Coombs v Dorset NHS Primary Care Trust and another [2012] EWHC 521 (QB), [2012] All ER (D) 42 (Apr)
A detained patient was in a very different position to one who was not subject to compulsory detention. The detaining authority had powers to control, not only the patient’s placement and treatment, as provided for in the Mental Health Act 1983 (MHA 1983), but also many more general activities and freedoms. So long as a person remained detained, any decision about his placement had to be made in accordance with MHA 1983 by the managers of the hospital where he was being detained.
Any decision about his treatment had to be made by his responsible clinician. If a patient, by electing to pay for treatment or care, thereby gained the ability or right to choose the treatment, then that would be inconsistent with the statutory scheme. There was no reason in principle why any practical difficulties should deprive a patient of the right to choose to pay if he so wished.
