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England and Wales Care Standards Tribunal

You are here: BAILII >> Databases >> England and Wales Care Standards Tribunal >> B v Secretary of State for Education and Skills [2003] EWCST 0200(PC) (3 December 2003)
URL: http://www.bailii.org/ew/cases/EWCST/2003/0200(PC).html
Cite as: [2003] EWCST 200(PC), [2003] EWCST 0200(PC)
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B v Secretary of State for Education and Skills [2003] EWCST 0200(PC) (3 December 2003)

DECISION

[2003] 0200.PC
B v Secretary of State for Education and Skills
William Evans (chair)
Janice Funnell
Margaret Williams
Hearing date 26 November 2003

Application

1. Mr B (the applicant) appeals under regulation 12 of the Education (Prohibition from Teaching or Working with Children) Regulations 2003 (the 2003 Regulations) against a direction made under regulation 5(1) (b) of the Education (Restriction of Employment) Regulations 2000 (the 2000 Regulations) that, on medical grounds, he should not be appointed or employed in relevant employment by any authority or body.

Preliminary

Representation

2. At the hearing the applicant appeared in person. The respondent was represented by Mr C Sheldon of counsel, instructed by The Treasury Solicitor.

Relevant regulations

3. The direction against which the applicant appealed was made on 16 May 2003 under regulation 5 of the 2000 Regulations. The 2003 Regulations, which came into effect on 1 June 2003, (a) revoked the 2000 Regulations and (b) by regulation 3 enacted that any direction made under regulation 5 of the 2000 Regulations should have effect as if it were contained in a direction under section 142 of the Education Act 2002.

4. The applicant's appeal, dated 17 July 2003, was made under regulation 12 of the 2003 Regulations. By regulation 13(1) of the 2003 Regulations, if this tribunal "considers that the direction is not appropriate it may order the Secretary of State to revoke or vary the direction." By regulation 13(2) the tribunal "shall not … consider (a) any information relevant to the decision to give a direction … which the Secretary of State did not have at the time the decision was made; or (b) any evidence of a material change of circumstances of the person concerned occurring since the decision to give a direction … was given."

5. At the start of the hearing we mentioned this to the parties. During the hearing, however, both parties (a) referred to matters arising after the date of the Secretary of State's decision and (b) said they had no objection to the other party doing so. We suggested to the parties that it was not open to them to enlarge our jurisdiction, and that we felt constrained by the explicit prohibition in regulation 13(2).

Procedure

6. On 19 September 2003 the then nominated chairman made directions under regulation 6(2) of the Protection of Children and Vulnerable Adults and Care Standards Tribunal Regulations 2002 (the 2002 Regulations). Those directions (a) included a restricted reporting order prohibiting publication of any matter likely to lead members of the public to identify any child at any time taught by the applicant, but (b) explicitly left for determination by this tribunal at the hearing (i) whether there should be an order excluding press and public from the hearing, and (ii) whether there should be a further restricted reporting order prohibiting the publication of any matter likely to lead members of the public to identify the applicant.

7. At the start of the hearing we invited representations from the parties on whether we should make such orders. The applicant asked for both. Counsel for the respondent had no objection to either type of order, but said the Secretary of State considered that if we were to uphold the direction, then the applicant should be identified: only if we were to order revocation of the direction would the applicant be aggrieved at being identifiable.

8. Under regulation 18 of the 2002 regulations we may make a restricted reporting order "if it appears appropriate to do so." Under regulation 19 we may exclude the press, the public or both from all or part of the hearing if we are satisfied that such a direction is "necessary in order to (a) safeguard the welfare of any child or vulnerable adult; (b) protect a person's private life, or (c) avoid the risk of injustice in any legal proceedings." "Vulnerable adult" is defined in regulation 1 of the 2002 Regulations so as to include someone who "suffers from mental disorder within the meaning of the Mental Health Act 1983."

