In this section
Please note all people seeking asylum are entitled to free medical care in Victorian hospitals - see Guide to asylum seeker access to health and community services in Victoria (this document is still current (2020) and has been in place since 2011, with earlier iterations from 2005).
An asylum seeker is someone who has applied for refugee status and who is awaiting a decision on this application. See: Refugee policy and timeline. Asylum seekers in Australia can broadly be divided by:
Whether they have a valid visa on arrival - This determines whether they are (or have been) subject to mandatory immigration detention and whether they are eligible for permanent protection.
Their date of arrival - This determines how their protection claims are processed and whether they are/were subject to offshore processing/resettlement
Their stage in the protection claim process - There were substantial delays in processing protection claims for people who arrived after Aug 2012 - processing halted between September 2013 and May 2015. The stages in the protection claim process can be divided into:
People who have had their claims assessed and declined at all stages of review may be described as 'finally determined'.
As of October 2019 (latest available at December 2019), the detention population is approximately 33% people who arrived by boat without a valid visa, 42% criminal cancellations and 25% 'other'. The last asylum seeker children who spent time in Nauru and were held in prolonged detention were released in April 2016. A small number of children remain in prolonged held detention. Detention centres also have ongoing turnover - with flows in and out of the detention network.
Now predominantly people transferred back from Nauru or Manus Island for medical reasons. Some of this group were placed on Final Departure Bridging Visa E (FDBVE), announced in Aug 2017 (and moved out of community detention). The FDBVE was initially applied to adults who arrived alone (late 2017), and then extended to a small number of families with children (from mid-2018).
There are several means of
identifying asylum seeker status; also see information on the DHA Immicards. As of 2019, Public Transport Victoria (PTV) cards have also recognised asylum status.
People who were successful in their asylum claim were granted a
Protection visa (subclass 866). This visa grants permanent residency, work rights, Centrelink eligibility, Medicare and settlement support; therefore 866 visa holders are no longer asylum seekers. People who arrived by boat before 13 Aug 2012 and whose claims were not finalised, were then subject to retrospective application of Temporary Protection Visas (TPV) - either TPV or Safe Haven Enterprise Visas (SHEV). Asylum seekers who arrive by plane and who are found to be refugees are granted a Protection visa (subclass 866).
TPVs were proposed for reintroduction in October 2013 - see NSW
Refugee Advice and Casework Service (RACS) Factsheet and the Victorian Refugee Health Network
Asylum seeker fact sheet from that time.
Legislation changes in December 2014 allowed TPVs to proceed, reintroducing the
TPV 785 (XD) (available from May 2015) and introducing a new form of SHEV Visa (790) (available from July 2015). SHEV arrangements included Victoria from October 2016. Also see
Department of Social Services - TPV entitlements.
Both immigration detention statistics and onshore processing statistics are available. In late 2019 in Victoria, there were:
All asylum seekers should have had a health assessment – either in held detention (through
IHMS), or in the community after release from detention as part of refugee healthcare, or by
BUPA (contracted by DHA). This assessment is similar to the offshore Immigration Medical Examination.
Detention health checks are recorded in the IHMS Health Discharge Assessment (HDA) - all people released from held detention should have a copy of their HDA. Initially these HDA were available through the Community Detention Assistance Desk (CDAD) - 1800 725 518. In 2017, this information stopped being available, and IHMS advised completing a
freedom of information (FOI) request to the (then) DIBP. From early 2018, IHMS has provided a copy of an individual's health record (to the individual) with consent.
In late 2016/early 2017, asylum seeker clients were sent proforma letters from the (then) DIBP requesting health examinations as part of the legacy caseload processing - to be completed at BUPA Medical Visa Services. Letters were sent to individuals where there was no record of IHMS screening being completed. Key details included:
Access to services, work rights, and Medicare for the different asylum seeker groups (and those on a TPV) is shown in Table 1.
Medicare cards for all asylum seeker BVE holders expired at the end of 2014 and again at the end of 2017. This was related to the Health Insurance Act (1973) Cth and administrative procedures that allow (time-limited) access for non-citizen access to Medicare. Medicare access has been extended for another 3 years; however, Medicare is dependent on having a valid BVE, and expires when an individuals BVE expires (although in 2018, we saw cases where Medicare duration was not connected to BVE duration). BVE duration was short (often 3-6 months) across 2016-17. Once people submitted protection claims (prior to the 1 October 2017 deadline) they were issued with longer duration BVEs (through to the end of their fast track assessment). If individuals have a negative initial and review decision, they revert back to short duration BVE (with the same issues with Medicare arising). Further, if Medicare has expired, Australian Immunisation Register (AIR) records cannot be viewed, although this situation is now being addressed in 2020.
Individuals who arrived on a valid visa and sought asylum usually remain on their entry visa (and associated conditions) for the duration of that visa. This means they usually do not have Medicare access (for example - arrival on student, tourist and short term visas which do not carry Medicare access), although there is an expectation that individuals arriving on such visas have their own (private) health insurance.
Asylum seekers may not have access to Medicare if:
Work rights were permitted for BVE holders after the legislation changes in December 2014. The restriction on work rights was lifted as BVE were renewed (i.e. work rights were granted when BVE were renewed after December 2014). In practice, BVE durations became very short over 2016-17, which precluded employment.
Status Resolution Support Services (SRSS) is a program providing supports to non-citizens as their immigration status is resolved, that includes casework, income support payments and access to torture-trauma counselling. In 2014, SRSS replaced the previous CAS – Community Assistance Support (changed to band 5) and ASAS – Asylum Seeker Assistance Scheme (changed to band 6) - see Department of Human Services information, application form, and 2018 policy manual. Most (but not all) people on SRSS were individuals who arrived by boat and sought asylum.
From 2017, access to SRSS decreased for asylum seekers in the community on BVE. SRSS access stops if an asylum seeker:
SRSS also applies for the cohort in community detention (previously band 3) which is now (Dec 2019) predominantly the medical transfers from Nauru and Manus. For this group, SRSS stops if they transition to a FDBVE within a period of weeks (one week for the first cohort to be granted a FDBVE (adults who arrived alone) and 4-6 weeks for later cohorts (details difficult to clarify). These individuals have not had work rights since arrival in Australia (now 6 years), and our clinical experience has been that the vast majority are substantially unwell. For this group - clinicians should ensure IHMS, SRSS providers and the DHA are aware of health status (with consent) to ensure accurate assessment of vulnerability. Timelines may be urgent where loss of SRSS support/payments poses immediate health and safety risk. The Victorian government has provided support for this group - in 2017, and again in 2019-2020.
Individuals may also re-apply for SRSS if their circumstances change - see application form.
Community detention (CD) also called Residence Determination, now mostly medical transfers from offshore
Final Departure BVE people previously in CD
Kindergarten, primary, secondary and language school
Tertiary education at international student rates
Life without Barriers, AMES.
SRSS Band 5 = vulnerable, Band 6 = majority. Able to engage legal assistance as above
Most remain on entry visa for the duration of that visa. May be on BVA,
or BVE, conditions may revert to entry visa
Often no case support, may be eligible for SRSS, may get case support through ASRC. May be eligible for
IAAAS if meet disadvantage criteria.
Immigrant health resources. Author Georgie Paxton and Rachel Heenan, 2017. Updated January 2020. Contact: