Sept 16
The claimant former police officers retired from the police force as a result of injuries which they sustained in the course of their duties, and were in receipt of injury awards pursuant to the Police (Injury Benefit) Regulations 2006, having each been found to be permanently disabled as a result of their injuries and consequently to have suffered a reduction in their earning capacity. Under the Regulations the injury pension was calculated by reference in part to the person’s degree of disablement. In 2008 the defendant’s statutory predecessor as the relevant police pensions authority had entered into an agreement with the Police Federation and the National Association of Retired Police Officers pursuant to which some award holders, including some of the claimants, were given guarantees by letter that their then current assessment of loss of earning capacity, and therefore pension, would remain at the same level for the rest of their lives and that there would be no review of their injury award unless they requested one following a significant change in their condition. In 2017 the claimants were notified by the defendant that their award would be reviewed as part of a reassessment programme applying to award holders in accordance with regulation 37 of the 2006 Regulations, and that in accordance with the Regulations, they would be assessed by a qualified selected medical practitioner (“SMP”) who would determine whether their degree of disablement had substantially altered since they were last assessed, and their awards would be adjusted accordingly if appropriate. The claimants refused to co-operate with the review process, contending that they were not obliged to do so, although some attended appointments. Since they refused to answer questionnaires on their medical and employment information or give consent to the defendant or the SMPs to access their medical records, the SMPs concluded that they could not carry out an assessment for the purposes of the 2006 Regulations. In respect of all the claimants, save the claimant in the first case, the defendant exercised his power to conduct the reviews himself, under regulation 33, which provided that where a person wilfully or negligently failed to submit to a medical examination or attend interviews that the medical authority considered necessary in order to enable him to make his decision, the pension authority could make a determination on such evidence and medical advice as it deemed necessary in its discretion. The reviews resulted in reductions in each case. The claimants sought judicial review. In the first case, the claimant contended that the assurances given in 2008 gave rise at common law to a legitimate expectation that his pension would continue for life and would not be reviewed unless he requested one, and that a review of his injury benefit would interfere with his right to peaceful enjoyment of possessions, contrary to article 1 of the First Protocol to the Convention for the Protection of Human Rights and Fundamental Freedoms. In the second case, the claimants contended that the defendant had taken decisions which he had no power under the 2006 Regulations to take or alternatively, if there had been a power to do so, he had acted unlawfully in any event as his decisions were in breach of their Convention rights, namely the right under article 6 to a determination of their rights before an independent and impartial tribunal, and the right under article 8 to respect for private life, and or the defendant’s common law duty of fairness, by applying a sanction to them for failing to consent to disclosure of all their medical records.
On the claims—
Held, claim in the first case dismissed. (1) On its true interpretation, regulation 37 of the Police (Injury Benefit) Regulations 2006 required a police pensions authority to consider, at suitable intervals, whether the degree of disablement of a pensioner had altered. It was for the authority to determine whether a suitable period had elapsed since the last assessment or reassessment and, if it had, it was obliged to consider whether the degree of disablement had altered. It followed that there was a continuing duty to monitor whether an injury award was being paid in accordance with the 2006 Regulations. Regulation 37 did not permit the authority to decide in advance that a suitable interval would never elapse and to abandon any duty to monitor a given case. Nor did it permit the authority to decide that an injury pension would be paid at a particular level, and on the assumption there was a particular degree of disability, regardless of whether that was in fact the case and regardless of the injury pensioner’s actual entitlement under the 2006 Regulations. It followed that (i) the defendant had not had the power to decide that the case of the claimant in the first claim would never be reviewed again, (ii) a promise to the contrary was contrary to the defendant’s duty under regulation 37 of the 2006 Regulations and (iii) there had been no power to give a guarantee to pay the claimant regardless of his true entitlement under the 2006 Regulations, which provided for payment according to degree of disablement. Therefore, since the defendant had not made a lawful promise which had induced a legitimate expectation of a substantive benefit, the claimant’s case based on legitimate expectation at common law failed. Moreover, in the light of the jurisprudence of the European Court of Human Rights, the promise not to review the claimant’s injury pension entitlement did not give rise to a legitimate expectation falling within the protection of article 1 of the First Protocol to the Convention. Accordingly, the claimant’s only legitimate expectation was that he would be paid in accordance with his entitlement under the 2006 Regulations (paras 80–86, 124–128).
