In the current climate of tight resources, hospitals are rightly concerned about beds being taken up by those deemed not in need of further treatment. This blog explores the options.
Stopping provision of services
Perhaps the greatest disincentive to a patient wishing to stay is the withdrawal of medical treatment. Indeed, section 3 of the National Health Service Act 2006 requires clinical commissioning groups only to meet the reasonable requirements of a patient. Thus, a clinical judgment is required to determine whether a patient needs more care. If a provider of services decides that a patient no longer requires care, it is difficult to see that there remains any legal duty to provide medical care.
Potential criminal offences
The overall effect of s119 of the Criminal Justice and Immigration Act 2008 is that, if the hospital is an NHS hospital, an individual commits a criminal offence if:
(a) He/she is causing a nuisance or disturbance to an NHS staff member without reasonable excuse;
(b) He/she is asked to leave but refuses without reasonable excuse; and,
(c) He/she has finished receiving advice, treatment or care or has been refused advice, treatment or care within the last 8 hours.
A police constable is then entitled to use reasonable force to remove that individual from the NHS premises: s120(1). I suspect this suite of powers is often overlooked by hospitals. Having said that, there may well be good reasons for not wanting to get the police involved.
Whether hospital patient can insist on hospital obtaining possession order before being removed
Even if a hospital decides that it does not want to get the police involved, a court order for possession will not always be necessary.
The requirement for a court order for possession is set out in the Protection from Eviction Act 1977. Importantly, s3 of that Act only requires court proceedings to be brought for licencees occupying premises “as a dwelling”.
A hospital patient is unlikely to be able to prove this. This is because:
- Following the Supreme Court decision in R (on the application of ZH and CN) v London Borough of Newham  AC 1259, as with those being accommodated under s188 of the Housing Act 1996 (accommodation pending homelessness enquiries) hospital patients are taken in on the understanding that their stay will be temporally limited;
- Unlike those being accommodated under s188 of the Housing Act 1996, however, the purpose of a hospital patient’s stay is not accommodation. The purpose is to treat the patient until they are well enough to be discharged. Accordingly, the policy justifications for not allowing a hospital patient to insist on a possession order are that much greater.
As a result, it seems as though a hospital patient is unlikely to fall within the provisions of the Protection from Eviction Act 1977 meaning that court proceedings are not necessary.
The practical consequence of this is that, apart from a notice that the patient’s licence to be on hospital premises is being removed after a reasonable amount of time, the hospital can, as a matter of law, simply lock the patient out of the room/hospital.
Circumstances in which sensible to obtain a possession order
Notwithstanding the above, it may sometimes make sense for a hospital to embark on court proceedings. Indeed, I am aware of many cases of hospitals seeking possession orders against patients. The most obvious example of where this may be necessary is if a patient is physically refusing to leave his/her bed/room. In those circumstances, locking the door is not going to have the desired effect and court proceedings is likely the safest and best course of option.
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