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Poor medical evidence and vulnerability
Our friend Nearly Legal writes about a Lambeth homeless application case and vulnerability.
Reading about the report from an outfit (needless to say outsourced private company) called Now Medical, it doesn’t half have the same overtones and resonance as virtually every WCA healthcare professional report that I’ve ever seen.
Ms T had a history ‘of depression which had on occasion manifested itself in suicidal thoughts and deliberate self-harm who at the material time was on an anti-depressant Sertraline. The Appellant was under the care of her GP regarding her condition.’
In support of her homeless application, her GP wrote:
It is clear that she is a vulnerable young woman, who has been a victim of personalised aggression, which has inevitably exacerbated likely predispositions to depression and anxiety. She has attended our Surgery this week with suicidal thoughts and a ramping up of her anxiety. There are prominent problems for her in getting out into any social context, with signs of hyper alertness, hyper arousal and exaggerated fear of people, whether strange or familiar. As a consequence, her coping strategies are significantly compromised at present and she will not cope with being homeless. There is a very high likelihood of a further deterioration in her mental health due to homelessness.
And then in bold:
Events in her history inevitably mean that both housing quality and a specific location are more than usually relevant in her symptoms and also please note her risk of harm.
Lambeth requested a report from Now Medical, the first of a number of (very similar) ‘brief letter type reports’.
Now Medical said:
The issues are DEPRESSION. The Applicant has a history of depression and I note has a history of suicidal thoughts and acts in deliberate self-harm. She has been treated with Sertraline 50mg, the standard anti-depressant in low dose, and has been referred for counselling which would be considered standard treatment. There is nothing to suggest that she has required urgent psychiatric intervention and there is no evidence in this case of a severe or enduring underlying mental illness such that would significantly affect her cognition or rational thought. Whilst I note that she has had suicidal thoughts, there is no evidence of significant concerns regarding intent in this case. There are no other relevant medical issues.”
And then in summary:
“For the reasons given above, I do not think the medical issue rendered the Applicant significantly more vulnerable than an ordinary person and I make no grounds for recommendations on specific medical grounds.”
Finding against Lambeth, the High Court noted the faults of the Now Medical reports as reflected in the review decision.
The gist of the reasoning for upholding the decision is that the information provided by the Appellant’s own doctors do not show that she is suffering from substantial cognitive impairment or a psychotic condition and that accordingly, she is not vulnerable. I consider that that approach, which is formed directly from the Now Medical opinions, is fundamentally flawed. And it is flawed because it fails to address directly the Appellant’s medical evidence which was specifically, that (a) she had depression, (b) the consequences of that depression would be exacerbated by the threat of homelessness and (c) those consequences were likely to include an increased risk of suicide and/or self-harm.
Just read the same thing.
Would be interesting to understand how many LAs use this company or similar.
Oh to be in Scotland…
Oh to be in Scotland…
Now that May is here?