Senate debates

Thursday, 14 November 2019


Independent Health Advice Panel; Order for the Production of Documents

3:47 pm

Photo of Simon BirminghamSimon Birmingham (SA, Liberal Party, Minister for Trade) Share this | | Hansard source

I table documents relating to orders for the production of documents concerning the Independent Health Advice Panel, the Regional Jobs and Investment Packages and a government response relating to road safety.

3:48 pm

Photo of Kristina KeneallyKristina Keneally (NSW, Australian Labor Party, Deputy Leader of the Opposition in the Senate) Share this | | Hansard source

I move:

That the Senate take note of the documents produced by the minister representing the Minister for Home Affairs on the Independent Health Advice Panel.

I want to begin not by quoting from the report—I will come to that—but by quoting from the Minister for Home Affairs, Peter Dutton, on the topic of medevac. On Sky News with David Speers on 22 October 2019, Minister Dutton said: 'The most dangerous con in my view is that people can't go back and you're being forced to take people of bad character. I can't deport them back. That's the law Labor has provided.' In that same interview, when asked if he can detain people who are transferred to Australia under medevac, Minister Dutton responded 'no' and continued: 'The medical advice in some cases will be that if an individual is here for mental health issues, even if they are of bad character, their advice may be not to have them in an immigration detention centre.' When pushed by David Speers on whether he has the power to detain people transferred to Australia under medevac, Minister Dutton chose to shirk all responsibility. He said, 'Well, in some cases you can. But look, I don't make decisions about, you know, those issues.' When asked who does make those decisions, Minister Dutton responded, 'Minister Coleman does, because he's immigration minister.' This is when I turn to the latest report from the Independent Health Advice Panel, or IHAP, for the 1 July to 30 September 2019 quarter, which was tabled in the Senate yesterday. It reads:

Any transitory person who is brought to Australia for a temporary purpose must be detained whilst in Australia. That detention must continue until the time of the person’s removal from Australia or until the person is granted a visa.

In short, this report from the Independent Health Advice Panel flies in the face of Minister Dutton's claims. It makes clear that the minister must detain all medevac transfers in immigration detention by law. It is a deliberate design feature of the medevac laws to keep the Australian community safe. The report clearly states that medevac transfers are clearly for a temporary purpose. Minister Dutton has the ability to return a transferee to a regional processing country at any time. The report proves that Minister Dutton, not Immigration Minister Coleman, is responsible for approvals under the medevac regime. This report proves that Minister Dutton has not been truthful with the Australian people when it comes to medevac. The Independent Health Advice Panel is, as of this most recent quarter, a panel of seven leading doctors, all appointed by Minister Dutton.. The panel reviews medevac decisions when the minister refuses political transfers, on health grounds only. The panel has no power to review on security grounds. The decision of Minister Dutton always stands in these circumstances and is not appealable.

In the July to September quarter the panel considered 57 cases on health grounds. This means that the panel looked at 57 cases where Minister Dutton had refused on health grounds. In the majority of the cases—45 cases, in fact—the panel upheld the decision of the Minister for Home Affairs. The IHAP came to these decisions as the facilities available for treatment in Papua New Guinea and Nauru were considered adequate. A panel of eminent doctors recommended medical transfers in 12 cases, as they deemed it necessary. This is further proof that medevac is working as it was designed to. The government, or government appointed doctors, control who comes to Australia while ensuring that sick people can get the medical care that they need when it's recommended by doctors. When we are sick we get a doctor's opinion, and medevac allows for sick people to get a doctor's opinion as to whether or not they need health care.

This report stands in stark contrast to claims made by the immigration minister, David Coleman, on Sky News on 10 February 2019. When asked by David Speers about the operation of the panel, Minister Coleman said:

… it's quite likely, very likely, David, that the panel would be so inclined that the transfers would occur, and that would mean that substantially everyone would come to Australia within weeks.

The reality, as proven in this report, is that the panel has agreed with Mr Dutton in close to 80 per cent of the cases in the most recent quarter—in almost four out of five cases. On 9 February 2019 the Prime Minister, Scott Morrison, told reporters: 'We cannot have Australia's borders determined by panels of medical professionals.' However, as this report shows, those medical professionals are working in accordance with the undertakings they have made as doctors along with rational, clear judgement about the medical provisions available in regional processing countries.

