The claim



The debate over medical transfers of asylum seekers from offshore processing centres on Manus Island and Nauru has continued into the new year, with the House of Representatives preparing to vote on an amendment that would see sick refugees brought to Australia for treatment.

Sorry, this video has expired Peter Dutton on medical transfers

But the proposals contained in the amendment have been strongly resisted by the Coalition, with Prime Minister Scott Morrison labelling them "stupid".



In a doorstop interview on February 7, Home Affairs Minister Peter Dutton questioned the influence medical practitioners would have in making transfer decisions as a result of the changes, and suggested that Greens figures could be among those qualified to provide the medical advice used to justify a transfer.



"Labor's proposal is to dismantle offshore detention [and will] essentially give the ability for two doctors — as has been pointed out, doctors including Dr Brown, Bob Brown, and Dr Richard Di Natale — potentially can provide the advice," Mr Dutton said.

The two men dispute this.



So, could Richard Di Natale and Bob Brown act as medical advisers under the proposed legislation? RMIT ABC Fact Check investigates.



The verdict

Mr Dutton is drawing a long bow.



According to the proposals, in order to be able to advise on the transfer of refugees to Australia for medical treatment, a doctor would first need to be registered — neither Mr Brown nor Senator Di Natale are registered medical practitioners.

While there is always the potential for the former and current Greens' leaders to re-register as doctors, neither have indicated they would undertake the lengthy process.

And though Labor voted in support of the changes in the Senate, it is a stretch for Mr Dutton to label these changes a 'Labor proposal'.

The then-leader of the Greens, Bob Brown (centre), with newly elected senator Richard Di Natale (right) in Melbourne in 2010. ( Alan Porritt: AAP )

What are the proposed legislative changes?



The bill set to be voted on in the House of Representatives this week is an amended version of the Government's Home Affairs Legislation Amendment (Miscellaneous Measures) Bill 2018.

Intended to amend visa laws in the Migration Act, the Home Affairs Legislation passed through the House in August and was set to be voted on in the Senate when independent senator Tim Storer and the Greens moved to add an amendment allowing transfers of refugees to Australia for medical treatment.

The added amendment was the result of a negotiation between Labor, the Greens and key crossbenchers, including Senator Storer, which makes it a stretch for Mr Dutton to label the changes a 'Labor proposal'.

The amendment was passed in the Senate on the last sitting day of 2018.

Coalition senators, together with Cory Bernardi and Pauline Hanson, filibustered to prevent the bill from moving to the House.



The amendment would allow the transfer of an asylum seeker on Manus Island or Nauru on the advice of two doctors who have assessed the refugee either in person or remotely, but gives the Home Affairs Minister the power to refuse the transfer.



This would stand in cases where the minister blocked the transfer on grounds of national security.



However, in cases where the Minister refused a transfer and there were no purported security concerns, an expert medical panel would be formed to reassess the transfer.

The panel could override the minister's decision.



According to the amendment, the Independent Health Advice Panel would consist of eight members, including the Chief Medical Officer of the Department of Home Affairs, the Commonwealth Chief Medical Officer and six others including:

At least one person nominated by the Australian Medical Association;

At least one person nominated by the Australian Medical Association; At least one person nominated by the Royal Australian and New Zealand College of Psychiatrists;

At least one person nominated by the Royal Australian and New Zealand College of Psychiatrists; At least one person nominated by the Royal Australasian College of Physicians; and

At least one person nominated by the Royal Australasian College of Physicians; and At least one person who has expertise in paediatric health.

Meanwhile, independent MP Kerryn Phelps — who is herself a GP — has introduced a bill in the House that also aims to bring refugees to Australia for treatment.

However, the so-called Phelps bill does not legislate specific ministerial powers or the creation of a medical panel.

It remains stalled in the House after failing to gain the absolute majority needed in order for the bill to be debated.

The Storer-led amendment does not need an absolute majority to be debated in the House, and has already passed the Senate.

If the amendment is passed in the House, the key aims of the Phelps bill will be made law.