9. The evidence includes medical information and opinion which would normally be confidential to the applicant as a patient. We are satisfied that (a) the applicant is a vulnerable adult because he suffers from a mental disorder as so defined (namely, mental illness, the illness according to the latest diagnosis being bipolar affective disorder), and his welfare needs to be safeguarded; (b) he has a child of primary school age whose welfare also needs to be safeguarded; and (c) exclusion of press and public from the whole of the hearing is necessary in order to protect the applicant's private life and that of his child. Those considerations outweigh any benefit the public might gain from, or any interest the public might have in, publication or other disclosure of the proceedings at the hearing. Accordingly we directed that the press and the public be excluded from the whole of the hearing.

10. By consent, an official of the Department for Education and Skills (DfES) attended the hearing as an observer. Also observing were the President and a Member of the Council on Tribunals, who were entitled to be there under regulation 21 of the 2002 Regulations.

11. Having made the decision in paragraph 9 above, for substantially the same reasons we think it appropriate to prohibit the publication of any matter likely to lead members of the public to identify the applicant. That is the case whether or not the direction is upheld. So we order that there shall be a restricted reporting order prohibiting the publication (including by electronic means) in a written publication available to the public, or the inclusion in a relevant programme for reception in England and Wales, of any matter likely to lead members of the public to identify the applicant.

12. In case there is any doubt whether the restricted reporting order in paragraph 5 of the directions issued on 19 September 2003 (prohibiting publication of any matter likely to lead members of the public to identify any child at any time taught by the applicant) may not extend beyond this hearing, we repeat that order.

Facts

13. When the Secretary of State issued the direction, the applicant was 40 years old. He had originally qualified as an engineer, but he underwent teacher training and qualified for that in 1993.

14. The applicant had his first contact with local mental health services in December 1994. He was prescribed antidepressant and antipsychotic medication. He decided not to pursue teaching, but reverted to engineering.

15. From 1995 to 1998 the applicant took antipsychotic medication only. His compliance with medication was erratic.

16. In January 1999 the applicant came for the first time under the care of Dr Rodin, who gave evidence at the hearing. Dr Rodin was and continues to be a consultant psychiatrist, with a completed certificate in specialist training in adult psychiatry. At that time Dr Rodin diagnosed the applicant as having a schizo-affective disorder. He prescribed olanzapine, an anti-psychotic. At first the applicant did not take it, but later did so. The applicant and Dr Rodin have seen each other regularly since then: the applicant reckons on more than 50 occasions.

17. In December 1999 the applicant showed mild disinhibition of behaviour, and expressed strange ideas about the impending millennium. He was taking olanzapine, but was keen to stop doing so, and his dosage was gradually reduced.

18. Some time after that the applicant decided to take up teaching after all. He obtained a number of short-term engagements as a supply teacher at secondary schools teaching students aged 11 to 16.

19. We infer that some time during the summer of 2000 the applicant applied for a full-time post to teach maths at a co-educational community secondary school (the school) maintained by a county council (the LEA). He completed a medical questionnaire, in which he mentioned certain health problems. As a result, he was interviewed on 18 July 2000 by the LEA's county medical adviser (the CMA). The applicant's general medical practitioner confirmed to the CMA that Dr Rodin intended to reduce the applicant's olanzapine dosage over the next few weeks.

20. On 22 August 2000 the CMA wrote to the headteacher of the school, saying that the applicant had had medical problems in the past and continued to be under the care of a specialist; that he seemed to be making good progress; but that it would be important that the applicant receive adequate and appropriate support at the school: although he was 37, this would be his first substantive appointment as a maths teacher. The CMA recommended that the applicant be seen by the head of department at least once a week to talk over his progress, and strongly urged that the headteacher review progress with the applicant at least monthly during the first term. He (the CMA) would review the applicant in November 2000.

