The High Court has approved a hospital’s application to transfer a woman in her 70s to a specialist care facility once she is medically fit for discharge, finding that remaining in an acute hospital setting beyond that point posed a significant and continuing threat to her wellbeing. The court declined to order her detention at the facility.
In an ex tempore ruling delivered on 19 February 2025, Mr Justice Heslin said the evidence was that the woman lacked capacity to decide where she should live after discharge. Her treating team and family agreed she needed full-time nursing care, though her family strongly opposed the proposed placement because of the distance from their home.
The judgment records that the woman had been in hospital since April 2024 and had complex care needs. Medical evidence described her as unable to understand, retain or weigh information relevant to her long-term care decision. She had suffered recurrent hospital-acquired infections, including pneumonia diagnosed on 4 February 2025. Her doctor expected her to be medically fit for discharge within seven to 10 days of a report dated 18 February.
The hospital said the proposed facility, identified as [B] in the judgment, could meet her needs, including specialist nursing and dementia-focused care. More than 30 nursing homes had been approached, according to the evidence, but no closer suitable alternative had been secured. A nearer home considered by the family could not accept her because it already had two residents requiring tracheostomy care and could not admit a third.
The judge acknowledged the burden that travel would place on the woman’s husband and daughter. The proposed facility was described as about 50km from the family home, with the journey taking at least an hour and longer by public transport. But he concluded that approving the transfer was necessary and proportionate to protect the woman’s rights and welfare, given the risks of staying in hospital after she was fit for discharge and the lack of a suitable alternative.
The order does not prevent the family from continuing to seek a closer placement able to meet her needs. The judgment says the proposed facility would hold a bed until 21 February and accept her when medically fit.
The hospital also sought an order detaining the woman at the facility. The judge refused that part of the application, finding the evidence did not show detention was necessary or proportionate in light of its effect on her autonomy. He said transfer and placement orders were sufficient to protect her personal rights.