Mentally Ill Killer Refused NHS Compensation on Public Policy Grounds

It has long been established that those who suffer injury or financial loss as a result of their own illegal acts are not entitled to compensation. The Court of Appeal upheld that principle in ruling that a mentally ill woman who killed her mother was rightly refused damages in respect of the psychiatric and other consequences of her crime.

The woman had at different times been diagnosed as suffering from schizoaffective disorder or paranoid schizophrenia. She fatally stabbed her mother whilst in the grip of a serious psychotic episode. She subsequently admitted manslaughter, on the basis that her responsibility for the killing had been diminished by her mental illness, and was detained indefinitely in a mental hospital.

Solicitors on her behalf sued the NHS trust that bore responsibility for her care prior to the killing on the basis that, had her mental state been adequately assessed, she would have been recalled to hospital and would thus have had no opportunity to kill her mother. Compensation was claimed for, amongst other things, pain, suffering, loss of amenity and loss of liberty. The trust admitted liability, but the woman’s claim was dismissed by a judge on the basis that all her heads of loss arose from her illegal act and were therefore barred by the doctrine of illegality.

In dismissing her appeal against that ruling, the Court noted that she was guilty of a serious criminal offence. It could not be said that she had not known the nature and quality of her act, or that what she was doing was wrong, since her mental state had not justified a verdict of not guilty by reason of insanity. The Court declined to look behind the manslaughter conviction and ruled that she was precluded by public policy from seeking to rely on her illegal act to advance her claim. The hospital order had in any event been lawfully imposed and she was thus barred from claiming compensation in respect of her loss of liberty.