Have your say on the health requirement

[Guest Migration Help]

Australia’s disability services—promoting participation

 

At its public hearing on Wednesday 25 November 2009, the Migration Committee will hear from the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) about what is happening with disability policy and services in Australia.

 

The hearing is part of the Committee’s current inquiry into the migration treatment of disability, which is considering how Australia might assess the potential costs and benefits represented by a person with a disability, disease or condition.

“The benefits of migration to the Australian economy are widely recognised,” Mr Danby said. “Evidence from FaHCSIA will provide a better understanding of the current costs of disability support services, of the wider benefits to the Australian community, and of the potential to build economic participation of people with a disability and their carers.”

 

“Many submissions to the inquiry have argued that our understanding of disability has evolved but our migration rules have not kept pace, framing disability solely in terms of liability.”

 

“The Committee looks forward to the hearing as a way of putting our migration rules in context,” Mr Danby said.

 

In addition to the Disability Support Pension and Carer support payments, FaHCSIA provides programs and services to increase social and economic participation of people with a disability and their carers. It does this in partnership with other government and non-government agencies.

 

The Department is currently working with the states and territories to establish the National Disability Strategy, an overarching framework for service delivery to improve support and provide opportunities for people with disabilities and their carers. The Strategy will include the range of services under the National Disability Agreement, whereby the states will receive $5 billion over five years to assist people with a disability into more sustainable living arrangements and also to support families and carers.

 

The public hearing will commence at 12.15 pm in Committee Room 1R3, Parliament House, Canberra. Visitors are welcome to attend, or you can listen to a live webcast at: Parliament of Australia: Live Broadcasting

 

 

For more information and the inquiry terms of reference, visit the inquiry website at www.aph.gov.au/house/committee/mig/disability/index.htm or contact the Committee Secretariat on (02) 6277 4560 or jscm@aph.gov.au.

[Guest Gollywobbler]

Hi All

 

There is a new spate of new medical queries on Poms in Oz at the minute. The easiest way for me to find the Senate Inquiry is to dig out the Inquiry Secretary's thread - ie this one - and to use the link she provided in her first post.

 

The Committee met again yesterday to hear some oral submissions in Brisbane. At the same time, they formally accepted Submissions 92 to 103 inclusive, which have been published for the first time in the last few hours.

 

Originally the Committee wanted all the submissions by the end of October but the migration treatment of people with disabilities, specific diseases or conditions that might develop into diseases is hugely emotive and a lot of private individuals decided to air their own experiences. including 3 people from Poms in Oz.

 

As Migration Help said in one of her postings earlier in the thread, if you want to talk then please do so. The Committee Chairman has shown that he does not expect members of the public to understand the details of how these Inquiries need to be dealt with - that is his job to know, not yours or mine. However the Chairman does want to hear from people who are affected by this issue and he is not fussy about whether you make a reasonably formal submission or simply write a letter. If you want to speak to the Committee members but not to the whole world, please put "CONFIDENTIAL" in capitals at the top of the first page. The Committee will record that a confidential submission has been received and will give it a number but it will not disclose anything else.

 

The Committee has described disability rather than diseases but in practice the migration legislation makes no distinction between the two in its wording and it treats them both as "a cost" with no other considerations taken into account. It is therefore impossible t divorce disability and disease for migration purposes - the legislation treats disability as being a disease.

 

The main link is here:

 

http://www.aph.gov.au/house/committee/mig/disability/index.htm

 

Cheers

 

Gill

[Guest Gollywobbler]

Hi All

 

A lot of the readers of this thread (me included) are watching the way the Health Requirement for Migration to Oz is unfolding.

 

Dr Paul Douglas and Mr Matt Kennedy of DIAC (both accompanied by Mr Peter Vardos of DIAC as their minder as far as I can see) addressed the Public Inquiry on 24th Feb 2010.

 

Dr Douglas is DIAC's Chief Medical Officer and he has an enormous input into the way that the Health Requirement worked historically, works now and will work in the future. He should never be ignored. He is a very good man. A Poms in Oz Member who is loaded with common sense had a couple of direct chats with Dr Douglas in May 2008. The PiO member told me that he thought then that Dr Douglas is first rate.

 

Mr Kennedy seems to be in charge of DIAC's Health Policy section if I have understood his job title correctly from Hansard.

 

The proof copy of the relevant Hansard is now on the Committee website and it is here:

 

http://www.aph.gov.au/hansard/joint/commttee/J12833.pdf

 

The main website for the Committee - via which everything can be accessed - is here:

 

http://www.aph.gov.au/house/committee/mig/disability/index.htm

 

The main Committee is involved with all of the big issues that all the readers of this thread are familiar with.

 

Ages ago - at least a year ago - George Lombard RMA told me that DIAC are conducting an internal review/enquiry of their own. I've never had time to ask George what the internal debate is about. However I think it is now revealed by the Hansard above. DIAC want to see the Health Waiver requirements extended to skilled visas. Doing this will raise the threshold for a dependant child with a problem from a measly $21,000 to at least $200,000 AUD overnight. It will also enable the DIAC visa processing teams to think about the benefits which would be going to Australia via the skills of at least one of the skilled Parents of the dependant child.

 

Mr Vardos is the second most senior person in the DIAC hierarchy. He says in Hansard that he reckons that the Minister for Immi will agree to DIAC's proposal above.

 

Although it isn't mentioned in Hansard, it seems to me that the Minister's changes of 8th Feb 2010 will be hugely important to this as well. The Minister intends to cut the eligibility for skilled migration right down so that it includes only those migrants whom Australia actually needs for its skills base.

 

I doubt whether DIAC have thought the whole thing through to its logical conclusions as yet, but the rest of us can. Let us say that Hubby is a General Electrician or a General Plumber. His occupation makes it on to the State Migration Plans for West Australia and South Australia. Father's occupation is on the SMPs for those two States because both States insist that they need people like him and must get them urgently, hence the ASPC say that Father's visa application would be processed within 12 months:

 

http://www.pomsinoz.com/forum/migration-issues/78598-aspc-adelaide-processing-update-email-9-february.html

 

DIAC say that they will consult the relevant State about the costs of accepting the dependant child with the problem. I don't think that the State Governments are likely to refuse a worker whose occupation is on the SMP for that State.

