D v East Berkshire Community Health NHS Trust [2003] EWCA Civ 1151

Facts

• The case concerned claims against a health authority for alleged misdiagnosis of child abuse.
• The plaintiffs argued that the misdiagnosis led to significant emotional distress and harm to family relationships.
• The court considered whether the health authority could be liable for the consequences of healthcare professionals suspecting and reporting child abuse that was not subsequently substantiated.
• The context involved the assessment and management of safeguarding concerns by medical professionals.

Issues

1. Whether healthcare professionals owed a duty of care to parents, as well as to the child, when reporting suspected child abuse.
2. Whether a mistaken diagnosis of child abuse constituted negligence if based on a responsible body of medical opinion.
3. Whether a causal link could be established between the alleged misdiagnosis and the harm suffered by the plaintiffs.
4. What policy considerations must be balanced between child protection and the rights of parents in these circumstances.

Decision

• The court held that healthcare professionals have a duty of care to the child, but not to the parents, in the context of suspected child abuse.
• It was determined that a diagnosis, even if mistaken, does not constitute negligence if it is supported by a responsible body of medical opinion (applying the Bolam standard).
• The court found that establishing causation requires a direct link between the negligent action and the harm, considering intervening factors.
• The judgment recognized the importance of enabling medical professionals to act in the child's best interests without fear of litigation from parents.

Legal Principles

• The three-stage test for a duty of care, as set out in Caparo Industries plc v Dickman, applies: foreseeability, proximity, and whether it is fair, just, and reasonable to impose a duty.
• The Bolam test governs the standard of care for medical professionals; reliance on a responsible body of medical opinion precludes a finding of negligence.
• Duty of care in suspected child abuse cases lies solely with the child, not with the parents, due to potential conflicts of interest.
• Causation requires the harm complained of to be directly attributable to the breach, acknowledging the role of intervening factors.
• Policy considerations favor protection of children and preventing a chilling effect on healthcare professionals’ duty to report suspected abuse.

Conclusion

D v East Berkshire Community Health NHS Trust [2003] EWCA Civ 1151 clarified that in cases of suspected child abuse, healthcare professionals owe a duty of care to the child but not to the parents, and that a mistaken diagnosis does not amount to negligence if it is based on responsible medical opinion, with liability contingent upon establishing direct causation of harm.