Denying Asylum Seekers Medical Treatment – the Medevac law
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;
Story

Denying Asylum Seekers Medical Treatment – the Medevac law

Issues/Healthcare , Issues/Human Rights , Stories/586
Sydney NSW
25th Sep 2019
Denying Asylum Seekers Medical Treatment – the Medevac law

The Coalition victory has brought renewed efforts to ensure Australia's system of offshore detention becomes even more draconian. 

Emergency medical evacuation of refugees on Nauru and Manus Island was legislated through the Medevac Bill passed early in 2019. However, emboldened by their surprise re-election, the government is now seeking to repeal it.

The Home Affairs Minister Peter Dutton has positioned himself against the so-called 'Medevac Law'. The Home Affairs Legislation Amendment (Miscellaneous Measures) Act 2019 introduced provisions to the Migration Act allowing for refugees detained offshore in Nauru or Manus Island to be transferred onshore for emergency medical treatment.

So far, 31 transfers have taken place, not the 250 as claimed by Dutton. It is hardly likely to 'open the floodgates' — it is not a legislative loophole but a minimal concession on the part of our government to ensure the health and safety of refugees. 

A series of steps are required and discretion is applied to the process of a transfer. Firstly, two doctors must assess the person to decide if a transfer is appropriate. The doctors do not have to directly see or examine the person - the person's records and other documentation is sufficient to make a recommendation.

The recommendation is then given to the Minister for Home Affairs who must approve or refuse it within 72 hours. The Minister can refuse a transfer on three grounds: 

1. If the person is a security risk 

2. If the person has a criminal record or other grounds of character

3. if the transfer is not medically necessary

If the Minister refuses the recommendation on the third ground, the decision goes to an independent panel of eight who have a further 72 hours to review. If they do not find any grounds of objection, the transfer must be allowed.  

Onshore medical evacuation is for treatment beyond the means of the existing facilities on Nauru or Manus Island. The range of cases may include complex surgeries or other procedures, however, a growing number of serious mental health issues have emerged. 

In late 2018, Médecins Sans Frontières published a report on mental health and access to care on Nauru. They found high rates of suicide attempts and self-harm amongst asylum seeker patients, whose indefinite detention has robbed them almost entirely of hope for the future. 

In June, an asylum seeker who had been denied medical treatment on Manus Island locked himself in his room and attempted to set himself on fire — he was the second to do so in two weeks.

The passage of the law was precipitated by several influential Federal Court cases which ruled that the government had breached its duty of care to asylum seekers by refusing their requests for a medical transfer. A refugee who was a victim of female genital mutilation required an abortion, but the government refused, suggesting that she receive treatment in Taiwan. The Federal Court overruled the decision

Cases like these formed the basis of the Medevac law. Discussion over the bill have been polarising since the beginning, and the Medevac Bill was pushed through Parliament in 2018-19 but not without a heated pushback.

Though the Medevac laws managed to prevail, it belies the overall policy of offshore detention, something which both political parties are accountable for. Those who arrive in Australia under the Medevac law are anything but settled. Like thousands of others, they are still trapped. Operation Sovereign Borders continues, as do the facilities on Nauru and Manus Island. Our money and our laws maintain them. Things have not gotten any better. 

Even so, Morrison harshly criticised the bill, exacerbating the fear that Medevac could allow criminals into Australia. Despite the fact that they could not actually settle, he was quoted saying,  'they may be a paedophile, they may be a rapist, they may be a murderer, and this bill will mean that we would just have to take them.' 

He and Dutton have claimed that medical resources and services for Australians would be siphoned off by refugees arriving through the Medevac law. The bill was nonetheless passed with the support of Labor and the Greens but the Coalition's new majority in the House means that they are poised to repeal the law, provided they can woo the crossbench in the Senate.

The Federal Court's decision earlier in June which allowed doctors to make recommendations for transfer based on a person's records resulted in alarmist rhetoric from Dutton also. He went as far as to claim 'activist doctors' are undermining government policy; that the law will entice people smugglers and that refugees are not electing to arrive in the United States because of the Medevac laws. He has also said that pregnant women were claiming to have been raped and are seeking abortions in Australia, only to have the child and seek an injunction to remain. None of these claims are backed with any substantial evidence.

Some other claims have been questioned. Fears that the Medevac law will entice people smugglers are not entirely founded: the Home Affairs department has pointed out that increases in people smuggling is 'dependent on a shift in Potential Illegal Immigrant (PII) intent,' not policies which are purported to attract people smugglers.

But with his attack on so-called 'advocate doctors,' not only has Dutton politicised the role of doctors, which some medical professionals have found offensive, he has shown himself willing to offer unfounded, spurious claims to justify decisions which threaten the lives and well-being of hundreds given the number of potential claimants for Medevac residing in Nauru and Manus Island. 

This rhetoric does not exist in a vacuum, nor is it only a case of fearmongering. The long-standing fixation on ensuring that refugees can never set foot on Australian soil no matter the circumstance has - over the years - almost turned to a race to the bottom in terms of human cruelty.

In a bitterly curious way, the pattern of anti-refugee rhetoric occurs in peaks and troughs roughly corresponding with the period during and after federal elections. Fears over 'watering down' border security have served as partisan ammunition: Dutton has said 'with 250 cases now being considered by doctors under the Medevac laws, this is a very dangerous period for Labor to go soft on borders yet again.' 

The Tampa crisis may have been the watershed moment in all this but so long as it remains politically expedient, increasingly harsh policies - backed up by unscrupulous claims - will continue. The price of this cynical rhetoric is nothing short of human misery and suffering.

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