A mother wept in the High Court today as it made orders for her brain-injured daughter to be moved to a UK facility after being told there is no public or private facility here capable of assessing her complex needs.
The president of the High Court, Mr Justice Peter Kelly, said it was "extremely distressing" to see the mother, aged in her seventies, break down in court a few times at the thought of her daughter, aged in her forties, having to go to the UK.
The mother had appealed to the judge not to sanction the move, saying she believed it would be “disastrous” and her daughter would not trust anyone again and would deteriorate. “It will kill both of us.”
As both she and her husband have health issues, it would be very difficult to visit her daughter in the UK, she said. In contrast, she visits her daily here in a psychiatric unit located close to her home.
She feared, while doctors said the move was for assessment purposes with a view to having her daughter return here, it could be decided later there is no appropriate facility here and her daughter would be left in the UK.
The judge paid tribute to the mother and other family members for their commitment and care but said all the medical evidence, including from an independent psychiatrist on behalf of the family, was the UK transfer is necessary and urgent to secure a proper assessment of her daughter’s complex care needs.
Assessment
He said the assessment, expected to take at least three months, is to be carried out with a view to informing the HSE of the nature of the precise services the woman requires after which the HSE will decide if those can be provided here.
All the medical evidence states the woman is “wholly unsuitably” placed in the psychiatric unit and doctors believed she would deteriorate and become institutionalised if she remained there, he said.
The independent psychiatrist had said he had some hope, if the woman underwent the assessment and was later appropriately placed, there might be some improvement in aspects of her condition. While the doctor was not optimistic, he was “not without hope”, it was important hope be maintained but it would be “extinguished” if she remains where she is.
The woman, who has been in various residential and psychiatric units for a number of years and was made a ward of court last April, is brain damaged as a result of alcohol misuse and also has serious behavioural and other problems.
Long-term care
The combination of those lead to three psychiatrists, two for the HSE and one for the family, agreed in evidence she requires specialist neuropsychiatric assessment in the UK unit with a view to identifying exactly what services she requires and whether those can be provided in Ireland.
The independent psychiatrist said her presentation, while not unique, was not common and he had not come across a similar case. He considered she needs long term care in a secure setting with some medication, appropriate therapies and activities.
Based on the evidence, Mr Justice Kelly said he would direct the transfer to the UK unit for assessment.
If, following that assessment, it is decided the services the woman requires cannot be provided here, he said he would then address an application by a family member, who was appointed by the court as the committee to present the woman’s interests as a ward, for orders compelling those services to be provided here within a set time.
That application raises “far-reaching” legal issues and, if it proceeds, other parties may have to be joined to the case, he said. The issues concern the extent of the court’s power to direct the State in relation to the spending of public money.
