Australian College of Nursing expresses serious concerns about the fragmented health care in immigration detention centres
In light of the tragic chain of events that contributed to the death of young asylum seeker Hamid Khazaei, as revealed by the Four Corners program, the Australian College of Nursing (ACN) reiterates its views on the health care of people in onshore and offshore Australian Immigration Detention Centres. The Australian College of Nursing also has grave concerns regarding the moral and ethical rights and obligations of the healthcare professionals providing care.

Four Corners has highlighted the inadequacies in the clinical management and delayed transfer of this young man, which played a significant role in his death. ACN advocates for the provision of equitable health care that includes culturally appropriate holistic health care. Access to comprehensive health care should be available to all persons regardless of visa status.

ACN recommends the Australian Government review how refugee and asylum seeker healthcare is delivered in on-shore and offshore detention centres and in the community to ensure it meets healthcare standards available to all Australians. The standards of health care that is provided for refugees and asylum seekers should be publicly available as should performance data on health outcomes achieved for this population.

ACN stands united with our medical colleagues and other health professionals that work in the area on this issue and calls on the Australian Government to conduct an open, transparent review into the health management of this vulnerable population which ensures no other person suffers the same fate as Hamid.

An open and transparent review can only be realised if the doctors and nurses employed by the contracted health provider, are granted exception from the Australian Border Force Act 2015 (the Act), which prescribes a penalty of 2 years jail for the disclosure of protected information.

Nurses play an integral role in caring for asylum seekers in health facilities, both in Australia and in Nauru and Papua New Guinea. To provide expert and professional care, nurses must be able to uphold standards that ensure the delivery of high quality health care and be enabled to speak up when care is compromised, especially when people’s lives are put at risk. The Act undermines the ability of nurses to fulfil their professional and ethical obligations under both the Code of Professional Conduct and Code of Ethics for nurses in Australia. “These Codes outline the minimum standards nurses are expected to uphold placing nurses in an impossible position,” stated Adjunct Professor Kylie Ward, CEO of the Australian College of Nursing.

As frontline health professionals nurses may be the only advocates available to persons in detention. Section 42 of the Act prescribes a penalty of two years imprisonment should a person working directly or indirectly for the Department of Immigration and Border Protection (an entrusted person) disclose protected information regarding events that occur within detention facilities.

Nurses are therefore prohibited from disclosing information regarding access and quality of health care and information detailing issues which may put people’s physical and mental health at risk including sexual abuse, violence or the presence of inadequate living conditions.

Furthermore, as the Australian member on the International Council of Nursing (ICN) the Australian College of Nursing believes the Act is also inconsistent with the ICN Code of Ethics for Nurses.

“Refugees and asylum seekers are often plagued by poor health status arising from poorly managed chronic disease and psychological issues, coupled with the consequences of physical and sexual violence. Australian College of Nursing believes that the nursing profession has a moral obligation to protect the human rights of refugees’ and asylum seekers’. Changes to the Act must be made to ensure nurses working within the immigration detention environment can fulfil their professional obligations without the fear of being prosecuted,” Adjunct Professor Ward said.