7.2.5 Was the Second Decision made on dictation (ground 2(e))?
158 The applicant submits that the proper inference to be drawn by the Court from the objective circumstances is that Dr Rankin acted on a "pre-determined footing".
159 However, in my view, the applicant has failed to establish any sufficient basis on which to infer that Dr Rankin failed to bring an independent mind to bear on the question of whether he considered that the applicant had intentionally not complied with the s 89 Notice to Produce but instead made the decision under dictation. To the contrary, while (as I shortly explain) I do not accept Dr Rankin's evidence that he considered that the applicant did not believe his lawyer's advice as to the scope of the Notice to Produce, Dr Rankin's account otherwise of what occurred on 8 November 2021, and in particular his evidence that he personally decided that the s 106ZPM notice should be issued, is corroborated by the evidence of Ms Parker and the documentary evidence.
160 It is convenient to explain my reasons for so holding by addressing each of the key circumstances set out in the applicant's updated submissions at [117].
161 First, relying upon the contradictory and unsatisfactory evidence which Dr Rankin gave regarding the factors he took into account in deciding to issue the s 106ZPM notice, the applicant submits that the Court should find that Dr Rankin's evidence "is a reconstruction of what … he ought to have done rather than what he did in fact do" and was "in part invented during cross-examination to address deficiencies in his account". The applicant further submits that this "casts enormous doubt over the reliability of his evidence about his decision making on 8 November 2021 generally."
162 The respondent properly accepts that Dr Rankin's alleged belief that the applicant did not genuinely believe in the construction of the s 89B Notice being presented by his solicitors, as part of the basis for his decision to issue the s 106ZPM notice to the applicant, is inconsistent with his other evidence. The respondent also correctly accepts that Dr Rankin's memory of his exact thought processes on 8 November 2021 is imprecise and has evolved such that it should be treated with some caution. In so finding, I do not accept that Dr Rankin was intentionally untruthful.
163 However, as the respondent submits, it does not follow from the deficiencies in his evidence that the entirety of Dr Rankin's evidence ought not to be believed, including his evidence that he came to his own independent decision as to the issuing of the s 106ZPM notice. Rather, Dr Rankin's evidence should be accepted where it is corroborated by other evidence, as it is most notably with respect to his evidence of bringing an independent mind to bear in making the Second Decision as I explain below. Furthermore, in drawing inferences, the fact that a witness is disbelieved does not prove the opposite of that which the witness asserted; nor importantly for present purposes, does disbelief of one party's case prove the opposing party's case: Macks v Viscariello [2017] SASCFC 172; (2017) 130 SASR 1 at [603]; Kuligowski v Metrobus [2004] HCA 34; (2004) 220 CLR 363 at [60].
164 Secondly, as the respondent submits, the applicant has not identified any reason why Dr Rankin might have felt constrained or under pressure to exercise his statutory power otherwise than in accordance with his own independent view after considering the material and taking advice from PSR officers and AGS with whom he met during the course of the day. Dr Rankin is a senior medical officer in the Department of Health who has acted as the Director on seven separate occasions, including over a five month period between August 2016 and February 2017. As such, his circumstances were far removed from, for example, the situation in Okwume where the primary judge held that the decision-maker had acted at the behest of his Duty Manager (albeit that ultimately the Full Court held that the finding had been made in breach of procedural fairness). The more probable inference, given his seniority and experience, is that Dr Rankin understood that the decision was his own to make, and acted consistently with this understanding.
165 Thirdly, Dr Rankin's evidence that he made an independent decision that the circumstances warranted the issue of the s 106ZPM notice is corroborated by Ms Parker's evidence, as well as the documentary evidence. In this regard, Ms Parker gave detailed and credible evidence in cross-examination by Mr Hodge, counsel for the applicant, about discussions with Dr Rankin regarding what he needed to be satisfied of in order to determine whether there had been intentional non-compliance:
[MS PARKER]… Dr Rankin had asked if - I don't he specifically asked but I recall discussing whether he needed to be cumulatively satisfied that both the records that were provided were only the review period and also there were - there could be handwritten cards that were missing or would it be sufficient if he formed the view on one of those pieces of information alone for him to be able to execute - to make - to form the view that there had been intentional non-compliance. So I recall discussing with him that - how those two different pieces of information related to each other and how he might use them to form his view. So matters such as that were discussed during the course of the day.
[MR HODGE] There was no dispute, was there, from Dr Yoong that he had not provided documents that existed outside of the review period? [MS PARKER] Correct.
