AMA shocked by disbanding of Immigration Health Advisory Group (IHAG)

Dr Hambleton said that with the high numbers of people seeking asylum in Australia in recent years – and a high incidence of poor health, especially mental health, among the asylum seeker population – there is a greater need for specialised medical care and advice.

“The health and mental health conditions that asylum seekers experience are often multiple and complex, and the Immigration Department needs to avail itself of sound health and medical advice from a number of disciplines,” Dr Hambleton said.

“IHAG had the capacity to provide this sort of advice. It is regrettable that the Department has disbanded this group.

“The Government and the Department now have a major challenge in understanding and dealing with complex health conditions in difficult circumstances without the benefit of the expert advice of the highly qualified and respected IHAG members.”

The AMA had called on the former Government to establish a truly independent medical panel to oversee and report regularly on the health services available to asylum seekers in immigration detention facilities, both onshore and offshore.  The AMA proposed that the Panel would be above the bureaucracy and would report regularly to the Parliament, the Prime Minister, and relevant Ministers.

“This is a health and social justice issue. We must ensure that desperate people seeking a better and safer life have access to quality health services,” Dr Hambleton said.

Dr Hambleton said that the Government should now seriously consider this AMA proposal in light of the disbanding of IHAG.

The AMA is also highlighting the ethical guidelines relating to doctors responsible for providing advice on the health of asylum seekers, which include:

• doctors in higher level policy or bureaucratic roles must be afforded the professional autonomy and clinical independence to make objective judgements and recommendations regarding the health of asylum seekers without undue influence by governments or other outside parties;
• doctors and their health care teams should be afforded reasonable access to assess detention (and relevant) environments, and asylum seeker health, and make relevant recommendations;
• the recommendations of health care teams and relevant policy groups should be transparent and the government should be accountable for responding to such advice;
• doctors who are also government employees or contractors working on asylum seeker policy groups may face competing obligations between their role as medical professionals and their obligation to the government (as employees or as members of government-appointed groups). The medical profession expects all doctors in such roles to prioritise the health interests of asylum seekers and the wider community first above any other competing interests. This principle applies to treating doctors as well as to doctors in higher level policy or bureaucratic roles.

The following 'ethics-based' AMA Position Statements and adopted policies are relevant to this issue:

• Medical Ethics in Custodial Settings 2013 - https://ama.com.au/position-statement/medical-ethics-custodial-settings-2013
• World Medical Association Declaration of Seoul on Professional Autonomy and Clinical Independence - http://www.wma.net/en/30publications/10policies/a30/
• World Medical Association. Declaration of Tokyo. Guidelines for Physicians Concerning Torture and other Cruel, Inhuman or Degrading Treatment or Punishment in Relation to Detention and Imprisonment -http://www.wma.net/en/30publications/10policies/c18/

16 December 2013

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