21. Some time during October 2000 the applicant experienced a manic episode with psychotic symptoms, and showed signs of having difficulty coping with certain situations. On one occasion he was so angry he left his class and another teacher had to take over. On another occasion another teacher helped the applicant quieten his tutor group, but the applicant made no effort to resume his role: he just stood there, reading a book. On another occasion he asked for time off to go to his son's school, in terms suggesting that his manager knew about it already, which was not so. One lunchtime he came back late and a colleague had to cover for him. On another occasion he was reported as having grasped a pupil by the neck.

22. On 18 October 2000, while the applicant was away from school on sick leave, he left 2 messages on the school's voice mail, saying he would not be in to school to teach, but would come into school to hold detentions and do some admin. The school telephoned the applicant's mother (his emergency contact), who described the applicant's problems and mentioned that he was on medication. The school later learned that he had not taken medication for 3 weeks. The school also telephoned the applicant's wife, who thought the applicant was at work. She mentioned his not having taken medication, and said that when it started to work the applicant felt so well that he thought he did not need it, and stopped taking it. On 19 October the applicant left a voice mail message at the school saying he was taking time out of school to sort out his car problem with the man who had sold it to him.

23. On 30 October the applicant told the school he would be absent because he needed to go on the internet to find out about the menopause because he was convinced his wife was going through it.

24. On 31 October the applicant lost control of a Year 7 class with difficult pupils. There was a fight. The applicant did not take up the school's offer of a room change.

25. During the morning of 1 November 2000 the applicant was teaching a maths lesson to a Year 8 class. While the students were doing coursework the applicant wrote on the board, as one of the pupils is recorded to have reported, "If you smack my bum, I'll smack your willy." The applicant then started advising the students not to have sex at their age. Pupils said there had been no conversation from a pupil to prompt that. One pupil walked out; others protested; the applicant said it was "part of life", and wrote on the board, "Be as little children." At the hearing the applicant said the word he actually used was not "smack" but "suck", and that he was trying to counter negative images produced by use of the word "gay".

26. During the lunch break the applicant told his head of department he was concerned that parents might complain about his discussion on sexuality during the Year 8 maths lesson. He said he had discussed pregnancy and wrote on the board; girl pupils said they were disgusted. Asked how the conversation was initiated, the applicant said he had started the discussion as he felt it important as one pupil seemed to be effeminate.

27. The following day a girl in the Year 8 class asked to discuss the matter with the applicant's head of department, and gave her the account we have summarised in paragraph 25 above. The head of department put that account to the applicant, who confirmed that the substance of the pupil's statement was true. Asked why he had got on to that subject in a maths lesson, the applicant said he felt it was an important area to cover, and that a colleague had told him that pupils had not taken recent sex education /counselling seriously. The head of department asked the applicant not to come into school the following day, but to see his doctor and let the school know the outcome. The applicant went home. The acting headteacher wrote to the applicant warning him of possible investigation under the school's disciplinary procedure.

28. On 3 November 2000 the applicant saw his general medical practitioner, who gave him a certificate for 1 month absence from work.

29. On 7 November 2000 the applicant wrote to the acting headteacher resigning his post. Later in the day he telephoned the school asking it to ignore his resignation.

30. On 17 November 2000 the applicant, accompanied by a member of his professional association, met the acting headteacher. The applicant said he did not wish to resign but would see his general practitioner in 2 weeks time with a view to being signed off as fit to return to work. The acting headteacher told him there had been 4 complaints from parents. On the applicant's return to work the matter would be investigated; if he did not return he would be suspended on medical grounds.

