Medical Law International

Much of the overall responsibility for primary care has shifted from the individual patient's general practitioner to ‘her’ Primary Care Trust (PCT). PCTs play a pivotal role both in relation to the provision of primary care in the community and arranging secondary care in hospitals. In so doing, PCTs ‘choose’ from a broad spectrum of ‘providers’ in the public and private sectors. Patients in need of surgery may find themselves admitted not to their local NHS hospital, but to a private clinic, or even a hospital abroad. Does ‘their’ PCT owe them a duty of care and does it matter?

This article argues that, if we question the relationship between private law and public health, we are led to deeper questions about the balance between public interest and private right. At a time of rapid developments in the bio-sciences and when public health projects such as the UK Biobank are being initiated, it is suggested that there urgently needs to be a debate about a constitutional framework for the regulation of public health.

In Canada, no patents on embryonic stem cell lines have been granted, though it seems likely that they are technically patentable. Nevertheless, there are reasons to believe that embryonic still cell patents may engender social controversy. Embryonic stem cell research remains a morally contested topic. The granting of patents in the area will serve as another opportunity to engage the debate. In addition, for those who have concerns about the commercialization of research and the commodification of life, stem cell patents will serve as another example of an undesirable trend.

It seems to be widely accepted in the United Kingdom that some form of regulation of assisted reproductive technologies is appropriate. Drawing on the position of the Warnock Committee, the 1990 Human Fertilisation and Embryology Act sought to control assisted reproduction and research using human embryos. However, a recent report from the House of Commons Select Committee on Science and Technology recommended a more libertarian approach to assisted reproduction, arguing that the legitimacy of the state's intervention needs to be justified rather than assumed. This article explores the extent to which it is now justified to control access to assisted reproduction and concludes that the regulatory mechanism currently in place is unnecessarily restrictive.

This essay considers a topic at the heart of much of Di Longley's scholarship, governance in health care. More particularly, it considers the effect of the EU's open method of coordination, an exemplar of the “new governance,” on social health insurance in Europe. It concludes that, paradoxically, the OMC might lead to centralisation of government power, rather than to greater participation in governance, in these countries.

Diane Longley's work draws attention to the potential of public law to articulate procedural standards which, by structuring decision-making on the allocation of scarce healthcare resources, can contribute to the legitimation of the process of priority-setting. This article assesses the importance of this judicial function in the light of recent developments in health policy and analyses the extent to which courts may be said to have performed it successfully. It focuses in particular upon the decision of the Supreme Court of Canada in Auton v British Columbia (Attorney General), but in so doing seeks to draw lessons and to identify issues which are pertinent elsewhere, notably to English law.