Thiering v Daly

Case

[2011] NSWSC 1345

11 November 2011


Supreme Court


New South Wales

Medium Neutral Citation: Thiering v Daly [2011] NSWSC 1345
Hearing dates:29/08/2011; 30/08/2011
Decision date: 11 November 2011
Jurisdiction:Common Law
Before: Garling J
Decision:

(a)The plaintiff is to bring in Short Minutes of Order. The proposed short minutes are to be filed and served within seven days of the date of judgment.

(b)If any party disagrees with the plaintiff's proposed short minutes of order, then that party is to file and serve any proposed short minutes of order within 14 days of the date of judgment.

(c)Within 21 days of the date of judgment, each party is to file and serve such written submissions as they wish with respect to the proposed short minutes of order, including any submissions as to costs.

(d)Proceedings listed for further hearing on any outstanding matters arising from the short minutes of order and submissions at 9.15am on Friday 9 December 2011.

(e)Liberty to apply on 24 hours' notice.

(f)Filing of the short minutes of order and submissions is to take place electronically to my Associate.

Catchwords:

PRACTICE AND PROCEDURE - Determination of separate questions - Whether a determination of the proposed set of questions will facilitate the just, quick and cheap resolution of the proceedings - Plaintiff catastrophically injured in motor vehicle accident - Assessment of damages detailed and complex - Clarifying legal basis of determining damages will assist parties - Promotion of settlement

STATUTORY INTERPRETATION - Damages - Personal injury proceedings - Motor vehicle accident - Whether Motor Accidents (Lifetime Care and Support) Act 2006 abolished damages pursuant to s128 Motor Accidents Compensation Act 1999 - No clearly expressed intention to abolish damages for gratuitous attendant care services - Statutory expectation that attendant care services will be provided as part of Lifetime Care and Support Scheme

DAMAGES - Personal injury proceedings - Motor vehicle accident - Lifetime participant of Lifetime Care and Support Scheme (LCS Scheme) - Whether LCS Scheme or motor vehicle tortfeasor/CTP insurer liable to pay for attendant care services provided gratuitously - LCS Authority obliged to make assessment of all treatment and care needs of a participant - Subject to questions of reasonableness and causation - Motor vehicle tortfeasor/CTP insurer remains obliged to pay LCS Authority for treatment and care costs of LCS participant - Griffiths v Kerkemeyer damages up to date of judgment recoverable if LCS Authority does not accept obligation to pay for gratuitous services - Services have not been provided for up to date of judgment - Question of fact if attendant care services provided for - Future attendant care services are excluded from damages

STATUTORY INTERPRETATION - Motor Accidents (Lifetime Care and Support) Act 2006 - LCS Guidelines subordinate to LCS legislation and cannot derogate from obligations - Total ban on inactive sleepover payments cannot be justified by legislation - LCS Guidelines regarding inactive sleepovers valid insofar as inactive sleepovers do not form care plan of participant - Question of fact
Legislation Cited: Civil Procedure Act 2005
Interpretation Act 1987
Motor Accidents (Lifetime Care and Support) Act 2006
Motor Accidents Compensation Act 1999
Motor Accidents Compensation Amendment Act 2006
Social Security Act 1991 (Cth)
Uniform Civil Procedure Rules 2005
Cases Cited: Carr v Western Australia (2007) 232 CLR 138
Caterpillar of Australia Pty Ltd v Industrial Court of NSW [2009] NSWCA 83
CIC Insurance Ltd v Bankstown Football Club Ltd (1997) 187 CLR 384
Commonwealth Bank of Australia v Clune [2008] NSWSC 1125
Doherty v Liverpool District Council (1991) 22 NSWLR 284
Dossett v TKJ Nominees Pty Ltd (2003) 218 CLR 1
Eastman v The Queen (2000) 203 CLR 1
Electrolux Home Products Pty Ltd v Australian Workers' Union (2004) 221 CLR 309
Figueroa v New South Wales Insurance Ministerial Corporation (NSWSC, 18 March 1998, unreported)
Gifford v Strang Patrick Stevedoring Pty Ltd (2003) 214 CLR 269
Gilchrist v Estate of the late Sara Taylor [2004] NSWCA 476
Griffiths v Kerkemeyer (1977) 139 CLR 161
Harrison v Melhem (2008) 72 NSWLR 380
Idoport Pty Ltd v National Australia Bank Ltd [2000] NSWSC 1215
Integral Home Loans Pty Ltd v Interstar Wholesale Finance Pty Ltd [2006] NSWSC 1464
Kingston v Keprose Pty Ltd (1987) 11 NSWLR 404
McCann v Sheppard [1973] 2 All ER 881
Mulholland v Mitchell [1971] 1 AC 666
Nolan v Clifford (1904) 1 CLR 429
Perre v Apand Pty Ltd (1999) 198 CLR 180
Pettersen v Bracha (1995) 21 MVR 71
Plaintiff S157/2002 v Commonwealth (2003) 211 CLR 476
Project Blue Sky Inc v Australian Broadcasting Authority (1998) 194 CLR 355
Pyneboard Pty Ltd v Trade Practices Commission (1983) 152 CLR 328
R v PLV (2001) 51 NSWLR 736
Re Bolton; Ex Parte Beane (1987) 162 CLR 514
Roads and Traffic Authority of NSW v Palmer [2003] NSWCA 58
Ross v The Queen (1979) 141 CLR 432
Simpson v Diamond [2001] NSWSC 925
Tallglen Pty Ltd v Pay TV Holdings Pty Ltd (1996) 22 ACSR 130
Tepko Pty Ltd v Water Board (2001) 206 CLR 1
Van Gervan v Fenton (1992) 175 CLR 327
Wik Peoples v Queensland (1996) 187 CLR 1
Wilson v State Rail Authority of NSW [2010] NSWCA 198
Category:Interlocutory applications
Parties: Alexander Thiering (P1)
Rose Thiering (P2)
John Daly (D1)
Lifetime Care and Support Authority of New South Wales (D2)
Representation: Counsel:D A Wheelahan QC / E Romaniuk (P1-2)
K Rewell SC / Mr D Wilson (D1)
C Needham SC (D2)
Solicitors:Slater & Gordon (P1-2)
Moray & Agnew (D1)
Workcover NSW (D2)
File Number(s):SC 2010/22260
Publication restriction:Nil

Judgment

  1. For about 35 years, ever since the decision of the High Court of Australia in Griffiths v Kerkemeyer (1977) 139 CLR 161, an injured plaintiff has been entitled to damages which represent the cost, or else the value, of nursing and attendant care services provided to him or her to meet the needs arising from his or her injuries and disabilities.

  1. In undertaking the assessment of these damages, the law has always disregarded the question of whether the services in question have been provided gratuitously, that is, free of charge or else free of any legal obligation to pay for the services.

  1. Literally hundreds, if not thousands, of injured plaintiffs have included a claim for " damages in accordance with Griffiths v Kerkemeyer " in their claims. So well known is the decision, and so frequently is it mentioned in courts and in cases, that a shorthand description is regularly used: " G v K damages " is the common rubric.

  1. It may therefore have come as a surprise to Mr Alexander Thiering, the injured first plaintiff in this case, and his mother, the second plaintiff, Mrs Rose Thiering, to be confronted with the submission that G v K damages had been abolished and that his care needs, which are being met by Mrs Thiering, ought go uncompensated.

  1. The submission in this case came from a motor vehicle tortfeasor, Mr John Daly, who is indemnified by a compulsory third party (CTP) insurer, which in New South Wales is supervised and licensed by a statutory body, the Motor Accidents Authority, and which provides indemnity against claims made in accordance with the statutory scheme of limited damages fixed under the Motor Accidents Compensation Act 1999 (MAC Act).

  1. The submission undoubtedly caused both plaintiffs surprise having regard to the fact that the statutory scheme for damages under the MAC Act makes specific provision for the payment of such damages by s 128, which is entitled " Damages for economic loss - maximum amount for provision of certain attendant care services ".

  1. This was not the only matter of surprise for the plaintiffs. Mr Thiering is an accepted lifetime participant in the Lifetime Care and Support Scheme created by the New South Wales Government ("LCS Scheme"), which is managed and overseen by another government authority, the Lifetime Care and Support Authority of New South Wales ("LCS Authority"), the second defendant, which provides for the lifetime care and support of catastrophically injured individuals who suffered their injuries in motor vehicle accidents. As such, Mr Thiering was no doubt astonished to be told by the LCS Authority that even though his mother was to provide care to him for at least eight hours each day, during the evening period, as part of the care plan formulated in accordance with the LCS Scheme, she was not entitled to be paid for providing his care, and he is not entitled to be compensated by way of damages so as to be able to reimburse her and thereby discharge any moral obligation he may feel towards her.

  1. The motor vehicle tortfeasor (or at least his CTP insurer) submits that G v K damages have been abolished and that the LCS Scheme is now responsible for this component of damages. The LCS Authority which manages the LCS Scheme denies any obligation to pay a family member for these freely provided services. All of the parties submit that the Court should determine whether these respective positions, each seemingly adopted as a matter of policy, are legally correct. The position will affect other claimants who are in a position similar to that of Mr Thiering.

  1. Whilst Mr and Mrs Thiering may be surprised to be confronted by the issues to which I have just referred, the public is entitled to question whether it is appropriate for this Court to be required to deal with this matter. This is because it is in essence a question of government policy. The Motor Accidents Authority, which licenses and regulates CTP insurers to issue policies which indemnify against claims under the MAC Act, is a statutory authority which is part of a division of the New South Wales Government known as the Compensation Authority Staff Division which, since 2009, has been a principal agency of government. As well, the LCS Authority is also part of the Compensation Authority Staff Division.

  1. The Compensation Authority Staff Division has a single Chief Executive Officer and the Division, and hence the two authorities, report to a single Minister of Government, namely, the Minister for Finance and Services.

  1. No doubt, the public would question the need for this dispute about a fundamental issue of Government policy and legislation to occupy a number of days of the Court's time and three sets of lawyers, when the dispute ought to be determined by the Government setting out clearly what the policy is, and then providing legislation which is sufficient to enable the policy to be implemented.

  1. Be that as it may, the parties seek that the Court determine the dispute and that is what the Court will do.

The Essence Of The Dispute

  1. The essence of the dispute before the Court can be encapsulated in two questions of significance to the parties in the proceedings. They are:

(a) Has the right of an individual who is catastrophically injured in a motor vehicle accident, and who becomes a lifetime participant in the LCS Scheme, to damages in accordance with s 128 of the Motor Accident Compensation Act 1999, been completely abolished; and

(b)   If not, who, as between the LCS Authority and a motor vehicle tortfeasor (in reality the CTP insurer) is responsible for paying the appropriate compensation either by way of damages, or other payments, for the provision of services which are otherwise gratuitous as that expression is to be understood from G v K.

  1. Both of these questions involve an exercise in statutory interpretation. But that exercise takes place in a context within which there are two principal components. The first is the Notice of Motion by which the dispute is brought before the Court and about which it will be necessary to say something. The second is the context of the pleadings and agreed (or else undisputed) facts which must be identified and addressed.

A Separate Question

  1. The second defendant, the LCS Authority, has filed an Amended Notice of Motion for the hearing and determination, separately and in advance of all other questions in the proceedings, of the following matters, which for convenience, I have amended to reflect the terms used in this judgment:

1. Does the LCS Authority have an obligation under the Motor Accidents (Lifetime Care and Support) Act 2006 (NSW) to pay for gratuitous care and assistance provided by the second plaintiff ('the mother') to the first plaintiff ('the injured person') up to the date of judgment?

