The construction of Rule 5.8(a)
30 The principles applicable to questions of statutory construction, which require consideration of the text, content, and purpose, are well established: see, in particular, s 15AA of the Acts Interpretation Act 1901 (Cth); Project Blue Sky Inc v Australian Broadcasting Authority [1998] HCA 28; 194 CLR 355 at [69]; Federal Commissioner of Taxation v Consolidated Media Holdings Ltd [2012] HCA 55; 250 CLR 503 at [39]; Certain Lloyd's Underwriters v Cross [2012] HCA 56; 248 CLR 378 at [25]-[26]; SZTAL v Minister for Immigrations and Border Protection [2017] HCA 34; 262 CLR 362 at [14]; Construction, Forestry, Maritime, Mining and Energy Union v Australian Building and Construction Commissioner (The Bay Street Appeal) [2020] FCAFC 192; 282 FCR 1.
31 In The Bay Street Appeal, the Chief Justice expressed the approach in this way, at [4]:
[4] … The principle is clear: Meaning is to be ascribed to the text of the statute, read in its context. The context, general purpose and policy of the provision and its consistency and fairness are surer guides to meaning than the logic of the construction of the provision. The purpose and policy of the provisions are to be deduced and understood from the text and structure of the Act and legitimate and relevant considerations of context, including secondary material. [Citations omitted]
[5] There can be no doubt that the search for principle in the High Court reveals a settled approach of some clarity: R v A2 [2019] HCA 35; 373 ALR 214 at 223-225 [31]-[37]. The notion that context and legitimate secondary material such as a second reading speech or an Explanatory memorandum cannot be looked at until some ambiguity is drawn out of the text itself cannot withstand the weight and clarity of High Court authority since 1985. [Citations omitted]
32 Section 3 of the NDIS Act specifies the objects of the Act. It relevantly provides:
(1) The objects of this Act are to:
…
(c) support the independence and social and economic participation of people with disability; and…
(f) facilitate the development of a nationally consistent approach to the access to, and the planning and funding of, supports for people with disability; and
…
(2) These objects are to be achieved by:
(a) providing the foundation for governments to work together to develop and implement the National Disability Insurance Scheme; and
(b) adopting an insurance-based approach, informed by actuarial analysis, to the provision and funding of supports for people with disability; and
(c) establishing a national regulatory framework for persons and entities who provide supports and services to people with disability, including certain supports and services provided outside the National Disability Insurance Scheme.
(3) In giving effect to the objects of the Act, regard is to be had to:
…
(b) the need to ensure the financial stability of the National Insurance Disability Scheme; and
(c) the broad context of disability reform provided for in:
(i) the National Disability Strategy 2010-2020 as endorsed by COAG on 13 February 2011; and
(ii) the Carer Recognition Act 2010; and
(d) the provision of services by other agencies, Departments or organisations and the need for interaction between mainstream services and the provision of supports under the National Disability Insurance Scheme.
33 Section 4 of the Act sets out general principles guiding actions under the NDIS Act. Most relevantly for present purposes, these include:
…
(2) People with disability should be supported to participate in and contribute to social and economic life.
(3) People with disability and their families and carers should have certainty that people with disability will receive the care and support they need over their lifetime;
…
(14) People with disability should be supported to receive supports outside the National Disability Insurance Scheme, and be assisted to coordinate these supports with the supports provided under the National Disability Insurance Scheme.
…
(17) It is the intention of the Parliament that the Ministerial Council, the Minister, the Board, the CEO, the Commissioner and any other person or body is to perform functions and exercise powers under this Act in accordance with these principles, having regard to the need to ensure the financial sustainability of the National Disability Insurance Scheme.
34 The background to the NDIS Act was described by Mortimer J in Mulligan at [12]:
The revised Explanatory Memorandum (at p 1) described the process which led to the Act in the following way:
In August 2011, the Prime Minister released the Productivity Commission Inquiry Report, Disability Care and Support, which identified that disability care and support in Australia was 'underfunded, unfair, fragmented and inefficient', and that major reform was needed.
Since the release of this report, the Commonwealth and all state and territory governments have agreed on the need for major reform in the form of a National Disability Insurance Scheme, which:
• will take an insurance approach that shares the costs of disability services and supports across the community;
• will fund reasonable and necessary services and supports directly related to an eligible person's individual ongoing disability support needs; and
• will enable people with disability to exercise more choice and control in their lives, through a person-centred, self-directed approach, with individualised funding.
