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England and Wales High Court (Queen's Bench Division) Decisions |
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You are here: BAILII >> Databases >> England and Wales High Court (Queen's Bench Division) Decisions >> Lawrence v Pembrokeshire County Council [2006] EWHC 1029 (QB) (11 May 2006) URL: http://www.bailii.org/ew/cases/EWHC/QB/2006/1029.html Cite as: [2006] EWHC 1029 (QB) |
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QUEEN'S BENCH DIVISION
SWANSEA DISTRICT REGISTRY
2 Park Street Cardiff South Wales CF10 1ET |
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B e f o r e :
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Mrs. Stephanie Lawrence |
Claimant |
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- and - |
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Pembrokeshire County Council |
Defendant |
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Mr. Alastair Hammerton (instructed by Dolmans) for the Defendant
Hearing date: 7th April 2006
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Crown Copyright ©
Mr. Justice Field :
85. In my view the Court of Appeal reached the right conclusion on the issue arising in the present cases. Ultimately the factor which persuades me that, at common law, interference with family life does not justify according a suspected parent a higher level of protection than other suspected perpetrators is the factor conveniently labelled 'conflict of interest'. A doctor is obliged to act in the best interests of his patient. In these cases the child is his patient. The doctor is charged with the protection of the child, not with the protection of the parent. The best interests of a child and his parent normally march hand-in-hand. But when considering whether something does not feel 'quite right', a doctor must be able to act single-mindedly in the interests of the child. He ought not to have at the back of his mind an awareness that if his doubts about intentional injury or sexual abuse prove unfounded he may be exposed to claims by a distressed parent.
86. This is not to suggest doctors or other health professionals would be consciously swayed by this consideration. These professionals are surely made of sterner stuff. Doctors often owe duties to more than one person; for instance, a doctor may owe duties to his employer as well as his patient. But the seriousness of child abuse as a social problem demands that health professionals, acting in good faith in what they believe are the best interests of the child, should not be subject to potentially conflicting duties when deciding whether a child may have been abused, or when deciding whether their doubts should be communicated to others, or when deciding what further investigatory or protective steps should be taken. The duty they owe to the child in making these decisions should not be clouded by imposing a conflicting duty in favour of parents or others suspected of having abused the child.
87. This is not to say that the parents' interests should be disregarded or that the parents should be kept in the dark. The decisions being made by the health professionals closely affect the parents as well as the child. Health professionals are of course fully aware of this. They are also mindful of the importance of involving the parents in the decision-making process as fully as is compatible with the child's best interests. But it is quite a step from this to saying that the health professionals personally owe a suspected parent a duty sounding in damages.
88. The claimants sought to meet this 'conflict of interest' point by noting that the suggested duty owed to parents has the same content as the duty owed to the child: to exercise due skill and care in investigating the possibility of abuse. This response is not adequate. The time when the presence or absence of a conflict of interest matters is when the doctor is carrying out his investigation. At that time the doctor does not know whether there has been abuse by the parent. But he knows that when he is considering this possibility the interests of parent and child are diametrically opposed. The interests of the child are that the doctor should report any suspicions he may have and that he should carry out further investigation in consultation with other child care professionals. The interests of the parent do not favour either of these steps. This difference of interest in the outcome is an unsatisfactory basis for imposing a duty of care on a doctor in favour of a parent.
89. This was the conclusion reached by the High Court of Australia in Sullivan v Moody (2001) 207 CLR 562. In Australia, as in this country, the professional and statutory responsibilities of doctors and other health professionals involve investigating and reporting allegations that a child has suffered serious harm or is at risk of doing so. The High Court held unanimously that it would be inconsistent with the proper and effective discharge of these responsibilities that those charged with these responsibilities should be subjected to a legal duty, sounding in damages, to take care to protect persons suspected of being the source of that harm. Gleeson CJ, Gaudron, McHugh, Hayne and Callinan JJ said, at para 62:
'The duty for which the [appellant fathers] contend cannot be reconciled satisfactorily, either with the nature of the functions being exercised by the [medical practitioners and others investigating allegations of child sex abuse], or with their statutory obligation to treat the interests of the children as paramount. As to the former, the functions of examination and reporting, require, for their effective discharge, an investigation into the facts without apprehension as to possible adverse consequences for people in the position of the appellants or legal liability to such persons. As to the latter, the interests of the children, and those suspected of causing their harm, are diverse, and irreconcilable. That they are irreconcilable is evident when regard is had to the case in which examination of a child alleged to be a victim of abuse does not allow the examiner to form a definite opinion about whether the child has been abused, only a suspicion that it may have happened. The interests of the child, in such a case, would favour reporting that the suspicion of abuse has not been dispelled; the interests of a person suspected of the abuse would be to the opposite effect.'
