According to an internal document obtained by Guardian Australia, detainees who are referred by International Health and Medical Services (IHMS) for further medical investigation or treatment will now be sent to the Pacific International hospital in Port Moresby.
Previously detainees from the Nauru and Manus Island detention facilities have been flown to Australia for medical care, and a number of people have taken the opportunity to launch legal action and prevent their return to the centre.
The Pacific International, which opened earlier this year, has been touted as a modern, well equipped medical facility, but as a private hospital is only accessible by the wealthy. Outside its walls, health indicators for PNG are poor, with high rates of infant mortality, extremely high levels of maternal mortality and little access to medical care for the largely rural population.
While receiving treatment in Port Moresby patients will be given accommodation, food, and transport to the hospital and allowed to make regular phone calls, the document states.
However, it also warns: “once you have undergone your medical investigation or treatment, you will return to Nauru.”
“If you decline to transfer to Port Moresby for your appointment, you will be considered to have refused medical treatment. A new appointment in Australia or another country will not be arranged for you.”
If a detainee chooses to remain in Nauru they will continue to receive the available medical care.
There have been several cases of asylum seekers who were flown from Nauru to Australia for medical care and then lodged a legal injunction to prevent their return.
One case is currently before the courts in Darwin. The family of a five-year-old girl are seeking to stop their return due to the extreme psychological distress of their daughter.
According to several medical and psychiatric reports , the young girl is diagnosed with post traumatic stress disorder and has displayed multiple acts of self harm, nightmares and bedwetting. Another report from a psychologist said depression and extreme anxiety were “pervasive throughout all areas of her life”. One psychiatrist’s reports said that was triggered by reminders of Nauru.
A review by former integrity commissioner Philip Moss revealed numerous allegations and substantiated many claims of sexual and other abuse at the Australian-run detention centre on the island.
Jacob Varghese, principal lawyer at Maurice Blackburn in Melbourne, said the policy change would be “a new attempt to even more prevent scrutiny of the conditions in which people are being held in detention”.
“We know from previous experience the government has covered up the bad conditions in Nauru, and it took whistleblowers to force the Moss review which discovered how bad things really were” Varghese said.
“At the moment one of the ways we are finding out what happens is when people come to Australia for treatment there is an opportunity for lawyers and social workers in Australia to hear first hand what those conditions are like.”
Medical treatment in Australia provides a “brief window” where detainees can access the Australian justice system “and to close off that window would be just another attempt to prevent scrutiny of what we all know is terrible … Nauru is effectively Australia’s Guantánamo Bay,” said Varghese.
“We’re effectively holding people but away from supervision by Australian courts. That’s the entire purpose.”
In April a joint statement from more than 100 refugee and legal groups called for the immediate halt of transfers back to Nauru and Manus Island of asylum seekers and babies born in detention. At that stage more than 200 people had been brought to Australia for childbirth or medical treatment.
IHMS referred all queries to the department of immigration and border protection. The department has been contacted for comment.