Search Results for: puberty blockers consent/page/28/Freedom of information - right of access) [2015] UKUT 159 (AAC) (30 March 2015)

Identity of social workers may be published following fostering bungle

13 January 2013 by Rosalind English

 Bristol City Council v C and others [2012] EWHC 3748 (Fam) – read judgment

This was an application for a reporting restriction order arising out of care proceedings conducted before the Bristol Family Proceedings Court. The proceedings themselves were relatively straightforward but, in the course of the hearing, information came to light which gave rise to concerns of an “unusual nature”, which alerted the interest of the press.

Background

After family court proceedings decided that child A was at risk of violence from her father, an interim care order was implemented and A was moved to foster carers. However some time afterwards the local authority received information from the police suggesting that someone living at the address of A’s foster carers had had access to child pornography. A also told social workers that another member of the foster household (also respondent to this action) had grabbed her around the throat. As a consequence police and social services visited the foster carers, informed them of the concerns about pornography, removed all computers from the house and moved A to another foster home. On the following day the male foster carer was found dead, having apparently committed suicide.
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Young persons’ consent for cross-sex hormone treatment

1 January 2025 by Rosalind English

O v P and Q  [2024] EWCA Civ 1577

(Jeremy Hyam KC and Alasdair Henderson of 1 Crown Office Row represented the mother in this case)

This was an appeal from a decision in the Divisional Court by Judd J in April 2024. The case raises a question at the core of the transgender debate involving young people: consent.

The young person at the centre of this litigation is now 16 years old. He was born female and started to identify as male in 2020 at the age of about 12.

His parents were estranged. In these circumstances his mother appealed against the refusal of her request for an adjournment of proceedings in which she sought a prohibited steps order and a best interests declaration in relation to her child, pending an assessment being undertaken by a private gender dysphoria clinic (Gender Plus), the first private gender dysphoria hormone clinic in the UK.

It was accepted that, now the young person was by now 16, no Gillick competence question arose (see Sir James Munby at [55] in An NHS Trust v. X [2021] EWHC 65 (Fam), [2021] 4 WLR 11, and MacDonald J at [48]-[49] in GK and LK v. EE [2023] EWCOP 49). It was also accepted that the young person was “impressive, hardworking and intelligent” and had no mental health problems.

Puberty Blockers and Cross-Sex Hormones: Policy Background

As Vos MR noted, a number of events coalesced to make this case a particularly sensitive one at the time of this appeal.

(i) the Cass Interim Review in 2022 led to the closure of the Tavistock clinic that had been in issue in Bell v. Tavistock;

(ii) on 12 March 2024, NHS England published a clinical policy concluding that there was not enough evidence to support the safety or clinical effectiveness of puberty blockers to make the treatment routinely available (outside a research protocol);

(iii) as the first instance judge recorded at [58], NHS Scotland had announced before the hearing that persons under 18 would not be prescribed cross-sex hormones;

(iv) on 21 March 2023, NHS England published a clinical commissioning policy laying down stringent eligibility and readiness requirements to be met before cross-sex hormones could be administered to those over 16;

(v) on 9 April 2024, NHS England wrote to all NHS gender dysphoria clinics asking them to defer offering first appointments to those under 18 “as an immediate response to Dr Cass’s advice that ‘extreme caution’ should be exercised before making a recommendation for [cross-sex hormones] in [children]”;

(vi) on 10 April 2024, the Cass Review was published*; and

(vii) on 11 December 2024 (the day before the hearing before the Court of Appeal), the government announced that the temporary embargo on the use of puberty blockers would be made indefinite (subject to a review in 2027). 

 * For the purposes of this case, the mother highlighted that the Cass Review had called into question the quality of the evidence on which hormone treatments for adolescents are based. Dr Cass says at page 13, for example, that “[t]he reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress”. Moreover, Dr Cass highlights new evidence about brain maturation continuing into the mid-20s, whilst it was originally thought to finish in adolescence. Dr Cass recommended that puberty blockers should only be available within a research protocol, and that recommendation has now been implemented. 

The judge at first instance had said first that, whilst the findings of the Cass Review might turn out to be very significant, she did not think they justified her departure from Bell v. Tavistock and from Lieven J’s decision in AB v. CD and Tavistock [2021] EWHC 741 (Fam) (AB v. CD), which the Court of Appeal approved in Bell v. Tavistock.

Arguments before the Court

The father sought to terminate the proceedings begun by the mother on the ground that they were causing the young person significant distress.
The mother contended that the proceedings should be adjourned because the legal and regulatory landscape for gender dysphoria treatment was changing rapidly; the Cass review had only been published a week before the hearing before the judge; and Gender Plus was a private provider whose practices and procedures were diverging from the NHS approach. In these circumstances, it behoved the court to keep an eye on a case of this kind in a time of flux. The mother also argued, though not strenuously, that cases concerning treatment for gender dysphoria should be regarded as being in in a special category requiring judicial oversight wherever there was less than complete unanimity. If necessary, the mother submitted that the Court of Appeal should depart from its recent decision in R (Bell) v. Tavistock and Portman NHS Foundation Trust [2021] EWCA Civ 1363, [2022] 1 All ER 416.

The judge below had concluded that, while the Cass review might be significant, it did not justify a departure from the decision in Bell v Tavistock and Portman NHS Foundation Trust [2021] EWCA Civ 1363, [2022] 1 All E.R. 416, [2021] 9 WLUK 157, in which it was held that treatment with puberty blockers should not be distinguished from the consideration of contraception in Gillick, and that questions of Gillick competence were for doctors, not the courts. Judd J held there was no realistic basis upon which to override the young person’s consent to treatment by a regulated provider and that there was no legitimate purpose in adjourning the case.

Gambling with Consent: Free, Specific, and Informed Consent in Data Protection Law

5 March 2025 by Matthew Leitch

Background

In RTM v Bonne Terre Ltd [2025] EWHC 111 (KB), the High Court considered claims brought in data protection and the tort of misuse of private information. The Claimant described himself as a “recovering online gambling addict” [1]. He sought damages for harm, distress and financial loss, and a declaration that his rights under data protection legislation had been infringed, from the Defendant, who operate Sky Betting and Gaming (SBG). The relevant period of the Claimant’s gambling for the claim against SBG (restricted by limitation periods) was 2017 until the end of 2018 or the start of 2019 [15].

The Claimant’s case was that SBG harvested his data using cookies without his consent. SBG the processed his personal data for marketing purposes without lawful basis, and targeted him through direct marketing emails (also without his consent) sent on average twice a day [68]. Consequently, he alleged he suffered substantial losses.

Despite the claim having started in an almost inquisitorial fashion, with the Claimant undertaking a broad investigation into gambling laws when recovering from his addiction, the narrow issue at trial was “what, if anything, [the Claimant] consented to in the marketing part of the operation” [77].

Are “squalid” prison conditions and the response to the Covid-19 pandemic breaching human rights?

6 July 2020 by Jonathan Metzer

The latest reports of HM Chief Inspector of Prisons and the Parliamentary Joint Committee on Human Rights lay bare the conditions in some British prisons.

Some of the language that is used to describe living conditions in the Chief Inspector’s report is shocking – including “appalling”, “squalid”, “intolerable”, “extremely squalid” and beset with “vermin and filth”.

The Chief Inspector’s view is that such conditions “should not feature in 21st century jails”. This conclusion was expressed prior to the further impact caused by the Covid-19 pandemic.

Since the pandemic, the Government has introduced measures to address the risk of contagion including a blanket ban on visits since around 24^th March which has still not been revisited despite the Covid-19 threat level having been reduced to level 3 on 19^th June.

The conclusion of the Parliamentary Joint Committee on Human Rights is that the Government’s response and the deficiencies in the measures to mitigate the impact of this “have put at risk the right to family life of up to an estimated 17,000 children of mothers in prison”.

In the view of this author, the evidence indicates that in several respects the UK may well be in breach of vital protections for prisoners and their families under Articles 3 and 8 of the European Convention on Human Rights (ECHR). This extended piece will examine these issues in detail.

Misconduct in public office – ECtHR reviews foreseeability of common law offence

6 September 2021 by Joanna Curtis

On 6 July 2021 the European Court of Human Rights (ECtHR) published its judgment in the case of Norman v UK (Application no. 41387/17).  The case concerned Mr Robert Norman, an officer at Belmarsh prison, who in 2015 was convicted of misconduct in public office for passing a variety of information to a tabloid journalist in exchange for money. The ECtHR found that, in Mr Norman’s case, the offence itself did not constitute a breach of Article 7 ECHR (no punishment without law): Mr Norman’s conduct was sufficiently serious for it to have been foreseeable that it would constitute a criminal offence. The ECtHR also found that the newspaper’s disclosure of Mr Norman’s activities to the police, and his subsequent prosecution and conviction, did not breach his rights under Article 10 ECtHR (freedom of expression).

Strasbourg rules on anti-gay speech for the first time

13 March 2012 by Karwan Eskerie

Vejdeland and Others v Sweden (Application no. 1813/07) – Read judgment

 “Will both teacher and pupils simply become the next victims of the tyranny of tolerance, heretics, whose dissent from state-imposed orthodoxy must be crushed at all costs?”, asked Cardinal O’Brien in his controversial Telegraph article on gay-marriage. He was suggesting that changing the law to allow gay marriage would affect education as it would preclude a teacher from telling pupils that marriage can only mean a heterosexual union. He later insinuated that the change might lead to students being given material such as an “explicit manual of homosexual advocacy entitled The Little Black Book: Queer in the 21st Century.”

A few weeks before that article was published, the European Court of Human Rights handed down its first ever ruling on anti-gay speech, in a Swedish case where a group of young men, seemingly motivated by a similar abhorrence to that expressed by Cardinal O’Brien for the “tyranny of tolerance” in education, put a hundred or so leaflets in or on the students’ lockers at a secondary school. The leaflets read:

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Case Law: JIH v News Group Newspapers, anonymity regained – Edward Craven

1 February 2011 by Guest Contributor

The Court of Appeal yesterday handed down judgment in the case of JIH v News Group Newspapers Ltd ([2011] EWCA Civ 42). In allowing the appeal against the order of Tugendhat J ([2010] EWHC 2818 (QB)) the Court ordered that the claimant’s anonymity should be restored.

Although the Court stressed that each decision is fact sensitive, this approach seems likely to be followed in most types of privacy injunction cases. This eagerly awaited decision adds to the growing body of case law concerning reporting restrictions where an injunction has been granted to restrain publication of information about a claimant’s private life.

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No removal without access to solicitor

27 January 2012 by Rosalind English

The Queen on the Application of Medical Justice v Secretary of State for the Home Department  [2011] EWCA Civ 1710 – read judgment

People who make unsuccessful claims to enter or remain in the United Kingdom cannot be removed without being given sufficient time for a lawyer to prepare a proper challenge to their claim.   The government has failed in its appeal against the Administrative Court’s finding that government policy unlawfully provided for expedited removal procedures in certain pressing circumstances – for example where there was a risk that the person concerned, if given advanced notification of his removal, might attempt to frustrate those measures of removal. The policy was quashed because it interfered with people’s right of access to a lawyer.

The Home Secretary is responsible for granting or refusing leave to remain in the United Kingdom for those who do not have the right of abode in this country in accordance with the Immigration Rules. It is an important aspect of maintaining immigration control that a credible enforcement process is in force and that those with no right to remain in the United Kingdom are removed from the jurisdiction while not infringing the accepted rights of those about to be removed.
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The South African ‘Secrecy Bill’: where are we now – Caroline Stone

24 June 2012 by Guest Contributor

When two Nobel Laureates, an eminent constitutional lawyer and the Secretary General of COSATU (South Africa’s largest trade union federation) are unified in their stinging criticism of a proposed Bill, it may be the time has come for a redraft. Following 293 condemnatory submissions to the National Council of Provinces’ Ad Hoc Committee, the ANC has begun to make concessions.

In an unexpected volte-face at Committee deliberations last month, the ANC tabled a raft of amendments to the current draft of the controversial Protection of State Information Bill. Key proposals include the insertion of a narrow ‘public interest defence’ in relation to a Clause 43 charge of unlawful disclosure of classified information and scrapping of the intolerably low mental element of constructive knowledge – “ought reasonably to know” – from many of the offence-creating provisions. By virtue of the former amendment, an accused would also be able to rely on a defence of ‘wrongful classification’.