90. For these reasons I am not persuaded that the common law should recognise the duty propounded by Mr Langstaff. In principle the appropriate level of protection for a parent suspected of abusing his child is that clinical and other investigations must be conducted in good faith. This affords suspected parents a similar level of protection to that afforded generally to persons suspected of committing crimes.
108. That being so, [i.e that the appellants' claims do not come within the reach of the distinct line of authority concerned with recovery for nervous shock] on the assumption that the appellants are claiming the same duty of care as was owed to their children, it seems to me that there would have to be some factor, over and above the foreseeable harm which the parents suffered, before the law would hold that the doctors and parents were in sufficient proximity to give rise to a duty of care. Mr Langstaff suggested that the necessary degree of proximity could be found in the fact that the parents themselves had taken the children to see the doctor. That is indeed what happened in these cases. But in itself this can hardly be a criterion for attaching liability to the defendants. For example, there is nothing in the nervous shock cases to suggest that taking the child to the hospital would, in itself, create the necessary proximity for a successful claim by her parents. Something more, by way of actually experiencing the critical event, is required. More generally, it would in my view be unacceptable for a doctor to be liable in damages to a father who took his daughter to the surgery, but not to a father whose daughter happened to be taken by someone else who was looking after her for the day when her symptoms developed. If that supposed distinction is rejected, I am unable to see why it would be fair, just and reasonable for the doctors to owe the parents a duty of care of this kind when, for instance, a defendant who negligently injures a child travelling in his car owes no duty of care to the parents who may foreseeably develop a psychiatric illness as a result of the strain of caring for her. I would therefore reject the appellants' submission that the defendants owed substantially the same duty of care to the parents as to the children.
109. As I have said, counsel for the appellants was anxious to present their case as one where the duty to the child and the duty to the child's parents in effect coincided. In this way he sought to outflank the objection that there is a potential conflict of interest between the child and the parents in a case of alleged child abuse. But this bland version of the supposed duty of care underplays, if it does not eliminate, what I would regard as the most powerful element in the case for the appellants: that by concluding that the children had been the subject of abuse or deliberate harm, the doctors simultaneously indicated that the appellants themselves had been responsible for the abuse or harm. It was, one might suppose, this devastating suggestion which caused the appellants the distress that resulted in their illness. As the High Court of Australia put it in Sullivan v Moody (2001) 207 CLR 562, 581, para 54, "the core of the complaint by each appellant is that he [or she] was injured as a result of what he [or she], and others, were told." It is precisely this very personal defamatory wound which distinguishes their claims from, say, the claims of parents who become ill due to the strain of caring for a child who has become disabled as a result of a surgeon's negligence. On this more focussed approach the health authority would be under a specific duty to take reasonable care to avoid causing a parent psychiatric injury by concluding that he had abused or harmed his child. Viewed in isolation, much might indeed be said for a duty of this kind which would mean that, when deciding how to proceed where they suspected that a child had been abused, the doctors would have to take account of the very real risk of harming the parents in this way.
110. In considering whether it would be fair, just and reasonable to impose such a duty, a court has to have regard, however, to all the circumstances and, in particular, to the doctors' admitted duty to the children. The duty to the children is simply to exercise reasonable care and skill in diagnosing and treating any condition from which they may be suffering. In carrying out that duty the doctors have regard only to the interests of the children. Suppose, however, that they were also under a duty to the parents not to cause them psychiatric harm by concluding that they might have abused their child. Then, in deciding how to proceed, the doctors would always have to take account of the risk that they might harm the parents in this way. There would be not one but two sets of interests to be considered. Acting on, or persisting in, a suspicion of abuse might well be reasonable when only the child's interests were engaged, but unreasonable if the interests of the parents had also to be taken into account. Of its very nature, therefore, this kind of duty of care to the parents would cut across the duty of care to the children.
