Evidence, Incidents and Attributions

EVIDENCE OF DIBP/ABF OBSTRUCTING
OFFSHORE MEDICAL TRANSFERS (2013-2018)

About this page: A collection of publicly available evidence in regards to the Australian Border Force (ABF) obstructing and interfering in health care procedures of asylum-seekers held on Manus Island and Nauru. The pieces of evidence suggest, the DIBP/ABF at Minister and Departmental Secretary levels had given directives to intervene offshore medical transfers. The earliest evidence is indicating a secrect DIBP directive to intervene existed since late 2013 (VE_011). The documented written evidence of such order covering for period of 2015-2018 (PE_003), where Minister Peter Dutton and Secretary Michael Pezzullo were in charge of those positions.

Purpose of this work: Firstly, to establish beyond any reasonable doubts that the DIBP/ABF, through IHMS, have made intervention on health care procedures of asylum-seekers. Second, in so doing such intervention, to determine whether there were manifestations of DIBP/ABF exercising any or all powers attaching to the right of ownership over these asylum-seekers.

Content of this page covered by Creative Commons Open License 4.0.

DETENTION SLAVERY AT ADMINISTRATIVE AND POLICY LEVEL

Discussion Live Updates
(March-June 2021 )

OFFSHORE DEATHS, DETENTION SLAVERY AND ICC LEGAL CONTEXTS

[VE_011] DR SANGGARAN ET AL EVIDENCE: THE CHRISTMAS ISLAND DOCTORS' LETTER OF CONCERN

In November 2013, the Medical Director of IHMS had asked the doctors deployed on Christmas Island Detention Center to comment on the standards of medical care provided at the Center. In response, Dr John-Paul Sanggaran and 15 other colleagues had given written reply which had raised concerns especially with gross deperture from generally accepted medical standards at the Center. This letter has been based on accounts of the doctors consisting documented case reports. Outlined concerns include:

• Rapid 48hr processing for initial health assessment: Patients are cleared on the basis of an ineffective assessment and without pathology;
• IHMS management interfering doctor's clinical autonomy: Patients requiring urgent transfer to the mainland are not being sent;
• Conflict of interest as a result of IHMS’ relationship with the Department of Immigration and Border Protection: The decisions by IHMS were not always made in the best interest of patients.

As of late 2013, the doctors at Christmas Island Center are alarming about the trend on "shifting of responsibility" between DIBP and IHMS which may result neither party acting appropriately in regards to the health care of patients.

The doctors' letter had reminded IHMS management about Australian doctors' mandatory reporting obligations when faced with a reasonable belief there has been the departure from generally accepted professional standards.

This Christmas Island doctors' letter has been a landmark evidence that there were the DIBP and IHMS interventions on asylum-seekers health care on late 2013. Such practice of DIBP/IHMS interventions on medical care can continue without any restraint at the offshore asylum-processing centers in PNG and Nauru.

[PE_010] DIBP/ABF, ROLES OF DR BRAYLEY, MR NOCKELS, COMM. WOODFORD-SMITH:

The 30-Aug-2017 meeting minutes of Transitory Person Complex Case Committee (TPC) reveals the names, ranks and their responsible roles in regards to offshore medical evacuations. The minutes Item 2.1 (5) states: "DN clarified the TPC process with the decision sitting with the Department. He described the rationale for the TPC committee and the function of each member role; JB to advise on clinical aspect, DN to oversee contracts and. expenditure, KWS to make the formal decision, LH to consider the approval of accompanying family member/s and to lead the formal operational process of the medical movement." Significantly, this is probably the last meeting Dr Brayley had attended this TPC Committee; Dr Brayley resigned from his ABF post on 8-Sep-2017.

We can therefore conclude that following persons have key responsibilities in offshore medical movements.

1. Mr. Kingsly Woodford-Smith, Assistant Commissioner, Detention & Offshore Operations Command (Active/In-active date unknown)
2. Dr. John Brayley, First Assistant Secretary, Health Services & Policy Division, Surgeon-General ABF (Joined: 18-Sep-2015; Resigned: 8-Sep-2017)
3. Mr. David Knockles, First Assistant Secretary, Detention Services Division (Joined: 4-Apr-2016; Active)

[AE_009] HON. MELISSA PARKE EVIDENCE ON MIGRATION AMENDMENT s198AHA, PRE-2015 OFFSHORE PROCESSING REGIME AND PE_003 CONNECTION.

The coincidence of the dates, i.e 24-Jun-2015, of the issuance of immigration directive PE_003 and the Parliament passing the s198AHA amendment to Migration Act of 1958(Cth) does suggest a direct link between these two issues. The Amendment s198AHA was passed through both Houses of Parliament within a day, of which even a casual readers of that amendment could have noticed a rather unusual and broad powers that have allocated for offshore processing operations. The Hon. Melissa Parke, a Labour Members for Fremantal WA, had spoken out about her suspicion on this bill:

.... But this bill is much broader than the Williams case. Through extremely broad wording allowing the taking of any action and the doing of anything incidental to such action, among other clauses, the government now seeks to retrospectively validate the detention of asylum seekers and indeed potentially all the actions and arrangements in offshore detention centres that have occurred since August 2012.

At that time in Jun-2015, the government's offshore processing scheme was still much in secrecy; and there was the death on Manus Island of refugee Hamid Khazaei in September 2014. Most members of Parliament were still in the dark about what government was doing at offshore. This parliamentary record has been an anecdotal evidence as to possible existence of the the government secret order, similar to PE_003, so as to obstruct/discourage asylum-seeker patients reaching to mainland Australia.

[AE_008] ABF-TALKING POINT ON DEATH OF FAYSAL ISHAK AHMED (DEC-2016)

On 15th December 2016, Manus Island refugee Faysal Ishak Ahmed put forward his last medical request to IHMS, stating "Don't wait treating me". Faysal was known to have been suffering from high blood pressure, chest and neck pains and have reported his illnesses to the IHMS clinic more than 20 times, where no action had been taken by IHMS. A week after filling up final medical request, Faysal collapsed on 22nd of December 2016. He was airlifted to Brisbane hospital and died on 24/12/2016.

The ABF and IHMS were aware about deteriorating health of Faysal Ishak Ahmed. In the internal email on 28/12/2016, the IHMS confirmed that they had previously received requests from Faysal. When Faysal Ahmed on death-bed had been brought to Brisbane hospital by air-ambulance, the ABF was already busy managing public media for Faysal's eventual death. It is clear that ABF and IHMS were neglecting Faysal's deteriorating health, undertaking the Departmental Secretary's 24-Jun-2015 directive (PE_003) "transfers to Australia should be avoided as a general rule and should in any event become increasingly rare". Whilst the IHMS had failed to escalate health request made by Faysal Ahmed, the ABF was ready to obstruct should any such request being escalated. Noticeable also that ABF Chief Medical Officer Dr John Brayley did not give clearance to the ABF internal TP. As of June 2021, there has been NO indication as to Queensland Coroner may start an inquest on the death of Faysal Ishak Ahmed.

[VE_007] ABF/(FMR) COMMISSIONER ROMAN QUAEDVLIEG EVIDENCE

Roman Quaedvlieg, the Former Commissioner of ABF, "unequivocally agreed" that there had been the ABF obstruction on medical transfers. A distinguished Officer in AFP, Mr Quaedvlieg joined the Australian Customs and Border Protection Service (ACBPS) as deputy chief executive officer in 2013. In October 2014, he succeeded Mike Pezzullo as chief executive officer. With the introduction of Australian Border Force (ABF) in 2015, Mr Quaedvlieg became the inaugural Commissioner of the Australian Border Force. I'd put his conversation with Dr Nick Martin that appeared in the 26/4/2018 article in The Guardian as "verifiable evidence".

[PE_006] IHMS/DR PETER YOUNG EVIDENCE

Dr Peter Young worked as the IHMS medical director for mental health since 2011 (resigned 2014). He testified before the Senate Inquiry in June 2015 that there have been DIBP intervention on the way IHMS doctors and psychiatrists reporting incidents. Dr Young testify an incident of a Fijian registered doctor, deployed by Nauruan Hospital, performed a botched operation upon a refugee. The refugee was evacuated to Australia after having serious post-surgical complications. The DIBP told IHMS (not Dr Young's section) to suppress that medical report. Dr Young also testified that DIBP routinely delayed taking actions on the Request for Medical Movement; rewrite 'urgency levels' and 'prospective dates'. Remember that in 2015, all the DIBP conduct in relation to offshore processing centres had been surrounded by much secrecy and, only in late 2018 it has come to light ( i.e. PE_003 ) that these medical intervention were being orchestrated at the top levels of DIBP.

[PE_005] DIBP/ABF DR JOHN BRAYLEY

The meeting minutes of "Transitory Persons Complex Case Review Committee" on 26-May-2017 indicate a continued operation of the directives (see PE_003) given by Departmental Secretary in 2015. Meeting note described an attempt to modify existing offshore medical transfer policy and practices had been resisted as: " Item 2.1 (5) JB provided update on policy for medical transfers. Policy hasn’t been signed off by Secretary yet. Note from Secretary says more consultation required. Until new policy is approved, revert to Secretary’s 2015 directive. " JB refers to Dr John Brayley, formerly a well known detention health advocate from South Australia who had joined DIBP on late 2015. Dr Brayley resigned from his post on September 2017 for unknown reasons. What is certain by this evidence is that the Secretary Pezzulo's 2015 offshore medical transfer directives has continued operating as of until May 2017, and, perhaps until August 2018.

[PE_004] DIBP/FAS, MR DAVID NOCKELS EVIDENCE

In April 2016, in the HCA court case s99/2016, a young African refugee on Nauru who wanted to have abortion was sent to Pacific International Hospital in PNG. The pregnant woman had complex neurological condition and also suffering from severe depression. The PIH did not have necessary medical equipment and it is time sensitive to have taken this medical procedure. Mr Nockels, First Assistant Secretary of DIBP, decided against bringing this woman to Australia, despite recommendations made by medical experts as well as IHMS (see 400-402 of evidence before the Judge). Mr Nockels had even set aside the Department's original directive for allowing those refugees who have 'compelling medical reason involving injury and disability' as 'exceptional circumstances' , and sought to obstruct that pregnant woman reaching Australia. This evidence indicates that the superior order to obstruct overseas medical transfers being given by the Minister and DIBP Secretary was undertaken; where the subordinate Mr Nockels implementation of the order exceeds top level DIBP instructions. (see s99/2016 judgment for details)

[PE_003] DIBP SECRETARY PEZZULO EVIDENCE

In the meeting minutes of DIBP Support Group in December 2017, the Departmental Secretary had given directives in 2015 to limits medical transfer "only on life or death" situation (excerpt):
"(24-Jun-2015) Secretary Directive stating 'unless there are compelling medical reasons, supported by second opinions, to do with life and death situations, or situations involving the risk of life time injury or disability, transfers to Australia should be avoided as a general rule and should in any event become increasingly rare.'".

[PE_002] THE EXTENT OF DIBP INTERVENTION ON MEDICAL TRANSFER

The LNP intention to obstruct medical transfer, as explained above, had existed since August 2013. The large-scale reduction in medical transfer, however, was observed as of 2015. The apparent fall in total number of medical transfer during financial year 2016 and 2017, despite expected increase in sickness of offshore asylum-seekers. This indicates a more coordinated effort by DIBP/ABF at high level to intervene offshore medical transfers after 2015.

[AE_001] DR LOUISE NEWMAN EVIDENCE

In 2014, Dr Louise Newman, a psychiatric who worked at Immigration Detention Health Advisory Group (Ihag)told The Guardian about changing health care policy under LNP government. At the last meeting of Ihag in August 2013, the issue was debated at length. An impasse was reached, says Newman. “The department at a very high level from secretary down argues the Australian government is not obliged to provide our standard of care to these people[asylum-seekers]." And "Clinicians who goes along with [arrangement] are absolutely compromised."