Adjudicator Determinations in Non-NHS Medical Contracts Amenable to Judicial Review: Shashikanth v NHS Litigation Authority

Introduction

The case of Shashikanth, R (On the Application Of) v NHS Litigation Authority & Anor ([2024] EWCA Civ 1477) presents a critical examination of the boundaries between public and private law in the context of medical service contracts. Dr. Shashikanth, a general practitioner, entered into two non-NHS general medical services contracts with the NHS Hillingdon Clinical Commissioning Group (CCG) for the provision of primary medical services. The CCG terminated these contracts based on an alleged breach of contractual obligations concerning cooperation with a primary care network. The central issue of this appeal was whether the adjudicator's decision, appointed by the Secretary of State under statutory regulations, could be subjected to judicial review.

Summary of the Judgment

The Court of Appeal held that determinations made by an adjudicator appointed under the National Health Service (General Medical Services Contracts) Regulations 2015 are amenable to judicial review, even when relating to non-NHS contracts that give rise to private law rights. The adjudicator erred in law by concluding that Dr. Shashikanth was in breach of a contractual obligation to cooperate with the primary care network, as the contracts had not been properly varied to include such an obligation. Consequently, the Court quashed the adjudicator's determination and remitted the matter for reconsideration.

Analysis

Precedents Cited

The judgment extensively engaged with previous case law to delineate the scope of judicial review in adjudicator determinations. Key precedents included:

Holmcroft v Financial Services Authority: Distinguished the nature of functions performed by private bodies from public functions, emphasizing that even with regulatory involvement, private law disputes remain non-amenable to judicial review.
West v Lloyd's London: Highlighted that decisions purely concerning contractual relationships without public law implications do not attract judicial review.
Krebs v [Unnamed Party]: Reinforced that certain adjudicator decisions fall outside judicial review unless rooted in public law elements.
R (Holmcroft Properties Ltd.) v KPMG LLP and R (West) v Lloyd's London: Used to support the argument that adjudicators dealing with private law rights are not performing public functions.

Contrary to these earlier positions, the Court in Shashikanth recognized that the statutory framework under which the adjudicator operated imbued the determination with public law characteristics, making it susceptible to judicial review.

Legal Reasoning

The Court's reasoning pivoted on the dual nature of the statutory provisions governing the dispute resolution process. Regulation 82(1)(b) and 83(5) of the 2015 Regulations empowered the Secretary of State to appoint adjudicators to resolve disputes arising from non-NHS contracts. The Court posited that the source of authority being statutory inherently introduces a public law element to the adjudicator's role, regardless of the private law context of the contracts. Furthermore, the Court discerned that the adjudicator was tasked not merely with resolving contractual disagreements but with interpreting statutory obligations (e.g., paragraph 15A of Schedule 3), thereby performing a public function.

Additionally, the Court refuted the notion that the appellant's choice to engage the statutory dispute resolution mechanism negated the public character of the adjudicator's function. The statutory nature of the process ensured that judicial oversight remained applicable to prevent legal errors in the interpretation and application of the law, even within private contractual disputes.

Impact

This judgment significantly broadens the scope of judicial review concerning adjudicator decisions. By affirming that statutory adjudicators, even when resolving disputes with private law implications, are subject to judicial review, the Court has reinforced the accountability mechanisms within statutory dispute resolution processes. This ensures that adjudicators cannot operate with unchecked authority, especially when legal interpretations are pivotal in contractual terminations. Future cases involving statutory adjudicators will now consider the availability of judicial review as a viable remedy against erroneous or unlawful determinations, thereby enhancing legal recourse for parties in similar contractual disputes.

Complex Concepts Simplified

Judicial Review

Judicial Review is a process by which courts assess the legality of decisions or actions made by public bodies. It ensures that such bodies act within their legal powers and adhere to principles of fairness.

Public vs. Private Law

Public Law governs the relationship between individuals and the state, or public body, focusing on matters that affect society as a whole. Private Law, on the other hand, deals with relationships between individuals or private entities, often involving contracts and disputes between private parties.

Adjudicator

An Adjudicator is a neutral third party appointed to resolve disputes between parties. In this context, the adjudicator was appointed by the Secretary of State to determine the validity of contractual breaches.

Statutory Framework

The Statutory Framework refers to the set of laws and regulations that establish the authority and procedures for adjudicators to resolve disputes. In this case, it pertains to the National Health Service (General Medical Services Contracts) Regulations 2015.

Conclusion

The Court of Appeal’s decision in Shashikanth v NHS Litigation Authority marks a pivotal shift in the interplay between public and private law within statutory dispute resolution mechanisms. By determining that adjudicator decisions under statutory provisions are amenable to judicial review, the Court has reinforced the jurisprudential principle that public law oversight can extend into areas traditionally considered within the private sphere of law. This ensures a more robust system of checks and balances, safeguarding against potential legal missteps in the interpretation and application of contractual and statutory obligations. Practitioners in the healthcare sector and beyond must therefore recognize the enhanced avenues for legal redress available to parties involved in statutory adjudication processes.