A proper consideration of the health care available in Fiji?
22 The Originating Application was correct in focussing attention upon the manner in which the Respondent Minister addressed the health concerns facing Mr Taivei should he be returned to Fiji. Other than in respect to the brief submissions advanced before this Court as to the consideration given by the Minister to the prospect of Mr Taivei facing homelessness and unemployment in Fiji, no broader submission was directed to the Minister's consideration of the impact of non-revocation on:
the bests interests of minor children;
the expectations of the Australian community;
the strength, nature and duration of Mr Taivei's ties to Australia;
Australia's business interest;
victims; or
the protection of the Australian community and the risk to that community.
It was common ground that if the Minister had erred in his consideration of the claims made in respect to Mr Taivei's health conditions, his decision as a whole was vitiated by jurisdictional error.
23 In approaching the process of weighing up the many competing considerations presented on the facts of the present case, the Respondent Minister quite properly acknowledged the submissions made that:
Mr Taivei's medical condition would require "regular monitoring by specialists, including Infectious Diseases, Ophthalmology and Cardiology" (at para [51]);
his condition would require antibiotics "most likely for the duration of his life" (at para [55]);
"Fiji does not have specialists with the level of training and expertise required by Mr Taivei" (at para [56]); and
"Mr Taivei faces 'an uncertain future' and that his complex medical problem requires long term antibiotic treatment, a high level of medical care and expertise, frequent medical reviews, and carries 'a high risk of morbidity and mortality'" (at para [58]).
Given these submissions being advanced, the Respondent Minister purported to resolve them by making findings that:
Mr Taivei "has complex health problems with a high risk of morbidity and mortality" (at para [60]);
Mr Taivei "may be unable to receive optimum treatment in Fiji" (at para [60]);
Mr Taivei will have "equal access" to Fiji's health care system and limited social welfare support "as other Fijian citizens" (at para [63]); and
his "removal to Fiji will involve an element a [sic] risk to his health" (at para [63]).
24 In reviewing the Minister's Statement of Reasons, and in reaching a decision as to whether such reasons expose legal error, it must be accepted that such reasons are not to be read with an eye attuned to the detection of legal error: Minister for Immigration and Ethnic Affairs v Wu Shan Liang (1996) 185 CLR 259 at 271 to 272 per Brennan CJ, Toohey, McHugh and Gummow JJ. Conversely, however, where a common sense reading of the reasons provided does expose a readily discernible error, a reviewing Court should not hesitate to intervene: cf. Soliman v University of Technology, Sydney [2012] FCAFC 146 at [57], (2012) 207 FCR 277 at 295 to 296 per Marshall, North and Flick JJ.
25 Decisions made under the Migration Act have the potential to adversely affect the livelihood and well-being of visa claimants. Applicants for refugee status, it has been acknowledged, are "engaged in an often desperate battle for freedom, if not life itself": Abebe v Commonwealth [1999] HCA 14 at [191], (1999) 197 CLR 510 at 577 to 578 per Gummow and Hayne JJ. Considering what is at stake, it is both necessary and appropriate that statements of reasons provided to visa applicants are sufficient to inform the visa applicant of the reasons for that decision and the factual basis upon which that decision was reached: cf. Yusuf [2001] HCA 30 at [69], (2001) 206 CLR 323 at 346 per McHugh, Gummow and Hayne JJ.
26 While the present case does not concern a Protection visa application or refugee status assessment, the claims being advanced on behalf of Mr Taivei nevertheless go to the very real prospect that his removal to Fiji will result in his premature death. Although the Minister's Statement in the present case must not be overly scrutinised with an eye attuned to the detection of error where none truly exists (cf. Salahuddin v Minister for Immigration and Border Protection [2013] FCAFC 141 at [22], (2013) 229 FCR 290 at 297 to 298 per Flick J (Katzmann and Wigney JJ agreeing)), it is appropriate to scrutinise those reasons with a considerable degree of care given the potential consequences faced by Mr Taivei. It is to be assumed that the Minister was also very conscious of the need to carefully consider Mr Taivei's fate given his rather unique medical condition.
27 The submissions advanced on behalf of Mr Taivei as to the significance to be attached to the absence of express "findings" should be understood in the context of not ignoring the "findings" which the Minister did make - primarily those made at paras [60] and [63]. The findings made by the Minister include that:
Mr Taivei has "complex health problems with a high risk of morbidity and mortality";
Mr Taivei "may be unable to receive optimum treatment in Fiji";
Removal to Fiji "will involve an element a [sic] risk to his health"; and
Mr Taivei "will experience considerable hardship" if he is removed.