(a) Is the mother's care and assistance 'expenses incurred by or on behalf of the injured person' within the meaning of section 6(1) of the Act?

(c) Do the Lifetime Care and Support Guidelines (Part 8) authorise the LCS Authority to decline payment of the mother on the basis that she is a family member and alternative care is available?

(d) Do the Guidelines (Part 8) authorise the LCS Authority to decline payment of the mother for:

(i)   care provided to or visiting the injured person while an inpatient in hospital?

(ii)   inactive sleepovers (after 8 October 2010)?

(e) Alternatively to 1(d), are these 'reasonable expenses' within the meaning of section 6 of the Act?

2. If there is an obligation to pay the mother, on what basis should an appropriate hourly rate be determined?

Second Plaintiff v Second Defendant

3. Does the mother have standing to bring and maintain these proceedings against the LCS Authority?

4. If so, issues 1 and 2 above also arise for determination in the mother's claim against the LCS Authority.

First Plaintiff v First Defendant

5. Whether on proper construction of section 130A of the Motor Accidents Compensation Act 1999 , the first plaintiff has any entitlement as against the first defendant other than damages for non-economic loss and loss of earning capacity.

  1. The other parties agree that these issues ought to be heard and determined separately.

  1. However, rule 28.2 of the Uniform Civil Procedure Rules 2005, invests the Court with a discretion as to whether it ought make such an order. It is necessary therefore to consider whether, in light of the agreement of the parties, it is appropriate for the Court to exercise its discretion to hear and determine these questions separately and in advance of all other questions. The rule is in the following form:

" 28.2 Order for decision
The court may make orders for the decision of any question separately from any other question, whether before, at or after any trial or further trial in the proceedings."
  1. This rule is in identical form to the previous r 31.2 of the Supreme Court Rules, which it has replaced.

Principles Relating to Separate Question Orders

  1. In exercising the discretion which exists in r 28.2 to make an order of the kind under consideration here, it is essential that the Court gives effect to the provisions of s 56 of the Civil Procedure Act 2005. By s 56(2), the Court is obliged to seek to give effect to the overriding purpose of the Civil Procedure Act and Rules of Court when exercising any power given to it by the Act or Rules of Court.

  1. Section 56(1) provides that:

"The overriding purpose of this Act and of rules of court, in their application to a civil dispute or civil proceedings, is to facilitate the just, quick and cheap resolution of the real issues in the dispute or proceedings."
  1. The commencing point for the consideration of a motion such as this is that it is ordinarily appropriate that all issues in proceedings should be disposed of at the one time: Commonwealth Bank of Australia v Clune [2008] NSWSC 1125 at [5] per Johnson J.

  1. In Perre v Apand Pty Ltd (1999) 198 CLR 180 at 332 [436], Callinan J said:

"Care does need to be taken in deciding whether to conduct separate trials of different issues. It sometimes happens that they may turn out to be productive of the disadvantages of delay, extra expense, appeals and uncertainty of outcome which they are intended to avoid. In tort cases in which damage is the gist of the action, it will be generally be undesirable to accede to requests for them, or to order them, unless all parties accept that compensable damage has been sustained by the plaintiffs or applicants as the case may be".
  1. In Tepko Pty Ltd v Water Board (2001) 206 CLR 1 at 55, Kirby and Callinan JJ said at [168]-[170]:

"168. The appeal should be allowed. However, we should not leave this case without making four comments. Both Mason P and Fitzgerald JA were critical of the course of limiting the issues to be tried that the primary judge adopted. In Perre v Apand Pty Ltd attention was drawn to difficulties that can be caused when that course is adopted. In light of the experience in this case, what was there said should be restated with emphasis. The attractions of trials of issues rather than of cases in their totality, are often more chimerical than real. Common experience demonstrates that savings in time and expense are often illusory, particularly when the parties have, as here, had the necessity of making full preparation and the factual matters relevant to one issue are relevant to others, and they all overlap.
169. The second and related comment is this. A party, whose whole case is knocked out on a trial of a preliminary or single issue, may suspect, however unjustifiably, that an abbreviated course was adopted and a decision reached in the court's, rather than the parties', interests.
170. Thirdly, there is an additional potential for further appeals to which the course of the trial on separate issues may give rise. Indeed, that could occur here were this appeal to be allowed and a retrial had in which the remaining issues of causation and damages were decided. Single-issue trials should, in our opinion, only be embarked upon when their utility, economy, and fairness to the parties are beyond question."
  1. Although these remarks were made prior to the introduction of the Civil Procedure Act , and whilst there may be room for a different view as to whether the Court should take a more interventionist role in particular cases, in identifying and separating issues which can resolve significant parts of litigation expeditiously : see Integral Home Loans Pty Ltd v Interstar Wholesale Finance Pty Ltd [2006] NSWSC 1464 at [6], I am satisfied that it remains the case that determination of separate questions is an unusual, perhaps exceptional, course which is only to be taken when the benefit can be seen to clearly outweigh the disadvantages of the kind discussed by Kirby and Callinan JJ in Tepko .

  1. Einstein J in Idoport Pty Ltd v National Australia Bank Ltd [2000] NSWSC 1215 has helpfully summarised the principles to be applied by a Court in considering whether to order the determination of separate questions. I will not set out the entirety of those principles. I derive from his Honour's judgment, with which I express respectfully, my agreement, the following principles of relevance in this case:

(a) it is for the party seeking the order to show to the Court that it is desirable for the determination of the separate question to occur: Idoport at [7(3)];

(b) the determination of a separate question may be appropriate where the resolution of the separate issue carries with it a strong prospect that the parties will be able to resolve their dispute themselves: Idoport at [7(4)(b)];

(c) the determination of a separate question will be unlikely to be appropriate where there is a commonality of witnesses and issues of credit as between the separate issue and the other issues in the case which will, or may, necessitate a ruling on the credit of one or more witnesses: Idoport at [7(5)(b)]; and

(d) a determination of a separate question is unlikely to be appropriate unless it is possible to clearly see that the determination will facilitate the just, quick and cheap resolution of the proceedings or the central issues in the proceedings: Idoport at [7(6)];

  1. Giles CJ in Comm Div (as his Honour then was) said in Tallglen Pty Ltd v Pay TV Holdings Pty Ltd (1996) 22 ACSR 130 at 141-142:

"Part 31 r 2 of the rules empowers the court to make orders for the decision of any question separately from any other question, whether before, at or after any trial or further trial in the proceedings, and for the statement of a case and the question for decision. In the ordinary course all issues in proceedings should be decided at the one time, but separate decision of a question may be appropriate where, for example, the decision of the question is critical to the outcome of the proceedings and (at least if decided in one way) will bring the proceedings to an end. In particular circumstances the separate decision of a question may be appropriate even if it will not bring the proceedings to an end, such as where there is a strong prospect that the parties will agree upon the result when the core of their dispute is decided or where the decision will obviate unnecessary and expensive hearing of other questions, but such occasions must be carefully controlled lest fragmentation of the proceedings (particularly when the exercise of rights of appeal is borne in mind) brings delay, expense and hardship greater than that which the making of an order was intended to avoid. It is often the case that the need to make findings of fact for a decision of the separate question, especially findings which may involve issues of credit, tells strongly against the making of an order because related facts, and renewed issues of credit, will or may arise at a later stage in the proceedings. Experience teaches that it should be able to be seen with clarity that decision of a separate question will be beneficial in the conduct of the proceedings and the resolution of the parties' dispute."
  1. Although the judgment was dealing specifically with r 31.2 of the Supreme Court Rules, the principles that are articulated, and the approach taken, are directly applicable to these proceedings.

  1. I have decided that this is one of those unusual cases where it is in the interests of all of the parties, and the efficient disposition of the proceedings for the Court to hear and determine such of the identified and separate issues as relate to the issues surrounding the provision of unpaid care by Mrs Thiering to Mr Thiering.

  1. I am of the view that to do so will positively promote settlement in these proceedings. As is clear, the plaintiff is catastrophically injured. Assessments of damages are usually detailed and complex. It will obviously assist the parties to know the proper legal principles upon which the assessment is to be based.

  1. As well, given the likely effect that the determination of this issue will have on other cases, the sooner that these questions are determined, the better.

  1. However, as will become apparent, it will be for the parties to provide by way of short minutes of order, the answers to the respective questions which are contained within the Notice of Motion, upon publication of these reasons.

The Pleadings

First Plaintiff v First Defendant

  1. The current pleading of the first plaintiff, Mr Alexander Thiering against the first defendant is the Further Amended Statement of Claim filed on 27 April 2011.

  1. That pleading so far as the first plaintiff is concerned, informs the Court and the parties of the following allegations:

(a)   Mr Thiering was injured on Sunday 28 October 2007 whilst riding a registered motorcycle in Elouera Road, Cronulla;

(b)   Mr John Daly, the named first defendant, was driving a registered motor vehicle, a Holden Commodore, out of a driveway at that time and made a right hand turn across the path of the plaintiff and his motorcycle;

(c)   A collision occurred, as a result of which Mr Thiering suffered severe injuries which were particularised (albeit in a separate document), as being a complete spinal cord injury at the C5 level, and a C6/7 vertebral fracture. Other injuries and disabilities were particularised and to which it is unnecessary to refer;

(d)   As a consequence of the complete spinal injury, the plaintiff is totally paralysed in the upper and lower limbs and trunk, with only elbow flexion, shoulder and neck movement possible;

(e)   The collision and Mr Thiering's injuries were the result of negligence on the part of Mr Daly.

  1. In his defence, Mr Daly admits that he was negligent and alleges that the plaintiff was guilty of contributory negligence in a number of specified ways. Mr Daly admits that Mr Thiering was severely injured but does not admit the full extent of his injuries and disabilities.

  1. Paragraph 6 of the defence is in the following terms:

"Further, the defendant says that, as a result of s 130A of the Motor Accidents Compensation Act 1999 the plaintiff is not entitled to damages for treatment and rehabilitation expenses and/or domestic assistance and attendant care whilst he is participating in the Lifetime Care and Support Scheme under the Motor Accidents (Lifetime Care and Support) Act 2006."
  1. The second plaintiff makes no claim against the first plaintiff.

First and Second Plaintiffs v Second Defendant

  1. The claims against the second defendant, although pleaded in the same statement of claim, and related to some common questions of fact, are entirely discrete from those made by the first plaintiff against the first defendant.

  1. The agreed context in which the claims are made is that Mr Thiering has been accepted into the LCS Scheme as a lifetime participant.

  1. Both of the plaintiffs claim that the LCS Authority owed a statutory obligation to them to pay for such of the care services, which it assessed as reasonable, and certified by including the services on a case plan, as provided by Mrs Thiering to Mr Thiering.

  1. The plaintiffs claim damages in an amount which represents the value of the care services provided. The Further Amended Statement of Claim notes that the full particulars of the care services (and the claim) are to be provided.

