Khan v Meadows, [2021] UKSC 21

Introduction

The tort of negligence involves a breach of a legal duty to take reasonable care, resulting in damage to another person. A critical aspect of establishing negligence is defining the scope of the duty owed by the defendant. The case of Khan v Meadows [2021] UKSC 21 provides a refined model for analyzing this scope. The Supreme Court, in this judgment, introduces a six-question framework designed to clarify the relationship between a defendant's breach of duty and the claimant's resulting damages. This framework moves past previous distinctions between "advice" and "information" to focus directly on the purpose of the duty of care, offering a structured method for determining which losses a defendant should be liable. The judgment also compares this new model with conventional approaches to negligence, such as those used by Lord Burrows. The framework presented in Khan v Meadows is of substantial significance for legal professionals and students because it introduces a method of assessing legal responsibility in cases of negligence.

The Factual Background of Khan v Meadows

The case involved Ms. Meadows, who consulted Dr. Khan, her general practitioner, to determine if she carried the haemophilia gene, a hereditary condition. Dr. Khan negligently advised Ms. Meadows that she was not a carrier, based on a test that only confirmed Ms. Meadows herself did not have the condition. Subsequently, Ms. Meadows gave birth to a son who was diagnosed with both haemophilia and autism, the latter being an unrelated condition. Ms. Meadows sought compensation from Dr. Khan for costs associated with both conditions. The Court of Appeal, relying on the SAAMCO principle, held Dr. Khan liable only for the costs associated with haemophilia. The Supreme Court was presented with an appeal to clarify the appropriate scope of liability in this negligence claim. The court ultimately agreed with the lower court ruling that Dr Khan was liable for the costs associated with Ms Meadows’ son's haemophilia, and not the costs associated with his autism.

The Supreme Court's Six-Question Framework

The majority judgment in Khan v Meadows, delivered by Lord Hodge and Lord Sales, presented a six-question model for analyzing the scope of duty in negligence. These questions provide a sequenced method for establishing liability:

1. The Actionability Question: Is the harm suffered by the claimant actionable in negligence? This initially ensures the harm is of a type that can be claimed for in a negligence case.

2. The Scope of Duty Question: What are the specific risks of harm against which the law imposes a duty on the defendant to take care? This establishes the boundary of the defendant’s legal obligations. In Khan v Meadows, it was identified that the duty imposed on Dr. Khan was to accurately assess and advise on whether Ms. Meadows was a carrier for haemophilia.

3. The Breach Question: Did the defendant breach their duty through an act or omission? In the present case, Dr. Khan’s actions in inaccurately assessing Ms. Meadows' carrier status did breach the duty of care she was bound to uphold.

4. The Factual Causation Question: Is the loss for which the claimant seeks damages a result of the defendant’s breach? This assesses whether there is a causal link between Dr. Khan's incorrect advice and the subsequent consequences. In this instance, there was a clear causal relationship between the breach of duty (inaccurate advice) and the birth of a child with haemophilia.

5. The Duty Nexus Question: Is there a sufficient connection between a specific element of the claimed harm and the subject matter of the defendant's duty of care? This requires a close look at the specific harm and whether it is tied to the duty. In this instance, there was no duty that related to the child's autism, thus this did not fall under the duty nexus question.

6. The Legal Responsibility Question: Is a particular element of the harm irrecoverable due to remoteness, an intervening event, or a failure of the claimant to mitigate the loss? This considers factors such as remoteness of the damage to the breach of duty.

This framework introduces a systematic process for analysing negligence claims, moving beyond the rigid application of the SAAMCO principle. The six questions were formulated to bring clarity to how the principle of scope of duty should be applied within the law of negligence.

