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21 SEP 2016

Re E (Medical Treatment) [2016] EWHC 2267 (Fam)

Re E (Medical Treatment) [2016] EWHC 2267 (Fam)
(Family Division, Sir James Munby, the President of the Family Division, 12 September 2016)

Medical treatment – Cranioplasty – Child subject to care proceedings – Urgent surgery carried out – Whether the court should order further non-urgent surgery

The court declined to make a decision as in relation to non-urgent medical treatment of the 2-year-old child.

The 2-year-old child was placed with his maternal aunt when his mother was unable to care for him. In April 2016 he was taken to hospital in a critical condition. A CT scan revealed a subdural haematoma and a piece of his skull had to be removed (craniectomy). A full examination by a consultant paediatrician reported 75 marks, bruises and lesions on his body. Care proceedings were initiated.

The child was discharged into foster care where he was said to be thriving. The local authority was granted permission to invoke the inherent jurisdiction of the High Court in respect of matters relating to the child's medical treatment. It fell to be determined whether the child should have a cranioplasty and, if so, when or whether the decision should be deferred. The medical evidence suggested that the risks of cranioplasty were larger than the risks associated with a craniectomy and that the decision involved issues of psychology and social interaction.

The President declined to make an order in the circumstances of the medical evidence; the fact that the decision was one for the parents or carers and not for the doctors; there being no clinical need for a cranioplasty at present; the child being spared what was likely to be traumatic surgery until he had further recovered and settled; his future carers being identified within a period of months at most; potential family finding was unlikely to be adversely affected by deferring a decision, but, conversely, future carers may be dismayed that they had been unable to contribute to such a decision. Since there was no particular urgency for a decision, it would be inappropriate and wrong for the court to make a decision which ought to be left to the child's long-term carers.

Neutral Citation Number: [2016] EWHC 2267 (Fam)
Case number omitted


Royal Courts of Justice

Date: 12 September 2016

Before :


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In the matter of E (A Child) (Medical Treatment)

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Mrs Fiona Walker (instructed by the local authority) for the applicant North Tyneside Metropolitan Council
Mr Barry N Speker (of Sintons Law) for the second respondent The Newcastle Upon Tyne Hospitals NHS Foundation Trust
Ms Elspeth Thomson (of David Gray Solicitors LLP) for the third respondent E
The first respondent (E’s mother) was neither present nor represented

Hearing date: 8 July 2016

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Re E (Medical Treatment) [2016] EWHC 2267 (Fam)

Judgment Approved
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