  1. In the Fourth Amended Statement of Particulars, the following particulars of the care services are provided:

"76B. On 18 April 2008 the [LCS Authority] conducted a care needs assessment for when the First Plaintiff was to be discharged from hospital. The total paid and unpaid care was assessed at 115.5 hours per week approving 59 hours of unpaid care and 56.5 paid care per week. The unpaid care was provided to the First Plaintiff by the Second Plaintiff.
...
76F. On 7 April 2009, [LCS Authority] approved 135 hours of care per week, 59 hours of unpaid care and 76 [hours] of paid care per week until 10 July 2009. The unpaid care to be provided to the First Plaintiff by the Second Plaintiff.
...
76J. On 22 December 2009, [LCS Authority] conducted a care needs assessment approving 152 hours of paid care and 30 hours unpaid care, a total of 182 hours of care per week until 7 April 2010. The unpaid care to be provided to the First Plaintiff by the Second Plaintiff. The First Plaintiff advised [LCS Authority] that he preferred the care provided by the Second Plaintiff and for the Second Plaintiff to be paid for her services."
  1. The LCS Authority does not dispute the facts in these paragraphs, but it reserves its position, and any admission as to whether the " unpaid care" was actually provided for the approved number of hours by Mrs Thiering. It does not dispute that some care was provided. Ultimately, the particularised claim is as follows:

"77. When the First Plaintiff's carers are not in attendance his mother, the Second Plaintiff, has to do everything for him. She feeds him, she operates the television set for him, she puts on DVDs, and she massages the First Plaintiff and cleans his teeth. She opens doors for him and does the entire First Plaintiff's laundry and ironing. The Second Plaintiff also attends to his personal hygiene.
...
79. For the period 29 September 2008 until 17 January 2011 the maximum amount that may be claimed is $931.40 per week. The calculation therefore is as follows:

(a)   181 weeks x $931.40 = $168,583.40

...
88. A claim is made for the duration of the First Plaintiff's life expectancy and the amount claim[ed] is $5,650.25 per week x 988.9 = $5,587,532.22."
  1. The LCS Authority's defence is lengthy. It is not necessary to set it all out in this judgment. As I understand it, the LCS Authority's position in that defence can be adequately summarised in this way:

(a)   It admits that it has made assessments of the treatment and care needs of Mr Thiering and that it has issued plans which provide for meeting these treatment and care needs;

(b)   It has made determinations as to which of Mr Thiering's treatment and care needs are reasonable and necessary, and it has certified such needs by the issuing of a certificate regarded by the legislation as final;

(c)   It admits that certain gratuitous care and assistance has been provided to Mr Thiering by his mother Mrs Thiering at his request and without any agreement for her remuneration;

(d) It pleads that the gratuitous care and assistance provided by Mrs Thiering is not 'a reasonable expense' within the meaning of s 6(1) of the Motor Accidents (Lifetime Care and Support) Act ;

(e)   It pleads that Mrs Thiering:

(i)   is not an approved provider of care nor is she employed by an approved provider;

(ii)   is not appropriately trained or qualified to provide attendant care;

(iii)   does not meet the employment criteria of approved providers;

(iv)   is unsuited for employment as an attendant care provider because of her physical limitations and psychological impairment.

(f)   It denies, for a variety of reasons, the existence of any statutory obligation to pay for the care provided by Mrs Thiering.

  1. In completing the review of the pleaded causes of action, it is relevant to note that in the course of both written and oral submissions, senior counsel for the LCS Authority acknowledged that it understood the claim against it by the plaintiffs to include an action for a debt due rather than a claim for general law damages.

  1. The LCS Authority submitted that there could not be a debt due in the absence of an express agreement entered into by it, or else in the absence of an agreement which was implied, such that there would be " ...a right to a quantum meruit recovery ." (T85.31-85.42)

Agreed and undisputed facts

  1. The parties agreed the facts upon which the Court would proceed with this determination. They were:

1. The first plaintiff was born on 18 August 1978 and was involved in a motor accident on 28 October 2007. As a result of the motor accident the first plaintiff suffered catastrophic injuries rendering him a high level quadriplegic.
2. The second plaintiff is the first plaintiff's mother ('mother').
3. The first plaintiff is a lifetime participant in the scheme established by the Motor Accidents (Lifetime Care and Support) Act 2006 ('the LCS Act'). He was provisionally accepted to the scheme on 6 December 2007 as an interim participant and subsequently was accepted as a lifetime participant.
4. At all material times Guidelines were in force under the LCS Act, relevantly the Lifetime Care and Support Guidelines gazetted 8 October 2011 and as amended.
5. The first plaintiff was admitted to the Prince of Wales Hospital from the day of the accident and was discharged on 29 September 2008 to reside at 37 Bundanoon Road, Woronora Heights, NSW.
6. While the first plaintiff was hospitalised his mother visited him in hospital.
7. Since his discharge from hospital the first plaintiff has lived in rented accommodation with his mother at Woronora Heights. His father resided there for a time but not longer lives at that address.
8. Since becoming a scheme participant, the LCS Authority has provided and paid for the first plaintiff to receive attendant care and domestic assistance from commercial providers, medical and nursing treatment, equipment and other items needed by reason of his injury. The first plaintiff's current (paid) attendant care provider is Australian Homecare Services Pty Limited.
9. Since his discharge from hospital, the mother has provided care and domestic assistance to the first plaintiff on a gratuitous basis. The first plaintiff and the second plaintiff have not negotiated any agreement in respect of the terms and conditions for payment of monies to the second plaintiff in respect of the provision of services to the first plaintiff by the second plaintiff.
10. The LCS Authority has declined to pay the mother as an attendant carer. The mother is in receipt of a carer's allowance from the Commonwealth Government for the care and assistance that she provides to the first plaintiff.
14. The first plaintiff has commenced proceedings No 2010/00022260 in the Supreme Court of New South Wales Common Law Division against the motor vehicle driver and the LCS Authority. By his Further Amended Statement of Claim the first defendant claims damages for negligence from the driver as the first defendant. The first defendant by his Defence filed 23 April 2010 admits breach of duty and alleges contributory negligence. The first defendant also relies on section 130A of the Motor Accidents Compensation Act 1999 (NSW).
15. By the Further Amended Statement of Claim the first plaintiff and the mother claim that the LCS Authority has a statutory obligation to pay for the mother's services to him 'in the order of' 106 hours per week and makes allegations of invalidity concerning Part 8 of the Guidelines made under the Act. The LCS Authority denies that it has an obligation as alleged and relies in particular on sections 6 and 10 of the Act and the Guidelines made under it. The LCS Authority also denies that the mother has locus standi .
16. The mother has also commenced proceedings [n]o 2010/351580 in the Supreme Court of New South Wales against the motor vehicle driver alleging psychological impairment, nervous shock and incapacity for work, and has submitted numerous expert and medical reports in support of her claim. Those proceedings will be heard together with the negligence proceedings.
  1. In addition, as I have noted above, by reference to the plaintiffs' Fourth Amended Statement of Particulars, these further facts were not disputed by the LCS Authority:

(a)   The care needs assessment carried out by the LCS Authority with respect to Mr Thiering included, although the details varied from time to time, an assessment of a number of hours each week of approved paid and unpaid care;

(b)   A care needs assessment particularised that the unpaid care was to be provided by Mrs Thiering;

(c)   No individual other than Mrs Thiering has been identified as providing any unpaid care to Mr Thiering.

  1. As to the undisputed fact in sub-paragraph (b) above, understandably, in the absence of evidence, the LCS Authority did not concede that the care had actually been provided for the precise number of hours contained in the approved care needs assessment, but as is agreed in fact 9 above, Mrs Thiering did provide care gratuitously to her son.

Principles of Statutory Interpretation

  1. Against the context of the pleadings and the admitted and undisputed facts, it is necessary to proceed with an exercise of statutory interpretation, involving the MAC Act and the LCS Act.

  1. In undertaking this exercise, I will apply the principles of statutory interpretation, as I understand them to be, which are:

(a) The commencing point is to engage in a purposive construction. That is, in the interpretation of a provision of an Act, a construction which promotes the purpose and/or object underlying an act, is to be preferred to a construction that would not promote that purpose or object: Carr v Western Australia (2007) 232 CLR 138 at [5]-[6] per Gleeson CJ;
(b) What is involved in an exercise of statutory construction is a search for the objective intention of Parliament and not the subjective intention of the Parliament, if one exists, or of Ministers: Eastman v The Queen (2000) 203 CLR 1 at [146]-[147] per McHugh J; Harrison v Melhem (2008) 72 NSWLR 380 at [14] per Spigelman CJ, [159] per Mason P, Beazley and Giles JJA agreeing; Wilson v State Rail Authority of NSW [2010] NSWCA 198 at [12] per Allsop P;
(c) A statement of intention by a Minister in a Second Reading Speech will not prevail over the words of a statute: Re Bolton; Ex Parte Beane (1987) 162 CLR 514 at 518; Harrison at [14] per Spigelman CJ, [162] per Mason P. Identification of the mischief to be addressed by the legislation, and the purpose to be served by the legislation, when contained in a Second Reading Speech are in a different context and realm to statements of the meaning of words, phrases or provisions in statutes: Kingston v Keprose Pty Ltd (1987) 11 NSWLR 404 at 424; Harrison at [162] per Mason P;
(d) Legislation must be construed by reference to the language which Parliament has used in the enactment as distinct from what others, including Ministers, may wish or think that the Parliament intended: Nolan v Clifford (1904) 1 CLR 429 at 449; Plaintiff S157/2002 v Commonwealth (2003) 211 CLR 476 at 499 [55]; Harrison at [159] per Mason P; Wilson at [12] per Allsop P;
(e) The courts in exercising judicial power, interpret legislation by determining what Parliament intended to mean by the words it used. The Court does not determine what Parliament intended to say or make any attempt to divine the intention of Parliament: Wik Peoples v Queensland (1996) 187 CLR 1 at 169; Dossett v TKJ Nominees Pty Ltd (2003) 218 CLR 1 at [10]; R v PLV (2001) 51 NSWLR 736 at [82]; Harrison at [16] per Spigelman CJ;
(f) In interpreting legislation, the primary object is to construe the relevant provisions so that it is consistent with the language and purpose of all of the provisions of the statute: Project Blue Sky Inc v Australian Broadcasting Authority (1998) 194 CLR 355 at [69] and [71] per McHugh, Gummow, Kirby and Hayne JJ;
(g) Legislation must be construed on the prima facie basis that its provisions are intended to give effect to harmonious goals. Where conflict appears between provisions, it must be alleviated, as far as possible, by adjusting the meaning of the competing provisions to achieve a result. This adjustment may require a Court to determine a hierarchy of provisions: Project Blue Sky at [70] per McHugh, Gummow, Kirby and Hayne JJ; Ross v The Queen (1979) 141 CLR 432 at 440 per Gibbs J; Wilson at [13] per Allsop P;
(h) It is both permissible and appropriate to have regard to contextual material without a need for ambiguity to be established: Caterpillar of Australia Pty Ltd v Industrial Court of NSW [2009] NSWCA 83 at [86];
(i) The contextual material, to which reference may be made, includes the history of the particular enactment, and the state of the law when it was enacted, namely, the legal and historical context of the legislation. This may include an examination of reports of law reform bodies (or the like): Pyneboard Pty Ltd v Trade Practices Commission (1983) 152 CLR 328 at 341 per Mason ACJ, Wilson and Dawson JJ; CIC Insurance Ltd v Bankstown Football Club Ltd (1997) 187 CLR 384 at 408 per Brennan CJ, Dawson, Toohey and Gummow JJ; Wilson at [12] per Allsop P;
(j) It is an established principle that a statute should not be presumed to abrogate existing fundamental or common law rights in the absence of clear language. The nature of the right being abrogated will determine whether the principle is strong or weak: Gifford v Strang Patrick Stevedoring Pty Ltd (2003) 214 CLR 269 at [36] per McHugh J; Electrolux Home Products Pty Ltd v Australian Workers' Union (2004) 221 CLR 309 at [19] per Gleeson CJ; Harrison at [209]-[221] per Basten JA, Spigelman CJ agreeing at [2].

