Riches no bar to free NHS, top judge rules

Crash victim wins test case after £2.95m award

A multi-million pound compensation pay-out to a catastrophically injured Oldham road crash victim does not rule out her right to free NHS care, a top judge has ruled in a vital test case.

In a decision which upholds the fundamental “free to all” principles of the NHS, Judge Mark Pelling QC said Oldham teenager Alyson Booker (19) is entitled to state-funded care despite last year having received one of the largest damages pay-outs ever seen by an English court.

Ms Booker was left tetraplegic and dependent on a ventilator by a 2001 road crash and, in October last year, insurance giants Direct Line agreed to settle her claim for £2.95million, as well as index-linked and tax-free annual payments of £247,500 to cover the costs of care.

The response of the Oldham Primary Care Trust was to announce that her free NHS nursing and social care would be withdrawn from October this year — on the basis that her damages pay-out meant she could well afford the full panoply of private care she herself wanted.

That in turn prompted a judicial review challenge by Ms Booker’s legal team — backed by insurers Direct Line, who would be left to pick up the entire bill for Ms Booker’s care if the NHS withdrew support.

Oldham PCT’s lawyers argued that, given Ms Booker’s pay-out, it was simply not necessary for the NHS to continue picking up the bill for her care when she wanted a private nursing regime and had the money to fund it.

However, Judge Pelling came down in favour of Ms Booker and Direct Line when he ruled that Ms Booker can do “as she pleases” with her damages pay-out and is just as entitled to free NHS care as an “independently wealthy” patient.

Stressing the principles underpinning the public health service, he said: “Access to NHS services is based on clinical need, not on an individual’s ability to pay.”

Ruling the PCT’s stance unlawful, he said there was nothing within the NHS’s framework “that suggests that financial considerations are relevant to the provision of future healthcare”.

He also pointed out that the private care regime envisaged for Ms Booker has yet to be established and the £247,500-a-year payments to fund it will not kick in until December next year.

Judge Pelling accepted that there is “much to be said” for negligent parties, or their insurers — rather than the NHS — having to pay for the consequences of their wrongdoing.

But he concluded that, if the law needs reform to lift the burden from the public purse — and instead place it on private insurers — “the remedy lies in primary legislation” by Parliament.

An NHS Oldham spokeswoman said they were reviewing the detail of the judgement.