31. On 30 January 2001 Dr Rodin wrote a report and forwarded it early in February to the CMA. In the report Dr Rodin summarised the applicant's medical history since 1994, and described his own contact with the applicant since January 1999. In particular Dr Rodin said that in the autumn of 2000 the applicant "developed a manic episode with psychotic symptoms. He was elated, showed mild disinhibition needed less sleep and was more energetic than usual. He had grandiose ideas about becoming a football player. He was thinking more about religion. He agreed to go back on the full therapeutic dose of Olanzapine but unfortunately his illness did not respond before he made a highly inappropriate statement about sexuality to a class of teenage children he was teaching. He has not returned to work since then. He has continued with Olanzapine and his mental state has gradually improved." Dr Rodin added that given the way the applicant's illness had developed in recent years, his diagnosis should be revised to bi-polar affective disorder. "There are important practical consequences to this revision of diagnosis. Antipsychotic medication is effective in bipolar affective disorder but mood stabilising drugs are often more effective. [The applicant's] prognosis will depend on whether he takes medication and how well he responds to it. There is a good chance that he will make a full response to treatment and I will be able to give a more accurate opinion of his prognosis once appropriate treatments have been tried."

32. On 15 February 2001 the CMA wrote to the LEA: "The specialist has indicated that the longer term outlook for [the applicant] could be quite good but I believe that it would be inappropriate for [him] to return to teaching for some months yet until he settles on his present treatment."

33. Some time between 17 November 2000 and 14 March 2001 the applicant may have written another letter to the school resigning his post, because on the latter date he wrote to the school asking to bring his resignation date forward so he could start a new job on 19 March 2001.

34. On 10 May 2001 the CMA recommended to the Secretary of State that the applicant be barred, at least temporarily, from teaching.

35. On 22 May 2001 the Department for Education and Skills (DfES)'s then consultant medical adviser wrote to the CMA asking for further information. On 21 June 2001 the CMA replied, very briefly summarising his involvement and enclosing a copy of the report Dr Rodin had sent him in February 2001.

36. On 7 September 2001 the DfES wrote to the applicant. The letter, which we were told was in a standard form, referred to the incident in the school; said the Secretary of State was considering whether to bar him and make a direction to that effect; explained the procedure; and asked him to see Dr Rodin for a report to be made. The letter said: "Dr Rodin will normally give you a copy of his report, and discuss it with you, as well as sending it to the Secretary of State's medical adviser. In exceptional circumstances however the consultant may decide not to do that." The letter then invited the applicant to give an explanation and make any representations he wished; and told him that if as a result of receiving the report and written representations the Secretary of State decided to give further consideration to the matter, the DfES would give the applicant an opportunity to attend an informal interview and make oral representations.

37. The applicant replied on 12 September 2001. He said his action (on 18 October 2000) was intended as a trial run of a sex and health education lesson he was due to give to a Year 9 tutor group; that it was prompted by someone making a silly remark in class; and that he had made an honest mistake.

38. In a letter dated "31/9/01" the applicant wrote to the DfES saying he felt depressed and that he would hate to be disqualified from teaching.

39. On 23 November 2001 the CMA saw the applicant, who said he was still on olanzapine. The CMA wrote to Dr Rodin.

40. The applicant was keen to reduce his medication as quickly as possible. Dr Rodin gradually reduced the dosage of olanzapine and it was stopped. At the start of 2002 the applicant reduced his lithium dose, by some 20%. His mental state gradually deteriorated. He did not agree with Dr Rodin's suggestion that he increase lithium and go back on olanzapine. He became increasingly active, disinhibited, irritable and elated. He was suspended from work after an adult student complained about the applicant sending him a sexually aggressive note.

41. On 22 May 2002 the applicant was admitted, we infer as a voluntary patient, to hospital, but that was converted to compulsory admission for assessment under s.2 of the Mental Health Act because of poor compliance. The applicant responded well to olanzapine and lithium, and was discharged on 24 June 2002.