28 The conclusion that the present reasoning process does nevertheless expose legal error is founded in large part on the manner in which the Minister:
merely "note[s]" many of the submissions which have been made and the medical opinions which have been expressed;
as opposed to:
proceeding to resolve those submissions or making findings of fact;
29 A fair and common sense reading of the Minister's reasons, it is considered, exposes the Minister:
carefully juxtaposing those matters which he "note[s]" and those in respect to which he makes "find[ings]".
In some cases, a practical and common sense reading of reasons of an administrative decision-maker may expose an interchangeability of terminology or "instance[s] of 'looseness in language' or 'unhappy phrasing'" (cf. Minister for Immigration and Border Protection v SZUSU [2016] FCAFC 50 at [41], (2016) 237 FCR 305 at 314 per Tracey, Flick and Katzmann JJ ("SZUSU")) such that no meaningful distinction should be drawn between the way two terms are used; in other cases, a practical and common sense reading of such reasons may expose a careful distinction being made by the decision-maker.
30 In the present case, the Minister:
sets forth the substance of the medical opinions being expressed, or at least some of those opinions, and either "note[s]" those opinions or submissions or sets forth that which the opinion "indicates" (e.g., at paras [51], [52], [54], [55] and [57]);
and thereafter:
sets forth what the Minister "find[s]" or "accept[s]" (e.g., at paras [60] and [63]).
But missing from the Minister's process of consideration are findings of fact directed to the opinions of Associate Professor Post and Drs Clezy and Ooi. Although the opinions may well have been "noted" or it may have been accepted that the evidence "indicate[d]" certain things, left unanswered in the reasons provided is:
whether the Minister accepted as factually accurate what was being put to him;
or:
whether the Minister rejected or had reservations about the medical opinions being presented or whether they (for example) overstated the medical difficulties Mr Taivei faced or whether they were opinions expressed more in the nature of a partisan statement or with an "advocate's flourish" rather than as objective statements of fact.
Rejected is a submission advanced by Counsel on behalf of the Minister that the use of the term "note" should be read as the Minister accepting as factually correct that which he merely "note[s]". The Statement of Reasons, it is considered, deliberately draws a distinction between that which is "note[d]" and that which the Minister "find[s]". The Minister, it may be assumed, was conscious of the statutory obligations imposed upon him to "set out the findings on material questions of fact" (Acts Interpretation Act s 25D) and conscious of the need to set forth those "findings" which he considered were "material" to the decision made: cf. Yusuf [2001] HCA 30 at [69], (2001) 206 CLR 323 at 346 per McHugh, Gummow and Hayne JJ. It may well be an unproductive exercise to consider the variety of other expressions which may have been employed by the Minister to convey his "acceptance" of the medical opinions being expressed. One simple expressions would have been for the Minister to "accept" those opinions (which is again language used elsewhere in the reasons) as opposed to merely "note" them. But the Minister did neither - he neither made "findings" as to the medical opinions being expressed nor "accepted" those opinions.
31 Although the Minister, for example, sets forth what the reports of Dr Clezy "indicated" (at paras [53] and [55]) and "note[s]" the submissions being made (e.g., at para [55]), there are no findings made directed to the opinions of Dr Clezy with respect to such matters as:
the comparative rarity of the medical condition suffered by Mr Taivei and the uncertainty surrounding the "most appropriate treatment";
the need for "regular monitoring" and regular "follow up visits with specialists"; or
the need for "access to immediate specialist health care" if Mr Taivei's health deteriorates.
Also missing from the Minister's process of consideration is any specific finding with respect to the opinions of the Interventional Cardiologist, Dr Ooi, as to such matters as:
that Mr Taivei's medical care will require "frequent visits and a high level of medical expertise" and that such care "will be of the utmost importance" to give Mr Taivei "the best opportunity for a favourable outcome".
Rejected is the further submission advanced on behalf of the Minister that the statements at (for example) paras [53] and [55] were but a short-hand acceptance of the entirety of the opinions being conveyed to him by the medical practitioners. There was, it was accepted by Counsel on behalf of the Minister, no disagreement expressed by the Minister with respect to those opinions. Given the terms in which the Statement of Reason were drafted, it is, with respect, far from self-evident that the Minister was nevertheless expressing any unqualified acceptance of the medical opinions being expressed or making any findings that the matters set forth in those opinions were factually accurate.