 

This notion would dovetail, it would work and reducing the numbers skilled migrants in the ways that the Minister proposes will, I reckon, help some of the visa applicants whose applications have been refused recently because of their dependant child. The other limitations on who will be eligible to apply in the first place will prevent the costs-floodgates from opening, it seems to me.

 

Cheers

 

Gill

[George Lombard]

Gill,

 

One issue we have been working on is that very few countries have such an exacting regime with respect to medical processing; in particular, it seems that many European countries regard it as anathema to refuse applications on the grounds of disability rather than communicable disease. I would be interested to see relevant documentation confirming that general issue. We have almost finished a late submission to the committee concerning the practice in Germany, but fwiw it might be helpful if the isolated position of Australia - and to a lesser extent Canada and New Zealand, could be confirmed.

 

Cheers,

 

George Lombard

[Guest Gollywobbler]

Gill,

 

One issue we have been working on is that very few countries have such an exacting regime with respect to medical processing; in particular, it seems that many European countries regard it as anathema to refuse applications on the grounds of disability rather than communicable disease. I would be interested to see relevant documentation confirming that general issue. We have almost finished a late submission to the committee concerning the practice in Germany, but fwiw it might be helpful if the isolated position of Australia - and to a lesser extent Canada and New Zealand, could be confirmed.

 

Cheers,

 

George Lombard

 

Hi George

 

I saw your post above a few days ago and set about the UK Border Agency website to see whether I could discover what the UK Policies are. It was too complicated, I got bogged down and I gave up! The Border Agency Home Page is here:

 

UK Border Agency | Home Page

 

Apparently the UK relies on the Immigration Act 1971 but the British Government accepts that this is now hopelessly out of date, so a new Immigration Bill 2009 has been presented to Parliament. Presumably the new Bill will re-think the whole thing, particularly in the light of the UK's entry into the EU. I understand that the UK's entry into the EU was established by the Treaty of Rome in 1976.

 

I found some vague references to the medicals in the description of the new UK Bill. However for a more detailed description, one would need to read the Rules. So I clicked on the link for the Policy Rules for the UK:

 

UK Border Agency | Policy and law

 

There seem to be loads of different Policy documents (no surprise there since it is a Labour Govt in the UK and has been since 1997, plus the Act is hopelessly old and out of date.)

 

It is just too complicated to

(a) work it all out; and

(b) be sure of being right

unless one works in the field of Immigration Law in the UK, I reckon. I don't think that anyone except a practitioner would understand how the whole thing is (a) supposed to work; and (b) actually works in reality. So I gave up because I didn't even know about the 1971 Act, to be honest!

 

Yesterday I decided to read DIAC's Submission to the Aussie Inquiry properly. When that was new, I skimmed through it quickly, decided it was boring and concentrated on some of the other new Submissions instead. However Dr Douglas (DIAC's CMO) then told the Inquiry on 24th Feb 2010 that the fomula for working out the $21,000 is in DIAC's Submission. I pricked my ears up. I didn't see anything marked "the Formula" in DIAC's Submission, so I decided to read it again, properly and in detail, which I did yesterday.

 

DIAC's Submission is below:

 

http://www.aph.gov.au/house/committee/mig/disability/subs/sub066.pdf

 

Actually, it is pretty good when you can find the time to read it properly. From about Page 50 onwards, there is a lengthy analysis of how other countries - ie NZ, Canada, the UK and the USA treat the meds for intending migrants. As far as I can tell, NZ mirrors Australia the most closely - but I think that this is not surprising.

 

DIAC do go into the comparison at length (though they do not attempt to draw any conclusions from the comparison in their Submission) and I'm not sure that anybody needs to do any more than they have done on this bit.

 

The narrative in the DIAC document reveals that since 2005, the 5 countries involved have had an International Immigration Health Working Group. They have a Conference annually, apparently. I googled it but there does not seem to be a micro-site for this Working Group. I am not sure that it would come under DIAC, either. I suspect that the "Aussie Owner" of this group is more likely to be DoHA or FaHCSIA (or whatever the latter are called - I don't know the order of the words so I usually get the acronym wrong as well.) I don't know what the Freedom of Information Acts in the UK and in Oz might produce in terms of extracting information out of this International Working Group, though.

 

A couple of other interesting snippets emerge from the DIAC Submission as well. In no particular order:

 

1. The Case Law: One of the attachments at the end contains DIAC's beliefs about the important cases that turned on the meds. It is well worth reading about what DIAC believe the ratios of the various cases to be because I am not sure that you or Peter Bollard would necessarily agree with some of the perceptions held by DIAC.

 

However the MOC is instructed to rely on DIAC's perceptions and interpretations of the cases, obviously. The most startling of which is that it does not matter what the experts who have actually examined the person say about him/her. Apparently the MOC is entitled and empowered to reach his own judgement about a person whom the MOC has never examined, even if the MOC concludes that the person is much more severely affected by the condition than the examining experts believe. (So at least we now know where that idea comes from, if nothing else! I think DIAC say that this perception of the law stems from the Blair case but if it isn't Blair, it is Imad and both of them have survived Robinson as far as this perception of the law is concerned, it would seem.)

 

I'm not sure that your Submission shouldn't be slanted towards analysing the cases and drawing some conclusions/disagreements about those rather than trying to deal with issues of comparitive law in different countrries? I'm more inclined to examine whether or not DIAC's legal interpretation of the case law is correct?

 

None of the other Submissions have attempted to examine the case law (apart from DIAC's own Submission) and I am not convinced that DIAC's beliefs about what the case law says and means should necessarily be accepted as being correct.

 

2. DIAC say that 1586 visas were refused on Health grounds during 2008/2009. 286 of these visas were refused under the "one fails, all fail" principle because a secondary applicant was the one with the meds problem. (In all the other cases, the main visa applicant had the medical problem if I have read the Submission correcctly?)

 

According to DIAC, refusing these 1586 visas led to Australia saving some $70 million AUD in costs. However there is no attempt to discuss either the social benefits to Oz or the taxes which those people would have crontributed, or the economic benefits that Australia might have accrued if the relevant people had been allowed to move to Australia instead. My guess is that no external qango or contractorr has been instructed to investigate this quesion? Apparently the Guidance Note contracts have been let to a company who say that they are Health Economists - which DIAC definitely aren't and Dr Douglas definitely isn't. He is a straightforward doctor when push comes to shove.

