Former Australian Border Force commissioner says he ‘accepts without equivocation’ that deserving cases were ‘thwarted’

This article is more than 2 years old

This article is more than 2 years old

The former commissioner of the Australian Border Force, Roman Quaedvlieg, has said on Twitter that medical transfers from Nauru were a “vexed” issue for the ABF, which has the ultimate authority to move people to care.

“A lot of [money] has been invested in upgrading medical services there but some cases are so acute they need specialists; but we also need to stop exploitation of this path.”

He conceded that genuine medical transfers were “obstructed and thwarted” by the ABF.

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A former senior medical officer on Nauru, Dr Nick Martin, told Quaedvlieg: “I appreciate your comments, but you must remember that every time, without fail, that I tried to get deserving cases the care they needed they were thwarted and obstructed by ABF. Every time.”

Quaedvlieg said: “Understood and I accept without equivocation. It’s true to say that the threshold for medical repatriation to Australia is high; it’s an issue which tormented me as far as I played any role in any case [because] every case was a practical v ethical dilemma. A tragedy borne from tragedy.”

Roman Quaedvlieg (@quaedvliegs) Understood & I accept without equivocation. It’s true to say that the threshold for medical repatriation to Australia is high; it’s an issue which tormented me as far as I played any role in any case bc every case was a practical v ethical dilemma. A tragedy borne from tragedy

The position of chief medical officer of the Australian Border Force is currently held by a person without medical training.

Previously psychiatrist Dr John Brayley held the role but since his resignation, the position has been filled by a department bureaucrat.

Quaedvlieg said Brayley was a trusted and respected colleague.

“I took his counsel over lengthy conversations at the oddest hours. It was wise, pragmatic and he had the utmost integrity. He never dictated but always advised and recommended.”

Roman Quaedvlieg (@quaedvliegs) Dr Brayley was a trusted colleague that I respected enormously. I took his counsel over lengthy conversations at the oddest hours. It was wise, pragmatic & he had the utmost integrity. He never dictated but always advised and recommended. I had no part in his departure.

Quaedvlieg said that doctors’ advice was not the only consideration in judging whether people should be moved to higher levels of care.

“Medical advice is a primary input but there are many other factors to consider in any case decision, and while it’s never easy, the decision-makers, including me, always did their best for a utilitarian outcome.”

Roman Quaedvlieg (@quaedvliegs) No Margaret, I didn’t always blindly take his advice & recommendations. Medical advice is a primary input but there are many other factors to consider in an case decision & while it’s never easy, the decision-makers, including me, always did their best for a utilitarian outcome.

The issue of medical transfers out of offshore processing has become one of acute tension between medical practitioners and the ABF. Patient transfers to higher standards of care are routinely refused or delayed for months, even beyond a year.

Even critically ill patients – such as Hamid Kehazaei or Omid Masoumali – have had their transfers refused or delayed. Both men died.

Three pre-teen children, suffering acute mental illnesses and having made repeated suicide attempts, have been urgently brought to Australia for treatment but only after court actions were launched in Australia to have them moved.

The Nauru hospital is deemed unsafe for surgery by the government’s own health contractor IHMS after a number of deaths.