The Relevant Legislation

  1. There are two Acts which are relevant to be examined.

Motor Accidents Compensation Act 1999

  1. The MAC Act was introduced in 1999. In addition to creating the Motor Accidents Authority and providing for the licensing and regulation of CTP insurers, the Act provided for a regime of damages to be awarded to individuals injured in motor vehicle accidents as a result of the fault of the owner or driver of the motor vehicle. In so doing, it altered some of the common law's approach to damages.

  1. The objects of the MAC Act are set out in s 5. Included in those objects are:

"(a) ... and to provide appropriately for the future needs of those with ongoing disabilities,
(b) to provide compensation for compensable injuries sustained in motor accidents ...
...
(e) to keep premiums affordable, in particular, by limiting the amount of compensation payable for non-economic loss in cases of relatively minor injuries, while preserving principles of full compensation for those with severe injuries involving ongoing impairment and disabilities"
  1. The provisions of s 6(1) of the MAC Act are of importance. That section reads:

" 6 Interpretation and application of Act by reference to objects
(1) In the interpretation of a provision of this Act ... a construction that would promote the objects of this Act or the provision is to be preferred to a construction that would not promote those objects."
  1. This seems to be a statutory encapsulation (albeit truncated) of the purposive construction approach to statutory interpretation to which I have earlier made reference.

  1. Section 128 of the MAC Act is a provision which deals, under the heading of " Damages for economic loss " with the permissible calculation of a sum for damages to which an injured plaintiff may be entitled as a result of the provision to him or her, of gratuitous attendant care services. I note that the term "gratuitous care" which found fashion in G v K is not actually used in s 128. Rather the section describes the relevant services as being

"...[services] for which the person in whose favour the award is made has not paid and is not liable to pay."
  1. Generally speaking, s 128 accepts the right of an injured plaintiff to recover G v K damages, but seeks to limit the sums of money which may be recovered. In so doing, it is seeking to fulfil the object in s 5(e) of the MAC Act, namely, to keep premiums affordable.

  1. Of particular importance to the issues in this case, is s 130A. It reads:

" 130A No damages for expenses covered by Lifetime Care and Support Scheme
No damages may be awarded to a person who is a participant in the Scheme under the Motor Accidents (Lifetime Care and Support) Act 2006 for economic loss in respect of the treatment and care needs (within the meaning of that Act) of the participant that relate to the motor accident injury in respect of which the person is a participant in that Scheme and that are provided for or are to be provided for while the person is a participant in that Scheme."
  1. Section 130A was introduced by the Motor Accidents (Lifetime Care and Support) Act 2006 which was assented to on 8 May 2006.

  1. The Motor Accidents (Lifetime Care and Support) Act established the Lifetime Care and Support Scheme. It was introduced into Parliament as a cognate bill with the Motor Accidents Compensation Amendment Bill which was also assented to on 8 May 2006 .

Motor Accidents (Lifetime Care and Support) Act 2006

  1. The LCS Act was passed in 2006 to create, and give effect to, a Scheme which provided for the reasonable lifetime care and support needs of catastrophically injured people, to be met by the LCS Authority, provided that the injuries arose out of a motor vehicle accident.

  1. This Act contains no statement of purpose, nor a list of the objects to be achieved by the legislation.

  1. Attendant care services are defined in s 3(1) in this way, namely, services

"...that aim to provide assistance to people with everyday tasks, and includes (for example) personal assistance, nursing, home maintenance and domestic services."
  1. This definition of attendant care services incorporates all of the services which have traditionally been compensated by awards of damages, including those instances where services are provided gratuitously to fulfil needs created by injuries and disabilities which were "tortiously" sustained in a motor vehicle accident.

  1. It is the existence of the need for these services, and the gratuitous fulfilment of that need, which is covered by the principles in G v K .

  1. Section 5 is a provision which provides some limited assistance in the interpretation of the LCS Act. It reads:

"Words and expressions used (but not defined) in this Act have the same meanings as in the Motor Accidents Compensation Act 1999. "
  1. It is appropriate to note, and make some observations about, the other provisions which are relevant to the present issues:

" 6 Scheme participants' treatment and care needs to be paid for by Authority
(1) The Authority is to pay the reasonable expenses incurred by or on behalf of a person while a participant in the Scheme in providing for such of the treatment and care needs of the participant as relate to the motor accident injury in respect of which the person is a participant and as are reasonable and necessary in the circumstances.
(2) For the purposes of this Act, the treatment and care needs of a participant are the participant's needs for or in connection with any of the following:
(a) medical treatment (including pharmaceuticals),
(b) dental treatment,
(c) rehabilitation,
(d) ambulance transportation,
(e) respite care,
(f) attendant care services,
(g) domestic assistance,
(h) aids and appliances,
(i) artificial members, eyes and teeth,
(j) education and vocational training,
(k) home and transport modification,
(l) workplace and educational facility modifications,
(m) such other kinds of treatment, care, support or services as may be prescribed by the regulations.
(3) As an alternative to paying the expenses for which it is liable under this section as and when they are incurred, the Authority may pay those expenses by the payment to the participant of an amount to cover those expenses over a fixed period pursuant to an agreement between the Authority and the participant for the payment of those expenses by the participant.
(4) The LTCS Guidelines may make provision for or with respect to determining which treatment and care needs of a participant in the Scheme are reasonable and necessary in the circumstances.
7 Eligibility for participation in the Scheme
...
(3) A person is not eligible to be a participant in the Scheme in relation to an injury if the person has been awarded damages, pursuant to a final judgment entered by a court or a binding settlement, for future economic loss in respect of the treatment and care needs of the participant that relate to the injury."
  1. It is appropriate to notice that s 7(3) denies eligibility to participate in the LCS Scheme, but only to a person who has received damages, by way of a court order or settlement, for future economic loss. That is, economic loss calculated as arising after the date of judgment or settlement (as the case may be). There is no mention of damages for past attendant care needs as a ground for lack of eligibility for the LCS Scheme.

  1. Section 9 deals with participation in the LCS Scheme in this way:

"9 Acceptance as a participant
(1) A person becomes a participant in the Scheme if the Authority is satisfied that the person is eligible to be a participant and accepts the person in writing as a participant in the Scheme, either as a lifetime participant or an interim participant (according to the person's eligibility).
(2) If the Authority is satisfied that a person is eligible to be a participant and that application for the person's acceptance as a participant has been duly made, the Authority must accept the person as a lifetime participant or an interim participant (according to the person's eligibility).
(3) A person accepted as an interim participant must be accepted as a lifetime participant if the Authority becomes satisfied during the person's interim participation in the Scheme that the person is eligible for lifetime participation in the Scheme.
(4) A person accepted as a lifetime participant in the Scheme remains a participant for life."
  1. I note that the effect of this section is that if a person, by reason of the extent of their injury (which by its nature is permanent and unlikely to improve) and it being caused wholly or partly by a motor vehicle accident, is eligible to participate in the LCS Scheme then:

(a)   the LCS Authority must accept the person into the LCS Scheme either as an interim or lifetime participant; and

(b)   the person, once a lifetime participant, remains a participant for life.

Whilst the LCS Authority has a limited discretionary decision as to whether it is satisfied that a person is "eligible", once that determination is made the inclusion of a person into the scheme is mandatory and not the subject of a further discretion.

  1. The provisions which affect the assessment by the LCS Authority of the needs of a participant are these:

"23 Assessment of treatment and care needs of participants
(1) The Authority is to make an assessment of the treatment and care needs of a participant in the Scheme.
(2) The assessment is an assessment of the participant's treatment and care needs that are reasonable and necessary in the circumstances, and as relate to the motor accident injury in respect of which the person is a participant in the Scheme.
(3) An assessment of treatment and care needs is to be made in accordance with the LTCS Guidelines.
(4) The Authority is to certify in writing as to its assessment of the treatment and care needs of the participant including its reasons for any finding on which the assessment is based, and is to give a copy of the certificate to the participant.
26 Effect of assessment
(1) The Authority's assessment of the treatment and care needs of a participant is final and binding for the purposes of this Act and any proceedings under this Act.
...
28 LTCS Guidelines
(1) The LTCS Guidelines may make provision for or with respect to the assessment of the treatment and care needs of a participant in the Scheme."
  1. Some features of these provisions which make provision for the administration of the LCS Scheme, should be here noted.

  1. Section 6 requires the LCS Authority to pay expenses incurred in providing, inter alia, for attendant care needs.

  1. Section 23 provides for a preceding and essential step to be taken, namely, the making of an assessment of the treatment and care needs of a participant. This section does not deal with costs or expenses. It simply deals with an assessment of needs.

  1. I note that there is no provision which specifically obliges the LCS Authority to provide or pay for all of the assessed needs of a participant. It seems to be assumed by the Act, that the LCS authority will provide for all the assessed needs of a participant. This is a significant lacuna in the legislation which seems, at least in part, to have given rise to the current dispute. Nor does the LCS Act articulate any objects or purposes, the equivalent of those in s 5(a) and s 5(e) of the MAC Act.

  1. Although s 54 was not referred to by any of the parties, it seems to be relevant to the consideration of how it was envisaged that the Scheme would work. It is unnecessary to set out the section verbatim. It provides that the LCS Authority is entitled to recover from a motor vehicle tortfeasor, or if insured, the CTP insurer, the present value of the Authority's treatment and care liabilities in respect of the motor vehicle accident. That present value is defined as including the Authority's past expenses and the present value of the amounts which:

"...the Authority estimates will become payable...in the future...in respect of the treatment and care needs."
  1. There is no identified exclusion from the recovery. The section envisages that the present value of all of the future treatment and care needs of an individual will be recovered where a motor vehicle tortfeasor is identified.

  1. The section also makes provision for a limited recovery if the identified motor vehicle tortfeasor is only partially liable, either because of the negligence of another person, or because of the contributory negligence of the injured plaintiff.

  1. The consequence of s 54 is that the position of the CTP insurer is no different, in principle, from that which exists under the MAC Act, or else where an injured plaintiff is accepted as a participant in the LCS Scheme. That is because the motor vehicle insurer will have to pay a sum of money that fully compensates for the injuries and disabilities suffered, and all of the treatment and care needs which are properly to be provided.

  1. There will be a difference in terms of to whom the money will be paid, namely either to the injured plaintiff directly, or else to the LCS Authority. Another difference which may be monetarily significant, is that the sum to be paid by the insurer to the LCS Authority is determined by the Authority's estimates and not a sum fixed by the Court in accordance with common law principles, as amended by the MAC Act.

  1. It is unclear from the terms of s 54, whether the CTP insurer is entitled to have the Authority's estimates of G v K damages calculated in accordance with s 128 of the MAC Act. That is an issue which it is unnecessary for me to resolve.

The Second Reading Speech

  1. The Second Reading Speech was delivered in the Legislative Assembly on 9 March 2006 by Mr John Watkins who was the Deputy Premier and Minister for Transport.

  1. The Speech referred to both of the cognate Bills which became the legislation to which I have earlier made reference namely, the LCS Act and the MAC Amending Act. The Bills were moved and debated together.

  1. The Speech includes these remarks:

"The Motor Accidents (Lifetime Care and Support) Bill establishes a scheme to provide lifetime care and support for persons who suffer catastrophic injuries in motor vehicle accidents covered by the Motor Accidents Compensation Act 1999 ... Each year about 125 people will be catastrophically injured in motor vehicle accidents in New South Wales and left with significant disabilities requiring lifetime support. They will have significant daily needs for care, personal assistance, domestic support, and ongoing equipment and medical needs. For those with the most profound injuries, this will extend to requiring 24 hour nursing care.
Under the current Motor Accidents Compensation Act , only 65 of the 125 people catastrophically injured in a motor vehicle accident are likely to be eligible for compensation. This is because compensation is available only where the accident was caused by the fault of another driver. People who are considered at fault are not entitled to any compensation and must rely upon family and community services to provide support. Even those in receipt of compensation are not guaranteed a lifetime of reasonable care and medical treatment. Typically, the catastrophically injured will be male and predominantly young. More than half will be less than 20 years of age at the time of the injury and more than 70 per cent will be under the age of 30. To address the special circumstances of catastrophically injured motor accident victims, the Government released its lifetime care and support plan in June 2005.
The plan proposed that all people catastrophically injured in motor vehicle accidents in New South Wales would receive the medical care and support services they need throughout their life, regardless of who was at fault in the accident.
...
A person will not be eligible to participate in the Scheme if the person has been awarded common law damages for his or her treatment and care needs. Acceptance into the Scheme as a lifetime participant will prevent a person from recovering common law damages for treatment and care needs. The scheme will provide for all the reasonable treatment and care expenses of participants. These reasonable expenses include medical treatment, rehabilitation, attendant care services, and home and transport modification. This is consistent with current entitlements in the CTP motor accident scheme which provides for an injured person's reasonable and necessary medical treatment, rehabilitation and care expenses. The LTCS guidelines will determine what are reasonable and necessary treatment and care needs for participants.
...
The Bill clarifies that for a participant in the scheme, the CTP insurer dealing with the claim is no longer required to meet any of the person's treatment and care expenses as those expenses are now required to be met solely by the Lifetime Care and Support Scheme. The Motor Accidents Compensation Act is also amended to exclude a lifetime participant in the Scheme from recovering economic loss damages for any treatment and care needs. The current lump sum compensation arrangements for meeting these needs will be replaced by the provision of lifetime treatment, care and support provided by the Lifetime Care and Support Scheme."

Purpose of the Legislation

  1. It seems tolerably clear that it was the intention of the Government to introduce legislation which would establish a scheme with these features:

(a)   It would cover those who, as a consequence of a motor vehicle accident, were catastrophically and permanently injured;

(b)   The injuries were such that the individuals would require treatment and care for the whole of their lives;

(c)   The LCS Scheme would provide for all of that treatment and care, including attendant care, for as long as it was necessary on an individually assessed basis;

(d)   Because the LCS Scheme would attend to the provision of lifetime treatment and care, an injured person would not need, and would not be entitled to, compensation by way of damages for any treatment and care needs including attendant care;

(e)   The only limitation on the provision of treatment and care was that it was reasonable in the circumstances, and that the injury was caused in a motor vehicle accident.

  1. The historical context by the time these bills were debated and the legislation assented to included these issues:

(a)   The largest component of awards of damages for catastrophically injured plaintiffs were for the costs of future hospital or nursing care, and the costs of future attendant care. One of the essential parameters for the determination of those significant components was the likely life expectancy of the injured claimant.

(b)   The determination by the Court of a finite life expectancy period for seriously injured plaintiffs was regarded as an exercise in the nature of an 'informed guess'. Often different methodologies, either statistical or clinical, were relied upon by different experts to reach widely divergent views.

(c)   The determination, in any one or other case, could be particularly complex because of co-morbidities, unassociated with the tortiously caused injuries. Such co-morbidities may have fallen outside either or both of the statistical and clinical experience. An example of such a case is Roads and Traffic Authority of NSW v Palmer [2003] NSWCA 58 at [105]-[117] per Spigelman CJ, Handley and Giles JJA agreeing.

(d)   The existence of cases where the death of a seriously injured person occurred at a time much earlier than that determined by the Court, and prior to finalisation of any appeal, so that a question of whether a significant monetary windfall to an estate should be allowed, needed to be determined. Examples of such cases include: Gilchrist v Estate of the late Sara Taylor [2004] NSWCA 476; Doherty v Liverpool District Council (1991) 22 NSWLR 284. I note that the courts of the United Kingdom seemed to take a different approach to that taken in the NSW Court of Appeal: see Mulholland v Mitchell [1971] 1 AC 666, and McCann v Sheppard [1973] 2 All ER 881 at 885-886 per Lord Denning MR.

(e)   The determination of a truncated life expectancy by a Court for a seriously injured person may, if proved to be too pessimistic by the individual living longer than determined, mean that such an individual was left without adequate compensation and thereby in the absence of proper care in a potentially life-threatening situation. This situation was described by Handley JA in Pettersen v Bacha (1995) 21 MVR 71 as perhaps amounting to " ... a sentence of death imposed by a civil court. ".

(f)   The issue was best expressed in summary form by Whealy J in Simpson v Diamond [2001] NSWSC 925 at [74]:

"The plaintiff's life expectancy is an issue which bears upon all those heads of damage which have been claimed ... on a continuing basis for the whole of her life ... This is often a practical assessment but it is ... a most critical and important one. A significant underestimate, for example, could leave a plaintiff without adequate care at a critical later point in his or her life. A significant over estimate, on the other hand, could result in a windfall for others."
  1. As well, problems had been identified in a number of cases about whether lump sum damages had been an adequate methodology where the claimant was a young person because:

(a)   the costs of nursing care, and commercially provided attendant care, had risen dramatically over time, so that sums awarded for damages had, by the elapse of time, proved to be wholly inadequate; or

(b)   in a small number of cases, imprudent investment of damages sums had resulted in the loss of the majority of the sum, and the injured claimant was left without adequate support.

  1. Legislative change had been called for to avoid what was perceived to be a lottery in some cases, and significant uncertainty in many other cases. Various models had been suggested. These pieces of legislation were the first in Australia to propose such a lifetime scheme as the solution to the issues which were part of the historical context.

  1. The LCS Scheme would, so it was intended, remove both the uncertainties and the windfalls that were an identified part of the historical context. The Scheme did so, in essence, by removing the relevance of a determination of a fixed life expectancy, and by assuming the burden of rising care costs.

  1. It is also appropriate to notice some of the context surrounding the introduction of these Bills. As the Second Reading Speech makes plain, in 1999 the then Government reformed compensation for those injured in motor accidents by the introduction of the MAC Act. That Act was intended to provide cheaper insurance premiums for CTP insurance. It did so in a number of ways which might be summarised as follows:

(a)   First, by reducing insurance premiums for compulsory third party policies for motorists;

(b)   Second, by improving the processes by which injured people obtained compensation; and

(c)   Third, by ensuring that people received treatment for their injuries sooner and in a more timely manner.

  1. The MAC Act continued, in s 128, previous similar provisions which are to be found in s 72 of the Motor Accidents Act 1988, that limited the sums of money which could be recovered for the value of gratuitous nursing and domestic services. It is relevant to observe that s 128 did not abolish damages of the kind which the Courts had recognised in G v K , but rather limited the amount of those damages by reference to a series of formulae contained in the section. In fact, s 128 gives statutory recognition to the appropriateness of G v K damages.

  1. Hence at the time of the passage of the LCS Act, the existing legislation well recognised (as did the common law) the entitlement of an injured person to recover damages for gratuitous nursing and domestic services, which are in substance the same as the attendant care services as that expression is used in the LCS Act.

  1. Nowhere in either of the Acts is there a clearly expressed intention to abolish G v K damages. Rather, the expectation seems to be that the attendant care services will be provided as part of the LCS Scheme and that there will be no need for G v K damages to be assessed and paid.

LCS Guidelines

  1. The LCS Authority has issued Guidelines from time to time pursuant to s 58 of the LCS Act. Those Guidelines, whilst they have generally varied, have been largely identical so far as attendant care is concerned. The references to attendant care are to be found in Part 8 of the Guidelines. It is appropriate to note at the commencement of Part 8 that, as with other parts of the Guidelines, the LCS Authority acknowledges that it may waive observance with any part or parts of the Guidelines in any one particular case.

  1. The Guidelines state that the policy with respect to attendant care is:

"The Authority will fund reasonable and necessary attendant care service for participants in relation to the injury sustained in the motor accident."
  1. It describes the background to that policy in the following terms:

"Attendant care services are paid services that assist the participant to perform tasks they would normally be able to do for themselves. Attendant care services focus on maximising the participant's independence across a variety of settings: home, work/vocational activities and community/avocational activities, with the aim of facilitating a return to their former roles or developing new functional skills and roles. Attendant care services should be centred on the participant and their family and be the most age appropriate and least restrictive response to meet their needs.
Attendant care services include personal assistance, domestic assistance, assistance to access the community, gardening, rehabilitation support, registered nursing and home maintenance. The type of assistance provided to the participant may include physical assistance, prompting and/or supervision."

So described, the Guidelines recognise that which had been recognised by the common law (and statutory modifications) since at least G v K , namely, that there are personal needs of the kind described which directly relate to tortiously caused injuries, which have to be met by the provision of comprehensive attendant care services, at the cost of the tortfeasor.

  1. The Guidelines note in Clause 1 that the Authority's decision on whether the attendant care services are reasonable and necessary " ... will be based on the participant's care needs assessment ".

  1. Of importance is Clause 6 of the Guidelines, which deals with the provision of attendant care by family and friends. It is in the following terms:

" 6. Attendant care - family and friends as paid attendant care workers
Policy
Employment of family members or friends as paid attendant care workers is not encouraged by the Authority, but may be necessary in some circumstances, for example, in rural and remote areas where access to attendant care workers may be limited.
Family members or friends will only be employed to provide attendant care services when it is determined by the Authority and attendant care service provider, with input from the participant and their family, to be in the best interests of the participant. This option will only be considered when all other alternative options to provision of attendant care have been exhausted."
  1. The Guidelines further note that in order for a family member to provide the attendant care, and be paid for it, the family member needs to be employed by an approved attendant care provider and that the family member has met that provider's criteria with respect to skills, knowledge and appropriate attitude. The Guidelines also provide that the family member must meet the provider's standards for service delivery and compliance with occupational health and safety guidelines.

  1. The Guidelines conclude with this paragraph, which seems to be the only one specifically dealing with gratuitously provided attendant care. It is in the following terms:

" The Authority will not fund attendant care services that are provided by family or friends and payment for the services is requested from the Authority, where the Authority has not approved the need for care, or the care provided is not part of the participant's care plan. The Authority will not fund a family member or friend to provide inactive sleepovers."
  1. The parties agreed before me that inactive sleepovers is a term used in the care industry to mean the presence of a person in the same accommodation as the injured person, during the overnight period when the injured person is ordinarily asleep, and circumstances do not require, on average across a period, the care provider to attend more than twice to the injured person in the course of the night.

  1. The issues to be separately determined in this judgment include a number dealing with, in a general sense, the validity or appropriateness of these Guidelines. It will be necessary to return to this question in due course.

