11th Apr 2024

18 St John Street Costs Law Specialist, James Miller, analyses an interesting case concerning medical agency fees in a fixed costs case.

I recently acted for the Defendant in a fixed costs case concerning the contentious issue of medical agency fees. The court had to decide whether to prosecute the Defendant’s Part 18 request for a breakdown of a Pain Management Report fee in the sum of £2916 plus VAT and/or to assess the Claimant’s costs and disbursements pursuant to CPR 36.20(11).

Upon receipt of the Defendant’s request for a breakdown of the fee, the Claimant’s solicitors said they did not know the answer and the information sought was neither in the Claimant’s possession nor their own. The medical agency later asserted that it was not its practice to provide breakdowns of its fees. Further, there was no obligation nor necessity and it would require a detailed and complex analysis of the macroeconomics of the wider medical reporting market, which would be disproportionate.

Although His Honour Judge Saggerson accepted that agency fees are recoverable in principle, he roundly rejected the medical agency’s stance. The judge determined that the paying party and the court were entitled to know what amount was being charged by the agency so an adjudication could be made on proportionality. His Honour Judge Saggerson ordered that unless a breakdown of the Pain Management Report fee was forthcoming, the disputed disbursement would be limited to £750 plus VAT. 

The Claimant sought permission to appeal, which was refused. To date, the Claimant has not provided a breakdown of the fee nor pursued an appeal.


This is a first instance decision from a Circuit Judge, which is not binding but persuasive. To welcoming paying parties, the court’s approach will be unsurprising as it mirrors the rationale of His Honour Judge Bird in Northampton General Hospital NHS Trust v Hoskin [2023]. Namely, that if the court is to determine what amount to allow for a report commissioned by an agency, it will want to understand what the latter’s fees are.

Receiving parties will disagree. In the present case, the medical agency was not a party to the proceedings and the information sought was said to be outside the possession and control of the Claimant. Ultimately, His Honour Judge Saggerson was “unmoved” by those complaints, deciding that transparency ruled the day.

A copy of the judgment is here: 

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