An audit of the medical services in Australia’s onshore detention centres has revealed the Government asked operators to reduce the costs of treating asylum seekers.

The Australian National Audit Office (ANAO) report examined the delivery of health care services in immigration detention.

“In December 2013, when planning for the re-tendering of the health service contract, the Government indicated, through a letter from the Prime Minister to the Minister for Immigration and Border Protection, its expectation that the total costs and the cost per detainee would be lower in the new contract,” the report said.

The department instituted a number of cost saving measures including determining “a fixed fee to cover all services and activities necessary to meet the health care needs of detainees”.

“Any additional service requests would only be used in exceptional circumstances,” ANAO’s report said.

It said the approach was aimed at reducing the risk of “over-servicing”.

The report found a high number of asylum seekers were at high risk of self harm or suicide, leading them to be placed “under supportive monitoring and engagement”.

More than 407 detainees were judged as at high or imminent risk of suicide or self harm between February 1 and November 9, 2015.

Contractor failed to deliver health services ‘to an accepted standard’

At May 2016, there were 1,570 detainees in onshore detention and 658 in community detention.

ANAO found the Department could improve its administration of health services by better monitoring of the “quality of the health services that are being delivered and key areas of health service delivery risk (such as services to detainees with mental health conditions)”.

International Health and Medical Services (IHMS) was selected to deliver health care services in held and community detention after a tender process in 2014.

But there were concerns raised about “alleged improper conduct by the contractor (IHMS) relating to the provision of health services”, the audit report said.

The report said an external review commissioned by the department found the contractor at the time (IHMS) was “failing to deliver health services to an accepted standard, which could impact on the health outcomes of detainees”.

The current contract is valued at $438 million over the five-year contract period from December 11, 2014 to December 10, 2019.

The ANAO report made a number of recommendations including that the Department of Immigration and Border Protection strengthen its monitoring practices to ensure the effective delivery of health services in onshore detention.

It also recommended that the Department of Immigration and Border Protection analyse complaint and incident reports data about health services to “inform management and operational decision-making”.

The Department of Immigration and Border Protection agreed to both recommendations.

— ABC