Key aspects of legislative regime summarised
6 The key relevant aspects of the legislative regime were summarised in the First NHDS Judgment at [6]-[79]. They need not be described at any length here. It is sufficient to focus on the primary legislative provisions which are relevant to the current proceeding.
7 As noted, on 24 July 2018 the Director decided under s 88A to undertake a review of the provision of services by NHDS, after being requested by the Chief Executive Medicare on 28 June 2018 to do so. Section 88A provided:
88A Director must decide whether to review
(1) If the Chief Executive Medicare requests the Director to review the provision of services by a person, the Director must, within 1 month after receiving the request, decide whether or not to undertake the review.
(2) The Director must decide to undertake the review if, after considering the request and any other relevant information the Director has obtained, it appears to the Director that there is a possibility that the person has engaged in inappropriate practice in providing services during the review period.
(3) If the Director does not make a decision under subsection (1) within the period of 1 month specified in that subsection, the Director is taken to have decided, at the end of that period, to undertake the review.
(4) The Director must give written notice of the decision to:
(a) the person; and
(b) the Chief Executive Medicare.
(5) The notice must be given within 7 days after the decision is made but failure to give the notice within that time does not affect the validity of the decision.
(6) If the Director decides to undertake the review, the notice given to the person under review under paragraph (4)(a) must set out the terms of section 89B.
(7) Failure to comply with subsection (6) does not affect the validity of the decision.
(8) If the Director decides not to undertake the review, the notice given to the Chief Executive Medicare under paragraph (4)(b) must include the grounds for the decision.
8 Following such a review under s 88A, the Director has two options:
(a) to decide to take no further action; or
(b) to give to the person the subject of the review a written report setting out the reasons why the Director has not made a decision to take no further action, and invite the person to make written submissions (see s 89C).
9 NHDS was provided with a report dated 3 April 2019 by the Director, which detailed the reasons why she had not made a decision to take no further action against NHDS.
10 If the person under review makes written submissions under s 89C, the Director has two further options:
(a) to decide to take no further action pursuant to s 91; or
(b) refer the person under review to a Committee pursuant to s 93 (s 89C(2)).
11 The Director decided in this case to refer NHDS to the PSR Committee which, as noted, gave rise to the challenges in the First NHDS Judgment. It may be interpolated here that, by an order dated 1 October 2019 in the previous proceeding, the members of the PSR Committee were restrained from further considering the Referral until the finalisation of those earlier proceedings or further order of the Court.
12 As has been emphasised, s 94 of the HI Act is of central significance. It provided:
94 Director taken to have made a decision after 12 months
(1) If:
(a) the Director decides to review the provision of services by a person; and
(b) before the end of the period of 12 months after making the decision, the Director has not:
(i) made a decision under section 91 to take no further action in relation to the review; or
(ii) entered into an agreement with the person under section 92 (whether or not the agreement has been ratified by the Determining Authority); or
(iii) referred the provision of one or more of the services to a Committee;
then, the Director is taken to have made a decision at the end of that period to take no further action in relation to the review.
Note: Sections 92A and 106R set out time limits for the ratification of agreements made under section 92.
(2) If the review is suspended:
(a) under paragraph 89A(2)(b); or
(b) because of an injunction or other court order;
the Director may determine, in writing, that the period of 12 months referred to in subsection (1) is extended by a specified period that is not longer than the period of the suspension.
(3) If a notice is given under subsection 89B(2) to the person under review, or to another person, and the person concerned fails to comply with a requirement of the notice, the Director may determine, in writing, that the period of 12 months referred to in subsection (1) is extended by a specified period that is not longer than the period during which the person fails to comply with the requirement.
(4) This section does not apply in relation to a review undertaken because of section 89.
13 It is desirable to set out s 89:
89 When Director must review
If:
(a) the Chief Executive Medicare makes a request (the current request) to the Director to review the provision of services by a person; and
(b) the Director decided not to undertake a review in relation to the most recent previous request made by the Chief Executive Medicare in relation to the person;
the Director must undertake a review in relation to the current request, and subsections 88A(4) to (6) and section 88B apply as if the Director had decided to undertake the review.
14 Section 89A(2)(b) provided:
89A Director may refer material to Chief Executive Medicare if certain offences or civil contraventions are suspected
…
(2) If the Director has acted under subsection (1), he or she may:
…
(b) suspend the review for such period as he or she thinks appropriate.
