might in future be “P” or members of P’s family in a Court of Protection hearing.  

And even in the Royal Courts of Justice we’ve covered really important hearings that have never been reported by the press: for example Mr Justice Hayden’s criticism of the  Royal Hospital for Neuro-disability in Putney, London for adopting an institutional “ethos” of care that appeared (in the hospital’s view) to trump the law, resulting in decision-making processes that were  “both poor practice and ethically misconceived.” (“’Burdensome and futile’ treatment and dignity compromised: Poor practice at a leading UK hospital”).

There’s often a belief that as long as the courts are open to journalists, that’s sufficient for open justice: they can act as the ‘eyes and ears of the public’.  But in practice, our experience is that the direction of information flow is often from us to journalists, rather than the other way around – with some journalists asking me to alert them to any “good cases” coming up in court. We’ve supported journalists by advising them of hearings, helping them to navigating the tricky business of access to the remote court, and explaining the way the reporting restrictions work.  It turns out, in many cases, that it is us members of the public (and not journalists) who have the relevant knowledge and expertise!

One of our stories (Secure Accommodation for Young People: “A well-known scandal”) was picked up by the Guardian national newspaper (Council paid £60k a week for ‘wholly unsuitable’ place for vulnerable girl, 27th April 2022).  A story in The Times drew on my experience in the COP (Fair Trials at risk with online courts); and our publications about ‘secret’ (closed) hearings concerning covert medication resulted in an interview in Joshua Rozenberg’s Law in Action (“Secrecy in the Court of Protection?”, 27 October 2022, BBC Radio 4).

Dependence on journalists alone to report on Court of Protection matters would radically reduce coverage. 

(ii) Many members of the public have intense personal/ family interests in Court of Protection matters and it is of benefit to them – and to their appreciation of and ability to participate in the justice system – to be able to observe hearings.

We’ve been contacted by many people wanting to observe COP hearings in preparation for a forthcoming hearing of their own – as well as by people wanting us to observe their own upcoming hearings, in the belief that having observers present will mean that the judge is more likely behave “fairly”.  

We’ve published blog posts by family members about their loved one’s hearing (e.g. ‘Deprived of her liberty’: My experience of the court procedure for my mum“An onlooker at someone else’s social event”: A mother’s experience of the court”) and a blog post to which P (the autistic man at the centre of the case) was supported by a family member to provide his own account of what the hearing was like (‘Vindicated!’ The experience of P in the Court of Protection).  

Watching (other people’s) hearings in preparation for an upcoming COP hearing can educate and reassure family members. 

 “… it was very useful for me as a litigant in person in my mother’s case, to see how a hearing proceeds and the efforts of the judge to be fair and even-handed with someone presenting their own case for a family member.” (Anna, daughter of a P in a s.21A case)

The law enabled a person with a learning disability to access the same rights and healthcare as any other citizen. This gives me a huge sense of relief that my family member will be safe and listened to with these structures in place, and free to live the life he chooses.” (NB, Full time carer)

Watching (other people’s) hearings after a challenging personal encounter with the Court can also help people to figure out what might have gone wrong.

Having acted as Court of Protection Deputy for my mother’s Property and Financial Affairs, and having been threatened by the Public Guardian with my removal (otherwise known as ‘discharge’), I decided to ask to observe this case…. Speaking from my own experience, I now realize that, when I started what seemed to be merely a bureaucratic exercise of the sort with which we are all familiar (tax matters, planning applications etc), I was in fact already in the foothills of fully fledged court proceedings that could seamlessly lead to actual court hearings. One thing I, and I believe the applicant here, did not understand is that you cannot simply inform the court that you want to desist with your application; you have to make a formal application to withdraw it. In my case, my application to withdraw was refused and I was at a complete loss as to why. I now realize that at least part of the reason might have concerned costs, as it did here.” (Georgina Baidoun, lay COP deputy for Finance for her mother)

There is no way that a journalist’s account of what happened in court could achieve the targeted personal effects described here. For people with personal/family involvements in the COP, there is no substitute for this direct, first-hand experience of observing the Court of Protection in action.  

(iii) Many members of the public work professionally with the Mental Capacity Act 2005. Direct observation of hearings improves their understanding of how the statute applies in action

I have found the whole observation experience very beneficial.  The googling, looking up of legislation, reading up of quoted case law – both during and after the court attendance – has given me a crash course in legislation, that I now realise, I only thought I understood. Listening to a talk about how the Mental Capacity Act is implemented in the courts is one thing – actually observing it as it happens is very different!” (Louise Burrell, social worker)

I think the most important learning for me from being able to observe this hearing, is the way it has again, allowed me to watch the Mental Capacity Act  2005 ‘in action’ and understand how a senior High Court Judge … works through the process of reaching a best interests decision. I’m also able to take away with me some ideas that I can incorporate into my own practice when completing best interests assessments myself in future.” (Astral Heaven, DOLS Manager)

My overall experience at the hearing was incredible. It made me rethink how I viewed ethics and its involvement in medicine. Now I will embark on my medical career with a better understanding of what ‘best interests’ means in practice. Doctors, much like the judge and barristers I observed, have the responsibility to protect vulnerable people in society, and I learnt that prioritising their wishes, beliefs and values before your own opinion is the only way to ensure this protection.” (Eloise Crang, aspiring medical student)

For my part, I left [the hearing] with a resolution to examine my own practice, and to consider deeply the motivations for the clinical decision-making forums (e.g. Multidisciplinary Team Meetings) I am part of that do not physically place the person or their family at their centre.” (Caroline Barry, Consultant in Palliative Care)

As a consultant for Lasting Power of Attorney and an Advocate for Advance Care Planning, learning more about the Court of Protection work and processes is important to me. I have attended previous hearings and found the experiences invaluable… I left the hearing with greater confidence in how to navigate the system, but more importantly, with great respect for seeing compassion in action.” Clare Fuller (Speak for Me consultancy)

As an experienced Best Interests Assessor… I find that both reading the reflective blogs and participating as an observer in the Court of Protection, is highly beneficial in terms of my continued professional development. … Observing this hearing has been of significance for me, aiding a deeper reflection on some of the pitfalls within proceedings that can impact on the outcomes for P, most notably around professional miscommunication and when choosing the right professional to assess capacity.” (Eleanor Tallon, Independent Best Interests Assessor)

This experience has been incredibly useful in giving me insight into the court – not only as to how barristers and judges interact and advocate in the Court of Protection, but also in  displaying the practical implications associated with a lack of capacity under the Mental Capacity Act 2005.  To see how deeply decisions about mental capacity can impact a patient’s life and the decisions that are made on their behalf was just eye-opening. … It is a great opportunity to see how the provisions and materials we learn about in our studies really affect people in a court of law.” (George Palmer, law student)

For these members of the public, the hearings provided a direct and unmediated opportunity to see how the statute (the Mental Capacity Act 2005) is applied to individual cases, and the processes by which best interests decision-making is achieved.  It’s no overstatement to say that these observations have been in some cases transformative for health and social care professionals in developing legal literacy in ways that profoundly impact their daily practice. 

(iv) Journalists are not the “eyes and ears of the public”

On the rare occasions journalists do cover Court of Protection hearings, there’s often a marked divergence between the way members of the public report what happened and the press report of the same hearing. 

In part that’s because of the range of expertise that public observers bring to watching hearings. For example, one case that attracted a lot of media attention concerned whether it was in the best interests of William Verden, a teenager with a learning disability, autism and ADHD, to have a kidney transplant. Media reports (e.g. here) were short, pithy, factual, and aimed at a general readership.  But members of the public who observed the hearing and blogged about it did so from specific professional and personal viewpoints and presented sustained and in-depth examination of the issues involved: from the perspective of a medical ethicist and mother of an autistic child (Imogen Gould); as an academic researcher on kidney donation (Bonnie Venter); and as a trainee barrister focusing on advocacy in the court (Jordan Briggs).  

What journalists ‘see’ and report is organised with reference to whether it’s (in their terms) ‘a story’ or not.  Members of the public observe court hearings through a multiplicity of very different lenses.  Compare for example media reports of the case of the woman with agoraphobia ordered by the court to give birth in hospital with the blogs from our contributors, who include a woman with agoraphobia, a medical ethicist, and some midwives.  Each of them brings her or his own unique personal and professional experience to bear, and each of them speaks authoritatively to a specialist constituency in relation to whom they are able to engage with acknowledged expertise.  

A fundamental difference between press accounts and the blogs authored by members of the public is that while journalists, by and large, focus on communicating “the facts” and the story behind them, members of the public regularly provide commentary on the case they’ve observed, reflections on their experience of observing it, and make connections with their own personal and professional experience. 

Journalist Polly Rippon and I both watched and then wrote about the same hearing and we reflected together on some of the differences.  This was Polly Rippon’s story, as published in The Times.

At my invitation, Polly Rippon also blogged for us about her journalistic choices in constructing her story for The Times – and she and I discussed why it is so different from the approach I took as a retired academic psychologist. We compared her first sentence (“A judge will decide whether a woman with a learning disability and a £1 million fortune should be allowed to marry a convicted thief and fraudster who her daughter believes is after her money”) with the rather less gripping first sentence of my blog post: “This case before Mrs Justice Roberts (COP 13503831 heard on 6th – 8th July 2021) concerns coercive control and a planned predatory marriage (or civil partnership)”.  This led me to reflect on my own approach to reporting hearings from my perspective as a member of the public:

I actively try to avoid foregrounding what might be considered ‘shocking’ or ‘exciting’ material in favour of a more educational, measured approach. My key aim in this blog post was to communicate what I’d learnt from the hearing about the law on controlling or coercive behaviour. My own background is in academic Psychology, so it’s not surprising that after this first sentence, I moved  quickly into giving a psychological account of controlling or coercive behaviour, including a link to an article in a counselling journal.  Mindful of the blog’s audience of lawyers and those concerned with the law, I then described the behaviour as an offence under s. 76 of the Serious Crime Act 2015 and quoted an extract from the Statutory Guidance Framework.  I provided all this background information up front, at the beginning of the blog, before addressing the specific issues in this particular case.  Comparing my account with the Times piece, I can see how far removed it is from a ‘human interest’ story!”

As I also reflected in relation to the ‘predatory marriage’ case, another absolutely key difference between journalists and bloggers is that the former focus overwhelmingly (with recent significant exceptions, such as the excellent “The Trial of Lucy Letby” podcasts) on the outcome rather than the process of the hearing. 

In writing for the Project, I want to communicate the process by which justice is done – not just the outcome.  So, the details of the questions asked and the answers given – and the way those answers are phrased – can really matter.  This is what we get  from observing a hearing, as opposed to simply reading the judgment afterwards.  In the blog post about this case there were lots of places where I quoted as close to verbatim as I could (given that we’re not allowed to audio-record) because I felt the exchanges in court revealed aspects of the case, and the participants’ perspectives on what was going on, in particularly vivid ways.  Compare, for example, the Times summary statement that the man “said that he was the victim of a conspiracy by his previous victims” (which is an accurate and succinct summary of the facts) with the more detailed account in the blog, which includes my own personal reflections on this.

from “Predatory marriage and coercive control: A hearing before Roberts J” by Celia Kitzinger

Because of the focus on the court process (as opposed to simply outcome), blog posts by members of the public also tend to be massively more detailed, describing the moment-by-moment unfolding of the hearing, and including (so far as possible given that we’re not allowed to audio-record hearings) verbatim dialogue. Compare, for example, this journalistic take on a hearing from March 2023 (“Judge overseeing treatment dispute raises concern about lack of legal aid”) with a PhD student’s detailed description of the same hearing (“Treatment escalation for a teenager in ICU”).

In sum, as members of the public, we have our own eyes and our own ears.  Journalists and members of the public sometimes ‘see’ and ‘hear’ very different things when they attend the same hearing – and write very different kinds of reports of it.

1.2. Open justice means that we should be able to communicate about what we’ve seen and heard in court, our views about it, and our experience of the justice system.

Our blog posts attract a specialised readership – mostly health and social care professionals working within the remit of the Mental Capacity Act 2005, but also lawyers (including ‘aspiring’ lawyers, students, pupils, and paralegals) and a smaller but significant proportion of family members of ‘vulnerable’ people, many of whom have personal experience of the Court of Protection.  

Many more people read our blog posts than will ever be able to make the time (or develop the courage) to observe a Court of Protection hearing. For many, we – rather than  journalists – act as their “eyes and ears” because we observe and write, in detail, from identifiable perspectives, in ways that resonate with their own experience.  For example: 

Excellent commentary on a nightmare of a case…. One of the most challenging things about my job (speech therapist) is when there is a chasm between families and clinicians and their interpretation of ambiguous/non-purposeful responses. It is often very difficult to know how much to walk families along the path of realisation and the clinical context matters enormously…. With the impossible time pressure on clinicians, this is sometimes just impossible. I’ll be the first to admit I don’t always get it right. …. Thank you so much for these reports from the Court of Protection. They are of enormous benefit to a wide range of readers. They certainly make me reflect on the privilege and pain of accompanying those who experience these heart-breaking traumas.” (Tom Richards, Speech and Language Therapist)

Would you please pass on my grateful thanks to “Anna” for taking the time to tell her story of her journey through the awful DOLS procedure. My friend discovered your website and passed on the link to me as I am going through the very same situation at the moment with my mother. I could not believe the similarities – it was almost the mirror of my situation! All of the professionals I had meetings with just dropped in random sentences such as ” it may go to the high court”,  ” it will take months to resolve” . No one sat down with me and explained the whole thing ….   I learned more from ten minutes reading Anna’s story than I did from any meeting with any of the professionals … I hope other people will find your website and read this story in future. It should be part of the Adult social care training programme , and I will be suggesting this when I contact my mother’s social work team.” (e-mail from Family member of P, quoted with permission)

This kind of engagement embodies the principle of open justice that underpins our Project. 

There are restrictions on what we are allowed to write – most relevantly, for our purposes, the reporting restrictions imposed by the court in the (somewhat Orwellian-named) “Transparency Order”.  

1.3 Open justice is a collaborative enterprise.

Having started out with the assumption that we would be doing “fly on the wall” observation, and with some concern about how the judiciary (in particular) would view our presence in court, I have learnt that open justice works best as a collaborative process. It changes the way that justice is done: first just through our presence, as lawyers and judges accommodate to having observers in court; second through our active engagement with the processes whereby justice is done.  

(i) Simply observing changes how justice is done 

Public observers in the Court of Protection have become much more common in the three years since our Project began. “Before Covid, I’d never had a public observer in court,” one barrister told me, “but now I’ve learnt to expect it.  There were 12 observers in one of my hearings in December”.

What we’ve learnt from barristers is that being observed changes how justice is done in the following ways. (Quoted material in this section comes from a small survey reported in our blog post, “How being watched changes how justice is done: ‘Insider’ Perspectives”)

First, counsel now regularly opening cases with introductory summaries for observers – often at the prompting of the judge who asks them to do so “for the observers”.  This is generally seen as a positive: “It’s good practice to have to think ‘how can I summarise this case in 2 minutes’ at the outset. I think it helps to do that in most cases anyway, but a public observer’s presence means we are more likely to have thought about it first. It aids the judge’s understanding and just as importantly the understanding of non-lawyer participants/litigants.” (Barrister)

Second, when observers are present lawyers are more likely to clarify and highlight key legal concepts and to avoid acronyms, jargon and initialisation. “There’s a few bad habits that have been corrected: […] we’re thinking about how we communicate and tend to explain the ratio of authorities, or what obscure pieces of legislation mean….”  (Ian Brownhill, barrister); “That drive to ‘clarity’ goes for lawyers and (as I perceive it) judges too, who are more likely to explain what they are doing in straightforward terms” (Barrister). One barrister is especially positive about the effect of observers in ensuring that fundamental legal principles come to the fore and as a result are “more rigorously and consistently applied”:  “There has been real enthusiasm for public observers in the Court of Protection. It has been seen as a real opportunity to counter the perception of it as a secret court. As a result, we have been taking the time to expressly set out the first principles and legal principles which should govern everything the Court does. This exercise, which was prompted by a desire to make the proceedings accessible and easier to follow has actually meant that as the principles are pushed to the forefront of everybody’s mind, they are more rigorously and consistently applied.” (Josh Hitchens, barrister)

Third, we’re told that blogs by observers create an opportunity for self-reflective learning “We reflect on our advocacy by reading the blogs!” (Ian Brownhill, barrister). “I have actually found the blogs produced by observers to be really interesting and useful.” (Barrister). “Reading the blogs is entertaining – a little bit like the review following opening night. It keeps everybody on their toes” (John McKendrick KC).

Fourth, there seems to be some agreement that having observers in court means that lawyers, and the judge, are “on best behaviour”:  “It absolutely changes things – practitioners and judges are less sloppy I think, and take the time to properly set out the facts, the law and judgments when they might otherwise refer to things in a more shorthand way.  This, I think, is a good thing since it means that anyone participating or watching (often family or even P themselves) can actually follow what is going on far better.  It means we are all on ‘best behaviour’ essentially!” (Barrister); “I think observers make the barristers try harder in a hearing – like in a driving test. You never drive like that normally. They are more aware of what they are supposed to do in court” (Solicitor). Eight barristers (independently of one another) told me that having observers present improves judicial behaviour – in particular via what was characterised by one of them as “improved civility in court”.  They referred to “rudeness” from judges who were “hostile” to or “impatient” with their oral submissions in court, or “dismissive” of P and P’s family members.   One barrister emphasised that that Court of Protection judges are “very good – from DJs up to HCJs. They are serious about the role they are performing and appear to enjoy the work” but added that being observed “acts as a brake on some of their more obstreperous characteristics”. One commented that judges behave better in front of observers, knowing that the public would be “horrified” at their customary level of disrespect (e.g. expressing the view that some hearings are “a waste of time”).  Some family members also believe that having observers in court leads to better behaviour by the judge, and that the judge was “fairer” to them because observers were there: “ [Observer’s] presence was valuable – the judge was quite snappy and aggressive with me before he arrived; and was clearly in fast-forward mode. That changed.” (Litigant in Person)

(ii) We actively engage with the justice system

The role of our Project is to support the oft-stated judicial aspiration for greater transparency in the Court of Protection, and to the extent that we may be seen as challenging the court, we try to frame our engagement as that of  ‘critical friends’.

Our engagement activities include:

  • attending  Court of Protection User Group meetings (there are around three each year for each of the eight regional groups), so that we can raise issues of transparency directly with judges and lawyers
  • liaising with a nominated Deputy Service Manager in HMCTS, who has taken on responsibility for trying to improve listings – we alert her to errors and she contacts the teams that are getting it incorrect to target and support them
  • giving invited talks about transparency matters to lawyers and judges (e.g. Park Square Barristers in Leeds, 19 January 2023; CPBA Annual Conference, 39 Essex Chambers, 13 July 2022; Court of Protection Practitioners’ Association Annual National Conference, Principality Stadium, Cardiff, 24November 2022; Inner Temple Advocacy Weekend, 29-30 January 2022).
  • Inviting lawyers to write ‘explainer’ blog posts supporting public understanding of legal matters (e.g. blogs by Aswini Weereratne KCIan BrownhillKirsty Stuart)
  • mentoring law students and aspiring barristers by supporting them to observe and blog about hearings and thereby (hopefully) creating a new generation of legal professionals for whom transparency is an established norm. 
  • We’ve twice made lengthy and detailed submissions to the Court of Protection Rules Committee – on Transparency Orders (outcome pending) and on closed hearings.
  • We quite frequently intervene in hearings to ask for variations to the Transparency Order. For a recent example, see Varying reporting restrictions to name Kent County Council in “shocking” delay case[2]. This is really important, since there are rarely journalists present in these hearings to address Art 10 matters.

None of this was what we’d envisaged in setting up the Project just over three years ago.  It has emerged organically, and in partnership with the court as part of its commitment to transparency.

Our Project sounds like a success story for open justice – and in many ways it is. But I want to make visible the hard work it takes to make this happen, the multiple barriers to transparency we have to overcome day after day, and the slow pace of change. It shouldn’t be this difficult.

Transparency in the Court of Protection works (when it works – and it often doesn’t) because of the hard work and dedication of individual judges, lawyers, court staff and members of the public – all of us battling against a system which seems set up to obstruct us.  

Here’s how it’s supposed to work.

The fantasy version of access to remote hearings in the Court of Protection

A member of the public looks in the “Court of Protection” section on Courtel/CourtServe for a hearing to observe. 

The listing provides essential basic information including: 

  • whether hearings are public or private
  • what hearings are about
  • what the attendance options are (in person/remote)
  • the type of hearing (e.g. directions, case management, final)
  • contact information (to confirm the hearing is going ahead and/or request remote access)

She picks a hearing to observe – say, a challenge to a deprivation of liberty (because that’s what her mum’s case is about), in the Midlands (because that’s her Mum’s area), at 11am the next day (when she’s free), and she chooses one that says it’s being held via cloud video platform (as she lives a long way away).  She sends off an email to the contact address given and receives a reply with the link and a Transparency Order attached well in advance of the start of the hearing, and logs into the hearing without problems.

But that’s not how it actually works in practice.

The reality

Very few members of the public find Courtel/Courtserve an accessible or user-friendly resource.  Almost all observers rely on our Project’s version of the listings: without our version, their observation simply wouldn’t get off the ground.

But our version of the listing depends on us being able to decode – or make informed guesses – about the hearings.  Quite a lot of hearings are listed as “private” when we don’t think they are. Many don’t say what the hearings are about, and unless we’ve observed earlier hearings in the same case, we have no way of knowing.  Some don’t say whether the hearings are in person, remote or hybrid (and the initialisation “CVP” doesn’t mean anything to most members of the public, so we have to spell that out).  

We provide a “template email” on our home page for people to use when requesting access to remote hearings because we discovered that without it, members of the public were not providing sufficient information (e.g. the case number and the name of the judge) for court staff to respond to their requests.   Emails saying “can I observe the hearing at 11am tomorrow please” do not meet with success and are frustrating for everyone.  

Nonetheless, a large number of people who’ve made well-formed requests to observe hearings get no reply. I know this because we suggest that emails are copied to us so that we can provide support with access, if necessary.  And it often is necessary – and still sometimes there is no response (or the response comes too late to observe the hearing).   My own experience is that I get no reply – no reply at all!– to about one in every six requests to observe hearings, even after sending repeated emails, and phoning the court. (Usually nobody answers the phone.) I’m knowledgeable and persistent: for most would-be observers the failure-to-respond rate is much higher.

