A woman accused of murdering her three young disabled children has been remanded to a secure hospital to receive immediate treatment.
Tania Clarence, 42, sobbed quietly as she appeared via video-link at the Old Bailey, accused of killing her three-year-old twin sons, Ben and Max, and four year-old daughter, Olivia, at their home.
In an unusual move, Judge Brian Barker, the Recorder of London, ruled that Mrs Clarence could be released from prison and enter a secure hospital under the Mental Health Act.
He told the court: "It seems to me, having heard submissions on both sides and having discussed the matter with medical experts, there is an overriding need for immediate treatment in a secure setting.
"There is a combination of circumstances here that makes this an exceptional case and allows this court to take an exceptional course.
"It isn't bail, but what we are doing is ordering for her to be subject to a Section 35 order under the Mental Health Act, so she can then be remanded effectively for review of her condition."
Judge Barker said the order should be processed by the end of the day and the case would be reviewed again in 28 days' time.
Wearing black jeans and a black zip-up fleece jumper, Mrs Clarence looked pale and emotional as she watched the proceedings via video-link from a green-curtained room at HMP Bronzefield in Surrey.
And her voice shook with emotion as she confirmed her name in a thick South African accent.
She did not watch all of the hearing because the video-link was needed by another court, but will be told by her legal team today that she will be sent to a hospital.
Her investment banker husband, Gary, 43, wearing a black suit and open-collar shirt, was supported by friends as he sat in the public gallery during the bail hearing.
Mrs Clarence is accused of three counts of murdering a child aged over one year old between April 20 and April 23 this year.
All three young children suffered from type 2 spinal muscular atrophy.
Also known as floppy baby syndrome, the genetic condition leaves children with little control of their movements and can drastically shorten life expectancy.
Police were called to the family's five-bedroom home in Thetford Road in the wealthy south west London suburb of New Malden at 9.30pm last Tuesday where they discovered the children, who were pronounced dead at the scene.
Mrs Clarence was treated for cuts at St George's Hospital in Tooting, south London, and charged on April 24 - two days after the bodies were found.
The Old Bailey heard that post-mortem examinations suggested that the three children had died from suffocation.
But authorities are waiting for further tests, including toxicology tests, to be carried out before a final cause of death can be given.
Zoe Johnson QC, prosecuting, told the Old Bailey: "By way of preliminary statement, Dr Nathaniel Carey, the pathologist, has indicated that the provisional cause of death is probably suffocation.
"Whether that was associated with some form of intoxication is yet to be determined."
The court heard that Mr Clarence, who works at City bank Investec, was away in the family's native South Africa with their eldest daughter, Taya, at the time of the deaths.
The Old Bailey's matron, wearing a distinctive blue nurse's uniform, sat in the packed public gallery during the hearing.
Mrs Clarence is originally from South Africa and moved to Britain with her husband some years ago.
A plea and case management hearing will be held at the Old Bailey on July 15.