16 The applicant did not have to admit the allegations. There is the possibility in a case such as this that the evidence of young children might not be accepted by a jury. By confessing to the offences the applicant gave up a chance of acquittal. Other evidence contributes too and, with that evidence, warrants a finding that the applicant has been and continues to be truly remorseful and contrite for his actions.
17 It is necessary to bear in mind that, for an elderly person "[e]ach year spent in prison represents a substantial portion of the remaining years of life which [he or she] may expect": Hunter (1984) 36 SASR 101. I also accept the submission made on behalf of the applicant that to be sentenced towards the end of one's life, as the applicant has been, means that there will be little opportunity to live down the shame and disgrace which the commission of the offences has occasioned. The longer the sentence the shorter the opportunity.
18 Generally speaking, ill health will be a factor tending to mitigate punishment only where it appears that imprisonment will be a greater burden on the offender by reason of his state of health or where there is a serious risk of imprisonment having a gravely adverse effect on the offender's health: Smith (supra); McDonald (1988) 38 ACrimR 470; Sellen (1991) 57 ACrimR 313; Bailey (1988) 34 ACrimR 154).
19 At the time of sentencing, the applicant had undergone treatment for a heart condition. That was the situation before he was charged with the offences. Ten days after being charged the applicant presented himself to his treating medical practitioner, Dr Yiannikas, with increased angina. The extent of coronary artery disease was diagnosed and the applicant underwent coronary bypass surgery and mitral valve replacement. There were post-operative complications requiring drainage of the lungs, for which the applicant was hospitalised on four occasions.
20 Dr Yiannikas said in a report:
"Continuing and unrelenting stress would play a role in bad hypertension management and in turn may deteriorate both his coronary disease and left ventricular function. It is at times possible that circumstances of continuing severe stress may precipitate acute coronary occlusion".
21 At that stage, the doctor estimated the applicant's annual mortality risk at approximately three to five per cent, so that there was, according to the doctor, approximately a 25 per cent chance that the applicant would not be alive in five years time. That was the state of the evidence as to health which was before the sentencing judge.
22 I would find, on that evidence, that the applicant's health was likely to be adversely affected by incarceration and that, because of his ill health, incarceration would be more onerous to him than would generally be the case.
23 Since sentence, the applicant's cardiac condition has deteriorated further and he has been diagnosed with prostate cancer. A biopsy and scan were recommended to confirm the existence of the cancer and to ascertain its extent and type for the purpose of management. The applicant is being held at the Junee Correctional Centre. It was thought that it would be necessary for the applicant to be brought to Sydney to enable the diagnostic procedures to be carried out. Having been brought to Sydney it was found the applicant could not be accommodated for those procedures at that time. It was then ascertained that the procedures could be carried out in Wagga Wagga. That was done. In the result, it had taken approximately six months for the diagnostic procedures to be carried out. That was attributable to the applicant's incarceration.
24 The applicant is under the care of a urologist, Dr J T Smith of Wagga Wagga, for the prostate condition. He has prescribed treatment. In his report of 27 March 2001, Dr Smith stated the prognosis needed to be guarded. If the response to treatment was good, the applicant would still have a 40 per cent chance of succumbing to the disease, which I take to mean dying from it. A more recent report shows the response to treatment has been good, so that is the prognosis.
25 Dr Smith did not think that imprisonment would have any major physical impact on the spread of the cancer or the treatment the applicant was to receive. There was, however, according to the doctor, the psychological worry of the disease and, being a doctor himself, the applicant would be more aware of the possible complications which include spread of the disease to other parts of the body.
26 Dr Yiannikas contributed an up-to-date assessment of the applicant's cardiac condition in an affidavit sworn on 13 August 2001. The doctor had obviously been unaware that the applicant would be going to gaol. He now addressed the effect of imprisonment. The applicant is on long term anticoagulation therapy because of the valve replacement. The doctor said that the usual risks of embolism and of bleeding associated with such treatment were substantially greater in prison because anticoagulation management was more erratic in the physical and emotional environment of gaol. The applicant is prone to significant cardiac arrhythmias which, according to the doctor, may not be well tolerated and would increase his risk of morbidity and mortality, including the possibility of stroke.
27 The applicant has now suffered urinary tract infections associated with his prostate condition. According to Dr Yiannikas, such infections may precipitate cardiac arrhythmias and give rise to the risk of infection associated with the prosthetic valve. Any such infection has a 50 to 75 per cent mortality rate. The stress of incarceration, according to the doctor, could also contribute to arrhythmias and/or coronary occlusion.
28 Dr Yiannikas revised his previous estimate of annual mortality risk, being now aware that the applicant is serving a gaol sentence and of the prostate cancer. This he now estimated at 10 per cent annually over and above someone the applicant's age without heart disease. That, as I understand it, translates to no better than a 50 per cent chance that the applicant will be alive in five years time.
29 This is an exceptional case. The offences are very serious and are not to be underrated. On the other hand, subjective features in mitigation of penalty are exceptionally strong. I have regard in particular to the applicant's state of health. He is now seventy-two years of age. His life is likely to be shorter than the average for that age. Also, because of his medical conditions, imprisonment has been and will continue to be very much more onerous for him than in the usual case.
30 The last of these considerations warrants a finding of special circumstances and I would make that finding.
31 I would propose the following orders: