The claimant junior doctors’ association challenged the imposition on them of new contracts of employment, on the basis that the 2006 Act gave him no power so to act, that the manner of imposition was opaque and confused, and was irrational and not based upon proper evidence.
Held: None of the challenges succeeded.
‘In determining whether a decision maker has acted irrationally the intensity of the scrutiny to be applied by a Court is context sensitive. Case law tends to suggest that the following considerations will tend to broaden the scope of the margin of appreciation: where the decision maker is taking a decision in the health field with the objective of improving patient care; where the decision adopted is prospective and precautionary (ie based upon a prediction of future benefit and where there is perceived to be a benefit in acting sooner rather than later notwithstanding uncertainties); where the decision maker has indicated a willingness and intention to review the policy as it unfolds to ensure that it is in fact working adequately and to review and modify it to address emerging problems. These sorts of considerations apply in the present case. My prima facie conclusion however is that on the basis of the evidence (of causal connection between senior staffing levels and mortality rates) there is a sufficient evidential basis upon which the Minister could rationally act. That conclusion stands alone but it is also reinforced by these other considerations, all of which apply in some measure in this case.’
Green J said that target duties in the Act: ‘(a) . . do not specify a particular or precisely defined end result as opposed to a broad aim or object and (b) their mandatory nature is diluted by the fact that they do not compel the achievement of that end result instead requiring the Secretary of State only to factor those objectives into consideration.’
Judges:
Green J
Citations:
[2016] EWHC 2338 (Admin), [2016] Med LR 599
Links:
Statutes:
National Health Service Act 2006
Jurisdiction:
England and Wales
Cited by:
Cited – A and B, Regina (on The Application of) v Secretary of State for Health SC 14-Jun-2017
The court was asked: ‘Was it unlawful for the Secretary of State for Health, the respondent, who had power to make provisions for the functioning of the National Health Service in England, to have failed to make a provision which would have enabled . .
Lists of cited by and citing cases may be incomplete.
Health Professions
Updated: 16 August 2022; Ref: scu.569628