The secret committee determining medical transfers from Nauru and Manus Island
7.30 has obtained details of Transitory Persons Complex Case Review Committee’s meetings. (ABC News)
A secret Australian government body tasked with making decisions on medical transfers from Nauru discussed eradicating a longstanding requirement that medical care in offshore facilities must meet “Australian standards”, according to internal documents.
7.30 can reveal highly confidential details of the Transitory Persons Committee, a body comprised of senior public servants in the Department of Home Affairs.
The committee serves as a crucial decision-making body for considering transfers of asylum seekers and refugees seeking urgent medical care, and has met roughly once a month over an 18-month period.
The existence of the body has emerged at a critical time for the Government, as crossbench MP Kerryn Phelps flags a renewed push to permanently remove children from Nauru to Australia.
New contract not to mention ‘Australian Standard’
Geoffrey Watson SC had never heard of the committee before, despite working on many asylum seeker cases. (ABC News)
The documents indicate the committee has the final say in regards to medical transfers.
Meeting minutes from May 2017 to August 2018, obtained under freedom of information laws, reveal Assistant Commissioner of Detention Kingsley Woodford-Smith is responsible for the “formal decision” for medical transfers.
Other members of the committee play a role in giving advice but do not have powers to make a determination.
Prominent barrister Geoffrey Watson SC has acted for many refugees who have been held on Nauru and Manus Island, but has never heard of the committee.
“I’m stunned at the composition of this committee,” he told 7.30.
“It’s primarily bureaucrats, heavily laden with lawyers, and every now and then there might be a medico, a doctor present.
“These are the people who finally decide: do they get off, do they stay.
“They’re making decisions about children’s lives.”
The August 2017 meeting included a key discussion point from one member.
“We are also co-ordinating … to ensure the new IHMS contract does not mention ‘Australian Standard’,” the minutes said.
The discussion appears to indicate that department officials are considering removing a longstanding requirement under Australia’s offshore healthcare contract with the private company International Health and Medical Services (IHMS), that care for refugees must be to an equivalent Australian standard.
Mr Watson said he was sickened to read that the committee considered removing references to Australian standards.
“They want to remove the reference to Australian standards so they can lower the standard of care provided to these people,” he said.
“Australian standards of care are set at a high level, a high international standard, and what they’re saying is these refugees should not get that care, or don’t warrant that care.”
It is unclear what the outcome of the officials’ discussion has been on this point. A department spokeswoman did not respond to specific questions about the contractual discussions, but said in a statement that the committee considered each medical request independently.
‘Prudent that close scrutiny be avoided’
A child points to a security notice sign for the Nauru Regional Processing Centre. (Supplied: World Vision)
The meeting minutes reveal other frank deliberations of the committee.
Minutes from a June 2018 meeting noted that “members discussed the level of compassion to be shown and if there is any compassion in the policy”.
The remarks appear to have been made in the context of a refugee who required medical attention but had declined to travel to Taiwan for treatment, and whether he should be permitted to receive care in Australia.
In the same case, the officials appear to be concerned about adverse attention from Australian courts.
“Ensure our timeframe/chronology is complete, as if this matter goes to court the dates and actions will all be examined,” the minutes stated.
“Once notified there appears to be a two-week period where it is unclear how his case was managed; and then the tempo of subsequent actions,” it later said.
“For these reasons it was noted that it would be prudent that close scrutiny be avoided.”
Mr Watson said he was not surprised that the committee was hoping to avoid legal scrutiny.
“As the impartial courts have been passing judgement on these matters time and again, it’s been established that the Commonwealth has been acting in breach in urgent cases,” he said.
“Of course they want to keep it away from the scrutiny of an impartial judge.”
The Taiwan deal
Committee minutes discussing the Taiwan deal for treating medical cases of asylum seekers on Nauru and Manus Island. (ABC News)
In several cases over the time period of the meeting minutes, the body observed that medical practitioners on the ground on Nauru had made recommendations for medical transfer to Australia.
In some of those cases, the group declined to immediately follow the advice of the officers, sometimes seeking second opinions, and on other occasions suggesting canvassing other options.
A spokeswoman for the Department of Home Affairs said in a statement to 7.30: “A decision is not made to refuse a transfer, but a transfer may be deferred until recommended treatment options have been explored and any barriers have been addressed.
“At times it is possible to provide the required service in Nauru or PNG via visiting medical specialists. Not all transfer requests are urgent.”
When the Australian Government signed a deal with Taiwan to accept refugees for medical treatment, the officials again considered whether the new deal could be viewed favourably by Australian courts.
“Should [redacted] not consent to transfer to Taiwan, has the department discharged its duty of care?” a discussion point from a July 2018 meeting noted.
“Given this is a legal case, the courts may order the department to transfer to a tertiary facility if the department can show the arrangements are in place for the transfer of [redacted] to Taiwan and that it can be undertaken in the same time as a transfer to Australia. The department may have a chance of only being ordered to transfer to Taiwan as opposed to Australia.”
A spokeswoman for the Department of Home Affairs said the department “has a decision making framework to consider medical transfers to Australia which includes the advice of a Medical Officer of the Commonwealth”.
“Transfers for medical treatment are considered on a case by case basis and no one is denied health care.”
Dr Phelps warns of ‘urgent medical crisis’
Dr Kerryn Phelps has tabled a private member’s bill to get all children of Nauru and Manus Island. (ABC News: Toby Hunt)
In the last 12 months, an increasing number of legal challenges have been launched in the Federal Court to seek injunctions removing children and adults from Nauru to Australia.
In October, three whistleblowers spoke to 7.30 and described the grave risks for adults and children that remained on the island, as their mental health continues to deteriorate.
As legal action has intensified, more children and families have been brought to Australia from Nauru.
Dr Phelps and fellow independent MP Andrew Wilkie on Monday introduced a bill to prioritise urgent medical transfers and to require that when two treating doctors make a recommendation for medical transfer, their orders are followed.
In an interview with 7.30, Dr Phelps said the current medical transfer process was “unacceptable”.
“What we need to see is the decision about urgent medical transfers handed back to the doctors who are treating the patient.”