Future Care
82As the parties have done, I will deal with general future care, any additional care during child care periods, and vacation care separately. Before providing any calculation of the allowances I make, I will resolve the life expectancy issue.
83In her second report dated 20th March 2012 (exhibit E-10) at page 45 [7.5.7], Ms. Morris, the plaintiff's qualified occupational therapist, prescribed a care regime of 6 hours per day to be delivered in two shifts of three hours each. She said the morning shift could be omitted when Mr. Clegg worked. In her second report dated 28th September 2011, exhibit 3(G), the defendant's qualified occupational therapist Ms. Dawn Mills revised her prescription upwards to a total of thirty hours per fortnight, including two hours allocated to heavy domestic work. Ms. Mills effectively recommended two hours of domestic and cognitive assistance per day.
84The occupational therapists met in conclave on 18th May 2012 and produced a joint report. Although they agreed on most issues, they did not agree on the care prescription. Ms. Mills maintained her previous position whilst Ms. Morris revised her position downwards to three hours per day of care plus six hours per week of domestic assistance. I understood this to be effectively four hours per day.
85Before the occupational therapists gave concurrent evidence, I was informed that both experts want to vary from aspects of the joint report (295.20T). I expressed my strong disappointment at this apparent necessity, but on the basis that experts have an obligation to inform the Court of changes in their position (see Rule 31.27(4) Uniform Civil Procedure Rules 2005), I adjourned to enable the supplementary report contemplated by the rules in those circumstances to be prepared. The handwritten addendum was tendered (299.25T) as part of exhibit E-11. I included it in the plaintiff's tender bundle and numbered the pages 197A - 197D.
86There were two changes of opinion. First, Ms. Morris for reasons I will discuss reverted to her previous position recommending 6 hours per day in split shifts. The second matter related to the topic of childcare. Although the original joint report had expressed agreement about the matter, it was attended by a great deal of ambiguity of expression. It transpires there was no agreement at all, but I will return to this topic when I deal with the question of additional care during periods of childcare. Although the addendum, or supplementary report, contains opinions about holiday care, those opinions are a restatement of what appeared in the original joint report.
87To understand and evaluate what caused Miss Morris to revert to something like the position set out in her report of 20th March 2012, it is necessary to set out some of her evidence as follows (311.40 - 312.25T):
HIS HONOUR: ...Can I ask this question of you, Miss Morris. What's changed since the original meeting which has caused you to up the basic hours that you have suggested for care?
WITNESS MORRIS: I think initially I have lumped in child care and daily living support all together and come up with a calculation, and I think that's got very confusing. I think the initial joint report, Miss Mills was confused as well in the end when we reread it.
HIS HONOUR: What I wanted to know, in the original report you have said Mr Clegg requires six hours per day (sic) [3 hours per day] of daily living support plus six additional hours per week but in the addendum that's provided today, you have said that he requires six hours per day of daily living support. Now my first question is, is that still in addition to the six hours of domestic assistance?
WITNESS MORRIS: No. What I have said, that's including everything. That 44 is inclusive of domestic assistance. The child care I have separated out as something entirely different. There is a couple of things that came to light. I think one was Jeremy actually physically assaulting his partner, and I think for him to have taken his behaviour to that next level of physical assault requires greater monitoring of his behaviour in the community, and also the fact that these social sponges or whoever they are I don't know but I am hearing about sponges who are circling means that Jeremy is not busy enough to be away from that and engaged, so if he had the greater six hours a day, he would be occupied doing something that's meaningful for him, therefore he would be more exhausted and tired and his routine would be more structured, or if it was broken up where he had three hours in the morning, three hours at night, that situation would also be monitored as well. He is incredibly vulnerable, your Honour, and that's my thought, and that's not going to change.
HIS HONOUR: When you saw him twice, I think, in March of 2012, did you get any history at that time of the sponges?
WITNESS MORRIS: No.
...
This evidence continued at 315.25 - 315.50T:
HIS HONOUR: I think, Miss Morris, what Mr Rewell is trying to find out, if your understanding was wrong, would what that change the prescription? If your understanding of the events that we are speaking of is wrong, would that change the prescription?
WITNESS MORRIS: I think the response is, that's the other side of the situation: His vulnerability, his behaviour. Having a brain injury means that he has done something that's violent against another human being, but also the sponges are circling which means he is apparently drinking alcohol. He is becoming more and more socially isolated and withdrawn and these people are taking advantage of him. Without structured care programmes in place, he is going to continue down in a spiral.