 

Elderly Parent migrants (even the Contributory Parents) cost Australia an arm and a leg apparently, and they make "no" economic contribution to Australia because very few of them join the mainstream Aussie workforce. Fine - why haven't DIAC discussed the fact that the elderly Parent frequently enables their grandchild's mother to go out to work, thus producing a household with two earners and two lots of tax revenue instead of only the one? It is unlikely that Contributory Parents make no other financial contributions at all once they reach Oz, I suspect. Again, the figures are in one of the attachments and you are likely to discover far more from the breakdown (which is given) than I can.

 

I am - personally - cross about this because my mother is now 89 and she has a CPV 143, granted in 2006. She paid the Contribution which the Aussies said they required. They knew her age from the visa application and the proof supplied with it. The MOC also knew her age from Form 26, and the MOC requested a Geriatrician's report, which was provided. (Despite DIAC's claim that they only use a three year period when the visa applicant is over 70, the MOC asked about residential care during the next 5 years. The consultant Geriatrician told the MOC firmly that when a patient is 85, making predictions beyond the end of that week is completely impossible.) Mum did everything that the Aussies required, so it is very bad form for DIAC to complain about it now, in my view. The Aussie Govt invented the CPV Scheme - not Mum. Now they can spend her 2nd Instalment on keeping her alive for as long as possible in my view. The Contribution s not supposed to be a windfall for the Aussie Govt. They set the amount of the Contribution - Mum merely paid as much as they said to pay. And because Mum is at home all day during the week, Mum's two grandsons do not cause my sister to demand Centrelink's help with the cost of Childcare, plus Mum enables Elaine to work full-time, which is not possible without Mum whilst the boys are not adults as yet.

 

3. Right at the beginning of the document, DIAC say that medical expertise is not part of their job or their role. They then describe how the delegate can ignore medical expertise in order to decide on a Health Waiver in spite of the MOC's Opinion - which strikes me as a mite illogical.....

 

4. The independent contractors were engaged to write the new Guidance Notes for the MOC way back in 2006 (the first contract) and the second contract was let in March 2007, after it was discovered that the Australian Auditor General was dropping in to the HOC for a visit. I found both contracts and I read them both, some time ago when I ws first told about the ANAO Report in 2008. (A British barrister visa applicant - a member of Poms in Oz - did the sleuthing and found the Report, which is dated 2007.)

 

Here we are in 2010. Only 3 out of the promised new Guidance Notes have been produced as yet - on HIV. Ophthalmology and a third medical issue. (These three documents are on Legend according to Dr Douglas.) The new "General Principles" Guidance Note to the MOC has not been completed as yet, so even if the condition is decribed in one of the 3 new Guidance Notes papers, the MOC still doesn't know what conclusions to draw because the new General Principles are either not used or the MOCdoctors are relying on a document that was produced before 1995, which pre-dates everty single one of the important cases, which DIAC agree began with Seligman in 1999.

 

According to Dr Douglas, in his address to the Committee, any intending visa applicant can contact DIAC and ask for the Guidance Notes etc etc. Which exercise will be a fat lot of use to the intending applicant when the new General Principles Note has not been written and so it isn't available, plus he may not be suffering from one of the conditions for which the three detailed, up to date Guidance Notes are now available. The applicant is nevertheless NOT given the benefit of the doubt - his visa is simply refused.

 

5. According to Dr Douglas, two MOCs now have to confirm a negative finding before one of them says "does not meet" in Form 884. (He does not say when he introduced this new rule, but I know that in May & June 2008, Dr Douglas made an enormous fuss to DIAC, following the British Kidney Case. Again, the couple are Poms in Oz members and the Husband contacted Dr Douglas personally and directly twice, in order to sort out the mess made by the solo GP MOC. Dr Douglas listened intently, read all the documents himself, agreed that the guy's wife did indeed meet PIC 4005 fully and Dr Douglas himself signed the new Form 884, saying that the lady meets the Health requirement for permanent migration. Dr Douglas told the girl who produces Form 884 to send a copy of the new Form 884 direct to the visa applicant by e-mail as well as to the ASPC, to sort out the fact that the visa applicant had Nigel Dobbie aboard and the two of them were threatening to sue the Minister for Immi in the FMCA. Dr Douglas then made a huge fuss to DIAC HQ according to the couple's CO at the ASPC. In this huge fuss, Dr Douglas allegedly told DIAC that irrespective of the cost, two MOCs must be involved in any "does not meet" conclusion, according to the CO.)

 

The Canadian High Commission submission confirms that they rely on two different doctors who reach negative findings independently of each other as well. I think the Royal Australasian College of Pysicians would still hit back. I think they would argue that you could use 6 GPs and rely on a unanimous Opinion from all of them. All 6 of the GPs could still be wrong if none of them has any specific training in the condition concerned and there are no Guidance Notes or General Principles for them either.

 

I'd have thought that the simplest, most logical way for Dr Douglas to prove that his "two MOC GPs" argument is true is for both of them to be seen to sign the relevant Form 884. Have you ever seen one that is signed by two MOC doctors and concludes "Does not meet?"

 

6. The MOC takes a pure guess at what Special Education might cost. The State Governments have never been asked for their own figures, so the MOC does not even have the benefits of an average, Australia-wide cost to work from - according to DIAC's own admission in their Submission to the Inquiry. The MOC is not told which State will be involved, but when he does not even have an average figure to work from, any costs estimates from him are based on thin air, it would seem. Which is particularly important for Dermot Hogan - hogand - who I know subscribes to this thread.

 

I think that Michael Danby, the Inquiry Chairman, has the bit between his teeth with the current Inquiry. The two contracts with the external providers who are working on the new Guidance Notes are not expected to end until mid-2011 at the earliest. DIAC claim that all 18 of the new Guidance Notes will be available a year early - by mid 2010, along with the new General Principles Guidance Note, which might make 19. I think Mr Danby is likely to ask how the rest of the Guidance Notes can be produced so quickly when hardly any of them are ready? I think he can also be relied on to remark that the current Inquiry was flagged by the Minister in November 2008 but the new Guidance Note on Disability is not yet available for the Inquiry Committee to use.

 

However we are assured that DIAC really are Good Guys. Finally - eventually - they are now busting a gut to sort out their administration of the Health requirement, it seems.

 

In the meantime, visas will continue to be refused, of course...... Which fact DIAC have chosen not to mention!

 

Cheers

 

Gill

[Guest Gollywobbler]

Hi All

 

It might be that nobody knows the answer to my question, but just in case somebody does....

 

On Wednesday 17th March 2010, Dr Paul Douglas made a second appearance at the Public Inquiry in Canberra. I was up and about late that night in the UK, intending to watch that particular webcast live. However I became engrossed in something else and forgot all about it until it was too late.

 

Ever since then, I have looked at the Inquiry website every day, refreshed the page and everything else, waiting for publication of the proof Hansard of the latest Hearing.

 

http://www.aph.gov.au/house/committee/mig/disability/hearings.htm

 

The others were all published very quickly indeed, so I cannot understand why the latest one has not been published as well?

 

Is there a process via which documents are not published on the aph website if the relevant Committee is taking a holiday or something, please?

 

Many thanks

 

Gill

[Guest Migration Help]

Hi Gill

 

I dont know the answer to your question unfortunately - I too have been waiting for the transcript to be published as I missed the live webcast. Not sure why it should take so long but hopefully it will be up shortly.

 

In the meantime, another sad case - Adelaide GP's battle with immigration over autistic son .

 

Perhaps DIAC and the MOC could ask Temple Grandin to come and give them a talk about autism? Check her out on TED.com . I think she could open a few blinkered eyes.

 

Temple Grandin, diagnosed with autism as a child, talks about how her mind works -- sharing her ability to "think in pictures," which helps her solve problems that neurotypical brains might miss. She makes the case that the world needs people on the autism spectrum: visual thinkers, pattern thinkers, verbal thinkers, and all kinds of smart geeky kids.

 

What an inspiration she has been to many. And which is why in my view, as a society, Australia should not be so short-sighted in refusing entry to migrants with such 'disablities'.

 

Kind regards

 

Sheelagh

[Guest Gollywobbler]

Hi Gill

 

I dont know the answer to your question unfortunately - I too have been waiting for the transcript to be published as I missed the live webcast. Not sure why it should take so long but hopefully it will be up shortly.

 

In the meantime, another sad case - Adelaide GP's battle with immigration over autistic son .

 

Perhaps DIAC and the MOC could ask Temple Grandin to come and give them a talk about autism? Check her out on TED.com . I think she could open a few blinkered eyes.

 

Temple Grandin, diagnosed with autism as a child, talks about how her mind works -- sharing her ability to "think in pictures," which helps her solve problems that neurotypical brains might miss. She makes the case that the world needs people on the autism spectrum: visual thinkers, pattern thinkers, verbal thinkers, and all kinds of smart geeky kids.

 

What an inspiration she has been to many. And which is why in my view, as a society, Australia should not be so short-sighted in refusing entry to migrants with such 'disablities'.

 

Kind regards

 

Sheelagh

 

 

Hi Sheelagh

 

Many thanks for your reply. I guess that we will both just have to wait for the transcript from 17th March but my feeling is that LOADS of other people are probably waiting for it as well.

 

As a matter of fact, I don't think that Australian Society has a problem with understanding the Autistic Spectrum and that - if you like - all of us are on this spectrum. We merely fit into differing groups on the spectrum.

 

I don't believe that the Average Aussie has a problem with this notion. However the more I read of the submissions to the Public Inquiry and the transcripts of the public hearings for the Inquiry, I'm seeing the "medical model" emerging everywhere.

 

It is impossible to have a model that says "Abnormal" unless you have a model that is labelled "Normal" as well. When you come to the Autistic Spectrum, I think that this type of labelling is very unsafe. We don't even understand a fraction about how the brain works - every doctor involved with studying the brain admits that. So how can we say what is "normal" and what is "abnormal" when it comes to the human brain? The research is in its infancy and in 100 years' time, MRI scanners will be museum pieces for certain. Something better will have been invented - probably by somebody whom the medics today would write off as being "abnormal" on the Autistic Spectrum.

 

I don't believe that 'Autism' is a new "disease" or "disability." I think it is merely a different ability. I reckon that historically Hom Sap has been too busy worrying about his physical survival - eg the need to hunt or gather or farm or fish for food - than to have time to spare for worrying about the niceties of what others might say is a "normal" trait for a "normal" member of a given society.

 

The assumption has been made that a child with a "disorder" somewhere on the Autistic Spectrum will definitely cost the Australian Government more money than a "normal" child would cost them. When you drill down, it turns out that the Aussie States foot 90% of the bill, not the Federal Government. The Feds have never even bothered to ask any of the State Governments to give them any of the figures for this. The State Governments say that if a child has basic literacy and numeracy then the best place for him or her is in a normal school. So how is this going to cost more than it would cost for the "normal" child, one asks the Fed Govt?

 

They don't know. They can't produce a single figure that proves any of their assumptions. Why can't they prove them? Computers have been reliable and large enough for more than enough years to do the number crunching and the abacus was able to crunch the same numbers for millenia before the computer.

 

The excuse from the Government is that, "The Doctors say it will cost extra."

 

I splutter, "WOT? You mean Dr Sawbones over there? 100 short years ago, he thought that chopping limbs off without anaesthetic was a Brainy Idea. 100 years ago he decided that anybody who couldn't earn a living wage on their own - doing the activities that were considered to be "normal" back then - was an "imbecile" who should be locked up in an asylum at the Government's expense. When Dr Sawbones himself comes from such recent, humble, primitive and - we now know, horrendously mistaken - beginnings, who the hell is he to claim that he suddenly knows "everything" today?"

 

It becomes circular. The Governments blame the doctors. The doctors agree that clinically the ideas that they think are good ones today will have been dismissed within 20 or 50 years from now. But they blame the Government and claim that the Government sets the parameters. A bunch of civil servants invented the "costs" apparently. And so it continues, with everyone insisting that the scapegoat is somebody else.

 

To give Senator Chris Evans his due, the man is not afraid of grasping the nettle on this one. He insists that the Aussie public must thrash the whole thing out and decide amongst themselves what they think the medical criteria for Immigation to Oz ought to say.

 

DIAC have promptly subverted that notion, it seems. Give decision making power to the Aussie bloke in the street? Good God forbid!!!!! NOOOOO!!!!! DIAC admit on the one hand that their officials know nothing about anything except Immigration to Oz. On the other hand, if anyone is to be given any greater powers with regard to the medical criteria for Immi, that greater power will go to the very officials who know absolutely nothing about medicine according to DIAC.

 

It amazes me that DIAC either can't see - or don't want to see - the flaws in their own logic......

 

Cheers

 

Gill

[Guest Migration Help]

As a matter of fact, I don't think that Australian Society has a problem with understanding the Autistic Spectrum and that - if you like - all of us are on this spectrum. We merely fit into differing groups on the spectrum.

 

I don't believe that the Average Aussie has a problem with this notion.

 

On one level, yes I agree with these comments.

 

However, when the chips are down and push comes to shove my experience is that Australians baulk if they think there are going to be any 'inherent' costs to themselves i.e. the taxpayers, when it comes to funding what they see as a 'disability' of a potential migrant. The majority I suspect just accept the 'numbers' without looking too deeply at anything else. It is too hard to look beyond what appears to be the obvious. Why allow a migrant with a disability into Australia when we struggle to support and help our own? A rhetorical question of course and on the surface a very valid one. Very few have the time or inclination to scratch below the surface of the issue.

 

It becomes circular. The Governments blame the doctors. The doctors agree that clinically the ideas that they think are good ones today will have been dismissed within 20 or 50 years from now. But they blame the Government and claim that the Government sets the parameters. A bunch of civil servants invented the "costs" apparently. And so it continues, with everyone insisting that the scapegoat is somebody else.

Yes, it is a circular blame game. But an easy game to play (says successive cynical federal governments). They say, give us good reasons which will motivate us to try something different. And that's where as a society we fall down. Who is really going to lead this charge? Who is going to try and get things changed? Who cares about the comparatively miniscule number of potential migrants who fail to come to Australia because of being barred by a 'disability', either their own or that of a family member? They are voiceless. They have no champions. And they certainly have no political clout.

Occasionally they get some air time in the media which raises their profile and the Minister's involvement. Have you noticed that most of these occur in regional areas? Where Australian communities regularly have to deal with issues like - if we let this migrant doctor settle here with an autistic child, what is the overall likely impact to our community going to be - negative or positive? It is impressive how quickly such regional societies sum up that overall, the community is going to be better off despite the additional expenditure of having to deal with a 'disabled' migrant. This does not happen well or at all in our cities. And I personally cannot see this changing much despite any recommendations that are put forward after this inquiry is concluded. I sincerely hope I am wrong.

 

Cheers

 

Sheelagh

[Guest Gollywobbler]

Hi Sheelagh

 

If you have had time in the last few hours, you will already know that the proof Hansard from the Public Hearing on 17th March is now available.

 

For anyone who is interested and has not read the 17th March Hansard, it is here:

 

http://www.aph.gov.au/hansard/joint/commttee/J12880.pdf

 

Cheers

 

Gill

[Guest Migration Help]

Thanks for the headups Gill. I hadnt looked today.

[George Lombard]

Dr Douglas seemed a bit evasive Gill or perhaps he doesnt' have command of his material, but it seems to me to that it's not good enough to just refer to the Notes for Guidance, the NSW Department of Education information, the formula for costing, implementation of the ANAO audit, and so it goes on without bringing the relevant documentation to the table. A genuine review of disability and migration would have to work through all that machinery.

 

One tragicomic note - Dr Douglas mentions that a person who is young and "legally blind" will fail the "health requirement" - presumably he means condition 4005 - but unfortunately there is at least one case of a blind child being allowed in by a now former panel doctor as an exercise in charity, and I think that kind of failing lies at the heart of the medical assessment system, indeed it compromises the entire migration system.

 

The discussion of a hypothetical Downs syndrome child was jejune at best. I guess I'm pleased he didn't choose any autism spectrum disorder conditions because it just would have upset me.

 

Cheers,

 

George Lombard

 

Cheers,

 

George Lombard

[Guest Gollywobbler]

H George

 

I hear what you say about Dr Paul Douglas but I do not agree with you. Dr Douglas himself is very sensible and level headed, and he is very knowledgeable about a huge range of medical conditions and medico-legal situations. A PiO member spoke with Dr Douglas on the phone a couple of times in May 2008 and they exchanged a couple of e-mails at the time. The PiO member is British and very sensible. He told me that he thought that Dr Douglas is first rate.

 

At the moment, a second British case has just been referred to Dr Douglas in the last few days. 3 examining doctors in the UK all insist that the MOC's verdict of "does not meet" PIC 4005 is clinically inaccurate and that it is unfair. Dr Douglas is really the only DIAC Officer who can sort it out, so the whole thing has been referred to him for consideration.

 

Dr Douglas sorted the first case out two years ago. The skilled sc 136 visa had been refused. No opportunity to comment had been offered. No report from the applicant's treating consultant specialist had either been sought by the MOC or sent to the MOC. The MOC simply took one look at the Form 26, saw the words "kidney transplant" and according to the first Form 884, the visa applicant was so ill that she was likely to drop dead at any moment! If she did not drop dead she would undoubtedly cost Australia a fortune instead according to the MOC in the first Form 884.

 

The treating consultant surgeon in the UK went mental. He said that the Form 884 proved only that the MOC doctor knew nothing about kidney transplants in this day and age and that the MOC's beliefs were absolute medical rubbish. He was scathing about the notion that "a mere GP" should take it upon the GP's self to disagree with a world-famous Nephrologist surgeon, as well! He produced a very pithy report for Dr Douglas to read. Dr Douglas promptly produced a new Form 884 confirming that the lady did, in fact, meet PIC 4005 hands-down.

 

To my certain knowledge, that particular fracas led to Dr Douglas insisting to DIAC in Canberra that, regardless of cost, it could NOT be left to a solo MOC doctor to decide "does not meet" PIC 4005, since there is no Waiver with PIC 4005. From what Dr Douglas says at the top of Page M12 in the first Hansard, below, it does not seem to me to be likely that DIAC have agreed to spend any money on letting Dr Douglas have his own way about this one:

 

http://www.aph.gov.au/hansard/joint/commttee/J12833.pdf

 

I strongly suspect that DIAC are relying on the free-of-cost "method" known as "an informal chat with one or more of one's colleagues," but at least Dr Douglas is trying to do something worthwhile, I reckon. Modern, international, Quality Assurance standards such as the ISO 2000 series (used by the British Government amongst others) have never heard of the idea of the "informal chat" but I guess that one has to start somewhere!