The Bill establishes a scheme that gives effect to these critical principles, and gives effect in part to Australia's obligations under the United Nations Convention on the Rights of Persons with Disabilities.
35 Section 18 of the NDIS Act permits a person to make a request to the NDIA to become a participant in the NDIS. Sub-section 20(1)(a) requires the CEO (decision-maker) to decide whether the person meets the "access criteria".
36 Section 21(1) of the NDIS Act sets out the access criteria a person must meet to access the NDIS:
A person meets the access criteria if:
(a) the CEO is satisfied that the person meets the age requirements (see section 22); and
(b) the CEO is satisfied that, at the time of considering the request, the person meets the residence requirements (see section 23); and
(c) the CEO is satisfied that, at the time of considering the request:
(i) the person meets the disability requirements (see section 24); or
(ii) the person meets the early intervention requirements (see section 25).
(Emphasis added)
37 Section 24 of the NDIS Act provides that:
(1) A person meets the disability requirements if:
(a) the person has a disability that is attributable to one or more intellectual, cognitive, neurological, sensory or physical impairments or to one or more impairments attributable to a psychiatric condition; and
(b) the impairment or impairments are, or are likely to be, permanent; and
(c) the impairment or impairments result in substantially reduced functional capacity to undertake, or psychosocial functioning in undertaking, one or more of the following activities:
(i) communication;
(ii) social interaction;
(iii) learning;
(iv) mobility;
(v) self-care;
(vi) self-management; and
(d) the impairment or impairments affect the person's capacity for social or economic participation; and
(e) the person is likely to require support under the National Disability Insurance Scheme for the person's lifetime.
(2) For the purposes of subsection (1), an impairment or impairments that vary in intensity may be permanent, and the person is likely to require support under the National Disability Insurance Scheme for the person's lifetime, despite the variation.
(Emphasis added)
38 In assessing whether a person meets the disability requirements, s 27(b) of the NDIS Act relevantly provides, inter alia, that the Access Rules may prescribe circumstances in which, or criteria to be applied, in assessing whether an impairment (or impairments) result in substantially reduced functional capacity of a person to undertake one or more activities for the purposes of s 24(1)(c).
39 Rule 5.8 of the Access Rules outlines when an impairment results in "substantially reduced functional capacity" to undertake relevant activities:
An impairment results in substantially reduced functional capacity of a person to undertake one or more of the relevant activities - communication, social interaction, learning, mobility, self-care, self-management (see paragraph 5.1(c)) - if its result is that:
(a) the person is unable to participate effectively or completely in the activity, or to perform tasks or actions required to undertake or participate effectively or completely in the activity, without assistive technology, equipment (other than commonly used items such as glasses) or home modifications; or
(b) the person usually requires assistance (including physical assistance, guidance, supervision or prompting) from other people to participate in the activity or to perform tasks or actions required to undertake or participate in the activity; or
(c) the person is unable to participate in the activity or to perform tasks or actions required to undertake or participate in the activity, even with assistive technology, equipment, home modifications or assistance from another person.
(Emphasis added)
40 "Assistive technology" is not defined in the Access Rules of the NDIS Act, nor is "equipment".
41 "Assistive technology" is defined in the Assistive Technology Operational Guideline, issued by the NDIA on 20 June 2022, in the following way:
The World Health Organisation has a universal definition of assistive technology.
Assistive technology is equipment or devices that help you do things you can't do because of your disability. Assistive technology may also help you do something more easily or safely. Assistive technology will reduce your need for other supports over time.
This could be small things like non-slip mats, or special knives and forks. It could be big things like wheelchairs and powered adjustable beds. It also could be technology like an app to help you speak to other people if you have a speech impairment.
Not all equipment or technology you use is assistive technology. Many people use some equipment as part of their lives, for example, a radio to listen to music, or a standard microwave oven to cook food.
Assistive technology is only the equipment you need because it helps you do things that you normally can't do because of your disability. It includes items that:
• mean you need less help from others
• help you do things more safely or easily
• help you to keep doing the things you need to do
• allow you to do tasks independently
• are personalised for you.
(Emphasis added)
42 The definition is clearly broad enough to include catheters.
43 Rule 7.1 of the Access Rules is concerned with the process of assessing whether a person meets, inter alia, the disability requirements.
