New curbs on mentally ill

Tough new restrictions on the admission of mentally ill people to hospital are expected to follow a Court of Appeal judgment yesterday which could affect thousands of psychiatric patients.

Lord Woolf, Master of the Rolls, and two other judges ruled that the subject of the appeal - a 48-year-old man who "has no ability to consent or dissent to treatment" - was unlawfully detained at Bourne- wood psychiatric hospital, Surrey, after doctors decided he should be admitted on an "informal" basis.

Yesterday, the three judges gave their reasons for their ruling last month that the doctors had acted unlawfully. The practice of informal admissions - as opposed to formally "sectioning" patients - "bypasses the safeguards" for patients contained in the 1983 Mental Health Act, they said.

Although he was admitted to the hospital as a voluntary patient, his mental condition meant he was unable to indicate whether he wanted to stay or go and the judges said that he was therefore in effect detained.

They unanimously agreed that the Bournewood Community and Mental Health Trust had misinterpreted the law - and said they were "troubled" that the Trust was not alone in getting the law wrong. "Apparently there could be many patients, especially those suffering from dementia, who are in the same position," they said.

The judges gave permission for an appeal against their ruling to the House of Lords after John Grace QC, appearing for the Trust, said it contained "serious public resource implications" for the NHS. Unless overturned on appeal, it meant that doctors would "have to section ... a whole group of patients it was hitherto thought unnecessary to compulsorily detain".

The health department said last night it was "looking carefully" at the judgment.