42. It was not until 25 November 2002 that Dr Rodin sent his report to the DfES. He did not send a copy to the applicant. Dr Rodin repeated the early history in his January 2001 report, and summarised the applicant's health since October 2000. He said that since discharge from hospital on 24 June 2002, the applicant had remained well. "For the first time, he has recognised that he has a mental illness for which he needs to take long-term medication. He has also given me an advance direction that he would like to be detained under the Mental Health Act if his mental state is deteriorating and he is refusing treatment as advised." Dr Rodin expressed the view: "He now has full insight into his condition and is committed to taking medication as advised. As a result his prognosis is good." In view of the applicant's "advance direction" Dr Rodin considered the risk of further inappropriate behaviour at work to be low. "His wife reliably reports to me any deterioration in his mental state so I will be in a position to intervene at an early stage of illness if this does recur." He saw "no reason why his illness should prevent him from practising his profession."

43. In November 2002 the applicant obtained a post with a large engineering company, teaching vehicle electrics to young people in the army.

44. In November and December 2002 there were letters and telephone conversations between the DfES and the applicant, details of which we did not have. By letter dated 15 January 2003 the DfES invited the applicant to an interview on 14 February 2003 under the procedure it had explained to the applicant in its letter of 7 September 2001. The letter included an invitation, should the applicant so wish, to bring someone with him such as a relative, friend, colleague or a union representative. The letter did not repeat the substance of, or enclose a copy of, the DfES's letter of 7 September 2001, nor did it enclose any copies of the documents the DfES had, so in particular it did not include Dr Rodin's report of 25 November 2001.

45. The applicant attended the DfES for interview on 14 February 2003, unaccompanied. Those present (whose names were not recorded on the DfES's note of the interview), included the DfES case officer and Dr Ling, a consultant occupational physician contracted to the DfES to replace the now retired consultant medical adviser. Both the case officer and Dr Ling gave evidence at the hearing. At the interview the applicant recounted his employment history; repeated his 12 September 2001 explanation of the 1 November 2000 incident at the school; said he had plenty of support at home but did not elaborate on that; did not elaborate about the note to the adult student; said that at the time of the school incident he had been on an induced high; said he thought that behaviours "have to come from ourselves" and that he could not believe that a "tiny tablet" could improve things. He said he had been told he had manic depression, but that he believed he was going to get better. He said his problems were the highs and that tablets could not rule his life: "Only I rule my life." He explained the incident when he was alleged to have grabbed a pupil's neck as grabbing his tie "to show him what it felt like", because he had been bullying another pupil. He said if a similar situation were to occur again, even though he got "these highs" he could guarantee that he would now deal with it calmly. The applicant said he saw Dr Rodin once a month, but might want to see someone else as there were certain things about Dr Rodin he was not happy with. If he could continue to teach, he would continue taking medication, but if the decision was to exclude him from teaching then he might discontinue taking his medication and he would prove to Dr Rodin that he could "do it without him."

46. On 18 February 2003 Dr Ling recommended that the Secretary of State issue a direction. The Secretary of State did so on 16 May 2003.

47. At the date of the hearing the applicant had not asked for review of the Secretary of State's decision.

48. The applicant asks us to order that the Secretary of State revoke the direction. In his notice of application dated 17 July 2003 the applicant (1) denied that he had no insight into his illness or had a history of non-compliance with medication, and (2) challenged the fairness of the interview on 14 February 2003 on the grounds that (a) the DfES had not sent him copies of relevant papers beforehand as he had asked; (b) he had expected to talk about only the incident in the school on 1 November 2000; so (c) he became irritated at the questioning and may have given the impression that he was non-compliant. He added that (1) he had been well for over 12 months and (2) he had complied with medication for the previous 2½ years.

49. At the hearing the applicant (1) acknowledged that he became confrontational and argumentative at the interview on 14 February 2003, but said he had been angry with Dr Rodin and had been shocked by the reference at the interview to the allegedly sexually suggestive message, which he had not expected to be asked about; (2) contended that it was inconsistent for the DfES to regard him as ill yet at the same time able to make full representations at the interview; (3) acknowledged that at the date of the interview he had been substantially compliant for only 1½ years; (4) said he did not disagree with any of Dr Rodin's report of 25 November 2001, but he thought Dr Rodin should have been firmer when the applicant wanted to reduce his dosage, and should have pressed him not to work (points which Dr Rodin agreed, with hindsight, he might have handled differently); (5) criticised the level and quality of support the school gave him; (6) said he now fully recognised that he had an illness and now saw the necessity of continued medication, and in particular that his illness was such that it was when he felt confident and on top of the world that his behaviour was likely to become uninhibited; and (7) acknowledged that his actions may have caused offence or upset, but denied that that amounted to significant harm.

