19 November 2020
This three-part extended analysis will discuss the important recent authorities on article 2 ECHR in the context of the provision of healthcare and identify important trends in the development of the law in this area.
Where article 2 of the Convention is invoked to allege inadequate provision of healthcare by the state, recent Strasbourg and domestic authority suggest an increasingly restrictive approach.
16 November 2020
In the news
Dominic Cummings departed from Downing Street in dramatic fashion this week. The departure may herald a change of tone for this government – but in the meantime, criticisms of government measures continue on human rights grounds.
The Joint Committee on Human Rights this week published two reports.
The first report provided legislative scrutiny of the Covert Human Intelligence Sources (Criminal Conduct) Bill. This contains a proposal to grant government agencies (of every shape and size, including the Food Standards Agency and the Competition and Markets Authority) the power to authorise undercover operatives to commit acts in the course of their undercover activities that would be otherwise criminal. The Committee’s conclusion was that the Bill does not contain adequate safeguards and oversight to prevent abuse of the proposed powers to authorise such conduct. Their report recommends a requirement for prior judicial approval before a public body can provide a criminal conduct authorisation, along with an upper limit on the type of criminal conduct that can be authorised, and a reduction in the range of public authorities with these powers, and The report is available here.
The Committee has also published a report on the human rights of black people in the UK. They have called on the government to set out a comprehensive Government race equality strategy, based on increased data collection. In particular, they have urged a focus on ending racial disparities associated with the security services (police and Home Office), democratic participation (unequal voter registration), and healthcare (the maternal mortality gap). They have also recommended that the Equality and Human Rights Commission be given stronger powers so that it can do more to tackle race inequality in the UK. The report is available here.
13 November 2020
R (Maughan) v Her Majesty’s Senior Coroner for Oxfordshire [2020] UKSC 46
The Supreme Court has now issued its judgment in this important case for Coroners and inquests dealing with the standard of proof to be applied where the death might have been caused by suicide or unlawful killing.
Everyone who has done an inquest where these conclusions were realistic on the evidence has traditionally gone along with the idea that in order to be satisfied that either conclusion should be returned the criminal standard of proof was required.
This is often seen in practice, particularly where suicide is concerned, as being a way for Coroners to return an open verdict where there is no positive and direct evidence that the deceased intended to take his or her life, even if the surrounding circumstances point clearly in that direction. Such an approach can be welcome to families grieving the loss of a family member.
However, that all changed with the judgment of the Divisional Court and then the Court of Appeal in this case (see my earlier blog post on this judgment here). This long held practice was held to be devoid of a sound legal basis and that given that the inquest was not itself a criminal proceeding then the civil standard ought to be applied. The Supreme Court has now confirmed that that is right, albeit by a majority of 3 to 2.
The result is that all forms of conclusion in the coroner’s court whether narrative or short form are to be rendered on the balance of probabilities. This includes suicide and unlawful killing.
9 November 2020
Artificial intelligence (AI) aims to mimic human cognitive functions. It is bringing a paradigm shift to healthcare, powered by increasing availability of healthcare data and rapid progress of analytics techniques. Robert Kellar QC of 1 Crown Office Row joins Rosalind English in the latest episode of Law Pod UK to answer some pertinent questions about the application of AI in healthcare and what it means for clinical negligence and other forms of litigation and regulation in medicine.
Will we come to a point when healthcare providers will be under a duty of care to use Artificial Intelligence? At some point the argument is likely to be raised that the advantages of AI are so stark that it would be illogical or irresponsible not to use it. What would this mean for the Bolam test? And for the courts – a judge hearing a clinical negligence case where the issues turn on algorithms may need to be more familiar with computer programming than with medical practice.
Hear these and more fascinating and not too far fetched points in discussion in Episode 130.
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5 November 2020
Would you be first in the queue for the Covid-19 vaccine if and when it is rolled out? Or would you prefer to wait and appraise its effects on more pioneering citizens? With nearly a year of widespread media coverage of the coronavirus, it would not be surprising if a large percentage of an already fearful population exercised its right not to be subjected to what would be an assault and battery under English law: medical treatment without consent.
