here to return to the Submission Index
Submission to the National
Inquiry into Children in Immigration Detention from
Health Services Australia
INFORMATION REGARDING FUNCTIONS
OF HEALTH SERVICES AUSTRALIA
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
- 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
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
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
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
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
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
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'?
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
HSA employs several
medical practitioners appointed as "Medical Officer of the Commonwealth"
but they do not perform the above role.
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
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
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
on contact with others should be imposed for people with TB, hepatitis,
and other communicable/notifiable diseases?
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
Immunisation Handbook" prepared by the Commonwealth Department of
Health and Aged Care. This may be of assistance.
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.
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
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"
Updated 10 October 2002.