Hollingworth & Ors v Specialist Training Authority of the Medical Royal Colleges

Transitional provisions for entry on a specialist register must protect doctors who were consultants, or were qualified for consultant appointment, under the former regime. They should not impose the new long-term training regime retrospectively.

For that purpose, a medical specialty means a field of medicine in which consultants had previously been appointed. The term has the same meaning throughout the transitional provision. Training under Article 12(2)(c)(i) must be assessed against the requirements then current for that field, rather than against those of a different recognised specialty.

Three doctors with extensive experience and qualifications in family planning and reproductive health care sought entry on the specialist register under Article 12(2)(c)(i) of the European Specialist Medical Qualifications Order 1995.

The Specialist Training Authority appeal panels held that family planning and reproductive health care was not a medical specialty in its own right. They assessed the doctors' training against the requirements for obstetrics and gynaecology and dismissed their appeals. Lawrence Collins J rejected their applications for judicial review.

The doctors appealed. The central issue was whether the transitional meaning of specialty included a field in which NHS consultants had been appointed before the new specialist-register regime.

1. Appeals allowed unanimously. Keene LJ gave the judgment, with Mantell and Simon Brown LJJ agreeing. The appeal-panel decisions were quashed and declarations were substituted that each appellant met Article 12(2)(c)(i) of the European Specialist Medical Qualifications Order 1995.

2. Article 12 was a transitional provision. Its purpose was to protect doctors who had already acquired consultant status, accreditation, or the qualification for consultant appointment under the former system, without requiring compliance with the new long-term regime.

3. The word specialty had to bear the same meaning throughout Article 12. The earlier consultant-appointment regulations proceeded on the basis that a consultant was appointed in a specialty. The Registrar was therefore correct to place existing NHS consultants in family planning and reproductive health care on the register. For Article 12, a specialty meant no more than a field of medicine in which consultants had previously been appointed.

4. The panels erred by treating family planning and reproductive health care as merely part of obstetrics and gynaecology and by testing the appellants against training requirements for that different specialty. The relevant inquiry under Article 12(2)(c)(i) was whether their training complied with the requirements then current for family planning and reproductive health care.

5. On the evidence before the panels, only one result was realistically possible once the correct construction was applied: all three appellants satisfied Article 12(2)(c)(i). Remittal was therefore unnecessary.

• Court of Appeal (Civil Division) – Allowed the appeals, quashed the Specialist Training Authority appeal-panel decisions, and substituted declarations under Article 12(2)(c)(i) of the European Specialist Medical Qualifications Order 1995: [2003] EWCA Civ 452.
• High Court, Queen's Bench Division, Administrative Court – Lawrence Collins J rejected the doctors' applications for judicial review. The citation is not stated in the judgment.