PB - [2020] WASAT 121

JURISDICTION     :   STATE ADMINISTRATIVE TRIBUNAL
ACT: GUARDIANSHIP AND ADMINISTRATION ACT 1990 (WA)
CITATION:   PB [2020] WASAT 121
MEMBER:   JUSTICE PRITCHARD, PRESIDENT
MR J MANSVELD, MEMBER
DR J CAUNT, SESSIONAL MEMBER

HEARD:   29 JUNE 2020
DELIVERED          :   12 OCTOBER 2020
FILE NO/S:   GAA 1414 of 2020

PB
Represented Person

Catchwords:

Administration - Whether represented person is unable, by reason of a mental disability, to make reasonable judgments in respect of matters relating to all or any part of his estate - Whether represented person suffers from mental disability

Guardianship - Whether represented person is in need of oversight, care or control in the interests of his own health and safety - Whether represented person in need of a guardian

Legislation:

Guardianship and Administration Act 1990 (WA), s 3(1), s 4, s 17A, s 43(1), s 64
State Administrative Tribunal Act 2004 (WA), s 27

Result:

Administration order revoked
Guardianship order varied

Category: B

Representation:

Counsel:

Represented Person

In Person

Solicitors:

Represented Person

In Person

Case(s) referred to in decision(s):

FS [2007] WASAT 202
FY [2019] WASAT 118

REASONS FOR DECISION OF THE TRIBUNAL:

Introduction

By a letter dated 6 April 2020, Dr TC applied, on behalf of PB, for a review of orders (Orders) in relation to PB which were made by the Tribunal on 17 March 2020, pursuant to the Guardianship and Administration Act 1990 (WA) (GA Act). That letter was received as an application for a review, pursuant to s 17A of the GA Act (Review Application), of the decision made by a single member of the Tribunal on 17 March 2020 (Original Decision), to appoint the Public Trustee as the plenary administrator of PB's estate (administration order), and to appoint the Public Advocate as the limited guardian for PB (guardianship order).
In the Original Decision, the learned Member declared that PB was unable, by reason of a mental disability, to make reasonable judgments in respect of matters relating to all of his estate; and in need of an administrator of his estate.
The learned Member also declared that PB was incapable of looking after his own health and safety; unable to make reasonable judgments in respect of matters relating to his person; in need of oversight, care or control in the interests of his own health and safety; and in need of a guardian. Under the guardianship order, the Public Advocate was given the following functions: to decide where PB is to live, whether permanently or temporarily and to decide with whom PB is to live (accommodation decisions); to make treatment decisions for PB, subject to Division 3 of Part 5 of the GA Act (treatment decisions); to determine what contact, if any, PB should have with others and the extent of that contact (contact decisions); and to determine the services to which PB should have access (services decisions).
At the commencement of the hearing of the Review Application, PB confirmed that he sought a review of both the guardianship order and the administration order.[1] The hearing of the Review Application had to be adjourned, part-heard, to enable further medical evidence to be obtained. At the resumed hearing, PB indicated that he accepted that he needed a guardian, but continued to dispute that an administration order was required.[2] However, in respect of the former concession, PB's view was somewhat ambiguous.[3] Given the ambiguity in PB's attitude to the guardianship order, and as the application for review of the guardianship order was not formally withdrawn, we have approached the Review Application on the basis that a review of the guardianship order, as well as the administration order, is required.
[1] ts 3, 4 June 2020.
[2] ts 21, 29 June 2020.
[3] PB acknowledged that 'sometimes I do need them, sometimes I don't, you know? So, yes … I do need a guardian but not all the time': ts 11, 29 June 2020. PB also told us that 'I really don't care if - if nothing changes. But I would appreciate it if something did change': ts 30, 4 June 2020.
For the reasons which follow, we are not satisfied that PB is a person who, at present, is unable, by reason of a mental disability, to make reasonable judgments in respect of matters relating to all or part of his estate. As that fundamental requirement for the appointment of an administrator is not satisfied, there is no basis for the appointment of an administrator at present.
We are satisfied, and we find, that PB is in need of oversight, care or control in the interests of his own health and safety, and that he is in need of a guardian. The Public Advocate should be appointed PB's guardian with limited powers of guardianship. The only decision making functions which are presently required, having regard to PB's circumstances, are the functions of making services decisions and contact decisions.
The guardianship order should be reviewed in five years, namely by 9 October 2025. Should PB's circumstances change, an application may be made for an earlier review of the guardianship order, or alternatively for the making of an administration order.

Factual background

PB is 49 years old. PB has cerebral palsy and as a result he lives with significant physical disabilities. PB uses a wheelchair to move around. His vision is impaired and he wears glasses. He is doubly incontinent. PB's fine motor skills are deteriorating, which gives rise to increasing challenges in his daily living, such as in opening and locking doors, and holding a drink without spilling it.
PB has never been diagnosed with an intellectual disability or learning issues, and has no history of mental illness.
PB lives on his own, in a Department of Housing property. His only income is a disability support pension.
PB receives NDIS funding for assistance 24 hours' a day to enable him to live independently, with support. He has carers who know him very well, and who attended the hearing of the Review Application. It was evident that they are extremely supportive of him.
PB was described as 'a fiercely independent man who does not like being identified as "disabled"'.[4] PB regularly exhibits negative behaviours. He can be verbally and physically aggressive to his carers.
[4] Undated report of BP, Clinical Neuropsychologist, Hearing Book (HB) 27.
PB can speak, but when he becomes frustrated or angry, he has difficulty communicating clearly. That presents difficulties for those trying to provide care and support if they do not know him well.
On the other hand, the evidence available to us suggested that PB can be very generous, kind, and trusting of others, which has led to difficulties in the past, as we explain below.
PB has family who care for him. However, they do not live nearby to him. PB's relationships with his family appear to be strained at times, perhaps in part because of the tension between his desire to be independent and their desire to ensure he is receiving all the care he needs. None of them attended the hearing of the Review Application, or sought to be appointed as a guardian or administrator for him, because of their concern that this would damage their relationship with PB.
In January 2020, PB became very unwell and was eventually admitted to hospital with an impacted bowel. He experienced some delirium as a result of that condition.[5]
[5] Report of JD, Senior Social Worker, dated 10 March 2020.
In the months leading to his admission to hospital, PB's family and carers observed him making decisions which caused them to become concerned about his capacity to make reasonable judgments about personal and financial matters. While in hospital PB's cognitive ability was assessed. As there was evidence that his decision making capacity was impaired, an application was made to the Tribunal for the appointment of a guardian and administrator for PB.
Since his discharge from hospital, PB has fully recovered from the physical illness that led to his admission to hospital. The key evidentiary questions on the review included whether PB shows signs of cognitive impairment, whether that was attributable to him suffering from a 'mental disability' as defined in the GA Act, and whether, by reason of that mental disability, he was unable to make reasonable judgments about his person or his estate.