 

I've noticed that in the two relevant Hansards and in DIAC's written Submission to the Public Inquiry, the term "Quality Assurance" is carefully not mentioned by anyone, anywhere! If it existed, DIAC would be trumpeting about their use of it, I reckon!

 

I think that what Dr Douglas said on 17th March simply shows that DIAC's administration of the Health requirement for migration is nothing more than a cottage industry. Apparently Dr Douglas had a chance meeting with one of the Directors of the NSW Education Department, he mentions. Nobody knows whether the other Directors of that Department would agree with what the first fellow told Dr Douglas, but apparently the whole of the MOC's knowledge of the "Special Education" system and its costs for the whole of Australia depend solely on what the NSW Education Dept Director happened to tell Dr Douglas, it seems!

 

According to Dr Douglas, the figure of $21,000 has not been revisited since the financial year 2002-2003, when it was first decided upon, but not to worry because the figures used for the Health Waiver costings date from 2000, so they are even older!!!!! Apparently the obsolence of all of the figures, coupled with a few informal chats, create a situation that is "fair, reasonable and - so I am led to believe - transparent." Hiding the new Guidance Notes for the MOC on Legend.com will make them highly visible to the general public, I gather!!

 

If the visa applicant happens to live in Australia, apparently Legend.com can be accessed by the computers in any State Library. I would guess that it would take quite a while for the hapless visa applicant to learn to work Legend, but with enough time in the State Library he might get far enough to discover that the Guidance Notes that he specifically wants are not yet available on Legend anyway. If I were him, I would write to the HOC, threatening the Freedom of Information Act, and I would demand copies of the missing material. If the visa applicant does not live in Australia, I recommend simply demanding the material instead.

 

Dr Douglas states firmly that the figure of $21,000 was decided upon by FaHCSIA and DoHA between them. Both of the alleged culprit Departments stoutly deny that either of them had anything to do with hatching up the $21,000. The Inquiry Committee asked FaHCSIA about it. FaHCSIA checked their own records and absolutely deny - in their supplementary Submission - that they ever had anything to do with it! DoHA have evidently decided to say as little as possible in their own Submission. Their one-page letter confirms that they warn DIAC about communicable diseases from time to time, but beyond that they leave DIAC's own Health people to paddle the medical canoe concerning migration to Australia, apparently.

 

Bang goes the ANAO's Recommendation about a proper forum between DIAC, DoHA and FaHCSIA, then! Nothing has ever been done about it and the other two Departments seem to be hostile about even the very idea!

 

Adhealth - the external contractors who were hastily commissioned by DIAC to produce 19 new Guidance Notes at a contract cost of about $861,000 AUD minimum (a cost of not less than $4,300 per Note, IF the contracts come in on budget, which they probably won't) seem to be going great guns, though!

 

Consultants and consultancy services - Managment and accountability - Annual Report 2006-07

 

So far it has taken Adhealth 3 years to produce 3 Guidance Notes which are now hidden on Legend, concerning HIV+, Opthalmology and Hepatology according to the DIAC Submission (see Page 11 of the main DIAC Submission below.)

 

http://www.aph.gov.au/house/committee/mig/disability/subs.htm

 

If you ain't got something wrong with you that can be cured by one of those 3 Notes then you can stay sick and you can be sick somewhere other than in Australia, it seems!

 

Nonetheless, Dr Douglas says in the second Hansard that his information is that Adhealth have been unusually speedy with the production of the remaining 16 Notes:

 

http://www.aph.gov.au/hansard/joint/commttee/J12880.pdf

 

(Please see the bottom of Page M6 and the top of Page M7.)

 

At any rate, Adhealth promise to bring the two Contracts home at least 12 months before the projected completion date, apparently!

 

My own experience of external contractors working for Government Departments is that the projects invariably take ages longer - and cost a great deal more - than the contractors claimed in the beginning. The Contractors invariably blame the Government Department for both issues - the Department did not produce a proper Specification at the beginning.

 

The Department also failed to mention what when a re-hash of the old guidance note on Nephrology went to the Royal Australian College of Nephrologists, the College chucked the whole thing out. The College said it was based on hopelessly obsolete material and research, and to do the whole thing properly if DIAC wanted the College to endorse it, I heard. Needless to say, the Nephrologists gossiped to all their friends in the other Colleges in Australasia. The Nephrology paper was the first draft produced about a year ago, but the College threw it out so I assume that that has now gone to the back of the queue!

 

Dr Douglas says that the new Guidance Note on Mental Health is with the Royal Australian College of Psychiatrists, apparently. Unless they give the OK, gawd 'elp the visa applicant with a mental health problem, no doubt!

 

I am not sure whether Dr Douglas is deliberately taking the lid off the whole thing or whether that is an accident. However if I were DIAC, I would threaten to stop his pay-cheques unless he stops undermining his employers!

 

From my point of view, the antics of the three Government Departments are miles more amusing than reading the Beano for breakfast. Mr Danby, the Chairman of the Inquiry, is not stupid. I reckon that he will have noticed all the same things as I have noticed.

 

However it now seems pretty clear that two different inquiries are going on anyway. It seems to me that the Joint Standing Committee on Migration are trying to work out what to do about the CRPD.

 

DIAC, on the other hand, seem to me to want to prevent the Dr Moeller problem from arising again, via extending the Health Waiver idea to all skilled visa applications, with DIAC's staff in charge of making the proposed Health Waiver decisions.

 

The Terms of Reference of the main Public Inquiry do not touch upon what DIAC actually seem to want. Have DIAC actually bothered to read the ToRs that are in front of the Joint Standing Committee, one asks?!

 

I think that DIAC and the Joint Standing Committee are talking at cross purposes, myself....

 

Cheers

 

Gill

[Guest Rave]

Hi All,

 

Is there any further news or when are we expecting an outcome to all the hearings?

 

Regards,

 

Deon.

[Guest Migration Help]

Issued by: House of Representatives Liaison & Projects Office, Monday 21 June 2010

 

Report on the migration treatment of disability to be released tonight

 

The Joint Standing Committee on Migration will table its report into the migration treatment of disability in the House of Representatives at approximately 9:15pm tonight (Monday 21 June 2010).

 

The Committee’s inquiry was referred in August 2009 by the Minister for Immigration and Citizenship Senator Chris Evans. The terms of reference called for a review of the approach under the migration Health Requirement to assessing visa applicants with a disability.

