AMA calls on Malcolm Turnbull to heed concerns at Melbourne’s Royal Children’s hospital about discharging asylum seeker children back to unsafe conditions

This article is more than 4 years old

This article is more than 4 years old

Doctors are calling on Malcolm Turnbull to heed concerns at Melbourne’s Royal Children’s hospital about discharging asylum seeker children back into detention.



Hospital doctors are placed in an “invidious position” often at odds with their ethical and legal obligations when discharging children back to immigration detention, the vice-president of the Australian Medical Association has said.



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The comments come as hundreds of staff from Melbourne’s Royal Children’s hospital (RCH) have protested to demand an end to the continuing detention of almost 200 children in centres on Nauru and the Australian mainland, the Herald Sun reported.

The AMA is backing staff at the hospital who say it would be unethical to send children back to unsafe conditions, noting the difficult position doctors are placed in when discharging a child back into the environment that evidently caused the harm.

It says it will contact the prime minister and the immigration minister, Peter Dutton, urging them to intervene with a compassionate and humane solution.

But reports the doctors would flatly refuse to discharge children have been hosed down.

It has become “almost normal” for children in detention brought to hospitals around the country to present with severe health issues including mental illness, behavioural problems, bed wetting and trauma, said Dr Tom Connell, head of general medicine at RCH, in a pre-recorded statement.

“At the children’s hospital our team find it almost impossible to treat these children effectively while they remain detained.”

An RCH paediatrician, Prof Paul Monagle, said: “What we see from children in detention is a whole range of physical, mental, emotional and social disturbances that are really severe, and we have no hope of improving things if we’re sending those children back to detention.

“Many of the children we’re seeing have spent more than half their life in detention. This is all they know and it is not what children should know. Children should be safe in a community with their family, not in detention.”

In February the peak psychiatrists’ body said children should be kept in detention for no longer than three days.

In an opinion piece published by News Corp on Sunday, the doctors called for “moral leadership on this issue to find a solution, quickly — to use alternatives to detention and to stop the harm”.

The AMA’s vice-president, Dr Stephen Parnis, said the peak body was “certainly supportive of the notion of getting all children out of detention”, and “principally concerned about the healthcare of all asylum seekers who are in the care of the Australian government”.

Parnis told Guardian Australia the circumstances around doctors treating detained children in hospitals were legally and ethically complicated.



Reports the RCH doctors would simply refuse to discharge children back to detention were overblown, he said, and he expressed concern it would create a reluctance in the immigration department to send children to hospital.

But the environment a child came from was “often” an important factor in assessing whether or not to discharge a child from hospital.

“Part of that assessment is what are the causative factors to what’s presenting before them,” Parnis told Guardian Australia. “It’s no surprise I think to most Australians that children who are in immigration detention have a substantially higher rate of things like mental illness, failure to thrive – which is a medical term – and depression.

“They are in an environment which is completely counterintuitive to a natural environment. It’s a logical extension that you try to remove them.”

Doctors are legally obliged to notify social services if they believe a child is at risk but children presenting to hospital from detention are wards of the state, which creates a “dichotomy”.

“The current circumstances we’ve placed doctors in offers an invidious position,” Parnis said. “It’s quite distressing.”

In a statement to the Herald Sun the immigration minister, Peter Dutton, said he understood the Melbourne doctors’ concerns, “but the Defence and Border Force staff on our vessels who were pulling dead kids out of the water don’t want the boats to restart.”

Jill Hennessy, the Victorian health minister, told media on Sunday she supported RCH staff.



“I’m extremely proud to be the health minister in a state where its doctors and nurses are putting the interest of children first,” she said.



“If the staff of the RCH come to the clinical view that it is not in the interests of those children to go back into detention, then we will support them.”

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The federal government has committed to getting all children out of detention but has been criticised for the length of time it is taking and condemned for the continuing treatment of children in detention.

Laws introduced this year threaten up to two years in jail for health and care professionals working in the detention network who disclose information about conditions inside the facilities. They were roundly criticised by medical professionals in Australia and internationally.

While the RCH staff are unlikely to be affected by the laws, Parnis reiterated the AMA’s objections. “As I understand it the Border Force Act talks about these penalties for people who provide care within the confines of federal jurisdiction,” he said.

“The government and the opposition have both said there are other aspects of federal law where whistleblowers are protected but we take little comfort in that.”