Problem
R v North West Lancashire HA ex parte A [2000] 1 WLR 977
R v North West Lancashire HA ex parte A [2000] the health authority's policy and blanket refusal to fund the applicant's treatment, including gender reassignment surgery
Keywords:
Medical Law - Health - NHS - Medical treatment - Allocation of funds - Policy - Gender reassignment surgery - Court of Appeal
Facts:
In R v North West Lancashire HA ex parte A [2000], the applicants suffered from an illness called "gender identity dysphoria". Each was born with male physical characteristics, but psychologically has a female sexual identity. Two of them had been diagnosed to have a clinical need for gender reassignment surgery. The third was awaiting assessment of suitability for surgery.
In 1995, the health authority allocated a low priority to gender reassignment surgery and decided that it would not fund such surgery. In 1998, there was slight changes in the policy, but the funding remained a low priority.
The health authority refused to fund the applicant's treatment, including gender reassignment surgery. All three applicants challenged this refusal and argued that the authority's policy was irrational. In the applicants' view, transsexuals had a low priority.
Issue:
Whether the restrictive policy adopted by the health authority for transsexuals was justified?
Held:
The judge quashed the authority's refusal to fund the applicants' treatment and that the cases of the applicants be considered afresh. The authority appealed.
The Court of Appeal dismissed the appeal and gave the following judgment. From the outset, the Court agreed that the health authorities were entitled to make lists of treatments which were and were not a priority. Also, it would 'make sense' to give gender reassignment surgery a lower priority than treatment for cancer, heart disease, or kidney failure.
However, the Court of Appeal held that the authority's policy did not take into account an individual's exceptional circumstances. So, the Court concluded that the authority should reformulate its policy and give proper weight to its acknowledgement that transsexualism is an illness. Herewith, the authority should examined each individual case and give a proper treatment.
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