Finally, this report definitively disproves the Morrison government's claims that medevac would unravel or undo offshore processing. In that same interview on 10 February, the immigration minister told David Speers on Sky News:

… it's very, very clear that the outcome of this would be, as our advice suggests, that substantially everyone would come to Australia within a matter of weeks. That's what would happen under this structure …

Then Minister Coleman doubled down further. He said:

… you've seen the structure of the panel, David, but the key point is within weeks it is highly likely—and as you know that's the advice we've received—that substantially everyone who is currently on Manus or Nauru would come to Australia. Yes I do believe that.

That is what Mr Coleman said. No matter how many times Minister Coleman says 'very, very' or what he believes, the reality is that it has simply not happened. In the July through September quarter, the report shows, 96 people were transferred to Australia from PNG under medevac and eight people were transferred from Nauru. By comparison, as of 30 September 2019 there were still 562 people in Papua New Guinea and Nauru. I don't know if those opposite can do the maths, but I have to tell you 96 plus eight is a lot less than 562.

Every claim made by this third-term Morrison Liberal government about medevac is not backed up by the facts. At the heart of these claims lies the desperate attempt of the Morrison government to discredit the medevac scheme. Facts matter and facts are proving that medevac works and that the Morrison government is wrong. The facts have consistently proven that the immigration minister is wrong. They have proven that the Minister for Home Affairs is wrong. They've even proven that the Prime Minister is wrong when it comes to medevac.

I must take a moment to highlight that the report tabled in the Senate also shows that the Minister for Home Affairs and his department do struggle with basic numerical facts. We've seen the department forced before to correct the record on the topic of aeroplane arrivals seeking asylum in Australia. As per this report, they have had to correct the record for the first two independent health advisory reports for the quarters ending 31 March and 30 June, respectively. The June report simply forgot to include the statistics for 25 people who were transferred from Papua New Guinea under medevac in that quarter. It also got wrong the number of people transferred from Nauru under medevac. So the department has, with this report, amended the original figure of zero people to four people. In effect, Minister Dutton's department lost count of 29 people transferred to Australia under medevac. I'm glad that finally the department has learnt to count and that those figures, as well as those from the 31 March report, have been corrected.

I want to take this opportunity to thank the doctors on this panel, including the Commonwealth Chief Medical Officer and the Chief Medical Officer at the Department of Home Affairs, for their commitment to ensuring that sick people can get medical treatment when required. I congratulate the Australian Medical Association representative, Dr Antonio Di Dio, for his elevation to the chair of IHAP, succeeding the Home Affairs CMO, Dr Gogna, whom I thank for his service as chair and for his ongoing role on the panel.

The reality is that medevac works. The leading medical professionals in Australia support medevac. All submissions to a Senate inquiry into medevac except those from the Department of Home Affairs supported this scheme. The religious sisters, the Josephite nuns, Rural Australians for Refugees—I met them this week on the lawn of the Parliament House—were here rallying to support medevac. I believe that quiet Australians support medevac. When people are sick and need help, they go to the doctor, and that's what we should be providing—sick people getting the health care they need.

3:58 pm

Photo of Simon BirminghamSimon Birmingham (SA, Liberal Party, Minister for Trade) Share this | | Hansard source

We've heard from Senator Keneally, a senator who failed to acknowledge that the previous system in place worked. The reality was that medical treatment necessary for individuals on Manus or Nauru was there. Systems were there to make sure that, where necessary, additional support was available. It also worked to help stop the flow of illegal arrivals into this country that the Labor Party, when they were last in office, so successfully created. The Labor Party has a track record of unpicking border protection laws when in office. The Liberal and National parties have a clear track record of fixing those holes and providing border security.

Labor's medevac law, their 'bring them all here' law, was passed by parliament, based very clearly on a misunderstanding or a lie from those opposite. There was no medical emergency that existed, the treatment options were available and are available, and the processes under the previous law were clearly available. Whichever way you look at it, the creation of this law by those opposite has only weakened Australia's borders, created another window of opportunity and effectively removed the ability of the government to have final decisions in terms of who comes to our country.