111. The need to put the interests of the child first in any case of suspected abuse is a theme which runs through the guidance in Working Together (1991) which was issued under section 7 of the Local Authority Social Services Act 1970. Doctors and social workers must be alert to possible signs of abuse. If they suspect that a child is suffering, or is at risk of suffering, significant harm, they should refer their concern to the appropriate agency (para 5.11.1). They are specifically warned, moreover, that the interests of parents and children may conflict and that in such cases the child's interests should be the priority (para 6.12). The real dangers of such a potential conflict are more than amply vouched by the statements of Professor Sir Alan Craft and Mary Marsh which my noble and learned friend, Lord Brown of Eaton-under-Heywood, has quoted. I see no basis whatever for brushing them aside. On the contrary, the appropriate response of the law is to recognise and minimise these dangers. It does so by holding that in these cases the doctors do not owe a duty of care to the parents.
129. …. If the doctor is to be held liable in law for any injury to the parent occasioned by the taking of his child into care, that can only be because the doctor, in fulfilling his primary duty to safeguard the child against abuse, also owed the parent a separate duty to take account of his, the parent's interest, in not being unreasonably suspected of child abuse. I find it impossible to see how such a duty could fail to impact upon the doctor's approach to his task and create a conflict of interest. Of course, if he acts within the bounds of proper professional skill and care he is liable to no one. But if he were to act negligently he would know that whereas a negligent non-diagnosis of child abuse would expose him to liability only to the child, a negligent diagnosis based on suspicions unreasonably held would render him liable also to the parent.
133. There are other powerful considerations too militating against the imposition of a duty of care to parents arising out of the doctor's discharge of his role in combating child abuse. These perhaps are best discerned by reference to the legal principles applying in certain related situations. Take a doctor whose negligent diagnosis or treatment of a child causes it to die with the result that the bereaved parent suffers psychiatric injury. Whilst clearly in such a case the parent can bring a claim on behalf of the child's estate under the Law Reform (Miscellaneous Provisions) Act 1934, there can be no claim by the parent in respect of his own loss unless exceptionally he can bring himself within the narrow parameters recognised to give rise to secondary liability—see for example the decision of the Court of Appeal in North Glamorgan NHS Trust v Walters [2003] Lloyd's Rep Med 49. The law has always placed strict limitations upon the right to recover for psychiatric injury and it is not easy to see why, if no such right exists in a father whose child is negligently allowed to die, it should be given to a father wrongly suspected of child abuse. In the first case the child is lost forever; in the second for a comparatively short time.
134. If it be said that in the second case the father's reputation is blackened, the law's response must be that a defamatory communication in the context of reporting suspicions of child abuse would inevitably attract the defence of qualified privilege so that liability would arise only on proof of malice, not mere negligence. The reason for such a rule is obvious: the law is concerned to encourage candour in such communications; doctors should not feel inhibited in reporting their concerns.
……As I hope I have already made clear, it would, in my judgment, be both highly artificial and unprincipled if the protection afforded to social services and the doctors in the investigation of child abuse ceased (perhaps temporarily, or in relation to only to part of the investigation) when an interim care order was made, or otherwise where it might temporarily be argued that there was no actual conflict of interest between the parent and the local authority. In the context of a child abuse investigation, a duty of care cannot exist at one moment and then cease to exist the next because of a shift in the factual matrix. It either exists throughout the investigation or it does not.
3.4 (2) (a) The court may strike out a statement of case if it appears to the court (a) that the statement of case discloses no reasonable grounds for bringing the claim.
Part 24.2 The court may give summary judgment against a claimant …. on the whole …. of a claim ….if (a) it considers that (i) the claimant has no real prospect of succeeding on the claim…..; and (b) there is no other compelling reason why the case or issue should be disposed of at a trial.
