Evaluation of the Integrated Humanitarian Settlement Strategy (IHSS)

a range of medical illnesses prior to travel and entrants undertake to have follow up treatment if
required on arrival in Australia. However, not all entrants do this. If an entrant elects to defer or not to
have a health screening/assessment through the EHAI service and if they do have health problems,
failure to provide a prompt physical health examination may not be in their best interests or those of
the broader Australian community.
Recommendation 14
Medical Information Requirements
DIMIA needs to ensure that information on medical examinations conducted overseas (and any
undertakings made) is provided to the most appropriate IHSS service before or upon the entrant’s
arrival in Australia and that the IHSS facilitates any follow up action.
Application of the EHAI model
The way that the EHAI service is currently designed reflects the IHSS principle of client choice and
entrants only receive a health screening/assessment if they elect to have one after having received
information from the EHAI provider. EHAI providers report that about 60% of entrants provided with
information elect to have a health screening/assessment and the others either do not take up this
opportunity or defer it until other needs such as housing and employment are resolved. Given the
data on the high health support needs of this group, 60% flow on for physical health support is of
concern. Health conditions left untreated for some time may worsen considerably and undermine the
ability of the entrant to rebuild their life in Australia. The evaluation found that there is a gap in the way
that the model is designed in relation to addressing the early health needs of entrants. The IIOA
provider is contracted to link entrants to emergency medical assistance if needed in the initial 24
hours after arrival and the EHAI contract allows the provider up to two weeks after referral to contact
the entrant with information and assistance on health services available. In the interim period,
entrants can have urgent medical needs and at present the model does not clearly identify any
provider with responsibility for addressing these needs.
This gap in the design of the model needs to be addressed as soon as possible to overcome the
current situation in which IIOA providers can be required to deliver support beyond their contract
responsibilities, and entrants may experience considerable anxiety shortly after arriving in Australia
having to navigate their way through a medical system with no support.
As stated above, 80% of the clients screened for health issues by EHAI providers require referral to a
GP who then conducts a physical health examination and refers to any specialist health services as
required. There is the issue of whether it is necessary to have the EHAI model involve a physical
health screening leading to referral to a GP for a physical health examination if the process could be
done earlier by the IHSS service offering a client linkage to a GP on arrival.
It would be more efficient and useful to offer all entrants, on arrival, the options of a referral to a GP or
health clinic which can offer a full physical examination and referral to specialist services as required
rather than having an initial screening by an intermediate agency. Clearly there would still be an
ongoing need for training/consultancy advice to GPs and other health professionals working with this
client group.
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Evaluation of the Integrated Humanitarian Settlement Strategy 27 May 2003