“Schizophrenic who killed three elderly men launches legal battle for compensation” (The Independent, 20 June 2023). “Insane triple killer, 28, is suing NHS and police over care ‘failures’ that he says led him to bludgeon three elderly men to death” (Daily Mail, 13 March 2022).

These headlines just scratch the surface of how interesting the judgment in Lewis-Ranwell v G4S Health Services (UK) Limited & Ors [2022] EWHC 1213 (QB) is to read. The considerable mainstream media attention the case has garnered demonstrates the fascinating moral issues raised for lawyers and non-lawyers alike. Stephanie Clarke and Helena Khullar consider this decision in an article first written for the November 2023 edition of PI Focus.

The claimant was a 27-year-old man who had been diagnosed with schizophrenia and psychosis, requiring psychiatric treatment.

On 8 February 2019, the claimant was arrested on suspicion of burglary and detained. It was noted that he posed a risk of violent assault and was growing progressively agitated, irrational and paranoid. When the claimant’s mother telephoned the police station, she said he had a history of violence when unwell, and that she would have “grave concerns” if he were to be released. Despite this, the claimant was charged with burglary and criminal damage and released on bail.

Following his release, the claimant met the elderly owner of a small holding, asked him whether he was a paedophile and then attacked him with a long double-handed saw. He was arrested on suspicion of causing grievous bodily harm and detained for a second time.

During this second period of detention, the claimant continued to deteriorate, exhibiting aggressive and agitated behaviour. However, he was considered not to be psychotic and was released a second time on bail.

On 10 February 2019, the claimant killed three elderly men. At the criminal trial, he was acquitted of murder because the insanity defence applied.



The claimant brought proceedings against the four defendants (G4S Health Services (UK) Limited, the Chief Constable of Devon and Cornwall Police, Devon Partnership NHS Trust and Devon County Council), alleging negligence in treating him and that they had breached his rights under Articles 3 and 8 of the European Convention on Human Rights. He claimed for damages for personal injury, loss of liberty, loss of reputation and loss of dignity, as well as an indemnity in relation to any claim brought against him on account of his violent behaviour.

Mr Justice Garnham heard an application for strike out brought by three of the defendants in relation to the action for negligence. This was brought on the basis that the claimant did not have a cause of action because the illegality doctrine applied (ex turpi causa non oritur actio).


Relevant legal principles

  1. In criminal law, the insanity defence is established where “at the time of the committing of the act the party accused was labouring under such a defect of reason from disease of the mind as not to know the nature and quality of the act he was doing; or, if he did know it, that he did not know, he was doing what was wrong” (Daniel M’Naghten’s Case (1843) 10 CL & F 200, 210)
  2. In Clunis v Camden Islington HA [1998] QB 978, the claimant was charged with manslaughter with diminished responsibility. The Court of Appeal overturned the first instance decision to dismiss the strike out application on the basis that the claimant must be taken to have known what he was doing and that it was wrong [989D]. This reflects the M’Naghten test for insanity.
  3. Several interesting principles arise from Gray v Thames Trains [2009] 3 WLR 167:
    1. Defendants are not excluded from liability purely because the immediate cause of the loss was the claimant’s voluntary and deliberate act.
    2. When a person is criminally sanctioned, they are subject to a criminal penalty and the civil consequences of the sanction.
  4. There are some acts that are not necessarily criminal but can be described as “quasi-criminal” because they engage public interest in the same way (Les Laboratoires Servier v Apotex Inc [2015] AC 430).
  5. Patel v Mirza [2016] UKSC 42 set out the trio of necessary considerations for assessing whether allowing a claim where the illegality defence has been alleged is contrary to the public interest because it would be harmful to the integrity of the legal system. Firstly, the underlying purpose of the prohibition that has been transgressed should be considered. Secondly, one should consider any other relevant public policies that may be rendered less effective or ineffective by denying the claim. The final step is a proportionality assessment.


The court found that the illegality defence did not apply in this case.

While the defendant might have known the nature and quality of the act he was doing, he did not know that what he was doing was wrong. Mr Justice Garnham found that for illegality to be made out, it must be established that the claimant knew that what he was doing was wrong.

This is to be contrasted with cases such as Henderson v Dorset Healthcare University NHS Foundation Trust, where the claimant pleaded guilty to manslaughter by diminished responsibility and carried criminal responsibility for killing her mother in a psychotic episode. While the claimant in Lewis-Ranwell was given a hospital order and a restriction order at the conclusion of the criminal case, this was a disposal for public protection as opposed to being a criminal sanction.

Illegality can apply to cases with quasi-criminality, but this is distinct from cases where the defendant does not carry any criminal responsibility for his actions. Allowing the claim also ensures consistency between civil and criminal law.

Mr Justice Garnham found that allowing the claim would not harm the integrity of the legal system. The prohibition for examination here was the prohibition on the taking of life. The prohibition is not enhanced by denying the claim because an insane person is not receptive to the prohibition. Similarly, there is no deterrent effect because the person in question was insane and extremely unlikely to be affected by the deterrent of not being able to recover compensation.

Mr Justice Garnham also addressed the issues raised regarding the likelihood of the claim shaking public confidence and offending public notions of the fair distribution of resources, particularly given that allowing the defendant to proceed would allow the claimant to claim damages instead of the victims’ families. However, he rationalised this on the basis that public notions of the fair distribution of resources are offended where a claimant should be compensated for the consequences of his own criminal conduct, as per Lord Hoffman in Gray v Thames Trains. These notions are not, however, undermined in this case because the claimant’s conduct was not criminal.



This is an interesting case that ultimately turned on whether or not the claimant had criminal responsibility for their actions. The substantial media coverage of Lewis-Ranwell could be taken to reflect public feelings of disquiet with the notion of a person being able to recover damages despite killing another person (even though the claimant had been insane at the time).

In the Australian Supreme Court case of Presland v Hunter Area Health Services [2003] NSWSC 754, the claimant had been negligently discharged and killed his brother’s fiancée. He was not criminally responsible because the insanity defence applied. However, according to the judgment of The Honourable Justice Santow, the notion of a person being able to recover damages despite having committed murder prompted an “instinctive recoil” which may “be a reflection of more considered community values”.

While this case does not affect the reasoning in Lewis-Ranwell, it is interesting to see an example where an alternative conclusion on similar facts had been reached in a different jurisdiction. This highlights the complexity of the public policy considerations in this case.

Lord Hoffman in Gray v Thames Trains cited the example given by The Honourable Justice Sheller in Hunter, whereby if a negligent psychiatrist was murdered by his own patient, the patient could sue the deceased’s estate for damages. While Lord Hoffman did not comment on this example, he deemed it “an interesting question about the limits of the rule”. It remains to be seen whether the established principles could be limited should such a scenario find its way to the courts in the future.

The Court of Appeal heard the defendants’ appeal in June this year, and it will be interesting to see whether they decide to depart from the first instance decision. Whatever the outcome, there is no doubt it will hit the headlines.



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