15 Section 89B provided for the Director to require the person under review or other specified persons to produce documents or give information relevant to the review.
16 In view of the fact that NHDS placed particular emphasis on s 89C as supporting its preferred construction of s 94 (see [49] ff below), it is desirable to set out that provision:
89C Director's action following review
(1) Following a review of the provision of services by a person, the Director must either:
(a) make a decision under section 91 to take no further action in relation to the review; or
(b) give the person under review:
(i) a written report setting out the reasons why the Director has not made a decision under section 91; and
(ii) an invitation to make written submissions to the Director, within 1 month, about the action the Director should take in relation to the review.
(2) If the Director gives the person under review a report and invitation under paragraph (1)(b), the Director must, as soon as practicable after taking into account any submissions made as mentioned in subparagraph (1)(b)(ii):
(a) decide to take no further action in relation to the review in accordance with section 91; or
(b) enter into an agreement with the person under review under section 92; or
(c) make a referral to a Committee under section 93.
17 The Director contends that NHDS cannot now challenge the validity of the resumed review based upon the operation of s 94 because NHDS could, and should reasonably have, raised that issue in the proceeding which resulted in the First NHDS Judgment. The Director contends that NHDS is prevented by both Anshun estoppel and abuse of process from now raising that matter. Moreover, the Director contends that NHDS's case must fail because its preferred construction of s 94(1) of the HI Act is not supported by text, context or purpose. The Director says the NHDS's preferred construction was rejected by the Court in the First NHDS Judgment at [188]-[189]. Those paragraphs are as follows:
188. The Director asked to be heard on the terms of any final orders in the event that any of the grounds of review were upheld. This concern appeared to relate to the possible effect of s 94 of the HI Act if the s 93 referral decision was set aside. There was a brief discussion at the end of the hearing regarding the relevance of Jagot J's decision in Ikupu v Minister for Immigration, Citizenship, Migrant Services and Multicultural Affairs (No 2) [2020] FCA 234 in respect of the effect of a similarly worded provision in s 500(6L) of the Migration Act 1958 (Cth). Her Honour referred inter alia to the Full Court's decisions in Somba v Minister for Home Affairs [2019] FCAFC 150 and Khalil v Minister for Home Affairs [2019] FCAFC 151 in relation to that provision.
189. Consistently with those authorities I consider that, even though the Court will quash the Director's decision dated 23 July 2019 to set up, and refer to, Committee No 1228 the matters set out in Item 2 of the referral, it is nevertheless a decision for the purposes of s 94 of the HI Act with the consequence that this section has no application.
18 The extent to which the proper construction and application of s 94 of the HI Act was raised by the parties at the hearing of the previous proceeding is reflected in the following extracts from the transcript, commencing with what was said by Mr Kirk SC on behalf of NHDS and then what was said by Mr Kennett SC on behalf of the Director [(T 112-113 and 166-167)]. These exchanges occurred after the Court raised with Mr Kirk SC whether or not the request for a review "springs back" in the event that the Referral was set aside [T 110, L 41]:
MR KIRK: …Can I take your Honour to section 94, and this, in a sense, cuts a bit each way, but it's relevant for your Honour, perhaps, to take account of it.
HIS HONOUR: Yes.
MR KIRK: In this case, the director referred off to the committee on the 364th day. She chose to do it at the very last minute. Your Honour may not need to decide this, but I thought I should be - we thought we should be frank in indicating what our position is. If this matter goes back it can no longer be referred because of section 94. Now, your Honour should also note section 94(2) - sub (2). The Parliament deals with this kind of issue specifically by saying:
If the review is suspended under ... 89A(2)(b) -
which I think relates to a - yes. 89A(2)(b) relates to referring things off if there are - if there's the potential for offences or civil contraventions, and if the director does that - in other words, if something much more serious is raised, she can suspend the review whilst that is dealt with, on the principle, no doubt, that you deal with the more serious things first and then come back to the less serious things later. Or, to go back to 94, sub (2):
If the review is suspended ... because of an injunction or other court order -
so if the director had been more prompt in making her decision to refer and we commenced proceedings within the 28 days allowed by the AD(JR) Act, the first thing the director would have done is, in a sense, raised the issue at least of an injunction such that she could then suspend the review under 94(2), and something somewhat similar, in fact, happened before your Honour at the first case management hearing, because the Parliament has been very careful in dealing - in recognising and then dealing with the fact that judicial review may be brought at various places. So, for example, if your Honour turns to 106G, which is - - -
HIS HONOUR: But just before we go on here, I mean, this is - this is not - I don't - I think I know where you're heading, but and it may well be you're going to take me to some case law, but this is not an unusual provision, and there will be an issue as to whether 94 operates with the guillotine that I think you're going to suggest that it operates, depending upon what the effect of any decision I might make on the notion of decision.
