Yet another damning report was released about the Christmas Island, Nauru, and Manus Island Detention Facilities, spurring yet another round of unhinged rhetoric from the usual blowhards: ‘Why do we put asylum seekers in concentration camps?!’ It’s easy to get swept along by the flow of outrage. It’s even easier when the Government commits the most astounding outrages and then refuses to discuss the issue. It’s more difficult to tap into that outrage and use it to motivate a productive outcome.
When people have been found guilty of a crime and are sent to prison in Australia, we expect that they are provided with a certain standard of medical treatment. Being denied access to medical services is not considered to be an acceptable punishment, nor is it considered to be an acceptable consequence of punishment. The Standard Guidelines for Corrections in Australia state that prisoners must have ‘access to evidence-based health services provided by a competent, registered health professional who will provide a standard of health services comparable to that of the general community.’ The last part of that sentence provides a baseline standard by which we can evaluate the provision of health: is the quality of health services provided at the prison comparable to that of the general community?
The Royal Australian College of General Practitioners (‘RACGP’) has guidelines to assist GPs to discharge their duties in prisons, explicitly stating that the guidelines are to ‘provide a framework for safe, high quality healthcare in the prison setting comparable to healthcare available in the general community’.
Immigration Detention Facilities are not prisons. The people being detained are illegal arrivals seeking asylum have not committed a crime. These are people in our care.
It should not be controversial to state that the quality of health services provided to people who have not committed a crime should not be less than the quality of health services provided to people who have committed a crime. This is what makes the letter from the doctors on Christmas Island alarming. Although we will be understandably distressed, outraged, and upset about individual allegations — women having miscarriages, HIV-infected patients going missing, hearing aids being confiscated, &c., — it’s the broader principle that’s the problem: why aren’t people in Immigration Detention Facilities being provided with standards of health services comparable to that of the general community?
Shifting the conversation to this discussion of principles avoids tit-for-tat conversations about specific allegations. If a woman has a miscarriage on Christmas Island, was it because she was in an IDF or was it because she had spent a week at sea? If a person shows signs of depression on Christmas Island, is it because they’re in an IDF or is it because they fled torture back home? And so on and so forth. Moving it up to an objective standard means we can hold the Government account rationally and measurably. It’s a question that we should be asking week after week of the Minister: ‘Are we providing health services that are comparable to that of the general community? If not, why not?’
Focusing on the higher policy questions also allows us to open a new discussion about the standard of care we expect in Australian-funded IDFs overseas. If we agree that people who are in IDFs should have standards of health services comparable to that of the general community, which general community is the relevant standard? If a person is detained in Nauru, should they receive a standard of care comparable to that available to a local of Nauru, or to that available to an Australian?
This is not an easy question to answer. Back in October, I wrote that Australian commentary only seems to acknowledge the existence of our neighbours’ problems when it’s linked to asylum seekers. Anti-homosexual laws were only a problem because homosexual asylum seekers might be sent there. Capital punishment was only a problem because asylum seekers might be subject to it. Australian commentary was callous in its treatment of the locals. So if we want to answer that the standard of care available to the local Nauruan is insufficient for our asylum seekers, why on Earth do we think it’s sufficient for the local Nauruans?
Consider also what happens when Nauru and PNG begin to resettle refugees as signatories of the Convention. If local conditions are insufficient while their protection claims are being assessed, why are they sufficient when they’ve been found to be a refugee?
This is why a Regional Cooperation Framework is so important, despite the Coalition’s dismissive attitude towards it. Under an RCF, we can have a consistent approach to the welfare of asylum seekers throughout the region. We know, upfront and transparently, what the agreed standard is and that it will be the same for a person detected in Thailand as it would be for a person transferred to Nauru. No advantage and no disadvantage.
Ultimately, we have to grasp an uncomfortable truth: this isn’t actually about asylum seekers. In the 21st Century, there is no good reason why health standards vary so wildly around our region, even within our own country. Neglecting the health needs of asylum seekers is horrifically consistent with our neglect of Aboriginal and Torres Strait Islanders, and our neglect of our regional neighbours. Horrifically consistent.
This is why the Regional Cooperation Framework will only be successful if Australia starts to shoulder its regional responsibilities to its neighbours and not just its guests.
Mark Fletcher is a Canberra-based blogger and policy wonk who writes about conservatism, atheism, and popular culture. He blogs at OnlyTheSangfroid. This article was originally published onAusOpinion.com.
