The High Court refused the Health Service Executive’s application to stay an order requiring K.W. to return to Ireland and be detained as a psychiatric patient in an adult ward at Ennis General Hospital, subject to periodic court review.
In a judgment delivered on 14 May 2015, Ms Justice Bronagh O’Hanlon accepted that the HSE had a genuine and arguable ground of appeal against the part of the earlier order requiring that detention. The court nevertheless concluded that K.W.’s welfare interests outweighed the HSE’s stated wish to clarify its obligations to vulnerable adults through an appeal.
The application concerned an order made on 19 March and perfected on 30 March 2015, following a principal judgment delivered on 12 March. That earlier judgment found, on medical evidence, that K.W. lacked capacity to make material decisions about her medical treatment and therapy. It directed her return from St Andrew’s Healthcare in Northampton to Ireland as soon as possible and no later than 12 June, with detention at Ennis General Hospital under the care of its clinical director. The court had allowed her to remain in an adolescent ward in the interim.
At a review hearing on 30 April, the court was told that K.W. was due to transfer on 8 June, but the HSE had not yet produced a formal care plan. The guardian ad litem’s counsel also said K.W. was receiving only depot medication and was not receiving adequate treatment. A report from her treating clinician, Dr Boris Iankov, dated 1 May, said she required hospital care in a female-only setting with psychiatric, psychological, occupational therapy, education, social work and nursing support. It described her current risk assessment as high across all domains, including self-harm, suicide and absconding.
The HSE later supplied a written plan outlining the proposed return and supports. K.W.’s counsel, the guardian ad litem and her parents argued that it lacked detail and did not match the supports recommended in Dr Iankov’s report. They opposed a stay, accepting that the HSE’s appeal was genuine but submitting that suspending the order could undermine its protective measures.
The judge said the balance of convenience required the court to weigh the consequences for both sides, with K.W.’s welfare a paramount consideration. Granting a stay amid uncertainty about the care to be provided after her return risked, the court said, creating a “vacuity of care and supervision”. It refused the stay, leaving the principal order in force. The judgment determined only the HSE’s stay application; it did not decide the appeal itself.