I rise to speak on the Migration Amendment (Repairing Medical Transfers) Bill 2019.
I say from the outset that the name of this Bill is a fallacy.
There is nothing to “repair” when it comes to the medical transfers of sick people from regional processing countries to Australia.
The name of this Bill – like so many pieces of legislation from this visionless Government in the post-truth era – is untruthful, misleading and misdirected.
I will speak on those matters shortly.
Last week, I received an email from an Australian doctor.
His name is Dr Chris Jones.
He is a doctor who worked on Nauru in August last year – only 16 months ago.
Let’s remember – Dr Jones was working in Nauru only six months before the law now known as “Medevac” came into existence.
Having worked an earlier stint on Nauru, Dr Jones kept a diary of his time during his second stint – a diary that I have now read.
It shines a light on the conditions he was working in, the pressures he was faced with – including from officials from the Australian Border Force and Department of Home Affairs – as well as the lengths he had to go to in securing medical transfers for patients.
On the 18 August last year – after less than two weeks on Nauru – he wrote about his experience:
“It is like being witness to people dying on a Palliative Care ward, slowly fading away, physically and emotionally. The only difference here is that they do not have the dignity of Palliative Care.”
The diary recalls a teleconference update Dr Jones had with an orthopaedic surgeon, who had operated on a child to remove metalwork from their left forearm. He wrote:
“The operation went really well, but the surgeon could only remove one of the two plates, due to a 12 month delay in the procedure. The remaining plate had become embedded in bone, and attempting to remove it would do more damage. The call didn’t go well, with the family distraught, venting their anger and frustration against the surgeon.”
This diary sheds a light on how doctors – contracted by Australia, being paid for by your taxpayer dollars – were being disregarded by departmental bureaucrats.
Let’s reflect on that for a moment.
Doctors – the people we all trust when we’re sick, when we’re unwell, when we are struggling mentally – were being ignored by people with no medical qualifications.
How did we get here?
How did we – Australia – end up in this position?
In June 2015, the Secretary of the then-Department of Immigration and Border Protection issued a directive to the staff of the then-Australian Customs and Border Protection Service.
It said, and I quote:
"Unless there are compelling medical reasons, supported by second opinions, to do with life and death situations, or situations involving the risk of life-time injury or disability, transfers to Australia should be avoided as a general rule and should in any event become increasingly rare.”
A general rule. To become increasingly rare. In any event.
That was over four years ago.
It was before the Australian Border Force came into existence on 1 July 2015.
It was before Minister Dutton was handed his custom-made Department of Home Affairs.
It was before Prime Ministers Morrison and Turnbull – Tony Abbott was still the Prime Minister.
And it was only the beginning of the medical transfer process for sick people – asylum seekers and refugees in Australia’s care on Nauru and in PNG – being frustrated by the current Government.
Minutes from internal meetings at then-Department of Immigration and Border Protection in 2016 reveal this directive effectively stopped medical transfers to Australia.
The documents, released under Freedom of Information laws, described the impact of this measure it as “significant”.
There was a 92 per cent drop in medical transfers.
Transfers dropped from close to 550 in 2014/15 to approximately 50 the following year (2015/16).
Those same minutes from the then-Department of Immigration and Border Protection admitted they, and this Government, had created a problem.
“Despite the work done to reduce the instance of transfer to Australia for medical care, the cases we continue to see are unique and complex (physical health, mental health and child protection all combined) and there exists a high likelihood that they will become the subject of legal proceedings.”
The alarms bells were sounding back in 2016.
And what did the Minister for Home Affairs do?
Just like many of his ministerial responsibilities, Mr Dutton did nothing.
In fact, the Secretary of the Department doubled-down in April 2016 and issued another directive.
"The aim should be to avoid to the maximum extent possible such transference to Australia... this Instruction is to be overridden only if and when there is a reasonable apprehension that inaction would result in an Immediate threat to life, or the occasioning of permanent debilitating injury.”
In Manus Island, broader PNG, and Nauru, requests for medical transfer – by hard-working, honest, and committed doctors – started being ignored.
People without medical training were deciding if sick people receive treatment or not.
Over time, the problem grew – and medical transfers were denied time and time again.
People’s physically injuries were left to worsen – often to the stage where people were facing life-long disabilities.