Kerryn Phelps after delivering her maiden speech in the House of Representatives in November. ( AAP: Lukas Coch )

The advising doctors



Neither the Storer amendment nor the Phelps bill specify exactly who the two advising doctors would be in the case of an asylum seeker requiring medical treatment in Australia.

The amendment merely states that a treating doctor must be "registered or licensed to provide medical or psychiatric services in a regional processing country or Australia", and must have "assessed the transitory person either remotely or in person".



In an email to Fact Check, Dr Phelps said she would expect at least one of the doctors to be on the ground in Nauru or Manus Island.



"Depending on the circumstances, the patient may have been under the care of the first doctor for some time," Dr Phelps stated.

"The second doctor would most likely be an experienced specialist in the relevant area, depending on the patient's needs, who would be able to assist in the judgment call."



What is a registered or licensed doctor?



A registered health practitioner is legally able to practise in Australia within the scope of their registration.

There are 15 health professions covered by the national register, which is controlled by the Australian Health Practitioner Regulation Agency (AHPRA).



Registrations are renewed on an annual basis, with practitioners required to undergo checks on criminal history, meet an English-language proficiency standard, and prove "recency of practice".



In addition, the AHPRA requires medical practitioners who are engaged in any form of practice "to participate regularly in continuing professional development … to maintain, develop, update and enhance their knowledge, skills and performance".



According to the Medical Board of Australia, which oversees the registration of medical doctors, an individual who has not been a registered or practising medical practitioner for more than 36 months is required to fulfill a range of industry standards before they can be re-registered.



These include supporting documentation of an individual's absence from the field, a curriculum vitae, practice history and a "plan for professional development and re-entry to practice".



A spokesperson for the Medical Board of Australia told Fact Check: "Registered medical practitioners renew their registration each year so they can keep practicing medicine.



"If a doctor does not renew their registration, they can no longer practice medicine in Australia and their name will be removed from the national register of practitioners.



"If they wish to renew their registration, they need to apply and demonstrate that they meet all the Board's standards to provide safe care, including standards about recency of practice."



These mandated standards apply to all medical practitioners regardless of the length of time they have been absent from the field.

To be successful in their bid to re-register, a person would need to prove to the board that they meet those standards.

A person who has trained as a doctor but has not practiced for more than 12 months would need to "commence work under supervision in a training position approved by the Board".



So, could Bob Brown and Richard Di Natale advise on transfers?

Mr Dutton's claim that sick refugees could be brought to Australia on the advice of Greens politicians was echoed by Minister for Defence Christopher Pyne, who said on Insiders:



"Maybe Bob Brown and Richard Di Natale, could sign a certificate saying that they think that they're suffering from mental health issues and they need to come to Australia."

Loading

A search of the Australian Health Practitioner Regulation Industry database reveals that neither current Greens leader Senator Di Natale nor former Greens leader Bob Brown are registered medical practitioners.



This would make both currently ineligible to provide advice on medical transfers.



Dr Brown told Fact Check he had let his registration as a medical practitioner lapse in 1996, when elected to the senate.



"I'm a bit rusty, I wouldn't presume to take on the health needs of those poor people on Nauru," Dr Brown said.



In a comment sent to Fact Check and later tweeted, Senator Di Natale said he was not currently registered as a doctor and therefore could not sign off on a medical transfer.



Principal researcher: Ellen McCutchan

Additional research: Natasha Grivas

factcheck@rmit.edu.au



Sources

Australian Health Practitioner Regulation Agency (AHPRA), Registration Standards



Australian Health Practitioner Regulation Agency (AHPRA), Continuing Professional Development, 2015



APH, Home Affairs Legislation Amendment (Miscellaneous Measures) Bill 2018



APH, Migration Amendment (Urgent Medical Treatment) Bill 2018



Medical Board of Australia, Revised registration standards for all medical practitioners and new cosmetic guidelines take effect on 1 October 2016, September 29, 2016



Paul Karp and Katherine Murphy, The Guardian, December 6, 2018