The problem seems to be that the listings instruct the would-be observer to email the regional hub – so Birmingham for a hearing in Worcester, or Bristol for a hearing in Truro, or Cardiff for a hearing in Caernarfon.  Court staff at the hub then have to forward the email to the regional court.  Court staff at the regional court then pass it on to the judge in the regional court whose hearing it is (often, they say, for “permission” for the observer to attend – although in fact no “permission” is required for public hearings).  They then wait for the judge to get back to them, and the whole process happens again in reverse: regional court staff send email to hub and hub replies to would-be observer.  This is a cumbersome and time-consuming process. It places burdensome and unnecessary pressure on court staff – and I am told that they are already overworked and under-resourced (and also that there is rapid staff turnover, resulting in frequent unmet training needs). It is setting everyone up to fail.  Surely HMCTS can devise a better system?

If an observer is lucky enough to receive the link in time for the hearing, there’s still a good chance that the hearing will be vacated – about 1 in 3 of all COP hearings are (and most observers don’t know what “vacated” means so we’ve had to explain that too). It’s more likely than not that she won’t have received a Transparency Order (in fact, it’s more likely than not that she will never receive a Transparency Order) – and there’s also a real risk that the cloud video system won’t work well enough for her to either see or hear what’s going on.  We do provide would-be observers with a link to the gov.uk information about how to use CVP but sometimes that’s not enough. I once watched – and then blogged about – a two-and-a-half hour hearing with no sound (“The silent courtroom: A remote hearing without sound – and why transparency matters”).

Workarounds

To the extent that transparency “works” in the Court of Protection, it relies on a range of  pragmatic “workarounds” that enable us to bypass systemic pressure points, limitations and fractures in the system. Although we continue to lobby HMCTS to get the system working better, we’re increasingly figuring out ways around the system.  And by “we”, I mean all of us – observers, court staff, lawyers and judges.  Here are some of our workarounds.

  • Since lists are obscure and incomprehensible to most members of the public, the Open Justice Court of Protection Project runs our own listing service on social media, where we translate “s.21A”, “CVP”, etc into intelligible prose and also select out some “Featured Hearings” which we think are likely to be accessible/of interest to observers.
  • Knowing that hearings are often not in the COP list on Courtel/CourtServe (the only public listing service for county courts), we also spot-check the Daily Cause Lists across England and Wales for ‘missing’ hearings. A systematic check of Daily Cause Lists for incorrectly listed COP hearings takes about 2 hours and often adds a third as many hearings again – but we only do this occasionally due to time constraints. (Things have improved – a systematic check in 2020 doubled the number of CoP hearings!)
  • Some Tier 3 judges know (because we’ve complained in the past) that if they leave the RCJ and hear cases in regional courts, there’s very likely to be a listing problem (often their hearings don’t appear at all, anywhere) – so when they have hearings in the regional courts, they ask their clerks to alert me.
  • When hearings are listed as “private”,  we know that this is most likely to be because someone filled in List Assist instead of the COP template, and that the hearing is actually public, not private. I sometimes make a special effort to attend “private” hearings to check this out – and I’m almost always correct. On the Open Justice Court of Protection Project listings we either omit the word “private” or say that although it’s listed as private, we doubt that it is. 
  • Because so many emails to the regional hub contact address provided in the lists get no reply, I often contact the judge’s clerk for the link, or one of the barristers if I know who’s involved in the hearing.
  • Knowing how frequently there’s no reply to my requests for links for remote hearings, some court staff and a couple of lawyers simply send me the links to hearings without waiting for me to ask for them. This reduces stress on everyone!
  • Because there’s no information at all on the RCJ website as to what hearings are about, lawyers involved in cases they think the public will be interested in regularly alert me themselves.  (That’s true of some cases in the regional courts as well, although at least there is some, minimalist, information available there.)
  • There’s no way of knowing when cases I have been following are back in court – no search facility that enables me to search on the case number, and no way of setting an automated ‘alert’ using the case number to inform me that a case is being heard again (including the possibility that it’s being heard in the Court of Appeal, or before a different judge, or has been removed from the Tier 3 list and returned to a regional court).  So, when I’m following cases with multiple hearings over time (several of the cases I’ve observed have continued for years with 5-10 hearings), I often have to rely on lawyers to let me know, via a personal email, that the case is back in court.
  • A judge regularly gives me permission to circulate the link to his hearings directly to other observers – because otherwise I have to negotiate emails from members of the public complaining of lack of access, which I have been in the habit of forwarding to his clerk so she can send the link to them.
  • Several judges send me links (unrequested) to out-of-hours or urgent hearings that have not made it onto the published lists.
  • Several judges have, on more than one occasion, delayed the start of a hearing so that observers can be there from the beginning– knowing full well that it’s likely to be a tardiness not of our own making.
  • We know some judges who have set up personal MS Teams systems in their own courtrooms so as to avoid having to use cloud video platform, and to provide the best experience for remote access (which is often how P and their family access the court as well as observers).  At least one RCJ judge has delayed the start of a hearing and moved courtrooms to enable an observer (and only an observer) to attend a hearing remotely. 
  • Journalists who have access to information not made available to the public (e.g. via the alerts service) sometimes let me know via a personal email.

My conclusion is that “the justice system” is not at all open and transparent: it’s a system that seems designed to frustrate the judicial aspiration for transparency. It’s not fit for purpose.

The transparency we have achieved via the Open Justice Court of Protection Project is the outcome of the collective commitment of judges, lawyers, court staff and members of the public (plus journalist Brian Farmer) who’ve dedicated their time, knowledge and skill to making it happen – because some of us really believe that transparency is fundamental to justice in a democratic society.  It would be good if “the justice system” could support that.

Please engage with the Courts and Tribunals Observers’ Network (of which I am a part). It brings together a range of stakeholders with expertise across different courts and tribunals and we are actively seeking to inform the Government and Judiciary and other relevant bodies about access problems in the justice system and to help develop better policies and law. 

C. Listings

Listings are currently desperately inadequate – although I have been forced to recognise (in conversation with observers in other courts) that the Court of Protection may be better than most. It’s extraordinary to me that the Court of Protection – a court with “transparency” as a central philosophical principle – produces court listings entirely unsuited to delivering on its stated objectives.  

I’ve been writing publicly about problems with the court listings since August 2020 – and tweeting about particular instances, expressing my concern in talks before lawyers and judges, and sending written complaints to relevant persons and organisations.  There have been some improvements, but the pace of change is glacial.

Here’s one from the Courtel/CourtServe list today that gets it right and I’m displaying it first of all because it shows that it’s possible to list hearings in a way that the public find accessible and covers all the relevant information.  This hearing is about “Appointment of an Interim Deputy” – something members of the public who are family members of vulnerable people are often concerned about, especially if they want to be Deputy themselves or have been removed from acting as a Deputy. It’s important for people to see that they can watch a hearing about this issue.  It’s clear that the hearing can be watched remotely, that it lasts an hour, and the contact information is correct.  It doesn’t look that complicated to me – so I don’t really understand why so many listings get it wrong. 

Here are some of the most egregious problems.

1. Failure to list hearings in Courtel/CourtServe (or any other public online list)

If we don’t know that a hearing is happening then it is effectively taking place in secret.  Obviously, I can’t know how many hearings are happening in secret without ever being publicly listed – but I do know of some.  I’m not referring here to urgent or emergency out-of-hours hearings – I know it’s inevitable that those can’t make the listings – but to hearings that everyone involved in them knows are happening weeks or months in advance. Here’s one recent example. 

It was a hearing I particularly wanted to observe concerning a young woman with autism, mental health issues and some physical health problems who was ready for discharge from hospital but was refusing to return to the bungalow where she’d been placed previously and been desperately unhappy, leading to several episodes of self-harm.  There were questions about her capacity to make her own decision about where to live and about her best interests. The case was heard on appeal by Mr Justice Peel (Wilshire County Council v RB & Ors [2023] EWCOP 26) who says in that judgment that the case would be re-heard, the appeal having been allowed, by HHJ Robertshaw on 27 June 2023 for three days. 

 My subsequent letter to Mr Justice Peel (see below) describes what happened next.  

The depressing reality is that I wasn’t even particularly surprised.  There’s a recurrent problem with hearings simply not appearing on any listing accessible to the public – not on Courtel/CourtServe’s COP list, not on the Daily Cause list for the relevant court, and not on the RCJ or First Avenue House lists.  

The correspondence below provides another example: a hearing in Northampton before a Tier 3 judge (Lieven J) never appeared on a public list – as I explained to my HMCTS contact.  (My suggested solution has not been implemented).  Hearings before Tier 3 judges on circuit are regularly omitted from the listings: I’ve described other cases in my blog posts including “A ‘secret’ hearing on life-sustaining treatment” before Hayden J in Newcastle.

Dear Jess

I was told by someone involved in the case that there was a hearing before Lieven J today at 10.30am, and I wanted to observe it.

The hearing was not listed on the Royal Courts of Justice Daily Cause list.

I checked with the person where the hearing was happening and was told Northampton.

I looked in Courtel/CourtServe.  There was nothing in the COP list for Northampton.

I went to the Northampton Daily Cause list in Courtel/CourtServe and found two hearings before Lieven J but they were listed for 12noon and 2pm and the case numbers lead me to believe that they were not COP hearings.

Finally, I wrote to Northampton County Court asking whether they were able to help me, and I copied in Lieven J’s clerk, Sarah McMohan.  Most members of the public would not, of course, know who Lieven J’s clerk is, or have the chutzpah to bother her.

I have not received a response from Northampton County Court, but Sarah McMohan replied promptly with a link to the hearing, and I was able to watch it. So this had a happy ending.

But yet again a hearing before a Tier 3 judge has taken place without ever appearing on a public court list.  This is a recurrent and apparently intractable problem which I have documented many times before.  Is there anything that HMCTS can do about it?  

In my view ,the best solution would be to continue the doomed attempt to get these hearings listed in the regional courts but, recognising that this often doesn’t happen, to also list them on the RCJ Family list where these judges’ hearings normally appear, and where those of us who regularly observe hearings know to look for them.  A note could be added to say that they are not actually happening in (or from) the RCJ or the actual location could be given in place of the RCJ Court number.  

In this case, since it was an MS-Teams hearing anyway, the fact that the judge was conducting it from Northampton rather than London was irrelevant except for the fact that it led to a listing failure.

When I report these listing failures, I am usually told that there is a “training need” and that someone will send a memo round.  Then it happens again.  If you have ideas about how to fix this, that would be wonderful.

Best wishes

Celia

When I learn about a hearing from a source other than the listings (from a published judgment as with the hearing before HHJ Robertshaw, from a barrister as in the hearings before Lieven J and Hayden J; or from family members), I always look for it in Courtel/CourtServe.  About 50% of the time, I can’t find it – not in the COP list, and not in the Daily Cause list.  It’s a “secret” hearing, and I’m only able to watch it because I have “inside” information.  This does not support the judicial commitment for transparency.

Hearings are also frequently listed in CourtServe in the wrong place – not in the COP list which is where they’re supposed to be, but in the Daily Cause list for the individual court (and often under a sub-list for a particular judge) – making them challenging to locate.   Every so often I go systematically through all the Daily Cause hearings listed for a particular date looking for COP hearings that should be in the COP list instead or as well as the Daily Cause List: the percentage of COP hearings that don’t appear in the COP list has fluctuated between about a quarter and about a half ever since I’ve been doing this. 

Here’s an example from last year that I incorporated into a talk for lawyers and subsequently tweeted.  A hearing (which actually I did manage to observe and blog about) before DJ Birk in Leicester did not appear in the COP list.  I found it (as the slide says) in the Leicester Daily Cause list, under a sub-list labelled “Daily DJs”.  Additionally: it says it’s PRIVATE – which turned out to be wrong – and it doesn’t say what it’s about : “MATTERS IN PRIVATE” is about as opaque as it’s possible to be.  In fact, it turned out to be really interesting for me to observe: see  “When family members apply to become parties: A hidden and “private” (but not sinister and secret) hearing”).

2.  Hearings are regularly and erroneously labelled “PRIVATE”  or ‘NOT OPEN TO THE PUBLIC” 

Almost all COP hearings are supposed to be listed as “Public”.  That’s the default, except for two categories of hearings: “Dispute Resolution Hearings” (DRH) and “closed” hearings, both of which are always held in private. It’s open to judges to hold other COP hearings in private – or to exclude the public from part of a hearing that is otherwise in public – and this happens occasionally, but rarely.

On that basis, it should – surely! – be straightforward for HMCTS court staff to list COP hearings as “Public” because 95% or more of them actually are “Public”. But (as already illustrated in the slide above) they don’t.  I struggle to understand why there is a repeated and seemingly intractable problem with this.

Here’s a recent example.

4 September 2023

to COP.Manchester

Dear DJ Gray

I’m writing in my capacity as co-director of the Open Justice Court of Protection Project.  We support the judicial aspiration for transparency in the COP by encouraging members of the public to observe hearings.

Looking at the hearings listed in Courtel/CourtServe for tomorrow (see photograph below), I notice that all three of the hearings before you are marked as “NOT OPEN TO THE PUBLIC”.  It’s very unusual for COP hearings not to be held in public. Is this actually correct?  We have not alerted the public to your hearings in case you are planning to hold them in private, but we are surprised to see this, as there is no indication that they are Dispute Resolution Hearings.

I notice also that none of them includes case descriptors (i.e. indication of the issues before the court).  This is also unhelpful for transparency purposes.

I wonder if you can offer me any help in understanding how your hearings have come to be listed like this. 

Thank you for your support of open justice.

Celia

CourtServe listing

In response, the Team Leader from the Court of Protection in Manchester thanked me for bringing the matter to his attention and said: “The points you raise have identified a training need for one of my colleagues …  who is new to the role of usher and has recently taken on the responsibility for producing the daily lists…” (email 5th September 2023) 

As I said earlier, most of my observations about listing problems are responded to with reference to a “training need” – but the same problems recur over and over again.

3.  There’s no information as to what hearings are about 

There was a clear official statement, when the Court of Protection Transparency Pilot was launched more than seven years ago now (on 29th January 2016) that descriptors of the issues before the court would be made publicly available in listings.  According to the “Pilot Background Note”: “Policy officials will also work with Her Majesty’s Courts and Tribunals Service to amend the way in which court lists are displayed, so that they provide a short descriptor of what the case is about, allowing the media to make an informed decision on whether to attend the hearing” (Available at https://www.judiciary.uk/wp-content/uploads/2015/11/cop_transparency_pilot_background_note_19.11.15.pdf, downloaded 6 September 2023).

Nearly eighteen months later, this still hadn’t been achieved, and the judiciary seemed unsure about how to go about implementing it. The (then) Vice President of the Court of Protection, Mr Justice Charles, said: “It is recognised that it is important that cases are appropriately described when they are listed to provide information to the public at large of what they are about and when and where they will be heard. Comment on how this should be and is being done is welcomed.  As is more general comment on how the public and the media can make themselves aware, or should be made aware, that certain types of case are due to be heard…” (Charles J, The Transparency Pilot, 20th June 2017)

It’s still the case that many (sometimes most) listed hearings don’t have any indication of what the hearing is about. None of those posted on the Royal Courts of Justice website ever does – and it’s enormously frustrating for members of the public who have special interests in observing hearings on particular issues. Some indication of their content (‘treatment withdrawal”, “caesarean”, “coercive and controlling behaviour”) would be much more likely to induce observers to attend.  (So, too, would be some indication of their likely duration.)

There is a set of “descriptors” provided for use in listing cases in the regional courts and in First Avenue House.  First Avenue House routinely provides this information (e.g. in FAH list of 6 September 2023, “Whether the applicants should be appointed as deputies for property and affairs’;  “(a) Where ESZ should live (b) Authorising a DoL in connection with care and residence (c) Contact with specified persons”; “(a) Assessments of capacity and need for care and support (b) Access to KB in order to carry out such assessments”).  This information is should be, but is not, systematically supplied in the regional courts listings – albeit that this is something that’s been improving (slowly) over the last three years.  Information remains minimal – and is often likely to be inaccessible to ordinary members of the public  (e.g. s.21A, s.16, DOL, LPA). A few summarising sentences would, of course, be excellent but is almost certainly beyond the resources of the court.  

The Project has created some (very modest) “Key Performance Indicators” against which to assess the performance of the Court of Protection in relation to transparency in listing. The most recent assessment is as follows:

KPI 1.  List the hearing in the COP list on Courtel/CourtServe   POOR  (more than a third of COP hearings did not appear in the COP list on CourtServe on the date of assessment)

KPI 2. Make it clear the public can attend – POOR  (fewer than a half of hearings said they were PUBLIC)

KPI 3. Tell us how we can observe (i.e. remotely/in person) – VERY GOOD  (a pleasing improvement on this KPI – almost all of listings provide this information)

KPI 4. Supply correct contact information  – FAIR (nearly 1/5 hearings provided contact details for the court where the hearing was taking place, rather than the regional hub)

KPI 5. Tell us what the hearing is about – FAIR  (around half of the listed hearings provide some indication of the issues before the court – another pleasing improvement) 

Many people who contact the Open Justice Court of Protection Project believe that the court is deliberately obstructive of open justice.  I understand why it can feel like that.  It takes an effort of imagination to realise that problems of transparency are caused not by deliberate intent, but because of systemic failings in the necessary infrastructure needed to support open justice. Open justice fails despite the judicial commitment to it. I don’t  really believe that the lists are deliberately designed to discourage us from observing hearings.  It’s just that – very often – they have that effect.  It’s glaringly apparent that the listing system wasn’t set up in an outward-facing user-friendly way for members of the public.  It needs a thorough overhaul.

Finally, two listing issues, in particular, that have arisen this year in connection with our work relate to (1) ‘closed hearings’ and (2) committal hearings.  

In relation to ‘closed hearings’, we were dismayed to discover that we’d misreported the facts of a case due to the judge having decided to run secret ‘closed’ hearings (without P’s mother and without us) in parallel with the hearings in open court which we’d attended and reported on.  We didn’t know about the decisions made in the secret hearings (the intention was to conceal this information from P’s mother) and the observers felt we had been misled by the court, making (as we said) a mockery of open justice. We wrote a blog about this here: Statement from the Open Justice Court of Protection Project concerning an inaccurate and misleading blog post and publicised the threat this poses to transparency on the Radio 4 programme Law in Action (“Secrecy in the Court of Protection”).  We subsequently made a submission to the subgroup of the Rules Committee set up to advise the (then) Vice President about how closed hearings should be dealt with in future.  This led to  New Guidance on Closed Hearings from the Vice President of the Court of Protection. Since then, we have seen “closed” hearings listed on the RCJ site – so although we still don’t know which case they concern, or what they’re about, and although we still can’t observe them, at least the court is providing public notification of the fact that closed hearings are happening. We don’t think any of this would have come to light without our Project, and we’re proud to be able to highlight a concrete achievement in ensuring better transparency in the future.

In relation to committal hearings, it’s only this year that we’ve had the opportunity for the first time to observe and report on hearings at which judges consider whether someone (usually a family member) should be sent to prison for breaching court orders – for example, for publishing material on social media identifying P when there’s an order that they must not do so, with a penal notice attached. This year we reported on one such hearing in A committal hearing to send P’s mother to prison – and the challenges of an in-person hearing.  This is an ongoing case: P’s mother recently lost an appeal against her suspended custodial sentence. One reason why we’ve not observed these committal hearings previously is because they have not been correctly listed. There is a Practice Direction (Committal for Contempt of Court – Open Court) which says that says that open justice is “a fundamental principle” and that “the general rule is that hearings are carried out in, and judgments and orders are made in, public” (§3), and that these hearings should normally be publicly listed with the information that an application is being made to commit someone to prison, and the full names of that person and the person/organisation seeking committal (§5.2). In fact, it seems that some committal hearings – in both the Court of Protection and in the Family Court – have been listed as private, and/or the fact that they’re committal hearing is not included in the list, and/or the names of the applicant and alleged contemnor are not published (see Committal hearings and open justice in the Court of Protection)).  Here’s one recent example which is in breach of the Practice Direction because it doesn’t name the applicant or the person alleged to be in contempt.  

On request, I was subsequently provided with a name, but no information about the alleged offence or the outcome of the hearing. I was told that the judgment would be published on the judiciary.uk website. I have not been able to find it there, despite checking regularly having since the end of June 2023). Some weeks ago, I asked the court to help me locate it, and was told “we are awaiting the directions”. I don’t know what that means.  I suspect that someone whose name has not been made public has been given a prison sentence in secret and that there is no public record of this.  This is not open justice. I find this very troubling. It reinforces, and provides concrete evidence of, exactly the notion that Mostyn has said he hopes to dispel – “the idea, which continues to be peddled by certain sections of the press, that the Court of Protection is a secret, sinister court which dispenses justice behind closed doors.” (Mr Justice Mostyn “Judge defends Court of Protection as not a “sinister secret court“, Today’s Wills and probate)

KPI 6. If the court is going to hold hearings with the deliberate intention of excluding one party (usually a family member), there needs to be some public accountability for this so that we at least know that it is happening, how often, and why.  Listing the hearings as ‘closed hearings’ is a good start.  I don’t think the court is planning to produce an annual report covering the number and nature of ‘closed’ hearings, but I think it should.

KPI 7. Hearings at which the court is deciding whether or not an alleged contemnor should be sent to prison should normally be listed in accordance with the Practice Direction, held in public and a judgment published.  This is not always happening and it’s corrosive of open justice. 

It’s essential to have these lists published online. It would also make a huge difference if they could be searched (e.g. via case number) and if it were possible to set up an ‘alert’ so that we could know (without bothering barristers) when a case is coming back to court.

We use the information to inform members of the public about hearings they can observe.   We check the online lists every day and reproduce them in a more accessible form on social media (fixing problems with initializations, explaining obscure terminology, removing the word “private”, and correcting or adding contact information (RCJ managers have supplied us with an additional email address and a phone number – neither available from their website – to support us in seeking to gain access).  See above for the problems and difficulties we face.

I’m concerned about the proposal to allow professional users to access lists “not available to the public”. As a member of the public, I’m already excluded from information available to journalists, including the “alerts service” whereby the COP brings to the attention of journalists those cases in which it proposes to impose particularly draconian reporting restrictions – thereby giving journalists the opportunity to contest or query those reporting restrictions. As a member of the public, I also have an investment in knowing about these hearings in advance and having the opportunity to consider the appropriateness of unusually stringent reporting restrictions and making the case for greater transparency.  

