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Tuesday, 11 September 2012
Senator HANSON-YOUNG (South Australia) (16:12): I move:
That this bill be now read a second time.
I seek leave to table an explanatory memorandum relating to the bill.
Senator HANSON-YOUNG: I table an explanatory memorandum and seek leave to have the second reading speech incorporated in Hansard.
The speech read as follows—
MIGRATION AMENDMENT (HEALTH CARE FOR ASYLUM SEEKERS) BILL 2012
This bill establishes an independent panel of health and mental health experts, an Expert Health Care Panel (the Panel) to monitor and evaluate the wellbeing of asylum seekers who are sent offshore by Australia for processing of their protection claim.
The Panel proposed by this bill is a harm-minimisation measure in response to the changes to the Migration Act 1958 passed by federal Parliament on 16 August 2012, which removed the human rights and welfare protections from the Act in order to facilitate offshore processing on Manus Island (Papua New Guinea) and Nauru.
The Australian Greens oppose punitive offshore processing because it is harmful to people and does not work as a deterrent to asylum seekers who are desperate to find a durable solution. Like many in the health, refugee, human rights, legal and social justice sectors we are deeply concerned about the health and well-being of people in the offshore detention given the lack of time limits on detention and the inadequacy of local facilities.
Even a cursory look at the known outcomes of the Howard government’s ‘Pacific Solution’ earlier this century demonstrates why there is cause for alarm as Australia enters another regrettable era of offshore processing. Experts in the health and mental health fields have repeatedly said over the years that the uncertainty, aimlessness and alienation of indefinite detention have an extremely detrimental effect on men, women and children’s health and mental health. This bill seeks to provide a safety net by establishing expert oversight and high quality protection for the health and wellbeing of asylum seekers in response to those clear risks.
Outline of the Expert Health Care Panel
The chief change made by the Government and supported by the Opposition after the Houston Panel recommendations was the insertion of s198AB to the Migration Act, which allows the Minister for Immigration to, by legislative instrument, designate that a country as a ‘regional processing country’ and under s198AD permit the removal of asylum seekers to one of those designated countries.
This bill inserts a new section that requires the Minister to establish a Panel either at the same time as making the designation of an offshore processing country or within 30 days of making a country designation. The Panel will operate independently of the Minister, Government and Department of Immigration. Its primary role will be to monitor, evaluate and make recommendations on the health and mental health of asylum seekers.
The Minister for Immigration will nominate the membership of the Panel from a field of nominations provided by peak medical, mental health, nursing, dental and child health organisations such as: Australian Medical Association (AMA), Royal Australian College of General Practitioners (RACGP), Royal Australian and New Zealand College of Psychiatrists (RANZCP), Royal Australian College of Physicians (RACP) and Australian Psychological Society (APS).
Under this bill the Panel is mandated to make ad hoc recommendations directly to the Minister on individual cases, and to report directly to Parliament on a six-monthly basis by tabling a report in both Houses on the health and welfare of detainees. This feature is similar to the powers and reporting functions of the Commonwealth Ombudsman.
The Panel will have powers to subpoena and inspect medical records held by the Department of Immigration and Citizenship or private companies running the detention sites including in the area of health services. The Panel will largely set its own Terms of Reference, as advised by the expert physicians’ organisations, and will be independent of the Minister for Immigration. The Panel will set its own terms and operational guidelines to how to best undertake its monitoring and reporting functions including through visits to offshore sites and monitoring of local health services in offshore sites of detention.
The mandate of the Panel has been left very wide on purpose, because the Greens believe it should be the expert physicians who set the parameters, the priorities and the processes for the Panel. However it is anticipated that the Panel will assess the access to specialist health and medical care being provided to asylum seekers considering the logistical and geographic hurdles facing detention operators, the adequacy of responses to health and mental health emergencies, the capacities of local health services in offshore places of detention and the stress and trauma impact that indefinite detention is causing children.
Health of detainees under the Howard government’s Pacific ‘Solution’
The woeful outcomes of the last era of punitive offshore processing make it very evident that a truly independent body of experts must be established to oversee the health and mental health of detainees.
Around 1,500 asylum seekers were processed on Nauru under the previous government’s Pacific Solution. Many of those suffered serious mental health issues as a result of detention. A number were assessed as ‘at grave risk’ and were taken to Australia because of their deteriorating mental health.