The effect of these decisions
79. Section 2(1) of the Human Rights Act requires the Court to have regard to the jurisprudence of the Strasbourg Court where relevant to proceedings under the Act. Thus any English court, when dealing with a claim under the Act in relation to action or inaction after October 2000 on the part of a local authority in relation to suspected child abuse, must take into account the decisions to which we have just referred. Where a claim alleges breach of Article 3, in circumstances such as those in Z v United Kingdom and E and others v United Kingdom, the court is likely to have to consider whether the local authority knew, or should have known, that positive action was called for. This will necessarily involve consideration of the conduct of the individuals involved. A claim of this nature will, so it seems to us, necessarily be a claim by a child rather than a parent.
80. Where a claim alleges breach of Article 8, on the ground that a child has been removed from a parent without justification, this will also require examination of the conduct of the individuals involved to see whether, on the particular facts, the action was 'necessary in a democratic society'.
81. Thus litigation involving factual enquiries of the nature considered above is now a potential consequence of the conduct of those involved in taking decisions in child abuse cases. In these circumstances the reasons of policy that led the House of Lords to hold that no duty of care towards a child arises, in so far as those reasons have not already been discredited by the subsequent decisions of the House of Lords, will largely cease to apply. Substantial damages will be available on proof of individual shortcomings, which will be relevant alike to a claim based on breach of section 6 of the Human Rights Act and a claim based on breach of a common law duty of care.
82. Can there, in these circumstances, be any justification for preserving a rule that no duty of care is owed in negligence because it is not fair, just and reasonable to impose such a duty? It is true that a claim under the Human Rights Act will only lie against public authorities and not against the individuals employed by them. But the reality is that claims in negligence are brought primarily to establish liability on the part of the local authorities and individuals are unlikely to be personally at risk. In so far as the risk of legal proceedings will inhibit individuals from boldly taking what they believe to be the right course of action in the delicate situation of a case where child abuse is suspected, we think that this factor will henceforth be present, whether the anticipated litigation is founded on the Human Rights Act or on the common law duty of care.
83. In so far as the position of a child is concerned, we have reached the firm conclusion that the decision in Bedfordshire cannot survive the Human Rights Act. Where child abuse is suspected the interests of the child are paramount - see S.1 Children Act 1989. Given the obligation of the local authority to respect a child's Convention rights, the recognition of a duty of care to the child on the part of those involved should not have a significantly adverse effect on the manner in which they perform their duties. In the context of suspected child abuse, breach of a duty of care in negligence will frequently also amount to a violation of Article 3 or Article 8. The difference, of course, is that those asserting that wrongful acts or omissions occurred before October 2000 will have no claim under the Human Rights Act. This cannot, however, constitute a valid reason of policy for preserving a limitation of the common law duty of care which is not otherwise justified. On the contrary, the absence of an alternative remedy for children who were victims of abuse before October 2000 militates in favour of the recognition of a common law duty of care once the public policy reasons against this have lost their force.
84. It follows that it will no longer be legitimate to rule that, as a matter of law, no common law duty of care is owed to a child in relation to the investigation of suspected child abuse and the initiation and pursuit of care proceedings. It is possible that there will be factual situations where it is not fair, just or reasonable to impose a duty of care, but each case will fall to be determined on its individual facts.
85. In reaching this decision we do not suggest that the common law duty of care will replicate the duty not to violate Articles 3 and 8. Liability for breach of the latter duty and entitlement to compensation can arise in circumstances where the tort of negligence is not made out. The area of factual enquiry where breaches of the two duties are alleged are, however likely to be the same.
86. The position in relation to the parent is very different. Where the issue is whether a child should be removed from the parents, the best interests of the child may lead to the answer yes or no. The Strasbourg cases demonstrate that failure to remove a child from the parents can as readily give rise to a valid claim by the child as a decision to remove the child. The same is not true of the parents' position. It will always be in the parents' interests that the child should not be removed. Thus the child's interests are in potential conflict with the interests of the parents. In view of this, we consider that there are cogent reasons of public policy for concluding that, where child care decisions are being taken, no common law duty of care should be owed to the parents. Our reasoning in reaching this conclusion is supported by that of the Privy Council in B v Attorney-General.
