Imigration Department secretary Michael Pezzullo. Credit:Alex Ellinghausen Doctors welcomed the move, predicting it would lead to a flood of disclosures from health professionals who had worked with asylum seekers and refugees on Nauru and Manus Island. The Fitzroy Legal Centre and Doctors for Refugees had taken the government to the High Court to challenge the legitimacy of the laws, which were passed last June with the support of Labor. The government was due to file its defence against the High Court case shortly. Doctors for Refugees president Barri Phatarfod said the timing of the amendment was "interesting".

Children playing near the Refugee Processing Centre on Nauru. Credit:Amnesty International "It's a blanket exemption for health professionals," she said. "It's a huge win for doctors." But the threat of jail has not silenced former detention centre workers. Doctors and other health professionals have repeatedly flouted the ban on them speaking out, as have Save the Children staff. In August, 103 current and former staff from the Nauru and Manus Island centres signed an open letter calling for an end to offshore detention, and warned that the only way to ensure the safety of asylum seekers and refugees was to bring them to Australia.

Doctors for Refugees says it is concerned that the new exemptions do not cover other workers in offshore detention centres, including guards and teachers who, in Australia, would have clear duties to disclose any abuse of children. Dr Phatarfod said the change also "only allows us to speak for our patients – it doesn't change the appalling lack of care they often seem to receive". "Currently, Doctors for Refugees is advocating for several children denied special needs care as well as women unable to get a breast lump biopsy and other significant deviations from appropriate medical treatment. We have around 160 active cases of concern." Immigration Minister Peter Dutton's office declined to comment, referring questions to the Department of Immigration and Border Protection. In a statement, a spokeswoman for the department denied the Border Force Act had been designed to "gag" health professionals, and said the changes clarified that health professionals were not subject to its secrecy provisions.

"Despite consistent incorrect claims and reporting of the ABF Act, the Act is not and has never been an instrument to 'gag' lawful disclosures in the public interest," she said. However, the threat of legal action against health professionals speaking out had been real, as Mr Pezzullo intimated last year, when he responded to criticism about the changes. "It has never been permissible for contracted service providers to make public operational detail which poses a risk to the safety and security of individuals, or which affects the operation of the Department or the former Australian Customs and Border Protection Service," Mr Pezzullo said. The spokeswoman said the department "still expects that health practitioners will maintain their strict ethical, professional and contractual obligations of confidentiality and privacy". The ABC's Four Corners this week featured several former teachers employed by Save the Children at Nauru, who told of their concerns for children in their charge.

Distressing interviews showed children discussing suicidal thoughts and self harm. Rather than responding to their reports Coalition senators attacked the creators of the program and accused the ABC of acting as a mouthpiece for activists. Amnesty International this week also released a major report on the detention of asylum seekers and refugees on Nauru, and said it had evidence the Australian government's treatment of detainees amounted to torture. In August, Guardian Australia published more than 2000 leaked incident reports from the detention camps on Nauru. In June 2014, then-immigration minister Scott Morrison used an anti-whistleblowing law against 10 Save the Children staff on Nauru.

The staff were referred to the Australian Federal Police under section 70 of the Crimes Act after they were accused of communicating privileged information to non-Commonwealth workers. All accusations were later dropped. Save the Children's policy and public advocacy director Mat Tinkler welcomed the changes. "But the current ban remains in place for others, such as child protection workers and teachers, leaving them with an invidious choice to risk prosecution and speak publicly when they've witnessed rights violations and have not seen them addressed," he said. "Independent oversight and monitoring of the conditions for refugee and asylum seeker children on Nauru should be an absolute minimum requirement." Greens leader Richard Di Natale, also a doctor, said the changes removed a legislative requirement for doctors to betray their patients by not speaking out on their behalf.

But he questioned the timing. "It's hard to escape the conclusion that they're pre-empting a negative finding from the High Court on their legislation." Follow us on Twitter