23.28AH v Hertfordshire Partnership NHS Foundation Trust [2011] EWHC 276 (COP), (2011) 14 CCLR 301
It was not in the best interests of a severely learning disabled man to be moved from an NHS facility where he had lived for many years to a flat in LondonValuing People guidanceValuing People guidance
Facts: AH was a learning disabled adult who had spent most of his life in a long-stay hospital and, when it closed, moved to a specialist facility within the grounds of a former hospital, in a rural location. Pursuant to central government policy, Valuing People, that persons with a learning disability should have increased choice and control over their lives, the NHS decided to move AH, contrary to the wishes of all those concerned about him, to a flat in London, to be cared for by an agency and the local authority there. AH himself lacked the relevant capacity to oppose this move.
Judgment: Peter Jackson J held that the proposed move did not entail a single benefit for AH but would cause him significant upset possibly amounting to serious harm:
77. Although the ambition to maximise Alan’s opportunities is laudable, it has not been possible to identify a single dependable benefit arising from the proposed move. The thesis is that it would provide him with a greater experience of ordinary life in a local community, and that this would improve his quality of life. Each element of this proposition is incongruous with the realities of Alan’s life. His experience is so far from being ordinary that it is not useful to use ordinariness as a yardstick. Ealing is not local for Alan and there is no community there which would be meaningful for him. I also accept the evidence of the clinicians, the experts, and not least of Alan’s committed parents, that the prospect of him living a more expansive and fulfilled life following a move is a chimera. It is more likely that it would lead to a deterioration from which he might – or might not – recover. It is not enough to say that ‘the benefits of community living may matter to Alan’’if one cannot show that they will. Facing up to these realities does not in any way diminish or demean Alan, but values and respects him for who he is.
78. I agree that the prospect of a home for life for Alan is attractive and accept that there is no guarantee that an alternative of the quality now offered would be available if he had to move at some point in the future. Nevertheless, only the closure of SRS could justify the turmoil of a move and as this is not expected in the foreseeable future, there is no reason to anticipate it.
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80. This case illustrates the obvious point that guideline policies cannot be treated as universal solutions, nor should initiatives designed to personalise care and promote choice be applied to the opposite effect. The very existence of SRS, after most of the institutional population had been resettled in the community, is perhaps the exception that proves this rule. These residents are not an anomaly simply because they are among the few remaining recipients of this style of social care. They might better be seen as a good example of the kind of personal planning that lies at the heart of the philosophy of care in the community. Otherwise, an unintended consequence of national policy may be to sacrifice the interests of vulnerable and unusual people like Alan.