A homeless woman was turned away five times by the London Borough of Barnet after she lost her home, a Local Government Ombudsman (LGO) investigation has found.

Because the council failed to review her situation properly, the woman was left street homeless over the winter months, and spent nights sofa surfing with friends or sleeping on the night bus. At one point she was hospitalised for 10 days due to a severe asthma attack.

The woman first approached the council for help in January 2015 after she was evicted by her private landlord. The council provided her with a place in a hostel for three nights, but failed to determine whether it had a duty to her as a homeless person.

She approached the council four further times over the following 15 months, but on each occasion she was told she was not a priority need and given advice on contacting charities for support. On no occasion did the council give her a formal decision about her homeless status, that they are legally obliged to do. This meant she had no way of challenging the council’s decision.

The woman and her father complained to the Ombudsman. During the investigation, the council told the LGO that if it “were to issue formal decisions to all those seeking housing assistance there would be significant challenges with the number of Housing Needs officers being required to conduct such a high volume of assessments and write the subsequent decision letters.”

Local Government Ombudsman, Michael King said:

“Councils are legally required to issue a written decision to people who approach them as homeless. Without this those people are left in limbo; denied their review and appeal rights, and are potentially without access to accommodation which they might need.

“The LGO issued a special report on councils’ duties to homeless people in 2011 and I am disappointed to see councils are still making errors in this area. As shown in this report, failing to deal with homeless people properly can have very real and serious consequences for some of the most vulnerable in society.”

Since complaining to the LGO, the woman has received an apology from the council and has been offered temporary accommodation, which she has refused.

The Ombudsman has also recommended the council provide the woman with a written decision on her homelessness application, and pay her £300 to reflect her lost review and appeal rights.

It should also pay the woman’s father £200 to reflect his time and trouble in complaining on behalf of his daughter.

The council should also ensure that in future, homelessness applications are taken and decision letters issued in all appropriate cases.

Barnet Homes delivers the homelessness service on behalf of the council. The council retains responsibility for the service. In our report, we refer to the council, rather than to Barnet Homes. This is because the council is accountable for any failings in the service.

IOI Ombudsman News 12/2017

Within the scope of performing the duties and powers of the National Preventive Mechanism (hereinafter: the NPM) on the basis of the Act ratifying the Optional Protocol to the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment, the Human Rights Ombudsman of the Republic of Slovenia (hereinafter: the Ombudsman) discovered upon visiting the Begunje Psychiatric Hospital that patients in secure wards are required to wear pyjamas. Furthermore, quite a number of female patients in the women’s secure ward expressed their wish to obtain their clothing, brassieres in particular. It was their opinion that they appeared unkempt in hospital pyjamas, which caused them to feel unpleasant, especially when receiving visitors. Employees responded by saying that pyjamas help female patients accept their illness, face it, and embrace it, and it was also supposed to represent a security feature, as the chances of pyjama-clad patients escaping was presumably smaller, and brassieres were said to be dangerous from the perspective of suicidal tendencies in female patients.

We disagreed with these clarifications. In our opinion, equal concern should also be shown for strengthening the self-respect of female patients and other patients in all phases of their treatment and for their later reintegration into the home environment. However, this is difficult to provide if they wear uniform sleeping attire. We warned that suicidal tendencies are indeed possible, but we emphasised that it is difficult to understand why sleeping attire would be safer in this regard than regular clothing. If a female patient intended to commit suicide, she could also use e.g. a sheet, a towel, or a hospital robe belt instead of a brassiere. Furthermore, we expressed our opinion that, if there is a risk of a patient escaping, this does not justify the use of sleeping attire instead of regular daytime clothing. If the security standards are well-constructed and strictly adhered to, the chance of escaping from a secure ward should be minimal anyway.

Because the hospital stressed in its response that experts should express their opinions on the matter, we turned to the     
Expanded Professional Board of Psychiatry at the Ministry of Health (hereinafter: the EPB) and asked for its opinion on the issue. We pointed out that, upon visiting psychiatric hospitals, the Ombudsman discovered variations in the practice of requiring patients in secure wards to wear hospital clothing. Moreover, we warned that the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (hereinafter: CPT) has already warned in its report on the visit to the Psychiatric Ward of the Maribor General Hospital in 2001 with regard to the wearing of pyjamas during the day, that wearing pyjamas throughout the day does not contribute to the strengthening of personal identity and self-respect. Therefore, the CPT recommended that patients who are not seriously ill or are not confined to their beds should be enabled, and if necessary encouraged, to wear their own daytime clothing, or they should be enabled to wear non-uniform hospital clothing.

The EPB also stressed in its response of 5 June 2009 that it agrees that the clothing worn by persons hospitalised in the secure wards of psychiatric hospitals is also extremely important for their self-esteem and personal dignity. The EPB thus encouraged wearing personal clothes in these wards and supported this by professional and humanistic factors, except in very rare cases when the specifics of a patient’s physical health or need for medical interventions make it more difficult or even prevent it. Furthermore, it encouraged personnel in psychiatric wards to wear personal clothing as well.

