Conrad recently appeared in the case of Briggs before the Vice-President of the Court of Protection, a case which is likely to have profound implications for the way in which Serious Medical Treatment and other welfare cases are dealt with and funded where a deprivation of liberty has been authorised.
Medical Treatment: Decisions and the Law (3rd Edition) Bloomsbury Professional (2016), co-authored by Conrad, has now been published.
experience & expertise
Conrad’s practice is primarily centred on Court of Protection work and clinical negligence. He also practises in public law, police and employment law.
Conrad has been acting in serious medical treatment cases for many years and also has an extensive Court of Protection welfare practice, particularly in cases involving deprivation of liberty, risk of sexual abuse or capacity issues.
Conrad also has a sizable clinical negligence practice, and is regularly instructed by the various Medical Defence Organisations and Claimant firms.
Cases & work of note
Northampton General Hospital NHS Trust v CBA (by OS) (2024)
Conrad represented P in this case involving an application for a planned Caesarean section for a young woman who suffered from schizoaffective disorder. This was the second such application in just over two years, suggesting that P was stuck in a cycle that appeared to be causing her significant psychiatric harm. This case raises an interesting legal point regarding capacity in relation to contraception.
J v Luton Borough Council (2024)
Conrad represented the respondent in the Court of Appeal against a decision that it was in the best interests of P, a young man, not to travel to Afghanistan with his extended family who were planning a trip to their country of origin. Conrad successfully resisted the suggestion that the first-instance judge had erred by giving too much weight to the Foreign Office Guidance not to travel.
Doncaster City Council v DS (2023/2024)
Conrad represented the city council in this case involving a woman with an acquired brain injury who was at risk of abuse from others, as well as a risk to herself, as a result of the behavioural impact her injury had on her. The case touched on the ‘gap’ between the MHA 1983 and the MCA 2005.
Nottinghamshire University Hospitals NHS Trust v Indi Gregory and Ors (2023)
Conrad represented the Trust in its application to withdraw ventilation from an 8-month-old baby born with a life-limiting mitochondrial condition. At this stage the baby’s parents had brought an application to have her come home in circumstances where efforts were being made to persuade the UK government to allow the Italian authorities to have some influence over the case’s outcome.
A Local Authority v LD (2023)
Conrad represented the local authority in this case involving an elderly lady who attempted to care for her adult son with Down’s syndrome in squalid conditions. Before COVID lockdown they would go into the community. The local authority developed safeguarding concerns when they did not come out of lockdown and applied to have LD removed from his mother’s care. The case required a close analysis of the interpretation and and proper exercise of s.48 MCA 2005.
S v AS (2023)
Conrad represented P in this case involving a high-net-worth elderly man with international assets and property who had developed Alzheimer’s disease. His brother brought an application seeking to set aside LPAs on the basis that P lacked capacity to enter into them. Despite lacking subject matter capacity, P asserted litigation capacity. This ultimately went unchallenged.
North Middlesex University Hospital NHS Trust v MB (2023)
Conrad represented the Trust in an application for obstetric care for a woman with episodes of psychosis and fluctuating capacity. A best interests determination was sought not to tell P of the local authority’s plan to take away the baby at birth given the effect this would have on her mental state and cooperation with the birth plan.
Bournemouth, Christchurch and Poole Council v TN (2023)
Conrad acted for P in this case involving an 18-year-old male who had autism and had been taken from the family home and to a placement during the COVID pandemic. This had caused him a significant breakdown in his mental state because he believed he had been abducted by aliens. P was hospitalised but would only accept care from his mother. Conrad submitted that P should be allowed to return home with a package of care.
IXA v (1) Royal Surrey County Hospital NHS Foundation Trust (2) NHS England (2022)
Conrad represented IXA in this claim that arises out of the delay in the diagnosis of IXA’s profound deafness and the consequent delay in the institution of appropriate treatment in the form of cochlear implant surgery. This delay had a significant impact on IXA’s development and ability to engage with the world, particularly in relation to speech and language. A case of significant medical and evidential complexity on both causation and quantum issues that settled (with Court approval as IXA is still a child) for the sum of £4m.