 

The Committee’s inquiry received over 100 submissions, many recounting the circumstances of people rejected under the Migration Health Requirement, because of disability. While these accounts are exceptional among the many thousands of successful visa applications processed annually, the Committee concluded that current arrangements are prejudicial to people with a disability relative to other applicants.

 

The Committee Chair Michael Danby MP said: “Prospective migrants with disabilities and their families are currently excluded by the Migration Health Requirement as costs to our society. Applicants for permanent residency are particularly disadvantaged as there is little scope to consider the social and economic benefits of their inclusion”.

 

The Committee’s report, to be tabled tonight, recommends fundamental change to the Migration Health Requirement and its administration.

 

“The Committee believes its recommendations will not only address problems experienced by people with a disability and their families, but will also provide for a fairer and more efficient migration process for all visa applicants,” Mr Danby said.

 

Embargoed copies of report will be available to members of the parliamentary press gallery in Canberra from Suite R1 106 at 12 noon Monday 21 June 2010.

 

The report is available following tabling at Joint Standing Committee on Migration: Reports and other activities An electronic html version for screen readers will be available on the website from Monday 28 June.

 

For media comment, please contact the Committee Chair, Michael Danby MP, on (02) 6277 4520.

 

For background information, please visit the inquiry website at http://www.aph.gov.au/house/committee/mig/disability/index.htm or contact the Committee Secretariat on (02) 6277 4560 or jscm@aph.gov.au.

 

This is excellent news. Now we just have to wait and see what has been recommended and whether or not the recommendations are implemented by the immigration department.

[Guest jayde]

For anyone who is interested the report from the Joint Standing Committee on Migration Inquiry into migration treatment of disability is now available

 

<http://www.aph.gov.au/house/committee/mig/disability/report.htm>

 

hope this helps

[Guest Gollywobbler]

Hi Jayde

 

When the Inquiry opened, the Inquiry Secretary very kindly joined Poms in Oz because she had noticed a number of threads where people (or their children) had Health issues that theiy were worried about in connection with the meds for migration to Oz.

 

After the Public Hearing in March 2010, everything seemed to go dead. I understood originally that there was going to be a Public Hearing in Perth. However that never happened.

 

Then the Reports page said last week that the Report would be published once it had been tabled in Parliament. I wondered what that meant and how long it would be before an ordinary member of the public like me would be able to read the Report.

 

Today I know!

 

I haven't read the Report yet. I've downloaded the Consolidated version to get the general gist and plan to get a drink and read it over the next hour or two. It is only 5.40pm in the UK but it is 6.40pm in France, so that will do!!

 

I've moved your thread into here because I was going to post the link to the Report on this thread anyway but you have very kindly saved me the bother.

 

Many thanks

 

Cheers

 

Gill

[George Lombard]

Just to assist everyone trying to make sense of the report, the following are the listed recommendations. What happens next is that the Government/Department responds and then we wait for change. The discussion of Australia's international obligations is clearly a weak point in the report, one which will no doubt be tested by litigation if reform does not come quickly.

 

3 The Migration Health Requirement .................................................................... 25

Recommendation 1 ................................................................................................................. 38

The Committee recommends that the Australian Government raise the

‘significant cost threshold’ (which forms part of the Health Requirement

developed under the Migration Regulations 1994) to a more appropriate

level. The Committee also recommends that the Department of

Immigration and Citizenship quickly complete the review of the

‘significant cost threshold’.

Recommendation 2 ................................................................................................................. 43

The Committee recommends that the Australian Government adopt a

contemporary Health Requirement for prospective permanent and

temporary migration entrants under the Migration Act 1958 (Cth).

The Committee recommends changes to the Health Requirement include

changes to the assessment criteria, processes and waiver options. These

are outlined in subsequent recommendations.

Recommendation 3 ................................................................................................................. 55

The Committee recommends that the Australian Government amend

Schedule 4 of the Migration Regulations 1994 to allow for the

consideration of the social and economic contributions to Australia of a

prospective migrant or a prospective migrant’s family in the overall

assessment of a visa.

Recommendation 4 ................................................................................................................. 58

The Committee recommends that the Australian Government amend the

Migration Regulations 1994 (in particular Public Interest Criteria 4005,

4006A and 4007) so that the assessment of diseases and medical

conditions are addressed separately from the assessment of conditions as

part of a disability.

xxiii

4 Decision making processes ............................................................................... 59

Recommendation 5 ................................................................................................................. 77

The Committee recommends that the Department of Immigration and

Citizenship make the current ‘Notes for Guidance’ publicly available. It

further recommends that, when such papers are revised, their updated

version be placed on the Department’s website as soon as possible.

‘Notes for Guidance’ and associated background information should also

be referred to in the Department’s Fact Sheets for prospective visa

applicants.

Recommendation 6 ................................................................................................................. 77

The Committee recommends that the Department of Immigration and

Citizenship publish on the Department’s website the cost calculation

methodology used by Medical Officers of the Commonwealth in

assessing the costs associated with diseases or conditions under the

Health Requirement.

Recommendation 7 ................................................................................................................. 78

The Committee recommends that the Department of Immigration and

Citizenship provide each applicant with a detailed breakdown of their

assessed costs associated with diseases or conditions under the Health

Requirement.

Recommendation 8 ................................................................................................................. 79

The Committee recommends that the Australian Government remove

from the Migration Regulations 1994 the criterion under Public Interest

Criteria 4005, 4006A and 4007 which states that costs will be assessed

‘regardless of whether the health care or community services will

actually be used in connection with the applicant’.

The Committee also recommends that the Australian Government revise

the approach which assesses visa applicants’ possible health care and

service needs against ‘the hypothetical person test’. This test should be

revised so that it reflects a tailored assessment of individual

circumstances in relation to likely healthcare and service use.

Recommendation 9 ................................................................................................................. 79

The Committee recommends that the Australian Government amend

Regulation 2.25A of the Migration Regulations 1994 in a manner which

does not bind the Minister of Immigration and Citizenship to take as final

the decision of a Medical Officer of the Commonwealth in relation to

‘significant cost’ and ‘prejudice to access’ issues, and provides scope for

Ministerial intervention.

xxiv

Recommendation 10 ............................................................................................................... 94

The Committee recommends that visa decision-makers in the

Department of Immigration and Citizenship be provided with the

discretion to consider mitigating factors for any visa stream once a ‘does

not meet’ the Health Requirement decision is received from a Medical

Officer of the Commonwealth. These factors may be used to mitigate the

‘significant cost threshold’.