Senator Keneally interjecting

Despite Senator Keneally's claims, Labor's medevac law failed to provide a mechanism to return or remove transferees brought to Australia back to PNG or Nauru. This advice, I'm told, has been provided to Senator Keneally on multiple occasions by the Department of Home Affairs, including at the Legal and Constitutional Affairs inquiry into the legislation and including through Senate estimates. Time and again Senator Keneally has been advised that the legislation does not include a provision to return or remove transferees back to PNG or Nauru.

The Department of Home Affairs advised that, since the introduction of Labor's medevac law into parliament, as well as the creation of that hole in our border protection laws, there has been a marked increase in self-harm behaviours in regional processing centres. That is, tragically, the type of consequence that can come, just as when Labor unpicked border protection laws when last in office. The flow of boats to Australia didn't just weaken our border protection and it didn't just create the tragic circumstances of government having to reopen processing centres that we had been able to close in the Howard years; it also saw many lives lost at sea as a result of those seeking to come here.

Our policies have managed to ensure that we stop the arrivals. They've meant that we've been able to close the centres and that we've been able to make sure, overwhelmingly, that we have addressed this problem. If we stick to the policies that we've put in place, we will end up in the situation we were in at the end of the Howard government—without people in detention, without arrivals, and with policies that allow the government of the day to provide for the humanitarian intake that we need.

This bad legislation that the Labor Party forced through in the last parliament is not helping in terms of maintaining the types of policies that have given us the success to date. That's why the government continues to believe that it should be repealed.

4:02 pm

Photo of Nick McKimNick McKim (Tasmania, Australian Greens) Share this | | Hansard source

I rise to speak on the same document, firstly in regard to comments just made by Senator Birmingham. He referenced in his speech an alleged increase in self-harm post the passage of the medevac legislation. I want to place very clearly on the record that, in fact, there has been a relatively recent significant increase in self-harm amongst those poor people who have been in offshore detention for nearly seven years now, but that had nothing to do with the passage of the medevac legislation; it was as a result of the coalition winning the last election. I challenge Minister Birmingham, because my sources for that are the primary sources—the multiple refugees on Manus Island, who are my friends and whom I've spoken to directly. I spoke with them in person during my relatively recent trip to Manus Island, where I was deported from Papua New Guinea by the Papua New Guinean government—I suspect, on the orders of the Australian government.

Ultimately, that self-harm was because the Labor Party, to its credit, had taken to the election a policy of supporting the New Zealand resettlement, and yet this coalition, this heartless group of politicians, including Senator Birmingham, who's now fleeing the chamber rather than listening to this, have basically tortured people for nearly seven years now. So that spike in self-harm was not caused by the medevac legislation; it was caused by the victory of the coalition in the recent federal election. I know that from the primary sources, unlike Senator Birmingham, who, once again, is just making stuff up to suit a political agenda.

Ultimately, at the end of the day, the medevac legislation is about taking decisions about whether people need to be evacuated to Australia on medical grounds out of the hands of politicians and bureaucrats and putting those decisions where they should be, which is in the hands of medical professionals. If Minister Birmingham is ever unfortunate enough to suffer a medical condition which requires medical treatment, I can guarantee you he's not going to go and see Minister Dutton to ask how he should treat his medical condition; he's going to see a doctor, and rightly so.

So why should Minister Birmingham and his serried ranks of colleagues on the LNP side of this chamber force people who have been marginalised; disadvantaged; and illegally detained, according to the Papua New Guinea Supreme Court, for over 6½ years now—people who have only ever stretched out a hand to this country to ask us for sanctuary—to have their medical futures determined by politicians and bureaucrats? The answer, of course, is he should not and his colleagues should not, and they do not have a moral leg to stand on on this issue.

