[2025] EWHC 2025 (KB)

Given my findings on liability, it is not necessary to consider the issue of causation. However, I will deal with this issue briefly for completeness. As I have said at paragraph 147 above, the approach set out in Smith is particularly relevant here for the reasons I have given. As Hutchinson J said in Smith, “the assertion from the witness box, made after the adverse outcome is known, in a wholly artificial situation and in the knowledge that the outcome of the case depends upon that assertion being maintained, does not carry great weight unless there are extraneous or additional factors to substantiate it.” I do not consider that there are any such extraneous or additional factors to substantiate the claimant’s evidence on this issue. For the reasons I have already given, there are in fact several factors which undermine her evidence on this issue.

For completeness, in the unlikely event that she decided to try non-surgical options first, then the parties agree that within 2 years she would have required a surgical haemorrhoidectomy to permanently resolve her symptoms and that is the advice she would have been given. At that point, she will have had two further years of recurring symptoms that she was already finding troublesome, and she will have had two years of evidence that conservative methods do not work. I consider therefore that she would at that time probably have opted for surgery and therefore, applying Chester damages would have been limited to two years acceleration of her symptoms.