Kim Carr (Victoria, Australian Labor Party, Minister for Innovation, Industry, Science and Research) Share this | Hansard source

The Minister for Immigration and Citizenship has provided the following answer to the honourable senator's question:

(1) (a) For people transferred to Christmas Island via a Royal Australian Navy (RAN) vessel or undetected arrivals, the Department's contracted Health Services Provider (HSP) conducts public health screening immediately following their arrival. For people transferred to Christmas Island via an Australian Customs and Border Protection Service (ACBPS) vessel, initial public health screenings are usually conducted prior to arriving at the Christmas Island Wharf.

For clients transferred to Christmas Island via a RAN vessel or undetected arrivals, on arrival at Christmas Island, a comprehensive health screen is undertaken by the HSP, comprising a team of primary health care staff, including mental health staff. The health screen process consists of the following:

For a client arriving via an ACBPS vessel, the HSP completes the health screening process initiated by ACBPS, by ordering and reviewing pathology tests and a CXR. A Health Induction Assessment is also carried out.

(b) Health screening takes approximately 90 minutes per client, assuming there are no interruptions to the process and not including the time taken for CXR and pathology blood tests.

(c) All Irregular Maritime Arrivals (IMAs) are subjected to health induction and screening, with the following exceptions:

(2) (a) Health screening processes are comprehensive and include:

(3) (a) TB testing includes:

(b) The screening process does include a CXR for all IMAs, except those under 12 years of age and those who are pregnant (a urine pregnancy test is carried out and the result documented prior to the CXR being conducted).

(c) All IMAs undergo this screening process, however, CXRs are not undertaken for those under 12 years of age and those who are pregnant (a urine pregnancy test is carried out and the result documented prior to the CXR being conducted).

(d) See (3) (a).

(e) There have been a total of three IMAs identified as having active TB in the period 1 August 2007 to 30 April 2011.

(f) Yes. The TB Questionnaire provides a method for evaluating the possibility of an acute (active) TB infection. The CXR will show scarring from an old infection (possible latent TB) and signs of active infection. Further clarification and appropriate treatment is determined by the Western Australian (WA) TB Service.

(4) IMAs do not undergo the TB skin test (i.e. Purified Protein Derivative – PDD test). As indicated above, TB testing for IMAs includes:

Any person noted to have a cough for three months or haemoptysis, has a mask put on immediately and the GP is notified and the client is sent to the Christmas Island Hospital for an urgent CXR, sputum collection and management. All contacts have a Mantoux test and a CXR and treatment is provided, as necessary. All long term clients with a productive cough for three months or more have a repeat CXR conducted. All long term clients with haemoptysis are sent to hospital with a mask on for sputum collection and repeat CXR. All positive active TB cases are reported to the WA Population Health Unit (PHU) and the Chest Clinic, Perth.

All practices followed on Christmas Island are according to advice and guidelines provided by the WA TB service.

(5) As per WA TB Service protocols, secondary testing is not routinely carried out unless the IMA is symptomatic or has a high index of suspicion, in which case three samples of sputum on consecutive days is collected and submitted for an acid-fast bacillus (AFB) smear and culture. All practices followed on Christmas Island are according to advice and guidelines provided by the WA TB service.

(6) The WA TB Service (or other respective State/Territory TB service), is contacted immediately if a sputum result returns positive on either AFB smear or culture. Treatment, including drug supply, medical follow up, the need for isolation and contact tracing is led by the WA TB Service (or other respective State/Territory TB service), with HSP staff assisting, as needed.

(7) (a) The need for isolation is determined and coordinated by the WA TB Service (or other respective State/Territory TB service), with HSP staff assisting, as needed. With regards to Christmas Island, the local hospital has a negative pressure room and if needed, the HSP has the capacity to isolate on site at the North West Point Immigration Detention Centre. It prefers, however, to utilise the hospital, pending transfer off Island to a tertiary hospital.

(b) See response to (a).

(c) The need for and duration of isolation is determined by the WA TB Service (or other respective State/Territory TB service). A client would usually be admitted to the Christmas Island Hospital and/or Perth Chest Clinic and would be isolated/treated according to Department of Health, Western Australia policies and procedures.

(8) There are no formally designated quarantine facilities (as such) in Australian Immigration Detention Centres. Rather, each site has a designated area that can be utilised to medically isolate an individual or several individuals, as per the HSP's contractual requirement and scope of service. On Christmas Island/North West Point, there are two negatively pressured rooms for the purposes of medical isolation and there is also one such room at the ChristmasIsland Hospital. These were constructed and commissioned in recognition of the fact that Christmas Island is the most common entry point of IMAs into immigration detention and the most likely site to identify potential communicable/transmissible diseases. Once the client has been identified as having a communicable/transmissible disease, advice is immediately sought from the respective public health body and in many cases, the client is transferred to a tertiary unit for further treatment and isolation.

(9) (a) In June 2010, the Department received advice from the National Tuberculosis Advisory Committee (NTAC) regarding concerns they held around the way TB was being both screened and managed on Christmas Island by the Department, and when people in immigration detention were transferred to mainland detention facilities. The Department responded to the concerns and recommendations raised by NTAC by implementing a number of changes to its processes. NTAC subsequently advised they were satisfied the Department had responded appropriately to their recommendations, and the Department undertook to continue to consult with NTAC in relation to its TB policy. The Department is currently communicating with NTAC around developing a national approach to the screening and treatment of TB for people in immigration detention.

(b) A copy of this advice is not available, as it was provided to the Department verbally.

(10) All staff working within immigration detention facilities maintain universal precautions, as per current health standards and CDC guidelines. The HSP has an entire module of its Policy and Procedures Manual dedicated to the issue of Infection Control. This module was last formally reviewed by the Department and HSP in October 2010.

(11) ACBPS has advised that, as far as it is aware, no Customs officers have contracted TB from IMAs between 2008 and 2011 (as at 21 April 2011).

(12) All communicable/transmissible diseases are notifiable to the WA PHU and are recorded on a spreadsheet. The following table sets out established HSP disease management protocols for a number of communicable/transmissible diseases.

(13) Yes. The HSP monitors for threats of outbreaks through a system of clinical surveillance, index identification, case cluster analysis, State Public Health Authority liaison and State/Territory Department of Health notification for confirmed cases of communicable/transmissible diseases. These systems are in line with the current CDC guidelines.

(14) (a) Emergency plans are in line with current CDC guidelines.

(b) As above.

(c) As above.

(d) As above.

(15) As above.