Alternative Approaches to Analyzing Negligence

While the majority in Khan v Meadows proposed the six-question model, concurring judgments from Lord Burrows and Lord Leggatt presented alternative analyses. Lord Burrows advocated for a more conventional seven-question approach, aligning more closely with traditional negligence law principles. His method includes:

1. The Duty of Care Question: Was a duty of care owed by the defendant to the claimant?

2. The Breach Question: Was there a breach of the duty of care?

3. The Factual Causation Question: Was the damage or loss factually caused by the breach?

4. The Remoteness Question: Was the damage or loss too remote from the breach of duty?

5. The Legal Causation Question: Was the damage or loss legally caused by the breach of duty?

6. The Scope of Duty Question: Was the damage or loss within the scope of the duty of care?

7. The Defenses Question: Are there any valid defenses against the negligence claim?

Lord Burrows suggests that this model, unlike the six-question framework, begins with establishing the duty of care, treating the SAAMCO principle as focused on the ‘scope of duty’ question and considering contributory negligence alongside remoteness, rather than as part of it. Lord Leggatt, while concurring with the outcome, also expressed reservations about the majority’s approach. He specifically highlighted the potential for the new model to complicate the understanding of legal responsibility, particularly in cases that involve professional negligence. Lord Leggatt argues for a focus on causation and counterfactual analysis to determine the scope of duty, and sees an unnecessary complication in adding the new six-question framework when it is unnecessary.

Applying the Framework in Khan v Meadows

In Khan v Meadows, the application of the six-question framework demonstrated that Dr. Khan's duty extended only to the haemophilia risk, not to the unrelated risk of autism. The court concluded that while Dr. Khan breached her duty of care to correctly advise on the haemophilia gene, the duty did not extend to the risk of Ms. Meadow's child developing autism. This was determined in particular during application of the duty nexus question, meaning the costs associated with the autism fell outside the scope of Dr. Khan’s duty of care. This limitation on liability underscores the significance of the six-question framework in clearly defining the extent of a professional’s responsibility. The case showed how applying the framework can reveal the boundaries of legal liability and clarify the scope of a professional’s obligations, in a manner that is both technically consistent and fair in its application of principles.

Comparison with Manchester Building Society v Grant Thornton LLP

The Khan v Meadows ruling should be considered alongside Manchester Building Society v Grant Thornton LLP [2021] UKSC 20, which also addressed the scope of duty in negligence, in the context of financial auditing, rather than medical negligence. Manchester Building Society v Grant Thornton LLP clarified that the counterfactual test of SAAMCO should not be applied as a rigid test but more of a method of cross-checking the outcome of determining the purpose of duty. In the case of Manchester Building Society v Grant Thornton LLP the Supreme Court determined that the purpose of Grant Thornton's duty was to determine if the society’s accounts could be prepared using hedge accounting, to accurately represent the society’s finances. This was different to the lower court rulings that determined the loss sustained was not within the scope of Grant Thornton’s duty. The Supreme Court held that Grant Thornton were liable for the close-out costs associated with the long-term interest rate swaps that the society entered into. Together these cases highlight the Supreme Court’s focus on clarifying the legal principles of scope of duty in negligence, and moving away from rigid application of past principles.

Conclusion

Khan v Meadows [2021] UKSC 21 presents a refined approach to establishing the scope of duty in negligence. The introduction of the six-question model provides a clear and progressive method for assessing liability. This framework ensures that the harm for which damages are sought is directly connected to the scope of the duty owed by the defendant. The judgment establishes a clear departure from the rigid application of previous principles, such as the "advice" and "information" distinction in SAAMCO, to a structured, purposeful approach. Khan v Meadows alongside Manchester Building Society v Grant Thornton LLP, illustrates a shift towards a more nuanced consideration of legal responsibility in professional negligence, where the scope of duty is central to establishing liability. The concurrent judgments of Lord Burrows and Lord Leggatt, advocating for alternative approaches, demonstrate the continuing debate surrounding the most appropriate methods for analyzing complex negligence claims. The framework articulated by Lord Hodge and Lord Sales, however, remains a significant contribution to the tort of negligence, offering a methodology designed to establish a clear nexus between breach of duty and the recoverable damages.