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Submission to the National Inquiry into Children in Immigration Detention from
Health Services Australia (HSA)
INFORMATION REGARDING FUNCTIONS OF HEALTH SERVICES AUSTRALIA
The functions of Health Services Australia, the services it provides and that nature and extent of reports it makes on services provided to and in immigration detention centres (including also the provision of services to people who may be "in immigration detention" but not in a centre (for example, in a nominated hospital, goal, house in the community etc));
Health Services Australia (HSA) was established in 1997.
The company is wholly owned by the Australian Government and accountable to its shareholders, the Minister for Finance and Administration and the Parliamentary Secretary to the Minister for Health and Aged Care. It is managed by an independent Board of Directors.
The services offered by HSA include
- work place health and Safety services
- pre employment assessments
- overseas travel vaccinations and health advice
- medical assessment for government benefit and pension applicants
- medical assessments for immigration applicants
The primary service provided in Immigration Detention Centres is the medical assessment of detainees. These assessments are performed upon request from DIMIA and these examinations and findings are documented on DIMIA For UA26.
The DIMIA guidelines utilised to guide medical practitioners providing these assessments is "Guidelines for medical and radiological examinations of applicants for onshore-protection visas"
This document is "Sch4/4005/onshore protection doctor guidelines", in the Department of Immigration and Multicultural Affairs' Procedures Manual (PAM3)
It directs that officers deciding visa applications are not to regard any part of the document as a substitute for, or supplementing, instructions elsewhere in PAM 3:Sch4/4005
HSA does not generally provide services to persons in immigration detention not in a centre
INFORMATION ON IMMUNISATION SERVICES
Information on immunisation services to both adults and children would be appreciated, including the date such services commenced for all Immigration Detention Centres and Immigration Reception and Processing Centres
HSA understands DIMIA's service provider/s for detention centres (eg ACM) undertake such procedures and services.
HSA recommends such information on the provision of such services and commencement dates should be sought from DIMIA or such service providers
HEALTH ASSESSMENT BY HEALTH SERVICES AUSTRALIA
Reference has also been made in DIMIA's submission (p.61) to a second health assessment undertaken by Health Services Australia staff (the first being undertaken by the detention centres' service provider, ACM). Does this second assessment identify any disabilities and include recommendations on the appropriate treatment and services required, and whether such services should commence immediately?
HSA medical staff are required to conduct their assessments according to policies and procedures established by DIMIA.
HSA medical staff complete the DIMIA Form UA 26
"The purpose of the medical examination conducted is to determine the health status of the applicants so that the presence of tuberculosis and other medical disorders can be identified and handled appropriately" (Ref: Sch4/4005/onshore protection doctor guidelines in DIMIA PAM 3)
This form seeks information on medical conditions and these are recorded in accordance with "Guidelines for medical and radiological assessment of applicants for onshore -protection visas"
It is not generally HSA's role to recommend treatment and services required, except as per the DIMIA PAM 3 guidelines.
Where, at the examination for the purpose of completing UA26, disease is identified, and that disease requires attention, the medical staff responsible for primary care of the examinee are informed.
MEDICAL OFFICER OF THE COMMONWEALTH
At p.64 of DIMIA's submission, it is noted that where 'a Medical Officer of the Commonwealth' identifies a need for a 'health undertaking', this patient is referred via the Department's 'Health Undertaking Service' for further treatment. Are HSA staff 'Medical Officers of the Commonwealth'?
Medical Officer's of the Commonwealth from DIMIA's Health Assessment Service (HAS) have, to date, issued the "health undertakings" for persons in detention.
For information regarding such Health Undertakings you should contact the Health Assessment Service of DIMIA
HSA employs several medical practitioners appointed as "Medical Officer of the Commonwealth" but they do not perform the above role.
HEALTH UNDERTAKINGS
If so, would such undertakings only be made in respect of matters such as TB and hepatitis when the individual has been in detention for a short period? In other instances, given that detention is often for a considerable period, would treatment commence within the detention centre?
This inquiry would best be directed to DIMIA's "Health Assessment Service" as the HAS issues such undertakings.
STATE AND COMMONWEALTH OFFICERS ROLE
Are State or Commonwealth officers responsible for ensuring that people with hepatitis etc are not allowed t work in detention centre kitchens?
HSA recommends this question be directed to DIMIA , State and Commonwealth Health Departments, and the provider of such service involved in management of detention centre operations eg ACM.
HSA is not in a position to precisely identify the responsibility for such matters
DETENTION CENTRE KITCHENS AND FOOD SERVICES
Has Health Services Australia been asked to certify that detention centre kitchens and food services meet required standards, or is this undertaken purely by State authorities?
HSA does not certify standards for detention Centre kitchens nor is it part of HSA's remit to do so.
HSA suggests this question be directed to State or Commonwealth Health authorities or the DIMIA contractor providing these services .
RESTRICTIONS FOR TB
What restrictions on contact with others should be imposed for people with TB, hepatitis, and other communicable/notifiable diseases?
The restrictions and management for persons with such potentially communicable diseases vary depending on the individual disease and its infectivity Individual state health legislation is also relevant.
A general reference is available in the NHMRC publication
"The Australian Immunisation Handbook" prepared by the Commonwealth Department of Health and Aged Care. This may be of assistance.
Comprehensive information on each disease and information on medically indicated restrictions applicable, may be obtained from State Health Authorities
HEALTH ASSESSMENT SERVICES
Does HAS have any role in notifying such diseases or is this wholly the responsibility of ACM? (as is stated by DIMIA, Submission, p.62)
Notification of "notifiable diseases" resides with service provider staff of ACM (medical practitioner employed by ACM) in accordance with relevant State Health legislation.
FOLLOW UP OF DETAINEES
Does Health Services Australia have any follow-up role with respect to people in immigration detention centres - for example, would it ensure that required disability support, including appliances, was provided?
HSA has not had a role in "follow up" with respect of people in immigration detention centres.HSA has not been involved in ensuring that disability support including appliances were provided.
HEALTH STANDARDS FOR VISAS
Could you also state what is required in terms of health standards for persons on a visitor's visa. If this varies according to the country of residence of the intending visitor, or the length of the visa, can you identify variations.
This information is comprehensively documented in DIMIA PAM 3;Schedule 4/4005A chapter of this document entitled "The Health Assessment Framework" provides a summary in a table format which will be of assistance regarding this inquiry.
HEALTH STANDARDS FOR VISAS
Could you briefly outline the health tests that must be completed, and the basic standard of health to be met by persons seeking to spend more than 12 months in Australia, including those migrating.
The tests and criteria vary with age of applicant , country of origin and type of visa sought
The detailed answer to this question is contained in the DIMIA Procedures Advice Manual 3;Sch4/400 "The Health Requirement"
HSA advises that this information may be sought from the "Health Assessment Service" of DIMIA
Last Updated 10 October 2002.
