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2001/2002 ANNUAL REPORT
Appeals to the Specialist Medical Review Council
Under the legislation the Repatriation Commission, an ex-service person or an eligible dependant, or an organisation
representing veterans, may ask the Specialist Medical Review Council (SMRC) to review:
- a Statement of Principles; or
- a decision of the Repatriation Medical Authority not to determine a Statement of Principles in respect of a
particular kind of injury, disease or death; or
- a decision by the Repatriation Medical Authority under subsection 196C(4) of the Act not to carry out an investigation
in respect of a particular kind of injury, disease or death.
In the period 1 July 2001 to 30 June 2002, the RMA received the following advice in relation to SMRC matters:
- In relation to Statements of Principles Instrument Nos.191 and 192 of 1996 concerning malignant neoplasm of
the prostate, the SMRC declared, under subsection 196W (5) of the VEA, that it is of the view that the sound medical-scientific
evidence available to the RMA is insufficient to justify any amendment to either of those Statements of Principles
[decision gazetted 15 August 2001].
This decision was considered as part of a Federal Court case - Vietnam Veterans' Association of Australia New
South Wales Branch Inc v Specialist Medical Review Council [2002] FCA 733 ó Justice Moore (7 June 2002).
- The decision not to proceed with a previously advertised review relating to Statements of Principles Instrument
Nos.80 and 81 of 1998 concerning ischaemic heart disease [decision gazetted 19 September 2001]
- The decision not to hold a review relating to Statements of Principles Instrument Nos.44 and 45 of 1999 concerning
non-Hodgkinís lymphoma [decision gazetted 26 September 2001]
- The decision not to hold a previously advertised review relating to Statement of Principles Instrument No.245
of 1995 concerning motor neurone disease [decision gazetted 10 October 2001]
As reported previously, in January 2000, the SMRC advised the RMA that a request for review had been received
in relation to Statement of Principles Instrument No.72 of 1999 concerning myeloma. Notification of this review
appeared in the gazette of 17 October 2001.
In September 2001, the SMRC advised the RMA that a request for review had been received in relation to Statement
of Principles Instrument No.53 of 1996, as amended by Statement of Principles Instrument No.7 of 1998 concerning
malignant neoplasm of the small intestine. Notification of this review appeared in the gazette of 17 October 2001.
In the gazette of 19 August 2001, the SMRC notified a review in relation to Statements of Principles Instrument
Nos.31 and 32 of 2001 concerning hypertension. In the gazette of 27 March 2002, the SMRC notified its decision
in relation to this review:
"1. In relation to the Repatriation Medical Authority (RMA) Statement of Principles, Instrument No. 31
of 2001 concerning hypertension and death from hypertension (SoP 31 of 2001), made under subsection 196B(2) of
the Veteransí Entitlements Act 1986 (the Act), the Specialist Medical Review Council (the Council)
declares, under subsection 196W(4) of the Act, that:
(a) the Council is of the view that there is sound medical-scientific evidence to justify the amendment of SoP
31 of 2000 (sic) to include, as a factor, ëoccupational or work related stress consequent upon working
in a high demand, low decision latitude or control jobí; and
(b) the Council remits the matter to the RMA for reconsideration and:
(1) directs that the RMA reconsider the three biological markers of stress in hypertension, being the interrelationship
with the sympathetic nervous system, the brain transmitter studies, and the adrenaline hypothesis, all of which
are more particularly described in paragraph 49 of the Council's Reasons for Decision (the Councilís Reasons);
and
(2) recommends that the RMA have regard to:
- the list of key references referred to by Professor Esler, set out in paragraphs 54 and 55 of the Councilís
Reasons;
- the article by Drs Schnall, Pickering and Schwartz referred to by the applicant, set out in paragraph 56 of
the Councilís Reasons;
- any further information which has become available to the RMA since the determination of SoP 31 of 2001; and
- any further information which may become available to the RMA between the date of this Declaration and the
completion by the RMA of its reconsideration
(c) the Council is of the view that there is insufficient sound medical-scientific evidence to justify any other
amendment of SoP 31 of 2001.
2. In relation to the RMA Statement of Principles, Instrument No. 32 of 2001 concerning hypertension and death
from hypertension (SoP 32 of 2001), made under subsection 196B(3) of the Act, the Council declares, under subsection
196W(4) of the Act, that
(a) the Council is of the view that there is sound medical-scientific evidence to justify the amendment of SoP
32 of 2001 to include, as a factor, ëoccupational or work related stress consequent upon working in a high
demand, low decision latitude or control jobí; and
(b) the Council remits the matter to the RMA for reconsideration and:
(i) directs that the RMA reconsider the three biological markers of stress in hypertension, being the interrelationship
with the sympathetic nervous system, the brain transmitter studies, and the adrenaline hypothesis, all of which
are more particularly described in paragraph 49 of the Council's Reasons; and
(ii) recommends that the RMA have regard to:
- the list of key references referred to by Professor Esler, set out in paragraphs 54 and 55 of the Councilís
Reasons;
- the article by Drs Schnall, Pickering and Schwartz referred to by the applicant, set out in paragraph 56 of
the Councilís Reasons;
- any further information which has become available to the RMA since the determination of SoP 32 of 2001; and
- any further information which may become available to the RMA between the date of this Declaration and the
completion by the RMA of its reconsideration.
(c) the Council is of the view that there is insufficient sound medical-scientific evidence to justify any other
amendment of SoP 32 of 2001."
In response to this decision, the RMA notified an investigation in the gazette of 24 April 2002, to review
the contents of Statements of Principles concerning hypertension (Instrument Nos.31 and 32 of 2001),
in terms of the declaration of the SMRC as it appeared in the Government Notices Gazette of 27 March 2002.
This page last updated 16 October 2002.
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