In a landmark judgment delivered this morning, the Supreme Court has severely curtailed the secretive practices of the Family Division judges in cases involving withdrawal of life-saving treatment from critically ill children.
Following a seven-years-long legal battle involving two families supported by the Christian Legal Centre, Rashid and Aliya Abbasi and Lanre Haastrup, the injunctions which prevented the families from telling their stories have now been discharged.
Rashid and Aliya Abbasi and Lanre Haastrup were taken to court by respectively by Newcastle-Upon-Tyne NHS Foundation Trust and King’s College Hospital who sought permission to withdraw life-sustaining treatment from their children in two different ‘best interests’ applications.
Following high-profile controversies in the 2017-2018 cases of Charlie Gard and Alfie Evans, family judges routinely granted life-long anonymity to all doctors, nurses and other NHS staff involved in similar cases.
However, the panel of five justices chaired by the President of the Supreme Court, Lord Reed, has now ruled that permanent gagging orders may only be granted exceptionally to protect a specific individual based on “compelling evidence” of “a real and continuing threat of a serious nature” to that individual.
The judgment of Lords Reed, Hodge, Briggs, Sales and Stephens will also have wider implications for the courts’ power to make injunctions restricting free speech in other legal cases. The country’s top judges have questioned the earlier case-law which permits injunctions being granted to protect right to privacy under Article 8 of the European Convention on Human Rights without any legal cause of action under British domestic law.
Both families were represented by Bruno Quintavalle, barrister. Both NHS Trusts were represented by Gavin Millar KC and Fiona Paterson KC.
The untold stories of cruelty
The Abbasis, both of whom are doctors, have described the ‘toxic environment’ surrounding the medical care of their daughter Zainab, which involved the shocking arrest (caught on video) of father, Dr Rashid Abbasi, at his 6-year-old daughter’s bedside in intensive care. Zainab died shortly afterwards and before the case was considered by the court.
Dr Abbasi’s legal action against the police for wrongful arrest and false imprisonment is due to be heard in Newcastle County Court on 16 May 2025.
Mr Haastrup’s baby son, Isaiah, had suffered fatal brain injuries due to medical negligence at King’s College Hospital’s maternity ward. The Hospital later admitted the negligence and paid financial compensation to the family, but nevertheless persuaded the court to authorise withdrawal of life support from Isaiah against his parents’ wishes. Isaiah died several hours after life support was withdrawn in March 2018.
Both families were threatened with imprisonment for contempt of court if they ever revealed the identities of any of the doctors or other staff involved in the death of their children.
The long legal battle
Years after both children’s deaths, the families applied to the courts to discharge the injunctions to be able to tell about their experiences in public.
The applications were fiercely resisted by the two NHS Trusts, who also enlisted support from the British Medical Association (BMA), Royal College of Nursing (RCN), Royal College of Paediatrics and Child Health (RCPCH), Paediatric Critical Care Society (PCCS) and Faculty of Intensive Care Medicine (FICM). Medical bodies argued that discharging gagging orders would create a dangerous precedent and cause systemic problems for the NHS. Both RCPCH and FICM argued that, without a guarantee of life-long anonymity, many doctors, fearful of public criticism, may become reluctant to take parents to courts to obtain authorisation to end the child’s life.
In 2021 Sir Andrew McFarlane, the President of the Family Division of the High Court, refused the parents’ applications and ordered for the injunctions to continue in force forever. However, the Court of Appeal panel which included two successive Chief Justices of England and Wales, Lord Burnett and Lady Carr, overturned Sir Andrew’s ruling in 2023. Both NHS Trusts, supported by the BMA, RCN, RCPCH, PCCS and FICM, appealed to the Supreme Court, which has today upheld the decision of the Court of Appeal and has discharged both injunctions with immediate effect. That decision is final and may not be appealed further.
‘Legitimate public interest’
In giving written reasons for its decision, the Supreme Court has stated: “the treatment of patients in public hospitals is a matter of legitimate public interest, and that the medical and other staff of public hospitals are public figures for the purposes of the Convention, with the consequence that the limits of acceptable criticism are wider than in the case of private individuals.”
Commenting on Dr Abbasi’s and Mr Haastrup’s criticisms of how their children were treated, the Supreme Court has observed:
“Zainab’s father made detailed criticisms of his daughter’s care, as well as of the clinicians’ behaviour towards him and his wife. They included: (1) the allegedly inappropriate attitude on the part of clinicians in the form of a reluctance to treat Zainab’s respiratory disorders because of her underlying neurodegenerative condition; (2) the decision to move Zainab to palliative care, and in particular the discussion at a management meeting on 19 August 2019 (which he recorded), at which he feels that he and his wife were pressurised by clinicians; (3) the circumstances of his arrest on the same date (which were recorded on video by police body-worn cameras); (4) the alleged refusal of Zainab’s treating physician to meet a senior paediatric respiratory consultant from the Royal Brompton Hospital who provided an opinion, following an assessment of Zainab on 8 September 2019, that she could be treated, in a time-limited way, with a further high dose of steroids; and (5) alleged inaccuracies or lies on the part of those clinicians who gave evidence in an emergency telephone hearing on 15 September 2019. Dr Abbasi has explained that his motivation for ventilating these matters is not personal vilification, but to achieve an improvement in systems and procedures, and to prevent a repetition of what he sees as the failures of the Newcastle Trust and its staff. He wishes to stimulate a public debate.
