When it comes to medical negligence claims, one of the most important legal principles is the Bolam test. This test determines whether a healthcare professional has breached their duty of care by failing to meet the standard expected of a competent practitioner.
What Is the Bolam Test?
The Bolam test originates from the landmark case of Bolam v Friern Hospital Management Committee [1957] 1 WLR 582. In this case, the court held that:
“A doctor is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art.”
In simpler terms, a medical professional is not considered negligent if their actions are supported by a responsible body of medical opinion, even if other professionals would have acted differently.
Key Elements of the Bolam Test
To apply the Bolam test, courts consider:
- Whether the medical practitioner acted in accordance with a recognised and accepted practice within the relevant field of medicine.
- Whether that practice is supported by a responsible body of medical opinion, not necessarily the majority, but one that is credible and competent.
This means that medical judgment is protected, provided it is based on sound medical reasoning and is not outside the bounds of accepted practice.
Why the Bolam Test Matters
The Bolam test is crucial because it recognises that medicine is not an exact science. Doctors often face complex decisions with no single “correct” answer but must act quickly and decisively. The test ensures that professionals are judged fairly, based on the standards of their peers, rather than with the benefit of hindsight.
It also means that a poor outcome does not automatically mean negligence. What matters is whether the care provided was reasonable and consistent with accepted medical standards at the time.
The Bolitho Addendum: Logical Scrutiny
The Bolam test was later refined by the House of Lords in Bolitho v City and Hackney Health Authority [1997] AC 232. This case introduced an important qualification:
Even if a body of medical opinion supports the doctor’s actions, the court must be satisfied that the opinion is logically defensible.
This is known as the Bolitho test, and it allows courts to reject expert medical opinion if it is deemed illogical, outdated, or indefensible. It ensures that the Bolam test is not a shield for poor or irrational medical practices.
Applying the Test: An Example from McGovern v Sharkey
In the Northern Ireland High Court case McGovern v James A Sharkey and Belfast Health & Social Care Trust [2014] NIQB 117, the plaintiff alleged that a delay in diagnosing and treating a retinal detachment led to permanent vision loss.
The court applied the Bolam and Bolitho principles and found:
- The treating consultant’s diagnosis and treatment plan were supported by a responsible body of medical opinion.
- The medical decisions were logically defensible, even though the outcome was poor.
- Therefore, no negligence was established.
This case highlights how the Bolam test protects medical professionals who make reasonable decisions, even in complex or uncertain clinical situations.
Conclusion: The Bolam Test in Medical Negligence Law
The Bolam test remains a cornerstone of clinical negligence law in the UK. It ensures that healthcare professionals are judged according to the standards of their peers, not by unrealistic expectations or hindsight.
If you believe you’ve been affected by substandard medical care, it’s essential to seek legal advice from a solicitor experienced in clinical negligence. Our team can help assess whether your case meets the legal threshold under the Bolam and Bolitho tests. Use our online portal to discuss your case with us.