The nature of the review

Section 17A(1) of the GA Act permits any party who is aggrieved by a determination made by the Tribunal consisting of one member, to request the President of the Tribunal to arrange for a Full Tribunal to review the determination. As the Tribunal is exercising its review jurisdiction, the hearing of the Review Application was conducted as a hearing de novo. Consequently, the hearing was not confined to the matters that were before the Tribunal at first instance but involved the consideration of new material including evidence the Tribunal received in the course of the hearing of the Review Application.[6]
[6] State Administrative Tribunal Act 2004 (WA) (SAT Act) s 27(1).
The purpose of a review is to produce the correct and preferable decision at the time of the decision on the review.[7]

Principles governing proceedings under the GA Act

[7] SAT Act s 27(2).

In dealing with the Review Application we are mindful of the obligation on the Tribunal to observe the principles set out in s 4 of the GA Act.
Under the GA Act, every person is presumed to be capable of looking after their own health and safety, making reasonable judgments in respect of matters relating to their person, managing their own affairs, and making reasonable judgments in respect of matters relating to their estate, until the contrary is proved to the satisfaction of the Tribunal.[8] That important presumption applies in respect of every application under the GA Act, including the present Review Application.
[8] GA Act s 4(3).
Underlying the GA Act is a principle that the derogation of a person's decision making authority, by the exercise of the powers under the GA Act, should be by means which are the least restrictive of a represented person's freedom of decision and action. So, for example, a guardianship or administration order should not be made if the needs of the proposed represented person could, in the opinion of the Tribunal, be met by other means less restrictive of the person's freedom of decision and action.[9]
[9] GA Act s 4(4).
Similarly, a plenary guardian shall not be appointed if the Tribunal is of the opinion that the appointment of a limited guardian would be sufficient to meet the needs of the proposed represented person.[10] In addition, any order appointing a limited guardian or an administrator should be in terms that, in the opinion of the Tribunal, impose the least restrictions possible, in the circumstances, on the represented person's freedom of decision and action.[11]
[10] GA Act s 4(5).
[11] GA Act s 4(6).
Finally, and most importantly, the primary concern of the Tribunal in exercising its jurisdiction under the GA Act, is the best interests of the represented person (or proposed represented person).[12]

The evidence before the Tribunal on the Review Application

[12] GA Act s 4(2).

In considering any matter relating to a represented person, the Tribunal is required, as far as possible, to seek to ascertain the views and wishes of the person concerned.[13] PB attended the hearing of the Review Application. He gave evidence and made his wishes very clearly known.
[13] GA Act s 4(7).
We heard evidence from PB's general practitioner, Dr MW, and his former general practitioner, Dr TC.
We heard evidence from PB's carers and the staff of service providers who provide PB with assistance and support in his daily living: JL, LW and JB.
We also heard evidence from the delegate of the Public Advocate and a representative of the Public Trustee, who informed us of the arrangements put in place for PB in light of the Orders.
Also in evidence before us were a number of medical reports and documents relating to PB's hospital admission in January 2020, namely:
(1)report of Dr MW, general practitioner, dated 10 June 2020, with attached Mini Mental State Examination test (MMSE test);
(2)report of Dr SS, Consultant Psychiatrist, dated 4 March 2020;
(3)report of Dr TC, general practitioner, dated 22 February 2020;
(4)report of Dr ADS dated 13 February 2020;
(5)copy of Montreal Cognitive Assessment test (MoCA test) administered at Fremantle Hospital, undated;
(6)report of Dr BP, Clinical Neuropsychologist, undated (which referred to a consultation during PB's admission to hospital earlier this year); and
(7)progress Summary notes, Fremantle Hospital, 10 March 2020.
Also in evidence were reports prepared by service providers engaged in PB's care at various times, including:
(1)report of JL, Valued Lives, dated 16 March 2020;
(2)report of LW, Service Coordinator, Cam Can, dated 6 March 2020 and further email report of LW, Cam Can, dated 10 March 2020;
(3)report of JD, Senior Social Worker, Fremantle Hospital dated 10 March 2020; and
(4)report of EC, Social Worker, Fiona Stanley Hospital, dated 5 March 2020.
Also in evidence were reports provided by the Public Trustee and the delegate of the Public Advocate namely:
(1)report of appointed guardian, dated 19 May 2020;
(2)report of Senior Investigator Advocate, Office of the Public Advocate, dated 16 March 2020; and
(3)report of Public Trustee dated 28 May 2020.

The administration order

It is convenient to commence by considering whether the correct and preferable decision is that an administration order should be made in relation to PB.

(a) The criteria for the appointment of an administrator under the GA Act

Before an administrator may be appointed, the Tribunal must be satisfied as to the matters set out in s 64(1) of the GA Act.
Those matters are whether:
(1)PB suffers from a mental disability;
(2)by reason of that mental disability, PB is unable to make reasonable judgments in respect of matters relating to all or any part of his estate; and
(3)PB is in need of an administrator of his estate.
If those three matters are established, then the Tribunal is required to consider subsidiary questions, such as who should be appointed the administrator.

(b) The need for a 'mental disability' and the causal link between that mental disability and an inability to make reasonable judgments in respect of matters relating to a person's estate

The term 'mental disability' is defined in s 3(1) of the GA Act as follows:
[M]ental disability includes an intellectual disability, a psychiatric condition, an acquired brain injury and dementia[.]
The meaning and scope of that definition was considered by the Tribunal in FY.[14] We adopt the Tribunal's observations in FY at [25] [32] without repeating them in their entirety. It suffices to refer to the following summary of the key parts of those observations which are presently relevant.
[14] FY [2019] WASAT 118 at [25]-[32].
The definition of mental disability is an inclusive one, rather than an exhaustive one. The definition expressly encompasses certain recognised medical conditions or diagnoses, each of which may result in some impairment in the functioning of a person's mind. However, a person may have a mental disability for the purposes of the GA Act even if they do not have one of the conditions or diagnoses referred to in the definition. It will suffice if a person has a mental disability according to the ordinary meaning of that term. The ordinary meaning of the term mental disability in the GA Act contemplates that a person's mind is affected by an impairment, incapacity or inability to function in a manner, or within a range, considered to be normal, or which is objectively measurable. A mental disability may manifest in a variety of ways, including as a disturbance or limitation in a person's thought processes or their cognitive ability, in their perceptions of reality, emotions or judgments, in disturbed behaviour or in learning difficulties.
Nothing in the definition of mental disability under the GA Act requires that a finding of the existence of a mental disability be based on a finding as to the existence of one, or more than one, recognised medical conditions or disorders. A finding that a person has a mental disability may, of course, be referrable to the existence of one, or a combination of more than one, identified medical conditions. In other cases, the underlying cause of a person's mental disability may not be entirely clear or susceptible to a particular medical diagnosis, but the existence of the mental disability (on the ordinary meaning of that term) may be beyond doubt.
The definition of mental disability in the GA Act does not contain any requirement that the mental disability be permanent. For the purposes of the GA Act, it matters not whether a person has a mental disability because they were born with an intellectual disability, whether they have developed an impairment in their mental functioning as a result of a disease or a medical condition, or whether they have experienced that impairment as a result of an acquired brain injury. An incapacity to make reasonable decisions in relation to a person's estate which arises as a result of a temporary or transient mental disability may be the basis for an administration order whilst that mental disability (and the impaired decision making it causes) continues.
Furthermore, the definition of mental disability does not require any precise degree of mental disability, measured by reference to some medical or scientific benchmark. For the purposes of s 64 of the GA Act, the only relevant measure is whether the person is unable, by reason of a mental disability, to make reasonable judgments in respect of matters relating to all or any part of their estate.
As we have already mentioned, s 64(1)(a) of the GA Act requires that a person be 'unable, by reason of a mental disability, to make reasonable judgments in respect of matters relating to all or any part of his estate'. The reference to a person's 'estate' is a reference to the aggregate of their property, their assets and liabilities, and in practice encompasses the entirety of their real and personal property and all of their financial affairs.[15]
[15] FY [2019] WASAT 118 at [54] and the references cited therein.
The application of s 64 of the GA Act involves both subjective and objective tests.[16] The Tribunal is required to consider whether the person in respect of whom the application is made has the ability to make 'reasonable judgments' about their estate. That constitutes a subjective test, because the person's ability falls to be assessed in relation to their actual estate. At the same time, the Tribunal must also consider whether the person has the ability to engage in the particular mental process which is required in order to make that judgment, and that test is an objective one. The Tribunal is thus required to:[17]
[C]onsider the extent to which a person with a mental disability is able to engage in the cognitive process that culminates in an ability to make a 'reasonable judgment' (which will vary from person to person and may include a lack of any observed ability), and then to set that ability against the requirements of the person's individual estate and circumstances.
[16]FY [2019] WASAT 118 at [52] citing FS [2007] WASAT 202 at [106].
[17] FY [2019] WASAT 118 at [52] citing FS [2007] WASAT 202 at [110].
As the Tribunal explained in FY,[18] an individual's ability to make reasonable judgments in respect of their estate requires that they have, amongst other things, the ability: to understand the need for, and sources of, income available to them; to understand the value of any income received relative to items of expenditure; to identify and calculate necessary expenditure for day to day living, together with expenditure for longer term financial objectives and discretionary items; to devise a budget so as to be able to live within their means; to identify and to assess the financial implications of particular items of expenditure or of financial decisions (for example whether to enter into contracts such as those for the purchase of a phone, household items, a car, or a house); to organise their affairs so as to be able to meet debts as they fall due; and to identify and implement problem solving strategies for resolving any unexpected financial issues.
[18] FY [2019] WASAT 118 at [53].

Finally, s 64(1)(a) makes clear that an inability to make reasonable judgments in respect of one's estate does not, of itself, constitute a sufficient basis for the making of an administration order. Individuals without a mental disability are entitled to make choices in respect of their estate which others might regard as unreasonable. Nor does the existence of a mental disability, of itself, constitute the basis for the making of an administration order. People with a mental disability may, depending on the nature of the mental disability, be capable of making reasonable decisions in respect of their estate.
It is only if the Tribunal is satisfied, on the evidence before it, that a person has a mental disability, and that it is 'by reason of' that mental disability that they are unable to make reasonable judgments in respect of their estate, so that the presumption of capacity to make such decisions[19] is displaced, that the criterion in s 64(1)(a) will be satisfied. As the Tribunal explained in FY, the use of the phrase 'by reason of' in the context in which it appears in s 64 implies a relationship of cause and effect between a mental disability and a person's inability to make reasonable judgments in respect of matters relating to all or any part of their estate. The context suggests that the meaning of the phrase 'by reason of' equates to 'because of' and 'due to'.[20]

Whether the criteria in s 64(1) are established by the evidence in this case

[19] GA Act s 4(3)(d).

[20] FY [2019] WASAT 118 at [75].

