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England and Wales High Court (Administrative Court) Decisions |
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You are here: BAILII >> Databases >> England and Wales High Court (Administrative Court) Decisions >> Scardfield, R (on the application of) v Police Appeal Board & Anor [2013] EWHC 3822 (Admin) (25 October 2013) URL: http://www.bailii.org/ew/cases/EWHC/Admin/2013/3822.html Cite as: [2013] EWHC 3822 (Admin) |
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QUEEN'S BENCH DIVISION
THE ADMINISTRATIVE COURT
33 Bull Street Birmingham West Midlands B4 6DS |
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B e f o r e :
____________________
THE QUEEN ON THE APPLICATION OF SCARDFIELD | Claimant | |
v | ||
POLICE MEDICAL APPEAL BOARD | Defendant | |
HAMPSHIRE POLICE AUTHORITY | Interested Party |
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WordWave International Limited
A Merrill Communications Company
165 Fleet Street London EC4A 2AG
Tel No: 020 7404 1400 Fax No: 020 7831 8838
(Official Shorthand Writers to the Court)
Mr Thomas appeared on behalf of the Interested Party
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Crown Copyright ©
"B5. (1) This Regulation shall apply to a regular policeman who—
(a)is entitled to reckon at least 5 years' pensionable service, or
(b)though not so entitled, has service as a regular policeman which, disregarding breaks in service of not more than a month, is continuous and which, when aggregated with any period of other service or employment by reason of which he is entitled to reckon pensionable service, is at least 5 years."
Then B5(2) says this:
"(2) A regular policeman to whom this Regulation applies who ceases or has ceased to be such in circumstances—
(a)in which no transfer value is payable in respect of him, and
(b)which do not entitle him to any award under any of the preceding provisions of this Part,
shall, on so ceasing to be a regular policeman, be entitled to a deferred pension..."
Pausing there those are the provisions that say you can get a deferred pension based on years of service.
"(4) A deferred pension under paragraph (2) or (3) shall be calculated in accordance with Part VI of Schedule B, subject however to Parts VII and VIII of that Schedule; but no payment shall be made on account of the pension—
(a) in respect of the period before the regular policeman attains the age of 60 years or, if he sooner becomes permanently disabled, before he becomes so disabled..."
Pausing there and translating that into ordinary language, a policeman will get a deferred pension under the rules in force at the material time at the age of 60 or, if he is permanently disabled he will get it when he becomes permanently disabled.
"(1) A reference in these Regulations to a person being permanently disabled is to be taken as a reference to that person being disabled at the time when the question arises for decision and to that disablement being at that time likely to be permanent."
A further relevant regulation is A12(1)(a) which says:
"For the purpose of deciding if a person's disablement is likely to be permanent, that person shall be assumed to have received normal appropriate medical treatment for his disablement and in this paragraph 'appropriate medical treatment' shall not include medical treatment that it is reasonable in opinion of the Police Pension Authority for that person to refuse."
"Disablement" is defined as follows:
"'Disablement' means inability occasioned by infirmity of mind or body to perform the ordinary duties of a member of the Force."
Pausing there, the regulations ask, first, whether you are disabled in a sense that you are unable to perform the ordinary duties of a member of the Force, and then you have to consider whether that is likely to be permanent at the time when the question arises for decision. There are procedures in section H of the rules to deal with deciding that question when it arises. Whether somebody is permanently disabled is the subject, first, of a reference to a medical practitioner. There is then provision for an appeal to a Board of medical referees and it is the decision of that Board (the Police Medical Appeal Board) that is the subject matter of this judicial review claim.
"In conclusion I believe the diagnosis to be that of a Chronic Regional Pain Syndrome, with significant psycho social components to the overall picture. Further specialist advice is being sought [the specialist at Addenbrooke's Hospital] and although treatment options had been recommended [Psychological Assessment Behaviour and Management] these had either been declined or not pursued further. On this basis I felt the appropriate decision at the time was that Mr Scardfield's condition could not be considered permanent due to the potential for further treatment options and the presence of perpetrating factors, ie the psycho social factors alluded to."
He then refers to a review of the decision that he carried out in January 2011. But essentially his decision remained the same.
"I'm unclear as to whether Mr Scardfield has tried antineuropathic agents including gabapentin or pregabalin. Given that he does not comply well with tablets and has had previous overdoses I would not be keen to administer high doses of antineuropathic agents"
Dr Shenker also says:
"Other treatments are more experimental including ketamine coma"
Dr Shenker says he did not have access to the facilities to administer this.
"There is good evidence from international studies to suggest that the prognosis for patients who suffer from complex regional pain is poor once they have ongoing symptoms at 1 year following the onset symptoms. Patients maintain their same levels of pain and significant levels of disability. Significant numbers of patients do not return to work."
Then under "Fitness for duty" Dr Shenker's opinion is this:
"Mr Scardfield is unable to perform any weight bearing or fine motor activity with his right hand and this is unlikely to change in the near future. He is in considerable discomfort when he moves his hand or clothing placed on his arm. It is unlikely that he is fit for active duty within the Police Service at present and I doubt his situation will change significantly. Should he have an amputation, there may well be issues of finding an appropriate prosthesis. From cohort studies performed many patients do suffer from post amputation stump pain, phantom limb pain or complication from wound healing. Some progress to have further amputation."
"Mr Scardfield easily satisfies the IASP/pain society criteria for a diagnosis of CRPS Type 1. He has not had a trial of antineuropathic pain drugs such as amitriptyline, gabapentin and pregabalin, which may give him symptomatic relief. He may also benefit from psychotherapy and CBT [which I take to mean cognitive behaviour therapy]. I am concerned that he may find a surgeon to amputate his hand which could have disastrous consequences."
"It is perhaps most unfortunate for Mr Scardfield that despite the time spent researching his condition, he appears to have rejected treatments such as psychological intervention and pharmaceutical medication because he believes it will not work. The Board considers that he can of course refuse treatment particularly if the treatment contains inherent dangers or have unproven values such as in experimental. However it seems detrimental not to try the normal treatments available for this condition."
"Dr Shenker's letters to the Police Authority clearly confirm that whilst the appellant has been offered treatment, it has been rejected, not because it is experimental but he believes it will not work. The Board said the appellant appears very contradictory in his evidence that he would be prepared to try anything to alleviate his symptoms and that he has tried everything but the evidence strongly suggests otherwise."
They then deal with another point, the question of the effect of litigation on Mr Scardfield's conditions but they do not rely on that. Then they say this and these are the critical parts of the report:
"However the much stronger evidence is that without normal treatment there can be no hope of his condition improving, thereby allowing the appellant to even contemplate a return to operational duties. The Board fully recognises the issue is not whether the medical condition is permanent but whether the appellant is permanently disabled from carrying out the normal duties of a police officer. However, clearly in the absence of effective normal treatment for his condition the issue of the fitness for duties is somewhat academic. The Board therefore unanimously agrees with the selected medical practitioner in this case that it is premature to argue that Mr Scardfield's disablement is permanent and that he has not received normal appropriate medical treatment for his condition. The determination of the Board therefore rejected the appeal."