IN September 1992 Christopher Clunis, who had a long history of mental disorder, was discharged from a hospital where he had been detained under section 3 of the Mental Health Act 1983. Under section 117 of that Act, it was the duty of his local Health Authority to arrange to provide after-care services for him until it was satisfied that he no longer needed them. After an interval of twelve weeks, during which he failed to attend three out-patient appointments and a mental health assessment arranged for him, Clunis launched an unprovoked and fatal knife attack on a total stranger, Jonathan Zito, at Finsbury Park tube station. Clunis was charged with murder, but a plea of guilty to manslaughter on the grounds of diminished responsibility was accepted, and the trial judge ordered his detention in a secure mental hospital. Clunis claimed damages for his incarceration from the Health Authority, arguing that it was in breach of a common law duty to treat him with professional care and skill, and that if it had acted more expeditiously he would either have been detained or consented to become a patient before the date of the attack and therefore would not have been able to commit it–in other words, that a timely brief period of hospitalisation would have saved him from an indeterminate but doubtless much longer period. The first instance judge refused to strike out the action, but a unanimous Court of Appeal allowed the Health Authority's appeal: Clunis v. Camden and Islington Health Authority [1998] 2 W.L.R. 902.
Out-of-hours primary care services: Demands and patient referral patterns in a Veneto region (Italy) Local Health Authority