REWELL: Who told you about sponges?
WITNESS MORRIS: It was from counsel today.
REWELL: When you went there to the home in August 2011, you didn't hear anything about sponges from anyone, did you?
WITNESS MORRIS: No.
REWELL: Neither from Jeremy, nor his mother, nor his partner?
WITNESS MORRIS: (Witness shook head.)
88Ms. Mills also gave evidence on this topic (316.40 - 317.40T):
HIS HONOUR: Miss Mills, do you have a view about this topic. There are two sets of assumptions. You have put one set of assumptions and you have heard the assumption that Miss Morris made. If Miss Morris' assumption that she was asked to make by Mr Clegg's lawyers is proven in this Court, does that make any difference to what you think should happen by way of care?
WITNESS MILLS: Are you referring to both issues of the vulnerability and the inappropriate aggression?
HIS HONOUR: Let's take them one at a time. Let's take the assumption that Jeremy was aggressive with Jacqui, his former partner.
WITNESS MILLS: And whether that's an issue of brain injury requiring extra care?
HIS HONOUR: Yes?
WITNESS MILLS: Again, it's very hard to comment on, of course, without knowing all the facts and evidence and that sort of thing, but in these situations and I know of course we are talking about somebody with a brain injury, but I try and also look at the bigger picture of society as a whole and these things happen whether you have a brain injury or not in normal daily life, unfortunately so whether it was related to his brain injury and therefore equals more care, no, I couldn't say that on just the information that I have just been given because again, these things happen in day to day life.
HIS HONOUR: The other issue as a means of linguistic shorthand, we will talk about the sponging. If I accept the evidence which suggests that sponging is going on on pay day or pension day, does that make any difference to the prescription that ought to be put in place in this case?
WITNESS MILLS: So we will theoretically say there is sponging going on one day a fortnight on pension day?
HIS HONOUR: Particularly then?
WITNESS MILLS: Certainly vulnerability is an injury in brain injury. When I assessed Jeremy, that wasn't mentioned at all as a problem. This is the first time this has been brought up, even in the other psychiatric and rehab specialist reports, there wasn't that particular issue raised as a particular risk for Jeremy needing care or supervision. Again, I couldn't say that it was a particular issue that would create the need for more care. What I would say is that as a case manager myself, if these issues come up when managing a programme, you are aware of it. Your role as a case manager is then to get to the bottom of what that problem is, go and meet with the family or the person and the carers and work out strategies to address that problem, so it would be things like when does this happen? If it seems to happen more when Jeremy has some cash on him, perhaps organise his environment or his days so that he is less likely to be vulnerable to those people dropping around. Also in cases similar to Jeremy's and his carers, there is often a whole set of issues in terms of boundaries. There are certainly other ways to deal with it that don't always equal providing more care.
89These extracts are not intended to be exhaustive, but rather representative of the evidence given on this topic by the experts. It's obvious that neither Ms. Morris nor Ms. Mills received a history of the particular aspect of vulnerability constituted by acquaintances sponging money from the plaintiff at the time they carried out their assessments. Both experts separately attended upon the plaintiff in the plaintiff's home for the purpose of carrying out their assessments. None of the medical practitioners received any such history. The plaintiff, who as I have said was in some respects quite articulate, gave no evidence to support the concern underpinning the opinion of Ms Morris.
90The evidence which, if accepted may support a concern about this aspect of vulnerability, came from the plaintiff's mother, Mrs. Clegg, and from his brother, Mr. Jamie Clegg. I consider it fair to remark that Mrs. Clegg attended upon the medical examinations with her son.
91Mrs. Clegg's evidence is at 48.5 - 30T; 57.5 - 58.5T; 58.30 - 59.5T and 60.35T. Mrs. Clegg said that as many as five new friends turn up around payday if he is working, or pension day if he is not, and hang around until the money is gone, by which she meant they look to the plaintiff to buy them alcohol and perhaps pot. In cross-examination Mrs. Clegg said that this had been going on for at least eight or nine months. She thought that the group were sponging off him (75T.30 - 45).
92The plaintiff's brother gave evidence about this topic from 148.20T - 151.20T. Mr. Clegg said there were between 15 and 20 in the group who induced the plaintiff to buy alcohol and pot.
