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" He may be a Quack"
398
Medicine and the Law
but it will be purely for custodial reasons, as he is not susceptible and I do not think at present a s.60 would be ". The judge sentenced the applicant to 15 years’ appropriate imprisonment and he applied for leave to appeal against that to treatment
" He may be a Quack" A WOMAN on the N.H.S. list of S., a general practitioner, had been treated by him for some years for hysterical aphonia. During that time she had been referred to two specialists, and his treatment continued; he made no subsequent referral, and no communication was made to him. On a visit to his surgery with a common cold she informed him that she was receiving treatment for her voice from " Dr. B. of Harley Street ", recommended by a fruiterer friend of her son. Thereupon S. consulted the London telephone directory. There was dispute about her pronunciation of the name and the precise words used by her and S., but he admitted saying " I don’t know this man from Adam, and for all I know he may be a quack ", and denied saying, You are a bigger fool than I thought you were, wasting your money on a quack. He is not in the Medical Register. He is not a doctor ". The telephone directory did not contain an entry for a medical practitioner under the name pronounced by her according to S., but did contain an entry, three pages further on, of the plaintiff’s name (differing from that pronunciation by only one vowel) of a registered medical practitioner in private practice, with an address other than Harley Street, who was not personally known to S. B. brought a jury action against S. for slander and an injunction. S. denied the words referred to B., and pleaded that he had used the words he had used on an occasion of qualified privilege in the course of an explanation, given out of concern for his patient, of the dangers of referral by fruiterers. B. claimed that S. was actuated by actual malice. In the jury’s absence counsel for S. submitted that qualified privilege applied and there was no evidence of actual malice. Mr. Justice MILMO said that qualified privilege clearly protected the words admittedly spoken. As to the disputed words, for the purpose of ruling it had to be assumed that they were spoken to a patient visiting a general practitioner in his surgery in the circumstances of the case, and the question was whether he would be privileged in communicating that information. Qualified privilege would protect such an occasion, but there was a clear issue to go to the jury on the question whether S. honestly believed what he said to her, and, apart from damages, the only question for the jury was whether S. was actuated by malice. The jury would, therefore, be asked whether they found for the plaintiff or the defendant, and, if for the plaintiff, what damages. After retiring for 55 minutes the jury returned a verdict for S. and judgment was entered for the defendant with costs. "
Blumberg v. Sheridan. Queen’s Bench Division: Milmo J. and a jury. Feb. 9, 10, 13, 1967. Counsel and solicitors: Ralph Millner, Q.c., and Stephen Sedley (Frederick Wills & Co.). Michael Kempster (Hempsons). L. NORMAN WILLIAMS Barrister-at-Law.
"A Particularly Dangerous Man" On Sept. 3, 1966, the body of a young woman travelling in train from Bognor to London was found in an empty compartment of the train when it stopped at Gatwick. Subsequently the applicant made a statement to the police admitting that he had killed her: he said that when she rejected advances he made to her he stabbed her and then left the train with some of her belongings. On Oct. 20, 1966, at Surrey assizes, he pleaded guilty to manslaughter, on the grounds of diminished responsibility. There were medical reports before the Court. In particular, Dr. W. Lindesay Neustatter, stated that the applicant had admitted to having a bad temper all his life and that there had been earlier incidents of violence; Dr. Neustatter was of the opinion that the applicant was a typical psychopath with aggressive tendencies, that his mental responsibility was substantially diminished, inherent causes being the reason for his instability, and that he was a particularly dangerous individual of the type " who might ultimately end up in Broadmoor, a
sentence.
Lord Justice WINN, giving the judgment of the Court, said that since Dr. Neustatter was unable to advise that treatment was warranted for the particular mental state of the applicant, the court had no jurisdiction under the Mental Health Act, 1959, to make a hospital order, still less a restriction order in respect of this particularly dangerous individual. Faced with that difficulty the judge thought it right to pass a sentence of 15 years’ imprisonment: an alternative would have been a sentence of life imprisonment. It would serve no purpose if the Court of Appeal were now to give leave to appeal so that it could consider what an appropriate sentence would be, since under the Criminal Appeal Act, 1966, there was no power to vary a sentence so as to make it greater than that passed at the trial. But for that, it might have been desirable to take some step which would obviate the appalling possibility that after not 15 years, but 15 years less one-third remission for good conduct, 10 years, the applicant might again be at liberty, again menacing the public, he being, as Dr. Neustatter had said, a particularly dangerous man. The application was refused. Reg. v. Gills. Court of Appeal, Criminal Division: Lord Parker C. J., Winn L. J., and Willis J. Jan. 30, 1967. The applicant did not appear and was not represented.
