What does the Bill say?
- The Bill states that in the event of a refugee or person seeking asylum requiring urgent medical assistance, two independent Australian doctors can recommend their temporary transfer to Australia.
- To make this recommendation, the doctors must be of the clinical opinion that it is necessary to remove them from Manus Island or Nauru in order to provide appropriate treatment, which they are not otherwise receiving.
- The Minister then has 24 hours to decide whether to approve the transfer or not. If the Minister refuses, they refer the decision on to the Independent Health Advice Panel (IHAP), which is comprised of independent doctors nominated by peak medical bodies.
- The Minister is bound by the decision of the panel, except in the case of national security concerns.
How does the Bill differ from the current system?
- The UMT would see the creation of an independent medical process, based on the orders of two independent Australian doctors, taking medical decisions out of the hands of politicians and bureaucrats.
- The process proposed will be clear, transparent, enforceable and timely. Until now, medical transfers have been hampered or blocked by delays and/or political obstruction.
- Under the UMT, families would be able to stay together during medical treatment.
- It is important to note that the Bill does not change Operation Sovereign Borders, boat turn backs, or other elements of either Coalition or Labor’s border policy, and does not provide for permanent resettlement in Australia.
Why is the Bill needed?
There is an urgent health crisis on Manus Island and Nauru:
- Many people came into detention with pre-existing injuries and trauma. This has been compounded by a widespread deterioration of the mental and physical health of the people detained as a result of the offshore detention conditions.
- 12 people have died in offshore detention to date. The inquiry into the case of Hamid Khazaei showed that he died as a direct result of the Australian Government’s refusal to follow medical orders.
- There has been an epidemic of self harm, suicides and suicide attempts, some of which have even been made by young children. In 2016, UNHCR found that 88% of people on Manus Island were suffering from depression, anxiety and/or post-traumatic stress disorder.
- The medical facilities on Manus Island and Nauru are grossly inadequate for dealing with this crisis. Furthermore, the Australian Government has made drastic cuts to the support services and monitoring previously in place.
What is the Government’s proposal and why does it fall short?
The Government have proposed a panel that would review medical cases. However, this is not a significant departure from the current system:
- The proposal gives ultimate say over medical decisions to bureaucrats rather than doctors, despite Government-appointed doctors speaking out about Border Force’s consistent undermining of their clinical recommendations.
- There is no opportunity for urgent cases to be addressed in a timely fashion when Border Force refuses transfer requests. A Medical Transfer Clinical Assurance Panel must be constituted as a first step – even in critical cases.
- The Government’s proposal allows the Minister to override the clinical decisions of the Medical Transfer Clinical Assurance Panel for any reason, and therefore doesn’t address the ongoing politicisation of what should be clinical decisions in the best interests of the patient.
- The panel would not be independent, as members would be selected by the Minister.
- There is no transparency – which has been a consistent problem. The proposed requirement of public reporting taking place twice a year, when urgent medical transfers might need to be arranged within hours, is simply not a solution.
- The proposal will not be enshrined in legislation – meaning it could be changed for any reason at any time.
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