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18 Oct 2018

Transcript:   AMA President, Dr Tony Bartone, Radio National, Breakfast with Fran Kelly, Thursday, 18 October 2018

Subject:   Health care of asylum seekers on Nauru


FRAN KELLY:   Well, pressure is mounting on the Morrison Government as humanitarian and medical groups warn the health of refugees and asylum seekers on Nauru has dangerously deteriorated. And yesterday the senior Australian doctor contracted to provide medical care on Nauru was arrested by police and deported. The sudden removal came less than a week after humanitarian group Médecins Sans Frontières confirmed that its staff had been kicked off Nauru by the country's government. Doctors in Australia have been watching these developments with growing concern. Last night, the President of the AMA, Dr Tony Bartone, met with the Shadow Immigration Minister, Shayne Neumann, to discuss legislation Labor says will help children on the island get the urgent medical care that they need.

Tony Bartone is in our Parliament House studio. Tony Bartone, welcome back to Breakfast.

TONY BARTONE:   Good morning, Fran.

FRAN KELLY:   I want to come to your meeting with Labor in a moment, but first the news from Nauru in the last 24 hours that the senior medical officer for the health contractor IHMS, which is funded by Australia, Dr Nicole Montana, was deported from Nauru last night. Are you concerned by this?

TONY BARTONE:   This is extremely concerning news that we've received and really points to crisis upon crisis on the island continuing to develop. It highlights the confusion and chaos around the medical treatment being provided to a group of very vulnerable people and various stages of medical care required on their behalf.

FRAN KELLY:   Dr Montana, as I understand it, is the second senior medical officer for IHMS deported in the last couple of months. In a statement, the Government of Nauru said it's fake news that Dr Montana was arrested and deported, and yet others have reported seeing her in handcuffs. Have you been able to speak with IHMS or Dr Montana about what did happen?

TONY BARTONE:   At this stage, I haven't, but you're right, it does point to a very concerning and confusing state of affairs and highlights the urgent need for a solution to this ongoing evolving humanitarian crisis.

FRAN KELLY:   A report suggests - an IHMS report claims, in fact, that Dr Montana was stood, turned down because she breached the rules of the processing centre and it's understood it's because she took a photo of a child being treated at the regional processing centre. What's your view on that? Taking a photograph of someone being treated, is that a sacking offence? Do you understand why she might have been doing that?

TONY BARTONE:   Taking photos of our patients is acceptable and it's an express part of provisional clinical care with - obviously with the patient's consent. Clinical photography involves a significant body of work which is involved in the delivery of that care. I can understand why the doctor might have been taking a photo of said child but, irrespective, it's not the kind of evidence or occasion that really should require the immediate deportation of someone entrusted to provide medical sovereignty and independence over that care to a group of very vulnerable people.

FRAN KELLY:   Another, this is a third IHMS chief medical officer, Dr Nick Martin, he was kicked off too, he says the government in Nauru is paranoid and increasingly paranoid about bad press. What's the position of the AMA? Should doctors working on Nauru be free to speak to the media about their experiences? What do you think?

TONY BARTONE:   What we're very clear about is that doctors working on Nauru, or any other processing centre, should be able to deliver the best care, the best appropriate care required by their patients. These people are under the care entrusted to the Australian Government, they are responsible for their health and wellbeing while in those centres, and they need to ensure that the provision of medical care is foremost unimpeded in that process. Now the processes and the regulations around that I'll leave to the authorities, but the doctors should be able to deliver their care unhindered and unencumbered.

FRAN KELLY:    And given IHMS, as you say, is the company contracted by the Australian Government to provide the health services, do you think the Government's doing enough to stand up for their doctors?

TONY BARTONE:   Well, this is part of the ongoing advocacy on our part. We've called on the Australian Government to ensure that their medical care is being provided, to allow an independent delegation of Australian medical professionals to visit the island, and assure with the transparency and the independence to the Australian public that that care is being delivered appropriately in the facilities we're talking about.

FRANK KELLY:   That's a proposal you put to the Government a few weeks ago, I think I'm right. Have you had a response yet from the Prime Minister on that?

TONY BARTONE:   As has been publicly reported, not as yet. But this remains an ongoing piece of advocacy on our front. We need a solution in this area. We need a solution which brings to a head this ongoing crisis. We're talking about the lives of children, in particular, many in very, very serious states of urgent medical care requirement, and we really do need to know that every day that goes by is another day of suffering for these children in particular.

FRAN KELLY:   Dr Bartone, the AMA doesn't lightly get involved in political issues and some would say the AMA was a bit slow to take a strong stand against the treatment of particularly children on offshore detention, but in recent weeks certainly you've made these- put these proposals to the Government to do something. There's been, in a sense, many of your members, many thousands of doctors have signed letters sent to the Government demanding that children and their families who are in need of urgent health care be removed from the island.

Are you saying the Government's not talking to you about this?

TONY BARTONE:   What we're saying is the Government and the appropriate department there is remaining steadfast with the lack of transparency in the approaches, in the information sharing. The information flow is very, very slow, very, very guarded, and very, very piecemeal when it does come our way. This is unacceptable obviously. We've said on many occasions and, Fran, let me just clarify that: our position on the refugees on the various facilities has been part of our advocacy for the best part of more than two years and even as recent as August, our Federal Council reaffirmed its position and then when the open letter to the Prime Minister and every Parliamentarian that I penned in the middle of September. This is an issue that we will continue to be very, very clear and forthright and front on with the Government. They need to have a solution which sees the health and welfare of these vulnerable people attended to as a matter of priority.

FRAN KELLY:   So you've met with Labor - I suppose in the absence of meetings with the Government - you've met with Labor last night, as I understand it, over legislation Labor says will make the advice of clinicians on Nauru, the primary factor determining whether a child is sent from the island to Australia for treatment. Labor wants to make the Minister the final decision-maker to speed up that process. Does the AMA support Labor's proposal?

TONY BARTONE:   What we're seeing in the Labor proposal is the most pragmatic achievable attempt to try and get a legislative solution to this problem, in the absence of any other formidable or meaningful approaches from the Government. This approach, this legislation will seek to both reduce the bureaucratic process in this transfer, increase the transparency, increase the medical decision-making powers, and increase the independent medical oversight of the whole medical treatment process on the facilities, in those processing centres, and ensure that vulnerable children, in particular, but anyone who requires urgent medical attention is afforded that care, appropriate care, before they get too far down the track.

FRAN KELLY:   So the AMA is supporting the Labor proposal, even giving the Minister the final decision?

TONY BARTONE:   What we know is that if the Minister has the final decision, that needs to be independently verified by a second medical doctor within 24 hours of that decision. That both speeds up the process of the decision-making capacity and it would be a very, very brave Minister who would refuse the advice of two treating doctors, independent, and then have to report back to Parliament in a transparent way to the Australian public that that decision was not proceeded with.

FRAN KELLY:   Okay, so the AMA's backing the Labor proposal.

TONY BARTONE:   We are.

FRAN KELLY:   Tony Bartone, thank you very much for joining us. Dr Tony Bartone is the President of the AMA.

And I should say as a postscript to that interview that we did approach the Minister, Immigration Minister, David Coleman, for an interview but he was unavailable.

18 October 2018

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Published: 18 Oct 2018