In 2002 Oxfam released a report Adrift in the Pacific—the implications of Australia’s Pacific refugee solution which stated:
One independent visitor to the Nauru camps has noted that the trauma and conditions facing the asylum seekers has many serious and adverse effects: The asylum seekers are traumatised by the events and many show clear signs of vulnerability. It is often difficult to interview them. It could be discussed whether it is appropriate to perform refugee screening determination in such situations, when the symptoms of Post Traumatic Stress Disorder are evident and seriously affect the eligibility process…
‘I am reliably informed that in the interviews, the following symptoms for PTSD were observed: nervousness, anxiety, aggressive attitude, muteness, distrust, withdrawal, lack of focus and concentration, often shivering of hands during interviews, outburst of crying.
In 2007, a report published by A Just Australia and Oxfam Australia entitled’ A price too high: the cost of Australia’s approach to asylum seekers’ outlined numerous concerns relating to the ‘Pacific Solution’, including the mental health impacts on asylum seekers leading to serious psychological damage and instances of people engaging in hunger strikes and self-harm.
We know that long term detention has a particularly damaging effect on children. The Australian Human Rights Commission, along with many other organisations and peak bodies, advises that significant numbers of children in long term immigration detention experience psychiatric illnesses such as depression and Post Traumatic Stress Disorder, developmental delay and in some cases, self-harming.
Concerns about health and mental health under the new Pacific ‘Solution’
Since the passing of the new laws last month to facilitate the current Government’s new Pacific Solution, peak medical experts have expressed concerns that asylum seekers accommodated in the proposed offshore processing centres may again experience serious mental health issues and will not be given adequate quality of care in the less resourced places to which they will be sent.
It is evident that facilities in Nauru and Manus Island may not be adequate to cope with the health and mental health needs of the thousands of asylum seekers who will be detained there. The report of the inquiry into A Certain Maritime Incident examined offshore detention during the Howard era Pacific ‘Solution’. It noted that the Nauru site initially lacked water, sanitation and electricity with asylum seekers housed under harsh conditions. Evidence to the Select Committee suggested that the facilities on Manus were a slight improvement on those in Nauru; however, several asylum seekers contracted malaria.
Australian Medical Association President, Dr Steve Hambleton, has called for ‘urgent establishment of a truly independent expert medical panel to oversee the quality of health services available to all immigration detainees in all locations’:
Detainees have a lack of access to health facilities. Indeterminate detention has a serious mental health impact. There are currently no specific guidelines for dealing with the health needs of children in detention. But there is plenty of research evidence of the harm that detention causes to a child’s development. We must do the right thing. We want this Panel to report directly to the Parliament, the Prime Minister, and Ministers. Part of its brief would be to monitor the health services available to the local communities outside the detention facilities on Nauru and Manus Island. It has to be above the bureaucracy. The current advisory group - Immigration Health Advisory Group or IHAG - reports to the Immigration Department. It is limited. Its members are constrained.
Shortly after the Government rushed through its changes to the Migration Act through Parliament to facilitate offshore processing, the spokesperson for the UNHCR, Adrian Edwards, noted the organisation’s significant concerns about the wellbeing of those facing indefinite detention:
We do not want to see a return to lengthy delays in remote island centres for asylum seekers and refugees before durable solutions are found. We are also concerned about the psychological impact for those individuals who would be affected.
The Australian Greens agree with these experts that, along with time limits on detention, the health and mental health of men, women and children are some of the most critical issues that must be urgently addressed.
It is not good enough to leave a critical role like the oversight of health and mental health a private company contracted to provide health services. We must establish an oversight body that is independent, expert in the field, empowered to inform itself, mandated set its own terms of reference drawing on the knowledge of Australia’s top specialists and, critically, able to report transparently to the Parliament and public, rather than the Department.
In the past offshore detention has operated under a veil of secrecy with very little scrutiny or accountability. The repercussions of that dreadful era have not passed away, especially for those refugees who were detained for far too long offshore. Yet Australia is embarking on a new offshore detention regime that is arguably even worse due to the prevailing mantra of indefinite duration and non-advantage. There could not be a more important time to take action to ensure independent, transparent and rigorous oversight by high quality experts in the medical and health fields.
We commend this bill to the Senate.
Senator HANSON-YOUNG: I seek leave to continue my remarks later.
Leave granted; debate adjourned.