Michael Horne KC

Joint Head of Chambers


Call 1992 | Silk 2016

Michael Horne KC | Call 1992 | Silk 2016

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Overview

Michael regularly appears in the Court of Protection and Family Division of the High Court in cases involving serious medical treatment decisions for adults and children. He represents both the patient (on the instruction of the Official Solicitor) and NHS Trusts in cases involving complex issues of capacity, best interests, and associated deprivation of liberty.

Court of Protection

“He is extremely detailed, thorough and on point. Clients really warm to him. He is brilliant to work with and goes through everything with a fine-tooth comb.”
Chambers & Partners

Michael appears for the Official Solicitor in a high-profile Court of Protection case concerning an application to move a woman with a rare, progressively degenerative mitochondrial disease to a palliative care plan. Please click here for the judgment.

 experience & expertise

Michael specialises in cases involving adults and children who cannot make their own decisions about serious medical treatment. There is a strong overlap with his clinical negligence practice which also involves issues of consent, capacity, and the choice of medical treatment which is in a patient’s best interests. His recent cases have touched on a wide range of issues such as prolonged disorders of consciousness, anorexia, cancer treatment, end-of-life care, organ donation, therapeutic sterilisation, non-therapeutic sterilisation, caesarean sections, withdrawal of life-sustaining treatment, and withdrawal of clinically assisted nutrition and hydration.

Michael was instructed by the Official Solicitor in the leading case on the obstetric mode of delivery for incapacitous women, Re FG, where his submissions formed the basis of Keehan J’s authoritative guidance.  He has been involved in a number of high profile Court of Protection medical treatment cases, such as University Hospitals Birmingham NHS Foundation Trust v ST [2023] EWCOP 40 (whether a woman with a rare, progressively degenerative mitochondrial disease could be moved to a treatment plan of palliative care) and Manchester University NHS Foundation Trust v KM & TM [2021] EWCOP 42 (withdrawal of life-sustaining treatment from a 52-year-old man who had suffered a cardiac arrest and contracted COVID-19).

REPORTED CASES

Reported Court of Protection cases Michael has appeared in include:

  • NHS North Central London Integrated Care Board v Royal Hospital for Neuro-Disability [2024] EWCOP 66 (acting for the Official Solicitor in an application for withdrawal of CANH from a patient in VS about whom very little was known);
  • University Hospitals Birmingham NHS Foundation Trust v ST [2023] EWCOP 40 (acting for the Official Solicitor in a high-profile case where a Trust sought to move a woman with a progressively degenerative mitochondrial disease to a treatment plan of palliative care);
  • Imperial College Healthcare NHS Trust v Mrs C [2022] EWCOP 28 (acting for the Official Solicitor in a case concerning the best interests of a religious woman who was left in a vegetative state following a cardiac arrest);
  • Manchester University NHS Foundation Trust v KM & TM [2021] EWCOP 42 (acting for the Official Solicitor in a case concerning the withdrawal of life-sustaining treatment from a 52-year-old man who had been healthy before suffering a cardiac arrest and contracting COVID-19);
  • X NHS Foundation Trust v A [2021] EWCOP 17 (acting for the Official Solicitor in a case where the applicant Trusts sought a declaration that it would be lawful to carry out an elective caesarean section on a mother whose mental health meant that she lacked the capacity to determine the appropriate treatment);
  • A Clinical Commissioning Group v P & TD [2019] EWCOP 18 (acting for the Official Solicitor in a case concerning the withdrawal of CANH from a patient in a minimally conscious state after a drug overdose; first case of this kind brought to court after the judgment in An NHS Trust v Y [2018] UKSC 46 removed the need to do so);
  • University Hospitals of Derby and Burton NHS Foundation Trust v J [2019] EWCOP 16 (acting for the Official Solicitor where the applicant Trust sought a declaration that it was in P’s best interests to undergo a hysterectomy and colonoscopy, and for her to be sedated in order to ensure her presence in hospital);
  • King’s College Hospital NHS Foundation Trust v (1) C (2) V [2016] COPLR 50 (acting for NHS Trust in application seeking declarations that a socialite who had ‘lost her sparkle’ lacked the capacity to decide to reject life-sustaining renal treatment);
  • NHS Trust (2) NHS Trust v FG [2015] 1 WLR 1984 (acting for the Official Solicitor, case giving detailed guidance for managing pregnancy in pregnant women with mental illness);
  • An NHS Trust & Others v DD [2014] EWCOP 8, [2014] EWCOP 11, [2015] EWCOP 4, [2014] EWCOP 13, [2014] EWCOP 44, and [2015] EWCOP 5 (acting for the Official Solicitor in a series of applications involving management of ante-natal care, forcible capacity assessment, per-natal care, contraception and culminating in forcible sterilisation);
  • NHS Gloucestershire CCG v AB [2014] EWCOP 49 (acting for Official Solicitor in case authorising withdrawal of artificial nutrition and hydration in patient in a permanent vegetative state ‘PVS’)
  • Heart of England NHS Foundation Trust v JB [2014] EWHC 342 (COP) (acting for Official Solicitor in case involving above knee amputation)
  • City Hospitals Sunderland NHS Foundation Trust v LO [2014] EWCOP (acting for Official Solicitor in case involving caesarean section for incapacitous obstetric patient)
  • Great Western Hospitals NHS Foundation Trust v AA [2014] EWHC 1666 (Fam) and [2014] EWHC 132 (Fam) (capacity; obstetric care)
  • Re SB [2013] EWHC 1417 (COP) (acting for patient resisting declarations that she lacked capacity to terminate pregnancy)
  • B v An NHS Trust [2002] 2 All ER 449 (acting for NHS Trust where patient refused consent to continued ventilation and associated treatment on ICU)