5 Family, humanitarian and refugee migration ................................................. 103

Recommendation 11 ............................................................................................................. 129

The Committee recommends that the Australian Government review the

operation of the ‘one fails, all fails’ criterion under the Migration

Regulations 1994 to remove prejudicial impacts on people with a

disability.

Recommendation 12 ............................................................................................................. 129

The Committee recommends that the Australian Government amend the

criterion for assessing waivers to the Health Requirement to include

recognition of the contribution made by carers within the family as an

offset to health care or community services costs identified in the process.

Recommendation 13 ............................................................................................................. 129

The Committee recommends that the Australian Government review the

requirements for health inspections for short term visas under the Family

Visits program.

Recommendation 14 ............................................................................................................. 134

The Committee recommends that the Australian Government amend the

Migration Regulations 1994 to provide access to consideration of a waiver

to offshore refugee visa applicants involving disability or health

conditions on compelling and compassionate grounds.

Consideration should also be given to extended family members for the

same treatment in the same circumstances.

Recommendation 15 ............................................................................................................. 138

The Committee recommends that the Department of Immigration and

Citizenship create a priority visa category for refugees who have

sustained a disability or condition as a result of being a victim of torture

and trauma. The Committee recommends that similar visa consideration

is provided to immediate family members within the offshore refugee

program.

xxv

6 Skilled migration and disability ....................................................................... 139

Recommendation 16 ............................................................................................................. 160

The Committee recommends that the Australian Government work with

State and Territory Governments to expand the waiver option to the

Health Requirement for skilled migration visa classes to a broader range

of skilled visa categories, targeting areas of skill shortages and rural and

regional development schemes.

Recommendation 17 ............................................................................................................. 163

The Committee recommends that the Australian Government investigate

the introduction of a voluntary bond or other scheme for visa applicants

to indemnify against, or manage health care or community services costs

assessed under the Health Requirement of the Migration Act 1958 (Cth).

The Committee recommends that any introduction of such a bond or

other scheme should not prejudice those applicants that are unable to

provide a surety.

7 Australia’s international obligations and domestic exemptions .................. 165

Recommendation 18 ............................................................................................................. 185

The Committee recommends that as part of its proposal to amalgamate

Australian discrimination law, the Australian Government review the

Disability Discrimination Act 1992 (Cth) with particular reference to the

section 52 migration exemption, to determine its legal implications for

migration administration and conduct expert consultations on its impact

on people with a disability.

 

 

Cheers,

 

George Lombard

[Guest Gollywobbler]

Hi George

 

I'm just reading the Committee's Report. So far, I am very impressed. It is very clear. It is also unequivocal in its comments and criticisms. (The ANAO mauled the maladministration of the Health requirement and now the Committee is mauling it again, to judge from what I have read so far!)

 

I have some questions for you, though, please:

 

In one of the Public Hearings, Mr Danby told the people who attended that he intended to recommend change. He reassured the attendees that when the Joint Standing Committee on Migration recommends that the Law should be changed, it is very likely that the Government will listen and will change the Law. Has this been your experience of the JSCM in the past, please, on other things?

 

If the Government accepts all of the Committee's recommendations, how long is it likely to be before the Law is changed? I assume that one year would not be enough but do you think 3 years would be enough or would it be more likely to be 5 years, perhaps?

 

Many thanks

 

Cheers

 

Gill

[George Lombard]

Hi Gill,

 

With respect to the Committee's report I think that overall it's a positive contribution and will bring about much needed reform. I think Ben Saul would be disappointed that the Committee sidestepped what he actually said in his advice on Australia's international obligations, but this is a minor quibble since there is much else to be positive about and DIAC now has a clear signpost to achieve significant reform, not before time.

 

With respect to legislative change following a relevant report, I would just note that in 2003 the inquiry into Ministerial Discretion provoked a series of bizarre responses from the Department including at stages a total refusal to engage in the process, misleading statistics, and the most grudging response imaginable. It's true that the original inspiration for that inquiry was certainly not bi-partisan and that DIAC might have seen its role as protecting the Government. That being said, with a change of government many recommendations have been sensibly reviewed and implemented over the past three years.

 

The implementation of change in any area of public administration depends on many different factors and it's impossible to predict the pace of change externally, however as a general observation I would have thought that changing the threshholds would be relatively simple, releasing the Notes for Guidance and cost methodology even simpler, and everything else would involve reviewing the legislation, which not only involves determining what the changes would be, but standing in line in the queue with other agencies waiting to use the legislative change machinery. So yes, three years seems a rational expectation.

 

Cheers,

 

George Lombard

[Guest Gollywobbler]

Hi All

 

I've just collected today's post off the floor in my hall. The first was a letter from the Dragons who run the local GPs surgery, whingeing that I am supposed to make an appointment to go and be poked about when there is nothing the matter with me so I shall continue to ignore the Dragons and their whingeing.

 

The second one was a thick, heavy envelope that said Airmail and it said Canberra. I wondered what on earth the Australian Government might want to talk to me about?

 

To my astonishment, they have sent me a printed copy of their Report entitled Enabling Australia, which is the Report produced by the Inquiry Committee described in this thread. I imagine that they have sent it out of pure courtesy simply because I happened to make a submission to the Inquiry into the matter.

 

I am very seriously impressed that they have taken the trouble to send a printed copy all the way from Australia and to send it by airmail especially.

 

My thanks go to Mr Danby, the Committee Chairman, to all the members of the Committee and to the team led by the Inquiry Secretary - for all their hard work in producing the Report, for coordinating the whole show and for doing an extremely professional job.

 

Cheers

 

Gill

[Guest pablomorphy]

I'm a newbie, so I'm just getting familiar with the subject matter. However, I wonder if there are any empirical analyses of migration decision review boards/tribunals cross-nationally. In addition to the rules governing health requirements, it is important to look at the record of those bodies in charge of adjudicating disagreements concerning the application of such requirements. We could well observe countries that seemingly have more flexible rules, only to be trumped by conservative or narrow-minded legal or judicial adjudicators that interpret the rules in the most restrictive possible way. Cheers!