Gregg v Scott [2005] 2 AC 176

Facts

  • Mr. Gregg consulted Dr. Scott regarding a lump under his arm.
  • Dr. Scott negligently misdiagnosed the lump as benign, leading to a nine-month delay in proper treatment.
  • During the delay, the cancerous tumor progressed significantly.
  • At trial, expert evidence showed that with prompt diagnosis, Mr. Gregg's chance of survival would have been approximately 42%, which dropped to 25% after the delay.
  • The central issue was whether the reduction in survival prospects constituted a compensable loss as a loss of a chance.

Issues

  1. Whether a claimant can recover damages for loss of a chance of a better outcome where a defendant's negligence reduces survival prospects below 50%.
  2. Whether the reduction in the prospect of survival due to delayed diagnosis constitutes a distinct and compensable head of damage.
  3. Whether the principle of causation should be extended to permit proportionate recovery in cases where definitive proof of causation is problematic due to medical uncertainty.

Decision

  • The House of Lords by a 3-2 majority held that loss of a chance is not a recoverable head of damage in medical negligence.
  • The majority (Lord Hoffmann, Baroness Hale, and Lord Phillips) refused to extend causation to permit damages for reduced chances of a favourable outcome.
  • Lord Hoffmann noted difficulties in defining the relevant injury and distinguished evidential from medical uncertainty.
  • Baroness Hale cited practical and policy concerns regarding the complexity and predictability of a proportionate damages system.
  • Lord Nicholls and Lord Hope dissented, arguing a significant lost chance is still a compensable harm.
  • The appeal was dismissed, upholding the requirement to prove causation on the balance of probabilities.

Legal Principles

  • Causation in negligence traditionally requires proof on the balance of probabilities that the defendant's breach caused the harm.
  • Loss of a chance is not a recognized head of damage in medical negligence when the chance was below 50% at the outset.
  • Proportionate damages for loss of chance are generally unavailable except in certain cases (e.g., third-party actions or special circumstances as in mesothelioma/asbestos exposure).
  • Policy and practical concerns were essential to maintaining the orthodox causation approach.
  • The decision confirmed and followed the precedent in Hotson v East Berkshire Area Health Authority [1987] AC 750, distinguishing exceptions such as Fairchild v Glenhaven Funeral Services Ltd [2002] UKHL 22 and Perry v Raleys Solicitors [2019] UKSC 5.

Conclusion

The House of Lords reaffirmed the traditional causation test in negligence, holding that damages are not recoverable for loss of a chance of a better medical outcome. This approach, influenced by policy and practical concerns, remains authoritative except for narrow exceptions involving third-party actions or specific conditions such as mesothelioma.

The answers, solutions, explanations, and written content provided on this page represent PastPaperHero's interpretation of academic material and potential responses to given questions. These are not guaranteed to be the only correct or definitive answers or explanations. Alternative valid responses, interpretations, or approaches may exist. If you believe any content is incorrect, outdated, or could be improved, please get in touch with us and we will review and make necessary amendments if we deem it appropriate. As per our terms and conditions, PastPaperHero shall not be held liable or responsible for any consequences arising. This includes, but is not limited to, incorrect answers in assignments, exams, or any form of testing administered by educational institutions or examination boards, as well as any misunderstandings or misapplications of concepts explained in our written content. Users are responsible for verifying that the methods, procedures, and explanations presented align with those taught in their respective educational settings and with current academic standards. While we strive to provide high-quality, accurate, and up-to-date content, PastPaperHero does not guarantee the completeness or accuracy of our written explanations, nor any specific outcomes in academic understanding or testing, whether formal or informal.
No resources available.

Job & Test Prep on a Budget

Compare PastPaperHero's subscription offering to the wider market

PastPaperHero
Monthly Plan
$10
Assessment Day
One-time Fee
$20-39
Job Test Prep
One-time Fee
$90-350

Note the above prices are approximate and based on prices listed on the respective websites as of May 2025. Prices may vary based on location, currency exchange rates, and other factors.

Get unlimited access to thousands of practice questions, flashcards, and detailed explanations. Save over 90% compared to one-time courses while maintaining the flexibility to learn at your own pace.

All-in-one Learning Platform

Everything you need to master your assessments and job tests in one place

  • Comprehensive Content

    Access thousands of fully explained questions and cases across multiple subjects

  • Visual Learning

    Understand complex concepts with intuitive diagrams and flowcharts

  • Focused Practice

    Prepare for assessments with targeted practice materials and expert guidance

  • Personalized Learning

    Track your progress and focus on areas where you need improvement

  • Affordable Access

    Get quality educational resources at a fraction of traditional costs

Tell Us What You Think

Help us improve our resources by sharing your experience

Pleased to share that I have successfully passed the SQE1 exam on 1st attempt. With SQE2 exempted, I’m now one step closer to getting enrolled as a Solicitor of England and Wales! Would like to thank my seniors, colleagues, mentors and friends for all the support during this grueling journey. This is one of the most difficult bar exams in the world to undertake, especially alongside a full time job! So happy to help out any aspirant who may be reading this message! I had prepared from the University of Law SQE Manuals and the AI powered MCQ bank from PastPaperHero.

Saptarshi Chatterjee

Saptarshi Chatterjee

Senior Associate at Trilegal