IN 1HL HIGH COUR1 OI JUS1ICL

DIVISIONAL COUR1
AND IN 1HL MA11LR OI AN APPLICA1ION
UNDLR S.J3 OI 1HL CORONLRS AC1 J988
1O QUASH 1HL INQULS1S IN1O 1HL DLA1HS OI 1HL INDIVIDUALS
WHO DILD AS A CONSLQULNCL OI
1HL DISAS1LR A1 1HL HILLSBOROUGH S1ADIUM ON JS APRIL J989
HM A11ORNLY GLNLRAL
Claimant
-and -
HM CORONLR IOR SOU1H YORKSHIRL (WLS1 DIS1RIC1)
Iirst Defendant
HM CORONLR IOR WLS1 YORKSHIRL (WLS1 DIS1RIC1)
Second Defendant
SPLAKING NO1L
1. May it please your Lordships I appear with Mr Glasson.
2. Miss Alison lewitt appears íor the lirst Deíendant, the Sheííield Coroner,
3. 1he Second Deíendant is not represented today but has íiled an
acknowledgment oí ser·ice indicating that he does not contest the
application.
4. As your Lordships know there are many interested parties to this
application, most importantly the íamilies oí those who died in the
lillsborough Stadium disaster.
5. Mr Michael Mansíield QC appears with Mr Roche |Mr \illiams and Mr
Straw| íor 63 oí those íamilies.
6. Mr Peter \eatherby QC appears íor Mrs \illiams, whose Memorial íor an
application in relation to the death oí her son Ke·in I granted at the same
time as I lodged this application with the Court. Mr \eatherby also
represents a number oí other íamilies.
¯. Ms liona Barton QC appears íor the South \orkshire Police.
8. My Lords, the Application that I am making íor the inquests into the
deaths oí the 96 people who died as a consequence oí the distaster at the
lillsborough Stadium on 15 April 1989 is supported by the Deíendants as
well as all oí the interested parties that are represented here today. 1hose
that are not represented ha·e indicated that they do not oppose the
Application and indeed some ha·e indicated that they expressly support it.
9. Nonetheless, gi·en the intense public interest in this case it is right, with
your Lordships` permission, that I set out, in summary íorm at least, the
basis íor the Application that I am making.
10. 1he horriíic e·ents on 15 April 1989 at the lillsborough Stadium are well
known. 1hey were seen by millions on tele·ision as the tragedy uníolded
and by many oí the spectators at the stadium itselí.
11. Lord Justice 1aylor, who conducted a remarkably expeditious and
thorough inquiry into the tragedy, set out the e·ents oí the day in his
Interim Report, published just a íew months aíter the tragedy in August
1989:
81. lrom 3 o'clock, gates 3 and 4 had been open and remained so. At
íirst, íans had walked or staggered out winded and íaint. But the íinal
surge at 3.04 pm, and the struggle to reach the open gates, caused a
horrendous blockage oí bodies. 1he dead, the dying and the desperate
became interwo·en in the sump at the íront oí the pens, especially by
the gates. 1hose with strength leít clambered o·er others submerged in
the human heap and tried to climb out o·er the íence. 1hey were now
helped by police and other íans who hauled them up and o·er.
Numbers oí íans were climbing o·er the radial íences into adjacent
pens. At the back, many were hauled up into the west stand to relie·e
the pressure.
82. 1he steps írom the sump at gateways 3 and 4 were so congested
with bodies li·e and dead that each had to be prised írom the pile by
the police. Initially, no oííicer took eííecti·e charge. A number oí
indi·idual oííicers and íans worked írantically to íree those trapped but
the gateways were so narrow that only two or three could get at the
entwined bodies. \illing hands got in one another's way. More oííicers
arri·ed írom the gymnasium and elsewhere in the ground. Many used
their own initiati·e to help those laid out on the pitch, to assist in
getting others o·er the íencing and to comíort the distressed. But
some stood in groups near the perimeter íence not knowing what to
do. 1hey had been summoned in response to what was thought to be a
threat to public order. \hat they íound was a horriíic scene oí carnage
and some young oííicers were shocked into impotence by what they
saw.