The Public Guardian v P and ors (2019)
Conrad represented the Local Authority in this case involving the Public Guardian’s application to remove Lasting Powers of Attorney in respect of both Property and Affairs, and Health and Welfare, from the daughter and granddaughter of P, with allegations of significant financial misuse. A rare example of a such a case proceeding to a final hearing, Conrad had the dual task of supporting the OPG’s application and fending off various criticisms the family attempted to make of the Local Authority during the proceedings. The family members involved had their LPAs removed and a panel deputy was appointed.
Manchester City Council v LC and KR [2018] EWCOP 30
Conrad is representing Manchester City Council in this widely reported case in which a young autistic woman with an obsessional interest in Asian men has been found by the Court to have capacity to marry and engage in sexual relations, but to lack capacity to decide whether contact with men is safe. The apparently conflicting findings as to capacity cause a significant legal dilemma for public authorities in that they are required both to safeguard P and at the same time to allow her to engage in sexual relations where it is safe to do so.
University Hospitals Coventry and Warkwickshire NHS Trust and anor v SG (2018)
Conrad has represented SG, by the Official Solicitor, in this case involving a relatively young man who suffered from Emotionally Unstable Personality Disorder and Dissocial Personality Disorder. SG has a long history of substance misuse and significant self-harming behaviour, including inserting foreign bodies into wounds and ingesting foreign objects such as scissors. SG was addicted to morphine and would on occasion threatened institutional staff with violence, brandishing furniture, needles and bodily fluids. He needed artificial feeding for 6 months before a definitive on his stomach operation was possible, and without which he would die. This presented a huge management problem. Despite understandable scepticism from the experts that the plan would work, the parties worked collaboratively to bring him to the point where the operation was possible, allowing SG a chance of recovery.
Briggs [2016]
Conrad appeared for the NHS Trust and CCG in this seminal case determining the limits of s21A of the Mental Capacity Act (MCA) before the Vice President of the Court of Protection. The applicant, the wife of a man in Minimally Conscious State after sustaining brain injury in a road traffic accident, brought an application for a court order to require life-sustaining treatment for Mr Briggs to be brought to an end, although she did so under the guise of a challenge to the ‘Standard Authorisation’, the legal mechanism whereby Mr Briggs’ technical ‘deprivation of liberty’ had been authorised by the local authority. By bringing proceedings under s21A MCA rather than through the usual route for a serious medical treatment case Mrs Briggs could benefit from non-means tested legal aid. The result will have profound implications for funding for the many ‘welfare’ issues that are dealt with under s21A MCA across the jurisdiction of the Court of Protection.
Re JM [2016] EWCOP 16
Conrad appeared for the five applicants (local authorities and CCGs) in this landmark test case before the Vice President to determine the lawfulness of procedural steps following the Supreme Court decision in Cheshire West. Charles J placed responsibility on central government to ensure that those lacking mental capacity had independent representation in circumstances where they were deprivation of their liberty, whilst finding that local authorities and CCGs had no statutory duty to provide such representation. The judge criticised the MoJ and DoH for their “avoidant approach that prioritises budgetary considerations over responsibilities to vulnerable people”. The case has implications for thousands of sensitive court applications regarding vulnerable persons every year. Described by the Law Society as an “unprecedented judgment.”
Bowstead v Wallace (2016)
Conrad continues to represent the Defendant in this on-going litigation involving a claim for over £3m in damages against an Orthopaedic Surgeon who is alleged to have been negligent during the course of a cement-on-cement hip replacement by allowing the cement to extrude and cause damage to the femoral nerve. Causation and quantum were also significantly in dispute, the Defendant contending that the Claimant’s level of disability was out of proportion to the injury sustained, and that a significant element of her disability was caused by a ‘Conversion disorder’ amenable to psychiatric treatment. Trial commenced on all issues in September 2016, although went part heard and, uniquely, the trial judge decided to split liability and quantum mid-trial to ensure that the breach of duty issues could be dealt with before the evidence became stale. The outcome of the case therefore remains outstanding, with liability to be determined before the end of the year.
