Whether the plaintiffs are entitled to have a medical expert of their choice present for the examination or whether r 23.5 of the UCPR ought be dispensed with
27The next question is whether, as the plaintiffs contend, they ought be permitted to have Dr Dinnen (in the case of the Rankin plaintiffs), or another psychiatrist (in the case of Ms Barlow-Smith), present for such examinations.
28The first basis on which the plaintiffs resist dispensation being granted to the defendants from the requirement in r 23.5 of the UCPR is that it is not, in substance, a "requirement", and therefore I do not have power to dispense with it under s 14 of the Act.
29The task of construing the Act and the UCPR is to be undertaken having regard to ss 56 and 57. The Act, which is to be read as a whole, includes s 61 which empowers the Court to make directions which are inconsistent with the rules. Although r 23.5 of the UCPR is not expressed in terms of a requirement, I consider that it does, effectively, impose a requirement on the examining expert. The examinee's right to have a medical expert present at such examination imposes, in my view, a correlative obligation, or "requirement", on the examining expert to permit such a person to be present.
30The mode of interpretation of the Act provided for by the specific provisions of the Act itself requires me to take into account, in construing the Act and the rules, the "just" determination of the issues and the "dictates of justice". I consider that the word "requirement" in s 14 of the Act is sufficiently broad to permit me to dispense with the requirement in r 23.5 of the UCPR that Dr Skinner permit another medical expert to be present. However, in any event, I consider that I would have the power to give the directions sought by the defendants under s 61 of the Act. As has often been said, the rules are the servants of justice, not the masters. That the Court may give directions that are inconsistent with the rules (s 61 of the Act) is an indication of the priority that is to be given to the dictates of justice, rather than to the letter of the rules where there is an inconsistency.
31It might be thought that an investigation of the genesis of r 23.5 of the UCPR would be helpful in determining its purpose and whether the circumstances of the present case warrant a departure from it. However, I have been unable to find the reason for the inclusion of a rule in the form of r 23.5 of the UCPR, which substantially replicates the former Supreme Court Rules (NSW) Part 25 rule 6, although it is also to be found in the rules of other Australian jurisdictions (see, for example, Order 28, r 1(1)(a) of the Rules of the Supreme Court 1971 (WA)). I am indebted to the analysis by the Full Court of the Supreme Court of Western Australia in Ryan v Regent Enterprises Pty Limited (1991) 3 WAR 552 (Malcolm CJ, Pidgeon and Nicholson JJ) from which the authorities referred to below are derived.
32The English Rules of the Supreme Court 1965 (the English Rules), on which the UCPR and its predecessors are based, contains no equivalent to r 23.5 of the UCPR. The usual order in the English Rules provided for mutual exchange of reports to be agreed and, in the absence of agreement, for each party to be limited to one witness of any particular specialty. The request by a party to have his or her own expert present arises in English cases in the context of the assessment whether a refusal to submit to a medical examination is unreasonable. This question typically arises where one party will only submit to examination by the opposing party's expert on the condition that a particular medical expert is present during an examination conducted by the opposing party's expert.
33Because there was no equivalent to r 23.5 of the UCPR in the English Rules, the issue of the reasonableness of conditional refusal was regarded as being one of fact to be determined in light of the relevant circumstances: Morgan v William Dixon [1912] AC 74. Their Lordships did not, accordingly, need to decide whether there was any legal right on the part of a worker to have his or her own medical practitioner present at a medical examination by the employer's medical practitioner.
34The reasonableness of a plaintiff insisting on a medical expert being present at such an examination was further considered by the Court of Appeal in Hall v Avon Area Health Authority [1980] 1 WLR 481. In that case a 52-year old woman agreed to be examined by an orthopaedic surgeon on condition that her own expert was present. The Court of Appeal decided that the reasons suggested for the imposition of the condition were not sufficient to outweigh the disadvantages occasioned by increased expense and delay in requiring one surgeon to be present when the other was examining the plaintiff. Stephenson LJ (Waller and Cumming-Bruce LJJ agreeing) recited the argument that was put on behalf of Ms Hall to justify the condition in the following terms at 490-491:
"By this condition [that the worker's own expert be present at an examination] counsel's instructing solicitors hope to protect unskilled and uneducated plaintiffs from being badgered or upset, as he put it, by medical examinations in the absence of anybody representing their own side, and from being led to feel that they are being unjustly treated, even if their feelings are irrational. They also hope, by this condition, to increase the chances of agreement between the medical men on each side and of the consequent settlement of their claims."