83. A pile oí dead bodies lay and grew outside gate 3. Lxtending
íurther and íurther on to the pitch, the injured were laid down and
attempts made to re·i·e them. More and more walking sur·i·ors
ílooded out on to the pitch as the players leít. 1he scene was emoti·e
and chaotic as well as gruesome.`
1
12. In the months and years that íollowed, the e·ents that led to that tragedy
ha·e been the subject oí numerous in·estigations and inquiries. As the
lillsborough Panel commented ív terv. of tire. to.t, tbe íitt.borovgb ai.a.ter i.
tbe vo.t .eriov. crora·retatea tragea, at a .¡ort. erevt iv ßritaiv. ít i. at.o tbe vo.t
ivre.tigatea ava .tvaiea.
2
13. My Lords, the Application today is made as a consequence oí the
lillsborough Panel's report that was published on 12 September 2012. It
is a remarkable document, the product oí a re·iew oí o·er 450,000 pages
oí documentation írom 84 organisations and indi·iduals, in addition to
audio-·isual material
3
.
14. In the immediate weeks íollowing its publication, I careíully studied the
íindings oí the lillsborough Panel with a ·iew to whether it was right to
exercise my powers under section 13 oí the Coroners Act.
15. On 16 October 2012 I announced to Parliament my intention to make an
application íor the inquests oí those who died as a consequence oí the
lillsborough disaster to be quashed and new inquests ordered. At the
1
Page 15 oí the Panel Report, tab A
2
Paragraph 1.6, page 2¯ oí the Panel Report, tab A
3
Page 382 oí the Panel Report, tab A
same time I indicated that I would immediately start the process oí
consultation with the íamilies as to their ·iews on whether such an
application should be made in their particular case as well as with the
deíendants and other interested parties.
16. Soon aíter my announcement to Parliament, I commissioned íurther
expert analysis oí the new medical e·idence which íorms the central plank
oí this Application. Consequently Dr Kirkup, the medical member oí the
Panel and a íormer Associate Chieí Medical Oííicer at the Department oí
lealth, as well as Proíessor Jack Crane, a leading íorensic pathologist and
the state pathologist íor Northern Ireland, ha·e each submitted detailed
reports in support oí this Application.
1¯. I am most grateíul to all those íamilies and parties that ha·e co-operated
íully with my Oííice in the consultation process that íollowed my
announcement. Lawyers íor the íamilies saw the Application in draít as
did the Deíendants. 1heir prompt co-operation has ensured that when the
Application was lodged with the Court last Monday it was possible to íile it
on the basis that all the íamilies as well as both oí the deíendants
supported it. linally, I should express my thanks, as well as the thanks oí
all oí those present, to the Court íor listing the Application so quickly.
18. 1he report oí the lillsborough Panel undermined a critical assumption
that underpinned all oí the in·estigations into the disaster and, most
importantly, that had underpinned the inquests. 1he Panel`s access to all
oí the rele·ant records and expert analysis oí the post mortem e·idence
coníirmed that the notion oí a single, un·arying and rapid pattern oí death
in all cases was unsustainable. Some oí those who died did so aíter a
signiíicant period oí unconsciousness during which they might ha·e been
able to be resuscitated, or con·ersely might ha·e succumbed to a new
e·ent such as inappropriate positioning. Consequently, the response oí the
emergency ser·ices was not in·estigated in any detail by the inquests. As
the Panel noted, 1be aocvvevt. ai.cto.ea .bor tbat, cov.iaerea atovg.iae tbe
re.trictiov. ¡tacea b, tbe Corover ov tbe e·avivatiov of tbe eriaevce ¡re.evtea to tbe
vivi·ivqve.t. ava tbe ¡re.evtatiov of tbe ¡atbotogi.t.` veaicat o¡iviov a.
ivcovtrorertibte, tbe iv¡o.itiov of tbe ².1:¡v cvt·off .ereret, tivitea e·avivatiov of tbe
re.cve, eracvatiov ava treatvevt of tbo.e rbo aiea. 1bi. rai.ea ¡rofovva covcerv.
regaraivg .vfficievc, of ivqvir, ava e·avivatiov of eriaevce.`
4
19. Dr Bill Kirkup has pro·ided íurther iníormation in relation to the íindings
oí the Panel. Dr Kirkup has explained that oí the deceased, 58 either
"aefivitet," or "¡robabt," had the capacity to sur·i·e beyond the 3.15 pm cut
oíí time. Oí the remaining 38, Dr Kirkup says "2: baa eitber aefivite ;º) or
¡robabte ;1¨) eriaevce of cta..ic travvatic a.¡b,·ia ritb revov. ob.trvctiov ritbovt
.igv. of cerebrat oeaeva. ív tbe.e ca.e., tbe eriaevce .vgge.t. tbat aeatb occvrrea
retatiret, ra¡iat, iv re.¡ov.e to .erere vvrevittivg cov¡re..iov ava tbat erevt. after
²:1:¡v rere vvti/et, to bare vaae a aifferevce to tbe ovtcove". lowe·er there is
a group oí about 12 where "tbe a¡¡earavce. a. ae.cribea iv tbe ¡o.t vortev re¡ort.
