T (A child), Re

A local authority with a care order may ordinarily authorise routine childhood vaccinations under Children Act 1989, s 33(3). Vaccination is preventative public healthcare and is not generally a grave medical-treatment decision requiring the court’s inherent jurisdiction.

Where vaccination is contested, the court must focus on the individual child’s welfare and best interests. It must consider the child’s particular medical circumstances and the evidence of risks and benefits, rather than adopt a general policy supporting immunisation. Routine vaccination lies at the least intrusive end of the spectrum of intervention, although the court must still address responsible parental objections with care.

The local authority applied for a declaration that it was in the interests of T, a healthy 10-month-old child subject to a care order, to receive routine vaccinations. T was placed with foster carers and had not received the recommended immunisations.

The mother opposed vaccination, relying on alleged health problems affecting other children and undisclosed research. The father supported those objections and made additional procedural applications. The central issues were whether the local authority could authorise vaccination under s 33(3) of the Children Act 1989, whether expert evidence was necessary, and whether vaccination was in T’s best interests.

1. Jurisdiction. The application concerned routine childhood immunisation. Vaccination is preventative healthcare intended to protect the individual child and society. It is not properly characterised as medical treatment of the kind ordinarily regarded as a grave issue. The local authority’s power under s 33(3) of the Children Act 1989 therefore extended to authorising the proposed vaccinations, subject to the statutory welfare safeguard in s 33(4).
2. Individualised welfare assessment. The court was required to consider T’s circumstances rather than endorse immunisation as a general principle. The evidence showed that T was a robust and healthy infant, had no medical contraindication to vaccination, and was vulnerable to a range of preventable illnesses. The risks of failing to vaccinate significantly outweighed the identified risks of vaccination. The court’s focus was entirely on T’s best interests, not broader public-health considerations.
3. Parental objections and spectrum of intervention. The court adopted the guidance that parental opposition to medical intervention falls on a spectrum. Vaccination was at the least intrusive end. The court nevertheless recognised the stress experienced by loving and responsible parents and considered the objections, but found them unsupported and unable to withstand scrutiny.
4. Expert evidence. The proposed Part 25 report from Dr Elliman was not necessary. It would cause delay when Dr Douglas’s recent and detailed assessment supported prompt vaccination. The application was dismissed.
5. Disposition. Although the local authority could have proceeded under s 33(3), the court granted the declaration sought because a contested application under the inherent jurisdiction would in any event have been brought.