If the core members of our Project were to be excluded from some more comprehensive lists available to journalists, this would negatively impact on our ability to contribute to open justice.  We recommend some mechanism for members of the public (neither accredited journalists nor duly authorised lawyers) to apply for access as well – in a swift, efficient manner.  I appreciate that lists with additional sensitive information might not be suitable for general public access, but would want to be sure that the core group members of organisations such as ours with a legitimate interest in accessing these lists, and a track record in open justice, would be able to access them too.  I have laboured the point (earlier in this submission, see my answer to Q1) that open justice cannot and should not be delegated to journalists alone – because there are not enough journalists covering the courts and journalists do not always function as the ‘eyes and ears of the public’ given the multiplicity of legitimate personal and professional interests members of the public bring to hearings, and the in-depth and detailed analyses they often write about them. So, if there are to be lists with restricted access, projects like ours should be able to gain access too.

Court of Protection lists do not identify all parties – they routinely suppress the name of “P” (the vulnerable person at the centre of the case) and their family. More problematically, they often do not include the names of public bodies as parties.

Court of Protection hearings are generally open to the public and should be  listed as “Public with reporting restrictions”.  They often say “PRIVATE” instead.  I’ve detailed this problem above.  We don’t know what exactly the reporting restrictions are until we receive the Transparency Order – but there is a ‘standard’ template which restricts publication of any information likely to identify P and their family, and where they live.  There is currently a sub-committee of the Court of Protection Rules Committee investigating how Transparency Orders can be improved.

D. Accessing courts and tribunals

You say: “We are seeking your views on whether there is more the government could offer to support public access to court and tribunal hearings”. 

Supporting the public with accessing courts and tribunals needs to start by improving the listings (see section C above) – since we’re unlikely to go along to a courtroom if we don’t even know that a hearing is happening.

In-person hearings pose a range of access challenges beyond simply locating the court. For example:

  • We need to be able to check, in advance of travelling to the court, that an in-person hearing is actually happening.  Since about 1 in every 3 hearings (in my experience) is vacated, we risk a wasted journey.  I have repeatedly tried phoning courts in advance of leaving home to check whether hearings are going ahead, and never had a satisfactory response.  (I now ask barristers or judge’s clerks instead, when I know who they are.)  Again, this is about having more – appropriately trained – outward-facing court staff that members of the public can access with questions like this.  This means more funding!
  • A member of the public turned up at the RCJ for a hearing, listed as public, before Arbuthnot J on 7thDecember 2022.   There was a sign on the court door saying “IN PRIVATE – NO ADMITTANCE”.  He left the building.  I learnt from Brian Farmer – who was similarly deterred from entering – that the sign had been left up in error.  I have previously experienced “PRIVATE” signs on courtroom doors myself and wrote to HIVE and to Arbuthnot J about this on 11 December 2022.
  • While waiting to enter a courtroom in the RCJ for a hearing before Hayden J,  I saw a sign on the door saying IN PRIVATE – NO ADMITTANCE”.  As I knew the hearing was supposed to be PUBLIC (I double-checked this with the lawyers also waiting outside the courtroom), I alerted the usher and asked that it be removed.  Unusually (ushers are generally helpful!), she was dismissive of my request and said she’d remove it “later”. As we entered the court the sign was still up, and I repeated my request.  She seemed irritated by this and said she’d do it “when the hearing starts” – which rather defeats the purpose of open justice, since seeing the sign on the door would likely mean that potential observers would have left by then. 
  • At Newcastle County Court, there was no listing up on the notice board for the hearing we wanted to observe before Poole J, and nobody readily available to ask. I’ve experienced this several times before – but this was a new experience for one member of the OJCOP core group, Claire Martin.  She describes what happened: “Once through security, we spotted several rows of A4 notices on a board on the wall.  They had the different courtroom numbers and cases being heard, with judges’ names and hearing numbers. Mr Justice Poole was not listed. What to do? A security guard suggested going to the first floor where courts and a reception desk were located. ‘Ask there’ he said. The reception desk on the first floor was empty. The listing boards on the first floor also didn’t include the hearing we were looking for. … There was a conspicuous absence of people whose job it was to ensure everyone knew where they were going. Perhaps these jobs don’t exist – or perhaps it was lunchbreak? We managed to intercept one person, a lawyer I think, who said she was really not sure but pointed us to a waiting area. The waiting area also had boards with listings, but ours wasn’t on these either. Celia attempted to identify whether the lawyers from the hearing we hoped to observe were in any of the six small consulting rooms (with small windows in them) leading off the waiting area, but was unsuccessful.  … At that point, we saw Joseph O’Brien, counsel for FP, arrive. Then we knew we were definitely in the right place.” (A committal hearing to send P’s relative to prison – and the challenges of an in-person hearing)
  • Some observers have disabilities that affect their ability to access the court – remotely and/or in person. In our experience, it can be difficult for observers to feel confident that their need for reasonable adjustments will be understood and supported – even, ironically, in the Court of Protection which works intensively with disabled people. An observer with hearing loss struggled to hear the proceedings when seated, as directed, in the back row of the court. The co-founder of OJCOP, Gill Loomes-Quinn describes how “I found standing when the judge entered the room problematic (I have compromised mobility and use walking sticks) but the formality of the proceedings meant that I felt unable to draw attention to myself in order to request an adjustment to the expectation that I would stand” (“Under the radar”) Since then we’ve heard reports of an usher calling out “Stand if you are able”, which sounds much more progressive.  
  • I bring my laptop to Court of Protection hearings and use it to make detailed notes and to access statute and case law during the course of the hearing to help me to understand, as best I can, the legal arguments.  I am sometimes directed towards seating without any desk surface on which to rest a laptop – even when there is vacant seating with desk space on the press benches or further forward in the court.  I once moved to a vacant seat and was ordered to return to the back of the court.  As far as I can see this simply works to prioritise an outdated protocol (probably invented before laptops even existed) over the practical exigencies of open justice. I do realise that when I’ve complained about this to other court observers, they’ve simply expressed amazement that I’m allowed to take a laptop into court at all. Electrical sockets for recharging laptops are also few and far between in some courts – I realise this can be a problem for lawyers too, and have several times lent them my extension lead.

So, there are some quite modest Key Performance Indicators for transparency here:

KPI 8 The courts should be properly resourced so that there are trained staff available first thing on the morning of a listed hearing to answer questions about whether it is actually going ahead or whether it has been vacated.

KPI 9 Remove any signs on courtroom doors stating that hearings are PRIVATE when they’re not.  (We recommend having a sign that says “THIS HEARING IS IN PUBLIC. EVERYONE IS WELCOME TO COME IN”.  I’ve never seen a sign like that on a courtroom door – but what a difference it would make!)

KPI 10 Court staff should be able to direct members of the public to the correct courtroom

KPI 11  Paper-based listings should be displayed in courts – on entry and on the courtroom door, indicating the number/name of the hearing and the correct room number.   (I think this is actually already required in theory, but it clearly isn’t happening in practice). 

KPI 12 When observers attend physical courtrooms, staff should be proactive in considering access needs.

E. Remote observation and livestreaming

Supporting public access to remote court hearings needs to start by improving the listings (see section C above) – since we can’t email asking for the link if we don’t even know that a hearing is happening.

Then someone needs to answer our emails promptly and send us the link. Very often, nobody replies to emails (or phone calls) requesting access, or responses come too late, after the hearing is started, or after the hearing is finished. 

Here’s an example. I tweeted about this case because I was pleased to see that a hearing before a Tier 3 judge (on circuit in Teesside) was properly listed in the Court of Protection list: that’s a rarity (see Section C above).  But then dismayed to find that despite two emails and a phone call (unanswered), I was unable to gain access.  

I don’t take not getting a reply personally – I’ve seen how common it is and appreciate that the root cause is understaffing, but I have spoken to members of the public who’ve requested access to hearings (often on multiple occasions) and had no response – and some of them do take it personally, and it creates a very negative impression of open justice in the COP.  This negative experience has particularly affected members of the public who wanted to observe COP hearings because they are family members of vulnerable people involved in Court of Protection cases – and were left feeling that they were excluded because of their own family COP hearings.  I’m fairly certain that this was not the case (apart from anything else, it would require an unusual level of organisation and cross-checking) – but this (recurrent) experience creates a very poor public relations effect.

In the case described above (before Mr Justice Poole) court staff sent an email later, after the hearing was finished, apologising for having been “unable to process your request in time” and saying “sorry for the inconvenience”.  I responded to what I experienced as this rather ‘casual’ approach by explaining that failure to admit a member of the public to a “PUBLIC” hearing is not so much a personal inconvenience as a derogation from a fundamental principle of justice in a democratic society.  To be fair, I expect the office was understaffed and he had a million other things to do that morning. I know that when tasks have to be prioritised, open justice never seems to be near the top of the list.  The solution might be to fund the justice system better and to employ more staff (and address their training needs).

Judges also sometimes delay giving us access to public hearings (or refuse it altogether) based on misguided efforts to ‘screen’ observers.  Some examples:

  • Recently I’ve been asked by a couple of different judges to confirm that I’m an accredited journalist or legal blogger as the ‘price ‘of admission.  This is an unintended consequence of the Transparency Pilot in the Family Courts, which has backfired on transparency in the Court of Protection. (For one such example, see Just another failure of open justice: DJ Bland in Lancaster County Court.)
  • Several judges have asked would-be observers to provide their reasons for wanting to observe, or asked for home addresses (for remote hearings!), or demanded the name of the would-be observer’s employer. 
  • One judge, whose hearing had been listed as “public”, circulated my request for the link (which he treated as a request for ‘permission to observe’) to the parties in advance of the hearing asking for their views. He didn’t hear back from them before the hearing, so didn’t arrange for me to receive the link.  
  • One judge sent a message saying that I could be admitted to the hearing if I downloaded, printed and signed an “attendance form”, which I was instructed to scan and return in advance of the hearing in ten minutes time. No “attendance form” was attached – and by the time this was sorted out he declined to admit me because I was late for the hearing. 
  • Complaints – from judges and court staff – that we ask “too late” to join hearings are quite common – where “too late” means after working hours the day before the hearing. They say they don’t have time to deal with our request.  But we usually can’t apply any sooner than that, because lists don’t appear until 4.30pm the day before.  We’re tried to explain this here: Why members of the public don’t ask earlier to observe hearings (and what to do about it)

Also, I spend a lot of time (up to an hour for some hearings) “waiting for the conference host to join” in the waiting room, anxious about whether or not I’ve been sent the right link (once I was on one link, the judge on another, and counsel on a third!), or whether anyone knows I’m there.  Hearings often start late and presumably (at least sometimes) the lawyers know this because the judge has told them, or the judge knows this because s/he gave the lawyers permission to start late in order to continue a pre-hearing meeting – but nobody tells observers. Some communication to let us know what’s going on would be helpful. Lots of observers give up and assume they’ve done something wrong and are not going to be admitted to the hearing.

This all has a chilling effect on open justice.

KPI 13.  When we email asking for access to a remote hearing, please could someone reply to our emails in advance of the time that the hearing is listed to start – even if just to say the hearing has been vacated or will be starting late.

KPI 14. Judges need to be clear about the Court of Protection rules for admission to public hearings.  We are not required to be accredited journalists or ‘legal bloggers’; we are not required to provide home addresses or names of employers, or give reasons for wanting to observe, or sign attendance sheets. 

KPI 15. My recommendation: If a hearing is listed as ‘public’, court staff should send us the link immediately (letting the judge know they’ve done so) without waiting for the judge to “consider our request” or “give permission” – since really, in the vast majority of cases, there is nothing to consider and no “permission” is required. I have also suggested to HMCTS that links could be published in the listings, thereby obviating the need for us to ask for them in the first place.  I didn’t understand the explanation of why this can’t be done.  If some consideration is, in fact, needed (e.g. if one party objects to observers, despite the fact that the hearing has been listed as public) then that consideration can happen at the beginning of the hearing and observers can be part of it – and then leave the platform, if necessary. 

F.  Public access to judgments

No. This is a particular problem when there is no oral ex tempore judgment in court. We’ve often been waiting for judgments to be handed down and then some days after a hearing finishes, the RCJ website listing tells us that the judge will hand down the judgment “in public” at 10.30am but there’s “no attendance”.  I think this just signals that this is the date and time at which a judgment is – or should be – “final” and therefore publicly available.  But it’s usually impossible to get hold of it.  I’ve been told many times that it will be published on BAIILI and/or The National Archives and I can read it then – and sometimes this happens within an hour or two of the judgment being “handed down in public” but sometimes it doesn’t happen for days or even weeks. It doesn’t make any sense to me for a list to say that a judgment is being handed down in public, but for it to be inaccessible to me for hours, days or weeks until someone puts it up on a public website.  I think I should be able to contact someone and get it at 10.30am.  Occasionally, the judge has specifically asked for it to be sent to me, knowing that I’ve been following the hearing (which is excellent), but I frequently pursue it without success.

On two occasions I’ve observed hearings before a Tier 3 judge (in both cases, Poole J) which dealt with ongoing matters previously decided before a less senior judge whose judgments had not been published.  I asked, in the interests of transparency, for these judgments to be made publicly available and Poole J acceded to my request and they are now accessible to everyone.  Publication of these two judgments  was very helpful in supporting public understanding of these two cases and was a very positive move in the direction of open justice.

KPI 16. When judgments are “handed down in public” (according to court listings) they should be available to members of the public immediately

KPI 17. When a member of the public asks a judge to consider publication of a judgment, that request should be taken very seriously.

G. Access to Court Documents

I regularly seek access to court documents in order to help me follow a hearing and to support accuracy of reporting.  

I request the skeleton arguments, or position statements, prepared in advance by the parties – since these usually underpin oral argument in court, even when they are not explicitly referenced.  These are rarely offered – but when I request them, I tend to get them more often than not.   As was said two decades ago, “ … the principle of open justice leads inexorably to the conclusion that written skeleton arguments, or those parts of the skeleton arguments adopted by counsel and treated by the court as forming part of his oral submissions, should be disclosed if and when a request to do so is received.” (Howell & Ors, v R. [2003] EWCA Crim 486 (28 February 2003)).  

I’ve also requested final orders from public hearings – to which I believe I am entitled as a matter of law.  It’s actually quite difficult to get these (compared with Position Statements) because the final Order isn’t approved by the judge on the day of the hearing, but several days later, by which time the judge (and the lawyers) have turned their attention to other matters and forget that I’ve asked.  

Other documents I’ve been sent on request include: written closing statements, an EasyRead version of “what this court case is about” prepared for a P with learning disabilities; stand-alone “Summaries of the Case Law” documents (agreed by all parties); a restraint plan; and witness statements from family members who wanted to share them.  

Court documents always help my understanding of the case and provide richness and texture to my reports.

KPI 18. If we ask for court documents, they should be sent in a timely fashion. If anonymisation is required, do it before the hearing so as not to create delay.

It’s worth noting that (for remote hearings in particular) we often don’t receive Transparency Orders – the injunction the court is supposed to serve on us regarding reporting restrictions. I only ever receive them for about 50% of hearings. Another member of the core Open Justice Court of Protection Project team has gone systematically through the 38 hearings (across 32 cases) that she’s observed: she has 14  (= 38%).  One important reason for the failure to send Transparency Orders to members of the public is because it does not seem to be anyone’s (agreed) job.  According to Senior Judge HHJ Hilder, “It is not Counsel’s role to provide orders. This is an HMCTS role.”, HHJ Hilder, Item 8 Minutes of COP User Group meeting, 20 April 2022), but when I’ve asked court staff, I rarely get them: either there’s no response at all, or court staff say they don’t have them and I should ask the judge. In practice, when I do get them, they’re overwhelmingly sent by counsel.  Other practical impediments to sending us Transparency Orders include: nobody knows how to separate out the Transparency Order from the rest of the electronic bundle; and (absolutely routinely) counsel and their instructing solicitors have the Transparency Order, but not the observers’ email addresses, while court staff have the observers’ email addresses, but not the Transparency Order. Counsel sometimes ask me to forward Transparency Orders to other observers (on the false assumption that I’ll always know who the other observers are).  I don’t know why this hasn’t been sorted!

KPI 19. Transparency Orders should be sent to all observers – we need to be clear about what the reporting restrictions are. In order for this to happen it needs to be part of someone’s job description and there needs to be a practical mechanism for doing it. 

H.  Public legal education

My experience is that the public has very little understanding of the justice system, and that this applies even to people working with the Mental Capacity Act 2005.  We have learnt a huge amount ourselves in running this Project.  

People struggle with understanding the language and concepts of the court – and also taken-for-granted aspects of court protocol, such as the order of speaking, the role of cross-examination, the function of expert witnesses, even what constitutes a judgment.  There’s a huge amount of public education to do here.  

One of the core team members of OJCOP, NHS Consultant Clinical Psychologist Claire Martin says: “Absolutely not! I don’t think professionals know very much either – especially in the health service, which is my area of knowledge.  We get very little training on the Mental Capacity Act 2005 and unless you are working with capacity all of the time – and involved in CoP, which most people aren’t, even if they use the MCA regularly – you won’t know much!  My experience of observing the COP has taught me how little I knew beforehand.  Unless you really make it your business to educate yourself, the baseline way of operating is with a global view of ‘capacity’ – I can’t count how many times I’ve read in patient notes, from medics as well as nurses, that someone has/does not have ‘capacity’ –  and with ‘best interests’ operationalised as ‘what I/we think is best for this person’”. 

On contempt of court in particular, this is something I am still learning about three years on.  As part of my commitment to working effectively on this Project, I’ve done an online course on media law (aimed at journalists) which left me with the impression that (since our Project doesn’t cover jury trials) there were minimal risks of anything we write unfairly influencing a court case.  My media law course, like  the government’s own website focused on criminal hearings.  Then I got an e-mail from Mostyn J suggesting I may be in contempt of court for publishing a blog post (by another member of the public) expressing opinions about a hearing before him while proceedings were still active. The judge suggested that there was “a not insubstantial (but real) risk …  that the course of justice in the proceedings would be impeded or prejudiced, in that the mind of the court may have been subconsciously influenced on reading the post”.  Partly as a consequence of that experience, I decided, at a subsequent fact-finding hearing (before Hayden J), against publishing a blog post  in which members of the public expressed opinions about the ‘evidence-so-far’ from witnesses, until all the witnesses had completed giving evidence (Adjournment and interim judgment – Hayden J’s fact-finding hearing).  I’m still not sure how ‘contempt of court’ might operate (or not) in either case – but it’s all been very educational, and something I am blogging about, thereby also supporting public education on ‘contempt of court’.

From the perspective of our Project: the existence of the Court of Protection and its role, why and how to make applications, what happens if you find yourself as a party especially as a LIP)or as “P” (there’s very little accessible information about this); the ‘inquisitorial’ rather than ‘adversarial’ nature of the court; its dependence on the MCA 2005.  And all the individual details that make up a court hearing, most of which diverge markedly from the (largely American, largely criminal) trials that pervade the media. 

Judges are increasingly taking the time to explain terminology and concepts, to read out (or display on screen) crucial evidence, and generally taking care to facilitate and support public understanding. This takes time and commitment. It has to be subordinated to, and run in parallel with, the substantive business of the hearing. It’s evolved over time, as a collaborative effort between those of us who want to learn, and members of the judiciary and lawyers who are sufficiently committed to open justice to help us with that.  It’s a long way from the ‘fly on the wall’ notion I started out with at the beginning of the Project.  

KPI 20. Every court hearing is also an opportunity for public legal education. Use it!

I.  Closing Summary

Nothing in this document should lead readers to underestimate the huge amount of time and effort that lawyers and the judiciary (plus staff) of the Court of Protection have expended on open justice – both before and (especially) after the founding of our Project.  Nonetheless, I have become concerned that the success of the Open Justice Court of Protection Project might lead to a sense of complacency – that the requirements of open justice are apparently met, as evidenced (for example) by our blog posts.  I hope that by exposing what it takes to run the Project and the ‘workarounds’ we rely on to make any of this happen, the systemic failures of open justice can become clear – not in spite of the Project’s achievements, but because of them.  

If the 20 KPIs listed in this document were met (and some of them are already!)  the experience of members of the public observing hearings in the Court of Protection would be immeasurably improved.  Meeting these 20 KPIs (or just most of them) would go a long way towards practical implementation of the judicial aspiration for transparency and open justice in the Court of Protection.  

KPI 1.  List the hearing in the COP list on Courtel/CourtServe (or whatever replaces it – where ever is displayed what is supposed to be a comprehensive list of COP hearings).

KPI 2. Make it clear the public can attend.

KPI 3. Tell us how we can observe (i.e. remotely /in person – is it hybrid? if remote is it phone or video-link (MS Teams or CVP)?.

KPI 4. Supply correct contact information.  

KPI 5. Tell us what the hearing is about.

KPI 6. If the court is going to hold hearings with the deliberate intention of excluding one party (usually a family member) (‘closed hearings’), there needs to be more public accountability for this so that we at least know that it is happening, how often, and why (e.g. an annual report covering the number and nature of ‘closed’ hearings, and the reasoning behind them).

KPI 7. Hearings at which the court is deciding whether or not an alleged contemnor should be sent to prison should normally be listed in accordance with the Practice Direction, held in public and a judgment published.  

KPI 8. The courts should be properly resourced so that there are trained staff available first thing on the morning of a listed hearing to answer questions about whether it is actually going ahead or whether it has been vacated.

KPI 9. Court staff should remove any signs on courtroom doors stating that hearings are PRIVATE when they’re not.  We recommend replacing it with a sign that says “THIS HEARING IS IN PUBLIC. EVERYONE IS WELCOME TO COME IN”.  

KPI 10. Court staff should be able to direct members of the public to the correct courtroom

KPI 11.  Paper-based listings should be displayed in courts – on entry and on the courtroom door, indicating the number/name of the hearing and the correct room number. 

KPI 12. When observers attend physical courtrooms, staff should be proactive in considering access needs in relation to disabilities and more broadly.

KPI 13.  When we email asking for access to a remote hearing, we should get replies in advance of the time that the hearing is listed to start – even if just to say the hearing has been vacated, or will be starting late.

KPI 14. Judges need to be clear about the Court of Protection rules for admission to public hearings.  We are not required to be accredited journalist or ‘legal bloggers’; we are not required to provide home addresses or names of employers, or give reasons for wanting to observe, or sign attendance sheets. 

KPI 15. If a hearing is listed as ‘public’, court staff should send us the link immediately (letting the judge know they’ve done so) without waiting for the judge to “consider our request” or “give permission”.