35His Lordship rejected the reasonableness of the condition and said at 492:
"Courts of law, as well as the parties to litigation and their solicitors, must give a Fellow of the Royal College of Surgeons, of high standing in his profession of orthopaedic surgeon, credit for being fair and considerate in his treatment of those whom he examines on behalf of the other side and fair and accurate in his recording of such examination, and for needing no third party, whether medically qualified or not, to prevent him from misleading the court by inaccuracies or, I would add, to restrain him, as was suggested (though not by the judge) from confusing the party examined by unfair interrogation."
36Although their Lordships agreed that the condition was unreasonable in that case, Waller LJ adverted to the circumstances where it might be reasonable to impose such a condition at 493:
"There may be cases where such an order would be justifiable: for example, a very nervous plaintiff. In such a case it might well be, indeed it probably would be, preferable to have some other person present rather than a consultant whom he or she has probably only seen once. Another case might be the sort of case which arose in Starr v National Coal Board, where it was thought that the consultant who the defendants wished to examine the plaintiff was one who tended to be hostile to plaintiffs. In such circumstances it might (I do not say it would) be a good ground for saying that the consultant on the other side should be present."
37Cumming-Bruce LJ at 494 said:
"It may be too dramatic a metaphor, but it seems to me that the remedy proposed by the solicitors was a sledge-hammer to crack a nut . . . To require a medical consultant to be present to act as a chaperone, although he has no personal function to perform in the course of the examination by the defendant's surgeon, seems to me to be a serious addition to the costs of the litigation and also an inexcusable requirement, on the part of the processes of litigation and justice, of the precious time of highly qualified consultants, whose professional business includes the examination of litigants for the purposes of litigation, but whose primary concern is with diagnosis and treatment of patients in order to alleviate their sufferings.
In my view, the court should hesitate long before encouraging or permitting any such addition to the time and expense in the conduct of personal injury cases as is proposed by the solicitors in this case."
38It may be that the lack of jurisprudence on the application of, or dispensation from, r 23.5 of the UCPR and its predecessors, is explained by the circumstance that it is generally impractical to have a medical expert present at such examinations since it would tend to add to the costs and time of litigation. The reasons given by the Court of Appeal in Hall v Avon Health Authority for regarding the condition as unreasonable are all, in my view, good reasons why r 23.5 of the UCPR may not be of general utility since it expresses the presence of a medical expert in terms of an entitlement. In addition, it may be that assessments by psychiatrists are a particular category which makes the rule inapposite in such cases. However, the general wisdom of such a rule is not a matter that arises for consideration, much less determination, in the context of the present case. The principle that the rules are to be the servants not the masters is sufficient to enable the rule to be dispensed with in appropriate circumstances.
39I now turn to the question whether an order sought by the defendants ought be made. The requirement of natural justice is a fundamental part of the just determination of civil disputes. I consider that it would be at odds with that requirement to impose on Dr Skinner in the present case a medical expert of the examinee's choice in circumstances where she has deposed that that requirement would be deleterious to her examination. She is entitled to conduct the examination in accordance with the Expert Witness Code of Conduct, which in turn requires her to assist the court impartially consistent with her paramount duty to the court.
40I have had regard to the degree of injustice that would be suffered by the respective parties as a consequence of any order or direction (s 58(2)(iv) of the Act). I accept the evidence of the plaintiffs that they are likely to suffer inconvenience, possibly discomfort and even anguish in the course of the examination with Dr Skinner. I am also disposed to accept that those negative emotions could be alleviated by the presence of Dr Dinnen or another psychiatrist or psychologist of their choosing. However I do not consider that these matters amount to an "injustice" that they will, or might, suffer within the meaning of s 58(2)(iv) of the Act.
41I am satisfied, for the reasons given by Drs Champion and Skinner in their reports, extracts of which have been set out above, that there are substantial reasons for not permitting the plaintiffs to bring another medical expert to such assessments. Although Dr Dinnen is of opinion that such consultations are feasible, I consider the question to be largely one to be determined by reference to the professional assessment of the assessing expert who is, in this case, Dr Skinner. I accept the expert evidence of Drs Skinner and Dr Champion that the presence of another medical expert will have a tendency to compromise the medical assessment in the circumstances of the present case. Notwithstanding r 23.5 of the UCPR, I do not consider there to be any legitimate forensic interest or entitlement of the examinee of a medical examination conducted in the circumstances of the present case to have a medical expert of his or her choice present. I consider that it is in accordance with the dictates of justice that the orders sought by the defendants be made.