50. At the hearing Dr Rodin told us, and we accept as fact, that (1) the applicant's disorder involves presentations of hypomania which warn of a possible manic episode; (2) the applicant's wife regularly tells Dr Rodin of any concerns; (3) the applicant is now substantially compliant with medication, and in the light of his 3 manic episodes in 18 months to May 2002 now accepts that he needs the medication to regulate his behaviour; (4) the applicant has had no manic episode since June 2002; (5) a manic episode could be triggered by emotional stress; (6) a patient might relapse even while compliant with medication, but the longer the interval since a manic episode, the lower the risk, and (7) the highest risk period for the applicant had now passed.

51. Through counsel the Secretary of State contended that, as explained in DfES Circular 4/99, the Secretary of State would consider barring only where the teacher's illness implies a risk or potential risk to the safety and welfare of pupils, and is most likely to do so for a teacher suffering from mental illness who has displayed psychotic or manic symptoms. Even with compliance there was a risk of relapse, and at the date of the direction the applicant had a history of non-compliance and only a comparatively recent record of compliance. It would be unfair and unsafe to rely on surveillance by Mrs B, work colleagues or others to trigger intervention. Barring was never irrevocable, but it was too early yet.

Conclusions and reasons

Evidence

52. Because regulation 13(2) explicitly prohibits us from considering information, even if relevant, which the Secretary of State did not have at the time the direction was made, we decided we ought to consider the following only in so far as they were part of, or helped understanding of, the information the Secretary of State had at the time the direction was made:
o the applicant's wife's statement dated 8 October 2003, the gist of which appeared to us not to have been conveyed to the DfES before the direction was made;
o Dr Ling's statement dated 10 October 2003 and related correspondence, in so far as they deal with matters occurring after the direction was made or were otherwise not brought to the attention of the DfES before that;
o Dr Rodin's statement dated 14 October 2003 giving his up-to-date opinion;
o the reports dated 14 August 2003 and 29 August 2003 from the applicant's current employer; and
o the applicant's further response dated 27 August 2003.

53. Consequently we did not consider whether there had been a material change of circumstances: we considered the matter as at 16 May 2003 on the basis of the information we conclude the Secretary of State then had.

54. If the applicant considers there has been a material change since 16 May 2003, or that relevant information had not been provided to the DfES by that date, then his remedy is application to the DfES for review, not application to this tribunal for an order that the Secretary of State revoke the direction.

55. By regulation 13(1) of the 2003 Regulations, if this tribunal "considers that the direction is not appropriate it may order the Secretary of State to revoke or vary the direction." Following the decision of our colleagues in S v Secretary of State for Education and Skills [2002] 78.PC, we consider that the burden of proof is on the respondent, and that the standard of proof is the balance of probability.

The fairness of the interview at the DfES

56. Certain aspects of the process leading up to the interview on 14 February 2003, and one aspect of the interview itself, cause us some uneasiness. (1) 10 months elapsed between the incident in the school and the DfES's letter of 7 September 2001 telling the applicant that barring might be under consideration. The letter of 7 September 2001 was to a man known to be mentally ill. A copy of that letter was not enclosed with subsequent letters from the DfES to the applicant. The applicant was ill for a long time, and Dr Rodin's report was consequently delayed. The result overall was that the interview took place some 2 years 3 months after the school incident, and some 1 year 5 months after the only letter to the applicant spelling out what the interview was going to be about. Correspondence in the interim did not repeat the information that letter had given. (2) When the interview took place, the DfES not only listened to the applicant's representations, but also elicited further information, and drew conclusions from the applicant's demeanour and from what he said about his perception of his illness and his treatment, and we wondered whether it was unfair not to have spelt out in advance that the Secretary of State might do so.