This is a syndrome, and it has a name. It is called “vaccine hesitancy”. The WHO describes this as “the reluctance or refusal to vaccinate despite the availability of vaccines”. Our willingness to avail ourselves of a future COVID vaccine is very much in doubt, and it is in doubt in high places.
Should a Covid-19 vaccine become available at scale, we cannot expect sufficient voluntary uptake.
Update: on Tuesday 17 November the Danish government finished considering a new law giving the government extended powers to respond to epidemics. Parts of this law that propose that:
People infected with dangerous diseases can be forcibly given medical examination, hospitalised, treated and placed in isolation.
The Danish Health Authority would be able to define groups of people who must be vaccinated in order to contain and eliminate a dangerous disease.
People who refuse the above can – in some situations – be coerced through physical detainment, with police allowed to assist. See the Danish newsletter here. In this country, Health Secretary Matt Hancock has refused to rule out mandatory inoculation, telling talkRADIO the government would ‘have to watch what happens and… make judgments accordingly’.
In July 2020 a group of philosophy and law academics presented written evidence to Parliament proposing that individuals should undergo vaccination as a
condition of release from pandemic-related restrictions on liberty, including on movement and association
The authors of the report base this proposal on two “parity arguments”:
a. If Covid-19 ‘lockdown’ measures are compatible with human rights law, then it is
arguable that compulsory vaccination is too (lockdown parity argument);
b. If compulsory medical treatment under mental health law for personal and public protection purposes is compatible with human rights law, then it is arguable that compulsory vaccination is too (mental health parity argument).
They contend that there is “an arguable case” for the compatibility of compulsory vaccination with human rights law.
5 November 2020
R (Peter Skelton and anr) v Senior Coroner for West Sussex [2020] EWHC 2813 (Admin) — Judgment here.
Susan Nicholson and Caroline Devlin were killed by the same man during the course of abusive relationships. They died in 2011 and 2006, but the man was not convicted – of murder and manslaughter respectively – until 2017. The inquest into Susan’s death in 2011 resulted in a verdict of accidental death. Following the murder conviction, the Coroner applied to the High Court for this to be quashed, with the intention of holding a short inquest at which a fresh conclusion of “unlawful killing” would be recorded. However, the Claimants in this case – Susan’s parents – sought to expand the scope of the inquest to consider what they thought, understandably, were police failings. They were successful; this blog explains why, and examines the wider implications of the ruling.
4 November 2020
In Episode 129, Emma-Louise Fenelon speaks to Joe Tomlinson and Alexandra Sinclair, authors of the new Public Law Project report: Plus ca change? Brexit and the flaws of the delegated legislation system. They are joined by Lord Anderson of Ipswich QC for a fascinating discussion about parliamentary goings-on in a time of Brexit.
The Public Law Project is an independent national charity carrying out research, policy work, training and legal case work to promote the rule of law, improve decision making and facilitate access to justice. The PLP takes no position on the UK’s decision to leave the EU.
Joe is Research Director at the PLP. He is also Senior Lecturer in Public Law at the University of York. He researches widely on public law, and particularly the administrative justice system and his work has been published in leading journals and cited by a variety of bodies, including the Ministry of Justice, the All Party Parliamentary Group on the Rule of Law, and the House of Commons Library. His work, with Professor Robert Thomas, on administrative review will also form the basis of a Law Commission project.
Alexandra is a Research Fellow at the Public Law Project and a PhD student at the London School of Economics Faculty of Law. She has worked as a judges’ clerk at the New Zealand High Court and as a barrister in Auckland, New Zealand. She was awarded the Cleary Memorial Prize by the New Zealand Law Foundation in 2015 for showing outstanding promise in the legal profession.
David Anderson will be well known to listeners. He is a barrister at Brick Court Chambers and a Cross Bench Peer. Following him on twitter @bricksilk is highly recommended to anyone with an interest in public law.
For those interested in public law more generally, signing up to the Public Law Project mailing list is also worthwhile.
Law Pod UK is available on Spotify, Apple Podcasts, Audioboom, Player FM, ListenNotes, Podbean, iHeart, Radio Public, Deezer
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3 November 2020
In Ecila Henderson v. Dorset Healthcare University NHS Trust Foundation [2020] UKSC 43 the Supreme Court has revisited the defence of illegality (“ex turpi causa”) in the context of a claim for clinical negligence.
The claimant — a mental health patient — had committed a criminal offence as a result of the defendant health authority’s admitted negligence. Can a claimant, who would not have committed an offence but for the Defendant’s negligence, recover losses arising from their own criminality? Can they seek compensation for the pain, suffering and loss of earnings caused by a custodial sentence? Can they recover general damages for feelings of guilt and remorse? The Supreme Court answered these questions with a resounding “no”.
The Facts
Ms Henderson suffered from paranoid schizophrenia or schizoaffective disorder. Whilst under the care of the Defendant’s community mental health team she stabbed her mother to death. She did so whilst experiencing a serious psychotic episode. She was convicted of manslaughter by reason of diminished responsibility.
In sentencing her, the judge said that: “… there is no suggestion in your case that you should be seen as bearing a significant degree of responsibility for what you did”. The judge sentenced Ms Henderson to a hospital order under the Mental Health Act 1983.
Ms Henderson subsequently brought a civil claim against the Defendant Trust. The Trust admitted liability for its negligent failure to return her to hospital when her psychiatric condition deteriorated and accepted that, if it had done this, the tragic killing of Ms Henderson’s mother would not have taken place.
However, the Trust argued that Ms Henderson’s claim was barred for illegality (“ex turpi causa”), because the damages she claimed resulted from: (i) the sentence imposed on her by the criminal court; and/or (ii) her own criminal act of manslaughter.
2 November 2020
On 29/10/2020, the Court of Appeal dismissed an appeal against an aggravated burglary conviction brought by a teenage victim of human trafficking.
The applicant’s personal circumstances, including as a victim of trafficking, were properly reflected by way of mitigation of sentence. But his culpability and criminality were not extinguished or so diminished as to lead to the conclusion that he would or might not have been prosecuted.
28 October 2020
The Court of Appeal has delivered a judgment in R (Officer W80) v Director General of the Independent Officer for Police Conduct [2020] EWCA Civ 1301 regarding the applicable conduct standard and provisions governing police in cases of use of force.
The Court ruled against the police officer W80, holding that his honest, but mistaken, belief that his life was being threatened could be examined for reasonableness in the context of disciplinary proceedings. Accordingly, the Independent Office for Police Conduct (IOPC) was justified in concluding that it was open to a disciplinary panel to make a finding of misconduct if W80’s belief was found to be unreasonable.
In 2015, W80 shot dead 28-year old Jermaine Baker. He challenged the IOPC’s decision to bring disciplinary proceedings for gross misconduct in using excessive force against him and to direct the Metropolitan Police Commissioner (Commissioner) to give effect to such recommendation after the Commissioner rejected it.
27 October 2020
On 21/10/2020, the Court of Appeal ruled that the Home Office’s removal window policy (‘the Policy’) was unlawful. The Policy incorporated an unacceptable risk of interference with the right of access to court by exposing a category of irregular migrants — including those who have claims in respect of their right to life and/or freedom from torture and inhuman or degrading treatment — to the risk of removal without any proper opportunity to challenge a relevant decision in a court or tribunal.
22 October 2020
In Episode 128 Emma-Louise Fenelon talks to Marina Wheeler QC about the Independent Medicines and Medical Devices Safety Review, better known as the Cumberlege Review, which investigated the response of England’s healthcare system to patients’ reports of harm from drugs and medical devices.
Since the report was published in July (available here), the National Institute for Health and Care Excellence has indicated it will be taking a number of steps in response to the review (more information here). In recent weeks a number of questions were tabled asking what the government plans to do next in response.
The episode includes a discussion about consent, and reference to Montgomery v Lanarkshire Health Board [2015] UKSC 11
Find an article written by Marina Wheeler QC and Amelia Walker on the Cumberlege Review on page 5 of Issue 6 of the 1COR Quarterly Medical Law Review (QMLR).
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22 October 2020
This article is a condensed version of a piece in the Edinburgh Law Review, Jan 2021 Issue.
