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Posts Tagged ‘rationing’

At Tale of Two Citadels travels to SLSA Aberdeen

In 2014, Gratuitous self-promotion, Testing project on May 8, 2014 at 11:33 am

In April 2014 I travelled up to Aberdeen for the annual SLSA conference, hosted by the Law School, Robert Gordon University, to deliver our paper on ‘Two Citadels’ in the Medical Law stream. Aberdeen is a great, albeit expensive city to visit (well, mid-week anyway – that’s oil money for you). There was a huge array of papers in parallel streams, with the inevitable difficult choices that this invokes for attendees – there are always papers you would have liked to hear but – in the absence of Potter-eqsue ‘Time Turners’ – the timing did not permit. The full programme can be found here ParallelSessionSummarySLSA2014.

Glenys Williams, convenor of the Medical Law & Ethics stream, put together an excellent programme. The first session focused on various and fascinating aspects of abortion, space, community, history and conscientious objection (and more), featuring Joanna Erdman (Dalhousie), Ruth Fletcher (QMU) and Michael Thomson (Leeds). It was a lively and engaging session, and a superb start to the conference.

After coffee, Claire Lougarre (UCL) and I shared the next session, giving plenty of time for questions and discussion for both papers, which was a real gift. Claire gave a thought-provoking and engaging account of her PhD research on the scope of the ‘right’ to health, something that she and Jonathan have already and I’m sure will continue to enjoy discussing ‘up’ at UCL. With Jonathan in Warsaw on NCOB business, and in the absence of a cardboard cutout of him (to direct any awkward question to …) it was left to me to present the latest iteration of our work in progress: ‘A Tale of Two Citadels: Competing Narratives in a Case Biography’, drawn from our British Academy/The Leverhulme Trust funded project ‘Test case biographies as a method for studying hidden law-making’.

The case study in this paper, focusing on the decision in AC v Berkshire West PCT [2010] EWHC 1162 (Admin) and on appeal [2011] EWCA Civ 247, starts from the position that legal cases are complex social phenomena. They have histories – and they link past and future events in a present encounter. There are established doctrinal approaches to ‘understanding’ cases, and situating their significance within a legal context according to institutional rules (ratio decidendi, obiter dicta, stare decisis, and per incuriam, for example). However, it seems valuable to us to seek to understand alternative ways of mapping cases in the Health Care Law context; exploring, for example, the parties’ understanding of the dispute (a specific dispute, or part of a campaign? Possibly a legal campaign, but alternaively one of a different character again?); also the lawyers and judges involvd have careers in which a specific case will play a part.

Our desk based research, for this case conducted largely by Alex Chrysanthou, has sought to explore the chain of case law leading into and(less significantly, currently) leading out of the AC case, and the network of legal personnel directly involved in this case (which will need further reflection). Our third line of enquiry, undertaken by me, has been to examine the interpretation of this case by legal reports and commentators. This research indicates that the choice of competing narratives began to take shape long before the issue is argued before a judge – i.e., is this about NHS resource allocation, or about transgender legal rights?

The questions, comments and responses from those at the Medical Law and Ethics stream were thought-provoking and will be invaluable in moving the project forward (not least in terms of encouragement as people said how interesting they thought the project was). Also, we look forward to presenting this work again at Southampton next week, at a dedicated event on Hidden Law-Making and Case Biographies – and for the opportunity for further reflection on the next phase of the project – but more on that event to follow in a future blog post.

Caroline Jones

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NHS Rationing: Introducing a new blog

In 2012, NHS on October 8, 2012 at 6:45 am

No, not a new blog by us, but a site devised & maintained by David Lock QC, a barrister at No 5 Chambers, who specialises in Health Care Law. David’s aim is to ‘seek to explain the reality of NHS Rationing and Post Code Prescribing within the NHS’. Just to be clear, the site is ‘independent of the NHS or any firm of solicitors’.

Initial posts include a guide to Individual Funding Requests, possible legal issues raised by post-code variations in the provision of IVF:  ‘IVF postcode lottery’ and of course David’s welcome post. There is a section dedicated to relevant case studies,  on how to challenge treatment decisions, and how to get the best use of the site.

We wish David the very best on his entry into the blogosphere!

This time last month: Tom Condliff & his gastric band request

In 2011, NHS, Testing project on September 12, 2011 at 8:57 am

On 15 August 2011, the BBC reported that Tom Condliff’s renewed request for a ‘gastric band’ had been granted by North Staffs PCT. Mr Condliff had previously requested this surgery, but the PCT in question had turned down his request as his BMI (body mass index) fell below the required threshold set out in the relevant policy – his was reported to be 43, whereas the policy in question required a minimum BMI of 50 before this operation would be routinely provided (among other conditions, including the clinicians indicating it was necessary, and the consent of the patient in question).

Part of the PCT’s policy excluded consideration of social factors, meaning that non-medical/non-clinical matters could not be used in consideration of the ‘exceptionality’ of a given case. The PCT refused his ‘individual funding request’ (IFR), which Mr Condliff had made based on the ‘exceptional’ circumstances of his case; and thereafter he sought judicial review of the PCT’s decision.

His application – based on arguments around the applicability of Article 8 of the Human Rights Act 1998 (right to respect for private and family life), together with section 6 of the same Act (whereby it is unlawful for a public authority to act in a way which is incompatible with a Convention right) – failed in both the High Court on April 7, 2011, and in the Court of Appeal on July 27, 2011. 

He submitted a new IFR in August 2011, and it was reported (by the BBC, above) that he was informed soon after that the request and additional medical evidence brought him within the exceptional category as per the PCT’s policy.

Other links:

Guardian: http://www.guardian.co.uk/society/2011/jul/31/tom-condliff-gastric-band-appeal?INTCMP=SRCH

Telegraph: http://www.telegraph.co.uk/health/healthnews/8703065/NHS-funds-weight-surgery-for-obese-man-despite-court-loss.html

Mills and Reeve (the N Staffs PCT’s solicitors) briefing on CA decision (27/07/11): http://www.mills-reeve.com/files/Publication/34b1ea56-ce83-4b47-a714-b7e2255cecd9/Preview/PublicationAttachment/a56af14a-d151-488f-96d9-bb64ab85d749/R_(Condliff)vNorth_Staffordshire_PCT_26_July%20_2011.pdf