Children were denied transfers because they didn’t want to be separated from their parents.
Women were denied the opportunity to have their reproductive health seen to.
Mental health across the cohort of Manus – and later broader PNG – and Nauru diminished terribly.
It is because of all of these circumstances that Labor and the crossbench moved to put provisions in place – Medevac – to fix the issues of this third term Liberal National Government’s own creation.
For those who aren’t familiar with Medevac, I want to explain how the process works – particularly because of the ways in which the Government has been loose with the truth about these important provisions.
Under Medevac – two treating doctors can recommend a transfer to the Secretary of the Department of Home Affairs.
The request is then considered by the Minister for Home Affairs.
The Minister can deny on national security grounds – as defined within the ASIO Act – or if they have concerns on serious character grounds – as defined in the Migration Act.
This decision does not get reviewed and cannot be overturned – the request for transfer is rejected.
The Minister can also deny a transfer on health grounds if they think they can provide that treatment in PNG or Nauru – including via telemedicine or by flying specialists to the patient.
If a Minister denies on health grounds – it goes to the Independent Health Advice Panel, or IHAP, for review.
The IHAP includes the Commonwealth Chief Medical Officer, the Home Affairs Chief Medical Officer and doctors from Australia’s peak medical bodies including the Australian Medical Association and the Royal Colleges.
All of these doctors are appointed by the Minister.
This panel is able to review cases on medical grounds only.
If they believe a medical transfer is necessary – they can require the transfer to happen.
At the end of the day, the Government, or Government-appointed doctors, control who comes to Australia under Medevac.
This is why Labor supports Medevac.
Medevac allows sick people to get the medical care they need and ensures the Minister or doctors appointed by the Minister control these transfers.
On 4 July 2019, the Bill now before the Senate was referred to the Legal and Constitutional Affairs Legislation Committee for inquiry, which reported on 18 October 2019.
Like all legislation referred to committees, the Government agreed to this Bill being sent to an inquiry – along with the timing of said inquiry.
The Minister for Home Affairs has described this important process as a “tactic” and a way of “delaying” the Bill.
He ignores the fact that the Government agreed to the reporting timeline for the Bill and could have changed it if they wanted to.
I want to thank my fellow Senators for their involvement in the committee’s inquiry – as well as Senator Lambie’s commitment that she wanted that important process to be followed before the legislation was debated in the Senate.
The Senate inquiry highlighted the evidence that Medevac should not be repealed.
Don’t take my word for it – the Morrison Government agrees with this assessment.
By the Government’s own admission – in the report Government Senators agreed to – it states, and I quote:
“The majority of the evidence to the inquiry argued that the medical transfer provisions enacted in March 2019 should not be repealed.”
Of the submissions made to the inquiry, only one submission recommended Medevac should be repealed.
Who was the one submission that supports the repeal?
Minister Dutton’s Department of Home Affairs – the people who wrote the Bill on behalf of the Government.
All other stakeholders said Medevac should not be repealed.
Despite the weight, the Government-dominated committee only made one recommendation – that the Senate pass the bill.
Labor Senators, Greens Senators and Centre Alliance Senators all made dissenting reports – actually listened to the evidence presented at the inquiry – and all three parties made separate recommendations to oppose this Bill.
In the past week, my crossbench colleagues and I accepted a petition of 51,000 Australians who are in support of Medevac.
A letter of over 5,040 doctors in support of these provisions was also delivered to this place last week and a new Guardian Essential poll released shows 62 per cent of Australians support Medevac.
This evidence continues to grow despite the Morrison Government’s brazen, desperate and dishonest in their attempts to discredit Medevac.
We saw the beginnings of this when an authorised disclosure of sensitive national security advice was made to The Australian newspaper – a leak that occurred for blatant political gain.
The former head of ASIO Duncan Lewis described that leak, and I quote as, “seriously damaging” adding, "it undermines all that we (ASIO) stand for".
When it comes to leaks, I have been appalled at the number of times the front pages of newspapers have been splashed with the personal medical records of vulnerable people.
Can you imagine having your medical history – your most private details – being leaked to the media for political gain?
This is exactly what has occurred under the Morrison Government under Minister Peter Dutton and his Department of Home Affairs.
We have seen the names, backgrounds, ages and ethnicities of asylum seekers and refugees published in papers.