Re Jake (a child) (withholding of medical treatment) [2015] EWHC 2442 (Fam); 148 BMLR 149
Conrad represented an NHS Trust in this emergency application before Lord Justice Munby, the President of the Court of Protection, to render lawful the withholding of medical treatment in the event of a serious deterioration in the condition of a gravely ill 10 month-old boy. The case was the first reported case to consider the updated guidance in this area: Making decisions to limit treatment in life-limiting and life-threatening conditions in children: a framework for practice 2015 and was otherwise notable in that it was a rare case in which the mother of the child involved herself lacked capacity to litigate in the proceedings.
Re X and others (Deprivation of Liberty) (No 1) [2015] 2 All ER 1154 and (No 2) [2015] 2 All ER 1165;
Conrad was instructed by Sunderland City Council in what proved to be a seminal hearing in open court, held by Lord Justice Munby on the question of how to deal with the profound consequences for those caring for the mentally disabled (especially Local Authorities) of the Supreme Court decision in the Cheshire West case, which opened up the definition of those who are considered to be deprived of their liberty considerably.
York City Council v C [2014] Fam 10
Conrad represented York City Council in the Court of Appeal in this landmark case on the correct approach to capacity under the Mental Capacity Act 2005 (MCA).
An NHS Trust v KH [2013] Med LR 70
Conrad successfully represented an NHS Trust in an application to have an open-ended Advanced Care Plan to withhold treatment from a brain damaged young boy in the event that his condition deteriorated approved by the High Court. Agreement for the plan had not been possible between the Trust and the natural parents (both of whom themselves lacked capacity to litigate and required litigation friends), as the parents had expressed objections to the proposed plan, whereas the Local Authority (who shared parental responsibility) took a neutral stance. In this important judgment Mr Justice Peter Jackson agreed that the plan was in KH’s best interests notwithstanding the open-ended nature of the declarations sought, and noted also that the views of parents should be afforded careful consideration and respect, even where they themselves lack capacity to litigate.
Owen v HM Treasury (2012)
Conrad successfully represented a senior civil servant, establishing that he was unfairly dismissed by HM Treasury and, in a second tranche of the litigation, successfully obtained a re-engagement order against the Civil Service. In the course of the litigation Conrad cross-examined Sir Nicholas Macpherson, Permanent Secretary to the Treasury, twice, and on both occasion Sir Nicholas’s decisions were overturned: firstly his decision to uphold Mr Owen’s dismissal at an internal appeal was found to be procedurally defective; and secondly his position that it was not appropriate to re-engage Mr Owen was rejected.
recommendations
Conrad is recommended by The Legal 500 as a leading junior in clinical negligence and by both The Legal 500 and Chambers & Partners for his expertise in Court of Protection matters.
Recent editorial includes;
- a formidable advocate who leaves no stone unturned on behalf of his clients;
- a meticulous and ferocious advocate;
- his written work is thorough and persuasive;
- Conrad provides timely, pragmatic and insightful advice;
- he is very strategic in his approach;
- he is absolutely fearless, knowledgeable, dogged and extremely eloquent;
- his ability to pick out the key areas of contention is impressive;
- clients like him, he knows his stuff and the Court of Protection judges respect his views;
- a strong advocate;
- he was brilliant in the Re X litigation and held his own;
- he persists in drilling down into the evidence;
- as an advocate, his approach is calm and composed;
- excellent – he is extremely reliable, inventive and intelligent;
- he has a real interest and passion for the work;
- he is really fair and works towards a resolution;
- is robust and very willing to strongly advocate a client’s case and to provide practical advice;
- very sound technical and procedural knowledge;
- ability to identify key medical issues in a case;
- Conrad demonstrates an excellent grasp of the technical complexities of the Mental Capacity Act, and the surrounding secondary legislation;
- he can approach situations in a really sensitive way, but can also be forceful when needed;
- his drafting is good and he is very experienced in Court of Protection matters;
- has sound judgement;
- an unflappable advocate;
- he has a fine eye for detail and provides clear and practical advice;
- is sensitive to the underlying issues;
- he’s very good at looking at the bigger picture;
- Conrad is thorough, forensic and tenacious;
- he does medical treatment cases very thoroughly and very well, and is relentlessly persuasive; and
- he is articulate and a good drafter, and also brave and willing to make difficult legal challenges.
