Queen’s Bench Division

Published June 29, 2007

Regina (Legal Remedy UK Ltd) v Secretary of State for Health and Others

Before Mr Justice Goldring

Judgment May 22, 2007

Where a specialist body’s decision involved balancing policy issues which a court was ill-equipped to judge, that reduced the likelihood that the decision would be found to be an abuse of power.

Mr Justice Goldring so held in the Queen’s Bench Division when refusing an application by Legal Remedy UK Ltd for judicial review of the decision of the Medical Training Application Service review group of May 15, 2007 to continue with its scheme for medical specialist recruitment in a modified form.

The decision was adopted by the Secretary of State for Health.

The Health Secretary introduced a new website-based system for appointing junior doctors to specialist appointments. The service was introduced without a pilot and deteriorated into fiasco. A review body was established by the secretary of state and it decided that the service should be continued in a modified form.

The claimant was a pressure group of concerned junior doctors who considered the modified process unfair for several reasons, including the claim that processes for listing candidates were defective and unfair.

The interviewing undertaken as a result was also said to be flawed, and there had been insufficient consultation.

Mr Thomas de la Mare and Mr Nicholas De Marco for Legal Remedy; Mr Jason Coppel and Miss Joanne Clement for the Health Secretary; Mr John Cavanagh, QC, for the British Medical Association, as interested party.

MR JUSTICE GOLDRING said that the Medical Training Application Service had resulted in what the BMA had rightly described as a dreadful mess.

The crucial issue was whether, having regard to the deficiencies apparent to the review body, and in all the circumstances available to it at the time, the modified service was a possible rational solution and not conspicuously unfair. Provided the solution was a rational one and not conspicuously unfair his Lordship could not quash it.

In deciding whether to interfere his Lordship had to beware of donning the garb of a policy-maker. If the court concluded that the decision of the review body amounted to policy and involved balancing issues which the court was ill-equipped to judge, the less likely it was that it would truly amount to an abuse of power.

The modified service did have elements of unfairness.

However, competing and very difficult issues faced the review group. It was deliberating in very difficult circumstances.

Although far form ideal, the decision of the review group was within the range of reasonable responses to the difficult situation it faced.

Solicitors: Leigh Day & Co; Solicitor, Department of Health; Mr Jonathan Waters, Bloomsbury.

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