Local authorities have the power to arrange for children in their care to be given vaccinations without applying for a court order even where the parents do not consent, the Court of Appeal has said.
The parents of T, a 9 month old child, had appealed against the conclusion of the High Court in February that the London Borough of Tower Hamlets had the power under the Children Act 1989 to arrange for the immunisation of a child in its care, despite its parents’ objections, without first obtaining a court order.
In the High Court, Mr Justice Hayden agreed with the local authority that it had the power under section 33(3) Children Act 1989 to arrange for the immunisations to take place.
In case that conclusion was wrong, he specifically declared that the vaccinations were in T’s interests. (The council also sought an order from the court to authorise them as being in T’s best interests if its primary argument was not upheld.)
However, as his decision about the powers of the local authority differed from the earlier High Court decision in Re SL (Permission to Vaccinate)  EWHC 125, Justice Hayden granted permission to appeal. In Re SL, the High Court had ruled that if a court order was necessary where there was disagreement between a local authority and parents about the vaccination of a child in care.
The child at the centre of the case, T, is a healthy boy aged 9 months at the time of the judge’s decision. The parents have had a number of older children, all of whom have been removed from their care after findings were made that they had suffered from the parents’ chaotic lifestyle, from exposure to violence, and from neglect.
In September 2019, after a period of time in a residential assessment unit with both parents and latterly with the mother alone, T was placed in foster care, where he remains.
In January 2020, Hayden J made final orders placing T in the care of the local authority and authorising it to place him for adoption (see  EWFC 4)
The parents, and particularly the father, were found by the judge to be “driven by the fundamental belief that neither the court not the State… has any jurisdiction to make decisions in relation to his children”. They declined to register T’s birth and in June 2019 the judge found that the local authority had the power to take that step: see  EWHC 1572 (Fam).
The parents also refused to agree to T receiving routine childhood immunisations and appealed against both the High Court’s ruling about the powers of the local authority and his decision about T’s best interests.
At the outset of the appeal hearing, heard on 2 April 2020. the parents accepted that the judge’s conclusion that it was in T’s best interests to be vaccinated could not be successfully challenged. As a result, T will now receive immunisations appropriate to his age.
With regard to the powers available to the local authority to override the parents’ opposition to routine immunisations or whether disputes of this kind must be decided by the High Court, the CoA upheld the High Court’s view that, under s.33(3)(b) CA 1989, a local authority with a care order can arrange and consent to a child in its care being vaccinated where it is satisfied that it is in the best interests of that individual child, notwithstanding the objections of parents.
“Although vaccinations are not compulsory, the scientific evidence now clearly establishes that it is in the best medical interests of children to be vaccinated in accordance with Public Health England’s guidance unless there is a specific contra-indication in an individual case,” the Court of Appeal’s judgment said.
“The administration of standard or routine vaccinations cannot be regarded as being a ‘serious’ or ‘grave’ matter. Except where there are significant features which suggest that, unusually, it may not be in the best interests of a child to be vaccinated, it is neither necessary nor appropriate for a local authority to refer the matter to the High Court in every case where a parent opposes the proposed vaccination of their child.
“Parental views regarding immunisation must always be taken into account but the matter is not to be determined by the strength of the parental view unless the view has a real bearing on the child’s welfare.”
A copy of the judgment can be found at www.judiciary.uk/judgments/re-h-a-child-parental-responsibility-vaccination/