32 Also missing from the Minister's reasons - which would readily be expected if "proper" and "genuine" consideration was given to the submission being advanced - is any consideration of or any findings directed to:
whether the particular medication required by Mr Taivei is even available in Fiji; and
whether the specialists identified in the medical evidence as necessary for Mr Taivei's care, namely specialists in "Infectious Diseases, Ophthalmology and Cardiology", are even available in Fiji.
Although it may be correct to find that Mr Taivei "may be unable to receive optimum treatment in Fiji", again what is missing is any findings being made or consideration being given to:
the "treatment" in fact available, not just whether or not it is "optimum" or even "adequate"; and
the nature of the "limited social welfare support" which is available to Mr Taivei as a citizens of Fiji (at para [63]).
33 Further, no finding addresses the representation made on behalf of Mr Taivei that a consequence of removal to Fiji would be that Mr Taivei is at risk of premature death. This submission was acknowledged by the Minister (at para [56] and possibly [59]). However, the finding (at para [60]) that Mr Taivei has "complex health problems with a high risk of morbidity and mortality" is true whether or not he remains in Australia. It does not address the consequences for those "health problems" of his removal to Fiji and, more particularly, the prospect of "premature death". At no point does the Minister make findings that there is, in fact, no risk of premature death from his removal to Fiji, only that he "may be unable to receive optimum treatment in Fiji" (at para [60]) and that removal would involve "an element of risk to his health" (at para [63]). Nor does the Minister conclude that, even if there is a risk of premature death, it is not "another reason why the original decision should be revoked" (Migration Act s 501CA(4)(b)(ii)).
34 The absence of any findings going to these matters is only underlined by the Minister's reference in his Statement of Reasons to the submissions of Mr Matherson (at paras [55] and [56]) but the absence of any consideration or finding with respect to an important part of those submissions, namely:
Mr Matherson's recounting of the content of the "SmartTraveller" website; and
the advice on that website that it is "usually necessary" to remove people with "serious illness" to Australia.
35 The focus upon those findings which are not made by the Minister in his Statement of Reasons is not to focus upon findings which this Court may itself have considered to be findings "material" to the decision to be made but rather is a focus upon what the Minister failed to do. The mandate imposed upon the Minister by s 25D of the Acts Interpretation Act to set forth those findings which he considered to be "material" exposes the Minister falling short of giving "proper, genuine and realistic" consideration to the material before him and the submissions being made.
36 In the present case it is respectfully concluded that there has been no "looseness" in language (cf. SZUSU [2016] FCAFC 50 at [41], (2016) 237 FCR 305 at 314 per Tracey, Flick and Katzmann JJ) but rather a careful and deliberate use of terminology on the part of the Minister.
37 Left to one side is further reservation as to why the Minister saw fit to qualify the finding made at para [60] by saying that Mr Taivei "may" be unable to receive optimum treatment.
38 It matters little, with respect, whether the missing aspects of the Minister's consideration be characterised as:
a failure to give "proper, genuine and realistic" consideration to the claims being made (cf. Khan v Minister for Immigration and Ethnic Affairs (unreported, FCA, Gummow J, 11 December 1987); Williams v Minister for the Environment and Heritage [2003] FCA 535 at [29], (2003) 74 ALD 124 at 130 per Wilcox J; WZAQU v Minister for Immigration and Citizenship [2013] FCA 327 at [12] to [13], (2013) 233 FCR 534 at 537 to 538); or
legal unreasonableness (cf. Minister for Immigration and Citizenship v Li [2013] HCA 18 at [28], (2013) 249 CLR 332 at 350 to 351 per French CJ ("Li")).
39 A decision based upon a process of reasoning or sequential factual findings in respect to which there are significant "missing" elements can also be regarded as:
a denial of procedural fairness. An opportunity to be heard and an opportunity to advance submissions may well fall short of affording procedural fairness if a centrally relevant submission is not genuinely "heard" and considered. It is a denial of procedural fairness to fail to take into account submissions that have been made: cf. MZAFS v Minister for Immigration and Border Protection [2016] FCA 75 at [7], (2016) 237 FCR 347 at 348 to 349 per Edelman J. An opportunity to be heard is of little meaning to a visa claimant if the decision-maker does not listen to what is being said and thereby does not "hear" and consider what is being advanced. An opportunity to be heard goes beyond the mere allocation of time in which to make oral submissions or an opportunity to provide written submissions; it includes the requirement to thereafter consider what is being put forward for consideration: Minister for Immigration and Citizenship v SZQRB [2013] FCAFC 33 at [389], (2013) 210 FCR 505 at 577 to 578 per Flick J.
