“BMI Edgbaston Hospital offers a ‘Self Pay Options’ scheme for patients. Please note that this scheme is subject to satisfactory pre-operative assessment by BMI Hospital during the week prior to admission to hospital. The prices quoted allow for up to a seven night stay to include everything related to the in-patient stay e.g. surgeons’ fees, any anaesthetic fees, accommodation fees, theatre fees, theatre consumables, ward consumables, radiology, pathology, inpatient physiotherapy etc.”
“Following your consultation with Mr McMinn please find enclosed details of our Self-Pay fixed price package for your surgery This offer is made subject to the Terms and Conditions set out in the enclosed and is subject to pre-assessment. It is valid at BMI the Edgbaston Hospital in Birmingham with Mr McMinn Please see the enclosed quote and associated terms and conditions. Fixed price packages may not be appropriate for everyone and confirmation as to whether you are eligible will be confirmed following your pre-assessment by one of our nursing team. If you wish to go ahead with surgery please sign one of the attached quote form pages and return to us at BMI the Edgbaston Hospital”
“Before your admission: - Pre-operative assessment before admission, if necessary During your hospital stay: - Hospital accommodation and meals - Nursing care and facilities - Theatre fees, drugs and dressings - High Dependency Unit and/or Intensive Care Unit, if required - Consultants’ operating fees - BMI Hospital approved prosthesis - Inpatient imaging, physiotherapy, pathology and histology - Walking aid, if clinically required After your discharge: - Take-home drugs for up to 5 days after discharge and antibiotics for the prescribed period - Removal of stitches, dressings or plaster at the hospital if required”
“NB No extra charges will be made by the hospital if you stay longer than anticipated if this is due to a clinical reason related to your operation/treatment Any additional items not included but required as part of your treatment will be charged to you by the hospital, your consultant or other third party separately. If you are in any doubt about what is included in the cost of your quotation, you are advised to seek advice from the hospital and/or your consultant.”
“18. All consultants are self-employed and provide their services direct to the patient. 19. Your quote will state whether the consultant’s fees for the procedure and the follow up (but not the initial consultation fee) are included in the quoted price. If the fees are included, the hospital will usually collect the consultant’s fees as agent but occasionally, you will receive a separate invoice from the consultant for his portion of the procedure cost. If this occurs, the package price will be automatically reduced by the amount of the consultant’s fees. 20. The initial consultation fee with the consultant is a separate fee (outside the package price) which will be invoiced to you directly by the consultant.”
“[18] A simple distillation, so far as material for present purposes, can be set out uncontroversially as follows: (1) When interpreting a written contract, the court is concerned to identify the intention of the parties by reference to what a reasonable person having all thebackground knowledge which would have been available to the parties would have understood them to be using the language in the contract to mean. It does so by focussing on the meaning of the relevant words in their documentary, factual and commercial context. That meaning has to be assessed in the light of (i) the natural and ordinary meaning of the clause, (ii) any other relevant provisions of the contract, (iii) the overall purpose of the clause and the contract, (iv) the facts and circumstances known or assumed by the parties at the time that the document was executed, and (v) commercial common sense, but (vi) disregarding subjective evidence of any party's intentions; (2) The reliance placed in some cases on commercial common sense and surrounding circumstances should not be invoked to undervalue the importance of the language of the provision which is to be construed. The exercise of interpreting a provision involves identifying what the parties meant through the eyes of a reasonable reader, and, save perhaps in a very unusual case, that meaning is most obviously to be gleaned from the language of the provision. Unlike commercial common sense and the surrounding circumstances, the parties have control over the language they use in a contract. And, again save perhaps in a very unusual case, the parties must have been specifically focussing on the issue covered by the provision when agreeing the wording of that provision; (3) When it comes to considering the centrally relevant words to be interpreted, the clearer the natural meaning, the more difficult it is to justify departing from it. The less clear they are, or, to put it another way, the worse their drafting, the more ready the court can properly be to depart from their natural meaning. However, that does not justify the court embarking on an exercise of searching for, let alone constructing, drafting infelicities in order to facilitate a departure from the natural meaning; (4) Commercial common sense is not to be invoked retrospectively. The mere fact that a contractual arrangement, if interpreted according to its natural language, has worked out badly, or even disastrously, for one of the parties is not a reason for departing from the natural language. Commercial common sense is only relevant to the extent of how matters would or could have been perceived by the parties, or by reasonable people in the position of the parties, as at the date that the contract was made; (5) While commercial common sense is a very important factor to take into account when interpreting