Ground 2
37 In the document dated 1 December 2004, received by the plaintiff's solicitors on 6 December 2004, the third defendant, described as the convenor of the Appeal Panel, recorded that the panel had conducted a preliminary review (by telephone conference) and considered there should be a further examination of the deceased by a urologist. The panel determined:
"1. The [deceased] is required to submit himself for a further clinical examination by Dr Greg Watters, to be arranged by the Commission.
2. It is not necessary to consult with any treating practitioners and/or health care professionals who have been involved in the [deceased's] care.
3. Following the examination, Dr Watters is to provide a report for the panel's consideration."
38 Dr Watters conducted that further examination on 15 December 2004 (according to the Appeal Panel's statement of reasons, Exhibit A, p 6) and proceeded to act on Dr Watters' report without further notice to the deceased. The deceased was not served with a copy of the report and no hearing followed Dr Watters' assessment.
39 Mr Jackson submitted that the procedure followed contravened s 328, and that the decision reached "was made in want of procedural fairness", and hence that the panel "acted beyond jurisdiction".
40 Mr Jackson referred to the judgment of Brennan J in Kioa v West (1985) 159 CLR 550 at 612-613 where his Honour said as to the concept of natural justice:
"The principles of natural justice have a flexible quality which, chameleon-like, evokes a different response from the repository of a statutory power according to the circumstances in which the repository is to exercise the power. The variable content of the principles of natural justice was articulated by Tucker LJ in an oft-cited passage in his judgment in Russell v Duke of Norfolk [1949] 1 All ER 109, at p 118.:
'The requirements of natural justice must depend on the circumstances of the case, the nature of the inquiry, the rules under which the tribunal is acting, the subject-matter that is being dealt with, and so forth. Accordingly, I do not derive much assistance from the definitions of natural justice which have been from time to time used, but, whatever standard is adopted, one essential is that the person concerned should have a reasonable opportunity of presenting his case.'
In the Privy Council that passage was cited with approval in University of Ceylon v Fernando [1960] 1 All ER 631. and again in Furnell v Whangarei High Schools Board [1973] AC 660, at p 679. where Lord Morris of Borth-y-Gest said:
'Natural justice is but fairness writ large and juridically. It has been described as "fair play in action".'
The same view was adopted in the House of Lords: Wiseman v Borneman [1971] AC 297, at pp 308, 309, 311, 314-315..
In this Court the flexibility of the principles of natural justice was recognized by Kitto J in Mobil Oil Australia Pty. Ltd v Federal Commissioner of Taxation (1963) 113 CLR 475, at p 504.:
'What the law requires in the discharge of a quasi-judicial function is judicial fairness. That is not a label for any fixed body of rules. What is fair in a given situation depends upon the circumstances. And it is not a one-sided business.'
In Reg. v Commonwealth Conciliation and Arbitration Commission; Ex parte Angliss Group (1969) 122 CLR 546, at pp 552-553., the joint judgment of all members of this Court cited with approval passages I have cited from the judgments of Tucker LJ and Kitto J Their Honours said (1969) 122 CLR, at p 553:
'It is plain that when it is necessary to consider a question of fairness in relation to a tribunal the whole of the circumstances in the field of the inquiry are of importance. The nature of the jurisdiction exercised and the statutory provisions governing its exercise are amongst those circumstances.'"
41 As was made clear in the above passage and in the authorities there cited, the "variable content of the principles of natural justice" is influenced by the particular circumstances, including the relevant statutory content.
42 Section 328 of the WIMWC Act is in these terms:
"(1) An appeal against a medical assessment is to be heard by an Appeal Panel constituted by 2 approved medical specialists and 1 Arbitrator, chosen by the Registrar.
(2) The appeal is to be by way of review of the original medical assessment. The WorkCover Guidelines may provide for the procedure on an appeal.
(3) Evidence that is fresh evidence or evidence in addition to or in substitution for the evidence received in relation to the medical assessment appealed against may not be given on an appeal unless the evidence was not available to the appellant before that medical assessment or could not reasonably have been obtained by the appellant before that medical assessment.
(4) When attending an Appeal Panel for the purposes of an assessment, an injured worker is entitled to be accompanied by a person (whether or not a legal adviser or agent) to act as the injured worker's advocate and assist him or her to present his or her case to the Appeal Panel.
(5) The Appeal Panel may confirm the certificate of assessment given in connection with the medical assessment appealed against, or may revoke that certificate and issue a new certificate as to the matters concerned. Section 326 applies to any such new certificate.
(6) The decision of a majority of the members of an Appeal Panel is the decision of the Appeal Panel."
