AMA Psychiatrist Representative on IHAG,Dr Choong-Siew Yong, ABC 666

ROSS SOLLY: Well, you may have heard in AM this morning the news that the Federal Government has basically ripped the heart out, have gutted, the independent body that oversees asylum seekers' mental health or health. This comes off the back of new research which is showing that half of all detainees have been taken to hospital emergency wards, most commonly for psychiatric illnesses and self harm.
 
Dr Choong-Siew Yong is a member of the Health Advisory Group - the Immigration Health Advisory Group, although I'm not sure that he still is a member of that group.
 
Dr Yong, good to have you on the show again.
 
CHOONG-SIEW YONG: Good morning.
 
ROSS SOLLY: So are you still a member of that group technically or not?
 
CHOONG-SIEW YONG: No, the group's been disbanded as we were informed by the department, so it no longer exists.
 
ROSS SOLLY: Were you surprised to receive this letter on Friday?
 
CHOONG-SIEW YONG: Well, we had no previous warning about it. There had been pretty much an agenda each year of looking at various detention centres and advising the Immigration Department on lots of matters concerning health services and provision.
 
ROSS SOLLY: What reasons were given for the group being disbanded?
 
CHOONG-SIEW YONG: It's not clear to me why it was disbanded, actually. It's just, I think - the reason given to me was that they just reviewed the need for it and they started to appoint a single adviser rather than a group. And that's a concern to the AMA, which has been expressing concerns for many years about the provision of healthcare to immigration detainees, particularly children and families. And this group at least allowed a professional group, like the AMA and the psychologists, the nurses, psychiatrists, and GPs in particular, to have input and provide advice to the department around how it should have a best practice model of healthcare.
 
ROSS SOLLY: We put a request in to the Minister, Scott Morrison, but we didn't even get a reply, let alone a knock-back, so obviously he's not going to talk to us today, but I'll read a statement out that he has given to one of the newspapers. He says that the group has a large membership and this has made it increasingly challenging to provide balanced, consistent, and timely advice in a fast moving policy and operational environment. Fair call?
 
CHOONG-SIEW YONG: Well, we were always conscious that things change rapidly and I think most of us as members were quite prepared to have a quick turnaround of advice and...
 
ROSS SOLLY: Had it become unwieldy though, do you think?
 
CHOONG-SIEW YONG: I don't believe so. I think we worked particularly well as a group. We've worked together, many of the members had been there for several years, and it represented, I think, people with specific interests and expertise in the area of asylum seeker health. People who - some of our members had been involved in providing services directly and others had been involved in research in the area. So it was a good high level of expertise in the group that allowed the department to very quickly, I think, the best possible advice for the various different things that were occurring in the health policy area.
 
ROSS SOLLY: Scott Morrison, though, seems to think that the advice you were given maybe lacked a bit of consistency and balance. Do you think that is fair? I mean, did you have problems coming to an agreed position?
 
CHOONG-SIEW YONG: I don't believe so. I think we worked very well. Most of the professional groups and they're the bulk of the members on the committee, so people from, for instance, the AMA, myself, College of Psychiatrists, College of Nursing, the Psychological Society, College of GPs. I think our organisation has got very similar views on what their needs were and what the issues were in terms of providing adequate, good healthcare and realistically in the sort of changing policy environment.
 
But one of the things that made it difficult was the fact that government frequently changed this policy on the area and, of course, the department then had to try and respond to the changes in policies, such having detention centres overseas, having detention centres in Australia, the differences in the states of detainees in terms of whether they were able to get a refugee visa or not, and so on. So that, I think, made it particularly challenging for the department.
 
ROSS SOLLY: So your group has been replaced by your chairman, I understand, Paul Alexander, who now will be the sole arbiter on these sorts of issues. Do you have faith in him being able to carry out the job or is it too bad for one person and is he the man to do it?
 
CHOONG-SIEW YONG: Well, I can't really comment on Dr Alexander's individual expertise, but I will say that if - what we're disappointed in I think is the opportunity for our professional group to have input and through our group we were able to access expertise elsewhere. So we co-opted other experts in to provide specific advice when needed, such as when we were setting some of the mental health model for care and practice, so that's, I think, something that will be more challenging with the input of those people around the table.
 
ROSS SOLLY: So are you saying that there is no way that one person could have all the expertise needed to analyse the whole range of problems that that may present?
 
CHOONG-SIEW YONG: I would expect that Dr Alexander will probably call on various individual medical and other health professional experts as he sees fit. So I don't think he'd be thinking of putting in all the information himself. I think - but the challenge will be that there won't be the input of those professional organisations which have larger networks and wide expertise.
 
The other concern for us is that one of the things that we were able to do was to try and at least bring some of the concerns of our members, these are practising doctors, psychologists, specialists who are providing healthcare to asylum seekers and we're bringing back to our organisations their concerns about deficits they saw in the healthcare. We were able to factor those things into the equation.
 
ROSS SOLLY: Of course, these are real people we're talking about here. Real people who come to Australia or try and get to Australia and obviously some of them present themselves here with problems. Are you concerned at all about where this might leave those people?
 
CHOONG-SIEW YONG: I think we're very concerned about the challenge in the current environment. One of the things if people do come with their own health problems to Australia and will need some screening and possibly if they're urgent issues, will need treatment. But what we're particularly concerned about is the research that shows that the longer people are in detention and the uncertainty of the immigration detention environment, which is not like, for instance, being a convicted criminal in the criminal justice system, the problem with the immigration system is that the length that you might be detained and the uncertainty about your outcome.
 
And the research is very clear that the longer that you're in detention and the greater the uncertainty, the greater the possible psychological harm and the - and we're seeing, you know, many of these people, as you pointed out, presenting with psychological and psychiatric problems, some of which are probably attributable to the actual detention and detention environment.
 
ROSS SOLLY: Can I ask you to - and I am asking you to speculate here - but what do you think, in your heart of hearts, Choong-Siew Yong, what do you think is the reason behind this sudden announcement on Friday, this sudden dismissal by letter of an entire panel?
 
CHOONG-SIEW YONG: I suspect it's in keeping with the current policy of maintaining the whole system in house, so within the government, if you like, similar to the way in which information about boat arrivals and what happens with boat arrivals is now done on a weekly basis at a briefing with limited information, so I guess the - my guess would be that the department is, and the government is wanting to manage all of this within its own sort of borders, if you like, rather than to have external groups involved with it.
 
ROSS SOLLY: What, do you think they might have been worried that loose lips - that there might have been too many loose lips at play here?
 
CHOONG-SIEW YONG: I don't know. I'm - all I can say is that it seems consistent with the other policies around information provision to the media and to the public. And as we said that, I think that's - we're disappointed from the AMA because we've had concerns brought to us by our members who work in the field.
 
ROSS SOLLY: Okay. Well, we'll watch this unfold, I am sure. As I said, we did put a request in to Scott Morrison, the Minister, to see if he would talk to us, but unfortunately they didn't even give us a knock back, let alone reply to our request. But thank you for taking some time to talk to us, Dr Yong, this morning.
 
CHOONG-SIEW YONG: You're very welcome.
 
ROSS SOLLY: Thank you.
Dr Choong-Siew Yong, who was a member until Friday of the Immigration Health Advisory Group.

16 December 2013

 CONTACT:    John Flannery              02 6270 5477 / 0419 494 761
                        Kirsty Waterford        02 6270 5464 / 0427 209 753