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Eleanor Roosevelt, 1958

'Where, after all, do universal human rights begin? In small places, close to home -- so close and so small that they cannot be seen on any map of the world. Yet they are the world of the individual person... Unless these rights have meaning there, they have little meaning anywhere. Without concerted citizen action to uphold them close to home, we shall look in vain for progress in the larger world.' Eleanor Roosevelt, 1958

The Small Places has moved...

The Small Places has moved to a new home here, including all the old posts. Any posts after 6th March 2014 will appear on the new website, but old posts are preserved here so that URLs linking here continue to work. Please check out the new site.
Showing posts with label Article 5. Show all posts
Showing posts with label Article 5. Show all posts

Wednesday, 31 July 2013

The advocacy providers: 5th Evidence Session of the Select Committee on the Mental Capacity Act 2005

It’s hard to keep up in legal capacity land these days, what with the Irish Bill being published, this rather marvellous report on legal capacity from the European Union Agency for Fundamental Rights and Munby’s transparency drive. But, still, better late than never. Last week the Select Committee on the Mental Capacity Act 2005 (MCA) heard evidence from advocacy providers, including Steve Gray (from Asist), Elyzabeth Hawkes (from PohWER) and Jonathan Senker (from VoiceAbility). The session primarily focussed on a form of statutory advocacy created by the MCA – Independent Mental Capacity Advocates (IMCAs). The Chairperson was Lord Hardie.

This evidence session did prompt a little twitter rant on my part in relation to the role of IMCAs in accessing the Court of Protection under the deprivation of liberty safeguards (DoLS). The gist of it – as I’ve written about before – is that I am concerned that not all IMCA providers appreciate that it is their job to help people exercise their rights of appeal against detention.  Nothing under the MCA or Article 5(4) ECHR says that people only have appeal rights where it’s in their best interests – and there are a welter of cases about legal capacity which point to the contrary (Shtukaturov, Stanev, DD, Kedzior, Sykora, Lashin and more...). Moreover, there are also ECHR authorities which say that a person’s rights of appeal against detention don’t rest on their case having merits, and there are cases which say that a person’s access to effective remedies in matters like appeals against detention and declarations of incapacity absolutely should not be resting on the individual judgment and discretion of public officials…  In the context of detention under s2 Mental Health Act 1983 - which has no automatic referral mechanism to the Tribunal - Lady Hale noted that the right to bring an appeal against detention under Article 5(4) must be 'practical and effective', meaning that 'every sensible effort should be made to enable the patient to exercise that right if there is reason to think that she would wish to do so'.  I can think of no sensible reason to distinguish the DoLS from this general proclamation, especially since the case was about a person who 'lacked capacity'.  If IMCAs aren't the ones who are supposed to make every sensible effort to help a person exercise their appeal rights, then who on Earth is?  The detaining authorities?  Should it just be left up to families to rock the boat?

Perhaps I’m being unfair, but comments to the effect that it’s a shame the DoLS don’t have an independent element like the Tribunal under the Mental Health Act 1983 had me holding my head in my hands and shouting ‘There IS an independent element. It is called the Court of Protection. And YOU are meant to help people to get there!! Read s39D(8) MCA!!’ Part of the difficulty, I suspect, is the the language of the statute under s39D around when an IMCA must help a person to challenge their detention is somewhat diluted in the DoLS Code of Practice, which merely comments that they may.  Meanwhile the duty to refer to an IMCA under s39D has been interpreted by the code in terms of when a person requests one - not when it appears to a supervisory body that without the help of an IMCA that person would be unable to exercise their rights of appeal and review.  Which - given the difficulty most people would have in understanding their rights under the DOLS and navigating the appeal appeal mechanism - must be most people.  That, I suspect, is why we still see local authorities with many DOLS authorisations (sometimes over 100) and yet not a single referral under s39D MCA.

Wednesday, 4 January 2012

3. DoLS v Guardianship - Summary and discussion

Update (December 2012): These posts are fairly out of date and contain some inaccuracies.  I've given them an overhaul, and you can read and download and updated and corrected version at DoLS v Guardianship - Redux.