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Supreme Court rules on true employment status of a contractor in Pimlico Plumbers case

18 June 2018 by Rosalind English

Pimlico Plumbers Ltd & Anor v Smith [2018] UKSC 29 – read judgment

The Supreme Court has unanimously dismissed Pimlico Plumbers Ltd’s appeal and upheld the Employment Tribunal’s ruling that the Respondent – Mr Smith – a plumbing and heating engineer had been:

(a) a “worker” within the meaning of section 230(3) of the Employment Rights Act 1996;

(b) a “worker” within the meaning of regulation 2(1) of the Working Time Regulations 1998 (SI 1998/1833)

(c) in Pimlico’s “employment” within the meaning of section 83(2)(a) of the Equality Act.

Questions concerning the true employment status of individuals who are presented to the paying customer as being an integral part of the business in question are increasingly common. Despite being presented to the end customer as such, the purported legal reality is that the individual is self-employed for both tax and employment law purposes. This is partly what is described by such arrangements being part of the so-called “gig economy”.
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Father allowed to proceed with embryo surrogate treatment after death of mother: Court of Protection

24 November 2024 by Rosalind English

EF v Human Fertilisation and Embryology Authority [2024] EWHC 3004 (Fam)

This was an application by a father for a declaration that it should be lawful for him to use an embryo created using his sperm and his late wife’s eggs in treatment with a surrogate. The Human Fertilisation and Embryology Authority opposed the application, on the basis that there was insufficient consent from his wife (AB).

The embryo was created in 2017 during the course of treatment being undertaken by EF and AB at a clinic licensed by the HFEA and remains stored by them. EF’s wife died unexpectedly along with the couple’s youngest daughter. It was against that background that this application was made.

EF argued that the HFEA’s decision preventing him from using the remaining embryo amounted to an interference (i) with his Article 8 rights, alone and as interpreted in light of Article 9, and (ii) with those rights when considered in the context of Article 14, which prohibits discrimination in the treatment of men and women. Such interference with those rights, in the circumstances of this case, was disproportionate. Therefore, argued the applicant, the Court was required by s 3 HRA 1998 to read and give effect to primary and subordinate legislation in a way which is compatible with Convention Rights.

Both EF and his late wife were adherents of what the court called the “J religion”, whose central doctrine is the sanctity of life and the divine purpose of all life forms. They believed that the divine soul enters the embryo at point of conception.

They both came from large families and wished to replicate that pattern for themselves. AB suffered a miscarriage in 2008. They went on to have a daughter (X) and they wanted a sibling for her. After IVF treatment AB gave birth to Y. Y subsequently died of neonatal complications. AB and EF wished to use their remaining embryo retrieved in that IVF treatment to have another child.

High Court rules dead partner’s sperm can be kept despite lack of written consent

12 March 2014 by Jessica Elliott

Elizabeth Warren -v- Care Fertility (Northampton) Limited and Other [2014] EWHC 602 (Fam) – Read judgment / court summary 

The High Court has ruled in favour of a 28-year-old woman who wanted her late husband’s sperm to be retained even though the correct written consent was not in place. Mrs Justice Hogg (‘Hogg J’) ruled that Mrs Warren has a right under Article 8 of the European Convention on Human Rights (the right to respect for private and family life) to decide to become a parent by her deceased husband.

Mr Brewer had put his sperm into storage in April 2005 in order to enable his wife, Elizabeth Warren, to conceive a child by him after his death. However, he was not advised by his Clinic as to the statutory steps he needed to take in order for his sperm to be stored for longer than 10 years. In the event, he sadly passed away shortly before the lawful expiry of his consent, leaving his widow insufficient time to decide whether she wished to conceive his child.

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Doctor/patient confidentiality in genetic disease case

29 February 2020 by Rosalind English

ABC v St George’s Healthcare Trust and others [2020] EWHC 455 (QB)

The High Court has ruled that the health authorities owed a duty of care to the daughter of their patient who suffered from the hereditary neurodegenerative order Huntington’s Chorea, to inform her about his condition. But in the circumstances, Yip J concluded that the duty was not breached and that causation had not been established.

The facts of this case are set out in our previous post about the interlocutory proceedings before Nicol J. It will be recalled that the father had killed the claimant’s mother and was detained in a psychiatric hospital at the time of these events.

The outcome of the hearing on the merits has been awaited with anticipation because the finding of an obligation on a doctor to inform a third party may undermine the doctor-patient confidentiality rule, and this in turn would have a significant impact on the health services, particularly as genetic medicine increases the number of diagnoses that affect not just the individual patients but their relatives as well.