[MR HODGE] That was just - from your perspective, that could never have been an issue on the day. You knew that Dr Yoong also accepted that he had not provided clinical records outside of the review period? [MS PARKER] That's right and I think what Dr Rankin was saying, is that a sufficient basis to proceed with the 106ZPM notice or do you also need to be satisfied that there was other material missing? I think would have been the nature of the discussion.
[MR HODGE] And when you say you think that would have been the nature of the discussion? [MS PARKER] Sorry. That was the discussion that we had.
166 Furthermore, Dr Rankin attended meetings with the PSR officers and AGS lawyers in respect of the decision-making process, and considered more material than was necessary for him to make the decision (including the applicant's clinical records). There is no reason why Dr Rankin would have taken these steps if he had not considered that it was necessary for him to be informed about matters relevant to a decision under s 106ZPM and therefore that the decision was one which he personally had to make.
167 It follows that, while Dr Rankin's recollection of his own thought processes is to some extent imperfect, the respondent correctly submits that the contextual evidence (as I explain further below) demonstrates that all participants, including Dr Rankin himself, were operating during the course of 8 November 2021 on the basis that Dr Rankin was making a decision personally.
168 In the fifth place, the applicant relies upon the statement in a briefing note provided to Dr Rankin via email at 12:17pm on 5 November 2021 in advance of his appointment as Acting Director that "PSR has not accepted" the applicant's position as to the proper scope of the Notice to Produce and that the historical card record was produced in error. The applicant submits that that statement implies that the PSR had pre-determined the question of whether the applicant was non-compliant with the Notice to Produce and that the reference to "PSR" should be read as referring to Professor Quinlivan.
169 With respect, the briefing note does not lend any support to the drawing of such an inference. At the outset the briefing note defined "PSR" as "Professional Services Review (PSR) staff" and not as the Director. As such, the briefing note set out the views of PSR staff. Furthermore, the note itself explained that it was intended only to provide Dr Rankin "with the key history and issues" (emphasis added), being language which is apt to convey an understanding that the note was to assist Dr Rankin to make his own decision. In line with this, the statement in the briefing note on which the applicant relies occurs in the context of explaining the historical approach taken by PSR to date, and, as an aspect of this, explained that the applicant has been put on notice that the failure to make substantial steps towards complying with the Notice to Produce "may result in a notice being issued under section 106ZPM" (emphasis added). As such, far from suggesting that a pre-determined decision had been made to issue the s 106ZPM notice, the briefing note makes it clear that no such decision had been made.
170 Sixthly, the applicant seeks to draw adverse inferences from the circumstances in which the draft s 106ZPM notice was prepared to the effect that Ms Parker and Ms Skinner were working on the basis that the issue of the s 106ZPM notice had been pre-determined. The short answer to that submission is that it is Dr Rankin's state of mind which is in issue, and not whether PSR staff believed that the issue had been pre-determined by Professor Quinlivan - a point equally applicable to the inferences which the applicant seeks to draw from the briefing note which I have otherwise addressed.
171 In any event, the circumstances in which the draft s 106ZPM notice was prepared on which the applicant seeks to rely do not provide a sound basis for drawing any such inference. Those circumstances were identified by the applicant as follows.
(1) It should be inferred that Ms Skinner commenced drafting the s 106ZPM notice on the night of 7 November 2021 because she was acting upon the basis that the decision to issue the s 106ZPM notice had been pre-determined by Professor Quinlivan, given the lack of any other explanation from the PSR.
(2) That inference is supported by the fact that:
there was no satisfactory explanation for when Ms Parker and Dr Rankin first became aware of the draft 106ZPM notice or why it was worked on by Ms Skinner and Ms Parker without those persons apparently having discussed with Dr Rankin the drafting of a 106ZPM notice. Having regard to the attached applicant's chronology, the available inferences are that (a) Ms Skinner first told Dr Rankin and Ms Parker about the draft 106ZPM notice during the video conference held at 9:30am on the morning of 8 November 2021; and (b) Ms Skinner and Ms Parker worked on the draft 106ZPM notice because the outcome had been pre-determined by Professor Quinlivan and all three of Ms Skinner, Ms Parker, and Dr Rankin appeared to understand this during the video conference at 9:30am[.]
(3) These inferences can more comfortably be drawn having regard to the unexplained failure to call Ms Skinner and Professor Quinlivan.