87. For the above reasons, where consideration is being given to whether the suspicion of child abuse justifies taking proceedings to remove a child from the parents, while a duty of care can be owed to the child, no common law duty of care is owed to the parents.
82. ….. Until recently it would have been unthinkable that health professionals owed a duty to parents; they did not owe a duty even to the child. But the law has moved on since the decision of your Lordships' House in X (Minors) v Bedfordshire County Council [1995] 2 AC 633. There the House held it was not just and equitable to impose a common law duty on local authorities in respect of their performance of their statutory duties to protect children. Later cases, mentioned by my noble and learned friend Lord Bingham of Cornhill, have shown that this proposition is stated too broadly. Local authorities may owe common law duties to children in the exercise of their child protection duties.
83. This development in the law gives no guidance on how 'wrongly suspected parent' cases should be decided. There have been a number of cases, in this country and in Strasbourg, involving claims by parents against local authorities in respect of the latter's discharge of their responsibilities regarding children. In only two cases, it seems, was the claimant a parent wrongly suspected of having abused his or her child. In L (A Child) v Reading Borough Council [2001] 1 WLR 1575 the Court of Appeal's decision concerned a striking out application. A police authority sought to strike out a claim in negligence brought by a father wrongly suspected of having sexually abused his daughter. Otton LJ held the police assumed no responsibility towards the father by interviewing him as a suspect. But it was arguable there was a legal assumption of responsibility when, there being no evidence to support criminal proceedings, the police officer nevertheless came to the conclusion that the mother's complaint was sufficient to show that the daughter was at risk of further abuse from her father. So the striking out application failed. The Court of Appeal left open the question whether there was a 'legal assumption of responsibility' on the alleged facts.
84. More recently a case concerning a wrongly suspected parent came before the European Court of Human Rights in Venema v Netherlands (2002) 39 EHRR 102. A young child aged 11 months was separated from her mother because of fears the mother was suffering from Munchausen syndrome by proxy. The child was returned five months later, following medical reports which found the child's arrested breathing had a physical explanation and that there was no sign the mother was suffering from any psychiatric disorder. The court noted that its approach in cases where a child has been taken into care is that it must be satisfied the circumstances justified taking such a step:
'In this respect, [the court] must have particular regard to whether, in the light of the case as a whole, the reasons adduced to justify the measure were relevant and sufficient such as to allow the conclusion that it was "necessary in a democratic society"'(para 90, emphasis added).
In that case the court held there had been a breach of article 8 because the parents had not been sufficiently involved in the decision-making process. They had not been able to put forward their point of view before the court order was made.
85. In my view the Court of Appeal reached the right conclusion on the issue arising in the present cases. Ultimately the factor which persuades me that, at common law, interference with family life does not justify according a suspected parent a higher level of protection than other suspected perpetrators is the factor conveniently labelled 'conflict of interest'. A doctor is obliged to act in the best interests of his patient. In these cases the child is his patient. The doctor is charged with the protection of the child, not with the protection of the parent. The best interests of a child and his parent normally march hand-in-hand. But when considering whether something does not feel 'quite right', a doctor must be able to act single-mindedly in the interests of the child. He ought not to have at the back of his mind an awareness that if his doubts about intentional injury or sexual abuse prove unfounded he may be exposed to claims by a distressed parent.
Secondly, since the relevant events occurred before the Human Rights Act 1998 came into force, the appellants could not seek damages for any possible breach of their rights under article 8 (1). Especially in view of the decisions in Wainwright v Home Office [2004] 406, 423, para 34 and R (Greenfield) v Secretary of State for the Home Department [2005] 1 WLR 673 I should wish to reserve my opinion as to whether, in such a case, it would be appropriate to modify the common law of negligence, rather than to found any action on the provisions, including section 8, of the Human Rights Act 1998: cf Fairlie v Perth and Kinross Healthcare NHS Trust 2004 SLT 1200, 1209L, para 36, per Lord Keith.