The claimant brought two simultaneous claims in negligence. The first, which was quickly dismissed, against her doctor, and the second, much more significant case against the London Ambulance Service after an ambulance, ordered by the doctor through a 999 call, took forty minutes to arrive at her house, where she was suffering a severe asthma attack, resulting in the claimant suffering respiratory arrest. In negligence cases, the claimant must prove that the defendant owed them a duty of care, that this duty was breached and that the injuries for which the claimant is seeking damages were a consequence of this breach. The issue before the court was whether an ambulance service owe a duty of care to those relying on its services.
Judgment
The claimant won in the first instance and the LAS appealed, whereupon the Court of Appeal held:
It was 'reasonably foreseeable' that the claimant would suffer further illness if an ambulance did not arrive promptly
The claimant and defendant were 'sufficiently proximate' once the LAS accepted the call and dispatched an ambulance, and a specific duty of care was established; there being no good reason for it failing to arrive within a reasonable time, this duty was breached.
It was 'fair, just and reasonable' to allow a duty of care to exist between an ambulance service and its patients with regards to promptness of pickup where no good reason for delay is offered.
Neither reasonable foreseeability nor proximity were disputed, nor were breach of duty or causation. However, the LAS submitted that to establish this duty of care was against public policy considerations which in previous cases had limited the duty of care ofthe police, fire brigade and coastguard, on the grounds that it would divert their resources from ambulance provision to fighting court cases. Lord Woolf expediently distinguished the ambulance service as different - despite answering 999 calls, it is part of the health service and thus shares the health service's duty of care to those in tortious proximity ; he deemed it relevant that it only has to deal with the victim at the scene, and is not having to act with 'concern to protect the public generally', unlike the fire and police services.
Obiter dicta
The ambulance service would not owe a duty of care under negligence for refusing to respond to a 999 call. Also, the burden upon the claimant of showing a causative want of proper care would ordinarily provide ambulance services with what he called the ‘necessary protection’ against liability, except where their conduct was manifestly deficient.
Significance
While the general rule has remained that the emergency services are not liable in negligence for an inadequate response, this case has made the exception that, where that inadequate response made the situation worse, a duty of care could exist under certain specific circumstances. However, it now seems that the statutory power granted to the ambulance service to answer an emergency call has crystallised into a specific duty to respond to a particular 999 call which was owed to C as a particular individual.
