Only one person has been transferred under medevac law, refugee advocates say

https://www.theguardian.com/australia-news/2019/apr/02/only-one-person-transferred-medevac-law-refugees-manus-nauru

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More than a month after the medevac bill passed the Australian parliament, just one person is believed to have been transferred under the law.

The Department of Home Affairs and Australian Border Force refuse to say how many transfers have occurred, but according to advocates and detainees only one of more than 25 people brought to Australia for treatment in recent weeks has been under the new law.

Instead, the government appears to be more readily using existing processes to follow health contractors’ recommendations for medical transfers to Australia. In February, Guardian Australia reported the department had been ignoring these recommendations for up to five years in some cases, refusing to transfer people who doctors said required treatment in Australia.

The medevac bill is law: what does that mean for ailing offshore refugees?

Many of those brought to Australia are being held in hotels. Doctors have concerns they are not being given appropriate care, and that the restrictive conditions are making their mental health worse.

The medevac law was intended to create a streamlined process to ensure sick refugees and asylum seekers on Manus Island and Nauru could be brought to Australia – on the recommendation of two doctors – for healthcare they were unable to access there. It allows for ministerial refusal, but that refusal can also be assessed by a medical review panel. The panel cannot overturn refusals on security grounds.

The passage of the law sparked bitter partisan battles over border security and asylum seekers.

The government reopened Christmas Island detention centre, and said any sick people would be sent there for assessment, then taken to the mainland if needed. Christmas Island has minimal health care facilities and the healthcare provider IHMS was contracted to bring in specialists.

IHMS, the healthcare giant at the heart of Australia's asylum system – explainer

But the process envisaged in the medevac bill has stalled. In the early days of its passage through parliament, it was expected “a handful” of cases would be ready within the first week. But the review panel is yet to be properly established, with only the Australian Medical Association’s nomination having been publicly finalised. Organisations that were asked to put forward nominations are yet to receive any government briefing, and their questions to the department regularly go unanswered.

A coalition of legal, health and advocacy groups which joined forces to streamline and assist the request process for medical evacuations is unable to say what has caused the delay.

Regardless, a number of people have been brought to Australia from Manus and Nauru for medical care. But there are concerns about where people are being held and the level of care they are receiving. Some are being held in hotels, under guard and without access to the outside or visitors.

Australian government ignored refugee transfer advice from its own doctors for up to five years

One refugee woman, who did not want to be identified, said she had spent years in detention before being moved into community accommodation on Nauru, and now she was back under guard in a hotel. She said she was not allowed to be taken to the park for the first 28 days, or to receive visitors, or even open a window. She said there were no cooking facilities, only microwave meals, and no fresh food.

“We are in the middle of a city, I don’t know what is the problem,” she said. “They know we came here to get treatment for mental and physical illness.”

Dr Robert Burns, a GP who has assessed some offshore-based refugees, said the hotel detention was preventing the people receiving the treatment for which they were brought to Australia.

“We’re not going to start healing these people if they’re locked away, if they don’t have some kind of ability to self determination,” he said.

“They’re not a threat to anyone, they’re proven refugees. We’re prolonging their agony at the expense of taxpayers. We have to look at what are we achieving here.”

Burns pointed to one man who has had at least one stroke and who he believes needs to see a neurologist, a psychiatrist and a cardiologist, and to undergo rehabilitation with a physiotherapist and occupational therapist. “But the most significant thing they’ve given him is aspirin,” Burns said.

“I’ve seen reports of some medical histories and you see a stark difference between what I would have done with someone who presented in my office here, and what’s happening with their treatment,” he said.

“It’s reasonably basic and there’s no holistic approach. No one is asking bigger questions. When a patient comes to see me you don’t just look at one complaint, you have to look the the whole person.”

The Department of Home Affairs did not respond to multiple requests for comment.