Having regard to the evidence adduced in the present case, we are not satisfied that PB presently has a mental disability, as defined in the GA Act. Even if we are wrong in that conclusion, so that PB does have a mental disability, we are not satisfied, on the evidence, that PB is unable to make reasonable judgments in respect of matters relating to his estate, by reason of that mental disability. Our reasons for those conclusions are as follows.
We start by explaining our conclusion that the evidence did not establish that PB suffers from a mental disability as defined in the GA Act.
First, we are not satisfied that the evidence established that PB has one of the specific kinds of mental disability referred to in the definition of mental disability in the GA Act. Dr ADS treated PB while he was in hospital earlier this year. In her medical report of 13 February 2020, Dr ADS expressed the opinion that PB had a mental disability which Dr ADS described as 'preexistent cerebral palsy with overlapped early onset of progressive dementia'[21] which she regarded as a progressive condition. We understand Dr ADS' opinion to have been that while PB lives with cerebral palsy, which is a physical disability, PB also had a mental disability, namely signs of the early onset of progressive dementia.
[21] Report of Dr ADS dated 13 February 2020, HB 21.
The report provided by Dr ADS was in the form commonly used by doctors providing reports to the Tribunal, which permits the doctor to tick boxes to indicate their opinions, and which merely invites (but does not require) the doctor to provide details of the opinions they expressed by ticking boxes. The elaboration provided by Dr ADS of her opinions was extremely limited. She referred to a neuropsychological report provided by Dr BP, as well as to PB's history of refusing investigations and treatments for 'non-significant' reasons, refusing help from carers, and his reliance on the advice or assistance of acquaintances who may not have his best interests at heart. It was not clear whether Dr ADS' opinion that PB was showing signs of the early onset of dementia was also based on any assessment that Dr ADS had personally made. No other explanation was offered for that diagnosis.
The report of Dr BP was also in evidence. Dr BP expressed the view that:[22]
Therefore, currently there is sufficient evidence, in my opinion, that [PB]'s capacity to make reasoned decisions is impaired at this point in time.
…
It is unusual for someone with [cerebral palsy] to show deterioration in their cognition over time as their injury happens at birth and generally remains stable (although there is some evidence to show an increased risk of dementia in people with [cerebral palsy] and intellectual disability). Therefore, investigations are needed to ascertain the possible causes of the change in his behaviour. … I feel that these investigations are essential in determining the exact diagnosis and therefore prognosis of [PB]'s behavioural change… .
[22] Undated report of Dr BP, HB 28.
We note that while Dr BP referred to the existence of evidence of an increased risk of dementia in people with cerebral palsy, she did not make that diagnosis and, moreover, thought that further tests were required to ascertain the possible cause of the changes in PB's behaviour.
Consequently, the only evidence to support a diagnosis that PB has the early onset of dementia is the report of Dr ADS. As the basis for Dr ADS' opinion was not explained in her report, and as (for the reasons outlined below) that diagnosis was not consistent with the balance of the medical evidence at the time, we do not place any weight on that opinion.
For completeness, we note that Dr SS, a Consultant Psychiatrist who assessed PB by reference to a 'Structured Interview for Insight and Judgment in Dementia' (SIJID), provided a report dated 4 March 2020. While Dr SS undertook his assessment by reference to the SIJID, he did not advance a diagnosis of dementia, nor any other any mental disability, and referred merely to 'potential' cognitive decline.[23]
[23] Report of Dr SS dated 4 March 2020, HB 12.
Secondly, we are not persuaded that the evidence establishes that PB presently has a mental disability, in that his mind is affected by an impairment or incapacity to function in a manner, or within a range, considered to be normal, the existence of which can be discerned through signs of limitations in his thought processes, his cognitive abilities, in disturbed behaviour, or otherwise.
In assessing the evidence relevant to whether PB shows signs of a cognitive deficiency amounting to a mental disability, it is useful to assess the evidence at particular points in time.

PB's cognitive capacity prior to his hospital admission in January 2020

Dr TC, who was PB's general practitioner until about May 2020, gave evidence at the hearing of the Review Application. We asked Dr TC whether PB had a mental disability (as broadly defined under the GA Act). Dr TC's evidence was that prior to PB's 'admission [to hospital], I didn't believe he had a mental condition which affected his ability to make those judgments.'[24] Dr TC told us that 'up until his hospitalisation, [PB] [in] my view had been quite capable of making decisions about his life, about his finances and about what he wanted for his level of care'.[25]
[24] ts 19, 29 June 2020.
[25] ts 18, 29 June 2020.
Dr TC was well placed to make an assessment of this kind. He has known PB for 15 years, and saw him on 14 occasions during the 12 months prior to February 2020. Dr TC's evidence was that he did not think that PB's cognition was compromised on any of those 14 occasions.[26]
[26] ts 19, 20 June 2020.
The evidence before us did not establish that PB showed signs of a mental disability of any kind up until the weeks or months leading to his hospital admission.

PB's cognitive capacity at the time of his admission to hospital in January 2020

By January 2020, however, PB had become very unwell. There was ample evidence that established that around the time of his hospital admission, when PB was acutely unwell, that his mental capacity was impaired, and that that impairment manifested in a variety of ways, including in an impairment of his cognitive ability, particularly his memory recall, and possibly (although less clearly) in some of the behaviour he exhibited at the time.
Dr TC gave evidence in relation to PB's mental capacity at the time of his hospital admission in January 2020. He explained that PB had been in a confused state at the time, but that changes in cognitive function were not unusual in people who become acutely unwell.[27]
[27] ts 18, 29 June 2020.
Dr BP assessed PB when he was in hospital at this time. In her report following that assessment, Dr BP noted that PB's family and carers had reported concerns about PB's behaviour over the months preceding his admission to hospital.[28] Dr BP then set out her opinion about PB's mental state at that stage:[29]
[PB] acknowledged that there had been deterioration in his function …
…
Based on my brief interactions today…I feel that the difficulties his carers have reported were clearly demonstrated in our session. Therefore, currently there is sufficient evidence, in my opinion that [PB's] capacity to make reasoned decisions is impaired at this point in time.
[28] Undated report of Dr BP, HB 27.
[29] Undated report of Dr BP, HB 28.
Dr ADS' opinion was that earlier this year, when PB was in hospital, he did not have the cognitive capacity to make reasonable decisions in relation to simple financial matters, complex financial decisions, or legal matters, and was incapable of making reasonable decisions in respect of medical treatment and procedures, accommodation and services.
We are satisfied that the evidence establishes, and we find, that when PB was very unwell and admitted to hospital in January 2020, his mental capacity was impaired in that he experienced confusion in his thinking. We are satisfied that it is more likely than not that that impairment was sufficient to permit the conclusion that at that time, PB was suffering from a mental disability within the ordinary meaning of that term in the GA Act.