How Does The Legislation Appear to Work?

  1. Not all of the provisions of these two pieces of legislation sit well together. There are three possible ways of the legislation operating so far as G v K damages are concerned (I use this expression here, as a term of convenience, to include damages calculated and awarded in accordance with s 128 of the MAC Act). It will be necessary to examine each.

  1. The three ways are:

(a)   G v K damages remain outside the LCS Scheme and are at the direct expense of the CTP insurers in the usual way;

(b)   G v K damages are wholly subsumed by the LCS Scheme and are no longer available to a claimant who is also a lifetime participant in the Scheme; or

(c)   G v K damages are available but only up to the date of judgment or settlement of the damages claim where gratuitous services have in fact been provided to the claimant, and have not been paid for under the LCS Scheme. They are not available after that time in respect to any services which are to be provided in the future.

Option (a) - G v K damages are available in full to an LCS Scheme participant

  1. The argument which supports this position features these steps:

(a)   The proper analysis of G v K damages is that they are not a payment of expenses but are damages for a non-economic need created by a tortfeasor. In Van Gervan v Fenton (1992) 175 CLR 327 at 333, Mason CJ, Toohey and McHugh JJ said:

"...the true basis of a Griffiths v Kerkemeyer claim is the need of the plaintiff for those services provided for him or her and ... the plaintiff does not have to show ... that the need 'is or may be productive of financial loss'."
Brennan J agreed with this statement at 340 as did Gaudron J at 347.
Their Honours also noted at 337 the claim "... is not one for special damages ... ". In that case, their Honours were using the term " special damages " in contradistinction to the term " general damages " as that was traditionally known in tortious damages claims.

(b)   The phrase " expenses incurred " in s 6 of the LCS Act carries the obvious meaning, namely expenses actually incurred and for which accounts exist, or else expenses which either the injured person or the LCS Scheme has a legal liability to pay; and

(c)   Since for the claimant, an award of G v K damages does not derive from " expenses incurred ", and the injured person has no legal liability to pay for such services, then such damages fall outside the purview of the LCS Scheme because they are not paid for by the LCS Scheme;

(d)   This approach is confirmed by the final words in s 130A of the MAC Act because the G v K damages are not an economic loss which is provided for by the LCS Scheme.

Option (b) - G v K damages abolished for LCS Scheme participants

  1. The argument which supports this approach relies on these steps:

(a)   The clear intention of the LCS Scheme was to " ...provide lifetime care and support for persons who suffer catastrophic injuries in motor vehicle accidents ";

(b) That intention was put into effect by the legislation as a whole and in particular is confirmed by the LCS Scheme's obligation under s 23 of the LCS Act to make an assessment of all of the needs of a participant. Such assessment is limited only by the qualification of reasonableness (which is no different from that underlying any award for damages) and causal relationship to the particular motor vehicle accident, again something which is necessary in the ordinary course of an award of damages, under the MAC Act;

(c)   Since all needs are covered by the LCS Scheme, if a need is not covered by the actual provision of services under the LCS Scheme, then it ought be concluded that it was neither reasonable nor was it causally related to the accident;

(d)   Section 130A of MAC Act intends that any double compensation is avoided, and so, as all attendant care needs are to be provided for under the LCS Scheme, there is no factual basis for any award of G v K damages.

Option (c) - G v K damages are permissible for the past but not for the future

  1. This option commences by accepting the interpretation of s 6(1) of the LCS Act, namely that the expression " expenses incurred " means an expense which has been paid, and for which a legal liability to pay exists. This has the consequence that, at least as at the date of any judgment or settlement, gratuitously provided attendant care is not an expense which has been incurred.

  1. It does not accept that the phrase " expenses incurred " is to be equated, as the LCS Authority submitted it should be, with what the LCS Authority has "provided for" as a component part of an assessment which accords with s 23 of the LCS Act. But it accepts that a care plan can provide for attendant care which is gratuitous.

  1. This is then supported by concentration on the terms of s 7(3) of the LCS Act which prohibits eligibility for the LCS Scheme where an applicant

"...has been awarded damages, pursuant to a final judgment entered by a court or by a binding settlement, for future economic loss in respect of the treatment and care needs of the participant." (emphasis added)
  1. In other words, acting upon the basis of what appears on the face of s 9(4) of the LCS Act, a person is only disqualified from participating if they receive money for the provision of future services, which the LCS Scheme would otherwise be obliged to provide. If the LCS Scheme has not paid for services in the past, then there is nothing to debar the participant from recovering, from the motor vehicle tortfeasor or else the CTP insurer, those damages. In such a case, there would be no double compensation, and hence the terms of s 130A of the MAC Act would be satisfied.

  1. It is apparent that none of these options easily sit with all provisions of this legislation. Clearly it is necessary for the legislation to be reviewed and amended to make plain which of these possible options is the one which reflects the intention of the legislature.

Submissions

  1. The plaintiff submitted that the attendant care services which had been provided gratuitously by Mrs Thiering should be compensated either by:

(a)   a conventional award of G v K damages against the motor vehicle tortfeasor or the CTP insurer for the period up to judgment, and for the future, because the LCS Scheme had not paid for those services, and by application of their policies, would not pay for them in the future; or

(b)   if G v K damages were no longer available to the first plaintiff, then the LCS Scheme ought to be obliged to compensate Mrs Thiering directly for her services to date because the LCS Scheme had received the benefit of her services being provided to Mr Thiering at no cost to it.

  1. The plaintiff's submissions were centrally focussed upon the recovery, by whatever legal pathway, of adequate compensation for all Mrs Thiering had done for Mr Thiering. It was unnecessary for the plaintiffs to engage, as a matter of legal principle, in the fundamental question as to whether the source of the compensation should be the LCS Scheme or the CTP insurer.

  1. The first defendant, the motor vehicle tortfeasor (in reality the CTP insurer), submitted that where, as was here the case, a plaintiff was a lifetime participant in the LCS Scheme, damages in accordance with G v K had been abolished. It submitted that the first plaintiff was not entitled to an award of damages from the motor vehicle tortfeasor (or his CTP insurer) for any head of damage other than non-economic loss (subject to Part 5.3 of the MAC Act) and damages for past and future loss of earning capacity (subject to Part 5.2 of the MAC Act).

  1. The first defendant argued that the provisions of s 130A of the MAC Act were the primary support for their submissions. The appropriate interpretation of that section was informed by the Second Reading Speech and the purpose and effect of the LCS Scheme.

  1. The second defendant, the LCS Authority, submitted that if attendant care services are provided to an LCS Scheme member gratuitously, then the LCS Authority has no obligation to pay for them, because the Guideline did not permit such payment and because the LCS Authority had no legal obligation to pay for them.

  1. In a somewhat troubling submission, which seemed initially at least, to be the justification for its stance, the LCS Authority submitted this:

"The mother receives a carer's allowance from the Commonwealth Government [agreed fact, par 10]. The allowance is paid under the Social Security Act 1991 (Cth) ss 954, 956. There is no pay back provision. Any recovery by the plaintiffs for the mother's care would be additional to her carer's allowance which will continue."
  1. The gravamen of this submission was that the LCS Authority could obtain without cost, the benefit of a carer whose services were being embraced by the LCS Scheme, but being paid for by the Commonwealth Government under the Social Security Act 1991 (Cth). It also suggested that if it were required to pay the carer, then such a carer would inappropriately be being paid twice for caring for the same injured claimant.

  1. When this submission was drawn to the attention of senior counsel for the LCS Authority, she disavowed any reliance by her client upon the fact of Mrs Thiering being in receipt of a carer's pension, as a basis for excusing the LCS Authority from paying Mrs Thiering if she was otherwise entitled. Upon the basis of that concession, I can put this deeply troubling submission to one side.

  1. Although this submission was withdrawn, it is appropriate to observe that the policies of the LCS Authority and its conduct in the management of Mr Thiering's case suggest that the LCS Authority takes the view that a carer's pension is a wholly adequate recompense for, and is the appropriate remuneration for, a family member providing gratuitous attendant care services to a participant in the LCS Scheme.

  1. The second defendant made it plain that its principal submission was that the obligation of the LCS Authority was only to pay the reasonable expenses incurred by or on behalf of an injured person who was a participant in the Scheme and that the obligation does not extend to pay globally for all of the treatment and care needs of the participant. The second defendant submitted that the term " expense ", to be found in s 6 of the LCS Act ought be interpreted as a cost which had been incurred, or else a legal obligation to pay for the attendant care services which had been provided. It submitted that gratuitously provided attendant care was not an expense which had been incurred.

  1. It further submitted that in the proceedings, the plaintiffs were seeking in effect to recover G v K damages from the LCS Authority, which it noted, if they were permitted so to do, would not be subject to the usual statutory cap applicable to such a claim under s 128 of the MAC Act.

  1. The second defendant further argued that s 130A of the MAC Act does not exclude, or show an intention to exclude, the value of gratuitous care from being included as an item in the damages recoverable by an LCS scheme participant, from the motor vehicle tortfeasor. It argued that s 130A does not exclude damages for the value of gratuitous attendant care because such care is not " provided for or to be provided for " under the LCS Scheme. It must follow from that submission that if a scheme participant was to recover from the CTP insurer G v K damages, either for the past or for the future, that recovery would have no consequence on the individual's entitlement to remain a participant in the scheme.

  1. There are, at least, two difficulties with this submission, insofar as it relates to the future. The first is that s 7(3) of the LCS Act suggests to the contrary, because future G v K damages modified in accordance with s 128 of the MAC Act, would fall within the phrase " future economic loss in respect of the treatment and care needs ", as this is the way in which s 128 is described in the MAC Act.

  1. The second difficulty is that the submission assumes that the Court's assessment (or the parties' agreement) that gratuitous care will be provided in the future, will in fact be a certainty. It does not permit the circumstance in which the individual may change their mind about the receipt of gratuitous care or alternatively, the gratuitous care provider may change their mind about providing the gratuitous care and thereafter as a result of changed circumstances, the injured claimant will require commercial care to be provided by the LCS Scheme, to replace the anticipated gratuitous care which has been provided for, as part of a damages award or a settlement.

Validity of Guidelines

  1. One issue which is central to the determination of a number of the questions posed for separate determination, is whether in so far as Part 8 of the Guidelines:

(a)   sets out a Policy for the delivery of attendant care services by family members or friends, and the payment by the LCS Authority for those services; and/or

(b)   states that the LCS authority will not fund a family member or friend to provide inactive sleepovers,

the Guidelines are valid.

  1. The precise way in which the Guidelines provide for these two areas is more fully set out in [ 94 ] to [101] above, and need not be repeated here.

  1. The introduction to Part 8 of the Guidelines announces that it and the Guidelines are issued under s 58 of the LCS Act. Section 58 is, relevantly, in these terms:

58 LTCS Guideline
(1) The Authority may issue guidelines ( LTCS Guidelines ) for or with respect to any matter that by this Act is required or permitted to be the subject of those guidelines.
...
(5) Sections 40 (Notice of statutory rules to be tabled) and 41 (Disallowance of statutory rules) of the Interpretation Act 1987 apply to a guidelines under this section in the same way as those sections apply to a statutory rule.
  1. The LCS Act permits, amongst others, the following matters to be the subject of guidelines:

(a) which treatment and care needs of a participant are reasonable and necessary in the circumstances: s 6(4) LCS Act;

(b) injury criteria for eligibility to participate in the LCS Scheme: s 7(1) LCS Act;

(c) motor accident criteria for eligibility to participate in the LCS Scheme: s 7(4) LCS Act;

(d) approval of care providers, standards of competency of care providers and requiring identified treatment and care services to be provided only by approved providers: s 10 LCS Act;

(e) the assessment of treatment and care needs: ss 23 and 28 LCS Act.

