I rise to speak on the Migration Amendment (Repairing Medical Transfers) Bill 2019. This bill seeks to repeal the medevac legislation that was passed by the parliament in February this year. It also seeks to amend the Migration Act to extend existing powers in relation to persons transferred to Australia under the medical transfer provisions, allowing for their removal from Australia or return to a regional processing country once they no longer need to be in Australia for the temporary purpose for which they were brought here.
Let me be very clear: Labor does not support a repeal of the medevac legislation. Therefore, Labor will not be supporting this bill. In Labor, we have always had two objectives with respect to the medical transfer of vulnerable people from PNG and Nauru: firstly, to ensure that sick people get the medical care they need, as determined by medical advice; and to ensure that the minister has final discretion over medical transfers on national security, public safety or character grounds. Labor's objectives have not changed, nor have the grounds that caused us to support the medevac legislation.
In introducing the bill, the minister made quite an extraordinary speech, but extraordinary for all the wrong reasons. Though short, it managed to pack in an outrageous series of allegations, undiluted by facts or any sense of responsibility to the people who are directly the subject of this debate or to the Australian people. The minister said there was never a need for Labor's law in introducing this attempt to repeal the much needed amendments to the Migration Act passed at the end of the last parliament. I wish he was right. I wish this parliament had no need to make a law that makes it clear to the government that Australians want people, ultimately in our care, to get the medical care they need, medical care as determined by medical professionals.
It still saddens me that we needed to make that law. But it angers me that the Morrison government and this minister are still using sick and vulnerable people as their political playthings. On more than 50 occasions medical transfers occurred prior to the passage of the medevac legislation, following litigation. As I understand it, as I am informed, every case that commenced resulted in a transfer to Australia, either by court order or through the concession of this government. Is this really how government members want this question of medical treatment to be addressed, through the courts?
On the other hand, what the medevac bill, the regime presently in place, does, sensibly and clearly, following compromise in this place, is to codify something that was already happening and to ensure our objectives, both of them, are met. This is so that we can ensure treatment can be received in a timely fashion and that questions of security, safety and character can also be addressed. If the government were seriously concerned about the operation of medical transfers they would have proposed amendments to deal with their concerns. But the facts demonstrate that medevac is working, and no amendments have been proposed. It's simply wrong to play politics with the lives of sick and vulnerable people in our care, and it's a nonsense and an abdication of responsibility to return to the situation prior to the enactment of the medevac bill.
I want to briefly share with the House the human story I think best illustrates what a difference this regime has made and how dangerous it would be to go back. The story concerns a two-year-old girl known as DIZ18. Her parents fled Iran to Australia, arriving in 2013 without a visa. They were taken by the Australian government to Nauru and recognised as refugees under the refugee convention in 2014. DIZ18 was born in Nauru on 5 June 2016.
This little girl became ill in June 2018 and her illness rapidly got worse over the next few days. On 12 June the treating doctors, with the International Health and Medical Services—the medical service contracted to provide health care to refugees on Nauru—diagnosed her with severe sepsis. In short, IHMS recommended that the little girl be urgently medically evacuated, to a tertiary level hospital, to Australia or a third country. A senior officer of the Australian Border Force involved in the decision inquired whether it was possible for the applicant to, instead, be evacuated to a hospital in PNG or Taiwan. Each doctor and specialist who recommended her medical evacuation recommended that she be taken to a tertiary hospital in Australia or another first-world country; however, the sick little girl was treated at the hospital in Papua New Guinea.
It rapidly became clear that the standard of care required, including MRI brain scans and other scans, were not available at this hospital. Justice Murphy, presiding over the case, stated, 'There is a strongly arguable case that in evacuating the applicant to PIH rather than to a hospital in Australia, the respondents provided inadequate medical care to the applicant. The evacuation resulted in the applicant being sent to a hospital which, at least arguably, did not have the capacity to properly respond to her medical needs.'
The case of this little girl demonstrates that decisions about medical care should be taken by medical professionals. The advice of doctors should be listened to and acted upon. The Australian people are good, decent and generous. They don't want to see vulnerable, sick people in our care suffering when medical care is available to treat them. They appreciate that these circumstances are distinct from the complex policy debates in this area. This is why the parliament must not allow the medevac legislation to be repealed. This is why we are proposing our second reading amendment to the bill, which is before the House. I move:
That all words after "That" be omitted with a view to substituting the following words:
"whilst not declining to give the bill a second reading, the House notes that the:
(1) Minister for Home Affairs has:
(a) failed to accurately describe the processes providing for the medical transfer of people from Papua New Guinea and Nauru; and
(b) consistently mischaracterised the effects of these processes; and
(2) Minister for Home Affairs and the Minister for Immigration and Citizenship have failed to put forward any amendments which would address any genuine concerns they may have with the operation of the processes".
