Migration Amendment (Repairing Medical Transfers) Bill 2019 [Provisions] I am writing this submission to put my points before you in the hope and expectation that you will read and consider them. My submission addresses the following points: The necessity of adequate, safe and timely healthcare for the people held on Manus and Nauru Islands. The obligation of Duty of Care towards the people held on the islands by our Government Australia is responsible for the health and safety of the people held on the islands. Why Medevac is necessary to ensure the health and safety of the people held on the islands. Why there is a medical emergency for people held on the islands. Why Medevac does not weaken our country’s border protection. Medevac does not prevent Australians from accessing health care. I support the Medevac legislation which Dr Kerryn Phelps introduced to Parliament last year and which passed through our Parliament and became law. I hope it will not be repealed. DECENT HEALTH CARE Should the Australian Government ne successful in reversing this law, I can see no option other requesting the assistance of the International Red Cross to tend to the health and mental health needs of the refugee people living on the islands of Nauru and Manus. That is, unless the Australian Government members and non-government parliamentary members decide to consciously continue to accept more preventable deaths, illnesses, infections and acute and deteriorating mental health conditions amongst the refugee people than have already occurred — 12 people to date have died — on their watch on those islands. DUTY OF CARE I believe that the Australian Government and all members of Parliament, who govern our country, have a Duty of Care to the refugee men and women who continue to be held on these islands without trial. The children have been brought to safety now, many of them suffering the same and similar acute mental health problems as the men and women still held on the islands. AUSTRALIA IS RESPONSIBLE FOR THE PEOPLE HELD ON THE ISLANDS I believe the argument that the health and mental health of the men and women are the sole concern of the Nauru and Papua New Guinea Governments is untrue. Both the Australian Government, the Labor Opposition and some cross-benchers have passed legislation which now exists within our legal system, and it is this legislation which enables the Nauruan and Papua New Guinea Governments to hold the refugee people on their land in captivity with no access to suitable or specialised medical treatment they require within 1 the safe period of time they require it. That is, until Dr Kerryn Phelps introduced the Medevac legislation last year in 2018 and saw it successfully passed in our Parliament. I believe to date, the Medevac legislation has seen the Government approve 90 medical transfers. Of these, 20 applications have been refused by the Government, none of which, incidentally, were refused for security or character reasons. Of these 20 applications which were refused and referred on to the medical panel, the panel upheld 13 of them. WHY MEDEVAC IS NECESSARY Recently, on the 19th July, I received an email from Médecins Sans Frontières/Doctors Without Borders (MSF), an organisation of health professionals which provides free health care to people in need around the world. The email stated in part: “Formally known as the ‘Migration Amendment (Urgent Medical Treatment) Bill 2018’, the Medical Evacuation Bill simply allows two doctors to decide whether sick refugees and asylum seekers held on Nauru and Manus Island should be transferred to Australia for medical treatment. … Decisions around how patients should be treated must always be made by independent medical professionals, not politicians. Independent medical assessments help ensure the health and safety of asylum seekers and refugees detained on Nauru and Manus Island, and medical professionals need to be able to recommend medical transfers when they are needed. If this Bill is repealed, and they are prevented from doing so, it will put lives at risk.” THERE IS AN MEDICAL EMERGENCY ON THE ISLANDS On the 4th July, 2019, the day the Minister for Home Affairs introduced legislation to repeal the Medevac legislation in the lower house of Parliament. Minister Dutton asserted that there is “no medical emergency on Manus or Nauru”. I draw your attention to the following assessment of medical practitioners published in emails I have received from Médecins Sans Frontières. The following quote is from an email I received from MSF on the 3rd December, 2018 “… after 11 months of providing mental healthcare on Nauru, Médecins Sans Frontières (we found) the mental health situation of refugees on the island …beyond desperate.” Please note also, that the Governor of Manus Island has acknowledged his community’s inability to respond to or manage the acute mental health crises being experienced by refugee men on their island. On the 20th December, 2019, I received another email from MSF containing a disturbing report which I am sure MSF will forward to you. I will, however, high;ight the following information for you: 2 “Médecins Sans Frontières provided mental healthcare on the Pacific island of Nauru for 11 months, before being forced to leave by the Nauruan government in October 2018. (During those 11 months, it was found that) close to one-third of MSF’s refugee and asylum seeker patients had attempted suicide, while 12 patients were diagnosed with the rare psychiatric condition of ‘resignation syndrome’. Nauruan nationals also had high levels of severe mental illness; almost half of MSF’s Nauruan patients needed treatment for psychosis.” Their report contains documented quantitative as well as qualitative evidence which the medical practitioners collected and based their findings on. THERE HAS BEEN A DEMONSTRABLE NEED FOR MEDEVAC FOR SOME TIME Minister Dutton also asserted that ‘there never was a need for Medevac’ on the day he proposed the repeal Medevac legislation. I draw your attention to the report by the Queensland Coroner following the death of Mr Hamid Kehazei on Manus Island. The Queensland Coroner reported that delays, errors and systemic failures in offshore- processing medical arrangements had led to the death of Mr Kehazei from infection. Mr Kehazei’s death was preventable. The system in place prior to the Medevac legislation endangered these men’s lives. In the case of Mr Kahazei, this situation was responsible for his death. MEDEVAC DOES NOT WEAKEN AUSTRALIA’S BORDER PROTECTION Minister Dutton also asserted that the provisions under the Medevac legislation “have served to weaken Australia’s border protection policies by effectively removing the ability of the government to decide who comes to Australia.” This is not the case, as the Medevac legislation enables the Minister to override medical decisions on security grounds. It is written in the legislation, in black and white. Where there is disagreement between the two doctors involved in the decision-making regarding a recommendation to transfer a person from either island to Australia for medical treatment, about the medical basis for the decision to transfer the person to Australia for treatment, and the Minister, the final decision on the legitimacy of the medical concerns is forwarded to and made by a medical panel. This panel includes the Australian Government’s Chief Medical officer, the Surgeon-General of Australian Border Force and no less than six other suitably qualified medical professionals who have been nominated by the relevant medical body. Members of this panel are unpaid. The Minister is still able to refuse the transfer, but only for reasons of character or security risk. As I have mentioned previously, since the passing of the Medevac legislation, the Government has approved 90 medical transfers. Of these, 20 applications for transfer have been refused by the Government. None of these 20 which were refused, were refused for 3 security or character reasons. Of these 20 applications which were refused and referred on to the medical panel, the panel upheld 13 of them. MEDEVAC DOES NOT PREVENT AUSTRALIANS FROM ACCESSING HEALTHCARE St Vincent’s Hospital in Sydney’s Darlinghurst — a pre-eminent public hospital renowned for its quality medical care and exacting standards — has described the Prime Minister and Minister Dutton’s claims that the Medevac legislation will have a negative impact on the ability of Australians to access medical services as “baseless”. St Vincent’s is on the record as saying that “public hospitals can accommodate the health needs of asylum seekers without disadvantaging anyone” and that it is happy to make its hospitals available to provide care to transferees without affecting waiting lists. THANK YOU Finally, I believe our elected Members of Parliament are basically good and decent people who do not wish to harm anyone or see anyone harm themselves on their watch during the term of this Australian Parliament. Most of all, I firmly believe that where there is life, there is hope. Thank you for reading my submission. Rose Costelloe 4.