Calls for offshore processing clinics to be accredited to RACGP standards

Doug Hendrie

31/07/2018 2:49:53 PM

The coroner investigating the preventable death of an Iranian asylum seeker has called for clinics in offshore processing countries to be accredited to RACGP standards.

The 2014 death of asylum seeker Hamid Khazaei on Manus Island was found to be ‘the result of the compounding effects of multiple errors’.
The 2014 death of asylum seeker Hamid Khazaei on Manus Island was found to be ‘the result of the compounding effects of multiple errors’.

Queensland coroner Terry Ryan found that the 2014 death of Manus Island detainee Hamid Khazaei from a small leg infection that turned septic could have been prevented with better medical care.
‘His death was the result of the compounding effects of multiple errors rather than any single action or inaction,’ Mr Ryan found.
Issues included a lack of antibiotics, a failure to detect Mr Khazaei’s rapid deterioration, and the inability for doctors to transfer him to Australia due to visa issues.
The coroner recommended that all offshore clinics providing medical services to asylum seekers in regional processing countries, such as Nauru and Manus Island (Papua New Guinea), be accredited to a level equivalent to the RACGP’s Standards for health services in Australian immigration detention centres, which apply only to onshore detention facilities.  
He also recommended that the Department of Home Affairs and International Health and Medical Services (IHMS), which ran the clinic in the now-closed Manus Island centre and still runs clinics in Nauru, work with the RACGP to bring in a standard clinical audit tool at all regional processing country clinics.
Mr Ryan called for the RACGP to undertake clinical audits in offshore processing countries at least annually in conjunction with the Department of Home Affairs. He also wants the Department of Home Affairs to introduce a policy placing the clinical needs of detainees first when medical transfers required the approval of the Australian Government.
RACGP President Dr Bastian Seidel welcomed the call for improved standards and audits for clinics serving offshore detention facilities.
‘The majority of those in detention have unique mental and physical healthcare needs as a consequence of the circumstances they have fled, and these are further exacerbated by a prolonged period of uncertainty in detention,’ he told newsGP.
‘The recommendations that have come out of yesterday’s findings show the importance of professional standards, like those set by the RACGP, to ensure proper healthcare delivery.
‘The primary care staff in these facilities, many of whom are GPs, are continuing to work in ethically challenging environments. As a consequence, GPs may not be able to uphold the appropriate clinical and ethical standards of quality patient care, because of the restrictions of these settings.’
Former IHMS regional medical director Dr Mark Parrish gave evidence during the inquiry that Australia’s onshore clinics and the Christmas Island clinic were already at a standard similar to RACGP accreditation.
He told the inquiry there were ongoing discussions over whether the clinics on Manus Island and Nauru could achieve similar accreditation at the time he left the role in 2015.
The Department of Home Affairs is reviewing the findings, a spokesperson told newsGP
‘The Department [of Home Affairs] has provided full assistance to the inquiry,’ the spokesperson said. ‘The Department expresses its condolences to the family and friends of Mr Khazaei.’
The new Chief Medical Officer at the Department of Home Affairs, Dr Parbodh Gogna, is a former medical director of IHMS on Christmas Island.
The IHMS website states that it provides primary and mental health care services ‘broadly comparable’ to Australian public health standards to asylum seekers in the Nauru centre.

asylum seekers coroner offshore processing refugee health

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