  1. The subject matter referred to in [126(a)] above, namely a Policy for the delivery of attendant care services by family members and friends, is a matter permitted by the LCS Act to be the subject of Guidelines: s 10 of the LCS Act.

  1. Accordingly, I conclude that that part of the Guidelines is specifically authorised by the LCS Act. The terms of that part of the Guideline do not on their face suggest anything which is inimical to the LCS Act and the LCS Scheme. I would not be prepared to hold that the identified part of it is invalid.

  1. In terms of the subject matter in [126(b)] above, namely a total ban on the payment of family members or friends who provide an inactive sleepover, the position is different.

  1. There is no question that the subject matter is permitted to be dealt with by Guidelines: ss 6(4) and 10 of the LCS Act. However, subject to the overriding reservation at the commencement of Part 8, that the Guideline can be waived in any one case, the Policy imposes a total ban on payment for inactive sleepovers by family members and friends.

  1. An inactive sleepover requires a person to sleep in the house of the participant in the LCS Scheme, and to be available to provide attendant care services, namely:

(a)   attending no more than twice during each overnight period to provide assistance to the participant, such as turning the person over, providing medication or fluid to drink, assisting with toileting, or changing bed linen if necessary - in short, doing anything appropriate to ensure that the participant is able to sleep adequately each night; and

(b)   being present to assist in the preservation of the participant's life where a medical emergency occurs or else where some other emergency presents itself, such as fire, gas escape, flooding or some neighbourhood or environmentally related emergency.

  1. Any of the services provided to meet the needs identified immediately above, are necessary because of the participant's injuries and disabilities. There is no personal "profit" or "benefit" which enures to the individual care provider in doing what is called for during an inactive sleepover. The only person who benefits is the participant themselves.

  1. As G v K , and subsequent decisions have clearly demonstrated, the motor vehicle tortfeasor has by his or her tort created a need in the injured claimant for services. That need is what is fulfilled in one way or another. The fact that the fulfilment of the need is brought about by the conduct of a family member or friend, gratuitously, does not mean that the need does not exist, nor does it mean that it does not need to be met.

  1. There are many circumstances, which can be readily called to mind, where the provision of attendant care by way of inactive sleepover by a family member or friend is entirely appropriate. The accepted intimate presence of a family member or friend does not readily translate to the presence of a stranger being paid by an approved commercial care provider. Housing accommodation may not permit a separate bedroom or sleeping area for a stranger to the home. The fact that the house in which the LCS Scheme participant lives is also occupied by other family members, means that considerations of their privacy and inter-familial relationships may tell strongly against a stranger sleeping in their home overnight.

  1. This outline of these circumstances, although brief and necessarily selective, demonstrates that a Guideline of the kind described in [126(b)] above, cannot be supported by the provisions of the LCS Act because, in its terms, particularly where an assessment of a participant's attendance care needs has been made under s 23 of the LCS Act, and that assessment identifies 24 hour attendant care (or at least inactive sleepover care) as necessary to meet the participant's needs, it denies the provision of appropriate and necessary attendant care services.

  1. As well, the terms of this part of the Guideline suggests that the LCS Authority is entitled to benefit from the gratuitous provision of attendant care by means of an inactive sleepover, but can escape the obligation or burden of paying for the provision of the services which meet the needs of the participant. A provision of a Guideline which has such an effect is not consistent with the legislative provisions by which the LCS Scheme is constructed, because the legislation places on the LCS Authority the obligation, as a matter of fulfilling the statutory purpose of the comprehensive LCS Scheme, of providing for, including payment for, all reasonable and necessary attendant care services.

  1. Accordingly, I conclude that, that part of Part 8 of the LTCS Guidelines, as is referred to in [126(b)] above, is invalid. It cannot be relied upon, alone, to deny payment to family members and friends who provide attendant care to an LCS Scheme participant, by way of inactive sleepovers.

Discernment

  1. It can be seen from the articulation of the various options and the submissions that there are components of the legislation and statements in the Second Reading Speech which are capable of being construed in a way which support any of the options which were urged on the Court.

  1. It is necessary to find an interpretation which best fulfils the purpose of the legislation.

  1. Some conclusions about parts of the legislation and some of the principal features of the LCS Scheme will help in identifying the option which best fits the purpose of the legislation. They are these:

(a) Once a person becomes a participant in the LCS Scheme, there is an acknowledgment that their injuries are sufficiently serious and permanent, such that they are unlikely to appreciably change for the future. Hence once they are a participant in the LCS Scheme, they remain a participant for life: s 9(4) of the LCS Act.

(b) The LCS Authority is obliged, subject to questions of reasonableness and causation, to make an assessment of all of the treatment and care needs of a participant in the Scheme: s 23(1) of the LCS Act, which is final and binding as between the participant and the LCS Authority: s 26 of the LCS Act, and which is only to be revised to give effect to the findings of a review panel under s 25 of the LCS Act.

(c) The assessment of the treatment and care needs of a participant is to be made in accordance with the LCS Scheme: s 23(3) of the LCS Act. The Guidelines are akin to regulations and therefore subordinate legislation. Those Guidelines cannot derogate from the overall requirements of the legislation so as to diminish the LCS Authority's obligation to provide for the treatment and care needs of an individual participant.

(d)   The LCS Guidelines insofar as they state that " [t]he Authority will not fund a family member or friend to provide inactive sleepovers ", are not valid, and do not, alone, provide a proper basis for declining to pay for attendant care services provided by way of inactive sleepovers, by a family member or friend.

(e) Where the injuries sustained by the participant have been wholly or partially caused by the negligence of a motor vehicle tortfeasor, the CTP insurer remains obliged, if and when called upon, to pay to the LCS Authority, money for the treatment and care costs of the participant: s 54(1) of the LCS Act.

(f) The creation of the LCS Scheme by the LCS Act was not intended to limit the application of the MAC Act in respect of a participant in the Scheme except as specifically provided for by that Act: s 11(1) of the LCS Act. The only provision of the MAC Act which limits or otherwise affects its application is s 130A of the MAC Act.

(g)   Section 130A of the MAC Act is intended to prevent double compensation and is addressed to " ... economic loss in respect of ... treatment and care needs ... ", but only where those treatment and care needs " ... are provided for or are to be provided for ... " to a participant by the LCS Scheme.

(h) Section 6 of the LCS Act identifies an obligation upon the LCS Authority to pay for expenses incurred by or on behalf of a participant, or moneys for which a legal liability exists to pay. That legal liability may include a claim being made for monies assessed on a quantum meruit basis by the provider of the services. Such a claim is not one based on contract, because it assumes the absence of a binding contract, but rather is imposed by a rule of law arising from the acceptance of the services provided and the benefit conferred on the recipient by the provision of those services.

(i)   Where a treatment and care plan includes the provision of attendant care services, whether gratuitous or paid, the plan constitutes an acknowledgement of the reasonableness of those services and the need for the provision of them, and as well, their causal relationship to the motor vehicle accident. It is an acknowledgment that in order to properly provide for the treatment and care needs of the participant, the attendant care services are an integral feature and should be provided for by the LCS Authority in fulfilment of its mandate.

(j)   Where however, the LCS Authority does not pay for those services, and either does not have or else does not accept an obligation to pay for those services, then, within the meaning of s 130A of the MAC Act, the services when delivered prior to an assessment date, have not been " ... provided for ... " and damages can still be recovered under the MAC Act for such services. However, since such services are a necessary part of the treatment and care needs of the participant, and since the LCS Authority is obliged to provide for those services in the future, the future attendant care services are excluded from an award of damages to a participant by reason of s 130A of the MAC Act, because they are "...to be provided for ...".

(k) This interpretation is consistent with s 7(3) of the LCS Act which prevents eligibility to participate in the LCS Scheme, by reason of receipt only of damages (by settlement or judgment) for future economic loss relating to treatment and care needs.

Conclusion

  1. I have come to the conclusion that Option (c), to which I have earlier made reference, is the correct option for the interpretation of this legislation.

  1. It requires an exercise, at the time the assessment of damages is made, whether as part of a judgment, or else as a basis for an agreed settlement, of the determination of the following issues:

(a)   is the injured person a lifetime participant in the LCS Scheme;

(b)   has the LCS Scheme paid for or accepted an obligation to pay for, attendant care services up to the date of assessment. If so, then no damages for attendant care are recoverable by the injured claimant from the CTP insurer, because the claimant does not have any unmet needs.

(c) if the LCS Scheme has not paid, or accepted an obligation to pay, for attendant care services, then damages up to the date of assessment are recoverable, calculated in accordance with s 128 of the MAC Act, from the CTP insurer by the injured claimant.

(d) this means that there is necessarily a question of fact which has to be determined in each case as to whether attendant care services have or have not been delivered to the injured claimant up to the date of assessment. Where the LCS Authority has not paid for those services under s 6 of the LCS Act, and where there is no accepted or proved legal obligation to pay for them, then there has been no provision of attendant care services by the LCS Authority, and damages under s 128 of the MAC Act are available up to the date of assessment.

(e)   as for the future, consistent with the policy of the LCS Scheme and the intention of the legislation, and to take account of the historical context about the difficulties in fixing life expectancy and the risks which flow from such determination, the LCS Authority is obliged to provide, and to pay for attendant care services in the future where those services are assessed and determined under a plan to be reasonable and necessary for the treatment and care needs of the participant.

(f) if those services are provided by a commercial provider, then no doubt pursuant to s 6 of the LCS Act, the LCS Authority will be obliged to make payment. Where the services are provided gratuitously, then the provider of the service may, depending upon the facts and circumstances in each case, have available a claim against the LCS Authority for those services in accordance with the principle of quantum meruit.

(g)   whatever be the position about the provision in any one case of attendant care services, a total ban on the payment for provision by family members or friends of " inactive sleepovers " is a policy which is not grounded in the LCS Act or the LCS Scheme. The LTCS Guideline is not to that extent valid. There may be circumstances in which a family member sleeping over in a house is part of the provision by the LCS Authority of reasonable and necessary treatment care services. That will be a question of fact to be determined in each case. Hence a blanket statement that in no circumstances will such services be paid for, cannot be justified by the legislation. To enforce such a policy would be to conscript the carer not into the service of the injured claimant, but into the service of the LCS Authority: see Figueroa v NSW Insurance Ministerial Corporation (NSWSC, 18 March 1998, unreported) per Simpson J. This is an untenable outcome.

  1. My conclusion that the proper interpretation of the LCS Act and the MAC Act permits the awarding of G v K damages, in accordance with s 128 of the MAC Act up to the date of judgment or settlement, means that the end point reached for each of the parties can now be stated.

Mr Thiering

  1. Mr Thiering, for the period up to judgment (or settlement) continues to be entitled to obtain G v K damages for any reasonable gratuitous services provided to him. This accords with his common law entitlement, as modified by s 128 of the MAC Act. It also reflects the fact that nowhere is there plainly expressed an intention in the legislation to abolish this common law entitlement.

