A secretive Department of Home Affairs task force charged with deciding the fate of sick refugees on Nauru and Manus Island was in place to avoid bringing people to Australia and undermine medical recommendations, according to a doctor who worked on Nauru.
Dr Nick Martin spent nearly a year on Nauru as a senior medical officer with International Health & Medical Services (IHMS), which is contracted by the Australian government to provide healthcare on Nauru.
"I would recommend someone be transferred. It would then be seen by at least two other doctors senior to me in Sydney who would agree, clinically, and to be fair with them they would never disagree with me,” he said.
“By the time these cases go to Australian Border Force, they’ve already had IHMS signing off on them, basically. So all I can see that committee does, is only ever going to be, 'no they can’t go'."
BuzzFeed News yesterday published heavily redacted minutes of over a year’s worth of meetings of the Transitory Persons Committee, obtained through FOI. It is the first look at how decisions are made within the Australian government about whether to bring sick refugees to Australia for healthcare.
The committee’s members are senior bureaucrats in the Department of Home Affairs. For months there was no member with a medical background, as the position of chief medical officer in the department was left vacant. A spokesperson for the department said that the committee considers cases where, in the opinion of their treating physician in Nauru or Papua New Guinea, the medical condition of the person is unable to be treated by contracted service providers or the local health service.
After reading the documents, Martin said that the committee’s mindset was to try to avoid bringing refugees to Australia. “They’re certainly not listening to doctors,” he said.
“They’re coming at it from the position of, what can we do to keep this person out of Australia? That a dangerous point to start off from,” he said.
The minutes record that the committee’s chair, Elizabeth Hampton, suggested providing treatment for complex cases on a Royal Australian Navy ship.
"A decision is not made to refuse a transfer, but a transfer may be deferred until recommended treatment options have been explored and any barriers have been addressed," the department's spokesperson said in a statement. "At times it is possible to provide the required service in Nauru or PNG via visiting medical specialists."
“It looks like it was there to truly and solely enforce the policy of the government at the time, which was to show no compassion and ensure no people could come to Australia,” Martin said.
The minutes show that at a meeting in June this year the committee members discussed whether “compassion” could be shown. In relation to the same case, the committee heard it was preferable to avoid “close scrutiny” because there was a two-week period in which it was unclear how the case was managed. “If this matter goes to court the dates and actions will all be examined”, the minutes said.
Martin confirmed that, to the best of his knowledge, the case discussed in that meeting was that of an Afghan refugee on Nauru who was dying of advanced lung cancer and needed palliative care. The man was diagnosed in April but was not brought to Australia until June. In the meantime, the Australian government had tried to send him to Taiwan, where he knew nobody and where there is no Hazara community.
Martin described the delay as “bureaucracy and policy getting in the way of his medical treatment”.
In October last year, senior Home Affairs official Kingsley Woodford-Smith told Senate Estimates that the committee made its decisions “only” on the basis of medical advice. However, Martin told BuzzFeed News that the list of people attending the committee's meetings – including lawyers and public servants overseeing contracts – shows their considerations were broader than that.
Martin said that while he knew the committee existed, he was “never allowed to approach them directly”. He described recommending that patients be evacuated from Nauru and, when asking for an update, he would be told, “it’s gone to a meeting, it’s gone to a delegate”.
The minutes also show that IHMS’s regular advice to the government from mid-2018 was that the environment of Nauru was causing ill health among the refugees and asylum seekers detained there.
As someone who worked on Nauru, Martin’s reaction on seeing the committee minutes was: “It does not surprise me in the least.”