To so recognise is to recognise nothing more than the fact that grounds of review, including grounds of review which go to the jurisdiction of an administrative decision, may overlap.
40 A similar conclusion to that reached in the present case was reached in Buadromo v Minister for Immigration and Border Protection [2017] FCA 1592 at [49]. It was there concluded that the Minister's mere "not[ing]" of various matters of evidence was a failure to give "proper, genuine and realistic consideration" to the matters identified. An appeal from that decision was heard by the Full Court in May 2018, but judgment is still reserved. The Respondent Minister submitted that if the decision in Buadromo is to be determinative of the present application, it may be appropriate to await the decision of the Full Court. That submission is rejected. It is respectfully considered that the decision in Buadromo and the decision in the present case are decisions directed - not surprisingly - to the facts and circumstances of each individual case and a proper construction of the reasons provided in each case.
41 The absence of findings directed to the content of the medical opinions being expressed, it is respectfully considered, goes beyond a mere failure to refer to each and every piece of evidence presented for resolution and exposes a failure on the part of the Minister to genuinely engage with those medical opinions. There is no requirement upon an administrative decision-maker "to refer to every piece of evidence and every contention made by an applicant in its written reasons": Applicant WAEE v Minister for Immigration and Multicultural and Indigenous Affairs [2003] FCAFC 184 at [46], (2003) 236 FCR 593 at 604 per French, Sackville and Hely JJ. Nor is an applicant entitled to opportunistically trawl back through submissions made with a view to finding some statement of a disputed fact or some material which has not previously been given much emphasis in submissions made and one which has (perhaps not surprisingly) not been specifically addressed by the Minister or given any great prominence in the reasons provided and thereafter rely on it to found an argument as to error on the part of the Minister: cf. Stojanovski v Assistant Minister for Immigration and Border Protection [2017] FCA 609 at [71] per Flick J.
42 But what an applicant is legally entitled to is a "proper, genuine and realistic consideration" of the claims being made. The present case is one in which the visa holder was presenting his medical condition and the consequences of non-revocation as a substantial basis for seeking Ministerial intervention and a case where submissions centrally relevant to the claims being made went largely unanswered. The generalised finding (for example) that Mr Taivei "may be unable to receive optimum treatment in Fiji" is no substitute for findings directed to the medical opinions being expressed and the potential consequence of premature death.
43 It is considered that the conclusion as to legal unreasonableness by reason of that which is missing from the Ministerial process of consideration - as opposed to simply (and impermissibly) reaching a different assessment of the facts presented - does not impermissibly elevate a finding of legal error into a "vehicle for challenging a decision on the basis that the decision-maker has given insufficient or excessive consideration to some matters or has made an evaluative judgment with which a court disagrees even though that judgment is rationally open to the decision-maker": Li [2013] HCA 18 at [28] to [30], (2013) 249 CLR 332 at 350 to 351 per French CJ. See also: [2013] HCA 18 at [66], (2013) 249 CLR at 363 per Hayne, Kiefel and Bell JJ.
44 The conclusion in the present case that the decision is legally unreasonable is a conclusion founded upon the fact that the decision made by the Minister appears to be based upon a series of unstated assumptions or unstated findings of fact. The decision is thus one which "lacks an evident and intelligible justification": Li [2013] HCA 18 at [76], (2013) 249 CLR at 367 per Hayne, Kiefel and Bell JJ.
45 The present conclusion, it is considered, does not impermissibly trespass into the area of "decisional freedom" which remains a matter for the Minister alone: Minister for Immigration and Border Protection v Eden [2016] FCAFC 28 at [62], (2016) 240 FCR 158 at 171 per Allsop CJ, Griffiths and Wigney JJ. Had findings of fact been made in respect to those "missing" matters, even if erroneously found, any such error may have been an error within jurisdiction. To recognise such possibilities, however, is to simply recognise that any future findings that may be made and any future decision remain matters for the Minister.