The Royal Australian College of General Practitioners has said it is willing to work to accredit the medical services in offshore immigration to Australian standards, but only if the government gives it full and free access to the centres offshore, and makes its audit public.

In handing down findings into the 2014 death of Iranian asylum seeker Hamid Kehazaei on Monday, Queensland coroner Terry Ryan recommended that the RACGP accredit offshore medical services in the same way they do those onshore.

Australia – which runs the offshore regime on Manus and Nauru – was responsible for his “preventable” death, the coroner found.

The president of the Royal Australian College of General Practitioners, Bastian Seidel, said the college would be willing to accredit the offshore medical services, but that they must be given full access free from any interference, and their findings made public.

“The RACGP has been very vocal about the circumstances of offshore detention. We have said repeatedly our members are willing to go to detention centres to look after patients and to see the circumstances.

“In order to audit, there can be no caveats, or pages and pages of terms of references, or where a report then just get lost in a file in the bureaucracy somewhere. There can be only two conditions: that the RACGP has full access to these centres; and that the results of the audit are available publicly, so people can know the situation.”

A separate recommendation from the coroner was that doctors be put in charge of medical transfers of critically ill patients off the islands. At present, Australian Border Force personnel or bureaucrats within the department of home affairs routinely overrule doctors’ recommendations for treatment.

The department’s initial refusal to agree to Kehazaei’s transfer to hospital-level treatment in Australia – and then delaying the final approval – was found to be a key reason for his death.

Seidel told Guardian Australia: “It happens all the time, that bureaucrats overrule the clinical decisions of doctors who are employed to provide care for people in offshore.”

“If a doctor had made the wrong call in treating Hamid Kehazaei, the discussion would have been around medical negligence and professional responsibility. But in this case, bureaucrats overruled the doctors’ clinical recommendations. Should the discussion be around the professional responsibility of people in those positions?”

Previously, the independent Detention Health Advisory Group (DeHAG) provided clinical advice on immigration detention healthcare and repeatedly advocated for reform and improved standards of care. It was disbanded in 2013, and replaced by the Immigration Health Advisory Group (IHAG) which was disbanded after just nine months, and not replaced.

Doctors for Justice convenor Professor Louise Newman – a former IHAG member – said a new independent oversight and monitoring body was needed, as was a special commission of inquiry into the health and mental health needs of asylum seekers and refugees.

“There have been 12 deaths ... in offshore processing facilities, and high rates of self-harm including in children as young as 10 years of age. We are witnessing the consequences of a system which fails to acknowledge the vulnerability and mental health needs of this group and contributes in a direct way to mental deterioration and mental illness.”

Elaine Pearson, Australia Director with Human Rights Watch said the Australian-run offshore system should be shut down as quickly as possible.

“In the meantime, the Australian government should follow the coroner’s recommendation that doctors working offshore should be the ones to approve medical transfers to Australia, not bureaucrats in Australia.”



Pearson said HRW supported the coroner’s recommendation for Australian judicial investigation - such as a coroner’s inquest - into all deaths within the offshore processing regime.

“Twelve people have died in Australia’s offshore processing centres. Australian officials should be held accountable for failing to protect those who remain in the government’s care - wherever they are.”

The departments of home affairs and attorney general have both said they will consider the recommendations of the coroner, but have not commented publicly on which would be implemented.