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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.