It's important to remember that the medevac regime only applies to those refugees and asylum seekers in PNG and Nauru at royal assent on Friday, 1 March 2019. For the medevac process to be enlivened, two or more treating doctors for a patient in PNG or Nauru must advise the Secretary of Home Affairs that the patient needs to be brought to Australia for medical or psychiatric assessment or treatment. The minister can approve or deny the transfer on national security, public safety or character grounds if the patient has a substantial criminal record as defined under section 501(7) of the Migration Act and believes the transfer would expose the Australian community to serious risk of criminal conduct, or the minister suspects the transfer of a person to Australia would be prejudicial to security within the meaning of the ASIO Act, including because of an adverse security assessment, or ASIO advises the minister that the transfer of the person to Australia may be prejudicial to security and that threat cannot be mitigated.
If the minister denies the transfer on national security, public security or character grounds, that is the end of the matter. I repeat: that is the end of the matter. In these circumstances, the transfer does not occur. If the minister denies the transfer on health grounds only, then the following must occur: the minister must inform the Independent Health Advice Panel as soon as practicable, and, within 72 hours, the panel must conduct a further clinical assessment and inform the minister that the minister's decision to deny on health grounds is confirmed or that the transfer has been approved.
We know that the government has approved approximately 90 transfers and that 20 cases have been referred to this panel. Of the 20 referred to the panel, the panel has upheld the minister's decision not to transfer the individual on 13 occasions and overturned the minister's decision not to transfer in seven cases. Let us remember that these are decisions made by an independent panel of doctors that the minister got to choose himself. The panel includes some of Australia's best doctors, including the Commonwealth Chief Medical Officer and the Surgeon General of the Australian Border Force. Despite this, the minister has been vigorously arguing that two doctors from Nimbin can force the government to bring people from Manus or Nauru to Australia, which is just ridiculous. Ultimately, I think the numbers demonstrate both the need for medevac—that it is helping vulnerable people get the care they need, based on advice—and also that there is an effective safeguard in place that enables ministerial discretion.
Regardless of what you think about the wider debates about asylum policy, Australia can and should show humanity. We should not fail to provide critically ill people in our care—in particular, children—with urgent medical treatment. That was the rationale behind the medevac bill—the Migration Amendment (Urgent Medical Treatment) Bill 2018 introduced by the former member for Wentworth, Dr Kerryn Phelps, and the member for Clark. It was one that Labor supported. Medevac is modest and necessary, and, importantly, it is working. I note that there are presently no government members listed to speak in this debate, and perhaps that's as eloquent a testimony to its effectiveness as anything else.
It's very important to note that there is very strong support for the retention of the existing legislation and its framework among stakeholders, including the AMA, the Royal Australian College of General Practitioners, the Law Council and the Asylum Seeker Resource Centre. Medecins sans Frontieres, or Doctors without Borders, provided mental health care on Nauru for 11 months up until late last year, and their report, Indefinite Despair, released in December of last year, makes extremely difficult reading. The report states that of the 208 refugees and asylum seekers the organisation treated in Nauru, 124 patients—that's 60 per cent—had suicidal thoughts and 63 patients—that's nearly one in three—attempted suicide. Children as young as nine years of age were found to have had suicidal thoughts, committed self-harm or attempted suicide. Let us think about that—all of us who have the capacity to help these people or not to. Their report goes on to say:
Almost two-thirds … of MSF's 208 refugee and asylum seeker patients were diagnosed with moderate or severe depression. The second highest morbidity was anxiety disorder (25%), followed by post-traumatic stress disorder—
nearly one in five.
A total of 12 adult and child patients … were diagnosed with resignation syndrome, a rare psychiatric condition where patients enter a comatose state and require medical care to keep them alive.
The AMA president, Dr Tony Bartone, said:
There is compelling evidence that the asylum seekers on Nauru, especially the children, are suffering from serious physical and mental health conditions, and they should be brought to Australia for appropriate quality care … This is a health and human rights issue of the highest order. We must do the right thing.