PB's cognitive capacity following his recovery and discharge from hospital

However, there is no doubt that PB recovered his physical health after being treated in hospital. The evidence also suggested that PB's mental capacity improved as his physical health improved.
In evidence was a copy of the MoCA test that PB undertook during his hospital stay. There was no evidence as to the date on which PB undertook that test. The MoCA test is a standardised test which is widely used as an initial screening tool for cognitive impairment. PB scored poorly in those parts of the test concerned with memory recall, but nevertheless scored 18/22 on the test overall, which is at the lowest end of what is regarded as a 'normal' score. In other words, that test result suggests that in January or February 2020, when he did the MoCA test, one aspect of PB's cognitive ability was impaired - namely his memory recall - but overall his test result suggests his cognitive ability was still within the 'normal' range (albeit at the lowest end).
Similarly, Dr SS saw PB on or about 4 March 2020. While he noted that PB had 'cognitive deficits' and 'potential cognitive decline' PB was aware of these, and scored at level 0 on the SIJID assessment. Dr SS's view was that at that time, PB was 'competent regarding making decisions.'[30]
[30] Report of Dr SS dated 4 March 2020, HB 12.
Finally, in his report of 22 February 2020, Dr TC expressed the opinion that he was unsure of PB's ability, at the time of giving his report, to make reasonable judgments in respect of simple or complex financial matters or legal matters, or in respect of medical treatment, accommodation and services decisions, because 'prior to the hospitalisation [PB] could self manage'.[31] However, he later explained that, at that stage, he:[32]
[W]as unable to provide any recommendations as to his capacity to make decisions. This statement was true because I had not seen him since his hospitalisation.
[31] Report of Dr TC dated 22 February 2020, HB 15.
[32] Letter dated 6 April 2020 (Review Application) HB 1.
Dr TC reviewed PB again on 6 April 2020. In a letter of the same date, he stated that 'my review today find[s] [PB] is almost back to his preadmission state.'[33] In his oral evidence at the hearing of the Review Application, Dr TC elaborated on PB's presentation on that occasion:[34]
[I] felt that when I saw him last he was back to what I would say was his old self. He was able to describe to me how he felt about being under the State Administrative Tribunal and … the order which was placed on him. But that gave me the understanding that he has the capacity to know what is perhaps for his best interests.
[33] Review Application, HB 1.
[34] ts 18, 29 June 2020.
In his evidence to the Tribunal, Dr MW referred to the fact that PB had scored 18/22 on the MoCA test, and that that was within the normal range. He went on:[35]
I'm not a neurologist, I'm not a neuropsychiatrist, I don't know really where they're coming from other than obviously something must have gone on in the hospital.
[35] ts 5, 29 June 2020.
The evidence concerning PB's MoCA test, together with Dr SS' evidence, and the evidence of Dr TC, support the conclusion, and we find, that while PB experienced impaired cognitive ability during his hospital admission, as PB recovered his physical health, his cognitive impairment also improved. We find that there is no basis for concluding that after PB recovered physically, he continued to suffer from the mental disability he exhibited whilst in hospital.

PB's cognitive capacity as at the date of the Review Application

We turn next to the evidence concerning PB's cognitive capacity as at the date of the Review Application.
Dr MW, who is PB's general practitioner at present, gave evidence that in June 2020, he saw Dr MW, who undertook the MMSE test. Dr MW explained that the MMSE test is 'a screening device for cognitive impairment, looking at short term memory, attention and calculation, recall, language repetition and … complex commands.'[36] PB scored 24 points on that test, out of a maximum of 30 points. However, he was unable to undertake parts of the test (to which a score of a total of 5 points attached) because of the limitations of his physical disabilities, so that the maximum possible score he could have achieved was 25. A score of 24/30 or better is regarded as 'normal'. Dr MW's evidence was that PB's score of 24/25 on the MMSE test 'doesn't demonstrate to me that there's a huge deficit there.'[37]
[36] ts 3, 29 June 2020.
[37] ts 3, 29 June 2020. This evidence was transcribed as 'that would demonstrate to me that there's a huge deficit there' but that is an error in the transcription. The quoted passage reflects what Dr MW actually said in his oral evidence.
On the other hand, shortly prior to giving his evidence in the Tribunal, Dr MW provided the Tribunal with a written report, in which he indicated that he was 'unsure' about PB's ability to make reasonable decisions about financial matters, legal matters, medical treatment, accommodation or services.[38] In his oral evidence Dr MW explained why he stated that he was unsure about PB's decision making ability, notwithstanding the result PB achieved in the MMSE test. Dr MW said that he knew there had been an issue raised about PB's capacity, but that was at variance with the observations and testing that he had done himself. However, because he had only known PB for about two weeks, had only seen him on three occasions, and had little prior history of his own observations of PB, he felt constrained as to the opinions he could express.[39]
[38] Report of Dr MW dated 10 June 2020.
[39] ts 5, 29 June 2020.
Dr MW went on:[40]
I understand that … previous to his admission to the … Hospital he had been doing all his own finances and everything else and, to be honest, I haven't really seen that there has been as much impairment as perhaps being reported by the hospital. So I've got the problem that my assessment of him based on my talking to him and my assessment is that it's in variance to what has been obviously reported by the hospital and by people who are more qualified to judge than I am.
[40] ts 4, 29 June 2020.
We asked Dr MW whether, if he had just relied on his own observations, limited as they were, and the MMSE test result, he would have had any doubt about PB's capacity. His evidence was:[41]
I don't think I would have done, to be honest. It wouldn't have been something that I would have approached with him. I wouldn't have thought this man needs to be under a guardianship order.
[41] ts 5, 29 June 2020.
Dr MW's evidence, and PB's score on the MMSE test, weighs against any conclusion that PB presently has a mental disability as that term is defined in the GA Act.

Other evidence as to the decline in PB's decision making capacity - in relation to his estate

In contrast to the evidence to which we have so far referred, there was a considerable volume of evidence, from PB's carers and support workers, to the effect that they had observed a gradual, ongoing decline in PB's behaviour, and in his decision making capacity.
Before assessing that evidence we note that PB's estate is a simple one. His only income is the disability pension. After the payment of ongoing bills (for utilities and so on) he has only a very small surplus of funds available to him each fortnight.[42]
[42] Report of the Public Trustee dated 28 May 2020, HB 65; ts 27, 29 June 2020.
There was some evidence to the effect that in the past, PB had not budgeted well, was often without money and regularly asked his support workers to purchase food for him, without paying them back.[43]However, in their evidence at the hearing of the Review Application, PB's carers did not express concerns about his ability to make reasonable judgments in respect of simple financial decisions, such as how to spend a weekly budgeted amount.[44] LW noted that while subject to the administration order, pursuant to which he has been in receipt of an allowance each week, to cover expenses such as groceries, PB had demonstrated the ability to make simple financial decisions, even if others might not always agree with the choices he made:[45]
[PB] … manages the daily allowance that he's given quite well, he makes some choices and, obviously, we agree people can make good and bad choices with their weekly spending about what they want and that's absolutely fine. … [PB] has had a budget to allow him to buy some groceries, you know, fill his fridge with fresh food and that was kind of allocated to that whereas sometimes in the past that's not something you always see readily.
[43] Email from LW dated 16 March 2020, HB 29.
[44] See, eg, evidence of JB, ts 25, 29 June 2020.
[45] ts 11, 29 June 2020.
The primary concern held by PB's carers in relation to his financial decision making was that they regard him as at risk of exploitation by others. However, the evidence was not to the effect that the risk of exploitation existed because of a cognitive impairment which means that PB is unable to assess and make judgments about the pros and cons of one decision or another. Rather, the evidence of PB's carers and support workers was that they considered PB to be at risk of financial exploitation because he is very trusting.[46] PB was described by JB as 'such a nice man and friendly, he is vulnerable to people taking advantage of his kindness'.[47] JL also noted that 'because of the kindness and generosity that [PB] has in his heart, he can be taken advantage of'.[48] Concerns were raised about PB's vulnerability to the influence of acquaintances who do not have his best interests at heart, and who have sought to provide assistance to PB in order to have access to his money[49] or his NDIS funding.[50] In response to their influence, PB has refused to engage in supports and services from his care providers because he wants his friends to support him to selfmanage, and to pay them for that support.[51]
[46] ts 11, 24, 25-26, 29 June 2020; Report of JD, Senior Social Worker, 10 March 2020, HB 43.
[47] ts 24, 29 June 2020.
[48] ts 26, 29 June 2020.
[49] ts 25, 29 June 2020; Email from LW dated 16 March 2020, HB 29.
[50] ts 26, 29 June 2020.
[51] Email from LW dated 16 March 2020, HB 30.

An example of PB's vulnerability to financial exploitation, which was referred to on a number of occasions in the evidence, was that in January 2020, PB was introduced to a woman by one of his friends. Within 12 hours of meeting her, he had given her a key to his unit, access to his bank account, and a key to a van he owned. The woman accessed his bank account and took all of PB's pension money that had just been deposited. She then stole his van, although that was eventually found.[52]
[52] Report of LW, Service Coordinator, dated 6 March 2020, HB 47; See, eg, report of JD, Senior Social Worker, 10 March 2020, HB 43.
In assessing whether the deterioration in PB's behaviour and the quality of his decisions may be viewed as evidence of a mental disability, it is necessary to have regard to the evidence given by PB about these matters. In the course of his evidence on the first hearing day of the Review Application, we asked PB a number of questions to seek his response to the concerns raised by others about his ability to make decisions about his own personal and financial matters, and to gain a greater understanding of the basis for his confidence in his own ability to make such decisions. PB quickly became agitated, frustrated and angry, and as a result, had difficulty communicating his views to us. However, eventually PB regained his composure, and was able to give his evidence, and explain his wishes, with clarity.
PB explained to us, quite cogently, how he had been able to manage his finances, prior to the appointment of an administrator, and how he would do so again. He was able to tell us the amount he had to live on from his pension after his rent was paid, and how he had paid, or would arrange for the payment, of regular bills, such as rent, namely via a direct debit arrangement, so that the funds would came out of his pension before he used the balance[53] or by paying the bill at the post office.[54]
[53] ts 24, 4 June 2020.
[54] ts 10, 4 June 2020.
PB was asked about how he would handle the situation if he needed to make a purchase of an item with a substantial cost (for example a washing machine), and how he would pay for that. He said that he would purchase the item with funds from his pension, and would save up for it.[55] PB explained that the amount left over after the payment of all his bills each week depends on the amount of the bills.[56]
[55] ts 23, 4 June 2020.
[56] ts 20, 4 June 2020.
PB was asked about the incident where he gave his bank details to a woman he had known only for a short time, who then stole his money. His response was:[57]
Yes, but that was one decision. That was my fault. That wasn't anyone else. That doesn't mean everyone else has to make a decision for me.
… That doesn't clarify that I am - I'm mental.
[57] ts 17, 4 June 2020.
We note that this incident took place very early in January 2020, closely proximate in time to PB's period of acute illness which required his admission to hospital. That gives rise to the possibility that this particular instance of poor judgment may have been attributable to the cognitive decline associated with PB's acute ill health at that time.
Furthermore, PB's response to our question about this incident was instructive because he did not seek to deny responsibility for the decision, or to deny that the decision was a poor one. PB's response supports the conclusion that at present he has the capacity to reflect on his past decisions and has sufficient insight to assess the quality of those decisions.
We are not persuaded that the evidence in relation to this incident provides any support for the conclusion that PB is presently suffering from a mental disability. On the contrary, PB's evidence about this incident supports the conclusion that PB has the cognitive ability to make sound decisions, partly because he is able to identify and understand the reasons for his poor decisions in the past.
We accept the evidence of PB's carers that in the past PB has made some poor decisions in respect of financial matters. However, having regard to the medical evidence to which we have referred, and to PB's own evidence at the hearing, we are not satisfied that the deterioration in PB's conduct, or the evidence of PB's poor decision making about financial matters in the past, is sufficient to support the conclusion that PB has a mental disability.
Furthermore, in our view, the evidence taken as a whole is not sufficient to establish that even if PB has a mental disability that the poor judgments about financial matters which he has made in the past can be regarded as due to that mental disability. Other possible explanations for the deterioration in PB's behaviour and for his poor decision making (including in relation to his own health - discussed below at [101] - [113] - as well as financial matters) appear to us to include his increasing level of frustration at the physical decline he is experiencing; his desire to be independent, even to the point of making decisions which are not in the interests of his health; an unwillingness to accept his increasing physical disability, its implications, and the additional care needs that he has as he ages; and in so far as social contact is concerned, a desire to have contact and form relationships with others apart from his carers and support workers. It is not necessary for us to make any findings as to whether PB's poor judgments in relation to his health and safety, or financial matters, is attributable to any one or more of these possible explanations. The point is that in our view, the evidence did not establish that to the extent that PB has made decisions which may be regarded as not in his best interests, that that can be attributed to a mental disability, nor can it be inferred that that is the case.
We do not discount the possibility that the deterioration in PB's behaviour, and in the quality of his decisions, which his carers have noticed are symptoms of an underlying but more subtle cognitive disorder amounting to a mental disability. However, the evidence presently before us did not support that conclusion. It hardly needs to be said that if PB's circumstances change, so that he begins to manifest unambiguous signs of cognitive deficits which leave him unable to make reasonable judgments, then a further application may be made to the Tribunal.

Conclusion - mental disability

We are not satisfied that the evidence establishes that PB is suffering from a mental disability. Even if we are wrong in that respect, we are not satisfied that the evidence establishes that PB is, by reason of a mental disability, unable to make reasonable judgments in respect of his estate.
That being the case, it is unnecessary for us to consider whether PB needs an administrator. The requirements of s 64 of the GA Act are not satisfied in any event.
In those circumstances, it is unnecessary to consider subsidiary questions such as the identity of an administrator, were one to have been appointed.

