LA v SB & Ors

Care proceedings are not a vehicle for the court to decide a medical-treatment issue which is not properly constituted between parties who seek a decision. The court must respect the division of responsibility created by the Children Act 1989. Its role is to determine applications for care orders, not to supervise local-authority services or decide matters falling to parents, treating clinicians or the authority. Where the local authority withdraws care proceedings and the court is satisfied that withdrawal is appropriate, the court has no continuing function under Part III. It cannot impose unenforceable conditions on withdrawal or order further expert evidence where no live issue remains.

The local authority issued care proceedings concerning five children. By the final hearing, it accepted that proceedings concerning four children were no longer appropriate and sought permission to withdraw them all. One child, MB, suffered from severe epilepsy caused by Rasmussen’s encephalitis, and clinicians had recommended epilepsy surgery. The parents did not agree to surgery, but the hospital was not seeking an order and declined to intervene or issue a summons.

The local authority sought permission under section 100 of the Children Act 1989 to invoke the inherent jurisdiction, alternatively permission to apply for a specific issue order concerning surgery. The father sought conditions on withdrawal, and the guardian sought permission for a second medical opinion. The central issue was whether the court should continue its involvement when the treatment dispute was not presently before it.

1. Withdrawal of proceedings. The court granted the local authority unconditional permission to withdraw the care proceedings. Its function was to satisfy itself that withdrawal was appropriate. Having done so, it had no further function.
2. No live medical issue. The question whether MB should undergo surgery was currently a matter between his parents and the hospital. Neither the hospital nor the parents invited the court to decide it. There was therefore no properly constituted lis and no issue for adjudication.
3. Limits of the court’s role. The Children Act 1989 creates a clear division between the functions of courts and local authorities. The court could decide whether the children should be subject to care orders, but could not decide issues that were the responsibility of others or outside the proper ambit of the proceedings. It could not control the activities of social services or otherwise supervise the local authority’s exercise of its statutory functions.
4. Medical-treatment authorities. Re O (A Minor)(Medical Treatment) [1993] 2 FLR 149 and Re R (A Minor)(Blood Transfusion) [1993] 2 FLR 757 illustrated the possible use of the inherent jurisdiction or a specific issue order where a properly constituted medical-treatment dispute existed. Re T (Wardship: Medical Treatment) [1997] 1 FLR 502 emphasised that the court must weigh parental objections broadly, rather than assessing them only against clinical opinion. Those authorities did not create a current issue for decision in this case.
5. Consequential applications. MB remained a child in need under section 17 and Part III of the Act, subject to the statutory procedures for local-authority support. The court had no supervisory role under Part III. The father’s proposed conditions had no nexus with the withdrawal application and could not effectively be enforced. Since no live issue remained, there was no purpose in ordering a further report. The proceedings should end.