Findings regarding harm and impediments if returned to Vietnam
18 The appellant submitted that there was "doubt" as to whether the appellant would receive his medication in Vietnam and, so long as there was such doubt, the Tribunal should not have concluded that harm was absent, or that impediments had no significant weight.
19 The "doubt" is said to have arisen by the Tribunal's reliance on the judgment of the earlier Tribunal as to evidence, rather than viewing the evidence independently. For the reasons outlined above we do not accept this contention.
20 In addition, the appellant contended the "doubt" arose because the earlier Tribunal decision did not distinguish between schizophrenia and schizoaffective disorder and contended that it is possible that they are not the same condition and, therefore, the reliance in the earlier Tribunal decision on the availability of medication for schizophrenia is of potentially less weight for a person with schizoaffective disorder. Further, the appellant submitted that the language in the earlier Tribunal decision is guarded regarding the availability of a particular medication, paliperidone. For instance, the earlier Tribunal found that (at MRD[90]):
[t]here is no country information which suggests that the applicant's medication, paliperidone is not available to health professional [sic] in Vietnam. In fact, the available country information indicates that the applicant's medication is available in Vietnam.
(Footnotes omitted.)
21 Lastly, it was contended that the 2022 DFAT Report is expressed in such general terms that it does not displace the doubt flowing from the earlier Tribunal decision.
22 The basis for the claimed "doubt" appears to arise from the appellant's recrafting or refining his claim on appeal and then criticising the Tribunal for not dealing with issues which were not properly before it. It is not apparent that the issue of the distinction between schizophrenia and schizoaffective disorder was before the Tribunal. The appellant described himself as having a "schizophrenic disorder" before the later Tribunal. Further, as identified by the primary judge, the appellant's case before both Tribunals varied (at J[40]):
First, as indicated, the evidence before the MRD Tribunal, and indeed the 501CA Tribunal, varied as to whether the applicant's diagnosis is schizophrenia or schizoaffective disorder. Although the better medical evidence, being the psychiatrist's letter referred to at [27(2)] above, supports a diagnosis of schizoaffective disorder, some medical reports recorded his diagnosis as schizophrenia and his own statement said that he had "schizophrenic disorder". Since the applicant did not himself present a clear case to either tribunal on just what his true diagnosis is, the tribunals can hardly be criticised for not drawing such a clear distinction themselves.
23 In any event, as the Minister submitted, the earlier Tribunal identified and accepted that the appellant lives with schizoaffective disorder and did not confine its analysis of country information to the condition of schizophrenia only: MRD[77]-[80], [89]-[90]. The appellant has not established how the country information cited by the earlier Tribunal, at MRD[77], was irrelevant to the appellant's circumstances as a person with schizoaffective disorder. Relatedly, the primary judge had found that there was no evidence before the Tribunal to support "the premise inherent in the applicant's criticism, namely that the medication to treat schizophrenia and to treat schizoaffective disorder is necessarily different": at J[42]. There was no challenge on appeal in this respect.
24 In order for the Tribunal to validly exercise its jurisdiction, it did not need to definitively find that the appellant would or would not have access to medication in Vietnam (and by extrapolation resolve any doubt about the same). This is particularly so where there does not appear to have been any claim advanced, as referred to above, as to the need for a specific form of medication and consideration of its level of availability in Vietnam before the Tribunal.
25 To assist the appellant's argument he sought leave under s 27 of the Federal Court of Australia Act 1976 (Cth) to rely on fresh evidence on appeal, namely an article contained in the Journal of Psychiatry and Clinical Neurosciences referred to at footnote 65 to MRD[90] of the MRD decision (the article). The Minister opposed that application.
26 The relevant paragraph (and footnote MRD[90]), was extracted in the primary judge's reasons (see J[25]):
The Tribunal has accepted that the applicant suffers from schizoaffective disorder and that his mental health condition is significant. However, the Tribunal notes that his condition has been treatable. There is no country information which suggests that the applicant's medication, paliperidone64 is not available to health professionals in Vietnam. In fact, the available country information indicates that the applicant's medication is available in Vietnam.65 Therefore, as a citizen of Vietnam, the applicant would be able to access mental health facilities and treatment in Vietnam on an equal basis with other citizens of the country. There is no evidence to suggest that he would be systematically or discriminatorily denied access to mental health facilities in Vietnam.
64 Paliperidone is sold under the trade name INVEGA among others. It is a typical antipsychotic. It is marketed by Janssen Pharmaceuticals. INVEGA is an extended release formulation of paliperidone that uses the OROS extended release system to allow for once-daily dosing.
65 'Polypharmacy and psychotropic drug loading in patients with schizophrenia in Asian countries: Fourth survey of Research on Asian Prescription Patterns on antipsychotics' 14 May 2018 https://doi.org/10.1111/pcn.12676; onlinelibrary.wiley.com/doi/full/10.1111/pcn.12676
27 The power to admit further evidence is remedial. Its primary purpose is to ensure proceedings do not miscarry. As observed by a Full Court of this Court in BVZ21 v Commonwealth of Australia [2022] FCAFC 122 at [12] per Markovic, Thomas and Halley JJ:
In exercising the discretion, the Court will normally need to be satisfied that the further evidence, had it been adduced at trial, would very probably have meant that the result would have been different, and further that the party seeking to adduce the evidence was, at trial, unaware of the evidence and could not have been, with reasonable diligence, made aware of the evidence: Northern Land Council v Quall (No 3) [2021] FCAFC 2 at [15]-[16] (Griffiths, Mortimer and White JJ).
28 We refuse the application for the Court to receive the article. The article was neither before the Tribunal nor the primary judge. Indeed, the primary judge specifically referred to the fact that it was not before him: at J[41]. It is clear that the appellant was aware of the article's existence, given its reference in the MRD decision, at the time of both the Tribunal hearing and before the primary judge, and no application was made to rely upon it. No explanation is provided as to why, despite that awareness, it was not put before both forums. Lastly, it appears to relate to a refined claim, regarding the availability of certain psychotropic medication available in Asia, which was not the subject of any specific representation before the Tribunal.
29 The Tribunal referred to the limited evidence, arising from the 2022 DFAT report (at T[42]), regarding the variable quality of mental health treatment, that about half of Vietnam's provinces have a mental health facility at the main hospital and out-of-pocket cost of medication is low and affordable to most people. In addressing what the appellant had raised (again, in a general way) as the impediment he would face as a result of his mental health, "that he would not have access to sufficient mental health treatment" (T[50(b)]), the Tribunal found that he "would likely be able to access some medical treatment for his mental illness and because he speaks the language and has some family in Vietnam" (T[53]).
30 We do not accept that the Tribunal's conclusion that the appellant would not face harm or significant impairment on account of his mental illness in Vietnam constitutes irrationality or unreasonableness. Further, we consider it was open for the Tribunal to conclude that some treatment was available, on the basis of the information disclosed in its reasons, such that there was no irrational attribution of weight to a relevant consideration.