UPDATED: Alfie parents lose latest Appeal Court battle

The parents of 23-month-old Alfie Evans, who has been at the centre of a life-support treatment battle, have had their latest legal challenge dismissed by Court of Appeal judges in London.
A man and woman (both centre), believed to be members of a German air ambulance crew, exit Liverpool's Alder Hey Children's Hospital after they were asked to leave the hospitalA man and woman (both centre), believed to be members of a German air ambulance crew, exit Liverpool's Alder Hey Children's Hospital after they were asked to leave the hospital
A man and woman (both centre), believed to be members of a German air ambulance crew, exit Liverpool's Alder Hey Children's Hospital after they were asked to leave the hospital

Three Court of Appeal judges have dismissed another challenge by Tom Evans and Kate James, who are both in their early twenties and from Liverpool.

The couple, who want Alfie to be cared for in a Rome hospital, appealed following a ruling made by a High Court judge late on Tuesday.

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But appeal judges on Wednesday dismissed their challenge following a hearing in London which the couple did not attend.

The judges gave rulings on the appeal grounds brought by the father first and then by Alfie's mother.

They have rejected all grounds raised by the parents.

The 23-month-old confounded doctors' expectations when he continued to live after life-support was withdrawn on Monday night, his father, Tom Evans, said.

Appeals have been made on the Alfie's Army Facebook page for ventilation equipment to be brought to Alder Hey Children's Hospital.

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Alfie's aunt Sarah Evans wrote: "Please continue to pray Alfie is still fighting."

Supporters were later seen running into the hospital entrance with what appeared to be medical equipment.

Alfie's dad Tom Evans has told ITV's This Morning his son is now being given food again after surviving for 36 hours without life support.

He said: "Alfie is doing still as well as he can. He's fighting. He's still not suffering and hasn't had any apnoeas or no sign of pain.

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"He's sustained his life, like any other child would, for 36 hours. Totally unexpected of him.

"I believe I am getting closer (to getting him home). We would be happy with that.

"But we would be more blessed to get him to Italy where he needs the treatment.

"He may need a tracheotomy, he may not. But at the moment he is showing he's still fighting and he's proved all the docs wrong and all the courts wrong.

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"We were told he wouldn't last five mins but now here we are 36 hours down the line."

During the This Morning interview, Mr Evans was asked how long it would take to get him home.

He said: "They have said in the court case yes it would take three days to observe Alfie and then three days to get the parents ready to go home.

"Alder Hey have decided to leave Alfie like this so he struggles and stops breathing and has apnoeas (suspension of breathing) because he has got a small infection.

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"Alfie just needs out as soon as possible while he's fighting and still breathing.

"That's the best option for him now where he can have a tracy [tracheotomy] and a pipe feed and they would probably get us home quicker.

"Alder Hey are just doing anything to put a grudge on him.

"I just don't see why it's fair why Alder Hey's barrister is fighting so hard against me to not release my son.

"He's proving that barrister wrong now. I'm so proud of Alfie and that's why I'm so devoted to him.

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Asked if he had given up on taking their son to Italy, Mr Evans said: "No, we haven't to be fair.

"Yesterday my barrister gave me an option of two things: to appeal against the Court of Appeal or to collaborate... to get him home.

"I agreed to getting us home because I couldn't take any more of these court cases being denied."

He said a Court of Appeal officer later phoned his barrister to say three judges were on stand by if the family changed their minds and wanted a further appeal.

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Asked how he and his wife Kate were coping, he added: "Just as well as Alfie is coping. We just bounce off him.

"They only started feeding him at one 'o'clock yesterday. It's disgusting how he's being treated. Not even an animal would be treated like this.

"He's proving them wrong. It's time to give him some grace and dignity and let him go home or to Italy."

Two people, believed to be members of a German air ambulance crew, were asked to leave the hospital on Wednesday afternoon.

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The man and woman, seen speaking to members of the Evans family, were escorted from the hospital by police and security staff.

Leading judges have begun hearing the latest plea on behalf of the parents of seriously ill Alfie Evans.