7.1 In deciding whether a prospective participant meets the disability requirements or the early intervention requirements, the CEO may, if the CEO considers it appropriate, conduct an assessment, which is to be done using an assessment tool specified in operational guidelines in accordance with this Part from time to time.
Specification of assessment tools in guidelines
7.2 The CEO may specify, in operational guidelines, assessment tools that may be used for the purpose of deciding whether a person meets the disability requirements or the early intervention requirements.
…
7.5 A tool must:
(a) be designed to ensure the fair and transparent assessment of whether a person meets the disability requirements or the early intervention requirements; and
(b) have reference to areas of activity and social and economic participation identified in the World Health Organisation International Classification of Functions, Disability and Health as in force from time to time.
44 The most recent Guidelines (Our Guidelines - Applying to the NDIS) were updated on 1 July 2022 and were not before the Tribunal. Relevant to the question of whether an impairment substantially reduces a person's functional capacity, the Guidelines in force at the time of the Tribunal hearing stated, at cl 8.3:
The NDIA must be satisfied that an impairment results in substantially reduced functional capacity of a prospective participant to undertake one or more relevant activities (section 24(1)(c)).
The NDIA is required to consider whether any permanent impairment, or permanent impairments when considered together, result in substantially reduced functional capacity to undertake one or more of the following activities:
• Communication: includes being understood in spoken, written, or sign language, understanding others and expressing needs and wants by gesture, speech or context appropriate to age;
• Social interaction: includes making and keeping friends (or playing with other children), interacting with the community, behaving within limits accepted by others, coping with feelings and emotions in a social context;
• Learning: includes understanding and remembering information, learning new things, practicing and using new skills;
• Mobility: this means the ability of a person to move around the home (crawling/walking) to undertake ordinary activities of daily living, getting in and out of bed or a chair, leaving the home, moving about in the community and performing other tasks requiring the use of limbs;
• Self-care: means activities related to personal care, hygiene, grooming and feeding oneself, including showering, bathing, dressing, eating, toileting, grooming, caring for own health care needs; or
• Self-management: means the cognitive capacity to organise one's life, to plan and make decisions, and to take responsibility for oneself, including completing daily tasks, making decision, problem solving and managing finances.
…
The NDIA does not need to be satisfied that a person's impairment is 'serious', or more serious than another person's. Rather, access to the NDIS is based on a functional, practical assessment of what a person can and cannot do (see Mulligan and NDIA [2015] FCA 44 at [56]).
…
It is sufficient for a prospective participant to have substantially reduced functional capacity in relation to one activity (see Mulligan and NDIA [2015] FCA 44 at 67).
Which activity the NDIA will need to consider will depend on the circumstances and the evidence presented by the prospective participant.
For example, if a prospective participant has an impairment which results in substantially reduced functional capacity to undertake mobility, but otherwise has full cognitive capacity, it may not be necessary for the NDIA to consider whether the impairment results in substantially reduced functional capacity to undertake activities related to cognition.
(Emphasis added)
45 Clause 8.3.1 of the Guidelines provided:
The following information provides further guidance in relation to determining when an impairment results in substantially reduced functional capacity:
By itself, reliance on commonly used items will not result in a substantially reduced functional capacity to participate effectively or completely in an activity. Commonly used items include glasses, walking sticks, non-slip bath mats, bathroom grab rails, stair rails, age appropriate child safety locks, simple adapted kitchen utensils and dressing aids.
In considering the role played by assistive technology, home modifications and equipment, the NDIA will consider specific needs arising from the prospective participant's impairment, and whether those needs are met (or need to be met) through the use of specialist disability aids and/or equipment.
Such items would generally be specifically designed to assist in increasing the functional capacity and participation of people with disability and be formally prescribed by a medical practitioner, specialist clinician or allied health professional such as an occupational therapist, physiotherapist or speech therapist.
When considering whether a person requires assistance from others to participate or perform tasks associated with an activity, the NDIA will have regard to whether a person's need for assistance is consistent with normal expectations of a person of a similar age. For example, children under the age of 2 will not necessarily have a substantially reduced functional capacity because they need assistance to provide for self-care needs.