Appointment of guardian

The appointment of a guardian requires that the Tribunal be satisfied as to the matters set out in s 43(1)(a)-(c) of the GA Act, namely that the represented person:
(a)has attained the age of 18 years;
(b)is -
(i)incapable of looking after his own health and safety;
(ii)unable to make reasonable judgments in respect of matters relating to his person; or
(iii)in need of oversight, care or control in the interests of his own health and safety or for the protection of others;
and
(c)is in need of a guardian[.]
If the Tribunal is satisfied that these threshold requirements in s 43(1) of the GA Act are met, then the Tribunal is required to consider subsidiary questions, such as who should be appointed the guardian.

Does the evidence establish that the requirements of s 43(1)(a)-(c) of the GA Act are met?

PB has attained the age of 18 years.

Is PB presently unable to make reasonable judgments in respect of matters relating to his person?

We take into account all of the medical evidence to which we have already referred without repeating it.
There was a considerable volume of evidence that PB had made what his carers and service providers regarded as poor decisions in relation to his own health and safety, and that his behaviour has deteriorated over time. LW observed:[58]
I think we've seen a gradual [decline] … I've known [PB] now for nearly six years and, absolutely, have daily connection with [PB] and we chat all the time. I think we've definitely seen a bit of a decline over a period of time and particularly - yes, there was an acute period where he was hospitalized … but, you know, there has been a gradual - it has been gradual.
[58] ts 12, 29 June 2020.
PB's carers and service providers gave evidence of their observations over approximately the past 12 months that sometimes PB appeared not to understand the information he received from medical and health care professionals, did not follow medical advice that he was given, made poor decisions with respect to the maintenance of his health, and that he refused support and prompting in this area.[59] They reported that PB sometimes did not attend appointments with allied health professionals and relays incorrect information to them. He has refused assessments in recent months such as a review of his swallowing function,[60] and an assessment for improving accessibility in his unit.[61] He did not follow up advice and care in relation to his disability and medical issues, and that has made it difficult for care providers and allied professionals to support him.[62] PB does not take medication as prescribed, and refuses supports for long periods of time, which means that he is not toileting, eating, or accessing the community safely.[63] In recent times, PB has been refusing to wear incontinence pads when he goes out in his wheelchair. He often sits for long periods of time in soiled clothes, and needs to be showered when he comes home. Despite his care providers expressing concern about his deteriorating sight and hearing, he has declined to have this checked.[64]
[59] See, eg, email from LW dated 16 March 2020 (HB 30).
[60] ts 15-16, 24 June 2020.
[61] See, eg, email from LW dated 16 March 2020, HB 30.
[62] Email from LW dated 16 March 2020, HB 30.
[63] Email from LW dated 16 March 2020, HB 31.
[64] Email from LW dated 16 March 2020, HB 30-31.
LW explained that:[65]
[T]he position that we've been in quite frequently is that [PB] will refuse services. … So there are periods of time where the support should be there and absolutely he should access it. But he'll often refuse those services, even if means it puts his personal hygiene or he doesn't eat at risk, he'll just say no. So although we have that 24 hour support there, often it doesn't end [up] that he has that support. He obviously has the right, as anyone, to refuse and... we will wait for him to re-engage with us.
[65] ts 8, 29 June 2020.
Furthermore, PB's carers reported that he often lets unknown people into his home at night when care providers are there, and this has endangered the safety of those care providers, and compromised their ability to provide care for him. [66]
[66] Email from LW dated 16 March 2020 (HB 30); ts 25, 29 June 2020.
PB's carers were concerned about a decline in PB's ability to solve problems relating to his own health and safety. One example given was that in March 2020, PB called a carer at 8.30 pm one night on a weekend, and reported that he had been out, that his wheelchair had broken down, and he was in the rain. PB had difficulty thinking of a solution to the problem of how he would get home. After discussing the situation with his carer, PB was able to call a maxi taxi to take him home.[67] PB's carers felt that previously he would have able to resolve an issue of that kind independently.[68]
[67] ts 13, 29 June 2020.
[68] Report of Senior Investigator Advocate, OPA, dated 16 March 2020, HB 60.
JL also said that she had 'seen a decline in [PB]'s ability to make decisions in all areas of his life'.[69] LW described the situation as being that '[PB] is increasingly getting on a "loop" and talking about the same issues over and over without any constructive conversation'.[70]
[69] Report of JL dated 16 March 2020, HB 33.
[70] Email from LW dated 10 March 2020, HB 37.
One of the difficulties with the evidence of PB's carers in relation to his decision making ability in relation to personal matters was that they accepted that his capacity fluctuated. JB noted that that she had observed 'declining capacity on some days and other days no decline'.[71] Similarly, JL told us that PB:[72]
[I]s a person that can change his mind very quickly. His decision making can be quite solid and concrete at times and then something might happen and [his] decision making can escalate very quick and it can be changed over time so [consistency] isn't always there. Around his supports, [PB] engages with supports when he is travelling very well and other times he wants to live his life as everybody else does and sometimes there is a lot of flexibility around his arrangements and supports.
It can be problematic at times about [PB] accessing the community around his safety and wellbeing and his personal care … [A]t times it can be, you know, very full on, very time consuming. But [PB] on another day could make those calls himself so it just depends on how his health is and his capacity on every day really. It changes on a daily basis.
[71] ts 24, 29 June 2020.
[72] ts 7, 29 June 2020.
PB denied that he had made poor decisions about taking medication and following his doctors' advice. When asked whether he took his medication his response was that 'I deal with that'.[73] PB claimed that he took his medication 'when I need to'.[74]
[73] ts 14, 4 June 2020.
[74] ts 14, 4 June 2020.
When it was put to him that he had not attended for medical tests and assessments, and when he was asked whether that was because he felt he did not need to have those tests or assessments, he said '[w]ell, I'm still here. I'm still breathing.'[75] In other words, PB's view appeared to be that it had not been shown that he had made a poor choice about whether he in fact needed the tests or assessments. PB said that the reason he hadn't had assessments for issues like his ability to swallow was that he did not think he needed those assessments, and that he would make a decision about those matters when he needed to.[76] He said he went to his doctor when he needed medical help.[77]
[75] ts 15, 4 June 2020.
[76] ts 15-16, 4 June 2020.
[77] ts 16, 4 June 2020.
PB was asked about the reports that he had refused assistance and support to manage his health needs. His evidence was that that had occurred at a time when he was not very well. As he put it, when he was first admitted to hospital, he was 'in constant pain'[78] and 'when you're - when you're in constant pain and as sick as I was, your brain does - your brain scrambles'.[79] However, he felt that his brain was working much better now, and that was why he wanted the orders to be revoked.[80]
[78] ts 27, 4 June 2020.
[79] ts 27, 4 June 2020.
[80] ts 27, 4 June 2020.
Furthermore, having observed PB in the course of the hearing of the Review Application, it is apparent that he can quickly become angry and frustrated, and that when he does so he has difficulty communicating clearly. There seems to us to be a real possibility that one explanation for the discrepancy in various medical reports in relation to PB's capacity, at least while he was in hospital earlier this year, especially when contrasted with the results of the MoCA test and the MMSE test which were in evidence, is that PB's difficulties in communicating clearly when angry and frustrated, and his propensity to become angry and frustrated quite quickly, may have contributed to the creation of a misleading impression of his cognitive ability, particularly for those health professionals or service providers who do not know him well.
It was also clear that PB struggles to find a balance between his desire for independence, and the reality of his need for a high level of practical support in his day to day living. He told us that he feels that at present he has 'too much support' in that he has support workers with him all the time in his small unit, and 'I don't get my house for myself.'[81] However, he also observed that if that support was taken away then life would become more difficult for him.[82]
[81] ts 26, 4 June 2020.
[82] ts 26-27, 4 June 2020.
We accept the evidence of PB's carers that they have observed him making poor decisions in relation to his personal health and safety. However, as we have explained at [92], there are a number of possible explanations for PB's poor decisions, which are unrelated to an incapacity to make reasonable judgments, about matters relating to his person.
However, having regard to the medical evidence to which we have referred, and to PB's own evidence about his decisions, we are not satisfied that the evidence of the deterioration in PB's conduct, or the incidents of PB's poor decision making about his health and safety, support the conclusion that PB is unable to make reasonable judgments about those matters, sufficient to overcome the presumption that he is capable of making those decisions.
However, that is not the end of the enquiry under s 43(1) of the GA Act. An alternative criterion for the appointment of a guardian under that subsection is that the proposed represented person is in need of oversight, care or control in the interests of his own health and safety. This criterion is not dependent on a finding that PB lacks the capacity to make reasonable judgments. Nevertheless, in assessing the evidence as it bears on this criterion, we bear in mind the presumption that PB is capable of looking after his own health and safety.
In a practical sense, there is no doubt that PB is heavily dependent on his care providers and support workers. LW indicated that PB 'calls many times a day - usually 4 plus calls and up to 30 calls a day wanting assistance around daily living and trying to manage to connect with others for services and support'.[83] LW's evidence was that:[84]
[PB] has actually spoken about the fact that he can see the plus side of having a guardian there because there are some things in his life that he feels quite overwhelmed with dealing with, particularly his NDIS planning … That is something that [PB] has expressed a number of times that he finds that [an] overwhelming and difficult process to do.
[83] Email from LW dated 10 March 2020 (HB 38).
[84] ts 9, 29 June 2020.
In addition, the evidence clearly establishes that over the last 12 months, PB has made numerous decisions which were not in the interests of his own health and safety, whatever the explanation or rationale for those decisions may have been.
The evidence did not suggest that all of those decisions were referable to PB's acute unwellness in January and February 2020, although as PB noted, that may have explained some of his poor decisions with respect to his health and safety at around that time.
We are satisfied that the evidence of PB's carers and service providers, to which we have referred, establishes that PB is in need of oversight, care or control in the interests of his own health and safety.
We are also satisfied that PB is in need of a guardian to provide that oversight, and who will have the authority to make decisions in the interests of his health and safety, when required.

