(Abstract of article first published in British Journal of Clinical &
Social Psychiatry 2004, updated 2008)
BY P Grahame Woolf FRCPsych
Consultant Psychiatrist in National Health Hospitals Service 1959-1985 (Holder of Distinction Award; member of Royal College of Psychiatrists Executive Committees (Forensic Psychiatry and Learning Difficulties sections). Latterly engaged in medico-legal psychiatric practice. Medical Member of Mental Health Review Tribunal 1966-98
Editor British Journal of Social & Clinical Psychiatry 2004-2006
This paper, which could not have been written by a younger doctor still beholden to the powers that be, relates to the surprise outcome of two Mental Health Review Tribunal hearings in 1994 and 1997 that led to permanent dismissal from public service.
Both patients were detained in hospital for short term assessment and the writer was the Medical Member of the panels. The social worker at the first hearing reported to her department having felt unduly pressed by questioning about the discharge plans for the patient. No one present at the hearing reported anything untoward. Responding to a subsequent complaint on her behalf, I apologised that she had felt discomfited by my persistence. Her client later died in police custody and the coroner's critical conclusions (publicized on a TV investigative documentary) highlighted his vulnerability, which was consistent with my pertinent questioning about his social circumstances and potential homelessness.
The second patient mentioned in passing during a preliminary examination that he thought I might have examined him some years before. That not unusual circumstance led unexpectedly to a request for an adjournment, which was granted nem con, although in like circumstances many Tribunal Presidents would have ruled that the hearing should proceed. The patient was not disadvantaged, nor was he discharged at the resumed hearing a week later.
The Regional Chairman subsequently took me to task for having omitted to pass on the information of possible prior contact with the patient before the hearing opened.
In both instances I was summarily suspended by letter pending investigation of the complaints--bolts from the blue!
The first suspension was partially lifted after a meeting at the
Department of Health, but the second was not even after legally supported correspondence with the authorities which included making formal complaints about a series of inappropriate behaviors by that same Regional Chairman, a retired Crown Court Judge.
Instead of answering those complaints, the appeal for justice was converted by the Lord Chancellor to formal dismissal, effectively terminating the career of an experienced senior medico-legal specialist.
That extreme decision in response to a strongly disputed and - at the highest - no more than a very minor misdemeanor was taken without prior opportunity for any meetings with members of the Lord Chancellor's Department, or with representatives of the Department of Health, which have joint responsibilities for the Mental Health Review Tribunal.
No reasons for dismissal were given beyond the Lord Chancellor citing "any likelihood that public confidence in [the holder's] impartiality will be impaired". However, according to the Tribunal Rules a contravention could have occurred only had I actually treated the patient, and "recently" too, instead of just assessing him.