J.
F. LAMB
Barrister-at-Law
Parliament Artificial
Kidney
Machines
ON Feb. 8 Mr. KENNETH ROBINSON, the Minister of a statement about the development of facilities for treatment of patients suffering from chronic renal failure by intermittent dialysis on artificial kidney machines. He said:
Health, made
"At present, 116 patients are being treated either in National Health Service hospital centres or in the home under the supervision of a centre. In the next few weeks I hope that new units will be opened which are designed to treat about another 60 patients. Home dialysis will also be extended. The service is growing slowly at present, but will grow more quickly as schemes on which we are pressing ahead with the highest priority come into use. Three main causes have conditioned the rate of growth; the need to recruit and to train staff, the time unavoidably taken to plan and build or adapt specialised accommodation, and outbreaks of infection in existing units. " Training of staff inevitably takes time, especially while working units in which they can be trained are comparatively few. But more doctors, nurses, and technicians must have the opportunity to acquire the experience that is vital for this kind of treatment, to enable the service to grow more rapidly. The present planned provision for training accommodation and equipment is not governed by availability of money. " The medical profession recognises that this treatment carries with it the danger of spread of disease carried in the blood-particularly jaundice which can be infectious and can be serious; and it is difficult to control. In recent months there have been outbreaks of jaundice in hospital dialysis units affecting both patients and staff, and there were deaths among staff. It was necessary to close one unit and to make emergency arrangements for patients already being treated: it was not possible to accept new patients. In another case, expansion of the service has been unavoidably delayed. " These setbacks reinforce the view of medical experts, which my advisers accept, that it is most important that units should not start treatment of patients until adequate facilities are available. Otherwise we place in danger not only the
Medicine and the Law
but it will be purely for custodial reasons, as he is not susceptible and I do not think at present a s.60 would be ". The judge sentenced the applicant to 15 years’ appropriate imprisonment and he applied for leave to appeal against that to treatment
" He may be a Quack" A WOMAN on the N.H.S. list of S., a general practitioner, had been treated by him for some years for hysterical aphonia. During that time she had been referred to two specialists, and his treatment continued; he made no subsequent referral, and no communication was made to him. On a visit to his surgery with a common cold she informed him that she was receiving treatment for her voice from " Dr. B. of Harley Street ", recommended by a fruiterer friend of her son. Thereupon S. consulted the London telephone directory. There was dispute about her pronunciation of the name and the precise words used by her and S., but he admitted saying " I don’t know this man from Adam, and for all I know he may be a quack ", and denied saying, You are a bigger fool than I thought you were, wasting your money on a quack. He is not in the Medical Register. He is not a doctor ". The telephone directory did not contain an entry for a medical practitioner under the name pronounced by her according to S., but did contain an entry, three pages further on, of the plaintiff’s name (differing from that pronunciation by only one vowel) of a registered medical practitioner in private practice, with an address other than Harley Street, who was not personally known to S. B. brought a jury action against S. for slander and an injunction. S. denied the words referred to B., and pleaded that he had used the words he had used on an occasion of qualified privilege in the course of an explanation, given out of concern for his patient, of the dangers of referral by fruiterers. B. claimed that S. was actuated by actual malice. In the jury’s absence counsel for S. submitted that qualified privilege applied and there was no evidence of actual malice. Mr. Justice MILMO said that qualified privilege clearly protected the words admittedly spoken. As to the disputed words, for the purpose of ruling it had to be assumed that they were spoken to a patient visiting a general practitioner in his surgery in the circumstances of the case, and the question was whether he would be privileged in communicating that information. Qualified privilege would protect such an occasion, but there was a clear issue to go to the jury on the question whether S. honestly believed what he said to her, and, apart from damages, the only question for the jury was whether S. was actuated by malice. The jury would, therefore, be asked whether they found for the plaintiff or the defendant, and, if for the plaintiff, what damages. After retiring for 55 minutes the jury returned a verdict for S. and judgment was entered for the defendant with costs. "
Blumberg v. Sheridan. Queen’s Bench Division: Milmo J. and a jury. Feb. 9, 10, 13, 1967. Counsel and solicitors: Ralph Millner, Q.c., and Stephen Sedley (Frederick Wills & Co.). Michael Kempster (Hempsons). L. NORMAN WILLIAMS Barrister-at-Law.