93The brother's evidence was rather different from that of Mrs. Clegg. He said that he thought his brother was a target for them to use and abuse. He numbered these people as between 15 and 20. He said they come as often as they can when they know he has money. They induce the plaintiff to buy alcohol and pot. He said this goes on almost every night between the hours of 9 and 3 or 4 in the morning. They disappeared when the money ran out. This situation had been going on since Mr Jamey Clegg moved back into the house sometime during 2010.
94He also gave evidence that the plaintiff was drinking every day to the point of intoxication, when he became very aggressive (153.30 - .50T).
95In cross-examination Mr. Rewell put it to Mr. Clegg that his evidence about these matters is exaggerated as to simply be false, a proposition Mr. Clegg denied: 161.25T; 168.20 - .30T. Mr. Clegg denied that the plaintiff was simply being a mate who might be prepared to buy a box of beer for the group when he had more money than the rest.
96Notwithstanding Mr. Clegg's description of his brother's incapacity and vulnerability, he agreed that whenever he was working the plaintiff, was up, organised and at work on time. He was out the door before the witness: 164.20 - .35T.
97The plaintiff's evidence varied from that of his mother and his brother on this topic. Having given evidence that he did not see much of his old friends except my best friends including Mr. Kevin Lou, whom he regarded as a brother. He gave evidence about seeing two younger fellows who live across the road from him aged 16 and 17 respectively every day: 189.10-25T. These two young fellows were amongst the new friends his mother and brother had described as being of concern. The plaintiff was not asked any further questions in chief that might have elicited evidence of the kind given by his mother and brother. At 189.30 - 35, the following evidence appears:
Q. Are you seeing other people than those two people as well apart from your old friends? Are there other people in the area?
A. My exgirlfriend's sister, I speak with her a lot. She is a really nice girl and her boyfriend and then, that's it.
Q. You are seeing people these days with whom you will have a drink?
A. Yeah
Q. Who are they?
A. Just like all of them really. Like everyone I know drinks except Kevin [Lou].
Q. I'm not talking about your old friends but other people in the area?
A. Other people in the area? No.
98In cross-examination (228.5T) he confirmed that he did not drink with those young fellows. He said there were no friends or acquaintances with whom he had a drink on a regular basis. He did see the two young fellows across the road on a payday, but he said they don't actually come over, it's a rhythm for me to go over there on payday, like its just what I am used to.
99He gave evidence that he did have a beer or two around the barbeque with his brothers. This was occasionally (228T.45). His evidence was that he drank if I am lucky, once a fortnight. One or two or three is a lot of beers for me. Initially he told me he drunk infrequently and that he never got completely drunk especially with my brain injury (229.20 - 230.5T). He then changed his evidence slightly and explained that he didn't limit his drinking all the time. He maintained that he only drank too much occasionally. At 230.30T he said:
I mean by a standard six-pack I am splattered
At 231.10-15T he confirmed that after four or five beers he was splattered.
100Although the evidence I have recounted is not entirely clear, I have concluded that the account given by the plaintiff probably represents the true situation. From this I infer that there is no particular problem with groups of people sponging off the plaintiff. Generally he is reasonably abstemious, imbibing only two or three beers a fortnight. Occasionally he drinks more perhaps as many as six stubbies of beer which makes him very drunk. This has to be looked at in the context of his brain injury. Before the accident he was a young man who may have been able to tolerate significantly greater quantities of alcohol.
101The plaintiff did not give any evidence from which it could be inferred that there was a real problem with people sponging from him. That matter does not figure greatly in the histories recorded by the experts he has seen for the purpose of the case. The differences in degree between the evidence of Mrs. Clegg and Mr. Jamey Clegg makes it difficult for me to accept the accuracy of the evidence of either of them on this point. I think there is force in Mr. Rewell's submission that Mr. Jamey Clegg was exaggerating to assist his brother's case. This is probably an understandable human trait born out of a genuine concern for his brother's welfare, but I felt his evidence about this topic was unreliable and I will not act upon it.