57. On balance, we do not think the applicant was so seriously prejudiced that that ought to render the Secretary of State's decision improper. The DfES complied with the relevant provisions of the 2003 regulations. The interview was not an adjudicatory hearing which decided the issue. The DfES's letter of 7 September 2001 had referred to the school incident, but it also made it clear what the procedure was, and what the larger issue under consideration was (that is, whether the Secretary of State should make a direction). So the applicant ought not to have felt misled as to what the interview would be about, nor ought he to have gained the impression that the interview was going to be about the school incident only. The letter also made clear that any representations the applicant might make would be considered. If the applicant made oral representations, it is difficult to see how the DfES and its medical professional adviser could not avoid drawing conclusions from what the applicant said or how he said it, and we think the applicant must be taken to have been aware of that, even though it had not been spelt out in the letter to him. As to not seeing the papers, given that the applicant has no quarrel with Dr Rodin's report, he was not in fact prejudiced by not seeing it, and the other documents of significance he had either written himself or had already seen.

The appropriateness or otherwise of the decision to bar the applicant

58. Taking into account all the evidence, written and oral, and the parties' representations, we do not consider that the direction was not appropriate. It was consistent with the information the Secretary of State had. At the time it was made the applicant had a mental illness which adversely affected his teaching and other aspects of his professional performance. In particular, it had caused him to grab a pupil by the neck or tie; to use inappropriate language with a sexual subject-matter which caused upset or annoyance or to students on 2 occasions, both in school and one in a lesson; and on another occasion to communicate with an older student, again using inappropriate language with a sexual subject-matter which caused upset or annoyance to the recipient. Whether or not the students were harmed, those actions were not appropriate or acceptable. The applicant's record of non-compliance with medication was such that a relapse might occur, and in the context of his medical history as a whole his record of compliance was comparatively recent and tinged with signs of reluctance. The applicant had shown a keenness to reduce, and even to get himself off, medication. He had expressed a lack of acceptance of his diagnosis and of the need for treatment. At interview, after a positive report from his consultant psychiatrist, the applicant had expressed disbelief in the efficacy of the medication and had said he could control his condition without it, which in the past he had not done, and he had shown anger. He had talked about not being happy with some things about his consultant and had said that he might see someone else. He had expressed an intention to continue medication only to get back into teaching, and that if he was prevented from doing so he would show that he could manage his problem without his consultant. We regard those thoughts as unrealistic and lacking in insight. In context, they undermine any reliance we might have wished to place on the applicant's "advance direction" to his consultant psychiatrist, which in any case seems to us to be likely to operate only once symptoms become apparent and have been drawn to the consultant's attention, which might be too late, and might depend on the perceptiveness of other people and their knowing what to do. All that information the Secretary of State had, and was relevant to the decision. That made the direction appropriate.

59. That led us to conclude we should not make the order requested.

60. Our decision is unanimous.

61. Nothing in this decision should be taken as deciding or implying, one way or the other, whether there may have been a material change of circumstances since the direction was made, or whether any matter not known to the Secretary of State at the time the direction was made might have been relevant.

Order

1. The application is dismissed.

2. We prohibit the publication (including by electronic means) in a written publication available to the public, or the inclusion in a relevant programme for reception in England and Wales, of any matter likely to lead members of the public to identify the applicant.

3. We prohibit the publication (including by electronic means) in a written publication available to the public, or the inclusion in a relevant programme for reception in England and Wales, of any matter likely to lead members of the public to identify any child at any time taught by the applicant.

Dated 3 December 2003


Signed


William Evans, Chair
Janice Funnell
Margaret Williams

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