KPI 16. When judgments are “handed down in public” (according to court listings) they should be available to members of the public immediately

KPI 17. When a member of the public asks a judge to consider publication of a judgment, that request should be taken very seriously and acted on unless there are good reasons to the contrary.

KPI 18. If we ask for court documents, they should be sent in a timely fashion. If anonymisation is required, do it before the hearing so as not to create delay.

KPI 19. Transparency Orders should be sent to all observers – we need to be clear about what the reporting restrictions are. In order for this to happen it needs to be part of someone’s job description and there needs to be a practical mechanism for doing it. 

KPI 20. Every court hearing is also an opportunity for public legal education. Use it!

***********

Celia Kitzinger is co-founder of the Open Justice Court of Protection Project and has personally watched more than 470 Court of Protection hearings since 1 May 2020. She is a prolific blogger. She is on LinkedIn (here), and tweets @KitzingerCelia


[1] For example: Loomes-Quinn, G Flying under the radar: Experiencing the Court of Protection transparency pilot as an academic researcherThe Transparency Project. 22 October 2017; Kitzinger J & Kitzinger C. (2017) Why futile and unwanted treatment continues for some PVS patients (and what to do about it) International Journal of Mental Health and Capacity Law. pp129-143; Kitzinger, J, Kitzinger, C & Cowley, J (2017) When ‘Sanctity of Life’ and ‘Self-Determination’ Clash: Briggs v The Walton Centre NHS Trust & Ors [2016] EWCOP 53,  Journal of Medical Ethics, 43:446-449; Kitzinger, J & Kitzinger, C (2016) Causes and Consequences of Delays in Treatment-Withdrawal from PVS Patients: A Case Study of Cumbria NHS Clinical Commissioning Group v Miss S and Ors [2016] EWCOP 32Journal of Medical Ethics, 43:459-468.

[2] See also the following blog posts covering occasions on which I, as a  member of the public, made submissions in court to request variations to reporting restrictions:  He’s Polish: Challenging reporting restrictions (before Cohen J – varied to enable reporting of P’s nationality); Prader-Willi Syndrome and Transparency (before Theis J – varied to enable reporting of P’s diagnosis); Predatory marriage and coercive control (before Roberts J – challenged a retrospective reporting order, see §108-§110 of her judgment which deals with this); Naming a putative ‘expert’ in a Covid vaccination case: A letter to the judge (before Deputy Circuit Judge Rogers – granted permission to name the ‘expert’); Reflections on open justice and transparency in the light of Re A (Covert Medication: Closed Proceedings) [2022] EWCOP 44  (before Poole J – addressed concerns relating to an interim RRO prohibiting reporting of covert medication). Another member of the core OJCOP group, Daniel Clark, has also addressed reporting restrictions in court and will blog about this shortly.

Capacity to consent to sexual relations: “I want my freedom back”

By Amanda Hill, formerly ‘Anna’ , 3rd September 2023

When I saw this case listed, I didn’t fully appreciate the complex issues it would cover, especially about the difficulties of ensuring that somebody who is used to going out independently can do so safely – and the role that technology might play. 

At the heart of this case is a woman I’ll call Sarah (I find the term P too anonymous and I like to try and visualise the person behind the letter P).  Sarah is a 41-year-old woman diagnosed with Asperger’s syndrome (a form of autism), bipolar affective disorder, atypical anorexia nervosa, obsessive compulsive disorder and severe anxiety.  She’s living in supported living, and she’s been accustomed to having a good degree of autonomy, including being able to go out into the community by herself. 

However, there are now concerns about a man she has met who may have “groomed and sexually exploited” her, and it has been suggested that she may lack capacity to decide on contact with others and engage in sexual relations. This is the third time over the last few years that she has been exploited by a man. An initial assessment by her social work team was that Sarah “was unable to understand, retain and use/weigh relevant information relevant to the decision” to engage in sex. There is now an ongoing criminal case against the man and concerns for her safety. 

After this, and without court authorisation, the local authority increased the 1:1 provision of carers, and prevented her from going out in the community alone. She objects to these restrictions on her freedom. Observing these hearings highlighted to me the practicalities of managing the difficult balancing act between the principle of autonomy at the heart of the Mental Capacity Act 2005 and the principle that vulnerable people in society must be protected. 

The case (COP 14088706) was listed with the subject matter as ‘Capacity to Consent to Sexual Relations’. I don’t have much knowledge about the law in relation to capacity for sex (I’ve learnt a lot writing this blog post) and it wasn’t because of the topic that I chose to observe this hearing.  Rather, in my role as a core team member of the Open Justice Court of Protection Project, I am focusing on hearings in the South East Regional Hub where the lead judge is HHJ Owens and, as she was the judge in this hearing, I thought I would observe it. The hearing did cover other areas that I do have a particular interest in, such as the role of Litigants in Person and Deprivation of Liberty – and, having previously focused largely on s.21A cases, because this is what my own mother’s case was about, I’ve discovered that I can learn a lot through observing COP cases concerning a variety of different issues. 

I’ve observed two hearings in this case: one on Monday 17th July 2023 and another on Wednesday 9th August 2023. I received the Position Statements (PS) for both hearings from Oliver Lewis after the hearings, which greatly enhanced my understanding and which I have drawn upon when writing this blog. In fact, without them, I don’t think I would have really understood the case at all.[1]

1. Hearing of 17th July 2023

Access was straightforward and I was sent the Transparency Order in advance. The Clerk gave me access to the video-platform at 1.55pm (for a 2.00pm hearing). There were already a number of people attending. I could see Oliver Lewis of Doughty Street Chambers who was Counsel for Sarah via her litigation friend, the Official Solicitor (OS); Sebastian Elgueta of Garden Court Chambers who was Counsel for the Local Authority (LA); and two people who I learned were Sarah’s parents. Various other people joined after me, including the solicitor for the LA, the solicitor for the OS, a trainee solicitor and Sarah’s social worker. Sarah was not present, either at this hearing or the following one, I don’t know why. This means that we didn’t hear her voice directly. The clerk asked everybody in turn (including me) to confirm that they could see and hear him. I turned my camera and microphone on so he could see me, and I replied I could. Then I switched my camera and microphone off. 

Then something happened that quite surprised me. Before the judge joined the platform, Oliver Lewis spoke directly to Sarah’s parents (who I shall call Dr and Mrs G) and because they had not taken part in pre-hearing discussions, asked them if they would like to be joined formally as parties to the case. They asked him to explain what that meant. This is something I know a bit about, as I asked to be joined as a party for my mother’s case, as I wrote about here. I was interested to know how it would be explained.  Oliver Lewis explained that Sarah was a party to the case and had a litigation friend to represent her.  They, her parents, were currently not parties to the case and so were not automatically entitled to receive all the information relating to the case (“the bundle”) or have their opinions heard. If they were joined as parties, they would play an integral role in the proceedings. Dr and Mrs G said that they would like to be joined as parties. Oliver Lewis explained that it would be up to the judge whether they needed to fill out an application form or if the judge could decide that they could be parties without the need to fill in the form. He then went on to explain that the hearing was about appointing an independent expert to determine capacity for “a range of capacity issues”. Mrs G said that the explanation was “very helpful”.

He then explained that the expert could cost between £2,000 and £3,000 and the cost would normally be shared between the parties, so that was a potential disadvantage to becoming a party. But if they didn’t have the means to contribute, they could ask the judge to excuse them from paying. (NB: In that case, the cost would be divided between the LA and Sarah, who is in receipt of Legal Aid). Oliver Lewis apologised to the parents for the “technical” nature of “all this”.

At 2.05pm the judge joined and made some introductory remarks about this being a formal hearing in a courtroom (even though it was online). She said that there was an observer present and reminded everyone about the Transparency Order preventing Sarah from being identified.

She next addressed the issue of Sarah’s parents becoming parties to the case, explaining (as had Oliver Lewis) that they would not be entitled to see all the documents if they were not joined as parties. Dr G said “We would like to ‘join’, if that’s the right word, but we are worried about the cost”. I thought at this point he was referring to the point made before the judge joined about the cost of the expert. However, in her reply, the judge referred to them not needing formal legal representation and that the court could assist Litigants in Person. She said “You are known as a Litigant in Person and we have an obligation to help you”.[2] The parents stated that they did want to be joined as parties. The Judge said it was clear that the parents have a personal interest in Sarah and what happens to her and she could see the benefit of them being involved. She waived the requirement for a formal application and said they would be joined as parties from that point on. As they had not been parties before the hearing, they had not seen “the bundle” of documents –  so she asked Sebastien Elgueta to explain what the hearing was about. He apologised for not having formally submitted a draft order, and he then set out what would be in it. 

As far as I know, there is no easy leaflet or resource for families on becoming an LIP in the Court of Protection, which I think would be really useful. I certainly wanted to feel fully informed before I became a Litigant in Person. 

Some points about the style of the hearing

There were some IT issues during this hearing. At one point, Sebastian Elgueta dropped off the call (later apologising for the “IT meltdown”) and the judge rose for a few minutes and left the video platform. While we were waiting for her to return, Oliver Lewis spoke to Dr and Mrs G: “Are you OK? Is there anything you want to ask?” I thought this was very thoughtful of him. The judge and Sebastian Elgueta re-joined the call a few minutes later. Oliver Lewis gently pointed out to the social worker that she was not on mute. HHJ Owens was also very sympathetic to Sebastian Elgueta about his IT problems. The way that this episode was handled indicates the generally amiable spirit that the case was conducted in, which I think helped discussions in what are very difficult circumstances. 

As a family member myself in COP hearings, I was interested in how the parents were treated. At points, I suspect reference to sections of the Mental Capacity Act 2005 would have been difficult for the parents to follow. At one point Dr G stated that Sarah’s mental health would decline if “getting an assessor (if that’s the right word)…..” took a long time, showing that language very familiar to professionals can be more difficult for lay people in the court to understand. That’s why it’s so important to explain things simply for parties who are lay people, something that can be lost with the time pressure of a hearing. Overall, I thought the parents were treated very well in the hearing, particularly by HHJ Owens and Oliver Lewis.  Interactions were personable and done in a way to put people at ease. Even I was made to feel welcome as an observer. In my experience, this is a common feature of the COP, although obviously it is dependent on the personalities and style of the legal teams and the judge. 

The substance of the hearing: Capacity to engage in sexual relations

Given that this case raised potentially very serious issues, the judge explained that she had had a gatekeeping concern which she took to the Vice President of the COP in early June 2023. There were question marks about Sarah’s capacity to make decisions about contact[3] with the man she was seeing (whom I shall call Mr Grey) and the risk he posed (which was information that would come from the police). The position of the Official Solicitor was that there seemed to be uncertainty as to what exactly the LA were asking the court to approve at this hearing, but the OS was concerned about how much Sarah’s autonomy was restricted in order to protect her. Sarah wants to continue to see the man, even if it is with a support worker. 

Reading the PS of Oliver Lewis on behalf of the OS, I understand that the OS agreed that on the basis of an assessment done by a social worker, there was sufficient evidence to cause the court to have reason to believe that Sarah lacked capacity to engage in sexual relations. However, the OS disputed that there was good enough evidence to override the presumption of Sarah’s capacity in other areas, such as decisions relating to her residence, to consent to her ‘de facto’ deprivation of liberty, or to make decisions about contact with others, including Mr Grey.  

So, although the hearing was listed as “Capacity to engage in sexual relations”, it became clear that it was about capacity to make decisions in various other domains as well. The OS was seeking to ensure that the LA’s view that Sarah lacks capacity for sex wouldn’t lead to an unlawful restriction of her rights in other areas. It seems that the OS was trying to ensure each domain was considered appropriately.  And it was all urgent as imposing new draconian restrictions on someone’s liberty, such as an increase in 1:1 support hours for Sarah (to 105 hours from 48 previously) can’t be justified unless they’re absolutely necessary.

Therefore, the OS submitted on Sarah’s behalf that “there needs to be a comprehensive capacity assessment carried out by an independent expert (if there is no person in the local Trust able to do a report under s.49, and enquiries are being made) to assess capacity to make decisions about (a) residence, (b) care, (c) contact with others, (d) engaging in sexual relations, and (e) contraception”.

On behalf of Sarah, Oliver Lewis said (in his PS): “It is unfortunate that (Sarah’s) freedoms on a daily basis are proposed to be curtailed because of the sudden appearance in her life of (the individual). The Official Solicitor invites the court to scrutinise the necessity and proportionality of the proposed care arrangements.”

It was also stated that the individual is the third man who seems to have posed a risk to Sarah as a vulnerable adult in the last few years. 

I wasn’t entirely sure what ‘Capacity to engage in sexual relations’ covers but it is a fundamental principle of the Mental Capacity Act 2005 that each person is presumed to have capacity unless it is established that they lack capacity ( s.1(2)) and a lack of capacity to make a decision cannot be established simply by reference to some ‘condition’ that a person has (e.g. mental illness) (s.2(3)(b)).  It must be shown that the “impairment of, or a disturbance in the functioning of, the mind or brain” (s.2(1)) causes the person to be unable:

(a) to understand the information relevant to the decision,

(b) to retain that information,

(c) to use or weigh that information as part of the process of making the decision, or

(d) to communicate his decision (whether by talking, using sign language or any other means). (s. 3(1) MCA 2005)

The courts have warned about setting the bar for capacity for sex too high since this could operate as an unfair, unnecessary and discriminatory bar against mentally disabled people. It’s also been stated that the person must understand the salient information but it is not necessary for them to understand all the peripheral detail (LBC v RYJ [2010] EWHC 2665). 

What counts as ‘relevant information’ depends on the decision being made and the circumstances of the case.  In relation to sexual contact, a recent decision by Lord Justice Baker in the Court of Appeal (A Local Authority v JB (Rev 2) [2020] EWCA 735) found that the relevant information includes: the mechanics of sexual intercourse, the fact that both people must have capacity to consent (and must in fact consent), that pregnancy is a reasonably foreseeable consequence of (heterosexual) intercourse, and that there are health risks involved such as sexually transmitted diseases, the risks of which can be reduced by use of precautions such as a condom.”

This is for capacity to consent on a “generalised” basis. The Supreme Court in Re JB also made clear that different consequences would arise if there was a person-specific decision to be made, such as in the case of  Hull City Council v KF [2022] EWCOP 33 (see also this blog post: Capacity to have sexual relations with a specific partner: In the matter of Hull City Council v KF [2022] EWCOP 33; and the very useful Mental Capacity Guidance Note from 39 Essex Chambers.

The following issues were also discussed during the hearing.

  • Appointing an IMCA for Sarah. Oliver Lewis proposed that an independent mental capacity advocate (IMCA) be appointed for Sarah as “even if her parents love her very much”, Sarah might not want to discuss her sexual relations with them. The judge agreed and said it could be “vice versa” too. I found this a very human exchange. I learned afterwards that IMCAs were introduced by the Mental Capacity Act 2005 (ss. 35-41) and their role is to support and represent the person in the decision-making process. 
  • Sarah’s mental health. At various points during the hearing, issues were raised showing concern for Sarah. Her parents said they were worried about the impact on her mental health of more delays in the assessment. Also, it seems that Sarah has to be accompanied at all times by a carer, even going to a café, and her parents were concerned that this was depleting her financial resources as she had to pay for the carer’s travel and coffees. Later in the hearing, after the judge had left to consult her listings team, Sarah’s solicitor returned to this point and suggested that the care should be provided within her existing care package. The parents confirmed that it was actually the additional cost of the coffee and meals for the carers that she was obliged to pay for. There was also a discussion about whether the police would be called in a particular situation, which was proposed by the LA in the draft care plan. Sarah’s parents said that she was terrified of the police as she had been chased by them once and she had found it very traumatic. On one occasion, they said, it had resulted in her being sectioned.  The judge talked about necessity and proportionality of calling the police and it was removed from the care plan. 
  • Urgency vs practicalities. It was clear that getting the care needs assessment (and a care plan proposed) was urgent as this had implications for the DOL. This was partly for Sarah’s mental health but also for her protection. After much discussion, HHJ Owens authorised 21 days for the identification of the expert to determine capacity, so that they could be appointed by the judge, and for a new care plan to be drafted in time for the next hearing on Wednesday 9th August 2003. 

2. Hearing of 9th August 2023

On requesting the link the evening before the hearing, I was surprised to get a quick reply from the Administration Officer, telling me that HHJ Owens had asked her to let me know that there was a doubt over the start time but they would clarify the situation the following morning. Mid-morning the following day, the Administration Officer got back to say the hearing was to be in two parts:  the first part, to start as listed at 2pm and to last 45 minutes, was going to be an “injunction application subject to reporting restrictions” and then the second part of the hearing was to last 95 minutes, being the “main COP proceedings, again subject to reporting restrictions”. I checked whether I could observe both parts and was told I could.

I was shortly sent the link and a new Transparency Order (TO). The difference between this one and the previous one was that not only could I not identify P, the protected party (Sarah) but also not the man who was to be the subject of the injunction (Mr Grey). 

Injunction application

I clicked on the link a few minutes before 2pm and was soon admitted to the hearing. This time I could see the clerk and another person in a physical court room. The clerk again asked me to confirm that I could see and hear him, which I did, before turning my microphone and camera off. Unlike the previous hearing, nobody else joined until 2pm and then nearly everybody else joined at once. I soon gathered that this was because there had been a pre-hearing meeting attended by most of the others. Most people were using the Cloud Video Platform and included: 

Oliver Lewis representing Sarah via her litigation friend, the Official Solicitor (OS)

Avril Rushe, Counsel for the LA (replacing Sebastian Elgueta, who was at the previous hearing).

Dr and Mrs G (Sarah’s parents and Litigants in Person)

There were also two instructing solicitors, Sarah’s Social Worker, and a mini-pupil with Dr Lewis. 

There was also a man who had joined by telephone: Mr Grey. 

Each person in turn was asked to confirm they could see and hear the Clerk. Then, at 14.08, HHJ Owens, the judge, joined the hearing. 

Once again, the judge started by telling everyone that they should behave as if it was a physical hearing, that there was a TO in place and there should be no recording of any sort allowed. She stated that there was an injunctive order affecting this hearing, Mr Grey was not to be identified, there was a police investigation under the Sexual Offences Act going on in the background which was outside her jurisdiction. 

This was a very stern warning given by the judge and my impression was this was so that the police investigation would not be compromised. HHJ Owens asked Mr Grey to confirm that he understood he was the subject of injunctive relief, and of the TO, which prohibits identification of Sarah and himself. She also mentioned that I was a member of the public and an observer, that I had been sent the TO and had observed the previous hearing – but I wasn’t asked to confirm this orally. 

In her introductory summary, Avril Rushe explained that this was an application for an injunction against Mr Grey under s.16 of the Mental Capacity Act and the jurisdiction of the Court of Protection (COP) was the test of whether it is just and convenient for an injunction to be made against Mr Grey because he was a risk to Sarah. There was an ongoing police investigation against Mr Grey for alleged sexual assault against Sarah. He is on bail with a condition that he is not to contact Sarah, which is due to expire at the end of August and that may be extended. However, the bail conditions by the police were less robust than those that could be imposed by the COP, so they are asking for a court injunction against Mr Grey. There had been a wide-ranging injunction proposed originally but they were now proposing a “pared back” injunction as that would be more proportionate.  This was that Mr Grey: 

  1. Must not speak to, call, text, email, or contact via social media (etc.) Sarah or any person involved in her care 
  2. He must not enter any property he believes Sarah would be in. 

An open injunction was asked for (I gather this means with no fixed ending). 

HHJ Owens asked about prohibiting Mr Grey from contacting Sarah via a third party. 

Avril Rushe said that this was not being sought because there was no evidence of Mr Grey attempting to use a third party to contact Sarah. 

The judge then stated that there was no current evidence, but what if that changed? She then asked Avril Rushe if Mr Grey could make oral submissions to the court and Ms Rushe confirmed that he could and that he had not seen the new terms of the proposed injunction. 

The judge then asked all parties involved in the main Order to speak and said that after that she would hear from Mr Grey.

There was then a discussion because Oliver Lewis had not been sent the version of the Order that the judge had in front of her, so the judge offered to read out the new version of the Order that she was being asked to approve: 

The proposed injunctive relief Order warns Mr Grey that he will be in contempt of court, which means he could have his assets seized, be fined or sent to prison (or all three, as she emphasised). Once the court has heard from all the parties and oral submissions from Mr Grey, the court decided that it is in Sarah’s best interests not to have any contact with Mr Grey and that he must not speak to, email, text or contact Sarah or any person involved her care and must not enter any property she is likely to be in, and the injunction would last until further order of the court. 

She then asked if there was anything else on behalf of the OS. Oliver Lewis asked that full names be included rather than abbreviations in the order, to avoid any confusion for Mr Grey. HHJ Owens said that would be no problem and with the TO in place that would avoid issues with identification. 

HHJ Owens then asked Dr and Mrs G if they wanted to say anything about the injunctive application and they replied “No, thank you”. 

The judge then turned her attention to Mr Grey. She went through what he was being prohibited from doing and he replied “I won’t speak to her, I won’t have anything to do with social workers, I won’t be going to her home or place of work so I agree with them”. 

HHJ Owens then stated that “It goes a little wider than that”. She reiterated that he should not speak, telephone, or attempt to contact Sarah in any way whatsoever, including Facebook, even via friends and in indirect form.” She also asked Avril Rushe whether as well as the social workers, should it be specified that Mr Grey be prevented from contacting Sarah’s parents? Avril Rushe confirmed that – and HHJ Owens stated that she would change the injunction accordingly. 

She then returned to Mr Grey. 

And Mr Grey, any premises where you believe she might be. So, if you believe she could be anywhere, you must walk away”. 

Mr Grey said “I understand”.  

The judge then confirmed that the order would be “indeterminate” and he replied “Yes, I agree, as it’s not going to happen”. 

HHJ Owens then said “That’s good, but the Order says that you mustn’t do it” and once again she outlined about contempt of court and what that entails. 

She continued “So, Mr Grey, thank you for agreeing to this. I am satisfied that it is in Sarah’s best interests not to have contact” and then referred to wording that would be slightly different to the draft order. 

She stated that “Mr Grey is prohibited from attending any further public hearing” so as to protect Sarah. 

Mr Grey was then disconnected from the hearing and the Clerk confirmed that he was no longer present. 

At this point, HHJ Owens suggested to Avril Rushe that she would need a sealed copy of the order sooner rather than later so she would rise to re-write it, and ask the COP hub to issue it so that it could be issued to Mr Grey as soon as possible. Avril Rushe confirmed that this would be “greatly appreciated”. HHJ Owens rose at 14.32. 

