LST [2025] QCAT 386 (13 October 2025)

Human Rights Act 2019 (Qld), s 13, s 17, s 24, s 25

Powers of Attorney Act 1998 (Qld), s 62, s 63

This matter was heard and determined on the papers pursuant to s 32 of the Queensland Civil and Administrative Tribunal Act 2009 (Qld)

• [1] This proceeding is under the Guardianship and Administration Act 2000 (Qld) ('Guardianship and Administration Act'). It relates to a woman who, for privacy reasons,[1] will be referred to only as LST. She has a mental illness and lives in supported accommodation.
• [2] On 11 September 2025, LST's community care manager Charleen Machingura filed applications in the tribunal:

(a) for the appointment of a guardian for LST;

(b) for the appointment of an administrator for LST; and

(c) for interim appointments pending the determination of the substantive applications.

• [3] Ms Machingura proposed the appointment of the Public Guardian and Public Trustee. On 25 September 2025 I decided to appoint, on an interim basis, the Public Guardian as guardian for the matter of health care and the Public Trustee for all financial matters. The Public Guardian has requested reasons, which I now provide.

• [4] Ms Machingura is an occupational therapist. She completed a health professional report about LST on 18 June 2025. According to the report, LST has treatment-resistant schizophrenia and is subject to a treatment authority under the Mental Health Act 2016 (Qld) ('Mental Health Act'). Ms Machingura considers that LST has impaired decision-making capacity for various matters including health and financial matters:

(a) LST 'has self-reduced her prescribed medication, refuses medical reviews, and declines all physical health monitoring despite known heath issues';[2]

(b) the health issues include obesity, back pain, arthritis, and lower limb oedema (and I note that the oedema is described elsewhere as 'severe lower limb oedema'[3]);

(c) LST spends up to $600 per week on groceries despite receiving prepared meals at her accommodation;

(d) LST spends money on a man 'whom she believes she is in a romantic relationship with, despite clear evidence to the contrary';[4]

(e) LST has chronically impaired insight and delusional thinking; and

(f) she does not appreciate the consequences of her decisions and is unable to make decisions freely and voluntarily.

• [5] Medical records provided by Ms Machingura illustrate that LST has held entrenched and pervasive delusional beliefs over the years.
• [6] Further, according to Ms Machingura:

(a) LST spends most of her time at home;

(b) support workers funded by the National Disability Insurance Scheme assist LST with transport, shopping and health management;

(c) LST 'frequently refuses essential medical care, including blood tests, physical examinations, and specialist review';[5]

(d) 'her fixed false beliefs often interfere with her understanding of health risks and necessary interventions';[6]

(e) 'a guardian is required to support timely, appropriate health care decisions in her best interest and to prevent further decline in her physical and mental health';[7]

(f) LST has been rejecting contact from family members for some time; and

(g) she receives a pension, and her only asset is $10,000 in a bank account.

• [7] I was mindful when deciding the interim application that LST and other persons had not had the opportunity for input. Ms Machingura's evidence was untested. Nonetheless, I considered that the information from Ms Machingura was likely to be reliable, having regard to her role and professional obligations.

• [8] Under section 129 of the Guardianship and Administration Act, the tribunal may appoint an interim guardian and/or an interim administrator for an adult if satisfied, on reasonable grounds, that the adult has or may have impaired capacity for a matter, and that there is an immediate risk of harm to the health, welfare or property of the adult. The harm may be by way of exploitation or self-neglect.[8]
• [9] It is also relevant to take into account:

(a) the acknowledgements in section 5 of the Guardianship and Administration Act, including that the right of a person to make their own decisions should be restricted to the least possible extent;

(b) the general principles set out in section 11B and the health care principles set out in section 11C of the Guardianship and Administration Act, including respect for the values of the adult and taking into account the views, wishes and preferences of the adult (though section 129 does permit the tribunal to decide an application for an interim order without consulting the adult);

(c) the adult's human rights set out in the Human Rights Act 2019 (Qld) ('Human Rights Act') including that a person must not be subjected to medical treatment without their full, free and informed consent;[9] and

(d) the limited circumstances in which a human right may be limited.[10]

• [10] On the basis of the health professional report by Ms Machingura, I was satisfied that LST has or at least may have impaired capacity for making decisions about health and financial matters.

