EXPLANATORY STATEMENT
AMENDMENT Statement of Principles concerning
HYPOPITUITARISM
(REASONABLE HYPOTHESIS) (NO. 53 OF 2022)
VETERANS' ENTITLEMENTS ACT 1986
MILITARY REHABILITATION AND COMPENSATION ACT 2004
- This is the Explanatory Statement to the Amendment Statement of Principles concerning hypopituitarism (Reasonable Hypothesis) (No. 53 of 2022).
Background
2. The Repatriation Medical Authority (the Authority) has determined, under subsections 196B(2) and (8) of the Veterans' Entitlements Act 1986 (the VEA), Amendment Statement of Principles concerning hypopituitarism (Reasonable Hypothesis) (No. 53 of 2022).
3. This Instrument amends Statement of Principles concerning hypopituitarism (Reasonable Hypothesis) (No. 11 of 2019) (Federal Register of Legislation No. F2019L00009) by:
- replacing the existing factor in subsection 9(16) concerning 'taking an immune checkpoint inhibitor or an interferon';
- replacing the existing factor in subsection 9(34) concerning 'taking an immune checkpoint inhibitor or an interferon'; and
- replacing the existing definition of 'immune checkpoint inhibitor' in the Schedule 1 – Dictionary.
Day of Commencement
4. This Instrument also specifies a day of commencement for the amendment in accordance with subsection 12(3) of the Legislation Act 2003.
Consultation
5. Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to taking immune checkpoint inhibitors as a factor in hypopituitarism in the Government Notices Gazette of 12 October 2021, and circulated a copy of the notice of intention to investigate to a wide range of organisations representing veterans, service personnel and their dependants. The Authority invited submissions from the Repatriation Commission, the Military Rehabilitation and Compensation Commission, organisations and persons referred to in section 196E of the VEA, and any person having expertise in the field. No submissions were received for consideration by the Authority in relation to the investigation.
Human Rights
6. This instrument is compatible with the Human Rights and Freedoms recognised or declared in the International Instruments listed in Section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011. A Statement of Compatibility with Human Rights follows.
Finalisation of Investigation
7. The determining of this Instrument finalises the investigation in relation to taking immune checkpoint inhibitors as a factor in hypopituitarism as advertised in the Government Notices Gazette of 12 October 2021.
References
8. A list of references relating to the above condition is available on the Authority's website at: www.rma.gov.au. Any other document referred to in this Statement of Principles is available on request to the Repatriation Medical Authority at the following address:
Email: info@rma.gov.au
Post: The Registrar
Repatriation Medical Authority
GPO Box 1014
BRISBANE QLD 4001
Statement of Compatibility with Human Rights
(Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011)
Instrument No.: Amendment Statement of Principles No. 53 of 2022
Kind of Injury, Disease or Death: Hypopituitarism
This Legislative Instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.
Overview of the Legislative Instrument
1. This Legislative Instrument is determined pursuant to subsection 196B(2) of the Veterans' Entitlements Act 1986 (the VEA) for the purposes of the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA). Part XIA of the VEA requires the determination of these instruments outlining the factors connecting particular kinds of injury, disease or death with service such being determined solely on the available sound medical-scientific evidence.
2. This Legislative Instrument:-
- facilitates claimants in making, and the Repatriation Commission and the Military Rehabilitation and Compensation Commission in assessing, claims under the VEA and the MRCA respectively, by specifying the circumstances in which medical treatment and compensation can be extended to eligible persons who have hypopituitarism;
- facilitates the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal; and
- amends Instrument No. 11 of 2019 to ensure that it better reflects the available sound medical-scientific evidence concerning hypopituitarism.
3. The Instrument is assessed as being a technical instrument which improves the medico-scientific quality of outcomes under the VEA and the MRCA.
Human Rights Implications
4. This Legislative Instrument does not derogate from any human rights. It promotes the human rights of veterans, current and former Defence Force members as well as other persons such as their dependents, including:
- the right to social security (Art 9, International Covenant on Economic, Social and Cultural Rights; Art 26, Convention on the Rights of the Child and Art 28, Convention on the Rights of Persons with Disabilities) by helping to ensure that the qualifying conditions for the benefit are 'reasonable, proportionate and transparent'[1];
- the right to an adequate standard of living (Art 11, ICESCR; Art 27, CRC and Art 28, CRPD) by facilitating the assessment and determination of social security benefits;
- the right to the enjoyment of the highest attainable standard of physical and mental health (Art 12, ICESCR and Art 25, CRPD), by facilitating the assessment and determination of compensation and benefits in relation to the treatment and rehabilitation of veterans and Defence Force members;
- the rights of persons with disabilities by facilitating the determination of claims relating to treatment and rehabilitation (Art 26, CRPD); and
- ensuring that those rights "will be exercised without discrimination of any kind as to race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status" (Art 2, ICESCR).
Conclusion
This Legislative Instrument is compatible with human rights as it does not derogate from and promotes a number of human rights.