MR KIRK: Yes. Well, I'm not currently planning to take your Honour to cases because, to be frank, I'm not sure in the end whether this is truly before your Honour or not. It may be said to be premature, but it is part - but then, on the other hand, it may be before your Honour because it feeds into this jurisdictional fact issue.
HIS HONOUR: Now, you're using this to encourage me to get into the jurisdictional fact.
MR KIRK: Yes, although the irony, I also recognise, of my submission to that effect is that if I'm right about the guillotine it cannot - in a sense, wouldn't matter because it cannot be determined - redetermined, anyway. It's just game over. That being said, if we're right about employment, it's game over for the whole issue.
HIS HONOUR: You see, I'm just not sure of that, because I think that at the moment - I will hear what Mr Kennett has to say, but I think that your submission that if it goes back it can't be referred again may be predicated on a view of the proper construction and operation of section 94 which may not withstand scrutiny.
MR KIRK: And I recognise it hasn't been raised in the written submissions. In a sense, it has come up in light of discussions yesterday afternoon and again this morning, and so we have not sought to address it in detail, but I, to be frank, felt obliged to draw it to your Honour's attention - -
HIS HONOUR: Yes. Thank you.
MR KIRK: - - - so it was not going to be suggested later that we've acted in some sharp manner or suchlike by saying, "Well, this is going to be our construction of the section."
HIS HONOUR: Yes.
MR KIRK: So I just wanted to raise it. As I said, I'm not sure in the end it's truly before your Honour, but I felt obliged to be frank about it.
HIS HONOUR: Yes.
…
MR KENNETT: I was going to say something about section 94, even if my learned friend didn't. There may well be, at some stage, a contest between us about what work section 94 does, in the event that the director's decision is set aside.
HIS HONOUR: When you say he didn't say anything about it, he did: he drew it to my attention, but he didn't go in hard on it.
MR KENNETT: Yes, yes.
HIS HONOUR: He said he was discharging, effectively, an obligation to be candid with the court.
MR KENNETT: Yes, yes. No. What I intended to say was, even had he not done that, I was going to say something about it.
HIS HONOUR: Right. Okay. I beg your pardon. Thank you.
MR KENNETT: I wasn't being clear.
HIS HONOUR: Thank you.
MR KENNETT: It is something that your Honour will need, I think, to be - or should appropriately be aware of. If the director's decision is set aside, then there will be probably an argument between us, in some form or other, as to whether everything's now finished or whether there's still a decision to be made. There was - I was told at lunch time a judgment handed down last week, by Jagot J, Ikupu, I-ku- p-u, [2020] FCA 234 that dealt with a very similar provision in the Migration Act, section - - -
HIS HONOUR: Yes. No, it's come up - I didn't have that case in mind, but this concept's come up. Does her Honour - I'm not familiar with the case, but does her Honour resolve the issue by reference to the effect of a judicial review remedy, quashing a decision, having an impact on the operation of terms like "decides?"
MR KENNETT: I've only barely skimmed it, your Honour, but my understanding is that she does look at whether a decision was actually made, rather - decision in fact - rather than a determinative decision. Now, I just wanted to - I didn't want to take this very far because I don't think it is a live issue yet, but I just wanted to say two things. One is that if the - if the director's decision is set aside for any reason, then the position that our learned friend takes or foreshadows as to section 94 would indicate a lack of utility in the declaration. Because if his foreshadowed position is right, then there's no question of this case going anywhere, and the other thing I wanted to say was that, if your Honour is minded to set aside the director's decisions, we would be grateful for an opportunity to address you as to what are the appropriate orders, and that might be a point at which we do need to bite the bullet about section 94. I have in mind, for example, whether there should be a remitter under the ADJR Act. That's all I wanted to say.
19 To avoid adding unnecessarily to the length of these reasons for judgment, I will not separately summarise the parties' respective submissions. Rather, I will address those submissions, where relevant, in explaining why the originating application will be dismissed.