Kelly Nicholls from the Refugee Council of Australia stated:
The safety of lives must always come first. Doctors have been ignored for too long. People have died as a result. Pregnant women with complications have had to wait dangerously long to receive the treatment they need. Rape survivors have had to have traumatic late term abortions due to government blocks. This bill—
the medevac legislation—
changes the response to medical emergencies in offshore detention on Manus Island and Nauru.
The truth is that, if the government had legitimate proposals to improve the operation of the medevac regime, the Minister for Home Affairs would have put forward amendments rather than simply seeking to repeal the legislation while saying very little about it. He would enter into a good-faith discussion, setting out his concerns and how he would propose that they be addressed. But Minister Dutton has not sought to amend medevac. Rather, what he wants to do is to have us revert to a flawed medical transfer regime that was failing to provide adequate and timely medical care to refugees and asylum seekers in regional processing countries. This once again comes down to Minister Dutton—his mismanagement and his incompetence.
The medevac expert panel that the home affairs minister claimed would open the floodgates and admit sick refugees and asylum seekers to Australia has only been used a few times since the law passed—20 times—with the overwhelming majority of all medevac applications being waved through by the government before reaching the final medical body. Indeed, since the laws were enacted, only seven patients have been transferred without the approval of Minister Dutton or Minister Coleman, the Minister for Immigration, Citizenship, Migrant Services and Multicultural Affairs—seven people. Importantly—and this is a really critical point in the debate, and it really exposes the position of the minister and his government—the ministers did not reject any cases due to security or character concerns; the rejections were due to contested medical grounds. Then these people were only transferred to Australia after being assessed by an expert panel of doctors that the minister got to choose. Remember, this panel includes some of Australia's best doctors, as I mentioned before—the Commonwealth Chief Medical Officer and the Surgeon General of the Australian Border Force amongst them. Of course, every other asylum seeker or refugee who has come to Australia for urgent medical care has been approved by either Minister Dutton or Minister Coleman. But, despite this, the Minister for Home Affairs has been vigorously arguing that two doctors from Nimbin can force the government to bring people from Manus or Nauru to Australia. These claims are simply not true, and the minister knows it. At every step of the way, the government or government-appointed doctors control who comes to Australia through the medevac process.
Perhaps this is why the minister hasn't proposed any amendments to the medevac legislation. In his desperation to prevent the passage of the bill earlier this year, the Minister for Home Affairs claimed that a thousand people would flood Australia through medevac. This hasn't happened at all. Let's be clear: approximately 90 people now have been approved to come to Australia through the regime, and all of these transfers of people have been explicitly approved by ministers or ministerially appointed doctors.
I think I should briefly mention reports today that a boat from Sri Lanka has been intercepted by the Australian Border Force. It just so happens that this story appears in The Australian on the day this bill is being debated—what a coincidence that is! But this has nothing to do with medevac, and the minister's foolish attempts to link the two show that once again he's all about wedge politics and not concerned with good or decent public policy. We know the Easter bombings in Sri Lanka have been acting as a push factor in that part of the world. I'm very confident that our Border Force personnel will be acting professionally in dealing with any such people.
But of course this Minister for Home Affairs has plenty of form when it comes to over-the-top claims. This is the man who, it should be noted—and as we, on this side of the House, remember—was voted the worst health minister in Australia's history and was the architect of the GP co-payment. He said, in his typically opportunistic way:
I do fear that this opens the floodgates ... it sends a bad signal when you have a country like ours being dictated by doctors who can say that people must come here …
Once again, he wilfully mischaracterises the legislation, in the most inflammatory tones. Dictating doctors—really? I'll say it again: the process we are talking about—the process the government is proposing to repeal—balances medical opinion with an appropriate ministerial discretion.
And let's also remember: the doctors clearly aren't making all this up. The only person making things up in this debate is the Minister for Home Affairs. We had the ludicrous situation earlier this year where the minister was going around telling people that Australians were going to be displaced from hospital beds and other health services by this. Then the Prime Minister backed in this falsehood, and he said:
It's just a simple fact. If we've got to treat more people in Australia, then obviously they're going to take the place of people who were getting that treatment anyway. It's just simple math.