(4) The drafting of the s 106ZPM notice continued for much of 8 November 2021 and the whole of the day's activities on 8 November 2021 were in fact directed to getting to the point that Dr Rankin could sign the letter to the applicant.
(5) No work was done by PSR employees, or requested to be done, to prepare for any alternative outcome other than the issuing of the notice.
172 However, it is not correct to say that there is no explanation as to why the draft s 106ZPM notice was prepared in advance of any decision by Dr Rankin. Ms Parker explained that it was a "relatively common practice in PSR" to draft the s 106ZPM notice before knowing the Director's decision, and indeed she would draft letters for the Director, including s 106ZPM notices, "[e]very day, with extreme regularity". I accept that evidence as entirely plausible. The better inference from the preparation of a draft notice is, as similarly held in Loielo v Giles, that "[t]hat is common public sector practice and recognises that the decision-maker will not have time to draw up detailed documents": at [176].
173 More specifically, Ms Parker explained that the s 106ZPM notice needed to be drafted urgently "because you are operating under time constraints". Ms Parker understood that under s 106ZPM, "once the director forms the view there has been an intentional failure to comply with the notice, there is no discretion. They must advise the practitioner, and they must tell Medicare". Therefore, Ms Parker understood that "if he formed the view on that day, we would need the documents ready to go". She was therefore "preparing documents so Dr Rankin could make any decision available to him, and [they] would be ready to go whatever decision he made". Importantly in this regard, Ms Parker's understanding of the operation of s 106ZPM is correct. As I have earlier explained, there is no discretion: the prohibition on paying Medicare benefits in s 106ZPM(1) applies once there is in fact intentional non-compliance, and if the Director considers that there has been intentional non-compliance, the Director must issue the s 106ZPM notice in accordance with s 106ZPM(2). It follows that Ms Parker's explanation of why the s 106ZPM notice had to be drafted urgently in advance of the 8 November deadline whereupon Dr Rankin may form the necessary state of mind is completely plausible and I accept that evidence.
174 In that context, it is scarcely surprising that Dr Rankin was not consulted before steps were taken to prepare a draft s 106ZPM notice. It was prepared only to cover the possibility that the notice might need to be issued urgently, depending on what further material might be forthcoming from the applicant and his solicitors before the deadline expired and on what view Dr Rankin might take following the expiry of the deadline. In this context, Ms Parker's evidence that she did not tell Dr Rankin, on the morning of 8 November, that she and Ms Skinner had been drafting a s 106ZPM notice, because she was not sure that was the decision he wanted to make, and he was still in the process of making the decision, is also entirely credible. It follows that I do not accept the applicant's submission that Ms Skinner and Ms Parker were acting "on the basis of the decision that had already been made by Professor Quinlivan".
175 Additionally, as the respondent submits, Ms Parker's evidence is also consistent with a number of documentary records that demonstrate the PSR's understanding of the urgency of issuing the s 106ZPM notice. For example, the notification from the Department of Health to the applicant dated 9 November 2021 states that the disqualification was effective "from midnight 8 November 2021". Similarly, a letter from Professor Quinlivan to the applicant which issued the first s 106ZPM notice on 23 July 2019 stated that as of midnight that day, all Medicare benefits would cease to be payable, as did the email of the same date to the Department of Health.
176 Nor can any adverse inferences be drawn from the respondent's failure to call Ms Skinner as a witness. Ms Skinner was a junior employee who reported to Ms Parker. Ms Parker was the Head of the PSR case management unit, being the unit responsible for assisting the Director with implementing the processes of the PSR's review, and gave evidence, including about the preparation of the draft notice. So too did Dr Rankin, the Acting Director and decision-maker. Therefore, I do not draw an inference of the type in Jones v Dunkel from the respondent's failure to lead evidence from a subordinate employee of the PSR in circumstances where their superior and the actual decision-maker have been called to give evidence: Apand Pty Ltd v Kettle Chip Co Pty Ltd [1994] FCA 526; (1994) 52 FCR 474 at 490.
177 Additionally, the applicant alleges that an adverse inference should be drawn from the failure to call Professor Quinlivan. Precisely what adverse inference, however, is not explained given that Professor Quinlivan was not the decision-maker. Furthermore, as I have earlier explained, Dr Rankin accepted in cross-examination that it was likely that Professor Quinlivan had communicated her position to Ms Skinner and Ms Parker, both of whom "may have" formed a view that Professor Quinlivan believed that a s 106ZPM notice was to be issued.
178 In the seventh place, the applicant contends that Dr Rankin would not have had sufficient time before making his decision to consider the letter dated 8 November 2021 of more than 3 pages from MinterEllison which was forwarded to Dr Rankin at 12:57pm. However, this submission is purely speculative and is not supported by any evidence; nor was this contention put to Dr Rankin in cross-examination. Rather, I accept Dr Rankin's evidence that he "read that letter at around the time [he] received it". Furthermore, I note that Dr Rankin had a meeting with AGS lawyers at 2pm that day "to obtain legal advice from AGS to assist [him] with [his] decision whether to issue a s 106ZPM notice". While the contents of that meeting are subject to legal professional privilege and were not in evidence, it can reasonably be inferred that Dr Rankin would have discussed the letter from MinterEllison sent that day. As such, this case is a far cry from those where the Court inferred that there could have not been any active intellectual engagement by the decision-maker with the material before her or him: cf e.g., Burgess v Minister for Immigration and Border Protection [2018] FCA 69; (2018) 259 FCR 197 at [80]-[94] (Charlesworth J) where the Minister spent no more than 15 minutes on 89 pages of materials of varying importance and complexity, including draft reasons; and Chetcuti v Minister for Immigration and Border Protection [2019] FCAFC 112; (2019) 270 FCR 335 at [101] (Murphy and Rangiah JJ) (O'Callaghan J diss) where the Minister spent 11 minutes considering 130 pages of material, also including a draft statement of reasons.
179 In a similar vein, the applicant alleges that the most relevant documents were provided to Dr Rankin only late on 8 November 2021 because there was "an acute consciousness (arising from an earlier legal proceeding against the PSR) that Dr Rankin needed to be able to say he had read documents before he signed the letter". However, as is apparent from the events of 8 November 2021 chronicled above, throughout the course of that day, Dr Rankin was receiving documents, considering them, and having meetings with PSR officers and AGS lawyers. If the applicant's submission was accepted, that would require the Court to find that Dr Rankin had engaged in a ruse designed to avoid criticism of a kind allegedly made against the Director in another proceeding by Dr Kitchen. As the respondent submits, the applicant has failed to discharge his onus to explain "[w]hy such an elaborate farce was necessary", especially where it was open to Dr Rankin to make the decision that he did. There is absolutely no reason not to infer that Dr Rankin acted otherwise than to ensure that he could make a properly informed decision on whether the applicant had intentionally failed to comply with the Notice to Produce and a s 106ZPM notice should therefore be issued. Indeed, as the respondent submits, to the extent that there was any "acute consciousness" within PSR brought about by the Dr Kitchen matter of the duty to consider, the more likely inference is that PSR officers were acutely conscious of the need to comply with the duty to engage in an active intellectual consideration of the relevant material before making a decision, as no doubt were their legal advisers.
180 Next the applicant contends that an inference should be drawn from the fact that Dr Rankin did not make any contemporaneous record of his decision. However, as the respondent correctly submits, there is no requirement under the HI Act for the Director to give reasons; nor is there any requirement that a notice under s 106ZPM contain any specific content other than to notify the practitioner that s 106ZPM(1) is engaged. The only requirements are that: (1) the Director form the relevant state of mind; and (2) notice of that fact is given to the practitioner. Dr Rankin's evidence demonstrates his correct understanding of the legislative provisions. He explained during cross-examination that a s 106ZPM notice was nothing but notification of "the fact that, in PSRs view, [the practitioner] hadn't complied with the section 89B notice and they would be disqualified from Medicare". He also correctly explained that the notice did not need "to contain [his] reasons for making of the decision". As such, nothing turns on the fact that Dr Rankin did not make any contemporaneous record of his decision other than signing the notice.
181 Finally, the applicant contends that Dr Rankin's decision was made before the deadline for the applicant to comply with the notice. However, that submission contradicts Dr Rankin's evidence, which I accept, that he had made his decision at around 5:23pm (in New South Wales) on 8 November 2021. I further accept Dr Rankin's evidence that his decision was made subject to the applicant complying with the notice by close of business in Queensland. Furthermore, as the respondent submits, the notice was not in fact issued to the applicant until after 5pm in Brisbane. That is consistent with the approach which Dr Rankin said he had taken, namely that the applicant was afforded until close of business to comply and when it became apparent in Dr Rankin's view that the applicant had not complied with the Notice to Produce, s 106ZPM(1) was engaged and notices were given to the applicant and Medicare in accordance with ss 106ZPM(2) and (3).