Questions around government responsibility for food systems, churning away during the Brexit debates, long ignored, sometimes derided, are meeting stark realities in the coronavirus pandemic. This week we are back to free school meals (FSM).
This summer when the government proposed that it would be stopping the provision of free school meals in England over the summer holidays, it was met with public outcry. When the government U-turned on the decision it was attributed to a successful online campaign led by footballer Marcus Rashford. On 10 October he was awarded an MBE in the Queen’s Birthday Honours.
In the background human rights lawyers Jamie Burton of Doughty Street Chambers and Dan Rosenberg of Simpson Millar acting on behalf of the Good Law Project and Sustain had issued a judicial review pre-action protocol to the Secretary of State for Education, Gavin Williamson MP (hereinafter SSE).
When the government reversed the decision on free school meals, the legal proceedings were halted and as a result potentially significant legal precedent was lost. This comment sets out the human rights case against the government in respect of not providing free school meals in England that may be of renewed and wider relevance in the future. (Education is a devolved matter and therefore the UK government powers in this area do not extend to Scotland and Wales.)
It is also noted that yesterday an Opposition motion in the House of Commons to extend provision of Free School Meals to Easter 2021 was voted down by 322-261. Marcus Rashford has issued a tweet in response. The issue has not gone away.
21 October 2020
Christian Concern, R (On the Application of) v Secretary of State for Health and Social Care [2020] EWCA Civ 1239 CA (King LJ, Nicola Davies LJ, Phillips LJ) 25/09/2020
The secretary of state had granted a temporary approval during the COVID-19 pandemic of “the home of a pregnant woman” as a class of places for the taking of Mifepristone, one of the two drugs required for a termination of pregnancy during the first 10 weeks. The appellants challenged this decision by way of judicial review, arguing, inter alia, that it was unlawful as being without the powers conferred by the Abortion Act 1967 (as amended).
Legal background
The 1967 Act sets out the legal framework under which abortions can be performed in England and Wales. Section 58 of the Offences Against the Person Act 1861 makes it a criminal offence to administer drugs or use instruments to procure an abortion. Section 59 of the same Act makes the supply of drugs, knowing that they are intended to be unlawfully used to procure the miscarriage of any woman, a criminal offence.
The Act excludes from criminal liability the termination of a pregnancy by a medical practitioner under certain circumstances including maximum term of twenty four weeks and risk to the woman. The Act also stipulates that treatment must be carried out in an approved place.
21 October 2020
The Redress for Survivors (Historical Child Abuse in Care) (Scotland) Bill is currently undergoing parliamentary scrutiny.
How survivors experienced Ireland’s institutional abuse ‘redress’ schemes (the Residential Institutions Redress Board (RIRB) and the Magdalen Restorative Justice Ex-Gratia Scheme) over the past two decades can tell us a great deal about the elements of good practice in the Scottish Bill and the areas requiring amendment.
The Scottish Bill improves greatly on some problems that have beset Irish redress schemes by proposing a non-adversarial approach, provision of legal and other assistance throughout a survivor’s engagement with the scheme, freedom of expression for survivors, and a prohibition on the review body reducing the payment proposed at first instance.
However, the Bill’s shortcomings include the waiver requirement, the five-year time limit for applications, the anticipated obligation on survivors to provide documentary evidence ‘in all but exceptional cases’, and the exclusion of corporal punishment from the scheme’s scope. My recent correspondence to the Scottish Parliament’s Education and Skills Committee discusses all of these issues.
Here, I focus on the waiver. This requires that a survivor must trade their right to sue the State and any institution that has made ‘fair and meaningful contribution’ to the scheme in exchange for a payment of up to £80,000.
Scotland has the opportunity to use this redress scheme to support survivors who wish to pursue litigation against the State and/or other entities, by contributing to these individuals’ psychological and financial security in the short term. Instead of the current waiver proposal, the Bill could direct the courts to reduce any future damages award by the amount already paid by the relevant Defendant under the scheme. This approach would recognise the absolute and inalienable human right of survivors of torture or other cruel, inhuman or degrading treatment to accountability for such abuse, and to compensation commensurate with the gravity of the harm suffered. Such recognition would strengthen current and future protections against torture and ill-treatment while redressing past failings.
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