LCC v A & Ors (Minors By Their Children's Guardian)

When the inherent jurisdiction is invoked to resolve a dispute about medical treatment, the child’s welfare is paramount and the court must exercise an independent judgment. Parental views require careful and respectful consideration, but they do not determine the outcome. The court must also assess whether the proposed treatment is a necessary and proportionate interference with family life under Article 8. In determining whether immunisation serves the child’s welfare, the court may rely on competent medical evidence concerning the benefits and risks of vaccination, including evidence rejecting an alleged link between MMR vaccination and autism. Preventive healthcare may be particularly important where there has been chronic neglect or poor compliance with professional medical advice.

The local authority sought declarations under the inherent jurisdiction concerning booster immunisations, MMR vaccination for four children, and seasonal flu vaccination for one child. The children were subject to final care orders, and parental responsibility was shared between the local authority and the parents under section 33 of the Children Act 1989. The parents opposed the proposed vaccinations, principally because they believed that MMR vaccination had caused one child’s autism. The Children’s Guardian supported the application.

The central issues were whether the proposed immunisations were in the children’s welfare interests and whether authorising them would constitute a justified and proportionate interference with family life.

1. Outcome. Declarations were granted in relation to the booster immunisations and MMR vaccinations. The application for seasonal flu vaccination was left unresolved pending clarification of the child’s placement and further medical evidence.
2. Once the inherent jurisdiction is invoked, the welfare of the child is paramount. The court must make an independent and objective judgment. It assumes responsibility for deciding whether treatment should be authorised, while giving proper weight to the parents’ views.
3. The parents’ objections were given considerable importance, but were assessed in context. Their views concerning MMR vaccination relied on discredited research and there had been substantial failures to co-operate with health professionals and to attend to the children’s health needs.
4. The medical evidence established that measles, mumps and rubella carry serious risks, that vaccination is effective with rare side effects, and that there was no competent professional opinion supporting a link between MMR vaccination and autism. The evidence also supported completing the children’s booster programmes.
5. The court considered Article 8 of the European Convention on Human Rights and concluded that the proposed booster and MMR vaccinations were in the children’s welfare interests and constituted necessary and justifiable interferences to protect their health. The seasonal flu issue required further evidence because the applicability of the relevant Department of Health guidance was unclear.

First-instance decision. No prior appellate decision is stated in the judgment.