recommendations

“Michael is very thorough in analysing all issues raised in a case. His oral advocacy is persuasive and calm.”
Chambers & Partners

“Michael is very good on medical treatment cases.”
Chambers & Partners

“He has the confidence of his clients and is completely reassuring.”
Chambers & Partners

“A knowledgeable silk with lovely style in court. He is persuasive and so knowledgeable about all medical law.”
Chambers & Partners

“Sensible, personable and really knows what he is doing.”
Chambers & Partners

“His approach and manner with the lay client and witnesses is fantastic. Working as part of a team with instructing solicitor is very much appreciated. Knowledge and experience in Court of Protection is great.”
The Legal 500

“A pleasure to work with – he is particularly good at liaising with health and social care professionals to understand the nuances of the evidence.”
Chambers & Partners

“He is very good, solid and dependable.”
Chambers & Partners 

reflections

Applications in cases where adults and children are unable to make their own decisions about whether to undergo serious medical treatment are amongst the most rewarding that I deal with. It is not overdramatising to say that their outcome sometimes makes the difference between life and death. It is rare that lawyers are involved in cases of that gravity.

Serious medical treatment decision cases fit very well with the skills I have developed through my strong clinical negligence background. Both require the ability to read and distil technical medical issues quickly and accurately. Both require a strong understanding of whether patients retain the capacity to make their own decisions and the ability to analyse the pros and cons of the treatment in question. Both require a calm and methodical approach.

“Our collective willingness to discuss cases, share experiences, and debate difficult issues is an invaluable support to all.”

The self-contained nature of treatment decision cases is demanding and rewarding in equal measure. They often arise at short notice, sometimes out of hours, and require the barrister to drop other cases and focus solely on the application. There are few other areas where a barrister will see litigation through from first involvement to final conclusion in a matter of hours, days, or weeks.

I enjoy the variety in advocacy involved before the Court of Protection and Family Division. The proceedings are of a more inquisitorial nature than much of my practice. Although there are inevitably disputes between the parties along the way, the applications are less about winning or losing and more about reaching the ‘right decision’ for the patient, whether it is on capacity or as to what course is in their best interests.

Although most of my cases in this area of work involve medical treatment decisions, I am very familiar with the complex interface between the Mental Capacity Act 2005 and the Mental Health Act 1983, as well as the associated deprivation of liberty issues.

I find it an enormous help that in Chambers we have a number of senior colleagues who specialise in this area. Our collective willingness to discuss cases, share experiences, and debate difficult issues is an invaluable support to all.

publications