The issues before the Court

Now that the full trial of the merits of this case has been held, we have a more nuanced picture of the legal duties and defences. For a start, there were a number of defendants, not just the father’s clinician, but the medical team that made up the family therapy group that treated both claimant and her father. Furthermore evidence has come to light about the claimant’s attitude to the dilemma that she faced which has had implications for the decision on causation.

But first, let’s look at the issues that Yip J had to determine in this important case involving the implications for medical confidentiality in the context of hereditary disease.

i) Did the defendants (or any of them) owe a relevant duty of care to the claimant?

ii) If so, what was the nature and scope of that duty?

iii) Did any duty that existed, require that the claimant be given sufficient information for her to be aware of the genetic risk at a stage that would have allowed for her to undergo genetic testing and termination of her pregnancy?

iv) If a duty of care was owed, did the defendants (or any of them) breach that duty by failing to give her information about the risk that she might have a genetic condition while it was open to her to opt to terminate her pregnancy?

v) If there was a breach of duty, did it cause the continuation of the claimant’s pregnancy when it would otherwise have been terminated? (This involves consideration of whether the claimant would in fact have had the opportunity to undergo genetic testing and a termination in time but for the breach, and whether she would have chosen to do so.)

Will genetically-informed medicine upend medical confidentiality?

17 May 2017 by Rosalind English

ABC v St George’s Healthcare NHS Trust and Others [2017] EWCA Civ 336 – read judgment

All the advocates in this case are from 1 Crown Office Row. Elizabeth-Anne Gumbel QC, Henry Witcomb QC and Jim Duffy for the Appellant, and Philip Havers QC and Hannah Noyce for the Respondents. None of them were involved in the writing of this post.

In a fascinating twist to the drama of futuristic diagnosis, the Court of Appeal has allowed an argument that doctors treating a Huntington’s patient should have imparted information about his diagnosis to his pregnant daughter to go to trial.

The background to this case is outlined in my earlier post on Nicol J’s ruling in the court below. A patient with an inherited fatal disease asked his doctors not to disclose information to his daughter. The daughter came upon this information accidentally, shortly after the birth of her child, and found, after a genetic test, that she suffered from this condition as well, which has a 50% chance of appearing in the next generation. Had she known this, she would have sought a termination of the pregnancy. She claimed that the doctors were liable to her in damages for the direct effect on her health and welfare.

A claim for “wrongful birth” is well established in law; no claim was made on behalf of the child, who was too young to be tested for the condition. The twist is the duty of secrecy between doctor and patient, which has held very well for the past two centuries. Short of confessions pertaining to homicide or information regarding contagious diseases, the dialogue behind the consulting door should end there.

The problem is that the typical medical relationship only pertains to the pathology of the individual patient. Now that tests are available that make every single one of us a walking diagnosis not only for our own offspring but those of our siblings and their offspring, the one-to-one scenario collapses, along with the limited class of people to whom a doctor owes a duty of care. The pregnant daughter who came across the information about her father’s condition was not the defendant doctor’s patient. In pre-genetic days, that meant there was no duty of care relationship between her father’s doctors and her. But the certainty of hereditability brings her into that circle.
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Why EU law will not make the trains run on time

21 December 2016 by David Hart KC

Govia GTR Railway Ltd v. ASLEF [2016] EWCA Civ 1309, 20 December 2016 – read judgment 

As all domestic readers know, there is a long running industrial dispute between Southern Rail and ASLEF, the train drivers’ union. The issue : DOOP  – Driver Only Operated Passenger – Trains. The company says they are perfectly safe, have been used extensively, and there will be no job losses. It claims over 600,000 journeys are being affected per day. The union strongly disputes that the new system of door closing is as safe as the old for passengers, and says that the new system is very stressful for drivers. 

Under domestic law, there appears to be no doubt that the strike action is lawful. In the time-honoured phrase, it is in furtherance and contemplation of a trade dispute, and the company accepted that a proper and lawful strike ballot was held – with a 75% turnout of members of whom 90% favoured the strike.

But the company argued that strike action was in breach of EU law, and hence it was entitled to an interlocutory injunction preventing the strike pending trial.

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