7.5 Emergency healthcare The Commission is concerned about the inadequacy of emergency healthcare arrangements, particularly outside of clinic hours. As noted in the section above, there is no clinician on site outside of clinic hours whose role it is to see and assess urgent referrals or deal with emergencies. Neither is telehealth accessible, which is a well‑established modality. A reliance on Serco staff to provide first aid in a life-or-death situation is unlikely to be sufficient to prevent a poor outcome for a detained person and is also an occupational health and safety issue given the trauma associated with a failed resuscitation attempt by non‑healthcare staff. As has been noted earlier in this report, many people in detention spoke to the Commission about the aftermath of the fatal stabbing in 2022, with direct accounts suggesting that the ambulance took 1 to 2 hours to arrive, by which time the victim was deceased. There were reportedly no healthcare staff on site at the time. Senior Serco staff told the Commission that it took 20 minutes for the ambulance to arrive after the stabbing, but that the period where Serco staff, with their very basic training, had to attempt to manage the emergency situation was extremely stressful and distressing for the staff involved. There does not appear to have been a significant change to the emergency healthcare arrangements following this event. In relation to emergency capabilities, the Commission was advised that IHMS staff have Basic Life Support capabilities, and that Serco staff are provided with annual First Aid/CPR training. The Commission observed, however, that there are no alarm systems or panic buttons for detained people to summon help in a health emergency and, as noted earlier regarding the Falcon and Hawk compounds, not all accommodation is in line of sight. The Commission was told that the ambulance service in the area is a part volunteer rural St John Ambulance service. IMHS reported that it includes a paramedic. However, both staff and people detained told the Commission that it can take some time for the ambulance to arrive after they are called. Serco staff additionally told the Commission that the ambulance crew does not enter the compound. Consequently, stretchers have been purchased for staff to convey a detained person to meet the ambulance. The nearest hospital to the centre is the Northam Hospital, which is a small country hospital with limited capacity. The hospital has an emergency department and can offer simple investigations, such as x‑rays and blood tests. IHMS staff reported that they were aware that the hospital is unable to effectively manage complex cases and that any tertiary/ subspeciality level care requires transfer to Perth. During the inspection, the Commission was advised that 5 people had already been transferred to the hospital that week, mainly for x‑rays. The Commission was told that constructive attempts to strengthen the relationship with the Northam Hospital were being made through the Director of Nursing position. The Commission was told the relationship between the centre and the hospital was generally positive. However, another account indicated that the relationship was strained. Yongah Hill Immigration Detention Centre Inspection Report • 2024 • 39