a contract, a court should be very slow to reject the natural meaning of a provision as correct simply because it appears to be a very imprudent term for one of the parties to have agreed, even ignoring the benefit of wisdom of hindsight. The purpose of interpretation is to identify what the parties have agreed, not what the court thinks that they should have agreed. Accordingly, when interpreting a contract a judge should avoid re-writing it in an attempt to assist an unwise party or to penalise an astute party; (6) When interpreting a contractual provision, one can only take into account facts or circumstances which existed at the time the contract was made, and which were known or reasonably available to both parties [19] Thus the court is concerned to identify the intention of the parties by reference to what a reasonable person having all the background knowledge which would have been available to the parties would have understood them to be using the language in the contract to mean. The court’s task is to ascertain the objective meaning of the language which the parties have chosen to express their agreement. This is not a literalist exercise; the court must consider the contract as a whole and, depending on the nature, formality, and quality of drafting of the contract, give more or less weightto elements of the wider context in reaching its view as to that objective meaning. The interpretative exercise is a unitary one involving an iterative process by which each suggested interpretation is checked against the provisions of the contract and its commercial consequences investigated.”
“A standard form is designed for use in a wide variety of different circumstances. It is not context-specific. Its value would be much diminished if it could not be relied upon as having the same meaning on all occasions. Accordingly the relevance of the factual background of a particular case to its interpretation is necessarily limited. The danger, of course, is that the standard form may be employed in circumstances for which it was not designed. Unless the context in a particular case shows that this has happened, however, the interpretation of the form ought not to be affected by the factual background.”
“Where what is promised will be done involves the doing of a physical act, performance of the promise necessitates procuring a natural person to do it; but the legal relationship between the promisor and natural person by whom the act is done, whether it is that of master and servant, or principal and agent, or of parties to an independent subcontract, is generally irrelevant. If that person fails to do it in the manner in which the promisor has promised to procure it to be done, as, for instance, with reasonable care and skill, the promisor has failed to fulfil his own primary obligation.”
“A contracting party can in the case of many contracts enter into an arrangement by which some other person may perform for him, as far as he is concerned, the obligations of the contract, and the other contracting party will be obliged to accept that performance if it is performance in accordance with the terms of the Contract. The contracting party will, however, be liable for any breach that may happen and the other contracting party is not bound or indeed, entitled to sue the substituted person for breach of contract, although there may of course be a remedy in tort.”
“Apart from any express term governing the relationship of the parties, the extent of the obligation which one person assumes towards another is to be inferred from the circumstances of the case. This is true whether the relationship be contractual (as in the case of a nursing home conducted for profit) or non-contractual (as in the case of a hospital which gives free treatment). In the former case there is, of course, a remedy in contract, while in the latter the only remedy is in tort, but in each case the first task is to discover the extent of the obligation assumed by the person whom it is sought to make liable. Once this is discovered, it follows of necessity that the person accused of a breach of the obligation cannot escape liability because he has employed another person, whether a servant or agent, to discharge it on his behalf, and this is equally true whether or not the obligation involves the use of skill. It is also true that, if the obligation is undertaken by a corporation, or a body of trustees or governors, they cannot escape liability for its breach, any more than can an individual, and it is no answer to say that the obligation is one which on the face of it they could never perform themselves.”
“I think it depends on this: Who employs the doctor or surgeon - is it the patient or the hospital authorities? If the patient himself selects and employs the doctor or surgeon, as in Hillyer’s case, the hospital authorities are of course not liable for his negligence, because he is not employed by them. But where the doctor or surgeon, be he a consultant or not, is employed and paid, not by the patient but by the hospital authorities, I am of opinion that the hospital authorities are liable for his negligence in treating the patient. It does not depend on whether the contract under which he was employed was a contract of service or a contract for services. That is a fine distinction which is sometimes of importance; but not in cases such as the present, where the hospital authorities are themselves under a duty to use care in treating the patient. I take it to be clear law, as well as good sense, that, where a person is himself under a duty to use care, he cannot get rid of his responsibility by delegating the performance of it to someone else, no matter whether the delegation be to a servant under a contract of service or to an independent contractor under a contract for services.”