Several knowledgeable bodies and individuals have suggested that guardianship under the Mental Health Act 1983 (MHA) might be a preferable framework for community based detention than the deprivation of liberty safeguards (DoLS). I have compared the two frameworks on a range of issues in two previous posts (Part 1, and Part 2).  For those of you who prefer a printer-friendly word document, and would rather read this in one piece, here's a pdf version of all three documents that I've prepared (very kindly hosted by Celtic Knot Solicitors, so you don't have to create a Google Acount to read it).  And, two days after writing this post here's a brand new DoLS and guardianship case, with a very interesting comment from Jackson J:
It is a truly unhappy state of affairs that the law governing the fundamental rights and welfare of incapacitated people should be so complex. As this case shows, its intricacies challenge the understanding of professionals working in the field and are completely inaccessible to those for whose benefit the legislation has been devised, including those with a relatively high level of understanding, such as Mr C. This judgment, while keeping citation from statute, regulation, codes of practice and reported cases to the necessary minimum, still remains more focused on technical issues than I would like
If you’ve skipped to the end of these three posts, here’s what you’ve missed in a nutshell: 

2. DoLS v Guardianship: Appeal and review mechanisms

This is the second post in a series of three comparing guardianship under the Mental Health Act 1983 (MHA) with the Mental Capacity Act 2005 deprivation of liberty safeguards (DoLS).  The first post explains why some people have argued that guardianship would offer better safeguards than the DoLS against arbitrary detention.  In that post I explore the criteria for entry into each regimes, the coercive powers each regime affords public bodies, and the role they give to families.  In this, the second post, I will look in detail at the appeal mechanisms, and consider whether they are compliant with Article 5(4) of the European Convention on Human Rights.  If you are short of time, I strongly recommend you skip to the third and final post, which offers a summary and some thoughts on why both regimes for community based detention will have significant difficulties in practice.

1. DoLS v Guardianship: Applications, criteria and powers

Having written my thank you card to blog readers, I thought I’d kick of 2012 with a long-promised post on the deprivation of liberty safeguards (DoLS) and Guardianship. In true Small Places style, this will be not be a short one... in fact, it’s such a monster that I’ve decided to break things up into three separate posts. The first (this one) is on the criteria and powers of DoLS and guardianship; the second is on the appeal mechanism.  These are very long, and if you're pressed for time I recommend you skip to the third and final post which provides a summary and a general discussion of the issues.  Even so, I have a horrible feeling this might be one of those posts I spend hours on, and about 3 geeks like me actually read... Still, all fodder for the thesis, and this way I can kid myself I’m working.  I'm very aware that I'm much more familiar with DoLS than I am guardianship, so please alert me to any glaring errors, and I'd also welcome any guest posts or comments on people's views on these issues.


The question: Would guardianship have been better than the DoLS? 


Friday, 7 October 2011

Article 8 and tea without sugar

The Care Quality Commission and the Equality and Human Rights Commission  have a Memorandum of Understanding to facilitate them working together to promote a human rights approach to social care regulation.  They have issued some new guidance for CQC inspectors to help them understand and promote equality and human rights compliance in care settings.  I've just had a quick look through the guidance, and I am really impressed by the approach they are taking.  Not so long ago I was bemoaning the untapped potential of Article 8 in social care on the UK Human Rights blog.  The CQC and EHRC guidance makes clear that even the "small things" have potential human rights implications, as this example from this document (pdf) shows:

Friday, 24 June 2011

3. Ongoing uncertainty over the meaning of 'deprivation of liberty'

This post is the second in a series of three posts on the lawful use of restraint, and its relationship to deprivation of liberty.  It relates to the rulings in C v A Local Authority (2011) (Re C) and Cheshire West and Chester Council v P (2011) (Re P). The first post was on the importance of recognising restraint where it is occurring. The second post was on the expanded legal guidance set down by the Court of Protection on the use of restraint under the Mental Capacity Act (MCA).

As Allan Norman comments in Community Care, the cases show, along with Steven Neary v Hillingdon Council, ‘the manifold devious ways in which attempts are made to deprive of liberty without proper scrutiny are still a problem, 800 years after Magna Carta.’  The manipulative behaviour of Hillingdon Council in the Neary case, and the misconduct of employees of Cheshire West & Chester Council in Re C do rather suggest that local authorities were fairly consciously attempting to avoid proper scrutiny; and I don’t doubt that this problem may be significantly more widespread.  But I wonder also how far these situations are arising as a result of genuine confusion, or perhaps  exploitation of legal uncertainties in the evolving meaning of 'deprivation of liberty' in Court of Protection case law.

Friday, 10 June 2011

Safeguards and secrets

The ground shifted subtly yesterday for supervisory bodies in England and Wales.  It wasn’t the earthquake of the Bournewood judgment, but tremors from the Neary ruling will be felt by local authorities and primary care trusts around the country, and perhaps best interests assessors in particular.  The deprivation of liberty safeguards – patchy, bureaucratic, labyrinthine – had finally clunked into life, albeit belatedly, and returned Steven Neary to his father last Christmas.  For everything that can be said about this ruling, about all the aspects of the safeguards that can go wrong, the ways in which they can be distorted and manipulated, and the inherent conflicts of interest at their heart, it is still heartening to hold up this judgment against the ruling of the House of Lords in R. v Bournewood Community and Mental Health NHS Trust Ex p. L and see how far we have come.  The central message of HL v UK, of the importance of due process for people with impaired capacity who are deprived of their liberty, may yet have to fully sink in for some public authorities responsible for supporting and assisting them in their lives – but we can rest assured that it has been very well understood by the judiciary in the Court of Protection.  Mr Justice Peter Jacksons’ ruling was a far cry from deference of the House of Lords’ in Bournewood to professional opinion, the message was loud and clear: the tokenistic application of the safeguards by supervisory bodies is insufficient in and of itself, the court will scrutinise your every step to ensure you have understood and acted upon their spirit.

Thursday, 26 May 2011

Strategic litigation by the EHRC

The Equality and Human Rights Commission was established in 2007 to promote and enforce equality and human rights laws in the UK.  It replaced three well respected predecessor bodies: the Racial Equality Commission, the Equal Opportunities Commission and the Disability Rights Commission.  The EHRC has powers to conduct formal inquiries, to bring judicial review proceedings to prevent breaches of the Human Rights Act 1998, to undertake legal policy work including briefing ministers and parliament on human rights issues in draft legislation.  It also has powers to intervene in particular legal cases, where it feels important equality or human rights principles are at stake.

I wrote to the EHRC some time back asking whether it might consider sharing its written submission in the Court of Appeal hearing of P & Q v Surrey County Council (on appeal from the High Court ruling MIG & MEG).  The EHRC was under no legal obligation to share these submissions, as documents relating only to court proceedings are subject to an exemption under s32 Freedom of Information Act 2000.  However, the EHRC didn't only share it's submissions in P & Q with me, but also some very interesting written submissions in several other cases relating to mental health, mental capacity and human rights.  It's a common source of frustration for legal researchers that we have little access to court documents beyond the published judgment, so it's a wonderful opportunity to see some of the arguments that were put before (or will be put before) the courts, but which may not have been addressed or mentioned in the final judgment.  It's also a great opportunity to read some high quality legal reasoning produced on behalf of the EHRC.  I am very grateful to the EHRC for sharing them with me, and also pleased they're happy for them to be shared more widely on this blog.

EHRC written submissions in P & Q (MIG & MEG)

The EHRC intervened in the P and Q case at the Court of Appeal.  I've written previous posts about the judgment in the High Court, and the Court of Appeal, so I won't repeat any details of the case here.  As I understand it, permission to appeal in the Supreme Court is being sought (the outcome on permission should appear here in the next few weeks/months), and I hope the EHRC will also intervene at that point.

You can read a copy of the written submission here.  It was drafted by Paul Bowen at Doughty Street Chambers.  Bowen has been involved in lots of very high profile and important cases, including the Bournewood judgment itself and another important deprivation of liberty case JE v DE (2006).  In the Court of Appeal ruling, it was held by Lord Justice Wilson that absence of objections by the relevant person pointed away from their being deprived of their liberty [25].  The EHRC submission prepared by Bowen explicitly cautioned against this approach:
P's lack of objection to remaining may be a consequence of the measures placed upon her and her particular suggestibility or other vulnerability. This is one reason why it does not follow that, because P's objections are relevant in determining there is a DOL, P's lack of objection is also relevant in determining there is no DOL. P's lack of objection may be mere acquiescence in the face of the restrictions placed upon her, which is a reason for concluding those restrictions do give rise to a DOL rather than the opposite
I find this argument very attractive.  I and others have expressed concerns that the Court of Appeal ruling could leave people with very limited communication abilities without the protection of the safeguards.  Bowen's argument takes this one step further.  Even if people are physically able to communicate objections, the effect  of the restrictions placed upon them may be such that they acquiesce to them under pressure, and feel mentally or emotionally unable to express dissent.  Sociologist Erving Goffman called this effect 'institutionalisation', or - more dramatically - 'mortification of the self'.

John Wadham is the Group Legal Director at the EHRC, and in addition to the written submission prepared by Paul Bowen he drafted his own witness statement, which you can read here.  He expressed particular concern that the deprivation of liberty safeguards framework did not extend to children (MEG, now Q, was 17 at the time of the High Court hearing), and the potential for abuse where there is no external scrutiny of the treatment of vulnerable incapacitated children.  The Commission proposed an alternate procedure for children, whereby if the local authority has reason to believe deprivation of liberty may be taking place, they should conduct an assessment and appoint an advocate.  If either the local authority or the advocate do not find the restrictions proportionate, they should apply to the Court of Protection for a ruling on its lawfulness.  The Court of Appeal made no comment on this expression of concerns; perhaps it will be taken up by the Supreme Court.

Written submission in A Local Authority v A (A Child)& Anor [2010]
This was another extremely important case in the High Court, heard by Lord Justice Munby.  In A Local Authority v A Munby LJ was asked to determine whether an adult (C) and a child (A) with Smith-Magenis Syndrome, who were cared for by their parents in the family home, were deprived of their liberty.  A and C required constant supervision to keep them safe, and their parents locked them in their bedrooms at night.  According to expert testimony in the judgment this was the best way to ensure that A and C were kept safe at night whilst their carers got the sleep they needed to continue to support them at home.

The ruling is an extremely important one, I have not yet written about it here because my own views on it are still evolving and frequently change.  It raises such complex issues around the proper scope and purpose of Article 5, the relationship between families and the state, the very meaning of 'liberty' and the purpose of any safeguards to protect against arbitrary infringements.  Munby LJ sets out procedures to be followed by local authorities if they suspect that a person may be deprived of their liberty in the family home, creating a new aspect of the doctrine of positive obligations under Article 5.  It has to be said the judgment is rather less clear as to what might constitute deprivation of liberty in the family home.  Munby LJ emphasises that restrictions that promote a person's welfare, in the context of a loving family home, are far removed from the paradigm case of deprivation of liberty [150].  The difficulty that some of us have struggled with is how you resolve this with the provisions of Schedule A1 that say restrictions upon liberty, and deprivation of liberty, may only be permitted in a persons' best interests.  I suppose the problem that Lord Justice Munby and the courts more widely would have struggled with had they found otherwise is the extreme political toxicity of saying that parents who are doing their best to support family members with profound disabilities and challenging behaviours are depriving them of their liberty by keeping them safe.  One can only imagine how certain quarters of the press might react to dedicated carers having to seek authorisation from the court to "detain" those they care for, and perhaps with some reason.

In any case, here is the EHRC's submission to this case.  Again, it was drafted by Paul Bowen.  I notice that in finding that the state has positive obligations to protect people from violations of their Article 5 rights by private parties, Munby LJ has drawn heavily from Bowen's submission.

RP v United Kingdom
The EHRC also shared with me their written submission in a case that has yet to be heard before the European Court of Human Rights: RP v UK.  The case is one that has a certain amount of notoriety in the legal world, because it resulted in a Court of Appeal judge, Sir Nicholas Wall (now head of the family courts), heavily criticising the actions of John Hemming MP for his involvement in the case as RP's McKenzie friend.  You can read the somewhat infamous judgment; some of the exchanges reported are quite revealing  regarding the relationship between Hemming and the courts, particularly in the light of the events of the last few weeks.  The case concerned a young woman called RP, whose baby was subject to child protection proceedings.  As a result of a mental capacity assessment, which Hemming and RP herself dispute, RP was found to lack the capacity to conduct litigation in the proceedings and the Official Solicitor (OS) was appointed to conduct her case as a litigation friend of last resort.  The final outcome of the court proceedings was that RP's child was placed for adoption.  However, separate proceedings were brought by RP herself as a litigant in person, assisted by John Hemming as her McKenzie Friend, on the basis that her right to a fair trial under Article 6 was violated.  There is something extraordinary in the fact that an appeal could be brought by a litigant in person, when she was said to lack the mental capacity even to instruct a solicitor.  However, the court felt that there were important matters of principle at stake, so the appeal was allowed.

In thinking about this case it would be very easy to get distracted by a senior judge castigating an elected member of parliament.  It would also be very easy to get distracted by some of the more bizarre claims made by John Hemming reported in the judgment.  However, there are elements of the case that do give some cause for concern.  There are a few passages in the judgment where it appears that RP's solicitor and the OS made decisions on the basis of what they felt were in the best interests of RP's child, rather than RP herself (see paragraphs 77 and 160 of the judgment).  Perhaps it's because I'm more familiar with Court of Protection cases than the family courts, but it did strike me as odd: I would have thought that the role of the OS was to champion RP's rights and her best interests, and it is up to the local authority to make the case on behalf of her child's best interests.  It seems that the EHRC were also concerned about this aspect of the case, as they have decided to intervene in a legal challenge to the judgment at the European Court of Human Rights.

The EHRC's written submission to the Strasbourg Court expresses concern on several grounds.  The submission is drafted by Helen Mountfield from Matrix Chambers; Mountfield was involved in the case YL v Birmingham City Council, concerning whether care homes were 'public authorities' bound by the Human Rights Act.  The EHRC argued that families with parents with  learning disabilities are not offered adequate support to care for their children themselves before the commencement of child protection proceedings, and that this might be in breach of their Article 8 rights.  They cite a range of evidence that parents with learning disabilities are poorly supported in the community.  I have some limited experience of working in a family assessment centre that assessed some parents with learning disabilities for child protection proceedings; I have to say I saw little to refute the EHRC's concerns about the amount of support available in the community to parents with learning disabilities - but they may have been isolated examples.  It would be interesting to see whether the European Court of Human Rights is prepared to extend the positive obligations of the state in this direction, given it would certainly place a significant financial burden on the public authorities who would be in a position to offer that support.

The second grounds for concern raised by the EHRC are regarding the role of the OS himself.  Undoubtedly the OS plays an extremely important role in upholding the rights of people who are unable to conduct litigation; there are many cases I can think of where the OS's intervention has upheld the most fundamental of rights on behalf of people who were unable to do so for themselves.  These include a case where a hospital had actually begun to withdraw treatment from a patient without seeking the Court of Protection's determination first; the OS's intervention meant that he then went on to make some recovery.  The Steven Neary case being fought this week in court is, in no small part, down to the work of the OS.  The OS also acts on behalf of children, and I wonder if this led to some blurring of the boundaries in this instance, where the OS appeared to take the child's best interests into account.  The EHRC express concerns that this was a breach of RP's own Article 6 rights:
...the case they put forward must be focused solely on the needs and wishes of the parent. That is not to say that the litigation friend cannot put forward a case which departs from the case which would be advanced by the learning disabled persons if they were representing themselves. It may be that the Official Solicitor does not consider that case to be in his or her best interests. But the focus should be on that person’s interests, alone. It is not the role of the Official Solicitor or other litigation friend to balance the interests of the parent and the child. If and to the extent the parent is represented by a litigation friend who seeks to present to the court an opinion as to what is in that person’s best interests “balanced” with what is in the child’s welfare, there is a breach of Article 6 and/or Article 8 and/or Article 14 ECHR. The litigation friend’s sole role is to promote the best interests of the person for whom they are appointed. Promoting the child’s interests is the role of the child’s legal representative, and deciding on whether the best interests of the child and the interests of the parent are opposed is the duty of the court.
A third area of concern raised by the EHRC is that there is no mechanism to displace the Official Solicitor:
[22] ...it should be recognised that litigation capacity can fluctuate or alter. Loss of litigation capacity is a very serious a matter. So where, as here, there is a mechanism whereby an official litigation friend can be appointed against the litigant’s will, there should also be a formal mechanism prescribing the circumstances in which, the evidence upon which, and time or means by which, the litigant deemed incapable can apply to have that decision set aside. The absence of such a mechanism constitutes a disproportionate infringement of the right of access to a court protected by Article 6.
[23] Whilst the Commission casts no doubt upon the good faith of the Official Solicitor or any of the experts instructed in the present case, it considers it to be institutionally unsatisfactory for there to be no such formal procedure. Once a person has been declared to lack litigation capacity, under the present system there is no means of his reacquiring it unless the Official Solicitor or the solicitor instructed by him on behalf of the litigant considers that the litigant may have recovered the capacity. There is no procedure for the litigant him or herself to raise the question, or to seek a further expert’s opinion, and no obvious mechanism requiring a review where, as here, the litigant produces an ostensibly plausible report from a Consultant Psychiatrist who expresses the view that she does have capacity. '
To the possibility of litigation capacity fluctuating or altering, we should probably add that opinions on whether a person has litigation capacity may - at the borderline - be a matter of dispute.  In a recent case V v R (2011) the Court of Protection was asked to decided whether V had litigation capacity.  Her mother doubted  that she did, whilst the defendants (perhaps unsurprisingly) felt that V had capacity to run her case against them.  Once it has been determined that a person lacks litigation capacity there seems to be no straightforward mechanism to displace the OS if they are acting on their behalf.  In cases as contentious as child protection proceedings, one can see how this can lead to discord between the parent and their legal team, and a feeling of powerlessness and perception of injustice. This sense of powerlessness could leave vulnerable people inclined to seek less appropriate sources of support.  According to the admissibility decision in Stanev v Bulgaria, the UK may be in the minority of Council of Europe states in having no legal mechanism whereby people deprived of legal capacity can apply directly to the courts for discontinuation of the measure (see paragraph 78).  I understand that the research this claim was based on was undertaken by the ECtHR itself; I have contacted them to ask for a copy of the research report.

