A judge has said he would be "horrified" if the HSE ceases to fund reasonably priced overnight stays in a UK city to facilitate involvement of the parents of a young man with severe anorexia in his specialist treatment there.
The president of the High Court, Mr Justice Peter Kelly, said the only reason the man is in the UK is because there is no specialist unit here to address this form of treatment resistant anorexia.
The parents’ participation in their son’s treatment programme is regarded as very beneficial and the court would be horrified if the HSE was “parsimonious” about funding overnight stays for them, he said.
The parents should not be expected to get up “at the crack of dawn” to ensure participation in family therapy sessions and ward rounds on the same day and their son found it exhausting to have those on the same day rather than consecutive days, he noted.
The man was previously made a ward of court after being found to lack capacity to make appropriate decisions in the best interests of his health and welfare.
Aged in his twenties, he has suffered with anorexia since his teens, was hospitalised here a number of times and had made some limited progress since being transferred to the UK in recent months.
When his case returned for review on Monday, Mr Justice Kelly was told there were issues whether the HSE, which has funded some overnight stays for the parents, would continue to do so.
The HSE funds the anorexia specialist treatment and travel costs of parental visits but its policy generally does not include funding costs of overnight accommodation.
The man’s mother told the judge his UK treatment team regard the parents’ participation as very beneficial and his father said they would continue to visit their son irrespective of whether the HSE would fund the overnight costs.
David Leahy BL, for the general solicitor for wards of court, said it was “incomprehensible” there would be any effort to alter the regime of funding overnight stays, the money involved was small and it was “extraordinary” this issue was troubling the court.
In his ruling, Mr Justice Kelly said it was necessary to send the man to the UK for treatment and he was sure the family was grateful to the National Health Service.
When the man was sent to the UK, he weighed 42kg with a Body Mass Index of 13.4, a critical range for anorexia. He had made some progress in that he now weighs 46kg with a BMI of 14.7 but appeared to have plateaued and had returned to refusing and hiding food and over exercising.
His parents were not just visiting him, they were playing an important part in his treatment and welfare in the context of a “deeply disturbing illness” involving not just physical problems but no insight by their son into the seriousness of his condition.
Other young people with anorexia sent from here to the UK had demonstrated a similar pattern but many had made a good recovery and the parents should not be depressed by this plateau, he said.
He made orders continuing the man’s detention in the UK for treatment and will review the situation in six months with liberty to apply in the interim if any issue arises.