She came back at 14.53. This time there were no discussions between the other attendees as everyone waited, some with cameras on and some with cameras off. On her return the judge confirmed that she had “perfected” the injunction, emailed the draft approved order to the hub and rang them to ask them to do it quickly and for the TO “to be appended”. She finished with that hearing by thanking everyone for their patience but “I thought it was important to deal with it now”.  

At this point the court moved on to the “substantive hearing” about welfare. 

I had never observed a hearing where an injunction had been placed on somebody, not least when they were present. I was conscious of how the need to keep Sarah safe and as quickly as possible was paramount, to the extent of HHJ Owens ensuring the injunction could be served immediately. The judge was very clear to Mr Grey about what would happen if he ignored the injunction. 

Committal hearings for contempt of court in the COP are rare but the Project has blogged about a few (e.g.  A committal hearing to send P’s relative to prison – and the challenges of an in-person hearingCommittal hearings and open justice in the Court of Protection).

Case management

This second part of the hearing essentially comprised two elements:  the appointment of an independent expert acceptable to all parties and Sarah’s care and support plan. 

Appointing an independent expert

The first element was non contentious. An independent expert (Dr Camden-Smith) had been identified who had agreed to do the assessment and provide a report for the beginning of November 2023. I learned from the PS that the letter of instruction would be written within a week of the court “agreeing the identity of the expert”.  There was some discussion about what would be included in the letter of instruction, including asking the expert to diagnose whether Sarah has a learning disability – which is important because she does not currently have such a diagnosis and is therefore excluded from some health services such as sexual education. 

The OS’s PS shed further light on what exactly the expert was being asked to report on and the following paragraph caught my eye: “In addition to the capacity assessment and review of diagnoses, the Official Solicitor seeks from Dr Camden-Smith an opinion as to steps the carers and the family could take to encourage Sarah to engage with activities for a sustained period, so that she builds her skills and has meaningful activities to look forward to on a weekly basis. This would decrease the risk that she rides around on buses on her own where she has now been groomed by three different men.” This underlines to me how important the role of the independent expert is and how much finding the right person counts as the impact on Sarah’s future, both in terms of freedom and safety, is immense. It also highlights to me the vulnerability of women like Sarah, who strive to live freely but may not appreciate how at risk they are. 

Later on in the hearing, the judge scheduled a further hearing for 19th December 2023 to consider the report from the expert. But this meant that what should happen in the meantime had to be considered. Avril Rushe outlined that the LA was asking the judge to make best interests decisions under s. 48 of the Mental Capacity Act 2005, as there was ‘reason to believe’ that Sarah lacks capacity to engage in sexual relations (which would be confirmed or not by the expert’s report). The OS did not contest this and it was indeed ordered by the judge at the end of the hearing. 

A new care and support plan

The second element, Sarah’s care and support plan, proved to be a much more contentious issue. In order to try to protect Sarah when the incident with Mr Grey had occurred, the LA had increased the number of hours of 1:1 support from 48 to 105 per week, without the authorisation of the court. Sarah’s social worker had subsequently produced a new care and support plan outlining a gradual reduction in hours from 105 to 79 and eventually back to 48. But the OS was not happy with the plan and Oliver Lewis seemed somewhat frustrated with the way the case had been managed so far.  He said he and his solicitor were confused about “what is written in the care plan, what is being delivered and what is being proposed”. He wanted the LA to draft a new care and support plan that was much simpler than the current draft which was in the bundle. He went as far as to say that he and his instructing solicitor could not understand what the care and support plan was. “It’s a mixture of thoughts and intentions but does not set out needs and how care is to be put in place to meet those needs, so that the OS can understand and Sarah can understand”. The judge appeared to agree that the plan could have been written better as she said later that “The document as a whole….is not clear”.  And Avril Rushe representing the LA acknowledged that some of the details needed to be ‘fleshed out’

Oliver Lewis outlined that Sarah is a person who greatly values her independence and autonomy and is now distressed that she doesn’t have freedom. She has said “I want my freedom back”. There was concern that unless the situation was resolved quickly, it could have serious consequences for Sarah’s mental health, something both the OS and Sarah’s parents were very concerned about. She had previously been sectioned under the Mental Health Act and everyone wanted to avoid this happening again. But what could be done to protect Sarah whilst giving her as much freedom as possible? 

“Find my Device”: A technological solution? 

The proposed solution surprised and slightly shocked me, even though I can see why it was being considered: the use of technology via a GPS tracker. The idea was that Sarah’s whereabouts could be tracked, allowing her to go out independently but with a type of security blanket. Some of the 1:1 hours allocated could be used to monitor the tracker. This solution was supported by the LA, the OS and Sarah’s parents, even though there was disagreement as to the practicalities of how the tracker would be used. 

The social worker had met with technicians to discuss what was possible. It would show whether Sarah was near to places she had gone to with Mr Grey (his home and a particular pub) where she may be at risk. But it would not show if she was at risk in a new location. There was also a major concern about her using public transport to get to day activities or to spend time. It was agreed that Sarah had been groomed by three men on the bus over the past three years, and the LA wanted Sarah to be “chaperoned” on public transport, but the OS and Sarah’s parents felt that the use of technology would be the least restrictive option and more proportionate. 

Oliver Lewis proposed that the use of an app such as the android “Find my Device” could be the simplest to use. He stated something along the lines of “ …as many parents all over the world know – and I’m not equating her as being a child – but the Find my Device app could be adjusted so she does not switch it off”. Before the hearing, he had discussed with Sarah’s parents how it might work and that it could be used as a bargaining chip, as a price Sarah would have to pay to go out alone. “That might work”. The OS thought 48 hours of care should be returned to as soon as possible, as this is in line with the wishes and feelings of Sarah. With regards to the risk, the carers could use the extra hours to monitor her phone rather than going with her, and see if she goes to places where she is at risk. He said that it shouldn’t need much time for the technology to be sorted out. 

Urgency vs practicalities – again:  

There was then some discussion about how soon a new care and support plan could be completed and when the next hearing to consider it should be listed for. The OS wanted it as soon as possible given Sarah’s deteriorating mental health. But there were practical difficulties, given the social worker’s availability to draft the plan as well as the judge’s annual leave and whether judicial continuity was essential. The eventual decision was that the next hearing would be listed for 4th September 2023 and HHJ Owens would hear it.  (In the event, that hearing was vacated. I’ll keep a look out for when it next returns to court.)

In reaching this decision, the judge considered what was realistically feasible. She stated that there was a “tension between an ideal world and what was practicably achievable”. She directed the LA to provide a revised section of the care and support plan covering the use of technology. She stated that “None of us know what the impact of the injunction will be, regarding Mr Grey and Sarah” and- as had been flagged by Oliver Lewis in his PS – Sarah “reacts well to people in authority telling her what the rules are. The Official Solicitor suggests that it would reduce the risk of [her] seeking out [Mr Grey] if the judge or social worker phrases the best interests decision as a rule, by telling her “You must not try and find [Mr Grey]”. This may have the desired effect and would be a better way of ensuring that [Sarah] does not try to seek a meeting with [Mr Grey[.”

In consideration of the injunction, the LA was asked to reflect on what was proposed regarding technology as a replacement for 1:1 support or a partial replacement. The judge stated “none of us understand what might be practically achievable” as tracking on a phone only indicates location. But 1:1 support on public transport might function as a considerable restriction. Technology may answer that, as if it shows she is spending hours on a bus and at risk from men, then it might enable action to be taken so that she is discouraged from doing that. So, a key sticking point was not resolved during the hearing and it will be very interesting to see what is proposed in the revised care and support plan. 

One final point needed to be confirmed: Oliver Lewis asked HHJ Owens to confirm whether she was authorising the deprivation of liberty. HHJ Owens replied that, as she had alluded to, yes she was, there was a significant interference with Sarah’s right to liberty. Whether that would alter with a new care and support plan, there was still the issue of surveillance by technology, so it probably still would be. She asked whether he was raising the issue due to funding, as if there was no DOL, it alters funding.  

Oliver Lewis replied that there was no funding issue, as this was not a deprivation of liberty in a care home (which would be covered by the DoLS regime in Schedule A1 of the MCA, for which P is granted non means tested legal aid), but a community deprivation of liberty in a supported living placement (for which legal aid is available on a means tested basis) and means-tested legal aid was in place. After some final technical discussions, the hearing concluded. 

Final Reflections

The whole exchange about the proposed use of technology to enable Sarah to have more freedom to go into the community alone really made me think. As Oliver Lewis stated, many parents have become used to using smart phones to track where their children are. I also know families who use it to track where other family members are, even to the extent of knowing when to have dinner ready for. Or single friends using it to ensure that somebody has arrived home safely. Or family members living with dementia using “airtags” so that their families can see if they have started “wandering”. I have also read of smart phones sadly being used to enforce coercive control.  It seems as though tracking has become somewhat normalised in today’s world, for better or for worse. I wonder, how does this fit in with the law, especially with regards to the concept of Deprivation of Liberty? And the concept of “freedom”?

I also discovered something new about DOL. I had thought that it was restricted to hospital and care home settings, which can lead to s.21A appeals, as had happened in my mother’s case. But deprivation of liberty in the community was something I hadn’t heard of. 

I am very interested in finding out what steps will be put in place to help keep Sarah safe whilst giving her as much freedom as possible – and whether the injunction served on Mr Grey achieves its objectives. 

Anna was the pseudonym of a woman whose mother was a P in a Court of Protection s.21A application.  Since March 2025, Amanda Hill is allowed to reveal that she is Anna, because the Transparency Order covering her Mum’s case has been varied (changed). Amanda Hill is a PhD student at the School of Journalism, Media and Culture at Cardiff University. Her research focuses on the Court of Protection, exploring family experiences, media representations and social media activism. She is a core team member of OJCOP. She is also a daughter of a P in a Court of Protection case and has been a Litigant in Person. She is on LinkedIn (here), and also on X as (@AmandaAPHill) and on Bluesky (@AmandaAPHill.bsky.social). 


[1] I am also grateful to Celia Kitzinger for substantial feedback on earlier drafts and assistance in making sense of this case.

[2] The Equal Treatment Benchbook sets out this obligation  https://www.judiciary.uk/about-the-judiciary/diversity/equal-treatment-bench-book/

[3] I have learned that capacity for sex and capacity for contact are separate and are assessed separately.  It’s quite often found that P has capacity for sex, but not capacity for contact and this poses problems

Prolonging life or protracting death? An end-of-life decision by Hayden J

By Zach Moss and Jemma Woodley, 1st September 2023

At a hearing in the Royal Courts of Justice on 22nd-23rd August 2023, Mr Justice Hayden made the decision to withdraw treatment (dialysis and clinically assisted nutrition and hydration) from a man in his fifties who was in a coma following a stroke.  

There is, as yet, no published judgment, but this case (COP 14075103) has already been blogged by Rhiannon Snaith (“Withdrawing treatment from a pastor in a coma: Balancing religious beliefs and medical realities”).  She describes, in detail, the background to the case, and the evidence that was given in court. 

We watched the hearing too, and want to give our overall impressions of the experience. 

We are grateful to the Open Justice Court of Protection Project for alerting us to this hearing and for its tireless work to ensure transparency in the court. 

Reflections from Zach Moss

The first half of the day’s evidence served to build a picture of P’s current health situation. As someone who has observed hearings before concerning withdrawal of life-sustaining treatment I am familiar with some of the medical conditions usually explored. This case however was perhaps the sickest patient I’ve come across. The first half of the day’s evidence outlined just how sick P was. P suffered from stage 5 chronic kidney failure, requiring dialysis three times a week. P was also diagnosed as being in a prolonged disorder of consciousness. The prognosis from most of the clinicians who gave evidence was bleak, with the medical consensus being that P would likely not live beyond a year.

There seemed to be little doubt about P’s medical situation: the grim prognosis was perhaps more certain than any other case I’d observed. In previous cases, the focus has often been on the prolonged disorder of consciousness – the grade and prospects of recovery being explored. Often there are disagreements between the family (who visit often) and the expert (who doesn’t). This case did indeed have some elements of disagreement in terms of observed behaviours and the label of ‘vegetative state’ but I noted that Mr Justice Hayden made the point that there is, in these cases, sometimes very little practical benefit in focusing on the distinction between the vegetative and minimally conscious states. In this case, with P’s other medical conditions, this perhaps seemed even more pointless as he was also suffering from end stage kidney failure – a terminal illness.

Whilst the medical evidence was being discussed, I was struck by one moment, when Mr Justice Hayden asked that the relevant witness statement be brought up on the screen for the benefit of the family. This may seem a minor technical point, but I think serves to highlight the diligence and focus of the Court in placing P (and the family) front and centre. Given what is at stake, being mindful of the family and those close to P, and making sure they can follow and understand what is being discussed in terms of P’s medical situation and prognosis is crucial.

As the medical evidence seemed to be coming to an end in the hearing, it was becoming clear this was, in Mr Justice Hayden’s impression “not about preserving life, but from medical perspective… trying to focus on how to achieve for P the best death”. I took note of Mr Justice Hayden wanting to ensure he had a proper reflection of the medical evidence.

Another moment of note was where one of the witnesses, Professor Derek Wade (a consultant in neurorehabilitation) noted that of the hundreds of patients he’s seen in a prolonged disorder of consciousness, P was maybe in the bottom 2 – 5 patients in terms of the lower end of the spectrum of consciousness. In fact, it was made clear later in the day that P would not have met the criteria for dialysis in this condition. It was only due to the fact that P sustained a brain injury whilst already receiving dialysis that it continued, almost by default perhaps. It maybe highlights the grey area, lack of practical guidance and difficult situations medics face in these extreme situations.

Hayden noted: “…there comes a point where the laudable aspiration to prolong life is overtaken by the equally strong moral imperative not to protract death. Where that point arises is very difficult to identify…

Another moment of note in the hearing, was when footage was played of P in the role of Pentecostal pastor delivering a sermon. I thought it a very powerful moment after listening to hours of evidence about P, to spending just a minute listening to P. The family was understandably and visibly upset at this point. I am not surprised.

During the second half of the day, P’s family members, and a close friend, gave evidence. Mr Justice Hayden wanted the camera focused closely on each witness in turn – a reminder of his desire and need to build as rich and detailed a picture of P through these witnesses as is possible.

With one witness, Mr Justice Hayden posed several moral thought experiments to try and glean P’s theological position on life-and-death issues: abortion, euthanasia and withdrawing treatment. Mr Justice Hayden almost apologetically stated at one point “I’m creating a nightmare scenario because P is in a nightmare scenario“.

By the end of the day’s evidence, it seemed clear to me as an observer of P’s strong faith, that P would likely have wanted treatment to continue and for his life and death to be placed in the hands of God. In particular, the Pentecostal belief in present day miracles seemed particularly relevant. It seemed Mr Justice Hayden was also convinced of this, and seemed to already be clear about what P would have wanted. This was confirmed when the judgment was delivered ex tempore the next day.

In fact, Mr Justice Hayden said he’d had little difficulty in reaching this conclusion. He explained, though,  that whilst P’s wishes and beliefs are important, they are not (under the Mental Capacity Act 2005) to be regarded as determinative. This turning point in the judgment is not one I’ve observed before, so I was struck by how Mr Justice Hayden used the law to explain how in essence ‘context is everything’. 

He had carefully weighed P’s wishes and beliefs in the context of the degree of P’s incapacity and the strength and consistency of medical views. It seemed the plan to bring P back to hospital 3 times a week for dialysis whilst being in a PDOC and dying from end stage renal failure was too much. Dialysis was characterised in this context as being“both burdensome and futile”. I thought it interesting as well that the wellbeing of the treating clinicians was taken into account (because, said the judge, P would have taken it into account). With P’s future treatment likely to cause the treating clinicians distress, Mr Justice Hayden had heard enough to make a judgment that P would “be the last person to want to impose such a burden on anybody else”.

I found this hearing another advert for the Court of Protection – in particular for its ability to function as a forum to explore complex medical and legal issues. As Mr Justice Hayden noted, these are incredibly difficult cases for everyone involved – made slightly more bearable by the professional approach of all those involved in working towards a resolution for P and his family.

Reflections from Jemma Woodley

Over the last two days I watched both medical professionals and brave friends and family take turns to give powerful evidence about P’s medical situation and his wishes and beliefs. 

While the family gave evidence of P’s wishes, I was struck by their description of P’s uncompromising nature when it came to his religious beliefs and practices. It was clear throughout that P’s faith was the driving force behind this hearing. 

Mr Justice Hayden did not hold back on exploring P’s religious beliefs.  He asked both friends and family several hypothetical questions, designed to explore P’s personal views regarding topics such as euthanasia and abortion. At first I questioned the relevance of these hypothetical scenarios, but I came to realise that Hayden was intent on exploring the depths and possible limits to P’s faith, to further understand how far his religion makes up an integral part of his being. 

His friend’s and family’s answers continued to demonstrate the depth of P’s faith. Hayden J was led to be confident that, in face of absolute suffering, his family and friends believed this would not stop P’s commitment to sanctity of life. They believed P would rather hold out for a miracle or for death – whichever is the will of God –  even at the cost of personal suffering, rather than to have medical treatment withdrawn. 

Hayden J was faced with a difficult decision. Where do you draw the line between protecting P’s faith and the family’s belief that he would want to continue treatment at all other costs, against the decision not to protract death and to manage this in a dignified way. I was struck by Hayden’s clear description of the decision before him: 

“There comes a point where the laudable aspiration to prolong life is overtaken by the equally strong moral imperative not to protract death. Where that point arises is very difficult to identity.” – Mr Justice Hayden

In his judgment, Hayden J deemed the Trust’s application to withdraw life sustaining treatment was well-founded. Although the weight he attached to P’s wishes and beliefs was extensive, he told the friends and family present in the hearing that the weight attached to any individual’s wishes must be done within the context of the situation – that context being both the complex medical situation P is in and the consistent evidence given by all medical professionals involved. Hayden noted, in particular,  the concerning burden of continuing dialysis for P.  

I am confident that today we saw the very best of the Court of Protection. I was especially pleased to witness Hayden J’s continuing references to the importance of P’s autonomy throughout the two days of proceedings. 

The decision served as a stark reminder that our views on the line between prolonging life and protracting death are different for us all. Talking, recording and sharing your wishes, on treatment and care at the end of life, has never felt more important to me. 

Zach Moss and Jemma Woodley both work for Compassion in Dying – as Digital Manger and Information Support Officer respectively.  The charity supports people with making plans for end of life and loss of capacity.   They have both previously blogged for the Open Justice Court of Protection Project, e.g. here and here.  The charity tweets @agooddeath

Withdrawing treatment from a pastor in a coma: Balancing religious beliefs and medical realities

By Rhiannon Snaith, 30th August 2023

An evangelical preacher in his fifties (KT) had a stroke in February 2022. He underwent emergency surgery but has sustained significant brain damage and never regained consciousness. He is currently in hospital, in a coma and also has end-stage kidney failure and Type 2 diabetes. 

The Trust was seeking a declaration that KT lacks capacity to make his own decisions about treatment and approval of an Order permitting withdrawal of life-sustaining treatment, specifically dialysis and clinically assisted nutrition and hydration (CANH). His life expectancy if these treatments are continued is likely to be 6-9 months, and death could be sudden, and possibly without his family present.  Without the treatments, he will die a managed and predictable death within a couple of weeks. The family position is that it is in KT’s best interests to continue receiving treatment. The Official Solicitor, acting on behalf of KT, reserved her position until the closing statements at the end of the hearing.

KT’s wishes, beliefs and values were important factors that were considered throughout, along with their place in best interests decision-making.  Right at the beginning of the hearing, Mr Justice Hayden said:

“Mr T has practised in a proselytizing way as a pastor in a very robust, muscular, and uncompromising version of Christianity, and his has been uncompromising. The concept of faith being able to move mountains is not figurative for him. It is real. He believes very absolutely in the power of prayer. And that may lead me to the conclusion that, invidious though his situation is, he would have preferred it to the alternative. Much of the evidence points to that. If I do come to that conclusion, how do I address best interests?”[1]

The question of what KT would want for himself in this situation was difficult to determine. KT’s family did not have discussions with KT about what he would want in this situation but strongly believe that if KT had the capacity to choose, he would want treatment to be continued. The Trust argued that there is not sufficient evidence of what he would want. 

This case (COP 14075103) before Mr Justice Hayden was heard in the Royal Courts of Justice over two days (Tuesday 22nd of August 2023 and Wednesday 23rd August 2023). It was listed as ‘hybrid’ which meant that people could attend either in-person in the courtroom or (as I did) remotely using a video link.

The applicant in this hearing was the Trust, represented by Vikram Sachdeva KC

The person at the centre of the case (KT), the first respondent, was represented by Fiona Paterson KC  via the Official Solicitor. 

KT’s wife was the second respondent (as a litigant in person) and his sister (GT), whose views are aligned with the rest of KT’s family, was third respondent, represented by Francesca Gardner

Witnesses called for the Trust were: Dr D a Consultant Nephrologist, Dr W a Consultant in Neurorehabilitation,Dr B a Consultant Neurosurgeon, and independent expert Professor Derick Wade. Witnesses were also called for the family.

DAY ONE

Witness 1 – Dr D, Consultant Nephrologist

I joined the hearing slightly late (due to technical difficulties my end) as Dr D was giving evidence to the court. KT had been diagnosed with end-stage kidney failure in 2015 – meaning that his kidneys were providing less than 15% of their normal level of function. In end-stage kidney failure, the body is no longer able to survive without treatment to remove waste products (kidney dialysis), which he has been receiving since then. Dr D was explaining the burden dialysis has on patients’ quality of life, stating that treatment can often lead to patients experiencing cramps, feeling sick, fatigued or like they may pass out (although others cope reasonably well). It was described as a “burdensome” treatment.

Dr D said that KT is usually sat upright in a hospital bed and that dialysis comes to him three times a week so that he does not have to be moved to another location. 

Mr Sachdeva, counsel for the Trust, questioned Dr D as to why KT was no longer on the kidney transplant waiting list despite having kidney failure. Dr D explained that KT used to be on the list and was scheduled to have a transplant, but it never happened for “various reasons”. She further stated that when KT suffered a brain haemorrhage, he was taken off the list due to the increase in risk. They were not sure he would survive being put under anaesthesia and Dr D stated that there was an “unacceptable increase of risk” due to the medication KT would need to be on to have the transplant. Mr Sachdeva asked: “So, a transplant is not an option?”, to which Dr D replied “exactly”. 

