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Addiction, relapse and priority need


Simms v London Borough of Islington [2008] EWCA Civ 1083 is Court of Appeal case from a s.204 appeal.

The issue was vulnerability, the Pereira test, and the use of medical evidence.

Mr Simms was homeless,sleeping in his car, having lost his home after losing his job. He had an addiction to crack, asthma and suffered from depression and panic attacks. He applied to Islington as homeless, with support from Addaction Hackney, which pointed out the dangers of homelessness for his progress in drug treatment. His doctor first reported moderate depression and drug use.

At s.184 Islington found not vulnerable, following the recommendation of their medical advisor, who had not seen Mr Simms.

A further medicial report from Mr Simms doctor was submitted for the s.202 review. This report and the solicitor’s submissions highlighted the risk of relapse into drug use if Mr Simms was street homeless, the solicitors arguing that this was a clear injury or detriment.

Islington’s s.202 upheld the s.184, on the basis that his depression was not enough to make him vulnerable and that drug addiction was not a medical problem. The review letter mentioned the doctor’s second report. No further advice from the Council’s medical advisor was sought.

Mr Simms appealed, on the basis that:

(1) that the reviewing officer had not properly taken into account whether, having regard to the risk of a relapse, the appellant was vulnerable as a recovering drug addict for some “other special reason”;

(2) that the reviewing officer had not properly taken into account all the medical evidence bearing in mind that the council’s medical assessment adviser had neither seen the appellant nor consulted with his advisers. Moreover she had not been given the opportunity to consider Dr Anantha’s second report of 2nd May;

(3) that the reviewing officer had not properly considered how street homelessness would impact on the appellant’s psychiatric condition.

The s.204 appeal failed and was taken to the Court of Appeal on those grounds.


On the s.202 decision letter, the decision-maker had not overlooked the risk of relapse. The Council were well aware that Mr Simms was receiving assistance for his addiction and this had clearly been a factor in finding he was not Pereira vulnerable.

On the medical evidence, the decision-maker stated, correctly, that it was the LA’s duty to determine vulnerability. They were entitled to prefer the evidence of their medical adviser and there was no requirement in every case to refer any further medical reports to the advisor (Shala distinguished). The differences between the first and second report from Mr Simms’ doctor were not so great as to require a second opinion from the advisor. The review letter as whole did not give any reason to think that the decision-maker was not aware that the medical advisor had not seen Mr Simms or consulting his doctor.

The question of the impact on Mr Simms’ psychiatric condition was not arguable if the appeal otherwise failed. In any case, it was clearly considered by the review officer in the s.202 decision letter and she was entitled to decide it did not render Mr Simms vulnerable.

Overall, not a happy case, but evidence, if more were needed, that the Shala conditions on use of medical reports and advice is concerned with specialist advice and reports from those qualified in the field. Where it is clear that an adviser has not seen the homeless applicant, by itself this does not render their advice of no or limited value.

The issue of danger of relapse into addiction as vulnerability is not closed off. What was upheld here was that the decision-maker was entitled, on the evidence before her,to take the view that she did. The view that although a self induced drug alcohol problem was not a reason for vulnerability, the risk of relapse may be, suggested by Crossley v Westminster CC [2006] EWCA Civ 535, [2006] H.L.R. 26, remains open.

Giles Peaker is a solicitor and partner in the Housing and Public Law team at Anthony Gold Solicitors in South London. You can find him on Linkedin and on Twitter. Known as NL round these parts.


  1. Vickie

    This is fascinating from the view of the U.S. where we pretty much leave homelessness to “faith-based” homeless shelters, i.e., shelters supported by private donations. Also fascinating re relapse. As a recovering alcoholic/drug addict (15 years clean and sober) and frequent attendee of 12-step meetings, it always amazed me (continues to) that people stay sober while they’re also homeless. Attending these meetings also shifted my outlook on homelessness which I’d before seen as a permanent state and have now seen people return to functional living, quite well, in fact, restored relationships, new jobs, etc. The PROBLEM of homelessness is permanent, not the homeless. Thanks for this post.

  2. simply wondered

    i happened to sit in on this case and it struck me as interesting precisely because of the lack of something distinctive. a homeless man with drug issues and health problems was assessed (and i believe quite fully by the la) and not found in priority need. and then on appeal and then in the CA. no general principle on drug addiction as a special reason per se and the logic that each case is taken on its facts.
    either boring or interesting depending on how you look at it – the dog that didn’t bark?
    you’re right about it being bloody depressing, though.
    (at least as a total non-expert on homelessness issues in law, that’s how it struck me)


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