Health groups slammed over locking up of alcoholic

Rae Lamb, deputy Health and Disabilities Commisioner. Photo / Supplied

A health watchdog has slammed three organisations over the locking up of a vulnerable, 43-year-old alcoholic in a resthome for more than a year without proper legal authority.

Deputy Health and Disability Commissioner Rae Lamb, in a decision published today, says the woman, who later died of unrelated causes, was failed by the Auckland District Health Board, the Taikura Trust and the Aranui Home and Hospital.

Ms Lamb has referred the case to the commissioner's independent prosecutor for a decision on whether to take Aranui and Taikura - a needs assessment and co-ordination service contracted to the Health Ministry - to the Human Rights Review Tribunal.

The woman, identified only as Ms A, lodged her own complaint. Staff in the commissioner's office interviewed her before she died last year.

She was admitted to Auckland City Hospital in May 2007 by community-centre staff who were concerned about her physical and mental wellbeing.

She had a history of intermittent homelessness. Doctors diagnosed a range of conditions, including alcohol-related brain damage, fungal meningitis and walking difficulties.

Suffering memory problems and confusion, she was considered not legally "competent" to give informed consent for her own care. Her parents, who have guardianship of her daughter, felt unable to help.

The hospital's social work and legal departments began - but because of a staff misunderstanding never completed - the process of seeking a court order under the Protection of Personal and Property Rights Act to allow decisions to be made on Ms A's behalf.

She was discharged from the hospital in August 2007 and put by Taikura in Aranui's Oak Park Dementia Unit, a 20-bed secure facility in Epsom that mainly houses people over 65. She remained there until October 2008.

"Ms A made it clear on numerous occasions [to Oak Park staff] that she did not wish to be locked up in a dementia unit for older people," Ms Lamb said in her report. "However, like Taikura Trust, Oak Park failed to respond adequately to these concerns."

Based on medical reports about Ms A, both organisations had reasonable grounds for believing she was not legally competent, but they failed to promptly verify her legal status.

As it became clear that Ms A's capacity to make informed decisions was improving, Oak Park staff failed to act. Had the resthome acted on its responsibility to request a medical reassessment of her legal competence and have the supposed court order reviewed, "this would have resulted in the earlier discovery that there was in fact no such order".

Ms Lamb said Taikura's management of Ms A's case exhibited inexcusable deficiencies, including a "fundamental failure to respect Ms A's rights to dignity and independence ... she was treated more like a problem than a person."

She praised staff at the Waitemata DHB-funded Community Alcohol and Drug Services, whose persistence led to clarification of Ms A's legal status, which enabled her to leave Oak Park. The three organisations Ms Lamb's report criticised have made changes to address the shortcomings it identified.

Ms Lamb told the Herald her report highlighted the rights of vulnerable people who were at times unable to speak for themselves.

"It's about the protections that need to be in place when services are being provided which restrict people's fundamental rights and liberty."