You will be required to consider a mock problem scenario (detailed below). Prepare a legal memorandum, addressed to the Assistant Commissioner of the Ambulance Service that addresses the questions detailed below. You should prepare your memorandum with reference to the exemplar provided Factual Context You are a junior lawyer working at the NSW Crown Solicitors Office. The Assistant Commissioner of the Ambulance Service via the NSW Minister for Health has approached your department to ask it to provide legal advice on the charging of fees by the ambulance service for patients who are not transported to the hospital. This is because of the following matter: George is involved in an altercation. Someone else rings for an ambulance. George declines to go to the hospital. A week or two later George receives a bill for $519 in the mail for Ambulance Services. George was aggrieved by this. George made some enquiries and found that this was routine practice for the Ambulance Service. Fees are routinely charged for paramedics providing treatment to patients but then not transporting the patient to the hospital. George thinks it is pretty unfair that he should have to pay so much money when (a) he didnt call the ambulance; (b) he didnt go to the hospital. George contacted the Ombudsman. He said, On 8th January 2018 I was at the library when I was bitten, spat on, thrown to the ground, and had my wallet and car keys stolen in the carpark. The perpetrators partner called an ambulance for him. When the ambulance arrived, he lay on the ground and paramedics attended him. After attending him, one of the ambulance officers walked towards me, I was being questioned by police, I said: Im OK, I will go to the hospital later. The ambulance officer walked back to the van and came back with a clipboard. She took my pulse and said, sign this. I said, what is it? She said refusal of treatment form so I signed it. I now get an invoice from a debt collection agency for $519. I feel this process was dishonest and sneaky and not appropriate for such an organisation. My complete version can be confirmed by 6 video cameras. I did not call an ambulance, I told them I was OK. I think this is very unfair. You look up the Department of Health meaning of treatment. It says, “the department considers treatment as the dispatch and arrival of an ambulance resource and includes at least the clinical assessment of a patient. Assessment is expected to include recording of observations and/or vital signs (as relevant and/or appropriate), as well as documentation of any interventions and/or other relevant information.” You also know that the High Court has recognised that except in cases of emergency or necessity, all medical treatment is preceded by the patients choice to undergo it. (Rogers v Whitaker (1992) 175 CLR 479). The paramedics did not ask George if he consented to receiving treatment that would cost $500.Your client, the state Ambulance service, says it relies on a patients implied consent to treatment where the patient cooperates with the paramedics taking vital signs. George complained to the Ambulance Service who just responded with the following:- Thank you for your letter. Your matter has been investigated. We have found that you were treated in accordance with our policies and the law on the collection of fees for the provision of treatment. We will not waive the invoice on this occasion. An ambulance crew assessed you, and you were offered transport to the hospital, which you refused at that time. Our policy, which reflects the law, states that:- the fee charged by our service, is payable by the person, whether or not the person consented to the provision of the service.. We hope that that settles the matter, etc. George was not happy with this outcome and wrote back to the Assistant Commissioner pointing out that the policy was not consistent with the law because the Ambulance Services Act* actually says, If a person has been transported by an emergency ambulance service, the fee charged by the service is payable by that person whether or not the person consented to the provision of the service. (*not real) Now the Assistant Commissioner of the Ambulance Service is seeking advice on the powers of the Ombudsman and how the Ombudsman may view the actions of the ambulance service (reasonable and just or unreasonably and unjust). Your line manager has forwarded the case to you to handle. They have included a recommendation to review the following document:- Victorian Ombudsman. Investigation of a complaint about Ambulance Victoria. May 2019 viewed https://www.ombudsman.vic.gov.au/getattachment/Publications/Parliamentary-Reports/Investigation-of-a-complaint-about-Ambulance-Victo/Investigation-of-a-complaint-about-Ambulance-Victoria.pdf.aspx Issues to address In your memorandum you must consider and address the following questions:- Who can bring an action to the Ombudsman? What powers does the ombudsman have to resolve complaints against government departments? If the Ombudsman makes an adverse finding against the Ambulance Service, will they have an opportunity to respond? If so, what is the likely time frame for a response once it is requested by the Ombudsman? Explain your answer in terms of the concept of procedural fairness. The Ambulance Service says they were just following their policy. Does the Ombudsman have any discretionary power to find that the policy was unfair and thus has resulted in an unfair outcome; or does the Ombudsman have to find there was a misapplication of another law eg common law of informed consent, in order to find against the Ambulance service? Does the Ombudsman have any power to order the Ambulance Service to take any particular action? Are the recommendations the Ombudsman makes legally binding? What would likely happen if the Ambulance Service ignored any recommendations made by the Ombudsman? What would your advice be to the Assistant Commissioner with regards to attempting to resolve this dispute between the ambulance service and George before the Ombudsman makes a finding? Would you provide any advice to the Assistant Commissioner about changing the service policy of charging fees for no-transport?
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