43 Mr Jackson invited attention to the words "is to be heard" in sub-s (1) and to the provision enabling the injured worker to be accompanied at an attendance before the Appeal Panel by a legal adviser in sub-s (4).
44 Mr Jackson also relied upon the content of Practice Direction 8, which relates to appeals against medical assessments made under Pt 7 of Chapter 7 of the WIMWC Act. The practice direction in force when the Appeal Panel considered this matter was in the form as revised on 11 September 2003.
45 The practice direction addressed the procedures to be adopted by an appeal panel acting under s 328 in these terms:
"The Appeal Panel may adopt the following procedures, in accordance with the needs of the individual case:
s Preliminary Review (in all matters),
s 'On the Papers' Review,
s Further Medical Examination,
s Assessment Hearing.
Preliminary Review
Where the parties have lodged the necessary documentation in relation to the appeal and the Registrar has determined that at least one ground of appeal has been made out, the appeal may be referred to the Appeal Panel for preliminary review. The Appeal Panel will conduct a preliminary review of the matter in the absence of the parties.
Following the preliminary review the Registrar will advise the parties in writing of whether the Appeal Panel:
s will allow 'fresh evidence' to be submitted and, if so, what will be allowed,
s will conduct a further medical examination of the worker and, if so, the time and place of the examination,
s requires any further information, for example, medical records and evidence of treating practitioners,
s is of the view that the matter is capable of determination on the papers, and
s has set a date and time for the parties to attend an assessment and nominated who is required to attend.
On the Papers Review
Wherever possible the Appeal Panel will proceed to review the assessment on the basis of the documents provided by the parties. It is essential that the parties state their view on this issue in the application and reply to the appeal. Where the parties and the Appeal Panel agree to the matter proceeding 'on the papers' the Appeal Panel will review the assessment and the parties will be advised in writing of the outcome.
The parties may also request that the Appeal Panel deal with the matter 'on the papers' following receipt of the report of the further medical examination and prior to the assessment hearing.
Further Medical Examination
The Appeal Panel will not conduct a further medical examination of the worker in all matters. A further medical examination of the worker may be undertaken only where the appellant demonstrates to the Appeal Panel that:
s it was not reasonable or practicable for the worker to have been examined at the time of the first medical assessment,
s the previous examination by an AMS was materially defective,
s the examination will provide fresh evidence of deterioration of the worker's condition,
s the examination is necessary to show that the medical assessment certificate contains a demonstrable error,
s the examination is necessary to enable a proper medical assessment to be made.
The Appeal Panel may also require a further examination of the worker where specific questions or issues before the Appeal Panel can be answered only by a clinical examination.
Where necessary an AMS member of the Appeal Panel will carry out the further examination and a report will be provided to the panel and the parties . The Registrar will advise the worker of the time and place of the examination. A parent, carer or support person (other than an agent or legal adviser) may accompany a worker to the examination." (Emphasis added)
46 Mr Jackson submitted that the practice direction was not complied with because Dr Watters' report was not provided to the plaintiff and no opportunity was afforded to him to address its content, and in particular the history it apparently recorded that the plaintiff made no complaint that back pain was a limiting factor in his attempts to have intercourse.
47 Curiously, unlike the Practice Direction, the Medical Assessment Guidelines made pursuant to ss 328, 331 and 376 of the WIMWC Act contained no requirement for service of the medical report prepared for the Appeal Panel.
48 The relevant guidelines were published on 19 December 2003, some three months after the Practice Direction upon which Mr Jackson here relies. Paragraph 43 of those Guidelines outlines what is to happen following the lodgement of an appeal:
43. The Appeal Panel, comprising two AMSs and an Arbitrator, will undertake a preliminary review of the documents. The parties are not present for this preliminary review. The Appeal Panel decides on the appropriate action to take in the appeal including whether the worker should be examined and if new evidence should be allowed. The Appeal Panel may set a date for an assessment hearing or may decide the appeal on the papers without further involvement from the parties.
If the Appeal Panel decides that the worker should have a further medical examination, an appointment time will be arranged with one or both of the AMS members of the panel.
These procedures are detailed further below.
49 In para 44 the guidelines address what is to happen in a case where the Appeal Panel determines there ought to be a further medical examination. Para 44 provides:
"The Appeal Panel may require a further medical examination of the injured worker. The Registrar will inform the worker in writing of the time and place for the further medical examination.
One of the AMS members of the Appeal Panel may be asked to examine the worker in order to answer a particular question put by the panel or a party. The worker should not bring any additional medical or other reports to the examination, unless specifically asked to do so. If it is necessary to bring X-rays or similar documents the worker will be advised of this in the letter from the Registrar.