We are satisfied that there is no less restrictive means available by which such decisions may be made, otherwise than by the appointment of a guardian with those functions. Informal decision making structures will not suffice in these circumstances.
The evidence of the representative of the Public Advocate, and of the care providers who attended the hearing, support the conclusion that PB requires decision making assistance in relation to accommodation and services at present.[85] While it is the case that the unit in which PB resides requires renovations and modification to assist PB to maintain his independence, and that PB would benefit from the assistance of someone to advocate in his best interests with the Department of Housing, it is not necessary to appoint a guardian to make accommodation decisions at this stage. It may be that in the future, PB may have to consider moving to premises which are better suited to his physical needs. But no such decision is presently in contemplation.
[85] ts 22, 29 June 2020.

In relation to services, the key issue is PB's refusal to address issues that give rise to health risks, such as his refusal to use incontinence pads which placed him at risk of a kidney infection. While PB wishes to independently determine his access to services, he recognises that he needs assistance in doing so;[86] and especially when he is unwell,[87] such as when he develops an infection.[88]We accept that the guardian should have a services decision function.
[86] ts 21, 26 and 27, 29 June 2020.
[87] ts 22, 29 June 2020.
[88] ts 22, 29 June 2020.
The other decision making function which needs to be given to PB's guardian is a contact function. That is because PB is vulnerable to others imposing on him, and inhibiting the services able to be provided to him by care providers. The evidence has demonstrated that PB is not able to make decisions about those matters in the interests of his own health and safety. Those difficulties can be managed if the guardian is able to make decisions about the persons with whom PB is able to have contact.
There being no family member or other person who has expressed a willingness to act as a guardian for PB, the Public Advocate should be appointed the limited guardian for PB, with authority to make services decisions and contact decisions.

The duration of the order

The Tribunal is required to nominate a period of time by which a review of the guardianship order must be made.
The maximum time allowed under the GA Act is five years.
In this case, we consider that it is appropriate to review the order in five years' time, namely by 12 October 2025.
In the event that PB's circumstances change, so that the appointment of an administrator is thought to be warranted, or further functions should be conferred on the guardian in PB's best interests, it will be open to PB, or to those supporting and caring for him, to make an application to the Tribunal at any time prior to that mandatory review.

Orders

We therefore make the following orders:
1.The orders made by the Tribunal on 17 March 2020 are set aside and the following orders are made.
2.The Tribunal declares that the represented person, [PB]:
(a)is in need of oversight, care or control in the interests of his own health and safety; and
(b)is in need of a guardian.
3.The Public Advocate of David Malcolm Justice Centre, Level 23, 28 Barrack Street, Perth, Western Australia, is appointed limited guardian of the represented person with the following functions:
(a)to determine what contact, if any, the represented person should have with others and the extent of that contact; and
(b)to determine the services to which the represented person should have access.
4.The Tribunal approves delegation by the Public Advocate of her functions as guardian of the represented person to an officer or employee employed in the Office of the Public Advocate.
5.This order is to be reviewed by 12 October 2025.

I certify that the preceding paragraph(s) comprise the reasons for decision of the State Administrative Tribunal.
EH
Associate to the Honourable Justice Pritchard
12 OCTOBER 2020