Let’s not forget – these are people who, in the majority of cases, have fled persecution and have been found to be owed protection.
We have seen their medical conditions misconstrued and exploited for political gain.
These people have had their photos published, the treatment they have undergone shared and their information exploited – without their permission.
How would Minister Dutton feel if he woke up one morning to see his personal medical details on the front page of a national newspaper?
An investigation would be launched within minutes.
But when it comes to the private medical details of vulnerable people on Nauru or in PNG in need of medical transfers – there is a different standard.
And it doesn’t take a genius to work out the origins of these leaks.
To those people who have had their personal medical details shared in this fashion – I am sorry.
It’s clear the Government has been loose with the truth when it comes to Medevac.
They have falsely claimed doctors from Nimbin or doctors on Skype could approve transfers.
They have claimed Australian’s will be kicked off waiting lists at hospitals.
They have even claimed Australia’s border protection will fall apart – something that has not happened in the 10 months since these laws came into existence earlier this year.
Senate Estimates confirmed the Morrison Government has transferred 982 people to Australia outside of Medevac.
I note the majority of these transfers were before the Department of Home Affairs issued their 2015 directive to stop transfers to Australia.
This compares to some 160 under Medevac.
This Government has been blatantly and, I dare say, purposefully misleading when it comes to the matters of Medevac.
I have spoken at length in this place about the mistruths the Minister for Home Affairs, the Minister for Immigration and the Prime Minister have – and continue to – spout about Medevac.
But here are the facts you won’t hear the Government say about Medevac.
1. All Medevac transfers to Australia do so with Mr Dutton’s permission or the permission of doctors Mr Dutton has appointed.
1. Minister Dutton has extensive powers to refuse a Medevac transfer on national security and character grounds, with no appeal. He has used these powers before and can use them again.
1. If a person doesn’t require medical treatment, the Independent Health Advice Panel would deny the transfer.
1. All Medevac transferees must be detained in immigration detention by law, unless Minister Dutton approves their release from detention. This is designed to keep the Australian community safe; and
1. Medevac transfers are for a temporary purpose and Mr Dutton has the ability to return a transfer to a Regional Processing Country at any time.
These are the facts.
The system is working as intended.
No amount of protest – or outlandish claims – from the Minister for Home Affairs or the Prime Minister have proven otherwise.
I will add that despite the Government’s claims, this debate has nothing to do with border protection.
Let’s not forget – offshore processing was always intended to be exactly as its name suggests.
Instead, under this now third term Liberal National Government, it became indefinite detention.
The architecture of border protection include boat turnbacks where safe to do so, offshore processing and regional resettlement – all of which Labor strongly supports – work cohesively.
They are all of equal importance.
Former Prime Minister Kevin Rudd and Mr Morrison in his former role as Immigration Minister both put in place policies to stop people risking their lives at sea, on leaky boats, crossing one of the most perilous of oceans.
However, since the Member for Dickson – Mr Dutton – became the Minister for Immigration and Border Protection in 2014 – he has failed, like so many other areas of policy, to do his job.
He has failed to deliver on third country resettlement options – such as the New Zealand offer which has been on the table since 2013.
Ever since he became the minister responsible, he has left refugees to languish in indefinite detention – they are now in their seventh year in PNG and Nauru.
This languishing is the reason why the mental and physical health of asylum seekers and refugees diminished so profoundly.
It is why Medevac was needed and required – to ensure people who are sick should receive the medical attention they require.
Denying people medical care is un-Australian.
If you or I are sick, we see a doctor.
And vulnerable people in Australia’s care who have already suffered significant trauma in their lives should not be forced to the brink of death to receive the medical treatment they require.
These decisions should never been left in the hands of people without medical training – let alone concentrated in them.
Labor strongly supports Medevac.
Medevac is working as intended.
These laws should not be repealed.
I want to finish where I started – Dr Chris Jones’ diary of his time on Nauru.
On 17 August last year he wrote about, and I quote:
“Does it really take the possibility of sudden death to persuade our Government of the right thing to do?”
Labor opposes this bill for that very reason.
I implore the crossbench to oppose this Bill.
MEDIA CONTACT: TIMOTHY DUNLOP 0428 043 110
SECOND READING DEBATE: MEDEVAC REPEAL BILL
02 December 2019