The Health Act 1970 cannot be construed as requiring a health board to provide a person with the same facilities in their home as would be provided were they in-patients attending a hospital.
The Supreme Court yesterday overturned a High Court decision which had the effect of upholding a brain-damaged man's claim that the Northern Area Health Board was required to provide him with the same facilities in his sister's home as would be provided were he an in-patient in a hospital.
The man, a 62-year-old, secured substantial compensation in 1983 arising out of a serious injury sustained in a road accident in 1976. He was made a ward of court. He lives with his sister, her husband and son in a house provided for out of the compensation. This followed the break-up of his marriage in 1979.
Granting the NAHB's appeal against the High Court findings, Ms Justice McGuinness said the man did well in his sister's home, but in 1999 he accidentally swallowed a chicken bone which led to acute septicaemia. He was now blind, unable to walk, dress, feed or toilet himself without help.
While his health had improved, he still required a great deal of nursing and care assistance to enable him remain at home. The health board had offered to assist the man remain in his home. The man's sister was not satisfied with the offer. She asked that the existing care arrangements should continue and be financed by the health board.
Ms Justice McGuinness said it was in the man's physical and psychological interests to continue to be cared for in his own home. The High Court judge had inferred that the nursing services to be provided in the man's home were to be, in principle, equivalent to those that would be provided in institutional care.
It seemed clear the High Court judge understood the meaning of "home" in Section 56 of the 1970 Act to mean the ordinary home of an individual. Ms Justice McGuinness said she believed the High Court judge had erred in this view. In construing the legislation, it was clear that the "home" at which services were to be provided was in an institutional home, where a person resident at home attended a health centre, hospital or clinic.
She did not accept that the legislation intended the provision of a long-term virtually full-time nursing service for disabled persons in their own home.
However, Ms Justice McGuinness said it was clear the man's sister had grave need for assistance in caring for her brother. In its most recent proposals the health board had made a substantial effort to put discretionary power contained in the 1970 legislation into effect. It was to be hoped that the board would continue to give material assistance to both the man and his sister.