• [11] On the information provided, I was satisfied that there was an immediate risk of harm to the health and welfare of LST. LST's health was suffering badly because of her delusions and lack of insight. The more troublesome issue was whether the appointment of an interim guardian was necessary and whether such an appointment might be futile.

• [12] In Queensland, we have a statutory health attorney system under the Powers of Attorney Act 1998 (Qld).[11] Under that system, a statutory health attorney, who may be the Public Guardian if other persons are not available, can make a health care decision for a person with impaired capacity. A statutory health attorney gains their authority under legislation, not by appointment by a court or tribunal. The Public Guardian's website indicates that it has a phone number which health professionals can call to seek consent to a proposed treatment.
• [13] There are, though, cases, where the tribunal will appoint a health care guardian because it anticipates that the statutory health attorney system will not adequately meet the needs of the adult or will not adequately protect their interests. For example, the adult may have complex health problems which require a holistic and ongoing understanding by an individual delegated guardian, rather than a series of decisions by different people over time. I considered that this was the situation for LST.

• [14] Where a person is subject to a treatment authority under the Mental Health Act, their mental health treatment will be decided by the authorised doctor and not by a guardian. For as long as LST remains subject to a treatment authority, the scope of a guardian's powers will be limited to aspects of her health other than her mental health.
• [15] Further, it is important to bear in mind that a guardian cannot compel an adult to attend appointments or accept treatment. According to Ms Machingura, LST often refuses to attend appointments and chooses not to follow medical advice. However, it seems that there are times when LST will attend appointments. On those occasions, a need will often arise for a health care decision. I concluded that there were likely to be occasions when an interim guardian would be called on to make health care decisions. LST may or may not then permit the decision to be given effect, depending on her mental state. Overall, while I appreciated that the scope for a guardian to improve the situation may be limited, or may possibly even be wholly thwarted, the severity of LST's health problems warranted an effort to improve them.
• [16] The appointment of an interim guardian might limit LST's right under section 17 of the Human Rights Act not to be subject to medical treatment without her full, free and informed consent, though in practice she has a power of veto. To the extent that a limitation would result, I considered that, in terms of section 13 of the Human Rights Act, the limitation was lawful, reasonable and justified.

• [17] On the basis of the information provided by Ms Machingura, I was satisfied that there was an immediate risk of harm to the property and welfare of LST. LST has little in the way of income or assets. Unnecessary expenditure on the scale described by Ms Machingura jeopardises the financial wellbeing of LST.
• [18] The financial risks could undoubtedly be mitigated by the appointment of an interim administrator. The interim administrator would develop a budget and place limits upon LST's access to her funds.
• [19] Such an appointment would not infringe LST's property rights as articulated in section 24 of the Human Rights Act. In particular, it would not involve 'arbitrary' deprivation of any of her property rights.

• [20] I was satisfied that the Public Guardian and the Public Trustee were appropriate interim decision-makers, having regard to the factors set out in section 15 of the Guardianship and Administration Act. For example, they were likely to apply the general principles. The Public Guardian was likely to apply the health care principles.
• [21] I also took into account that the appointments would affect LST's privacy: the interim guardian and the interim administrator would need to access private, and often quite sensitive, information about LST in order to carry out their responsibilities. Section 44 of the Guardianship and Administration Act grants to a guardian or an administrator the right to information necessary to make an informed exercise of their power. Access to this information might well be contrary to LST's wishes. However, such access would not infringe LST's privacy rights as expressed in section 25 of the Human Rights Act, as it does not involve an 'unlawful' or 'arbitrary' interference with her privacy.

• [22] For the above reasons, I decided to make the interim appointments.

[1] The identity of an adult who is the subject of a proceeding under the Act must not be published: s 114A.

[8] Guardianship and Administration Act s 129(1)(b).

[9] Human Rights Act s 17(c).

[10] Ibid s 13.

[11] See particularly ss 62 and 63.