102Moreover, both occupational therapists agreed that the care prescription should include a large component of both occupational therapy and case management. Ms. Mills gave evidence that it was part of the role of the case manager to get to the bottom of what [the] problem is, go and meet with the family or the person and the carers and work out strategies to address that problem. Her evidence was that there are other ways of dealing with the sponging issue that don't always equal providing more care: (317.25 - 40T). Although maintaining that a greater number of hours was required by way of care, Ms. Morris seemed to me to agree with this general approach: 318.15 - 30T. Furthermore, I observe the parties have agreed that an allowance should be made for fund management to reflect the orders already made by the Court. I would envisage that proper attention to duty by the fund managers will involve the adoption of effective strategies to guard against acquaintances sponging money off the plaintiff. I do not accept that Ms. Morris' reasons for reverting to her original prescription (or something like it) are firmly founded in the evidence that I accept.
103On the other hand, although I found Ms. Mills to be an impressive, measured and thoughtful witness, her prescription of two hours a day struck me as overly optimistic. Inherent in the nature of the exercise of assessing future care is the need to assess future probabilities and strike averages which have a certain artificiality about them. This is unavoidable.
104The evidence of the occupational therapists was not the only evidence touching upon this matter. As I have already pointed out both Dr. Buckley and Dr. Zeman had much to say about the matter, appropriately, although their starting points are very different. The following evidence appears 374.40T - 375.50
.... I want you to assume that for three years he worked and may continue to work on a call in basis, in other words when his employer needed him he was called in either at very short notice or something less than that, and reasonable notice, and that he came into work for up to three weeks at a time fulltime. During that period he would get himself out of bed in the morning without any prompting, that the remaining family members would stay asleep while he organised for his alarm to go off, got out of bed, showered, dressed, had his coffee, walked to the railway station, got the train, got on the of train at Penrith, walk to the work place and arrived punctually, all without the slightest prompting and supervision. Doesn't that sound against a need for any more than some short period of daily checking on how he is going with his routine?
WITNESS BUCKLEY: I must say that that scenario is more persuasive than I had received previously. If I make that assumption, then I think 24 hours a day is probably not required and I would need to look at a revision of how many hours a day of care and supervision he would need.
HIS HONOUR: Can I ask you a question about that. If those assumptions that Mr Rewell has just put are accepted by me as being soundly based on the evidence, Dr Buckley, and we were looking at some revision of your prescription, how does something along these lines sound to you, everyday, seven days a week, somewhere between two and six hours on average, maybe in some sort of split shift so there is more than one attendance during the day. On occasions when he has contact with his young children there is substantially more provided to assist with the needs of the children. That you have, as well, the rather extensive and intensive regime of case management and occupational therapy that Mr Rewell has asked you about, as well as devices in the home particularly in the kitchen, to guard against things being left on. Now, how does that regime sound as a potential revision of what you have been saying if the assumptions Mr Rewell has made are correct.
WITNESS BUCKLEY: Your Honour, I think that would probably be close to the mark. The issue I would want to cover to ensure this man has a reasonable quality of life would be personal care type supervision because I do think that his capacity, for example, to independently have his alarm right and independently get out of bed and do those things must be at risk from time to time. I believe that that structure is likely to breakdown very easily, and he therefore requires someone to cover the, particularly the mornings in terms of ensuring that he is getting out of bed, getting dressed, that he is eating something decent, that the place is clean. And in the second side of his requirement, for an activities programme and presuming, in the absence of work, where an activities coordinator type person would ensure that he has physical exercise, and then mentally stimulating activities regularly through the week.
Now my usual view of prescriptions in that type of scenario would be four hours a day, five days a week of the activities coordinator, two hours a day, seven days a week of the personal care type supervisor, and then the additional childcare supervision.
HIS HONOUR: Thank you, Dr Zeman, we know you have been there patiently for a long time, do you remember the question I asked? I assume from your point of view you think what I have asked Dr Buckley about is too much, but if one was a bit more pessimistic than you have been about the capacity of the plaintiff to cope on his own, is the type of regime I have described in the ball park?
WITNESS ZEMAN: I would agree your Honour, I think that would be reasonable because I also consider he would need some additional help anyway for say some shopping and cooking and paying bills and if you include all of that that would very much fit in with what you have just suggested as a general plan.
105This evidence came at the end of the case when the issues had been fully explored over five days of evidence. I find it persuasive. Doing the best I can, I am of the view that I should allow on average future attendant care services on a commercial basis of four hours per day, on the basis of a split shift. Additionally, I allow one hour of gardener/general handyman services per week. This will be calculated in accordance with scenario three of MFI 4.