The Supreme Court allowed the Northern Area Health Board’s appeal in a judicial review case concerning care for P.K., a ward of court, and refused the relief sought by his sister, C.K. The Court held that sections 56 and 60 of the Health Act 1970 did not require the Board to provide the extensive home care claimed in the proceedings.
The appeal concerned a High Court declaration that the Board had failed to meet obligations under those sections. The Supreme Court, in a judgment delivered by McGuinness J. on 29 May 2003, concluded that the High Court had interpreted the statutory provisions too broadly. It did not decide the reasonableness of the Board’s proposed care plan, because that question did not arise under the Court’s interpretation of the law.
P.K. suffered a serious head injury in a 1976 car accident and was admitted to wardship in 1983. After a further serious illness in 1999, he returned home severely disabled and needing round-the-clock care. He continued to live with C.K. and her family. The judgment said his condition had since improved, though he still required considerable assistance. The available medical evidence supported his remaining at home, and the parties accepted that it was in his interests.
The Board’s January 2001 proposal included care attendants on weekdays, some evening and weekend coverage, day activation, respite care and community nursing and therapy services as appropriate. The judgment said the Board later offered a six-week respite period. C.K. sought continuation of the existing arrangements, funded by the Board; their stated cost was about €1,200 a week.
The Supreme Court held that “out-patient services” under section 56 meant services provided at hospitals and other institutions, not a home-based equivalent of inpatient care. It also read section 60’s nursing service as an advice and assistance service, rather than long-term or extensive part-time nursing in a person’s home. The Court noted that the service’s statutory parameters were not established in the evidence before it.
The Court agreed that section 61 gave the Board discretion to arrange assistance with maintaining a sick or infirm person at home, but that section was not the basis for the appeal. It observed that the Board’s proposals could be made under that power and expressed hope that it would continue providing material assistance. The appeal was allowed and the requested judicial review relief was refused.