rere vvctear, ava it ra. iv v, rier iv¡o..ibte to a..e.. ritb av, covfiaevce tbe voae of
aeatb. ít i. ¡o..ibte tbat a forev.ic ¡atbotogi.t rovta be abte to v.e e·¡ert ;vagevevt to
cove to a vore ivforvatire e·¡ert o¡iviov ov tbe.e."
20. Proíessor Crane has endorsed those conclusions. In his report he says, "ít
i. a¡¡arevt frov reaaivg tbe trav.cri¡t. of tbe vivi·ivqve.t. tbat tbe ¡atbotogi.t. eitber
rotvvteerea or rere ivritea b, tbe Corover to agree tbat to.. of cov.ciov.ve.. rovta bare
occvrrea ra¡iat,, ritbiv ² - : .ecova., ava tbat aeatb ra. iveritabte ava rovta bare
occvrrea ritbiv a fer. vivvte. ....ít i. v, o¡iviov tbat tbi. vvrar,ivg ¡ictvre of a
vviforv, ra¡ia ¡roce.. tbat tea iveritabt, to aeatb ritbiv a fer vivvte., i.
vv.v.taivabte".
21. Proíessor Crane has also commented on an aspect oí this case that initially
concerned me which was whether there was suííicient e·idence still
4
Paragraph 125, page 22 oí the Panel Report, tab A
a·ailable íor a íorensic pathologist to gi·e e·idence. Proíessor Crane`s
response was clear: he concluded that "frov v, e·avivatiov of tbe eriaevce
retativg to eacb of tbe aecea.ea, í cav covfirv tbat í betiere tbat tbi. i. .vfficievt to
evabte a forev.ic ¡atbotogi.t to ¡roriae tbe vece..ar, e·¡ert aarice ava a..i.tavce to a
Corover to evabte a Corover to carr, ovt effectire ivqve.t. iv retatiov to tbe íitt.borovgb
rictiv.."
22. 1he Panel also presented new e·idence that casts signiíicant doubt on the
weight placed at the inquests on alcohol le·els detected in the deceased.
1hat new e·idence undermines the Coroner`s summing up at the inquests.
1he Panel concluded: 1be ¡atterv of atcobot cov.vv¡tiov avovg tbo.e rbo aiea
ra. vvrevar/abte ava vot e·ce¡tiovat for a .ociat or tei.vre occa.iov`
5
.
23. As I ha·e made plain, the new medical e·idence íorms the essential basis
íor this Application.
24. 1here are howe·er other important íindings oí the lillsborough
Independent Panel that support the conclusion that it is vece..ar, or
ae.irabte iv tbe ivtere.t. of ;v.tice` that new inquests should be held.
,a, Some 116 oí the 164 police statements were subjected to
substanti·e amendments to remo·e or alter comments
unía·ourable to South \orkshire Police. 1he Panel`s re·iew oí
disclosed documents concluded that the practice oí re·iew and
alteration extended to the South \orkshire Ambulance Ser·ice.
In a number oí cases they deílected criticisms and emphasised
the eííiciency oí the Ambulance Ser·ice response. 1he Panel
concluded that in relation to the Police statements, 1be
ai.cto.ea aocvvevt. aevov.trate tbe rote ¡ta,ea b, tbe íorce .oticitor. ra.
5
Penultimate bullet point on page 1¯8 oí the Panel Report, tab A
vore .igvificavt ava airectire tbav ra. vvaer.tooa b, íora ]v.tice ´tvart·
´vitb
ó
.
,b, 1he Panel`s íindings on what is added to public understanding
by its re·iew oí e·idence relating to the period between 1981
and 1989 ,vvbeeaea rarvivg., tbe .eea. of ai.a.ter`
¯
, are suggesti·e
that there is íurther rele·ant material to how the disaster came
about that should ha·e been explored at the original inquests.
25. In order to grant this Application the Court must be satisíied under section
13 oí the Coroners Act that it is "vece..ar, or ae.irabte iv tbe ivtere.t. of ;v.tice"
that new inquests should be held.
26. My Lords, the authorities suggest that there are a number oí rele·ant, and
to some degree o·erlapping, íactors that are rele·ant to whether the Court
exercises its discretion to grant this section 13 application:
,a, Is there "a reat ri./ tbat ;v.tice ba. vot beev aove", to use 1albot J's phrase
in R r Dirive e· ¡ !attov.
,b, la·e new íacts or e·idence been disco·ered such that it is now
appropriate íor there to be new inquests· Does the new e·idence make
it "vece..ar, or ae.irabte iv tbe ivtere.t. of ;v.tice" that new inquests should be
held·
,c, Is there a possibility that a ·erdict other than accident might be
reached· L·en ií the answer to that question is "vo", would the
conclusions oí the inquests be oí a suííiciently diííerent character such
that it would nonetheless be in the "ivtere.t. of ;v.tice" íor the inquests to
be quashed·
6
Paragraph 13¯, page 24 oí the Panel Report, tab A
¯
Pages 61-86 oí the Panel Report, tab A
,d, Is the lapse oí time since 1989 such that there could be eííecti·e
inquests·
,e, Is there a need to allay suspicion that there had been an attempt by the
South \orkshire Police and the other emergency ser·ices to conceal
e·idence by amending and modiíying witness statements·
,í, \hat are the ·iews oí the íamilies oí the deceased as to whether there
should be new inquests·
,g, \hat are the ·iews oí the Deíendants to this Application·
2¯. In my respectíul submission, the answers to all oí those questions support
the granting oí this Application.
28. 1he new medical e·idence presented in the Panel Report strongly leads to
the conclusion that "tbere i. a reat ri./ tbat ;v.tice ba. vot beev aove", to use
1albot J's phrase in R r Dirive e· ¡ !attov. 1he íamilies ha·e each been
denied the opportunity íor a thorough inquiry at the inquests into whether
earlier inter·ention could ha·e a·erted the íatal outcome. Uníortunately it
is no answer to that conclusion to point to the admirably thorough Inquiry
by Lord Justice 1aylor as he also proceeded on the now impugned medical
e·idence ,insoíar as the medical causes oí death were rele·ant to his
Inquiry,.
29. In some cases the e·idence suggests that some "aefivitet," could ha·e been
sa·ed, in others that "¡robabt," they could ha·e been sa·ed whilst there are
other cases that would require more detailed analysis. In a íew, Dr
Kirkup's conclusions are that the injuries were not sur·i·able. 1he
interests oí justice howe·er require the inquisitions into all oí the deaths to
be quashed, e·en those where the Panel's analysis suggests that the injuries
were not sur·i·able. All íamilies were "ivtere.tea ¡er.ov." at the generic
inquest. All are now entitled to hearing the generic e·idence in·estigated
in the context oí the new medical e·idence.
30. Dr Kirkup's comments as to the íamilies' reactions at the meetings
subsequent to the publication oí the Panel Report are particularly telling
and bear repeating: "^atvratt,, veart, att tbe.e favitie. a./ea rbetber tbeir retatire
ra. ove of tbo.e tbat í baa .¡o/ev of a. ¡otevtiatt, .areabte, ava rbetber tbe, baa
.vfferea vore tbav baa beev .aia at tbe ivqve.t. I made a point of saying to
each family that I could not comment on the relationship between
the post mortem findings and any evidence on rescue and
resuscitation attempts that might have pertained specifically to their
relative, as this would be a matter properly addressed through any
potential new inquest." ,Lmphasis added,
31. 1he íamilies ha·e been gi·en important new e·idence but that is
necessarily incomplete: only new inquests can gi·e a íuller answer as to
whether inter·ention would ha·e altered the tragically íatal outcome. 1hat
may lead to markedly diííerent conclusions as to how the deceased came
by their death that would be recorded in new inquisitions. As such only
new inquests, rather than a íurther judicial inquiry, can meet the interests
oí justice.
32. lurthermore, the new e·idence in relation to the analysis oí the
signiíicance oí the blood alcohol le·els in the deceased also render it
"vece..ar, or ae.irabte" in the interests oí justice íor the inquests to be
quashed. 1he e·idence in that regard that was adduced at the inquests and
which was reíerred to in the summing up by the coroner wrongly
stigmatised the deceased contrary to what Simon Brown J ,as he then was,
described as "tbe a¡¡ticatiov ritbiv tbe corover´. ;vri.aictiov of a cteart, e.tabti.bea
¡otic, of aroiaivg .o far a. ¡o..ibte av, vvvece..ar, .tigva to tbe vevor, of tbe
aecea.ea" ,R r ívver ´ovtb íovaov Corover e· ¡ Kevaatt |1988| 1 \LR 1186
,DC, at 1191l-1192A.,
33. In his loreword to the Report, the Bishop oí Li·erpool wrote:
\hen the Panel began its work in lebruary 2010, it could not and did
not know whether the iníormation it would re·eal would add to public
understanding and change that understanding. O·er the inter·ening
months, we ha·e disco·ered that the iníormation disclosed will add
signiíicantly to public understanding.