What garbage! What utter, utter garbage! St Vincent's Health, amongst others, have comprehensively rejected those claims, saying they were 'baseless'. They said:
Public hospitals can accommodate the health needs of asylum seekers without disadvantaging anyone. St Vincent's is happy to make its hospitals available to provide care to asylum seekers without affecting waiting lists—
'without affecting waiting lists'.
Not to be outdone, just a couple of weeks ago the Minister for Home Affairs reached new lows. The minister said in an interview:
Let's be serious about this. There are people who have claimed that they've been raped and came to Australia to seek an abortion because they couldn't get an abortion on Nauru. They arrived in Australia and then decided they were not going to have an abortion. They have the baby here and the moment they step off the plane their lawyers lodge papers in the federal court, which injuncts us from sending them back.
And, as the Australian Medical Association noted, the minister said that without providing any evidence to back up his claims—these extraordinary and offensive claims.
It's important to ask the question: why, exactly, is this bill being debated in the House this week? I remind members opposite that the Senate inquiry into this bill isn't due to report until 18 October. Indeed, submissions for this inquiry are open until 16 August. The government did not seek an early Senate inquiry reporting date. The extended time frame of the inquiry means that this bill cannot be brought on for debate or vote in the Senate until the sitting week commencing 11 November 2019—11 November 2019—which, again, really begs the question: why now?
We all know that the Morrison government has really brought this bill on for debate today in the misguided belief that this issue is to their political benefit. Well, I'll tell you this: I don't think that people in Melbourne's or Sydney's outer suburbs or in the regions are amused by the Morrison government's political games at the expense of taking seriously its responsibility to govern on behalf of the Australian people.
I also want to put this on the record in this debate. The list of the incompetence and mismanagement of the Minister for Home Affairs is a long one. He oversaw a $300 million Australian Border Force budget blowout, resulting in the Australian Border Force fleet being ordered to stop patrols to save money on fuel, and putting the border at risk. There was the $7 million spent on the strategic review of the Department of Home Affairs that we're just not allowed to see. I wonder why that might be the case. ANAO report after report has highlighted significant mismanagement and waste or the minister's failure to manage offshore contracts. We think, of course, about Paladin in this regard as the most extreme example of many. And who could forget that ridiculous press conference by the Prime Minister on Christmas Island last year—a press conference that cost an estimated $60,000?
And right now we see the Minister for Home Affairs embarking on a disgraceful attempt to privatise Australia's visa processing system. I mean, seriously—who on earth thinks it's a good idea to sell off our visa processing system? I note this isn't something that the minister—or, indeed, his colleagues—seems to be particularly keen to talk about. And we should be very, very clear about this: selling off our visa system is a bad idea that could lead to thousands of job losses, cuts to services, increased visa fraud and also data security risks.
In summary, the only problem that the bill before the House is designed to solve is a political one—a political one of the government's own making. The Morrison government has talked about problems with the approach that's currently law in Australia but has put forward no solution by way of amendment. How the minister and the government have chosen to engage in the debate over the medical treatment of refugees and asylum seekers in PNG and on Nauru is as important and revealing as it is shocking. It's shocking, of course, that members of Australia's government would wilfully mischaracterise a proposed law and its consequences and recklessly demonise vulnerable people—of course it is, however accustomed we may be to this from this government—but there is something more to this.
The manner in which the minister has responded to calls to changes in the medical treatment regime exposes a difficult truth on the part of the government—that is, they lack the courage of their convictions. We see that obviously in the speakers list for this debate. A confident minister would welcome debate and would be comfortable defending his position calmly and rationally. He or she would look forward to the opportunity of exposing the shortcomings of alternatives in a considered and thoughtful way, looking to expert opinion and to our shared values as Australians, but not this minister and not this government. This is all about cheap politics—never the policy nor the people affected. For him the politics in turn is all about defending his position, nothing more than this so that we should look away from his failure to achieve resettlement for too many refugees after nearly six years in office.
When we look to the record of medical treatment and medical transfers, we see a litany of shameful events and an even more shameful refusal to accept responsibility, which is at the heart of the medevac legislation. That he won't talk about this is telling. That he continually seeks to deflect and confuse is telling. It exposes the gaping hole at the centre of his position here—that he can't find a genuine basis to oppose the legislation presently in place, which simply codifies what always should have been happening: medical treatment based on medical advice with appropriate discretion for the minister so that any wider policy or security questions can be had regard to in the national interest. That is why I urge members, particularly members opposite, to support the second reading amendment I have moved and to oppose this unnecessary and destructive legislation.