The Commission's submissions
36 The Commission's argument before us supports the construction of the Notice for which Mr Patterson contends. In relation to the alcohol hypothesis, the Commission drew attention to clause 4 of the Statement of Principles requiring that at least one of the factors set out in clause 5 be "related to … relevant service". It was said that "related" has the meaning given in s 196B(14) of the Act which, so far as presently relevant, provides:
"A factor causing, or contributing to, an injury, disease or death is related to service rendered by a person if:
(a) it resulted from an occurrence that happened while the person was rendering that service; or
(b) it arose out of, or was attributable to, that service; or
…
(d) it was contributed to in a material degree by, or was aggravated by, that service; or
…
(f) in the case of a factor causing, or contributing to, a disease - it would not have occurred:
(i) but for the rendering of that service by the person; or
(ii) but for changes in the person's environment consequent upon his or her having rendered that service …."
37 The Commission claimed there was no evidence that Mr Patterson's consumption of alcohol at the time of clinical onset of his hypertension in 1978 was related to his operational service in any of the ways listed in s 196B(14). It was said to follow that it was not open to the Tribunal, as a matter of law, to find that the alcohol hypothesis was reasonable, so that the error found by the primary judge was immaterial to Mr Patterson's prospects of success. Thus his Honour erred in not determining the Notice of Contention.
38 For the purposes of appeal, the Commission did not dispute that the material before the Tribunal was capable of establishing that Mr Patterson consumed "an average of at least 200 grams per week of alcohol … at the time of the clinical onset of hypertension" within par 5(b) of the Statement of Principles.
39 The Commission then submitted that in his written and oral evidence and his account to Dr Strauss, Mr Patterson did not attribute his drinking after his service to his operational service or to any occurrence during that service. It was said that on the undisputed account taken by Dr Strauss, Mr Patterson was "unscathed" by his service in Vietnam, he denied having any symptoms suggestive of post traumatic shock disorder, and had never had any psychological or psychiatric problems. Dr Strauss' opinion, which was not challenged, was that Mr Patterson did not suffer from alcohol dependence or alcohol abuse at any stage. His alcohol consumption was never an issue for him or for those around him. We were taken to what were said to be the relevant parts of Mr Patterson's and Dr Strauss' evidence. It is not necessary to record them.
40 Accordingly, it was submitted, assuming that the whole of the material before the Tribunal pointed to Mr Patterson consuming a weekly average of 200 grams of alcohol at the time of clinical onset of hypertension in 1978, it was incapable of pointing to that consumption being related to his operational service. It followed, it was said, that the Tribunal had to be satisfied, beyond reasonable doubt, that Mr Patterson's alcohol consumption was not sufficient ground for determining that his hypertension was war‑caused.
41 The next submission was directed to the Commission's "opinion" the subject of s 120(3) of the Act, which is summarised at [8]. It was said that it was not open to the Tribunal to reasonably form the requisite opinion because, for the reasons already elaborated, there was no material before it that raised or pointed to a relationship between Mr Patterson's operational service and his consumption of an average of at least 200 grams of alcohol in 1978.
42 The Commission then turned to the second limb of clause 5(b) of the Statement of Principles, which requires that the average of at least 200 grams of alcohol per week "cannot be decreased to less than an average of 200 grams per week" at the time of clinical onset of hypertension. This limb, if established, must also be related to relevant service. It was submitted that there was no material before the Tribunal pointing to Mr Patterson being unable to reduce his consumption to less than an average of 200 grams.
43 The Commission's next submission relied on the Full Court's observation in Bull v Repatriation Commission (2001) 66 ALD 271 at [23] that
"If the tribunal examined all the material and if the tribunal followed the correct approach to its task under subs 120(3) …, any error will be one of fact, unless the opinion was one which could not have been formed by a reasonable person who correctly understood the law under which he or she acted or unless the opinion was one which was not capable of being reasonably formed".
44 The Commission contended that because the material before the Tribunal was incapable of pointing to a relationship between Mr Patterson's consumption in 1978 and his operational service, an opinion that the hypothesis was upheld by par 5(b) and clause 4 was one that could not have been formed by the reasonable person referred to in Bull.
45 The Commission then dealt with par 5(c) of the Statement of Principles. For the purposes of the appeal, it did not dispute that the material before the Tribunal was capable of establishing that Mr Patterson ingested at least 12 grams of salt supplements per day on average for a continuous period of at least six months immediately before the clinical onset of hypertension in 1978. As with the alcohol hypothesis, the contention was that clause 4 was not satisfied. The principal submission was that Mr Patterson's salt supplements intake was incapable of being related to his operational service in any of the ways listed in s 196B(14), because that service was nothing more than the background in which he sometimes indulged his liking of salted cashews, peanuts and potato chips, all of which he had eaten before his service. It was said that there was no material pointing to the eating of salted nuts and chips causing or contributing to increased ingestion of salt supplements. The Commission detailed the relevant parts of Mr Patterson's evidence that were said to support this contention. It is not necessary to record them.
46 The Commission relied on evidence from Dr Kenardy that an appetite for salt is physiologically driven as a result of the body being in a state of sodium depletion. Dr Kenardy effectively ruled out any underlying mechanism of addiction, or any link between stress hormone activity and salt consumption.
47 The Commission also relied on Dr English's opinion that a connection between Mr Patterson's ingestion of salt supplements in 1978 and his eating salted snacks in Vietnam in 1971 was "remote speculation" and "very tenuous".
48 The foregoing account of the Commission's submissions is taken largely from its detailed written Outline of Submissions. The Outline was amplified and modified in the course of oral argument. The account we have given takes into account the modifications.