It was explained by Mr Sachdeva that in the written statements submitted to the court the doctors gave the average life expectancy for someone who has kidney failure, diabetes and is on dialysis as 3-5 years. KT has survived 6 years on dialysis so far. At this point, the judge intervened and asked why KT has lived longer than anticipated, Dr D replied that it was “hard to know for sure” but that it sounded as though KT was a “motivated”patient before suffering a brain haemorrhage and knew what to do to stay well. He also managed his own dialysis. 

Should treatment continue for KT, Dr D said that while cardiac arrest could be a cause of death, “infection is also a risk, particularly because he [KT] is bed bound, therefore he is at risk of pneumonia and pressure sores and the things that will ensue from that leading to sepsis”. Dr D explained that KT’s tracheostomy, PEG (Percutaneous endoscopic gastrostomy) and cerebral spinal fluid shunt could all be portals for infection. She went on to explain that for patients who require long-term dialysis “their access point for the blood stream is one of the key determinants of their prognosis”. 

Dr D explained that there were two ways to access the bloodstream for haemodialysisThe first, as is the case for KT, is with an AV fistula which is a blood vessel located in the arm, this method offers “a low risk of bloodstream infection”. However, some patients who have diabetes and need dialysis are unable to have a fistula in their arm, so they need a piece of plastic tube in the vein from which there is a “high risk of it becoming infected”. Dr D states that KT’s fistula “continues to work very well”, so there is currently “no increased risk in bloodstream infections”

The judge questioned whether “the most likely circumstances in which he [KT] might die would be cardiac arrest, or sepsis or fluid overload”. 

Dr D explains that “if we [treating team] can’t remove the fluid if the blood pressure keeps dropping, that would be what would lead to the fluid overload”. She further stated that “in KT’s case, sepsis is unlikely to occur from the fistular” but if it stopped working then they would have to put a tube in the vein which would result in a higher risk of sepsis. Dr D went on to clarify that “the risk of hospital acquired pneumonia remains…which could lead to sepsis which could prove fatal”. 

Mr Sachdeva asked why KT’s would not now be a candidate for dialysis were it not that he’d already been receiving it before his stroke. Dr D explained that “it’s really because of the lack of evidence of any benefit in terms of survival and quality of life in this situation”. Although, she said that it was “impossible” to comment on KT’s quality of life because “I don’t know how much he is aware of”. Reading the evidence submitted by (I think) Professor Wade, Mr Sachdeva said “a good death is possible…only through careful planning and avoidance of distress”. Dr D agreed. 

Dr D said that KT’s clinical situation has become worse explaining that in the first few months of KT’s admission they reduced his blood pressure tablets before eventually stopping them, and that KT got to a point where he was “tolerating dialysis”. However, KT then started experiencing drops in blood pressure during dialysis despite there being no change in the process. Dr D stated that his heart muscle had weakened which was a concern. In the statement submitted to the court it was stated that KT’s blood pressure dropped “in 9 out of 36 occasions” during dialysis. His low blood pressure could cause a heart attack, further brain injury and cardiac arrest. 

Dr D explained to the court that if KT’s blood pressure continued to go down then they “would sometimes have to give fluid back into the vein” to bring his blood pressure back up, but in doing so they are “going several steps backward” as KT needs fluid removed. So, having to give fluid back could make the situation worse and may lead to fluid overload. 

It was clarified by Mr Sachdeva that according to the written evidence, fluid removal was reduced as KT’s blood pressure dropped too low with it being 55 over 38. Dr D explained that “many people would not be conscious with a blood pressure of 55 over 38” and that for most people this would lead to unconsciousness and could “lead to heart attack or heart rhythm disturbance”. It was described as life threatening. 

Dr D said: “Sadly, I do believe that his [KT’s] death is inevitable, and there is a risk it could happen in a sudden and uncontrolled way”. She explained that she wanted to avoid causing “unnecessary suffering” for KT and his family but said that she also respects their wishes and beliefs. 

When asked by the Official Solicitor to describe the level of risk to infection in the coming months, Dr D stated that in the Autumn months there was an “increase in cases of seasonal flu and it’s quite likely cases of COVID would also increase”. She said that infection could be brought in from numerous sources including other patients, visitors, and staff members so the risk will increase over the autumn and winter months. However, Dr D stated that the risk of infection from the PEG tube or cerebral spinal fluid shunt is always a risk regardless of the season. She also said that the risk of hospital-acquired pneumonia will remain. However, if KT became ill with influenza or COVID there would be an increased risk of him developing bacterial pneumonia, from which the outlook would be poor. 

Dr D stated that sometimes patients can deteriorate rapidly with sepsis which can be scary. The judge intervened and questioned, “without wishing to distress the family, why is sepsis such a particularly difficult death?”.

Dr D responded that if someone has pneumonia and they’re producing sputum and are short of breath or feel like they can’t breathe it is “one of the most profound ways to suffer I would say”. Dr D said that no one knows how aware KT is, but with the tracheostomy there are increased problems with coughing up sputum which must be sucked out using special catheters. She said this was not a pleasant situation and is “not something any of us would ever want to have to go through”.

The judge responded saying “sometimes, I have heard it be described as being like drowning” – to which Dr D said “yes, I have heard it described that way too”.

When asked by the Official Solicitor about KT’s risk of developing pressures sores, since he is largely confined to his bed, Dr D says that “he [KT] has been very well cared for by doctors and nurses, and he has not yet suffered from a pressure sore, but the risk remains”.

Witness 2 – Dr B, Consultant Neurosurgeon 

Dr B was on call when KT suffered his brain haemorrhage and took him to surgery, which he assisted in. When questioned by Mr Sachdeva as to why KT had suffered brain bleeds, Dr B explained that brain haemorrhages can happen for a number of reasons but for those with cardiovascular disease the risk of having a brain haemorrhage is much higher. 

Dr B had prepared two statements that were submitted to the court in which he had stated that there had been no significant clinical improvement in KT’s neurological state. In his statements he had said that  KT’s “condition has plateaued”. When asked whether his opinion today differs, Dr B responded “no, it remains the same from a neurological perspective”.

Mr Sachdeva sought to clarify that there was no neurosurgical intervention that could help KT nor any ongoing neurosurgical role that could benefit. Dr B stated that this was “correct” and that KT “has been stable from a neurosurgical standpoint for a long time”

It was made clear that Dr B did not believe that continuing life sustaining treatment would be in KT’s best interests. Dr B stated “I agree with evidence [Dr D] has given that we can’t change the overall outcome for P” in that KT’s death is inevitable and the only thing that could be controlled is how he dies. Dr B said, “if we continue with current treatment his [KT’s] death with be unpredictable and could cause suffering to him and his family”.

Witness 3– Dr W Consultant in Neurorehabilitation

In her witness statement (read out in court), Dr W said: “It is the opinion of myself and the clinical team that neurorehabilitation is not appropriate. [KT] has no meaningful interactions which could be formulated into a rehabilitation plan”.

It was Dr W’s opinion and that of her colleagues – and the independent expert Professor Wade – that KT is in a prolonged disorder of consciousness (PDoC). She stated that there was “no evidence of awareness” and that KT had only “limited responsiveness”, most of which was clearly reflexive. 

According to the written evidence provided by Dr W, it was her knowledge and that of the treating team, that KT had not discussed his preferences regarding what he would want in his current situation. It was also stated that were no documents that contained KT’s views. 

Dr W told the court that “there is no prospect of recovery” for KT. She confirmed that the clinical team was “unanimous” in their view that it would “not be in [KT’s] best interests to continue treatment”. 

The court was told that KT presents as being in a coma. Dr W said that “it is a deterioration of his clinical state”that his episodes of eye-opening are less frequent. She also said that KT’s brain stem dysfunction is deteriorating which is evident by his disordered breathing pattern. Dr W confirmed that there were “no further neurosurgical interventions that can help him”.

When questioned by the judge whether she believed that it would not be in KT’s best interests for treatment to continue, Dr W answered “yes, that is correct”.

The judge then asked: “If I concluded that KT wanted what most of us wouldn’t want and would prefer to take his chances with a bad death because he believes that to be God’s gift and nobody else’s, would it be in his best interests to go against those wishes?” 

Dr W responded that it was a “very difficult question to answer, which is why it has taken so long to get to this stage”. She explained that in KT’s situation “unlike other patients I have been involved with who have prolonged disorders of consciousness and a tracheostomy, the burdens of continuing treatment are far higher, and I am referring to him needing dialysis three times a week. If he were not in hospital, he would need an ambulance three times a week…and because of his diabetes he has increased risk of infections”.  She added that the risk of pressure sores mentioned earlier would also be an issue. 

Dr W was then questioned by Francesca Gardner, counsel for the family. Ms Gardner began by emphasising that the family are “very grateful for the care [KT] has received and are complimentary of it”. She stated that it was important to them that Dr W was aware of that. The area of disagreement in this case stemmed from whether KT’s treatment should be withdrawn or continued. Dr W stated that she was aware of these facts. 

Ms Gardner asked whether Dr W was aware that the family believe that KT has some awareness of them. Dr W answered yes. She said that there was a “remote chance” that the family would be able to identify certain behaviours or mannerisms indicating conscious awareness that a clinician would not be able to.

Dr W was then asked whether she had spent much time with KT when his relatives were also present. She responded “no, I have not”, but explained that she had been with KT when his wife (JO) was there. She said that KT was not based on her ward, so she only tended to see him when there was a specific need. 

Ms Gardner questioned whether Dr W had watched the recordings submitted by the family that showed (they believed) that KT was showing signs of awareness. Dr W responded that she had. Ms Gardner referred to a specific entry where a Chaplain (KT receives prayers twice a week) had reported KT opening his eyes and looking at him as he read to him, which was of particular concern to the family. Dr W responded saying that when KT’s eyes are open they tend to move to his left – but this does not indicate a localising response. The configuration of KT’s room, with his dialysis machine on the right of the bed, means that visitors sit on the left-hand side, so it appears that he is looking at them.  She said: “the entry by the chaplain is an interpretation of what he has seen… I cannot say whether it was a meaningful response as I was not present at the time”

Ms Gardner then asked Dr W whether she had treated a patient with a similar prognosis and awareness to KT where she has concluded that it would be in their best interests for treatment to continue. Dr W answered that she had not been involved in a case previously where the patient had severe kidney failure, as KT does, but has had patients whose life expectancy was short and concluded nonetheless that continuing CANH would be in their best interests. 

After being questioned about how she had weighed in KT’s religious beliefs and his family’s views into her decision, Dr W stated that “the views are not purely my own, I express them on behalf of the treating clinical team, and I share their view. We tried hard to explore the views of the family…the dilemma was that [KT] had not expressed explicit views about being in this type of situation, which made it difficult”. She explained, “prior to his brain injury, he may have had discussions but there was no evidence of that… the decision is difficult, which is why we are here today”.  

If treatment were to continue, Dr W stated that KT “would remain in hospital for the rest of his life”. Counsel for the Trust asked whether, if treatment were withdrawn, she would object to a time allowance to enable KT’s family who live abroad to come to the UK. Dr W said, “I wouldn’t, but I’m not his treating consultant – it would be up to the treating team”.

It was at this point that KT’s wife JO (second respondent) and KT’s sister GT (third respondent) were given the opportunity to ask questions. Through the video link, KT’s wife JO (I think) stated that she first would like to express her appreciation towards the ward, saying that the “staff are great”. To Dr W she said, “You talked about [KT] and said he is in a vegetative state which means he can’t respond to things”. She goes on to explain that KT has a tube that causes “irritation” and says that KT tends to try and pull it out. GT asked, “what do you say about that?”

Dr W responded, “If he has involuntary movement, then he can dislodge it that way or they can catch when he is being repositioned or cared for, but I am not aware of him trying to dislodge his tracheostomy or PEG tube”.

In her written evidence, Dr W described that she had observed KT as having an abnormal breathing pattern in which he had periods of rapid breathing, followed by a period where he was not taking a breath followed by more rapid breaths. Dr W indicated that this was a poor prognostic sign and was due to central apnoea which is indicative of additional brain stem dysfunction. Dr W explained that she was with KT for “20 minutes” to establish a pattern in his breathing. When questioned by the Official Solicitor, Fiona Paterson, whether that was a sufficient period of time to establish a pattern, not just an observation, Dr W said that yes, it was. 

Dr W was further questioned by Ms Paterson, as to why KT’s deteriorating brain stem function was a poor prognostic indicator. Dr W said that it was because KT “in this situation can suddenly stop breathing”. KT’s current breathing pattern could result in further injury as the brain is not getting enough oxygen. 

When asked by Ms Paterson if KT’s functionality was deteriorating, Dr W said, “it appears so, yes”. She further stated that KT already has brain stem damage which has resulted in a swallowing impairment. Dr W was then asked whether there was a link between brain stem dysfunction and awareness to which she responded, “patients can have severe brain stem dysfunction and be aware”.

The judge intervened and asked Dr W whether KT would be more vulnerable if he acquired a hospital generated infection, as he already has difficulty swallowing. Dr W said that KT had already been on antibiotics for an assumed respiratory infection and that “he appears to have responded to intravenous antibiotics”. However, she did not know entirely how he has responded as she does not work on the same ward that KT is currently in. 

Witness 4 – Professor Derick Wade, Consultant in Neurological Rehabilitation, independent expert witness 

Following a lunch break, the independent expert witness, Professor Derick Wade, gave evidence. “I have seen a large number of patients with a prolonged disorder of consciousness”, he said, “and he [KT] is among the 2 or 3 at the most extreme lower end of that spectrum”

In his written reports submitted to the court, Professor Wade explained that according to early observations of KT, there was some indication that he showed low levels of awareness that included responses to oral commands. However, Professor Wade thinks that these are improbable. Observations made in more recent months had not included any suggestion of awareness on a significant level. According to Professor Wade, KT’s level of awareness is “minimal” and “transient”

In terms of categorising KT in either a vegetative state or a minimally conscious state, Professor Wade stated that there were “no unique signs that will put someone into one state or the other” and believes that it is not necessary to do so as it would not impact “treatability or prognosis”. So, categorising a patient in these terms would not be helpful. However, when later asked whether KT could be classified as being in a coma, Professor Wade said, “yes, as far as the criteria, he can be classified as being in that group”

The judge then said that while the family agree that there were not behaviours indicating a specific emotional state, they said that he “occasionally showed behaviours which, if he had a greater degree of consciousness, would automatically be suggestive of discomfort or pain”. Referring to one of the passages, the judge said that KT was said to have been “grinding his teeth”. He asked whether that is what Professor Wade had been referring to in his written report, which explained that some behaviours are suggestive of pain or discomfort and that if KT were to experience anything, it would most likely be pain, discomfort, or fatigue. Professor Wade answered “grinding teeth is a behaviour that would be more likely to suggest pain, discomfort or distress”. However, he later stated, “I think it is extremely unlikely that there is any experience [for KT]”

Professor Wade was asked by Mr Sachdeva about the multidisciplinary report that recorded the results of the WHIM test (a test that assesses and monitors the recovery of cognitive function after severe head injury). The test showed that grinding teeth had been observed 6 out of 9 times for KT. Professor Wade said the “only comment I would make of that is that I cannot say that it means he has pain; it may have no meaning and is just something he does, but if it does have meaning then it would be indicative of pain”. He went on to explain that grinding teeth is common for those with brain damage, though he does not know why. It was also noted that there were no records of KT showing behaviours that were suggestive of pleasure or happiness. 

Professor Wade clarified that when he states in his reports that a behaviour is suggestive of pain, “I’m not saying that [KT] is experiencing pain, but that he is showing a behaviour that suggests pain”

In his written report, Professor Wade stated that being immobile is also uncomfortable for patients and reported that most patients with spasticity report discomfort and pain. When questioned by Mr Sachdeva whether he was implying that KT had spasticity, Professor Wade said, “yes, to an extent. I am just making the point that for someone in his [KT’s] clinical state, overall being immobile is uncomfortable”

Professor Wade stated that it was “extremely difficult to know” whether someone who is almost completely unresponsive and has no awareness, as he believes is KT’s case, was experiencing pain. He said, “I do not think he has any experience, but those in prolonged disorders of consciousness will respond to external factors like cold or pain or warmth but that doesn’t necessarily mean he has experience…I do not know what is going on inside [KT]”

In his written report, Professor Wade stated that KT “has deteriorated clinically over the last few months, coinciding with an increase in cerebral atrophy… [KT] will never have autonomy or live outside a hospital environment”. Mr Sachdeva questioned whether this includes nursing homes, to which he responded that yes it did and that he meant any medical or clinical environment.

In terms of the prospect of continuing treatment for KT, Professor Wade believed that it would offer no benefit to him. “I do not think he is consciously experiencing anything, but one has to acknowledge that in the end for someone who is completely unresponsive, we don’t know what he’s experiencing”. Further stating that if KT was experiencing anything it would be an unpleasant experience that he is having, he said “I cannot identify any benefits other than the prolongation of life”

The judge intervened and stated that the points discussed by Professor Wade are extremely complex both morally and ethically but said that “there comes a point where the aspiration to prolong life is overtaken by the equally strong moral imperative not to protract death”.

Professor Wade said that “when it comes down to [KT’s] best interests, I am not satisfied that he would want to continue in this particular state”. He made the point that there was no evidence of what KT had previously discussed with his family. He further stated that KT was “someone who is concerned about other people…I think he would want to take into account the effect of his continued living on the care team, for example, who have to continue suctioning him when he looks like he’s in pain, and he likely would be – as it is an unpleasant process”

Ms Gardner, Counsel for the family, asked Professor Wade about the medical records that he had viewed. She stated that he had considered those records but “took the opinion that you did not need to see [KT] again. The family are concerned that it has been 8 months since you’ve seen [KT]” and that there are recordings of his awareness and of KT being awake. She asked what Professor Wade would say to that. He responded that “if I came up to see him, I may be there for two to three hours, not days…even if there were episodes, it is statistically unlikely that I would arrive when one of those episodes arises”. He said that he had to consider his efforts and the efforts of those involved. 

When asked by Ms Gardner whether the evidence provided by the chaplain made him want to visit KT, Professor Wade said, “I think that in the end what the chaplain wrote does not constitute in my view an observation independent of interpretation”. He stated that KT is “not totally immobile” and that an interpretation could have been made based on the chaplain’s belief or could have been a human interpretation of the movement. “Awareness isn’t something that will restrict itself to certain circumstances”; others would have also seen it. 

Professor Wade explained that KT “has cerebral atrophy, but he is also atrophying” as there are several factors that are causing damage to his brain including low blood pressure and diabetes. He is “deteriorating”. 

Video

It was at this point that the court was shown a short clip of KT preaching. After watching it, the judge addressed the family directly stating, “when I saw the video, it made me think that some people are born with charm… it’s perfectly obvious that [KT] was born with the gift of charm”

Witness 5: KT’s Friend and fellow pastor

This was the first witness produced on behalf of the family. He explained that he has known KT for over 35 years, and when describing their relationship, he said KT “is like a brother to me”. His friend spoke of how they had met when he was going to school near to where KT’s family owned a restaurant. He said they became friends after KT joined the same school where they would both attend a faith group for students. From then, they would try to “preach the gospel” and “reach the people” in their neighbourhoods. When KT moved to the UK, he explained that they would still speak to each other “a few times a week”.

When describing KT, his friend stated that he was “the type who will put his faith over everything else, he will gladly let everything go and just follow God…that was his life”. He described how he knew KT and “his theological views and views on several subjects”. He talked about KT’s belief in the sanctity of life which meant that he was “against abortion and euthanasia”, and “anything that directly or indirectly takes away life or puts it at risk”.

After being given several scenarios by the judge as to what KT would do or believe would be the best thing to do in those situations, his friend clarified that “anything that has to do with exercising human power to end life will not have his support” as it is something “God should decide”.  

It was mentioned earlier in the hearing that there was the belief that KT may not want to continue treatment if he knew that it would have a negative impact on his friends, family, and the clinical team. KT’s friend was asked by Francesca Gardner, counsel for the family, whether they had discussed a scenario like this. 

“It’s been said KT might take into account the impact of his situation on his clinical team and the family. Did you discuss that with him?”

“Specifically in relation to this situation, no. But he cares about people, that care and compassion and sense of empathy and trying to make sure he’s a blessing rather than a burden – these are all inspired by his belief in God. Now, this same God, he believes, expects  him to respect the sanctity of life, so he will not allow his love for people to triumph over his faith in God or his belief that God can bring about a miracle, or take that to mean that he can decide when his life ends.  He will not care about people to the point of offending God. Because his care for people is inspired by his love for God. So, the decision to do something that he does not believe will be pleasing to God will decide the boundaries for him. There is a truth to saying that he would not want to be a burden. That is consistent with his personality and character. But it goes too far to assume that because of his love and consideration for people he would say ‘I don’t care what God thinks – doctors think it’s over – just pull the plug on me’. That is a stretch too far. I don’t see him doing that.”

Counsel for the Trust asked about the history of the relationship between this witness and KT, and the judge intervened to enquire what they liked to do together when they weren’t being pastors  – to which he said that they would often debate on global issues and theological matters, go out to eat together, go shopping or do business research. The judge followed up by asking what was KT’s favourite food and how he adjusted his diet when he first became ill. KT’s friend explained that “he [KT] started eating more vegetables, he did a lot of research to identify what was okay or not to eat and so he adjusted his life to eat more natural food and drink more water”.

Mr Sachdeva picked up the cross-examination again, asking whether he had discussions with KT about what it would be like to be in a coma. He said that they hadn’t, “not in the context of him or me or anyone we know being in a coma,” but that they had discussions about other people. He explained that the subject of euthanasia was debated often in the area where they used to live. He and KT had conversations as there was “a situation where someone was in a coma and there were people of the view that their life should be terminated and [KT] did not share that view”

“What do you mean by ‘euthanasia’”, asked Vikram Sachdeva.

Friend: I know that’s a technical term – but I can tell you what it meant to us at the time.  Human beings were going to make decisions about whether to continue or to end another person’s lif,  because of a desperate situation where a person is never going to recover. So, to make it more bearable, let it end now. We used the word not as experts but as, “hey, this person is alive thanks to the machines, which have been invented by people who received knowledge and wisdom from God. If God wants the person to die, the machine won’t keep the people alive, because some people go on the machines and die anyway.  Let’s stay away from saying ‘we’re going to stop this now'”.

Sachdeva: So, your view is doctors can never stop providing life-sustaining treatments for someone who is still alive?

Friend: If there’s any technology keeping a person alive, that comes from God, and people capable of rendering that care should keep that care going.

Sachdeva: So what you mean is ‘yes’.

Friend: Yes. Doctors should prolong life when they have the ability to do so.

Sachdeva: Should doctors ever withdraw treatment from a patient who is alive.

Friend: Theologically, no.

Sachdeva: From KT’s point of view?

Friend: I would say KT would be saying ‘no’ to that too.  Based on my knowledge of him.

The Official Solicitor then took a turn to cross-question the friend.

In terms of KT’s prognosis, his friend said, “we honour and respect the doctors and hear what they have to say but never take their words as absolutely final” because “there’s another layer of power who is God” who can intervene. He said that KT has already lived longer than he was expected to, therefore there is always a chance for a “miracle”.

His friend was made aware by Ms Paterson that the evidence provided to the court indicated that ,despite the efforts of the treating team, and the fact that KT has lived longer than expected, the medical evidence is that his death is inevitable in the next six to seven months. There was a risk that KT could die “rapidly and unexpectedly” and “alone”.  His friend answered that he believes when people have chosen a path, they have made their own choices. He likened it to being a soldier.

“They join the military and put on a uniform, and travel to another nation to fight in defence of their countries, their fellow citizens. They kiss their wives goodbye on their way to strange countries, never sure they’ll come back.  When a person makes a choice of a lifestyle, to believe in God and the principles of the Bible, that person is also making an indirect choice. …. If you can leave your wife and go abroad, there is no question that you have a higher vision. The day you decide to follow Jesus, you are saying your life is no longer your own.” 

The judge intervened again.

“The picture that Ms Paterson was painting for you showed you that there are different scenarios for KT’s death”.  He said that KT was susceptible to hospital infection and could, essentially, drown in his own bodily fluids. “My every instinct as a judge and as a man is to spare [KT] from that if I can”.

He engaged in some theological discussion: “I think Pentecostalism believes that man is made in the image of God  and how we treat men is how we treat God” t- o which KT’s friend agreed. The judge went on to say:

“Now, I have said in many cases there is something intrinsic to the human condition that carries dignity with it, and we have an obligation to preserve human dignity.  The scenario I’ve just outlined to you does not preserve KT’s dignity as a human being, and it causes him avoidable pain and effectively protracts his death, rather than keeps him alive.  I don’t have KT here to be able to answer this question, but I am persuaded he was a committed Pentecostalist. Tell me what your position would be.”

His friend answered, “I’m not claiming to be a voice for Pentecostalism, but I can tell you my view – and this is a very important part of our theology. We will not promote poverty or anything that we believe will cause people pain, but we are familiar with the fact that we do not have an ideal world. And in this world, we try everything within our power and with the grace from God to create an ideal world, but we recognise the limits to where we can go. Let me give you an illustration”.

“No”, said the judge. “I want you to deal directly with my scenario. You think he would rather go through that dreadful death?”

“Yes”, he replied.  “People who think otherwise will think so out of love too – but he would not choose to end his life. He would rather go through humiliation”.

Witness 6: KT’s wife (JO):

After a short break, KT’s wife was invited to speak to the court. She described KT as “a caring person. He’s a believer, a good friend, a confidente” and said that “he’s been through a lot but never allowed the situation to get the best of him”.  

She said that she visits him “sometimes four times a week” due to work and said, “he is a good person, I would do anything for him”. She felt that KT knows she’s there when she visits. And when she plays recordings of sermons it’s her belief is that he hears them.

When asked about what she would say about whether or not treatment should stop, JO said, “it’s a life event. He didn’t allow his condition to bring him down. He did his research to see how he could improve. He tried his best to get better”. She told the court that they never had a discussion as to what KT would want to happen if he were to become as poorly as he is now. 

Judge: Thinking about situations when you see him struggling to breathe, or someone suctioning his throat in situations that are very distressing to watch.  We don’t have to have that. 

(She shakes her head)

Judge:  You could avoid it.

Wife: He’d want to leave it to God. 

JO described to the judge how KT did not tell her for a while after he was diagnosed with kidney failure because “he didn’t want me to worry”. The judge told her “I think you had a very happy marriage” to which she said, “I tried to make him feel happy because I didn’t want him to feel bad about his situation”.

When the judge said that if it were left to the prospects of a miracle, which would be unlikely, the course of events “will be very sad for both of you”. JO responded, that while she would “definitely want to be there…as a Christian, we take each day as the last day you will live on earth”. She said that “even if we’re not there, we visit him, so he knows he is loved”

Counsel for the Trust then proceeded with the cross-examination. Mr Sachdeva asked JO whether she believed that KT’s condition had deteriorated and whether she accepted the evidence from Dr W and Professor Wade. JO stated that she didn’t accept the evidence provided by Dr W and Professor Wade and disagreed with the belief that KT has deteriorated neurologically. She said that she “wouldn’t say he’s gotten worse” because “he was getting irritated with the pipes in his nose and would try to pull it out…he opens his eyes, he moves his legs and left palm”

JO was concerned that, if treatment were to continue, the plan would be to move KT into a nursing home. She asked, “wouldn’t it be best for him to stay in the hospital?” as he is currently receiving his treatment there and “they know what to do”. However, this was not an option proposed by the Trust.  Mr Sachdeva told her that “if the application is refused, then the Trust will seek to discharge your husband to a nursing home, as he does not need hospital care” but assured her that “he will go to a suitable nursing home” where they are trained to provide the treatment KT needs. 

KT’s sister (GT):

Although there was no further formal evidence, the judge asked KT’s sister if she could tell him about KT. GT, who joined virtually, described her brother as “a lively person and very active, very caring” – someone who “doesn’t take no for an answer…he is a fighter and doesn’t give up”

When talking about the prospect of treatment continuing for KT, the judge said that he “may pay a very high price” and experience a “painful death”. Similar to JO, GT responded saying that KT knows who is around him and knows that they care for him. 

The judge said that if he followed the family’s wishes “it would lead to a very painful death for [KT], do you think that’s what he would want?” JO said yes, she believed that is what he would want. When the judge raised the concern that KT would be “effectively choking on his own secretions”, JO responded saying “death is death, it is God’s will”.

Closing discussions

The judge spoke to her and the rest of the family who had joined virtually and said, “I appreciate how extremely difficult this must be for you”.

The evidence seemed to indicate that KT would have wanted treatment to continue. The judge stated that he found “the evidence compelling as to what [KT] would want”, but now had to confront that if it were the case that KT would want treatment continued (which could still be disputed), what weight would be given to KT’s wishes, values, beliefs, and feelings in determining best interests. Especially as the evidence indicated that continuing treatment could lead to an uncontrolled and painful or distressing death for KT. He asked counsel to address this question:

“If I come to the conclusion that this is what he would have wanted for himself, however painful, and however contrary to most people’s instincts, as a man rooted in Pentecostal faith, how determinative is that of the Court’s decision?”  He pointed out that KT’s human rights were engaged – including his right to exercise autonomy in the later stages of his life.  “Would it be wrong to impel people to treat him in this way? I don’t know. Would it be contrary to their ethics? I don’t know.  Is it workable and capable of preserving his dignity… I think we really are in the territory of what if those are his wishes and feelings, and what that means for best interests”. This was the issue he asked counsel to address in written submissions the following day when the court reconvened at 10.30am. 

DAY TWO

Closing statements

The judge had been sent written closing statements by 10.30am. I requested the closing statements from the Trust and counsel for the family, but only received the Trust’s closing statement. (Celia received all three and used them to help me with this section.)

The closing position of the Trust was that it was not possible to infer from the fact that KT was a Pentecostalist that he would have wished to continue to live in a coma, with the very significant burdens that life holds. There was no direct evidence (said the Trust) about his past wishes and feelings relating to this situation – no witness even claims to have had a conversation with him about this. He has no ascertainable current wishes or feelings.  In any case, a person’s values, wishes, feelings and beliefs are not determinative of a best interests decision. The Trust cited extensive case law to that effect.

The closing position of the Official Solicitor was also that it was not possible to be sure what KT’s wishes would be in this situation, because he “never contemplated the terrible reality of his present circumstances, which were outside his experience and probable knowledge”.  The OS argued that “The court cannot know how, had he known thi,s KT’s views may have been refined… It must be live to Lady Hale’s observation in Aintree at [45] that ‘[even] if it is possible to determine what his views were in the past, they might well have changed in the light of the stresses and strains of his current predicament’.  This is not in any way to undermine or belittle the strength of KT’s beliefs, but is to recognise the reality of human experience, i.e., we adapt and reflect upon our beliefs, in the face of circumstances”.  The OS submitted that the Trust’s application should be granted so that KT’s death would be peaceful, with full symptomatic relief and his family present. To continue treating him, they said, would be to deprive him of “the last vestiges of his dignity and comfort”.

The closing submission from the family was that all the evidence showed that if KT were able to decide he would elect for treatment to continue. He had dedicated his life to God, and for him there are no limits or exceptions to sanctity of human life. He would not support a decision to bring about the end of his life in any circumstances. This is not a case where the court has only one option. There is a formulated option for KT to continue his treatment until such time as he dies naturally or, as the family hopes, there is a miracle.  It has not been suggested at any point that the treatment plan is not an available option for the court to consider, or that any aspect of the plan goes beyond that which the clinicians would be willing to provide. It is the family’s unwavering position that treatment should continue because this is what KT would want for himself.

Delay with a ‘sensitive matter’

I used the link I had received the previous day to access the hearing, making sure I was ready at least 15 minutes before the scheduled start time. However, the hearing did not begin until a little past 11 o’clock. The judge was told by Ms Paterson that a sensitive issue had arisen. She made an application to the judge that this matter should not be made public. The judge was required to decide whether it would be appropriate for members of the public, the family, or the media to be present for this part of the hearing and he decided to ask everyone except the lawyers to leave the platform while he heard what it was that had arisen. Members of the public and the family were asked to leave, and the hearing was converted to a private hearing to deal with the sensitive matter. It was made clear to us prior to leaving that if it was determined that we could rejoin, we would be made aware. 

It was just under two hours later that Celia Kitzinger contacted me to say that we were able to rejoin the call. However, when we tried to rejoin we were denied access. There was some confusion over the coming hours as to what was going on and when we were to be readmitted with the answer being ‘soon’ but with no definitive time set. 

We were eventually readmitted at around 2.40pm at which time the judge informed us “I have to be limited in what I can say. I apologise if it sounds rather delphic. This morning an issue arose that may have had some bearing on the issues in the caseIn the event, and having heard from the counsel, I have concluded that the material is not relevant to the decision I have to make. It’s deeply sensitive, and because it is not relevant it does not need to be in the public domain. I will set out my decision on that in a separate judgment, which will not be placed in the public domain.”

The closing statements from the Trust, the family and the Official Solicitor were then discussed. It was agreed that all parties were happy not to provide an oral submission, but to leave it with the written submission. However, Ms Gardner told the judge that “in the event that it’s in [KT’s] best interests to stop treatment, the family would ask for a period of time to visit [KT]”.

The Official Solicitor applied to withhold the name of the Trust from the public domain. The Judge said that there would have to be “powerful reasons” as to why the Trust should not be named. Ms Paterson acknowledged that the “practice of the court is to name the Trust” but argued that the judgment would have to deal with KT’s age and religious background which may allow the public to determine his ethnicity, amongst other things, and combined with his brain injury it may make KT identifiable to the public if the name of the Trust is known. As a result, it was requested that the “Trust not be named between now and three months after [KT’s] death whenever that may be”

The judge stated, “excluding the names of Trusts bringing applications to withdraw treatment…greatly unsettles the public”. He explained that it can “have a corrosive impact not only on public trust in the healthcare system but also on the confidence in the court”. The judge refused the application stating that he did not believe “the relatively short-term advantages of not naming the Trust outweigh the very strong disadvantages of  undermining the public trust in the process of this court and the healthcare system”.

The judgment was then scheduled to be handed down at 4.15pm. 

The judgment

I rejoined the link and the oral judgment commenced at roughly 4.40pm. The judge found that KT was in a prolonged disorder of consciousness, stating that a “compelling medical consensus established that he [KT] has no awareness or scope of rehabilitation”.

He summarised that KT “is dependent on dialysis three times a week to keep him alive, but it has become increasingly difficult as his blood pressure drops which carries risk of further brain injury, cardiac arrest or heart attack”.

The judge acknowledged that the family holds a “strong Pentecostal Christian faith” that means they have “belief in the power of prayer and miracles” and  “confidence in the power of God to cure the sick, however parlous”. He also acknowledgesdKT’s faith, his role as a pastor and as an active member of the church. “He [KT] was a very highly regarded and popular preacher”.

Speaking of the family, the judge said, “[KT’s] family feel that his faith was such that he would want his life sustained for as long as possible. They do not proactively dispute his prognosis but feel he has a greater level of awareness than the Trust proposes”. They believe that KT is “aware of their presence and they have, on occasion, observed meaningful responses”

If treatment were to continue, the judge acknowledged that KT “cannot remain indefinitely” in hospital and “would need to be put in a nursing home” that would be able to appropriately care for him.  He stated that the Trust’s “multidisciplinary team agree that treatment should be removed and he [KT] should receive palliative care only”. The process leading to KT’s death would be managed by the Trust, and it would enable KT to have his family around him. In the hypothetical end of life plan proposed by the Trust, the likely cause of death would be due to the withdrawal of dialysis after which it is estimated that KT would “likely die within two weeks”.

The judge stated that “whilst there is disagreement…it is also important to emphasise there are high levels of respect and mutual understanding”

The judge spoke of the pastor in KT’s church who had described KT as “a man of stubborn faith” who believed in the supernatural power of God and would be strongly against withdrawing any form of treatment from anyone. “Even when confronted with pain and his own death he [KT] would still respect sanctity of life”

Speaking of KT, the judge said, “[KT’s] popularity as a pastor is, in my view, not only because he was manifesting a charming and engaging personality but also because his faith was so evidently genuine and sincere”. He said:  “the code by which he lives his life is clear…I find that [KT] would have chosen to continue with life sustaining treatment even in the face of a coma and with a terminal diagnosis”

The judge found that – contrary to the closing arguments presented by the Trust and by the Official Solicitor – there was compelling evidence that KT “would not have wanted treatment withdrawn” – and that he would “rather suffer and hold out for a miracle”. 

However, the judge said that “dialysis for [KT] can achieve nothing, it is both burdensome and futile”. The plan to sustain treatment would “cause harm without delivering benefit and it would cause great distress for the treating team to act in a way that would become contrary to their own professional principles”. He stated that he believed KT would be “the last person to want to impose such a burden on anyone else” and said that “it is plain from all I have read that he was both a kind and gentle man”

The judge said, “I have ultimately concluded that the application by the Trust is well founded… I can tell KT that which he would want to know, namely that everything possible had been done. I do however think that the family would want to say their goodbyes directly to KT and that he too would very much have wanted that. Family, plainly, was important to him”. The judge stated that the declaration is not to be put into effect until “twenty-one days from today’s date so they [the family] can arrange flights from diverse parts of the world, but it would be inappropriate to go beyond that period”.

The judge expressed his gratitude to counsel for their assistance, acknowledging that challenging and difficult cases like these can “take its toll on everyone concerned”.

REFLECTIONS

This case, like many others I have attended, greatly emphasised the importance of advance care planning (ACP). ACP is a process through which you can document your personal values, goals, and preferences regarding future medical care, appoint someone to make decisions for you if you can’t, and – if you want to – you can make legally binding treatment refusals. It was frequently mentioned in this case that there was not sufficient evidence to support the claims that KT would want treatment to continue. However, we were not made aware as to why, despite being ill with end stage kidney failure, KT had not (apparently) been supported by his health care team to explicitly discuss his wishes with them and with his family members, and why no advance care plan had been drawn up.

Undeniably, conversations about death and dying can be incredibly difficult and daunting, and there are a number of reasons as to why people – including doctors – avoid having these discussions and making an advance care plans. These reasons could include a lack of awareness, cultural or religious beliefs that conflict with planning, or general discomfort with the topic. However, it’s cases such as this one that highlight the importance of having a plan in place because even though KT’s family and friend were all unanimous in the belief that KT would want treatment to continue, and the judge accepted that this was KT’s position, it was ultimately decided that it was not in KT’s best interests. 

This case highlighted the intricate and complex nature of best interests decision making. The judge in this case acknowledged the compelling evidence that KT would have wanted treatment to continue, which the doctors were willing to continue to offer, yet decided that continuing treatment would not be in KT’s best interests. His decision not only draws attention to the diverse considerations that encompass best interests decision-making, but also suggests that ‘best interests’ extends beyond adherence to the past preferences and beliefs of P. It seemed in this case that the decision was made by considering not just KT’s beliefs and values but the medical evidence and expertise, potential outcomes, and the possible impact on the well-being of KT as he is now. Furthermore, and as expressed in the closing statement of the Official Solicitor, it cannot be truly known whether, in light of his current situation, KT would hold the same views. As a result, it’s clear that while KT’s religious beliefs and values are important to consider, they are not the sole determinant. Rather, the decision is made through the consideration of a range of factors. 

As a PhD student who is currently researching media representations of end-of-life decisions, the mention of a ‘good’ death and its opposite – a  ‘bad’ death  – was something I noticed in this case. with comments like “a good death is possible… only through careful planning and avoidance of distress”. When discussing a potential risk for KT in developing an infection that could essentially drown him in his own bodily fluids, the judge expressed his wish to “spare” him from that death, implying, to me, that it was undesirable. The concept of a ‘good’ death is often present in research pertaining to end-of-life and palliative care, although what constitutes a ‘good’ death is difficult to establish. There are also several studies that refer to the impact media coverage can have on public understanding of a ‘good’ death including the identification of certain circumstances that are deemed ideal – such as being surrounded by loved ones. Meanwhile other studies have considered the media’s ability to influence and shape cultural understandings of what constitutes a ‘good’ death. It made me keenly aware of the impact and influence cases such as this can have in shaping public understanding of a ‘good’ or a ‘bad’ death. However, it can be argued that the definition of a ‘good’ or ‘bad’ death is subjective – as personal or cultural beliefs can impact an individual. in this case I couldn’t help but question whether for KT, a ‘good’ death would be one that was, in his eyes, decided by God, or whether a ‘good’ death would be one that was as painless as possible and one where he was surrounded by his loved ones?  

Brain Farmer, PA journalist, also observed much of the hearing and wrote about it in The IndependentWife of brain-damaged pastor loses life-support treatment fight. It was interesting to read what he had written, especially in comparison to how I approached writing this blog. There’s no question that writing a news report, and writing a blog requires different approaches even when they both include information that stem from the same source. As suggested by the title, the news report has a significant focus on KT’s wife. This can make the case more relatable and emotionally engaging for the reader whilst also highlighting the contrast between the views of KT’s wife (and loved ones), and the views of the medical experts. While this focus emphasises the newsworthiness of the case, the report also delves into the key points of the hearing. Brian Farmer explores KT’s medical condition and treatment, the family’s beliefs and religious considerations, key points of the legal proceedings and the judge’s ruling. The article also highlights the ethical and moral dilemma and challenge of balancing deeply held religious beliefs with medical realities. It’s interesting to see the details that journalists like Brain Farmer pick out and to think about how news reporting of cases such as these could help develop public understanding of the Court of Protection and of end-of-life decision making. News reports such as this make information accessible, and easily digestible in terms of its succinctness. However, blogs can offer more context by providing an extensive account of what unfolded during the hearing moment-by-moment. Together, they can cater to a wide audience, potentially increasing engagement and providing balanced coverage of the case that caters to the various levels of interest and, hopefully, developing a more informed public audience. 

Finally, discussions relating to the transparency order also piqued my interest. The Court of Protection has, in the past, been referred to as a ‘secret’ court in which judgments were difficult to access and hearings were often held in private. It was encouraging to see the judge in this case consider the detrimental impact withholding information (the Trust’s name) could have on the public. It is not contested that the privacy of those involved in these cases should be respected, but it is also important to ensure that the public are able to access information that could develop their understanding of the court’s processes and how end-of-life decisions are made. 

As we have also seen in the dispute present in Independent News and Media Ltd & Ors v A [2009] EWHC 2858 where it was determined that there was ‘good reason’” for the media to be present at the hearing “with the potential for reporting its outcome”. In that case, the judge, Mr Justice Hedley, highlighted three reasons as to why he concluded that there was ‘good reason’ in this case. They are as follows: 

First, all these issues in principle are already within the public domain and the questions which they raise are readily apparent. Secondly, the court is equipped with powers to preserve privacy whilst addressing the issues in the case. Thirdly, the decision of the court will have major implications for the future welfare of ‘A’ and it is in the public interest that there should be understanding of the jurisdiction and powers of the court and how they are exercised. It can be objected that the second and third reasons above could apply to almost any case, and it is important to stress that it is the combination of those three reasons that impels my decision; by the same token it should not be assumed that the first standing alone would necessarily be sufficient. (my emphasis)

The ability to observe and read about cases can greatly aid the public in our understanding of the court process and end-of-life decision-making. Statements such as these point to a shift in attitude of those involved in the court in acknowledging the benefits and importance of transparency and openness. 

Rhiannon Snaith is an ESRC funded PhD student at the School of Journalism, Media and Culture at Cardiff University. Her research focuses on media representations of decisions about life-sustaining treatment, specifically for those without the capacity to make such decisions for themselves. She has previously blogged for the Project here and here.  You can learn more about her work by checking out her academic profile and her Twitter profile


[1] This quotation was supplied by Celia Kitzinger.  All extracts purporting to be direct reported speech from the hearing are drawn from contemporaneous notes made by Celia Kitzinger and (with this sole exception) Rhiannon Snaith, and cross-checked for accuracy.  However, we are not allowed to audio-record hearings and they are unlikely to be 100% verbatim.

A court system creaking under its own weight: Transparency challenges


by Daniel Clark
, 25th August 2023

Earlier this month (on Tuesday 16 August 2023), I was given an insight into the cracks spreading through the structure of the judicial system. 

This blog highlights those cracks, so that more people are aware of the pressure facing judges and, by extension, everybody else in the court system – from regional county courts to the Royal Courts of Justice. 

From Sheffield County Court…

It all started when I asked for the link to observe a hearing before HHJ Marson, sitting remotely in Sheffield. 

I asked for the link to observe this hearing because I had some previous knowledge of this case, having observed a hearing at the end of June this year. 

