Explainer: Why MSF is part of the Medical Evacuation Response Group (MERG)

What is the Medical Evacuation Response Group? 

The Medical Evacuation Response Group (MERG), also known as the ‘Medevac group’, is a partnership of organisations working to ensure the safe, orderly and effective implementation of applications for medical transfer under Australia’s so-called ‘Medevac Bill’. 

Put simply, the group aims to support the current Medevac process, through which refugees and asylum seekers held on Nauru and in Papua New Guinea (PNG) under Australian ‘offshore processing’ policy can be transferred to Australia for medical treatment. 

The staff supporting the work of the group include caseworkers, counsellors and lawyers, plus some administrative personnel. The MERG is independent of the Australian, Nauruan and PNG governments. 

Working alongside the MERG, but independently, are doctors who perform individual assessments of sick refugees and asylum seekers to determine whether they should be transferred.  

What is the Medevac Bill? 

The Home Affairs Legislation Amendment (Miscellaneous Measures) Act – generally known as the Medevac Bill – came into effect in March 2019. First proposed in late 2018, the legislation seeks to ensure timely and lifesaving medical care is provided to people currently in offshore containment.  

It allows two doctors to recommend the temporary transfer of patients in offshore detention to Australia for medical or psychiatric treatment or assessment. The two treating doctors must be satisfied that: 

• The person requires medical or psychiatric assessment or treatment; 
• The person is not receiving appropriate medical or psychiatric assessment or treatment in the regional processing country; and 
• It is necessary to remove the person from a regional processing country for appropriate medical or psychiatric assessment or treatment. 

These doctors notify the Secretary of the Department of Home Affairs of their recommendation, who must then inform the Minister for Immigration. The Minister retains the power to reject a transfer request.  

The House of Representatives voted to repeal the Medevac Bill in July 2019. The Senate should decide whether to support the repeal soon after a Senate Inquiry on Medevac reports in October.

How does MSF work with the MERG? 

MSF began supporting the MERG in May 2019, providing medical administrative support services to assist with the process of patient assessments. This aims to ensure there is sufficient capacity to manage and facilitate this very complex process as safely as possible and with the welfare of the patients supported as much as possible. Due to the nature of offshore containmnet and the harmful effect that it has, providing this administrative support must be done when possible by health professionals who have the skillset to support these patients.

Why is MSF involved with the MERG? 

As a medical humanitarian organisation, we are working within the referral system of the Medevac Bill to support people’s access to care. 

In October 2018, the Nauruan government forced the closure of MSF’s mental health activities on the island. In February 2019 it subsequently prohibited telemedicine in Nauru, again preventing patients and their families from accessing our services.  

Similarly, the PNG authorities have not yet granted MSF access to refugees and asylum seekers in PNG.  

MSF’s support to the MERG thus remains the only operational support we can currently provide refugees and asylum seekers in need of mental health and other medical care while held offshore under Australian policy. 

Is the Medevac Bill a solution? 

The offshore containment of asylum seekers and refugees is predictably harmful and should be stopped. However, falling short of this, the Medevac Bill provides one of the only current effective medical referral processes for people contained in PNG and on Nauru and must be allowed to continue. 

MSF continues to call for the immediate evacuation of asylum seekers and refugees from PNG and Nauru, and for their permanent resettlement in a place where they can rebuild their lives.