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AMA demands independent oversight of child detainee care

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The AMA and other medical organisations have stepped up their demand that an independent group of doctors be appointed to oversee the treatment of children being held in immigration detention amid disturbing accounts of poor treatment and neglect.

An Australian Human Rights Commission inquiry has been told that children being detained had all medication and medical devices, including hearing aids and glasses, removed and not replaced, and that detention centres lacked basic medical equipment and pharmaceuticals.

The hearing also heard serious claims from Dr Peter Young, the former director of mental health services at detention centre service provider International Health and Mental Services (IHMS), that the Immigration Department sought to suppress information about the extent of mental health problems among detainees on Christmas Island.

Dr Young said the Immigration Department had asked IHMS to withdraw damning statistics about the mental health rates of children in detention.

“The level of acceptance that the environment is the factor that has led to the condition, or is preventing the effectiveness of treatment, is often strongly opposed, and we’ve been told at times that it is unacceptable to state that,” he said at the hearing.

The evidence came as the AMA, the Royal Australian College of General Practitioners and the Royal Australian and New Zealand College of Psychiatrists voiced alarm about the detention of children, and the conditions under which they are being held.

Former AMA NT President and Royal Darwin Hospital paediatrician Dr Paul Bauert said the continued detention of children, and official secrecy surrounding their treatment, was “really worrying”.

“I do not feel these children are being adequately treated, and not at the same standards as the way Australian children are being treated and should be treated,” Dr Bauert told Fairfax Media.

The RACGP said standards for general practice were not being adhered to, and refuted Immigration Department claims that they were.

The RANZCP voiced alarm that IHMS had been instructed to hold back mental health statistics. Dr Nick Kowalenko, Chair of the College’s Faculty of Child and Adolescent Psychiatry, told Fairfax Media the suppression of such data could mean that the Immigration Minister, Scott Morrison, ended up being “ill-informed or ill-advised” on the extent of harm children in detention were suffering.

Earlier this year, information obtained by The Australian under Freedom of Information laws showed that the incidence of depression and other serious mental health problems has surged among asylum seekers amid a toughening of the immigration detention regime.

Information compiled by International Health and Medical Services, which is contracted to provide health services at the Department of Immigration and Border Protection’s detention centres, shows that almost 45 per cent of detainees were diagnosed with psychological problems in the September 2013 quarter, almost double the 23.1 per cent reported with a similar diagnosis six months earlier.

“The pattern shows the negative mental health effects of immigration detention, with a clear deterioration of mental health indices over time in detention,” IHMS said in the document.

The worrying disclosure follows the Federal Government’s decision late last year to disband an independent group of medical experts established by the Howard Government to advise on the treatment of asylum seekers.

In a shock move, the Immigration Health Advisory Group was abolished by the Department of Immigration and Border Protection in late December, at a time when concerns about the adequacy of medical services at offshore detention centres at Christmas Island and Manus Island were multiplying.

The AMA, which had a representative on the Group, has voiced concerns about its abolition and replacement with a sole practitioner, former Army doctor Paul Alexander.

The AMA’s IHAG representative, Dr Choong-Siew Yong, said earlier this year that research showed those in immigration detention faced a significant risk of developing mental health problems.

Dr Choong-Siew said that, unlike imprisonment, immigration detention was indefinite and the outcome uncertain, and “the research is very clear, that the longer you’re in detention, and the greater the uncertainty, the greater the possible psychological harm”.

The AMA has called for the establishment of a “truly independent” medical panel to oversee and report directly to Parliament on health services for asylum seekers being held in detention.

Adrian Rollins