The meaning of "complaint" - the parties' arguments
21The plaintiff submitted that since the complaints fell neither within s 7(1)(b) nor s 7(2), they were not made under the Act and the HCCC had no power to investigate them.
22It submitted that the complaints did not fall within s 7(1)(b) since the health service that it provided did not affect the clinical management or care of an individual client. It said that to fall within s 7(1)(b) the health service must actually influence an individual. Nor is it enough that the complainant alleges that the health service has that effect.
23The plaintiff submitted that the HCCC had to have an objective rationale or basis for concluding that there is an individual person, or persons, whose clinical care or management has been affected by the health service about which a complaint is made. In other words, the plaintiff submitted that the HCCC could not satisfy itself of this jurisdictional fact merely on the basis of an allegation made in the complaint.
24The plaintiff submitted that no distinction ought be drawn between the word "affects" in s 7(1)(b) and "directly affects" in s 59. The plaintiff submitted that both mean "produce a tangible result". It was insufficient for the health service to have such a tendency, if it could not be shown to have produced a tangible result in respect of an individual client.
25The plaintiff also submitted that the reference to "clinical management or care" ought be read as a composite phrase, as if Parliament had said "clinical management and clinical care". The plaintiff initially submitted that the word "clinical" imported an element of clinical judgment, which in turn would carry with it the requirement of some knowledge or understanding on the part of the health service provider of the client's personal circumstances and needs, and consideration by such a provider as to how the intended supply of the health service would affect those personal circumstances. The plaintiff referred to the Shorter Oxford Dictionary definitions of "clinic" and "clinical" and their etymology which derives from the Greek work for bed. The adjective "clinical" is relevantly defined in this text as:
"1 MEDICINE Designating or pertaining to teaching given at the bedside of a sick person, esp. In a hospital, and (branches of) medicine involving the study or care of actual patients ." [Emphasis added.]
26Accordingly, the plaintiff submitted that such a requirement would never be satisfied by information disseminated to the public at large. The plaintiff submitted that only complaints that concerned a particular health service supplied by a health service provider to an ascertained client which has affected the client's health, in the sense of producing an effect on the clinical care or management of individual clients are "complaints" for the purposes of the Act. Furthermore, he sought initially to distinguish between "advice" about which a complaint could be made under s 7(1)(b) and "information", and suggested that whereas the giving of advice would affect the clinical management and care of a client, the provision of information would be less likely to do so.
27However, the plaintiff accepted in oral argument that if I found that "care" should be read as an alternative to "clinical management", a complaint concerning a mother who had relied upon particular passages from the plaintiff's website to decide not to immunise her child could be a complaint under s 7(1)(b) since it could affect the care of an individual client. I took the plaintiff to accept that the making of such a complaint would confer jurisdiction on the defendant to assess and investigate it, notwithstanding that, in that scenario, the plaintiff might have neither knowledge nor understanding of the particular circumstances of the mother or the child and notwithstanding that it might be regarded as "information" rather than "advice". In that event, the causal connection would be established by an individual client relying on the information.
28Further, the plaintiff submitted that s 7(2) did not augment the process of complaint in s 7(1).
29The HCCC's primary submission was that s 7(1)(b) and s 7(2) provided separate avenues through which a complaint might be made under the Act.
30It submitted that it is sufficient for the purposes of s 7(2) that complaints were made against the plaintiff, which admits that it is a health service provider. It contended that any other construction would simply give no work for s 7(2) to do because a complaint about a health practitioner or health service will always be a complaint made "against" a health provider and would therefore be at odds with the principle of construction that all words are to be given some meaning and effect: Project Blue Sky Inc. v Australian Broadcasting Authority (1998) 194 CLR 355 at 381, per McHugh, Gummow, Kirby and Hayne JJ. It sought to confine the otherwise broad application of s 7(2) by submitting that the words permitting a complaint to be made against a health service provider ought be qualified by the gloss "in its capacity as a health service provider".
31Further, and in the alternative, it submitted that the action of the HCCC in the present case could be supported by s 7(1)(b).
32The HCCC submitted that the word "affects" in s 7(1)(b) ought not be read narrowly, particularly as elsewhere in the Act, for example in s 59, the word "affects" is qualified by the word "directly" thereby manifesting a Parliamentary intention that the word "affects" be read as encompassing indirect, as well as direct, effects. The HCCC submitted that the word "affects" is a word of wide import ( Yrttiaho v Public Curator (Queensland) (1971) 125 CLR 228 at 245, per Gibbs J). It relied on what McTiernan J said, in Shanks v Shanks (1945) 65 CLR 334 at 337:
"[I]n its ordinary usage, "affects" is a synonym for touching or relating to or concerning."
33The HCCC submitted that the expression "clinical management or care" should be read disjunctively, both because of the use of the word "or" and because not all of the health services within the definition, such as welfare services, health education services and forensic pathology services, would be relevant to "clinical management". It submitted that both complaints concern the plaintiff's health education service, which affects the care of an individual person who uses or receives such education. The HCCC submitted that it may reasonably be inferred that people access the plaintiff's website in order to obtain information about vaccinations to help them decide whether or not to have themselves or their children vaccinated, and that it is the plaintiff's intention that they do so. Children are "clients" because they use and receive the plaintiff's service through the agency of their parents.
34It contended that unless such a construction is adopted, it is difficult to see how a health education service could ever be said to "affect" the clinical management or care of an individual client and therefore be the subject of a complaint under s 7 since, by definition, a health education service will be one step removed from the actual provision of clinical management or care.
35The HCCC submitted that the section did not require that the client be an identified person and that the words "individual client" were merely another way of referring to a natural person or persons who received or used health services. Further, the HCCC put that a person may be said to use or receive health services merely by reading information provided by a health service provider such as the plaintiff. Such information was apt to affect (in the sense of touch or concern) the care of individual persons and therefore the HCCC had jurisdiction to assess and investigate the complaint.
36The HCCC submitted that I ought infer that the information the plaintiff has published on its website about vaccination has affected the decisions of people to vaccinate themselves or their children. It pointed to an extract from the website which was relied upon in the McLeod complaint which read:
"Unlike vaccination (which offers only temporary immunity), the natural occurrence of each of these diseases (measles, mumps and rubella) (all non-threatening illnesses in early childhood) generally results in lifelong immunity... Research also suggests that there is a connection between MMR vaccination and the development of autism, Crohn's Disease and Irritable Bowel Disease."
37Further, in so far as the HCCC had initially purported to justify its exercise of jurisdiction by reference to s 7(2), it submitted that if I find that its power resides under s 7(1)(b) but not s 7(2), the exercise of power would be nonetheless valid. It referred to the principle articulated in Lockwood v Commonwealth (1954) 90 CLR 177 at 184, per Fullagar J that:
"an act purporting to be done under one statutory power may be supported under another statutory power."
38It submitted that the qualification to the Lockwood principle: where there is a procedural or substantive difference in any material respect between the power originally relied upon and the power subsequently relied upon did not apply: cf VAW (Kurri Kurri) Pty Limited v Scientific Committee (established under s 127 of the Threatened Species Conservation Act 1995) [2003] NSWCA 297 at [12] - [60], per Spigelman CJ.