Ian Brady is passing notes and whispering to his barrister with increasing frequency as the hospital QC questions the expert's diagnosis of a paranoid personality disorder.
The hospital QC said Brady's behaviour and symptoms are evidence of a mental illness, not a personality disorder.
Ian Brady turns a little towards the camera occasionally so we can see more of his face.
For someone who has been fed solely through a tube for over a decade, he looks less skeletal than I had imagined.
Ian Brady is more animated now turning to the person next to him and communicating something.
His barrister again motioning him to be quiet.
Ian Brady is listening intently to the cross examination and repeatedly writing notes which he often passes to his barrister.
We cannot hear Brady but his barrister frequently turns to him and puts her finger over her lips, appearing to motion him to be quiet.
Dr Adrian Grounds, Ian Brady's medical witness, said the Moors murderer's condition has changed in the last 15 years and not in a way that is consistent with a schizophrenic process illness.
The Ashworth Hospital QC said that when Ian Brady was in prison he thought his cell was bugged.
In Ashworth, he thought he was taken outside in the dark and given injections.
"They say he suffers from paranoid delusions", the QC said
The QC representing Ashworth Hospital claims medical evidence strongly suggests Ian Brady has always deliberately concealed his mental illness.
"It is covert," Miss Eleanor Grey said.
Dr Adrian Grounds, Ian Brady's medical witness, is now being cross examined by Miss Eleanor Grey QC acting for Ashworth Hospital.
The mental health tribunal at this stage expects Ian Brady to give evidence after the medical evidence.
That will be next week or Friday at the earliest.
Answering a question on why Ian Brady should not be detained in hospital, Dr Adrian Grounds said: "There's a high degree of tolerance of some unpleasant parts of his behaviour in hospital.
"There might be less tolerance in prison."
Dr Grounds added: "If one thinks he has capacity for autonomy it would be wrong to stand in his way".
He added: "But it would be difficult to recommend something that you think would have consequences for him. So I would not recommend one or the other. I would not actively oppose him going back to prison.
"In Mr Brady's case, this is primarily a wish to have control".