A person will be considered to be unable to participate effectively or completely in an activity if they cannot safely complete one or more of the tasks required to participate in an acceptable period of time. Undertaking a task more slowly or differently to others will not necessarily mean a person cannot participate effectively or completely in an activity.
(Emphasis added)
46 In Mulligan at [52]-[56] , Mortimer J discussed the purpose and context within which s 24 was enacted:
[52] Although an impairment may, in general terms (and, for example, in the terms of Art 1 of the Convention on the Rights of Persons with Disabilities extracted above) be responsible for or related to a disability, the threshold in s 24 revolves around the severity and permanency of the effects of the impairments experienced by a person, so as to justify the provision of the "reasonable and necessary supports" to which participants may be entitled, after assessment in accordance with Pt 2 of Ch 3 of the Act.
[53] At p 14 of the revised Explanatory Memorandum, the purpose of what became s 24 is described:
Clause 24 sets out the disability requirements a person must satisfy in order to become a participant in the NDIS launch. The disability requirements are designed to assess whether a prospective participant has a current need for support under the scheme, based on one or more permanent impairments that have consequences for the person's daily living and social and economic participation on an ongoing basis. This clause also implements recommendation 3.2 of the Productivity Commission report.
[54] Recommendation 3.2 of the Productivity Commission Inquiry Report, "Disability Care and Support" (31 July 2011), stated:
Individuals receiving individually tailored, funded supports through the NDIS:
• should have a disability that is, or is likely to be, permanent, and
• would meet one of the following conditions:
• have significantly reduced functioning in self-care, communication, mobility or self-management and require significant ongoing support
• be in an early intervention group, comprising individuals for whom there is good evidence that the intervention is safe, significantly improves outcomes and is cost effective
In exceptional cases, the scheme should also include people who would receive large identifiable benefits from support that would otherwise not be realised, and that are not covered by the groups above. Guidelines should be developed to inform the scope of this criterion and there should be rigorous monitoring of its effects on scheme costs.
(Emphasis added)
47 The Productivity Commission Report to which her Honour referred identified "three different populations of customers" of the scheme that was subsequently implemented, described in terms of "tiers". Tier 1 was "all Australians". Tier 2 was "anyone with a disability and their primary careers". Tier 3 was described as "a much smaller group of people with significant care and support needs". At page 13 of the Report, in discussing the scope of support for people in Tier 3, the Commission said:
The NDIS would also not cover people whose requirements for support would most appropriately be met by other systems. Accordingly, the NDIS would not cover people:
• … with certain health conditions for which the publicly-funded healthcare system was best suited. For example, the care needs of people with terminal cancer would be best addressed in a palliative care setting. People with less severe musculoskeletal and psychological conditions would also typically receive assistance from the health system
…
In addition to the above requirements, people would have to meet at least one of the following conditions. They would:
• have significantly reduced functioning in self-care, communication, mobility or self-management and require significant ongoing support. For example, this would include people who need support in toileting, who require significant support for mobility and/or communication or who require supports in self-management and planning to live successfully in the community (such as those with intellectual disabilities or those with significant and enduring psychiatric disabilities)…
48 In its Report the Commission said that the scheme would cover the full range of disability supports set out in Box 2. Relevantly, Box 2 specified that in relation to personal care, these would include:
… help with showering, bathing, dressing, grooming, personal hygiene including bowel and bladder care/toileting, assistance with eating and/or drinking, mobility and transfers; health maintenance, such as oral hygiene, medication use or regular and routine exercises and stretches. This would also include nursing care when this was an inextricable element of the care of the individual (for example meeting the care and support needs of a ventilated quadriplegic).
(Emphasis added)
49 It is within this context, and having regard to the general purpose and policy of the NDIA legislative scheme, that the questions of construction of r 5.8(a) must be approached. Whether r 5.8(a) deems Mr Foster to have substantially reduced functional capacity to undertake self-care depends on:
(1) whether "activity" includes a task or action within the activity which is the impairment itself, in this case the inability to urinate;
(2) whether the need for "assistive technology, equipment" is directed at that equipment's use in managing the impairment itself, or is directed at assisting a person in one of the relevant daily activities specified in s 24(1)(c), being self-care;
(3) whether the phrase "effectively or completely" means that if there is any task or action that forms part of a relevant activity, no matter how insignificant it is in the overall concept of the activity, which cannot be performed without an aid, a person is deemed to be unable to participate effectively or completely.