Brain-injured woman still in UK unit with no certainty about acquiring a place in Ireland, court hears

A brain-injured Irish woman sent to a specialist UK unit last February for a three-month assessment of her needs with a view to placing her here is still in the UK with no certainty about when a suitable place will be provided here, the High Court has heard.

The woman, a ward of court aged in her late forties, does not want to be in the UK unit and wants to be in Ireland, the court was told.

Her family are also anxious she returns here so they can visit her more regularly.

The president of the High Court, Mr Justice Peter Kelly, directed the HSE to speed up its "self-imposed" objective of identifying a suitable place here for the woman, who has an acquired brain injury and pervasive developmental disorders.

In the interim, it is in the woman's best interests to remain in the UK unit where she has made some progress, he said.

For reasons including uncertainty about what Brexit means for wards of court placed in the UK, the judge said he would review the matter in February and would view "very unsympathetically" any application then to extend the UK detention further.

He had a “clear recollection” about how distressed the woman’s mother, aged in her seventies, was when he granted the HSE’s application last February to send the woman to the UK unit for diagnosis/assessment with a view to providing an appropriate placement here.

That assessment/diagnosis was expected to take about three months but has taken longer for reasons including lack of co-operation by the woman, he said.

He reviewed the matter in July when he continued orders for her detention in the UK subject to further review in December, with liberty to apply earlier.

During Tuesday's review, the judge was told, from the time a suitable healthcare provider was identified to provide the necessary placement here, it could take another six to eight months to put that in place.

The family were unhappy about this and also had concerns related to her welfare and safety in the UK unit which had recorded a number of assaults by other patients against her and her own involvement in assaults.

The general solicitor for wards of court, who visited the woman recently, reported her condition has improved but her clear wish was to be back home in Ireland. The general solicitor considered a return in the absence of an appropriate place being available now was not in the woman's best interests.

Peter Finlay SC, for the HSE, said the evidence is the woman has made progress. When she says she wants to come home, she means her family home but, given her serious disabilities, she cannot return there in the foreseeable future, he added.

Concern over woman's assessment

Ciarán Craven, for the family, said they had several concerns, including about her personal hygiene and safety, but were not seeking orders for her immediate transfer to Ireland without a suitable placement here being available now.

He asked the court to consider permitting the bringing of proceedings on behalf of the woman aimed at securing orders directing the HSE to provide an appropriate place here.

The judge was not convinced as of now such proceedings are necessary for reasons including he would be reviewing this matter again in February.

He said he had a number of concerns about the woman's situation, including the number of assaults on her and incidents where she was the perpetrator. While recognising the unit cares for people with various disabilities, the number of assaults was of concern.

He was also concerned she had come under the care of three different psychiatrists during nine months in the UK unit when consistency of psychiatric care was important. While her condition has improved, no one is seeking her discharge, he added.

A relative who represents the woman's interests had voiced legitimate concern the assessment has elongated into a detention almost a year-long which was never intended, he said.

It seemed to him all the components identified as necessary to meet the woman's needs are provided by existing services here but there may have to be some adjustments, he added.