  1. The recovery of these damages reflects the need created by the motor vehicle tortfeasor, and enables Mr Thiering, if he wishes, to discharge any moral obligation he may feel to his mother for providing those services.

  1. This entitlement for G v K damages up to judgment would cease to exist, if it could be shown that the LCS Authority had either, paid a proper and reasonable fee for the services, or else it has been established that the LCS Authority has a legal liability to pay a proper and reasonable fee for such services, and hence the services are " expenses incurred " in accordance with s 6 of the LCS Act.

  1. As for the future, that is, the period after judgment (or settlement), Mr Thiering as an accepted lifetime participant in the LCS Scheme, has no entitlement to G v K damages, as modified by s 128 of the MAC Act, for any gratuitously provided attendant care services. This reflects the nature and purpose of the LCS Scheme, s 7(3) of the LCS Act and s 130A of the MAC Act.

  1. But in the future, Mr Thiering has an entitlement, subject to the proper completion of an assessment process under s 23 of the LCS Act, to have all of his attendant care needs met and provided by the LCS Authority, including overnight periods where care can be provided by way of inactive sleepovers. Those inactive sleepovers can be undertaken by family members or friends who would be entitled to be paid by the LCS Authority providing:

(a) the attendant care is included as part of a care plan developed at the s 23 assessment; and

(b) the identified family member or friend complies with any other reasonable requirement contained within a valid LTCS Guideline authorised by s 58 of the LCS Act, and which has not been disallowed under s 41 of the Interpretation Act 1987.

Mrs Thiering

  1. Mrs Thiering is entitled to proceed to establish, in a properly pleaded claim, a debt due to her by the LCS Authority with respect to the gratuitous services which she has, to date of judgment of any claim by Mr Thiering, provided to Mr Thiering.

  1. That properly pleaded claim may include a claim based on quantum meruit principles for a proper and reasonable fee for her services. If she is able to establish a legal entitlement to be paid by the LCS Authority, then she is not limited in the making of that claim by the terms of s 128 of the MAC Act, because she is not making a claim for damages as a result of any injury which she has sustained in a motor vehicle accident.

  1. If she does not succeed in establishing any legal entitlement, then she is in no different position than anyone else who provides gratuitous care to a tortiously injured person.

  1. As for the future, she is under no obligation to provide any attendant care services to Mr Thiering. Whether she chooses to, or not, is a matter which she can determine in due course. No doubt her decision would be influenced by:

(a)   whether attendant care services are included as part of a treatment and care plan for Mr Thiering as assessed by the LCS Authority;

(b)   whether she has been approved by the LCS Authority to provide that care;

(c)   whether she has agreed to accept the terms of any remuneration, or other lawfully applicable conditions imposed by the LCS Authority;

(d)   whether the LCS Authority has provided paid carers to undertake the care she would otherwise deliver to Mr Thiering; and

(e)   what, having regard to the available expert advice, is in the best interests of her son.

  1. The choice to provide gratuitous care for the future is then one which she can make free of any compulsion created by a familial or moral sense of duty to her son.

The Motor Vehicle Tortfeasor (or CTP Insurer)

  1. Where attendant care services have been provided gratuitously to date of judgment of Mr Thiering's claim for damages, then the CTP insurer remains liable for G v K damages, as modified by s 128 of the MAC Act, regardless of whether the injured claimant is a participant in the LCS Scheme or not.

  1. This is no different from the current position and unless payment has been made, or else a legal liability exists in the LCS Authority to make a payment to the provider of the gratuitous attendant care, then s 130A of the MAC Act does not prevent such an award of damages.

  1. As for the future, the CTP insurer has no liability to pay for, and an injured claimant who is a lifetime participant in the LCS Scheme has no entitlement to, G v K damages as modified by s 128 of the MAC Act. The removal of this liability for future G v K damages means that the CTP insurer is not exposed to the lottery effect created by awards of damages which become excessive because of the early or sudden demise of an injured claimant. Conversely, an injured claimant is not left without care because of insufficient funds (through whatever cause).

  1. To the extent that the CTP insurer is called upon to reimburse the LCS Authority under s 54 of the LCS Act, there is no reason in principle why such an obligation needs to be dealt with on the "once and for all" basis which underpins claims for damages by injured plaintiffs, and hence the CTP insurer is not exposed to the "lottery effect". Reimbursements under s 54 of the LCS Act, can occur over time, and on more than one occasion.

The LCS Authority

  1. The position of the LCS Authority under this option reflects closely the statements made about the setting up the LCS Scheme, in the Second Reading Speech, and also the statute.

  1. For the position of the lifetime participant up to judgment (or settlement), the LCS Authority is not obliged, in the absence of an accepted or else determined legal liability, to pay for gratuitously provided attendant care services.

  1. However, if the plan formulated for an individual's treatment and care needs includes attendant care services which the LCS Authority acknowledges are to be provided gratuitously, then the LCS Authority may, depending upon individual circumstances and the available evidence, be exposed to a claim by the person who provides the services, for payment of a proper and reasonable fee for the services. In any such claim, the proper and reasonable fee is not limited to a sum calculated in accordance with s 128 of the MAC Act. But this is no different from remunerating any other provider of attendant care services.

  1. As for the future provision of attendant care services which are identified as reasonable for meeting the treatment and care needs of an eligible participant, the LCS Authority is obliged to provide for those needs in accordance with the legislation and any valid Guidelines. Gratuitously delivered attendant care services would not fulfil the LCS Authority's obligations, unless the LCS Authority accepted a liability to pay the person who provided that care.

  1. The LCS Authority is protected against the costs of paying for care which would otherwise be provided gratuitously because of its entitlement to recover " expenses incurred " from the CTP insurer under s 54 of the LCS Act.

  1. In summary, this option best accords with the legislative purpose which I have articulated in [ 85 ] above. It also arrives at a result which accords most closely with the fairness and justice to all parties.

Conclusion

  1. It will be for the parties to bring in short minutes of order to reflect these findings.

  1. To assist the parties to formulate the responses to the questions that have arisen, it would be convenient for me to expose my tentative views as to those answers.

  1. I do so by reference to the separate questions set out at [15] above.

1. Does the second defendant (LCS Authority) have an obligation under the Motor Accidents (Lifetime Care and Support) Act 2006 (NSW) to pay for gratuitous care and assistance provided by the second plaintiff ('the mother') to the first plaintiff ('the injured person') up to the date of judgment?

The LCS Authority may have an obligation under the LCS Act to pay for gratuitous care and assistance provided by Mrs Thiering to Mr Thiering up to the date of judgment, but only if it is established that the cost of the provision by Mrs Thiering of attendant care and assistance to Mr Thiering is an expense incurred by or on behalf of Mr Thiering within the meaning of s 6(1) of the LCS Act.

The provision of attendant care services by one person to another without charge and without either an accepted or else a determined legal liability to pay, does not constitute an "expense incurred by or on behalf of the injured person".

(a) Is the mother's care and assistance 'expenses incurred by or on behalf of the injured person' within the meaning of section 6(1) of the Act?

Mrs Thiering's care and assistance is not an expense incurred by or on behalf of the injured person, within the meaning of s 6(1) of the LCS Act, unless or until it has been established by evidence that the LCS Authority has accepted a legal liability to pay Mrs Thiering or else it has been determined that a legal liability rests in the LCS Authority to pay Mrs Thiering.

(c) Do the Lifetime Care and Support Guidelines (Part 8) authorise the LCS Authority to decline payment of the mother on the basis that she is a family member and alternative care is available?

Not appropriate to answer.

(d)   Do the Guidelines (Part 8) authorise the LCS Authority to decline payment of the mother for:

(i) Care provided to or visiting the injured person while an inpatient in hospital?

Not appropriate to answer.

(ii)   Inactive sleepovers (after 8 October 2010)?

To the extent that Part 8 of the Guidelines states as a policy that the LCS Authority will not fund family members or friends to provide inactive sleepovers, the Guideline is invalid, and therefore cannot alone authorise the LCS Authority to decline payments.

(e) Alternatively to 1(d), are these 'reasonable expenses' within the meaning of section 6 of the Act?

Any attendant care services can constitute " reasonable expenses " within the meaning of s 6 of the Act, provided that:

(a) they constitute part of the treatment and care needs determined by an assessment under s 23 of the LCS Act; and

(b)   there exists a legal liability resting on the LCS Authority to pay for those services or else if the services have been paid for.

2. If there is an obligation to pay the mother, on what basis should an appropriate hourly rate be determined?

Inappropriate to answer.

3. Does the mother have standing to bring and maintain these proceedings against the LCS Authority?

Mrs Thiering has standing to bring a claim against the LCS Authority, including maintaining these proceedings. The strength of that claim, including her likelihood of success, has not been assessed.

4. If so, issues 1 and 2 above also arise for determination in the mother's claim against the LCS Authority.

If the second plaintiff, Mrs Thiering, establishes a legal liability resting in the LCS Authority, such as one in accordance with the principles of quantum meruit, to pay her for the attendant care services which she has provided, the LCS Authority would be obliged to pay Mrs Thiering for the fair and reasonable value of the attendant care services she has provided, where those attendance care services are included in an assessment of the reasonable treatment and care services of Mr Thiering produced in accordance with s 23 of the LCS Act. Mrs Thiering, in propounding such a claim, is not limited to the formula contained within s 128 of the MAC Act for the recovery of a reasonable value of her services.

5. Whether on proper construction of section 130A of the Motor Accidents Compensation Act 1999, the first plaintiff has any entitlement as against the first defendant other than damages for non-economic loss and loss of earning capacity.

Yes, Mr Thiering, as a participant in the LCS Scheme is entitled to recover from the first defendant, motor vehicle tortfeasor (or its CTP insurer) damages in accordance with s 128 of the MAC Act for the period from the accident to the date of judgment, or settlement, as the case may be, unless the LCS Scheme has incurred an expense under s 6(1) of the LCS Act with respect to the provision of such gratuitous attendant care services.

Costs

  1. Costs ought follow the event. It seems to me that the plaintiffs have been largely successful in the motion and that each of the defendants should jointly pay those costs of and incidental to the motion.

  1. Since submissions have not been received on this issue, I would be prepared to grant the parties leave to bring in any submissions in writing within 21 days of the delivery of these reasons.

Orders

  1. I make the following orders:

(a)   The plaintiff is to bring in Short Minutes of Order. The proposed short minutes are to be filed and served within seven days of the date of judgment.

(b)   If any party disagrees with the plaintiff's proposed short minutes of order, then that party is to file and serve any proposed short minutes of order within 14 days of the date of judgment.

(c)   Within 21 days of the date of judgment, each party is to file and serve such written submissions as they wish with respect to the proposed short minutes of order, including any submissions as to costs.

(d)   Proceedings listed for further hearing on any outstanding matters arising from the short minutes of order and submissions at 9.15am on Friday 9 December 2011.

(e)   Liberty to apply on 24 hours' notice.

(f)   Filing of the short minutes of order and submissions is to take place electronically to my Associate.

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Decision last updated: 11 November 2011

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Cases Citing This Decision

29

Nominal Defendant v Adilzada [2016] NSWCA 266
Nominal Defendant v Adilzada [2016] NSWCA 266
Nominal Defendant v Adilzada [2016] NSWCA 266
Cases Cited

7

Statutory Material Cited

7

Griffiths v Kerkemeyer [1977] HCA 45
Griffiths v Kerkemeyer [1977] HCA 45