Questions about expertise and cloud of misconduct hang over Papua New Guinea contractor PIH

This article is more than 1 year old

This article is more than 1 year old

The Australian government has handed $21.5m to a healthcare provider to treat asylum seekers on Manus Island for 10 months without finalising a proper contract. It comes despite damning allegations of inadequate care and links to a former deputy prime minister of Papua New Guinea previously found guilty of misconduct for his handling of public funds.

Pacific International Hospital (PIH), the operator of the Port Moresby hospital, was chosen to deliver healthcare services at a clinic on Manus from May last year, after the previous provider, International Health and Medical Services, departed the island.

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The Department of Home Affairs chose PIH in a limited tender process, similar to that used in the Paladin and Canstruct cases.

Guardian Australia has confirmed with the department that it has still not finalised a contract with PIH almost 10 months later, despite having already paid the company $21.5m. The department has instead relied on a series of letters of intent to engage PIH.

“For probity reasons, the department cannot provide further details until contractual arrangements are finalised and the details are made public on AusTender,” the department said.

Delays in finalising deals with contractors were raised in a damning 2017 audit report about the department’s handling of offshore processing centre contracts.

PIH is chaired by former PNG deputy prime minister, Sir Moi Avei, who was in 2007 found guilty of misconduct in office for the way he handled public funds.

However, there is no suggestion that he is misusing Australian funds or any funds related to PIH, or that he is not fit to act as a director or chairman.

Serious concerns have also been raised about PIH’s expertise and treatment standards, both by asylum seekers still on Manus and during a 2016 coronial inquest into the death of Hamid Kehazaei.

PIH’s Port Moresby hospital was found sorely lacking in its treatment of Kehazaei, who died in 2014 from a treatable leg infection. An inquest into his death heard PIH staff had failed to comprehend that Kehazaei was critically ill and dying, leaving him unattended even as the life-saving machines he was attached to were sounding alarms.

A Queensland coroner found PIH lacked “necessary clinical skills”, provided “inadequate” care, and was far too slow in treating Kehazaei. It found Kehazaei had “required urgent and aggressive resuscitation with intubation, ventilation, intravenous fluids and broadspectrum antibiotics”, none of which he received.

“I conclude that if Mr Khazaei had been intubated immediately on arrival at the PIH and provided with adequate ventilation support, in addition to intravenous fluids and antibiotics, it is likely that he would have survived,” the coroner found.

Guardian Australia has also heard further complaints from those currently on Manus about substandard care from the PIH clinic at the East Lorengau refugee transit centre (ELRTC).

Among the numerous allegations received by Guardian Australia are accusations of people being refused admission, even as nurses and Paladin security guards advocated for the patient at the door, and of refusals to transfer people to Port Moresby even with medical referrals.

Other allegations include denial of simple pain relief, distribution of expired medication, poor standards of care, and broken or missing equipment and medication. There are repeated reports of the clinic being closed at random hours of the day, despite having daytime and after-hours staff.

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Journalist and refugee, Behrouz Boochani, said he believed PIH was making significant amounts of money from Australia, but did little with it.

“I think Paladin is much better than PIH. Paladin is here, there is someone,” he said. “Paladin is there to write our name and show our ID and they give us our food. At least they do this.

“I think PIH is worse than Paladin.”

“What is happening on the ground is very different. They make big money, but they do nothing.”

Patients requiring further care are transferred to Port Moresby for treatment at Pacific International Hospital, but this is also subject to consistent complaints, including long delays before they are seen by doctors.

Refugees have reported a growing mental health crisis, with dozens of acts of self harm and suicide attempts.

The transit centre clinic in Lorengau employs 13 health care professionals including three medical officers, three nurses, one paramedic, an after-hours GP and one after-hours nurse. The five mental health workers include just one psychiatrist.

In Port Moresby PIH has five health care professionals and three mental health professionals, but no psychiatrist. The PIH chairman, Avei, was deputy prime minister from 2004 to 2006, before being suspended pending the misconduct probe.

In 2007, Avei was found guilty of misconduct over his handling of public funds.

Avei was given 250,000 kina (AU$100,000) in district support grants from the PNG government, and deposited the money into an account titled “Moi Avei’s Discretionary Funds”.

He was found guilty of failing to ensure the grants went to the rural infrastructure projects to which they was allocated.

Avei has served on the boards of a range of large companies in PNG, including Bougainville Copper Limited, Kumul Petroleum Holdings, OK Tedi Mining, and PNG Water Limited.

PIH declined to comment when approached by Guardian Australia. PIH’s current letter of intent with the Australian government expires next week, according to tender records.

IHMS’s contract to provide care inside the detention centre expired in October 2017, in line with the centre’s scheduled closure, but was extended by the PNG government.

In statements at the time, IHMS reported it would continue to provide care from the ELRTC clinic from November, and it eventually left Manus at the end of April 2018.

Senate estimates in late May (pdf) heard PIH had been engaged under a letter of intent to deliver “like for like” services, comparative to IHMS.