Claims in the second case dismissed. (2) When construing regulation 33 of the 2006 Regulations, Parliament should be assumed to have had in mind that, other than in an emergency, it would be highly unusual for a medical practitioner to conduct a medical assessment without any access to information about the patient’s medical history, and such access was even more important where the patient was claiming a benefit or payment and the assessment was to be carried out by a doctor who had not dealt with them before. The very fact that the claimant’s entitlement and/or the extent of their entitlement needed to be established, whether or not it was formally disputed, meant that the assessor was entitled to see all of the materials which were relevant to the assessment. Access to those materials might also be required in order to obtain information which the patient was unable to recall, or to verify information which they say or believed they could recall. Where they were assessing loss of earning capacity arising out of a particular event, and particularly where they were assessing whether there had been a change in the loss of earning capacity consequent upon that event, the need for a consideration of the medical history was obvious, and all the more so where they were assessing whether there had been any such change since an assessment carried out 20 years earlier by a different practitioner. The medical authority was being required to carry out an assessment for the purposes of establishing the applicant or award holder’s entitlement to payments under a statutory scheme. Regulation 33 was not just concerned with situations in which the police pensions authority was carrying out a review under regulation 37, and applied to all medical questions arising under the 2006 Regulations including appeals. The Regulations contemplated, as a cornerstone of the scheme, that the medical authority would be enabled to make decisions which could be taken by the authority, the Crown Court and the appeal tribunal to be reliable and based on “accurate” and “adequate” evidence. The language of regulation 33 was deliberately broad so as to enable the medical authority to make an accurate assessment of the various different medical questions which might be referred. The key requirement was that the medical authority was provided with such information as considered necessary in order to enable the decision to be made. There could be a failure to submit to an examination, or to attend an interview, which was based on a prior indication by the applicant or award holder that they refused to do something which was necessary for the assessment to be of any value. The expectation reflected in regulation 33 went beyond merely being physically present at an interview or submitting to a physical examination, and extended not just to an expectation to provide at least some of the information necessary to enable a reliable decision to be made, but to other matters which might be considered implicit in any medical examination or interview, namely that the practitioner would have access to the medical history where and to the extent that they deemed it necessary. Regulation 33 was sufficiently flexible to embrace interviews or examinations which were conducted on the basis that the interviewer or examiner had been authorised to familiarise himself with the relevant background. Refusal to agree to that was capable of being a refusal to submit to, or attend, the examination or interview which the medical practitioner considered necessary to carry out their task. Although the Regulations did not create a duty on an applicant or award holder to do anything, they gave a choice to comply with the requirements of the medical authority or allow the decision to be taken by the authority, or their appeal to be deemed to be withdrawn (paras 167, 181–184, 189–193, 195).
(3) The defendant had not acted in breach of article 8 of the Convention, since (i) any interference with the right to private life had been in accordance with the law in that it was consistent with the 2006 Regulation, (ii) the request for access to medical records was necessary and proportionate and (iii) article 8 did not lead to a different interpretation of regulation 33. For all those reasons the defendant did not err in law in concluding that he could decide the regulation 37 question himself in the circumstances of each case or breach article 8 of the Convention. In respect of the claimants’ article 6 right to a determination of their rights under the 2006 Regulations before an independent and impartial tribunal, the Regulations did afford them such an article 6 compliant right, however the position where regulation 33 applied was that they had deliberately failed to avail themselves of that right. The claimants had been given sufficient opportunities to put their cases and regulation 33 providing the defendant with a discretion as to how to make his decision where the claimants failed to cooperate with the procedures, and the way in which the defendant exercised that discretion was not unfair (paras 208, 210–212, 230, 235, 238).
David Lock QC and Julia Smyth (instructed by Haven Solicitors Ltd and Taylor Law) for the claimants.
Jonathan Holl-Allen QC and Aaron Rathmell (instructed by Staffordshire and West Midlands Police Joint Legal Services) for the defendant.