“Mr Haastrup has also identified the areas of public, as well as private, concern about which he wishes to speak. These include: (1) the negligence of King’s staff during Isaiah’s birth; (2) the alleged financial motivation for taking the end-of-life route, in the context of the Trust’s liability in damages for medical negligence; and (3) the circumstances surrounding Isaiah’s last day of life.”
The Supreme Court has criticised the President of Family Division for failing to consider whether the parents’ criticisms “could be rejected as totally without substance or merit” given the recordings of the Abbasis’ meeting with the clinical team and of Dr Abbasi’s arrest immediately after the meeting were produced in evidence, and that “Dr Abbasi’s criticisms of Zainab’s treatment were based on his and his wife’s medical expertise and experience, including his expertise and experience as a consultant respiratory physician. As regards the Haastrup case, the negligence of King’s staff during Isaiah’s birth was admitted.”
Important first step towards justice for victims
Speaking outside the Supreme Court in response to the judgment, Dr Rashid Abbasi said:
“As a senior doctor myself, it was a shock for me to see the behaviour of some of my colleagues when my little daughter’s life was in their hands. Not only was Zainab denied life-saving treatment – which I, as a respiratory consultant, knew was appropriate. She was denied even the comfort of a peaceful death.
“Instead, the Hospital chose to declare an all-out war against us as her parents, to the point of deploying a police force to drag me away from my daughter’s bedside. We were brutally silenced both before and after Zainab’s death. Now, after six years of fighting in courts, we are finally allowed to tell our story.
“Throughout these years, we have been very careful to be fair and responsible in our criticism of what has happened to us. We shall continue to do so as we tell the full story of our ordeal in a few weeks, and name those responsible for it. This said, NHS patients and families deserve better than what we have been through. Individuals who abused their power and trust, in our case and in other cases, should be held to account.
“In a lifetime of working for the NHS, I have had the privilege of working together with many good, conscientious and kind doctors and nurses who always put patients first. However there are inevitably also some bad apples in this basket – and they are the ones who most need secrecy. They are the ones who gave the NHS a bad name by acting as they did in such cases as Zainab’s, Isaiah Haastrup, Charlie Gard, Alfie Evans, Pippa Knight, Archie Battersbee, Sudiksha Thirumalesh, Indi Gregory, Hyacinth McIntosh and a number of others. It is extremely unfair that, while the real culprits hide behind the court-imposed anonymity, the entire medical profession is painted with the same brush in the eyes of the public. Today’s judgment will hopefully put a stop to this unfairness, and by identifying the bad apples, protect the reputation of our profession as a whole.”
Lanre Haastrup said:
“No words can fully express what it was like to expect the birth of our son – after the pregnancy went well and after being told that our baby was perfectly healthy – and then to learn that Isaiah’s brain has been severely damaged by medical negligence during birth, and to be immediately taken to court by the NHS to take away his life. We as parents have experienced unbelievable levels of both cruelty and dishonesty from some of the doctors and NHS managers who were desperate to overcome our resistance. For the past seven years, we were banned by the court order from even telling our side of the story. It is astonishing to what lengths the NHS has gone, taking us through every level of the judicial system several times over, first to end Isaiah’s life and then to silence the truth about his death.
“Today’s judgment is the important first step towards achieving justice for our beloved Isaiah, for Zainab Abbasi and for other children like them. We have lost our children and they cannot be brought back, but if we leave this system in a better shape than we found it, we will know our children have not died in vain. All the cruelty and lies we have experienced were only possible under the cover of secrecy. When the public and Parliament hear the full truth of what some people within the NHS have done to families like us, nobody can defend the indefensible and the law will certainly have to change.
“The most important thing now is to tell the full truth of what has happened to us and to our son. I am going to do my bit by writing a comprehensive, fully documented book about what happened in Isaiah’s case from beginning to end. I urge other victims of this system to give similar public testimonies.”
Andrea Williams, chief executive of Christian Legal Centre, has said:
“It has been a great privilege for us to have stood with these two brave families through many years of this legal battle, where they had the combined resources of the NHS, British Medical Association and a united front of many Royal Colleges all thrown to gag them from telling their stories. I shudder to think how many other families, perhaps with similarly shocking experiences, may have been successfully silenced because they did not have the strength or resources to resist.
Justice must be done in the light. When courts are making life-and-death decisions, there should be no fear of public scrutiny. Transparency is essential to ensure accountability in a system that holds such profound power.
“Especially at the time of the important national debate about legalising assisted suicide, it is vital that families such as Rashid and Aliya Abbasi and Lanre Haastrup can tell the full truth of what happens to patients at the receiving end of the so-called end-of-life care in 21st century Britain.
“Hopefully, today’s judgment will enable the shocking testimonies of Rashid, Aliya, Lanre and other victims and witnesses to get the attention they deserve.
“It’s been our privilege to stand for many years with Rashid, Aliya, Lanre and all the parents who attended court today. Their stories must be heard.”