It caught my eye because Celia Kitzinger had tweeted about it from the Open Justice Court of Protection Project feed when she noticed it was incorrectly listed: it appeared in the Sheffield Daily Cause List rather than the Court of Protection list. It was only by chance that she’d looked at the Sheffield Daily Cause list, and so only by chance that we even knew this hearing was taking place. Celia tells me she also reported this incorrect listing to a Deputy Manager at His Majesty’s Courts and Tribunal Service (HMCTS) who said she would address this with the people responsible.  At the time she posted this, she didn’t know I’d observed a hearing in this case before.

When hearings are listed in Court of Protection list, would-be observers are instructed to contact the regional hub. As the hearing was in the Sheffield Daily Cause List, the instruction was to contact the Sheffield court directly. 

After some consideration, I decided to email the Sheffield court but copy in in the regional hub which, as a result of the last hearing (which had been listed correctly), I knew was the Leeds Hub. I cannot be sure which email resulted in a response because the response for my email (received at 09:45) came from the Sheffield Court of Protection email address. 

I was advised my details had been passed to the Judge and the Clerk and that they would join me to the hearing. The Transparency Order was also (unusually) attached. The hearing was listed to start at 10:30 but I still had not received the link at 10:40. I therefore sent a (polite) email asking whether there was some delay to the hearing getting started. 

At 10:50, having received no response, I rang the Sheffield Court directly, and the person I spoke to advised me to email them again so that my request could be sent to Sheffield’s Court of Protection team. I advised this was who I’d been in contact with so far but the person I spoke to advised me that this was the best option.  

At 11:11, I received a message from the judge (via the administration officer who sent me the Transparency Order) explaining that, ‘Circuit Judges in Sheffield are block listed at 10.30am. Just because they appear in the list at 10:30am does not mean that will be heard at 10.30am, I may not reach this case until this afternoon, I have too many other equally important cases to deal with at the same time.’ 

My first reaction was, if I’m honest, of frustration. I felt that the tone of the email was somewhat irritable, assuming that I should have some sort of knowledge about the way lists in Sheffield are composed. I also thought that it would have surely been possible for somebody I’d emailed or spoken to, to have made me aware that this hearing would not necessarily commence at 10:30am. 

I think it is also worth pointing out that the hearing at the end of June was also listed to start at 10:30am. On that occasion, I received the Transparency Order at 09:52, and the link at 09:58. In my opinion, it wasn’t unreasonable to except that would happen again. 

However, the tone of emails is very hard to judge. I’ve come across as short and irritable in email (I know because I’ve been told) when in reality I simply wanted to ensure information was passed on to somebody in a timely manner, when I didn’t have much time. 

In that light, I think this whole experience really demonstrates the way in which judges are expected to handle an increasingly high volume of hearings – as well as the demands of transparency, as exemplified by requests from would-be observers like me. We know about the volume of hearings: when we share listings on Twitter (aka X), we often have occasion to point out that some judges have multiple hearings listed for the same time, and so that inevitably some will start later than the listed time.

HHJ Marson is, of course, right to say that all cases are of equal importance. But every case has a diverse set of people involved, and every single one of them want to know about their own important case. 

I later found out that this case was vacated with consent orders in place. 

…to the Royal Courts of Justice

There was a hearing before Mr Justice Keehan that was also listed to begin at 10:30am that same day (Tuesday 16 August 2023).  I learnt from another observer that the start of that hearing had been delayed because the judge was involved with another matter. I therefore requested, and received, the link for this hearing, and joined the virtual waiting room. 

It was hard not to miss some similarities. Two cases, on the same day, were listed to start at the same time, only for the judge to be engaged in another matter, and the start of the hearing delayed. 

I knew, though I couldn’t see them, that also in the waiting room there must be lawyers waiting; lawyers who also have many other clients to make contact with, and other hearings to plan for. I thought there may well be professionals – a social worker, as it turned out – who were also anxiously waiting for the hearing to start, their diary already marked out as ‘do not disturb’ and facing the possibility of extending that period of not being available. 

And finally, I thought there may well be anxious family members, maybe even the protected party (P) herself waiting for the hearing to start. Although I could get on with other things, occasionally re-opening the tab to check I hadn’t missed anything, I highly doubted that they could switch between tabs with such comfort. For the hearing about you or your loved one to be delayed must be unbearable. 

Of course, this isn’t the judge’s fault at all.  He was apologetic (both at the start and end of the hearing) for the delay. In fact, it struck me again that this is an almost impossible situation for a judge to find themselves in: having to move with urgency from one hearing to the next, knowing full well how important each case is but inevitably having to keep somebody waiting.

Delay, delay, delay…

Both of these cases were, of course, dealt with by a judge on the day they were meant to be heard. However, it goes without saying that given the sheer volume of outstanding cases, there is delay elsewhere in the system too. 

It is not just public hearings that Court of Protection judges deal with. There are hearings that are private and others that are ‘closed’ (i.e. a party is being excluded, though all such hearings should now be listed).  There are applications for deputyship that must be approved by a judge, and applications for the deprivation of liberty where P is not living in a care home or hospital that must also be approved by a judge. 

The increasing number of people requiring a judge’s attention puts incredible strain on the judicial system: a system that is creaking under its own weight. Judges are expected to juggle an ever-increasing workload, as are the lawyers involved. Professionals feel the shockwaves of delays in the courts, and family members become even more anxious to see their loved one’s situation resolved.

And when we look past the judges and the barristers and the solicitors and the social workers and the nurses and the doctors and the anxious mother or worried uncle, we see P, the person at the centre of the case. When workloads are stretched and schedules would benefit from an extra couple of hours in the day, it is ultimately P who is left in limbo.  

Our focus, as the core team running the Open Justice Court of Protection Project, is of course on open justice and transparency.  We recognise the challenges the court faces in ensuring transparency – as well as everything else! –  in this context. It is to the credit of the Court of Protection that it continues to maintain its commitment to transparency as a fundamental principle, despite (or maybe because of) the pressures the system is under.  Our role is – and continues to be –  to support that judicial commitment to transparency.

Daniel Clark is a member of the core team of the Open Justice Court of Protection Project. He is  a PhD student in the Department of Politics & International Relations at the University of Sheffield. His research considers Iris Marion Young’s claim that older people are an oppressed social group. It is funded by WRoCAH. He tweets @DanielClark132.

Closed Material Proceedings: A ‘forced marriage’ hearing before Theis J

By Celia Kitzinger, 23 August 2023

The hearing (COP 13907545 on 27 July 2023) concerns a young woman in her twenties (M) who has a mild learning disability and can also experience anxiety, depression and impulsivity.  She needs 24-hour support to provide assistance with personal care, nutrition, medication and to allow her to access the community safely. 

In March 2022, M was moved from her parents’ home into supported living accommodation and the local authority (Luton Borough Council) made an application for personal welfare orders regarding her residence, care and support, and marriage.

In their application, the local authority described M as “a vulnerable lady who has entered into a marriage with her cousin” in Pakistan.  They said: “It is believed that her parents forced her to marry her cousin. M was previously living at home with her parents, who kept her locked in the house when they found out she is talking to a male friend”.  Divorce proceedings are now underway, and the parents are invited to file the Nadra Card providing final confirmation of divorce under Sharia law, with the court.

After 7 months in supported living accommodation, M returned home.  But just a few weeks later (in December 2022), she jumped from her first-floor bedroom window and sustained serious injury.  When she was admitted to hospital, her parents disguised how she had sustained the injuries (saying she had slipped and fallen in the snow in the garden), which led to M having an untreated fracture in one leg for nearly two weeks. 

On discharge from hospital, she was moved to a nursing and residential care home for rehabilitation. She’s engaging with physiotherapy and now (nearly 7 months after sustaining the injuries) is able to walk with a zimmer frame and crutches.  Her parents and younger sister visit her there, and she visited the family home recently to celebrate Eid – which went well. There are no restrictions on contact between M and her family 

M is currently subject to a Forced Marriage Protection Order (made by HHJ Hildyard).  This is an injunction preventing her parents, and her brother, from (amongst other things) forcing or attempting to force or otherwise instructing or encouraging any other person to force M to undergo any ceremony (or purported ceremony) of marriage, civil partnership, betrothal or engagement and from removing her from England and Wales.

The main issues before the court concern (1) M’s capacity to make her own decisions in the relevant areas; and (2) what best interests decisions should be made on her behalf in relation to those domains where she lacks capacity. The parties are not in agreement about the adequacy of the assessments before the court (made more than nine months ago) -which find capacity in some areas (including residence, contact, sex, and marriage, ) and not in others (including care and support).  There is a suggestion that her capacity fluctuates due to her anxiety and impulsivity.  There is also some concern about how she is affected by the “coercion and control” exerted upon her by her parents.

I’ve watched this case in court before – on 28 February 2023 (“A ‘closed material’ hearing on forced marriage”). On that occasion, PA reporter Brian Farmer also observed the hearing and wrote about it (“Arranged marriage: Judge protects woman with learning disabilities”).

A key issue to be resolved before the final hearing concerns redacted material in the court bundle – which had caused the judge considerable concern at the February hearing.

The parents, both of whom are parties to this case (as second and third respondents) do not have access to all the information available to the other parties and to the judge.  Some information has been redacted from the documents made available to the parents “because of certain matters M does not want discussed or disclosed to her parents”. I don’t know what that information is because it has also been withheld from observers.

At the last hearing, the judge was also unsure, on the basis of the paperwork before her, what the redactions were and hence what the parents did and did not know.

I’m unclear at the moment from the documents I’ve got what exactly has been seen by the parents.  I understand that certain parts of the information P has given has been redacted because of her concern about certain information being shared with her parents?  [Yes] I don’t know what has been redacted. It hasn’t been highlighted in the document and I think that is unsatisfactory…. I don’t think that was raised at the last hearing. I don’t know how much there has been discussion with the parents outside court so they know what all this means.”

At the end of the last hearing, she said: ” I’m minded to permit these redactions at the moment, but make it clear there is going to need to be some very rigorous thought and scrutiny of that before the next hearing.

So what happened at this hearing?

I watched the hearing from 11.16am when it started until the lunch break began at 1pm. I believe that the hearing continued in the afternoon, but I wasn’t able to observe then. So anything that was said or decided about closed material in the afternoon is not included in this blog post.

‘Closed material’ – the Guidance

The Court of Protection does have the power to withhold material in this way, but the starting point is that, in principle, all parties to proceedings should have sight of all materials upon which the court will reach its conclusions.  This is because:

  1. The principle of open justice, “fundamental to the dispensation of justice in a modern, democratic society,”normally requires that a judge cannot read or hear evidence, or receive argument which is not before all the parties to the proceedings;
  2. Securing the full participation of parties to proceedings, including by way of disclosure, not only enables them to present their case fully but also ensures that the court has the assistance of those parties in arriving at the right decision in relation to P’s capacity and best interests; 
  3. In any case where there is a suggestion that the court may in reaching its decision proceed on the basis of materials adverse to a party, both common law fairness and Article 6 of the ECHR normally requires that that party should be able to answer that material by way both of evidence and argument

This is taken from recent guidance available here (Guidance for the Court of Protection: ‘Closed hearings’ and ‘closed material’). For me, part of the value of observing this hearing was seeing how this Guidance (into which I had some input) played out in practice – and in relation to a very different set of facts from those that prompted my participation in creating the Guidance (see “New Guidance on closed hearings from the Vice President of the Court of Protection“).

The Guidance continues:

23. In any case where the basis for withholding disclosure is identified as being necessary to secure the rights of P, the following staged approach applies to the court’s consideration (and hence to the matters which must be set out in any application for material to be closed):

  1. When deciding whether to direct that a party should not be able to inspect the part in question, the court should first consider whether disclosure of the material would involve a real possibility of significant harm to P;
  2. If it would, the court should next consider whether the overall interests of P would benefit from non-disclosure, weighing on the one hand the interest of P in having the material properly tested, and on the other both the magnitude of the risk that harm will occur and the gravity of the harm if it does occur;
  3. If the court is satisfied that the interests of P point towards non-disclosure, the next and final step is for the court to weigh that consideration, and its strength in the circumstances of the case, against the interest of the other party in having an opportunity to see and respond to the material.  In the latter regard the court should take into account the importance of the material to the issues in the case;
  4. In all cases, the test for non-disclosure is whether it is strictly necessary to meet the risk identified by the court.

The July 2023 hearing

There had been some progress towards the “very rigorous thought and scrutiny” Mrs Justice Theis had asked for before the next hearing.

The position taken on behalf of M via her litigation friend the Official Solicitor (Emma Sutton KC of Serjeants’ Inn) is that the redaction of this information may be necessary to facilitate M’s full participation, and to promote her autonomy and independence.  This, she says, “trumps” the need for her parents to see all the materials.

A psychiatrist has been approached and offers a preliminary opinion that revealing this – currently redacted – information could lead to significant harm for M because of a risk of self-harm “if she feels unable to cope with negative emotions secondary to her family’s reaction”. 

The Official Solicitor is also looking at what steps can be taken by the care home staff to see if they could in some way be the conduit of the currently redacted information between M and her parents. It is (she said) “important to give M the tools to discuss the information currently withheld… We have been in discussion with the care home to see who would be best placed to support M with this”.

Acting for the local authority, Sally Gore of Fenners Barristers said that it was recognised that “to litigate, the parents are going to need this information”.  She also expressed concern that the local authority needs to build a good working relationship with the parents going forward and  “that is undermined by the fact that the parents know there’s information we have that we’re not sharing with them”.

The judge still seemed somewhat frustrated by the redactions and her impression was that “M believes she can keep these matters secret forever”.  She emphasised the need to have “open discussion with the parents, and at the moment, we can’t”. She said:  “The redaction issue needs to be grappled with before the next Case Management Hearing, with a view to the redactions being removed, so there can be meaningful discussion with the parents” – and in particular “the redaction issue needs to be dealt with before any placement options are approved by the court”. Returning home is one placement option; alternatives are either a Shared Lives placement or a supported living placement.

There is to be an in-person case-management hearing on Tuesday 17 October 2023 and a final hearing on 11-14 December 2023 (with a time estimate of 4 days).

It will be interesting to see how the issue of redaction has been handled.

Celia Kitzinger is co-director of the Open Justice Court of Protection Project. She has observed more than 470 hearings since May 2020 and written more than 100 blog posts. She is on LinkedIn (here), and tweets @KitzingerCelia

“I am very concerned … that the current situation is not tenable”: High-risk behaviour and questions about jurisdiction


by Daniel Clark
, 22nd August 2023

The young woman (AB) at the centre of this case (COP 12953545) suffered a Traumatic Brain Injury following a Road Traffic Accident some years ago. 

She is engaging in high-risk behaviour, and the local authority is seeking an order from the Court that it is in her best interests to be conveyed to a specialist unit for assessment. 

First, though, it must be established whether the Court of Protection has jurisdiction over this case. 

This hearing, which took place (remotely) on Wednesday 15 August, 2023 before Mr Justice Keehan, was in the urgent hearings list at the Royal Courts of Justice. The parties and their counsel were:

  • Conrad Hallin, of Serjeants’ Inn Chambers, representing the applicant local authority;
  • AB’s mother (the first respondent) who was representing herself as a litigant in person
  • Anna Datta, of Parklane Plowden, representing AB (the protected party) via her litigation friend, the Official Solicitor – as second respondent;
  • Francesca Gardner, of 39 Essex Chambers, representing the Integrated Care Board (ICB), the third respondent.

Background to the case
Very helpfully, and in accordance with the (former) Vice President’s advice (here), counsel for the applicant local authority offered to provide a background to the case, which was welcomed by the judge. 

He explained that following the accident, AB had spent some time in a neurological rehabilitation unit but, 18 months later, went on leave one weekend and refused to return. She was subsequently discharged.

In June 2021, she moved to rented accommodation with a support package amounting to 22 hours. In November of that year, a judge made a final order authorising her deprivation of liberty. 

In June 2022 she bought the property, and the deprivation of liberty was amended. Later, the local authority applied for a more restrictive package of care, which would entail an adjustment to the deprivation of liberty. 

Counsel for the local authority explained that ‘It was known [AB] was drinking a lot, inviting men to her house to have sexual intercourse, and wasn’t engaging with support staff’.” This escalation of high-risk behaviour prompted a Mental Health Act Assessment, wherein AB was assessed as not eligible for detention. Between May and August of this year, AB has been assessed several times.

AB’s behaviour has continued to escalate, with Counsel noting that “most recently I think it’s important to note that [AB] removed her own contraceptive implant which carries risk, it’s not medically advised that be done, and she’s also assaulted a support worker.” A specialist unit has been identified as a place that AB can move to for, initially, a period of 12-weeks of assessment. 

There was not any dispute that AB lacks the capacity to make this decision nor that it is in her best interests to move to this unit. However, Counsel for the local authority explained that, “there has been, it’s fair to say, some controversy about the status and the interaction between the Mental Health Act and the Mental Capacity Act in this case”.

The issue, in other words, is whether the Court of Protection has jurisdiction. 

The Mental Health Act and the Mental Capacity Act: An uneasy alliance

Counsel for the Local Authority submitted to the judge that the Court does hold jurisdiction, appealing to the judgment of Mr Justice Charles in the case of GJ v The Foundation Trust [2009] EWHC 2972 [Fam]. 

In that case, Charles J concluded that a decision-maker should, when considering whether to deprive somebody of their liberty, first accept the primacy of the Mental Health Act. Going forth, the decision-maker should assume that there is no alternative available under the Mental Capacity Act, and ask whether the person they are assessing could meet the eligibility for detention under the Section 2 or Section 3 of the Mental Health Act.

In this hearing, Counsel for the Local Authority submitted that, “in this case we have a situation where an assessment has taken place and [AB] has been found not to meet the criteria for section. It is very indicative that this patient is not within the scope of the Mental Health Act”. 

Having established (at least in the eyes of the local authority) that the Court has jurisdiction in this matter, the local authority was asking the Court to approve an Order that the move to the unit is in AB’s best interests. 

Given AB is “not in any way engaging” but that “there’s no way of managing that [risk] in the community”, the local authority also wanted approval for a draft transition and conveyance plan, including the possibility of the use of “restraint and chemical sedation”. This would be shared with both a private ambulance service and the unit. 

Following Counsel for the local authority’s submissions, the judge stated, ‘If I can just observe on the jurisdictional point, I’m inclined to agree with you and Mr Justice Charles. It would be absurd to know that a psychiatrist found her not to be detainable and yet the Court was still precluded from exercising its powers under the Mental Capacity Act 2005 to afford some protection to [AB] as this very vulnerable person”. 

The judge also acknowledged he had been to see AB the day before. He stated that, when he met her he learnt that “she feels though she has not been fully engaged in plans for her life ….I am concerned that [AB] has the opportunity to feel at least she has the opportunity to feel like she is planning for her life…She doesn’t accept that she needs help. Certainly she indicated to me yesterday, she doesn’t accept that she needs treatment, although she was urged to keep an open mind about a placement at [Unit]…But I am very concerned, as I think is the Official Solicitor and no doubt the local authority, that the current situation is not tenable.”

Counsel for AB via the Official Solicitor submitted that they were still awaiting instructions on the jurisdiction issue and the draft order. However, she did confirm that the Official Solicitor “has significant concerns about the vulnerability of [AB]”, and it is the Official Solicitor’s view that is in AB’s best interests to go to the unit identified. 

The judge also heard submissions from AB’s mother, who stated that the move “is not something I can see [AB] accepting….that’s like a zero to nothing chance.” However, AB’s mother explained that she wants “to get her back, to get her rehabilitation, to get her back into the community with support – how she was prior to the last 8-to-10 months”. 

I found this quite striking, and I thought at the time (and still do) that I cannot imagine the situation that AB and her mother are in. I have cared for people (in an inpatient setting) whose high-risk behaviour, whilst living in the community, placed them in dangerous situations, and resulted in moments of high anxiety for their families. They would often relay feeling as if their loved one has been ‘lost’, especially when the behaviour was so out of character.  

Counsel for the ICB also had limited submissions, agreeing with the consensus on best interests, and relaying that they will continue to support the parties as needed. However, “given the potential legal argument, I intend to say very little unless I can assist you, apart from this – it is not in my submission as straightforward as my learned friend suggests.”

Counsel made reference to the recent judgment of Mrs Justice Theis, Vice-President of the Court of Protection, in the case of Manchester University Hospital NHS Foundation Trust v JS & Others. In this case, Theis J commended the Official Solicitor’s suggested questions that should be asked in cases such as: 

“(1) Is P a ‘mental health patient’? 

(2) Is P an ‘objecting’ mental health patient? 

(3) Could P be detained under s 3 MHA 1983” [s48]

Counsel for the ICB simply made reference to this judgment and so the full position of the ICB on this matter remains to be seen. Whilst I did receive the ICB’s position statement, this was written at an earlier time, and does not acknowledge this issue in any great detail.

Similar to earlier in the hearing, Keehan J did state that “on a provisional basis, I would find it very unattractive that [AB] is not eligible for decisions made in the Court of Protection. Whilst she may not be judged to be detainable under the Mental Health Act, that may not be the same in the future. It leaves the question of what is to be done.” 

Given the fact that there is a sense of urgency in these proceedings, the judge decided to schedule another hearing for next week (week commencing 21 August 2023). At the very least, the “jurisdiction issue” will be dealt with at this hearing, as can what other evidence is needed for the formulation of a best interests decision.  

Transparency matters

Neither Celia Kitzinger nor I received the Transparency Order before this hearing, instead receiving it when the hearing was finished.

The purpose of a Transparency Order is to enable transparent reporting of Court of Protection proceedings.  This is usually achieved by permitting reporting but protecting the identity of the protected party (P), where they live, and the identity of carers and family members. It is usual to be able to name the public bodies involved in a case. After all, they are funded by the taxpayer, and cannot be accountable to the people who live in their area if they do things that go unreported.  

However, this Transparency Order (made by a different judge, Sir Jonathan Cohen, in an earlier hearing) extends further. It states that we cannot publish anything that “identifies or is likely to identify…any of the parties”. This goes far beyond protecting the identity of the protected party and her family. It means that we cannot name the local authority or the ICB. 

As she has done before (albeit much too often) Celia Kitzinger emailed the judge asking for the Transparency Order to be varied. She received an email not too much later, thanking her for her email and advising the judge is seeking the views of the parties. Hopefully, this can be addressed by the time of the next hearing.

Daniel Clark is a member of the core team of the Open Justice Court of Protection Project. He is a PhD student, funded by WRoCAH, in the Department of Politics & International Relations at the University of Sheffield. His research considers Iris Marion Young’s claim that older people are an oppressed social group. He tweets @DanielClark132.