However, the NPM continued to notice varying practices regarding enabling the use of daytime clothing in the secure wards of psychiatric hospitals. While some hospitals not only encouraged the use of daytime clothing, but also provided them for their patients (e.g. the University Psychiatric Clinic in Ljubljana offers tracksuits to its patients, who wear them during the day, even in such wards – the exceptions are geronto-psychiatric wards), others insisted that their patients wear pyjamas despite the repeated recommendations of the NPM and the aforementioned opinion of the EPB. Specifically, we visited the Idrija Psychiatric Hospital in 2016 and noticed contrasting practices with regard to patients wearing daytime clothing in secure wards. Most of the patients in the geronto-psychiatric ward wore sleeping attire or hospital attire (pyjamas), two patients in the S3 ward wore pyjamas, and most female patients in the S2 ward also wore pyjamas. As one of the most important reasons for the use of sleeping attire, our partners in dialogue also emphasised the fact that, in the event that a patient wanders off to the town, they are quickly notified that “one of their people” is walking around. With regard to the clothing, we were told in wards S2 and S3 that there is an internal agreement that patients are not allowed to use “civilian” clothing for the first three days, as they might abuse this and escape.

The NPM reiterated that experience shows that the practice of wearing hospital clothes does not contribute to strengthening the patient’s personal identity and his or her self-confidence. Since the individualisation of clothing in secure wards might be an important part of the therapeutic process, the NPM once again proposed that the Idrija Psychiatric Hospital should inform the patients to the greatest extent possible of the possibility of wearing their own daytime clothing and encourage them to do so, except when such practice is hindered or prevented by the specifics of the medical condition of a patient. Furthermore, we once again warned of the EPB’s opinion, which was already given in 2009.
 
During this visit, the NPM warned of the inadmissible practice of wearing hospital clothing during the first few days at the hospital, as internally agreed, in order to prevent patients from leaving the hospital, especially those patients who are in secure wards based on their consent, and it also proposed that the Idrija Psychiatric Hospital should inform its patients to the greatest extent possible of the possibility of wearing their own, daytime clothing and even encourage them to do so, unless this is hindered or even prevented by the special characteristics of the health condition of individual patients.
With regard to this recommendation, the Hospital communicated, among other things, that it will continue to insist on internal agreements within its medical team concerning the wearing of daytime clothing by patients, taking into consideration the strengthening of the personal integrity, self-esteem, and dignity of patients and by taking into consideration the described specific criteria with the aim of reducing the portion of patients in hospital clothing.

On the basis of this and other similar recommendations during visits to some other psychiatric hospitals, the Ministry of Health once again turned to the EPB and warned that the EPB’s expert policy concerning the (inappropriateness of) wearing pyjamas during the day from 2009 has still not been fully implemented. Based on this, on 13 February 2017, the EPB (once again) adopted a decision concerning the wearing of pyjamas, which was forwarded by the Ministry of Health to all psychiatric hospitals in Slovenia. According to this decision, the EPB once again encourages that patients from all secure wards in psychiatric hospitals, including the forensic psychiatry ward, should wear personal clothing, except in cases of contagious somatic issues and illnesses, medical interventions, and special conditions, and in the case of geriatric patients in such wards, who require additional medical care and are impaired due to illness (dementia, incontinence, infections, hospital infections, and similar). Moreover, the EPB believes that the medical personnel should also wear protective clothing in such cases in order to protect their personal integrity and physical health. All patients in hospital yards and near exits should wear their own clothing as per the recommendation. According to the opinion of the EPB, this applies to the medical personnel and patients in open wards, with the exception of special cases (somatic medical indications).

As the highest expert authority in the Republic of Slovenia in this field, the EPB thus confirmed its opinion, which has been reiterated by the NPM for a number of years when visiting some psychiatric hospitals. It must also be noted that the opinion of the EPB is pursuant to CPT standards, which warn that the practice of the compulsory wearing of pyjamas or sleeping robes does not contribute to the strengthening of the personal identity and self-confidence of a patient; the individualisation of clothing should also be a part of the therapeutic process.

The Ombudsman, Mr. Ixhet Memeti met with the Ambassador of the Kingdom of Netherlands in the Republic of Macedonia, Mr. Wouter Plomp. At the meeting the ambassador was acquainted with the work of the institution, and the current challenges the institution faces.

The meeting specifically discussed the activities that the embassy together with civil society and the Ombudsman has implemented in the field of anti-discrimination, in particular the project carried out during 2016 and the participation of the Ombudsman with its regional offices in it on a local level.

Both interlocutors stressed the importance of securing continuous and strong support to the Institution, especially having in mind the new Law on the Ombudsman and the competences arising from it.
 
The ambassador stands for continuity of the support which the Kingdom of Netherlands has given to the institution Ombudsman as a key player for protection of human rights and freedoms.