Repatriation Medical Authority
[1] In General Comment No. 19 (The right to social security), the Committee on Economic, Social and Cultural Rights said (at paragraph 24) this to be one of the elements of ensuring accessibility to social security.
Overview
The Amendment Statement of Principles concerning hypopituitarism (Reasonable Hypothesis) (No. 53 of 2022) was determined by the Repatriation Medical Authority under subsections 196B(2) and (8) of the Veterans' Entitlements Act 1986. This legislative instrument aims to facilitate claims for veterans and current or former Defence Force members with hypopituitarism, ensuring that the assessment and compensation processes are based on the most current and sound medical-scientific evidence. It amends the previous Statement of Principles concerning hypopituitarism (Reasonable Hypothesis) (No. 11 of 2019) to update the factors related to taking immune checkpoint inhibitors or interferons and to replace the existing definition of 'immune checkpoint inhibitor'. This amendment is designed to improve the quality of medico-scientific outcomes under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. The instrument promotes various human rights, including the right to social security, adequate living standards, and health, while ensuring non-discriminatory access to these rights.
The Repatriation Medical Authority finalised this investigation into hypopituitarism factors after advertising its intention in the Government Notices Gazette of 12 October 2021. Despite inviting submissions from relevant stakeholders and organisations, no submissions were received for consideration. This Legislative Instrument is compatible with the human rights and freedoms recognised or declared in the International Instruments listed in Section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011, as it does not derogate from any human rights and actively promotes several, including social security and health rights for veterans, current and former Defence Force members, and their dependents. The instrument's determination ensures that the qualifying conditions for benefits are reasonable, proportionate, and transparent, thereby facilitating the assessment and determination of social security benefits and compensation.
Scope and Application
The Amendment Statement of Principles concerning hypopituitarism (Reasonable Hypothesis) (No. 53 of 2022) amends the existing Statement of Principles concerning hypopituitarism (Reasonable Hypothesis) (No. 11 of 2019), impacting veterans and current or former Defence Force members eligible for benefits under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. The Act applies to individuals who have developed hypopituitarism, a condition affecting the pituitary gland, and seeks to clarify the factors that connect this condition to military service, ensuring that the provision of compensation and medical treatment is based on sound medical-scientific evidence. The instrument specifically addresses the factors relating to the use of immune checkpoint inhibitors, replacing previous references to these drugs in the Statement of Principles. This Amendment ensures that the legislation reflects the most current understanding of the medical conditions associated with military service, thereby facilitating claims and assessments by the relevant Commissions and reviews by the Veterans' Review Board and the Administrative Appeals Tribunal. The legislative instrument is designed to protect and enhance the human rights of affected individuals, promoting their right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health, in accordance with international human rights standards.
Key Provisions
The main sections of the Amendment Statement of Principles concerning hypopituitarism (Reasonable Hypothesis) (No. 53 of 2022) pertain to the adjustment of factors associated with the condition hypopituitarism, specifically regarding the use of immune checkpoint inhibitors or interferons. This amendment replaces certain existing factors and the definition of 'immune checkpoint inhibitor' in the Statement of Principles concerning hypopituitarism (Reasonable Hypothesis) (No. 11 of 2019). The changes are made to ensure that the legislative instrument more accurately reflects the current medical-scientific evidence regarding hypopituitarism, thereby facilitating the claims process for veterans and service personnel under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA).
The obligations imposed by the Act on the parties involved include ensuring that the Repatriation Medical Authority (the Authority) considers the most recent medical-scientific evidence when amending statements of principles. The Authority is required to consult with relevant stakeholders, including veterans' organisations and experts, to ensure that the legislative changes are informed by a broad range of perspectives. The Authority must also ensure that the amendments are compatible with human rights as recognised in international instruments. Furthermore, the Act imposes an obligation on the Authority to publish notices of investigations and amendments in the Government Notices Gazette and make the results of the investigations and amended statements available to the public, including on the Authority's website.
Failure to comply with the provisions of the Act may result in legal consequences. While the specific penalties for breaches are not detailed in the Explanatory Statement, under the VEA and MRCA, breaches may lead to civil or criminal penalties depending on the nature and severity of the breach. These penalties could include fines or imprisonment for individuals found guilty of knowingly making false claims or providing false information, which could potentially affect the entitlement of veterans and service personnel to benefits and compensation. The amendments themselves do not create new offences but ensure that the legislative framework is consistent with the latest medical evidence, thereby reducing the risk of improper claims being made or assessed.
In summary, the Amendment Statement of Principles concerning hypopituitarism (Reasonable Hypothesis) (No. 53 of 2022) updates the factors and definitions related to hypopituitarism in the context of veterans' entitlements and military rehabilitation compensation. It mandates the Authority to base its amendments on sound medical-scientific evidence and ensures that the changes promote the human rights of veterans and service personnel. Compliance with the Act is essential to maintain the integrity of the claims process and the fair distribution of benefits and compensation.