The lower house will next week vote on whether doctors should have more sway in medivac decisions for the 1080 refugees on Nauru and Manus Island.
Under the plan, most decision-making power would move away from the home affairs minister, currently Peter Dutton, and an independent panel of expert medical professionals would have the final say on most medical transfers. Any two licensed doctors can ask the home affairs minister to evacuate refugees needing treatment: the home affairs minister can turn down the evacuation if they do not think it is necessary, or if there are national security concerns.
If the home affairs minister rejects the medical transfer, their decision is sent to an independent panel of experts, who can override the minister on all justifications save for national security concerns.
Mr Morrison has warned that as the bill is currently written, refugees who have committed serious crimes — including paedophilia, rape, murder, theft and arson — cannot be vetoed by a minister concerned for nation security.
The independent medical panel will consist of both the government’s and the Department of Home Affairs’ chief medical officers, the surgeon-general of the Australian Border Force, and at least six others including the Australian Medical Association president, a nominee of the Royal Australian and New Zealand College of Psychiatrists, a nominee of the Royal Australasian College of Physicians, and at least one person with paediatric health expertise.
If, as anticipated, the government loses the vote next week, it will be the first time since 1929 that a sitting government has lost on a substantial piece of legislation.
Independent crossbencher Cathy McGowan is the Coalition’s sliver of hope: she says she will make up her mind on the bill, which needs her vote, when Parliament resumes.
Opposition Leader Bill Shorten also left the door open for switching his position on the bill by agreeing to «listen to the facts» when he meets with officials from the Department of Home Affairs next week for a security briefing on the bill.
«I do think if there’s middle ground, we should try and find it,» he said on Friday.
Dr Martin says the facilities on Nauru are insufficient for basic medical ailments and suggested the expert panel would endorse transfers for a range of health issues.
«You can have diabetes, you can have kidney stones, if you’ve got a breast lump and you’re a female on Nauru they’ve got no way of sending a sample to a laboratory and getting a definitive diagnosis.»
Broken bones, for example, could need a medical transfer as there is no X-ray machine on Manus Island.
«If you’ve got a broken bone and you need an X-ray which isn’t available there because you don’t have one, then you need to go somewhere where you can have it,» Dr Peter Young, the former medical director of mental health for International Health and Mental Services on Manus Island, said.
«On Manus, there’s no lab equipment, no CT scanner, no intensive care equipment… there really isn’t any equivalent mental health facilities.»
Dr Young, a practising psychiatrist, added that «you can’t effectively treat people with mental illnesses in a toxic environment».
On Monday, Prime Minister Scott Morrison warned that «hundreds» of people on Manus Island and Nauru would be flown to Australia «within a matter of weeks» if the bill was passed.
Both Dr Young and Dr Martin denied this, saying there would be a «triage» process in which the most urgent medical issues would be dealt with first.
Dr Martin added that the pace of transfers would be stymied by Nauru’s «inefficient» sovereign process: the country has its own panel of medical experts that must sign off on any resident seeking aid overseas.
Dr Kerryn Phelps, a former president of the Australian Medical Association and current independent MP, said she would imagine the two initial recommending would be on the ground on Manus Island or Nauru.
«I would expect that the first doctor and potentially the second need to be on the ground in either Nauru or Manus Island to make the medical decision to recommend a transfer,» she said. «The second doctor would most likely be an experienced specialist in the relevant area depending on the patient’s needs, who would be able to assist in the judgment call.»
A spokesman for Dr Phelps, who in recent years has run a medical practice in Sydney’s east, said she had «absolutely no intention whatsoever» of recommending a transfer herself.
«There is a 0.0000001 percent chance in an emergency, but no.»
On Wednesday, Mr Morrison rejected claims that the impending bill was a de facto motion of no confidence, and lambasted its creators.
«This is a stupid bill. It’s written by people who haven’t got the faintest idea how this works.»
Max is a journalist at The Sydney Morning Herald and The Age.