Kent v Griffiths

An ambulance service which accepts an emergency call for an identified patient may owe that patient a common-law duty to attend within a reasonable time. The acceptance of the call, the foreseeable risk of further injury from delay, and the absence of competing demands or resource-allocation issues can establish the necessary proximity.

The position differs from the police and fire services where their primary duty is generally owed to the public at large and difficult policy choices may arise. A statutory duty to provide ambulance services does not itself give a private right to damages, but a common-law duty may arise from the practical implementation of the service.

The claimant, an asthmatic patient, suffered a respiratory arrest after an ambulance requested urgently by her doctor arrived substantially later than it should have done. Turner J found that the delay was culpable, that the ambulance should have arrived at least 14 minutes earlier, and that timely attendance would probably have averted the arrest.

He awarded damages against the London Ambulance Service, while dismissing the claims against the claimant’s doctors. The service appealed on the novel question whether it owed a private-law duty of care after accepting a 999 request for an ambulance.

1. The appeal was dismissed. Lord Woolf MR, with whom Aldous and Laws LJJ agreed, held that the London Ambulance Service owed the claimant a duty to attend within a reasonable time after accepting the urgent request.
2. The service was not to be treated as a volunteer rescuer. It was providing a health service and had accepted a request focused upon an identified patient. Further injury from delay was foreseeable. There was no competing demand for the available ambulance, no issue about allocating scarce resources, and no policy reason making liability unfair, unjust or unreasonable.
3. The court distinguished Alexandrou v Oxford [1993] 4 All ER 328 and Capital & Counties Plc v Hampshire County Council [1997] QB 1004. Police and fire services ordinarily act to protect the public at large and may face conflicting priorities. Those considerations did not govern an accepted ambulance request for one patient in the circumstances found.
4. Section 3(1) of the National Health Service Act 1977 imposed an exhortatory or target duty and did not itself create a damages claim. Nevertheless, a common-law duty could arise from the manner in which statutory functions were implemented. The complaint concerned execution of an accepted request, rather than a challenge to a discretionary allocation of resources.
5. The judge’s findings established breach and causation. The unexplained delay caused the claimant’s additional injury, and inaccurate assurances about the ambulance’s arrival deprived those caring for her of the opportunity to arrange alternative transport. The appeal was therefore dismissed with costs.

• Court of Appeal (Civil Division): dismissed the London Ambulance Service’s appeal and affirmed the finding of a duty of care: [2001] QB 36 .
• Queen’s Bench Division (Turner J): awarded the claimant damages against the London Ambulance Service and dismissed the claims against the first and second defendants. Permission to appeal was granted because the duty issue was novel.