The latest round of the legal battle over the 23-month-old is being heard by Lord Justice McFarlane, Lady Justice King and Lord Justice Coulson at the Court of Appeal in London.

Alfie's parents, Tom Evans and Kate James, from Liverpool, are challenging a High Court judge's decision that their son cannot be moved from Alder Hey Children's Hospital to a hospital in Rome.

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The start of the hearing was delayed for half an hour to wait for the arrival of one of the barristers in the case.

At the outset, Lord Justice McFarlane described the appeal as an "important matter".

Jason Coppel QC said Alfie's mother Kate James had told him: "Alfie is struggling and needs immediate intervention."

The judges heard that Ms James is now represented by a different barrister from Alfie's father.

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After a short adjournment Mr Coppel said he had just spoken to her by telephone.

He said: "I have spoken to her directly.

"The purpose of the phone call was to say that Alfie was struggling and needed immediate intervention to ensure that he survives at least for the purposes of today and she asked me if I would pass that on to the court and ask that the court invite the hospital to take the appropriate steps."

Alfie's parents were not at the appeal hearing.

Arrangements were made to allow Mr Evans to listen via a phone link.

Paul Diamond, counsel for the father, said: "There is a military air ambulance on standby at the request of the Pope."

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Judges said they had been told that Mr Evans had talked about taking out private prosecutions against three doctors for "conspiracy for murder".

Mr Diamond said: "My general conversation with Mr Evans is 'save my boy'."

He added: "He would leave no stone unturned... He is clutching at straws."

One appeal judge, Lady Justice King, told the court: "There is an acceptance that Alfie is dying."

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Mr Diamond argued that there had been a "significant change of circumstances" because life-support treatment had stopped, but Alfie was still breathing.

He said an "alternative" was available.

Mr Diamond said there were "tensions', but that there was no "hostility'" against the NHS.

Lord Justice McFarlane told counsel: "Your client purported to take out a private prosecution to have three named doctors charged with the criminal offence of conspiracy to murder.

"Those summonses were served on the doctors and I hear you say that there is no hostility to the NHS."

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Mr Diamond replied: "There is no hostility but within that process there are tensions."

Lord Justice Coulson said: "There are rather more than tensions."

The accusation related to "the most serious possible offence".

The judge went on: "That simply doesn't square with there being no hostility to the NHS. As my children would say 'end of'".

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In a live video posted on Facebook, Mr Evans said Alfie's life had been "sustained" for a third time.

He said: "The warrior strikes again. He's back. He's just had a little dip, he went pale, lips started going a little bit but he's back."

He added: "Just wanted everyone to know Alfie's stabilised."

Mr Diamond said that circumstances had now changed and that the family should "not be bound by a decision which is now three months old".

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Mr Diamond said Alfie could be "kept prisoner" in hospital "when there is alternative, fantastic care available for him".

He told the judges: "We submit there is a likelihood of Alfie having some pleasure in life. That is beyond our knowledge."

Lady Justice King said: "That is not the evidence.

"The evidence is that he is unlikely to have pain, but that tragically everything that would allow him to have some appreciation of life, or even the mere touch of his mother, has been destroyed irrevocably."

Mr Coppel, making his submissions on behalf of Ms James, said that what had changed was the progress and continued survival of Alfie and the granting of Italian citizenship.

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Lord Justice McFarlane pointed out during the proceedings that "the only determining factor is the best interests of Alfie".

The judge added: "What rights others have, particularly the parents, falls into a subsidiary category..."

Michael Mylonas QC, for the hospital trust, said Mr Diamond had accepted "categorically" before the appeal court and before Mr Justice Hayden that "there is no new medical evidence to contradict the evidence" that was before the High Court in February.

He added: "There is not a single piece of evidence he has adduced to say there is any new evidence at all, let alone any compelling evidence."

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Mr Mylonas said: "It was never suggested that death would be instantaneous.

"In fact, to the contrary, the evidence had been that when previously extubated he survived.

"It has never been said to this family that Alfie would die immediately or before sundown.

"No doctor could have said that."