Robert Seal v United Kingdom
I am ashamed to say I had not heard of this case before the EHRC shared their submission to the ECtHR with me.  The case concerns a provision of the Mental Health Act 1983, s139, which in requires detained patients to seek the permission of the High Court before bringing any civil case "in respect of any act purporting to be done in pursuance of" the Mental Health Act.  Robert Seal claimed he had been prevented from bringing a case against the police for unlawful detention as a result of the provision meaning that he was out of time.  In Seal v Chief Constable of the South Wales Police [2007] in the House of Lords, Lord Bingham commented:
Parliament must, in legislating as it did, have recognised the risk that hard cases, such as Mr Seal's, may occur, but have considered the occasional occurrence of such a case to be a price worth paying for the reassurance and protection given by sections 141 of the 1959 Act and 139 of the 1983 Act to those whose very important and often difficult task it is to care for the mentally ill.
Baroness Hale and Lord Woolf dissented from the decision.  The EHRC's submission was written by David Wolfe at Matrix Chambers; Wolfe has been involved in several important human rights cases including the right to treatment case concerning 'baby Charlotte'.  The Commission argued that s139(2) created a barrier to justice that was not a proportionate interference with the Article 6 rights of detained patients, commenting that it 'treats disabled persons as second class citizens without any justification'.  The ECtHR pronounced its judgment in December 2010, where it found that Seal's Article 6 rights had not been infringed.  The basis for the court's ruling appears to be primarily that Seal did not provide an explanation for why it took him from 1997 until 2003 and "the very eve" of the expiry of the limitation period, to commence proceedings against the  police.  In their view, Seal had been unable to bring his case not as a result of this measure, but the unexplained delay on his part in bringing a claim.  The court did not, therefore, give extensive consideration to whether the measure itself was discriminatory and a potential infringement of the Article 6 rights of detained patients more generally.

The future of strategic litigation by the EHRC
The government is currently consulting on reforms to the Commission.  You can read more about the government's proposals and the EHRC's response to them here.

Monday, 18 April 2011

Do the DoLS provide an Article 5 compliant right of appeal?

Article 5(4) of the European Convention on Human Rights provides that:
‘Everyone who is deprived of his liberty by arrest or detention shall be entitled to take proceedings by which the lawfulness of his detention shall be decided speedily by a court and his release ordered if the detention is not lawful.’
A person deprived of their liberty under the deprivation of liberty safeguards can exercise this right by making an application to the Court of Protection under s21A Mental Capacity Act 2005. Under s21A the court may consider whether the qualifying requirements for deprivation of liberty authorisation are met (see s12 of Schedule A1), the duration of the authorisation, the purpose of the detention and any conditions that authorisation is subject to. The Court of Protection has the power to vary or terminate the authorisation, or direct the supervisory body to do so. The s21A appeal mechanism is, potentially, a very powerful safeguard. The court might consider, for instance, whether depriving someone of their liberty is in their best interests – or even whether they actually have the mental capacity to decide for themselves where they should be accommodated. It could direct that a deprivation of liberty authorisation should be terminated, in effect freeing a person to leave the place at which they are detained.  It did this in the case of Steven Neary just before Christmas and in another (unreported) case in the 39 Essex St Court of Protection Newsletter for January. Or it could place additional conditions upon on authorisation, in order to ensure that detention where it is occurring really is in somebody’s best interests, or is the least restrictive option available. The question I will be exploring in this post is – how effective is this safeguard in practice? My concern is that despite its potency, it remains inaccessible for the vast majority of people who are deprived of their liberty and their families.