Reflections
“Thou know’st ’tis common; all that lives must die, Passing through nature to eternity” (Hamlet)
Serious medical treatment cases are the only area of law in the modern era where life or death can directly be at stake. On occasion, it is possible that a life may be lost if a decision is not taken within a matter of hours. That places a great responsibility on all those involved. I feel it as a privilege to be able to offer the experience, knowledge and expertise to assist doctors and family members to navigate their way through proceedings of this nature.
“Learning of patients’ stories and helping them through the most difficult of times provides huge gratification”
“A cat looks down on man, a dog looks up to man, but a pig will look man right in the eye and see his equal” (Winston Churchill)
When I was a boy I remember a teacher suggesting that I was akin to Winston Churchill’s pig because of what he said was my refusal to bow to (his) authority without questioning its basis. At the time I am not sure I saw it as a compliment. Now, however, I hope that neither looking up to nor down on people, but looking them straight in the eye, is a characteristic that I have retained, whether advising lay-clients on the merits of a case or making submissions to a High Court judge.
“Medicine can only cure curable diseases, and then not always” (Chinese proverb)
Working day-to-day with patients, doctors and medical experts as a barrister is constantly rewarding. Learning of patients’ stories and helping them through the most difficult of times provides huge gratification. On the other side, it must be appreciated that doctors work under enormous pressures and against ever-increasing expectations, and not every poor outcome is the result of a blameworthy act. As with patients, doctors find litigation extremely stressful and demanding. Working on both sides allows for the greatest insight into the strengths of a case, how it will be seen from the other side and how a judge is likely to view it, which in turn allows for the best advice to be given.
Publications
Conrad is a co- author of Medical Treatment: Decisions and the Law (3rd Edition) Bloomsbury Professional (2016)
Conrad also is a contributing editor of the Medical Law Reports, providing headnotes and commentary on a range of medical and Court of Protection cases.
articles
Conrad has recently reported on the following cases for the Medical Law Reports:
- King v Royal United Hospitals Bath NHS Foundation Trust [2021] EWHC 1576 (QB) [2021] Med LR 577 Clinical negligence – Death – Post-traumatic stress disorder – Psychiatric harm – Secondary victim – Unexpected and shocking event.
- Hewes v West Hertfordshire Hospitals NHS Trust [2020] EWCA Civ 1523 [2021] Med LR 49 Clinical negligence – Breach of duty of care – Bolam – Bolitho – Delay in diagnosis – Findings of fact – Cauda equina syndrome – Out of hours GP – District general hospital – Resources.
- Bradfield-Kay v Cope [2020] EWHC 1351 (QB) [2020] Med LR 288 Clinical negligence – Breach of duty – Total hip replacement – Prominence of acetabular component – Risk to Iliopsoas Tendon – Bolam test – Bolitho exception.
- Re M (Declaration of death of a child) [2020] EWCA Civ 164 [2020] Med LR 165 Death – Babies – Medical treatment – Declaration of death – Definition of death – Brainstem death – Withdrawal of mechanical ventilation – Expert evidence – Reporting restrictions – Non-applicability of “best interests” test.
- Duce v Worcestershire Acute Hospitals NHS Trust [2018] EWCA Civ 1307 Clinical negligence – Breach of duty – Consent – Causation – Duty to warn of risk – But for causation – Suffi cient cause.