"A Particularly Dangerous Man" On Sept. 3, 1966, the body of a young woman travelling in train from Bognor to London was found in an empty compartment of the train when it stopped at Gatwick. Subsequently the applicant made a statement to the police admitting that he had killed her: he said that when she rejected advances he made to her he stabbed her and then left the train with some of her belongings. On Oct. 20, 1966, at Surrey assizes, he pleaded guilty to manslaughter, on the grounds of diminished responsibility. There were medical reports before the Court. In particular, Dr. W. Lindesay Neustatter, stated that the applicant had admitted to having a bad temper all his life and that there had been earlier incidents of violence; Dr. Neustatter was of the opinion that the applicant was a typical psychopath with aggressive tendencies, that his mental responsibility was substantially diminished, inherent causes being the reason for his instability, and that he was a particularly dangerous individual of the type " who might ultimately end up in Broadmoor, a
sentence.
Lord Justice WINN, giving the judgment of the Court, said that since Dr. Neustatter was unable to advise that treatment was warranted for the particular mental state of the applicant, the court had no jurisdiction under the Mental Health Act, 1959, to make a hospital order, still less a restriction order in respect of this particularly dangerous individual. Faced with that difficulty the judge thought it right to pass a sentence of 15 years’ imprisonment: an alternative would have been a sentence of life imprisonment. It would serve no purpose if the Court of Appeal were now to give leave to appeal so that it could consider what an appropriate sentence would be, since under the Criminal Appeal Act, 1966, there was no power to vary a sentence so as to make it greater than that passed at the trial. But for that, it might have been desirable to take some step which would obviate the appalling possibility that after not 15 years, but 15 years less one-third remission for good conduct, 10 years, the applicant might again be at liberty, again menacing the public, he being, as Dr. Neustatter had said, a particularly dangerous man. The application was refused. Reg. v. Gills. Court of Appeal, Criminal Division: Lord Parker C. J., Winn L. J., and Willis J. Jan. 30, 1967. The applicant did not appear and was not represented.
J.
F. LAMB
Barrister-at-Law
Parliament Artificial
Kidney
Machines
ON Feb. 8 Mr. KENNETH ROBINSON, the Minister of a statement about the development of facilities for treatment of patients suffering from chronic renal failure by intermittent dialysis on artificial kidney machines. He said:
Health, made
"At present, 116 patients are being treated either in National Health Service hospital centres or in the home under the supervision of a centre. In the next few weeks I hope that new units will be opened which are designed to treat about another 60 patients. Home dialysis will also be extended. The service is growing slowly at present, but will grow more quickly as schemes on which we are pressing ahead with the highest priority come into use. Three main causes have conditioned the rate of growth; the need to recruit and to train staff, the time unavoidably taken to plan and build or adapt specialised accommodation, and outbreaks of infection in existing units. " Training of staff inevitably takes time, especially while working units in which they can be trained are comparatively few. But more doctors, nurses, and technicians must have the opportunity to acquire the experience that is vital for this kind of treatment, to enable the service to grow more rapidly. The present planned provision for training accommodation and equipment is not governed by availability of money. " The medical profession recognises that this treatment carries with it the danger of spread of disease carried in the blood-particularly jaundice which can be infectious and can be serious; and it is difficult to control. In recent months there have been outbreaks of jaundice in hospital dialysis units affecting both patients and staff, and there were deaths among staff. It was necessary to close one unit and to make emergency arrangements for patients already being treated: it was not possible to accept new patients. In another case, expansion of the service has been unavoidably delayed. " These setbacks reinforce the view of medical experts, which my advisers accept, that it is most important that units should not start treatment of patients until adequate facilities are available. Otherwise we place in danger not only the