It is doctors that should be determining medical treatment for people to whom Australia owes a duty of care. And I can say very clearly that Australia does owe these people a duty of care, because that is what the courts in Australia have repeatedly found and that is what Minister Dutton implicitly acknowledged when he settled the civil case against his government brought on behalf of multiple detainees on Manus Island and Nauru, which he settled for about $70 million. That was Australian taxpayers' money he used to settle that case so that the courts in Australia did not force open the closed doors behind which this government operates, the secrecy, and lay open the whole sordid, sorry, bloody saga that has been going on for over 6½ years now to the disinfectant of sunlight.

What this report clearly shows, when read in connection with Minister Dutton's response, is, firstly, that the minister has admitted that incorrect transfer numbers were tabled in previous IHAP reports. We now know that two new medical professionals have been appointed to the IHAP—that's the International Health Advisory Panel. We now have a more detailed outline of the number of transfers and decisions made by the panel. But we also, importantly, have a range of concerns outlined by the panel that it has raised with the department. I'm referring to page 5 of the report here. Those concerns are about a lack of satisfactory interpreter services; delays in treating doctor referrals, and delays in referrals to the minister; a lack of movement from Nauru when the panel has recommended transfer; and the support provided to persons with negative transfer outcomes.

What this report, taken as a whole, actually shows is that the process is working. It's working as it was designed to do, and that is that the decisions be independent and that they be made by medical professionals—that those decisions be medically led, not politically led by politicians, ministers and bureaucrats beholden to the government of the day. This report is very strong evidence that the medevac laws should not be repealed.

4:09 pm

Photo of Raff CicconeRaff Ciccone (Victoria, Australian Labor Party) Share this | | Hansard source

I rise today to lend my support to Senator Keneally's and Senator McKim's contributions to this debate. Labor for some time now have supported the current medevac laws, and that is because we believe that sick people that are being looked after by government, regardless of whether or not they're in detention, deserve the care that they deserve, whether it's here in this country or anywhere else they are held. It's very, very important that we make this point—that, when someone is sick, they get the best medical care possible.

It was disappointing to hear Senator Birmingham earlier, talking about there being an increase in self-harm, giving the impressing that somehow the medevac laws were to blame. It is great to know that there are senators in this place—hopefully the majority of senators in this place—who support the medevac laws. We call on the crossbench to continue to lend their support, with Labor, in ensuring that these laws remain in place.

Being a new senator, it is interesting to see what happens when governments are required to provide reports on certain pieces of legislation, as is the case with medevac. Every three months a document is meant to be tabled in this chamber and, through that process, we can see that the medevac laws are working as they were intended to. We constantly see the government delaying the tabling of such reports, and we have to ask why. Why do they keep delaying reports? Whether it's on medevac or on other pieces of legislation, why does this government continue to hide from the truth? What are they afraid of? I can only conclude that this proves that Minister Dutton's ongoing scare campaign about this legislation is fanciful.

We need only look at the simple facts. Over the three months, the Independent Health Advice Panel affirmed the minister's decision nearly 80 per cent of the time. On 12 occasions the panel overruled the minister, so that sick people could get the health care that they needed. Minister Dutton's claims are all refuted with very simple facts. Since March this year, when the medevac legislation was passed by this parliament, the government has repeatedly stated that, after the laws were introduced, offshore refugees would flood Australia, that boats would overwhelm Operation Sovereign Borders and that Christmas Island would have to be reopened to deal with the large number of medevac transferees. However, in the last eight months, after medevac was passed, all these claims have proved to be false. The Christmas Island detention centre is empty, apart from having one family of four; boats have not arrived in greater numbers than in previous years; and only 200 people have been approved for medevac transfers as of this month.

Most importantly, Minister Dutton has failed to reveal one crucial aspect of the medevac operation to date. Of the 200 transferees, the minister has approved 172 himself. That means that, in 86 per cent of the transfers, he has read the reports of two different physicians, agreed that the patient required treatment and approved the transfer without seeking a review from the government-appointed independent health panel. The panel is supposed to review cases where the minister doesn't believe that a transfer is required. But, the vast majority of the time, the minister appears to have agreed with the patient that they required transfer, without seeking a further medical opinion. But, unfortunately, that hasn't prevented the minister or his Department of Home Affairs from trying to allege that people are not sick because they haven't been in hospital for longer than seven days or that they are refusing treatment in an effort to prevent removal.

Question agreed to.