Mental health law briefing 189 – Can a patient pay for their care?
Patients commonly pay for their own acute hospital care, for example, hip replacements, even though they are entitled to free NHS care. If the patient has the money, does a psychiatric patient have the same right to choose to purchase their hospital care or does their detention under the Mental Health Act deprive them of this right?
The question was recently considered by the Courts as a preliminary issue.
The Court held that the patient could chose to provide the money to facilitate his placement or treatment however the decision as to where he would be treated would remain with the managers of the hospital, and decisions about his treatment would remain with his Responsible Clinician.
The Court also held that this did not mean the NHS was unlawfully charging for the treatment as the detaining authority would always have been in the position of being required to provide suitable and appropriate care and treatment without the patient paying for it.
However, as the Judge said, “if the patient… chooses to pay for that, or for any other option, and the detaining authority agree, then why should he not be able to?”.
There is of course likely often to be a subsidiary issue of capacity: to what extent is the patient of sufficient capacity to make the decision? He may well have sufficient capacity but this will need careful assessment.
t: 020 7227 7282
Afternote: This case was subsequentley appealed but the decision was confirmed by the court of Appeal 
 Coombs –v- Dorset NHS PCT and Another  EWHC521
  WLR (D) 158
This briefing is for guidance purposes only. RadcliffesLeBrasseur accepts no responsibility or liability whatsoever for any action taken or not taken in relation to this note and recommends that appropriate legal advice be taken having regard to a client's own particular circumstances.