Asylum seekers held in a Papua New Guinean detention facility are being prevented from talking to lawyers and doctors, blocking them from medical evacuation to Australia approved under new medevac laws.

David Manne, the executive director of Refugee Legal, told a Senate inquiry on Monday that he had lost contact with one client who had been approved for urgent evacuation weeks ago but was then detained at the Bomana detention facility in Papua New Guinea.

Sara Townend, a doctor who has set up the process for medical assessment of people in PNG and Nauru, told the legal and constitutional affairs committee that two or three more were approved for evacuation after their detention and 33 have applications in progress, a “large number” of who would be eligible for evacuation.

Townend said the 53 asylum seekers detained at Bomana do not have access to their phones and the medical evacuation response group does not have a central phone number to have “approved communications” with them.

Manne said the inability to contact his client was a matter of “profound concern”.

“Being detained after his approval for medical transfer is not only putting him in an extremely dangerous situation, but is also frustrating the ability to make good the decision … for evacuation,” Manne said.

Greens senator Nick McKim described it as “outrageous” that detention at the prison is frustrating medical evacuation.

Home affairs department officials told the inquiry that Papua New Guinea had refused one man’s medical transfer, citing the fact its medical services disagreed they were unable to treat him.

In its submission, the home affairs department urged parliament to pass the Coalition’s bill to repeal the medevac provisions, claiming provisions which give clinicians a greater say in the medical transfers undermine regional processing and impinge on the sovereignty of Papua New Guinea and Nauru.

Pip De Veau, general counsel at the department, said the blocked transfer “highlights the sovereignty point” because it showed Australian doctors can order a transfer that “can’t be given effect to because of the laws of another nation”. Nauru has a record of blocking transfers.

At the hearing, doctors responsible for the new medical transfer provisions rejected claims by the department that asylum seekers are resorting to self-harm because it is the most “expedient” way out of detention.

Kerryn Phelps – a doctor and former independent MP – told the inquiry that people in detention “are suffering, they’re not trying to make a point, they’re trying to kill themselves because they’ve lost hope”.

The department reported that “since late 2018, and through 2019, there has been an upwards trend in the number of self-harm related incidents amongst the Papua New Guinea cohort”.

“Notably, self-harm incidents increased during the parliamentary debate on the [medevac provisions], and more significantly since the Australian federal election,” it said.

“Of the 72 transitory persons transferred to Australia under the [medevac provisions], 39 had undertaken an act of self-harm and 19 had threatened self-harm since the implementation of the Act.”

Neela Janakiramanan, a Melbourne surgeon and one of the leading doctors implementing the medevac provisions, reported results of an audit of 581 people in detention that found that 97% have significant physical health issues and 91% have serious mental health issues.

Mental health has “normal ebbs and flows”, she said, but there “is absolutely no evidence of an increase of self-harm behaviour since the implementation of the medevac bill”. Between 1 March, when the new law came into force, and the election in mid-May rates of self-harm were “actually extremely low”.

Janakiramanan said doctors had met the department in May and “identified that a Liberal win would destabilise the population of people who were overseas because of concerns that an ongoing Liberal government would not progress their applications for resettlement in a timely fashion”.

The home affairs submission rejected claims that it had been “legally compelled to transfer persons from Nauru and Papua New Guinea to Australia to receive necessary health care” before the medevac provisions.

It cited more than 1,300 transferred under pre-existing provisions, compared to 112 under the new rules.

Refugee and legal groups including the Human Rights Law Centre, Kaldor Centre and Refugee Legal described the previous system as “inadequate”.

Graeme Edgerton, the deputy general counsel from the Australian Human Rights Commission, said from 2015 there was a “sharp reduction” in medical transfers to Australia as a result of a new policy to send asylum seekers to third countries instead.

Since March 2018 the federal court had ordered medical transfers in 96 cases and a further 220 people were transferred after threats of legal proceedings, he said.

Edgerton said that 536 people were brought to Australia in 2018-19 and “approximately 60% were transferred due to actual or prospective litigation”, which “strongly indicates” the previous regime was not sufficient to ensure proper care.

Ed Santow, the Australian Human Rights commissioner, told the inquiry the repeal bill would “significantly limit” refugees’ and asylum seekers’ “right to the highest standard of physical and mental healthcare”.

Phelps and Santow both cited the case of Hamid Khazei, who died after delays and errors caused when the home affairs department refused a medical transfer for his leg infection.

With Labor, the Greens and Centre Alliance opposed, the Coalition will need the vote of senator Jacqui Lambie to repeal the medevac provisions.