- Spearman v Royal United Bath Hosiptals NHS [2017] EWHC 3027 (QB) Tort – Negligence – Personal injury – Duty of care – Occupiers’ liability – Hospital premises – Reasonable foreseeability –Contributory negligence – Vulnerable patient – Mental disorder.
- Gabriele Shaw (the personal representative of the estate of William Ewan (deceased)) v (1) Dr Jan Kovac (2) University Hospitals of Leicester NHS Trust [2017] EWCA Civ 1028 Clinical Negligence – Healthcare – Consent – Personal Autonomy – Damages – Vindicatory Damages – Compensatory Damages – Conventional Award – Recusal.
- FB v Princess Alexandra Hospital NHS Trust Muller [2017] EWCA Civ 334 Clinical Negligence – Healthcare –Breach of Duty of Care – Standard of Care – Bolam Test – Bolitho exception – Diagnosis – Omission – Error in Diagnosis – Hindsight Bias.
- Atkins v Co-operative Group Ltd [2016] EWHC 80 (QB) [2016] Med LR 169 Civil evidence – Negligence – Causation – Asbestosis – Fresh evidence – Change of circumstances – Entering judgment by consent – Interim payment – Repayment of interim payment.
- Re A (A Child) [2016] EWCA Civ 759 [2016] Med LR 427 Children – Best interests – Right to life – Life-sustaining treatment – Withdrawal of treatment – Balance sheet exercise – Pain – Wider best interests – Over-emphasis of one factor in best interest decision.
- Jefferies [2016] EWHC 2493 (Fam) MLR 2016 38.
- Welch v Waterworth [2015] EWCA Civ 11 [2015] Med LR 41 Clinical negligence – Re-do aorto bifemoral bypass graft – Findings of fact – Reliance on operation record – Adequacy of Reasons – No need for judge to determine every issue in evidence.
- Re JM (A Child) [2015] EWHC 2832 (Fam) [2015] Med LR 544 Children – Jurisdiction – Life sustaining treatment – Inherent jurisdiction – Children Act 1989 – Specific Issue Order – Best interests.
- Dusza and Sobhani v Powys Teaching Local Health Board [2014] EWHC 339 (Admin) [2104] Med LR 147 Contract – National Health Service – Local Health Boards – Dentists – Dental examinations – Duty to make clinical records – Standard General Dental Services Contract – Course of treatment – Whether examination meant full mouth examination – Failure to record carrying out a dental examination in the dental record – Dentists’ entitlement to payment.
- P v Cheshire; P&Q v Surrey [2014] UKSC 19 [2014] Med LR 321 Deprivation of liberty – Mental capacity – Incapacity – Disability – Vulnerable adult – Living arrangements for mentally incapacitated persons –European Convention of Human Rights, article 5 – Constant supervision and control – Residence and care arrangements amounting to a deprivation of liberty – Lack of objection to supervision and control – Relative normality – Supported living arrangements – Foster parents.
- K v Hospital Manangers of the Kingswood Centre and Another [2014] EWCA Civ 1332 Habeas corpus – Deprivation of liberty – Detention in hospital – Discharge order – Barring report – Service of discharge order – Service outside of Deemed Service Provisions.
Qualifications
Conrad has a First in BA History from University College London and was awarded the Margaret Elizabeth Dale Cast prize. He studied for the Common Profession Exam in law at City University, before reading for the bar finals at the Inns of Court School of Law in Gray’s Inn, and was awarded the Inner Temple Major Scholarship. He was the winner of the Inner Temple Lawson Mooting competition in 2004.
Memberships
Conrad is a member of the LCLCBA and PNBA.
privacy
Conrad adopts and adheres to the provisions of his privacy notice which can be accessed here.
Further Information
For further details of Conrad’s practice please click on the links to the left or contact a member of the clerking or client service team.
Bar Council Membership No: 47100
Registered Name: Conrad Laurence Hallin
VAT Registration No: 888003801