Kent v Griffiths [2000] EWCA Civ 3017

An asthmatic woman suffered respiratory arrest after the London Ambulance Service took 34 minutes to respond to an emergency call, when it should have arrived within 20 minutes. The Court of Appeal held that the ambulance service owed a duty of care to the claimant once the call was accepted, distinguishing it from fire and police services.

Facts

The claimant, Mrs Kent, was an asthmatic who suffered an asthma attack on 16 February 1991. Her doctor telephoned the London Ambulance Service (LAS) at 16:25, requesting an ambulance ‘immediately please’ to take her to hospital. The control responded ‘okay doctor’. Despite two further calls at 16:38 and 16:54, during which the LAS assured callers the ambulance was on its way, it did not arrive until 17:05 — taking 34 minutes to travel 6.5 miles. The claimant arrived at hospital at 17:17. The trial judge found that the ambulance crew member had falsified records to show an earlier arrival time of 16:47, and that the delay was culpable with no satisfactory explanation provided.

Medical Consequences

As a result of the delay, the claimant suffered a respiratory arrest which would have been averted had the ambulance arrived within a reasonable time. The doctor gave evidence that if informed of a 40-minute wait, she would have arranged alternative transport to the hospital.

Issues

The central issue was whether the London Ambulance Service owed a duty of care to a member of the public on whose behalf a 999 call is made, if due to carelessness it fails to arrive within a reasonable time. The LAS argued that, following decisions in Capital & Counties Plc v Hampshire County Council regarding fire brigades and Alexandrou v Oxford regarding police, no such duty existed.

Judgment

The Court of Appeal (Lord Woolf MR, Aldous LJ, and Laws LJ) dismissed the appeal and upheld the trial judge’s decision that the LAS owed a duty of care to the claimant.

Distinguishing Previous Authorities

Lord Woolf MR delivered the principal judgment, distinguishing the ambulance service from fire and police services. He noted that while police and fire services owe their primary duty to the public at large (preventing crime and preventing fire spread), the ambulance service is part of the Health Service and its function is focused on specific individuals.

“The ambulance service is part of the Health Service. Its care function include transporting patients to and from hospital when the use of an ambulance for this purpose is desirable. It is therefore appropriate to regard the LAS as providing services of the category provided by hospitals and not as providing services equivalent to those rendered by the police or the fire service.”

Proximity and Duty of Care

The Court found that once the 999 call was accepted, a relationship of proximity was established between the LAS and the claimant. There was no conflict of priorities or resource allocation issues — the ambulance was available and there were no competing demands.

“The acceptance of the call in this case established the duty of care. On the findings of the judge it was delay which caused the further injuries. If wrong information had not been given about the arrival of the ambulance, other means of transport could have been used.”

Policy Considerations

Lord Woolf noted that policy arguments against imposing a duty were weaker for ambulance services than for police or fire services. He observed that only the claimant could be adversely affected by the delay, unlike situations involving crime prevention or fire-fighting where broader public interests compete.

“I should have found it offensive to, and inconsistent with, concepts of common humanity if in circumstances such as the present where there had been an unreasonable and unexplained delay in providing the services which LAS were in a position to meet, and had accepted that it would supply an ambulance, the law could not in its turn provide a remedy to the person whose condition was significantly exacerbated in consequence.”

Implications

This decision established that ambulance services can owe a duty of care to individual patients once a 999 call is accepted. The case represents an important distinction between different emergency services: while police and fire services may not owe duties to individual callers due to their broader public protection role, ambulance services function as part of the NHS and can be held to the same standard as other healthcare providers. The judgment emphasises that whether a duty exists depends on the specific facts, particularly whether there are competing demands on resources or conflicts of interest. The decision also highlights that falsification of records by public servants will be viewed seriously by the courts.

Verdict: Appeal dismissed. The London Ambulance Service owed a duty of care to the claimant, and the trial judge's award of £362,377 in damages was upheld.

Source: Kent v Griffiths [2000] EWCA Civ 3017