A parent, carer or other support person may accompany a worker to a further medical examination if it is reasonable in the circumstances and the AMS agrees. An agent or legal practitioner must not accompany a worker to a further medical examination."
50 It is to be observed that the guideline imposes no requirement for the service of a report following the examination contemplated in para 44.
51 Paragraph 44 does not countenance a legal practitioner attending on the medical examination so that if para 44 of the guideline and s 328(4) are to be read consistently, what s 328(4) contemplates is an attendance by the plaintiff at the Appeal Panel other than an attendance upon one of its members for the purposes of a medical examination.
52 Paragraph 45 of the guideline makes provision for what is to happen at an assessment hearing
"The appeal is to be by way of review of the original medical assessment. Any party may bring a legal practitioner or other person with them to the assessment hearing to act as advocate and to assist in the presentation of the case.
The assessment hearing is informal and non-legalistic and will afford the parties a full opportunity to present oral submissions in support of their claims. Submissions must be limited to topics that were in issue in the medical assessment being appealed against. Fresh evidence cannot be given either instead of or as well as evidence that was considered by the original AMS, unless the evidence was not available or could not reasonably have been obtained by the worker.
The assessment hearing is non-adversarial and in most cases no evidence will be taken or cross-examination permitted. The parties may seek clarification of matters raised through the assistance of panel members.
The assessment hearing will be sound recorded and a copy of the recording will be available to the parties on request. "
53 Whatever be the explanation for the difference between the practice direction and the guidelines, I accept the submission of Ms Allars that in the present context greater importance is to be attached to the guidelines.
54 The guidelines were made pursuant to ss 328, 331 and 376 of the WIMWC Act, and s 331 provides:
"Medical assessments, appeals and further assessments under this Part are subject to relevant provisions of the WorkCover Guidelines relating to the procedures for the referral of matters for assessment or appeal, the procedure on appeals and the procedure for assessments."
55 Additionally, s 328(2) contains the provision, previously noted, that "the WorkCover Guidelines may provide for the procedure on an appeal."
56 The practice direction, on the other hand, is issued pursuant to a Rule of the Commission. Section 364 enables the making of Rules of the Commission "for or in respect to any aspect of procedures to be followed in connection with the jurisdiction or functions of the Commission". Rule 89 is a Commission Rule whereunder the President, in consultation with the Deputy President, may issue practice directions in relation to the operation of the rules.
57 In context, I do not consider that s 328(1) of the WIMWC Act compels the conduct of an adversarial hearing. An appeal is to be "heard" by a three person panel, but the Practice Direction and, more importantly, the Guidelines contemplate that the Appeal Panel may determine how the Appeal is to proceed. Under para 43 of the Guidelines, the Appeal Panel is authorised either to set a date for an assessment hearing, or to decide the appeal on the papers, without further involvement from the parties. The Guidelines do not specifically mandate an assessment hearing if the Panel decides that there ought to be a medical examination.
58 Nor do I consider s 328(4) ought to be construed as making an assessment hearing obligatory. What the subsection does is to entitle an injured worker to be accompanied to an Appeal Panel hearing, if such a hearing is conducted.
59 Under para 41 of the Guidelines, the respondent to the appeal has fourteen days to file a reply in relation to the appeal, including any submissions the party wants to make concerning the grounds of the appeal. The Practice Direction set out earlier (at para 45) contemplated review "on the papers" and stressed the need for parties to state their view as to such a review when replying to the appeal (see the paragraphs under the heading "On the Papers Review").
60 In the present case, detailed submissions were filed on behalf of the deceased, together with medical reports, and in those submissions the deceased submitted "that the appeal should be determined on the papers". Of course that was before notice was given of the Panel's determination that there should be a medical examination, but that determination did not prompt the deceased to revise his submission that the matter should be determined on the papers.
61 It is not without significance that the examination was conducted by one of the Panel members, who was to report to the Panel. It is reasonable to conclude from the statement of the Panel's reasons that Dr Watters' examination influenced his decision and that his report influenced the other members of the Panel.
62 The Appeal Panel was entitled to draw upon the expertise of one of its members, as plainly it did in this case. It was entitled to take into account that expertise and the conclusions reached by that expert without disclosing those conclusions to the deceased, before coming to a final conclusion. In making a submission to this effect, a submission which I accept as correct, Ms Allars referred to the decision of the Federal Court in Minister for Health v Thomson 1985 8 FCR 213, a case concerning alleged over-servicing by a medical practitioner. The Committee considering the matter was a committee of five medical practitioners. It was determined that the Committee was entitled to act on its own views without disclosing those views to the medical practitioner before the Committee. In his judgment in this case, Fox J said at 217: