Refugee Council of Australia
Nauru, long part of Australia's offshore detention policy, from the air

Australia’s offshore processing regime: The facts

Medical transfers and Medevac

Hundreds of people who were sent offshore have been transferred to Australia, mostly for medical treatment that they could not get there. In Australia, these people were usually held either in a detention facility or in community detention. Legally, they can be returned at any time, and cannot work or study unless given permission.

Statistics on medical transfers

Australia’s detention policies

Until 6 September 2019, these people also could not apply to be resettled in the US.

The number of transfers slowed to a trickle by 2018. This followed a shift in policy, so that people were no longer being returned offshore, as well as upgrades to facilities in Nauru and a new agreement with Taiwan for medical treatment for those in PNG. For example, a dying man with advanced lung cancer was pressured to be treated in Taiwan, or otherwise return to Afghanistan.

The Australian government also decided, on 27 August 2017, to put some of these people into the community, but without any income support. Another group was also released on the same terms in early 2018. State governments had to step in to support these highly vulnerable people.

As it became harder to get to Australia for medical reasons, refugees turned to the courts. In 2017-18, courts began ordering people to be transferred from Nauru for medical treatment.

Cases came to light of children in Nauru who were withdrawing from the world. These cases inspired a successful campaign, #KidsOffNauru, in August 2018. This called for all children to be taken off Nauru. Thanks to the pressure placed by the Australian community, the last four children on Nauru left in February 2019.

Australia’s man-made crisis on Nauru

The cases also highlighted the inadequacy of healthcare on Nauru and PNG, and the epidemic of self-harm even by young children.

The forgotten men on Manus Island


Another campaign led to the passing of a law, known as the Medevac Bill, in February 2019. This allowed independent doctors to recommend that those held in PNG and Nauru should be transferred to Australia for health care.

Home Affairs Legislation Amendment (Miscellaneous Measures) Act 2019

What did the Medevac Bill do?

The purpose of the bill was to take medical decisions out of the hands of politicians and bureaucrats. Instead, there would be a clear and transparent process for ensuring that people were transferred when they needed medical treatment. The Bill also ensured that families would be able to stay together during medical treatment.

The law meant that in the event of a refugee or person seeking asylum needing urgent medical assistance, two independent Australian doctors could recommend their temporary transfer to Australia. The doctors had to be of the clinical opinion that it was necessary to remove them from Manus Island or Nauru to provide appropriate treatment, which they were not otherwise receiving.

The Minister then had 72 hours to decide whether to approve the transfer. The Minister could refuse to transfer someone if the Minister reasonably believed it was not necessary to transfer the person or that the transfer would harm Australia’s se security, or because the person had a substantial criminal record that the Minister reasonably believed would expose the Australian community to a serious risk of criminal conduct.

If the Minister refused to transfer because he did not believe it necessary to transfer the person, the decision was referred to the decision on to the Independent Health Advice Panel (IHAP), which is comprised of independent doctors nominated by peak medical bodies.

The Panel would then recommend that a transfer be approved or refused within 72 hours. If the Panel recommended that the transfer should be approved, the Minister had 24 hours to approve the transfer and could only refuse on security grounds.

What happened to the Medevac Bill?

The Bill was passed while the Coalition government did not have a majority in Parliament. However, when the Coalition government was re-elected, it sought to repeal the Medevac Bill as a priority.

The law was repealed on 4 December 2019, as a result of a ‘secret deal’ with independent Senator Jacqui Lambie.

What happened as a result of the Bill?

During this time, 192 people were transferred to Australia as a result of this law.

Answer to Question on Notice AE20-216 (Parliament of Australia)

However, unlike people elsewhere, many of these people were transferred and held in detention, rather than living in the community. Many of them are being held in ‘alternative places of detention’, often motels, under extremely strict supervision. According to the Department, 110 people were held in hotels as at 31 December 2019. On average, by that time they had already been detained in Australia for 129 days.

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