...
\hen o·er 30,000 came to Aníield íor the 20th Anni·ersary oí
lillsborough, it showed that the wound oí grieí was still sore because
so many questions were yet unanswered. 1hese disclosed documents
address many oí those questions. 1he Panel, which was set up
deliberately and distinctly írom an inquiry, produces this Report
without any presumption oí where it will lead. But it does so in the
proíound hope that greater transparency will bring to the íamilies and
to the wider public a greater understanding oí the tragedy and its
aítermath. lor it is only with this transparency that the íamilies and
sur·i·ors, who ha·e beha·ed with such dignity, can with some sense oí
truth and justice cherish the memory oí their 96 lo·ed ones."
34. 1he Panel's report does indeed "aaare.. vav, qve.tiov.". 1hose that remain
can only now be answered by new inquests.
35. My Lords, we say, with the support oí all those today, that the interests oí
justice require the quashing oí the inquisitions oí the 96 people who died
as a consequence oí the disaster and íor new inquests to be heard.
36. Such inquests will be a major undertaking, though the recent example oí
the inquests oí those who died in the ¯,¯ bombings, demonstrates that a
single inquest into mass íatalities can be eííecti·ely heard where íeelings
may run high and where complex issues oí íact and law arise.
3¯. My Lords, in consultation with the íamilies, the coroners concerned and
with the Ministry oí Justice, we ha·e considered careíully the terms oí the
orders that we seek. 1hose orders are set out at paragraph 126.
38. In relation to the 95 who died and whose original inquests were heard by
the Sheííield Coroner, we ask that their new inquests be heard by a
"aifferevt corover iv tbe .ave aavivi.tratire area"
8
, that coroner being the
Doncaster Coroner.
39. In relation to 1ony Bland, who died in 1993 oí the injuries he sustained in
the disaster and whose inquest was heard by the Bradíord Coroner, we ask
in the íirst instance íor the new inquest to be heard by the Second
Deíendant, the Bradíord Coroner. |1he Bradíord Coroner is not in the
same administrati·e area as the Doncaster or Sheííield Coroner and so
cannot hear the inquest|
40. It is anticipated that ií this Application is successíul, the Second Deíendant
and the Doncaster Coroner |lM Coroner íor South \orkshire ,Last
District,| will each appoint as an assistant deputy coroner a member oí the
senior judiciary who would ha·e conduct oí the new inquests, such an
8
Section 13 (2) provides
,2, 1he ligh Court may-
,a, order an inquest or, as the case may be, another inquest to be held into the death
either-
,i, by the coroner concerned, or
(ii) by the coroner for another district in the same administrative area,
appointment being made in consultation with the appropriate bodies
9
.
1hat appointment ha·ing been made, the assistant deputy coroner can
hold a pre-inquest hearing to consider the ·enue íor the new Inquests, the
scope oí the Inquests as well as the timetable íor such Inquests.
41. My Lords, the Application that I make today is an exceptional one. I make
it personally, recognising the considerable public interest in ensuring justice
íor the íamilies íollowing the publication oí the lillsborough Panel
Report.
42. 1he power gi·en to this Court by section 13 is a broad discretion. As
Simon Brown LJ ,as he then was, said in 1abarv`. case Cov.iaeratiov of tbe
vav, avtboritie. iv tbi. fieta .vgge.t. tbat tbere are vo tovger av, ab.otvte ¡rivci¡te. iv
¡ta,, .are ovt, ¡erba¡. tbat tbe ivtere.t. of ;v.tice vv.t be tbe caraivat cov.iaeratiov.`
1o use Beldam LJ`s phrase in lletcher the power in section 13 "vv.t ta/e
ivto accovvt att a.¡ect. of tbe ivtere.t. of ;v.tice, ivctvaivg tbe ¡vbtic ivtere.t ava tbe
ivtere.t of tbe a¡¡ticavt`.
43. I respectíully submit that the section 13 test is clearly satisíied in this case.
My Lords, I ask you to grant my Application.
9
1he Lord Chieí Justice, the Lord Chancellor the Chieí Coroner

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