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Cardiff & Vale University Health Board v P [2020] EWCOP 8

In the Court of Protection sitting in London, Mr Justice Hayden heard an urgent case from Cardiff by telephone, in relation to certain long overdue dental needs of an incapacitous 17-year-old severely autistic young man. The “appalling consequences” of delay were attributed to a fundamental failure to communicate effectively.

P, 17 years old, is described as "unable to communicate either verbally or, for the most part, in any consistently effective way at all". Because of his severe autism and significant learning disabilities, he lacks the capacity to consent to treatment or to understand the various issues involved. He lives with his parents, with regular respite care.

In October 2019, his parents believed P was experiencing dental pain. A previous CT scan (under general anaesthetic) had revealed impacted wisdom teeth, so a speedy dental assessment was clearly necessary once P's behaviour indicated pain. But Cardiff & Vale University Health Board did not apply until 20 February 2020, some four months later, and the next medical step is not scheduled until early March. The judge commented on the indefensible delay.

On the second day of this two-day hearing, Cardiff & Vale University Health Board provided a chronology of the various decision-making stages. Having analysed it, "the full force of the delay and its impact on P became inescapably obvious" and the Health Board rightly made no attempt at all to evade their responsibility, offering P and his parents a profound apology.

As a result of not receiving treatment for almost five months, however, P likely experienced great pain due to impacted wisdom teeth. P's parents observed his behaviour deteriorate. They worry that P may not be considered eligible for a place in a residential unit when he reaches age 18. The judge therefore allowed for a copy of his judgment to be transcribed for P's parents, so that those who are considering options for P in the future will know that "his recent behaviour appears likely to have been triggered by a neglectful failure to address a dental/medical problem".

In light of the lurking threat of a pandemic in the form of the new coronavirus, a court's ability to hear an important and urgent matter by telephone should be kept in mind.

Summary by Lauren Suding, barrister, Field Court Chambers.

You can read the full judgment of Cardiff & Vale University Health Board v P [2020] EWCOP 8 on BAILII