High Court: Prison did not fail to provide appropriate medical treatment

About this case:

• Judgment:
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Finding that the prison medical team had not been informed of the appointments or alleged pain by either the applicant or his solicitor, Ms Justice Murphy said the solicitor “was more interested in setting up a judicial review application than in ensuring the best medical care for his client”.

Background

In September 2013, Mr Jimmy Cash was granted leave to seek judicial review limited to a declaration that the failure of Governor of Wheatfield Prison to provide appropriate medical treatment to Mr Cash was contrary to Rule 102 of the Prison Rules 2007.

Rule 102

Rule 102 provides that the Governor shall take certain steps upon being informed that a prisoner requests or is in need of medical attention.

The rule does not prescribe nor circumscribe the sources from which information may derive that a prisoner needs (as opposed to requests) medical attention.

A prisoner may not be aware that he needs medical attention and the rule allows for information to be provided to the Governor by persons other than the prisoner.

Mr Cash, who absconded from hospital care in February 2013, had given an address in Walkinstown as his home address on admission to hospital – Justice Murphy therefore opined that the details of the alleged missed medical appointments may have been sent to that address, but accepted from the evidence available that no such information was sent to the Governor.

Justice Murphy explained that “out of the blue”, the Governor received letters from Mr Cash’s solicitor complaining that Mr Cash was “in pain and has not been taken to multiple hospital appointments made for him”. The governor was not provided with the nature or specific dates of the appointments.

Pursuant to Rule 102(1), the Governor passed the information to the medical team for them to assess Mr Cash.

Nature of Assessment

Rule 102(2) provides that the prison doctor, nurse officer or other member of the prison healthcare staff shall as soon as practicable assess a prisoner in respect of whom information has been received.

Counsel for Mr Cash submitted that the assessment required by the rule was a physical assessment of the prisoner.

Counsel for the respondent in reply contrasted the use of the phrase “attend the prisoner” in Rule 102(3) which deals with medical emergencies, with the use of the phrase “assess a prisoner” in Rule 102(2) in respect of information received that a prisoner needs medical attention. He submitted that a physical examination is not required to discharge the prison authority’s obligation under Rule 102(2).

Evidence from the medical file was that in the two months prior to the first solicitor’s letter being sent, Mr Cash sought no assistance from nor made any complaint of pain or discomfort to the prison service medical team, a team which he had earlier accessed on a frequent basis. From this, Justice Murphy inferred that Mr Cash did not seek their assistance because he did not need to do so.

The prison medical file was “uncontested by any evidence”, and made clear that the prison service was not notified of any hospital consultations.

Having regard to the extensive injuries suffered by Mr Cash, Justice Murphy accepted that hospital appointments may have been sent out to the address in Walkinstown which he had given to the hospital as his home address.

However, the prison service was not notified of any such appointments. Mr Cash’s solicitors’ letters and grounding affidavit are somewhat vague on this issue and do not disclose where, when, or how the solicitor and Mr Cash became aware of alleged missed appointments.

Noting that the solicitor’s letters were vague as to the alleged missed appointments, Justice Murphy stated that if the solicitor became aware of specific medical appointments – the appropriate step should be to inform the Governor pursuant to Rule 102, so that appropriate action can be taken by the prison medical team.

Had the Governor been so notified, and had failed to act on that information; Mr Cash might have had a good claim for judicial review.

As such, Justice Murphy said it was difficult to avoid the conclusion that Mr Cash’s solicitor “was more interested in setting up a judicial review application than in ensuring the best medical care for his client”.

Action taken after assessment

Having conducted his assessment, the prison doctor reported back to the Governor that the medical team were satisfied that Mr Cash was being appropriately cared for.

In the light of the complaint made, the doctor arranged for a radiological examination of Mr Cash – Justice Murphy strongly rejected claims that this was evidence of an acknowledgement of the inadequacy of treatment.

In all the circumstances, Justice Murphy was satisfied that the Governor of Wheatfield Prison complied with his obligation pursuant to Rule 102(1) by referring the information received from Mr Cash’s solicitor to the medical team for assessment pursuant to Rule 102(2).

Refusing the application, Justice Murphy was satisfied that the assessment carried out by the medical team in Wheatfield Prison was entirely appropriate to the information furnished by Mr Cash’s solicitor to the Governor.