3 | Key observations and concerns The Commission has previously expressed concern about the length of time that individuals who were part of the Medevac cohort were waiting to access the medical assessments or treatments for which they had originally been transferred. These delays are on top of the long delays already experienced in Nauru and PNG waiting for the proper assessment and treatment of their health conditions prior to being transferred to Australia, noting that we were advised by IHMS staff that the length of time a person has waited for assessment or treatment offshore is not considered in accessing health care through the public health system in Australia. Previous recommendations from the Commission have focused on ensuring that this specific cohort is provided with immediate and expedited access to required health care services.71 A number of the individuals released noted that by the time of their release from the hotel APOD they had still not received treatment for the medical issue that had led to them being transferred to Australia in the first place. One individual described himself as having been ‘brought here as a patient but then they put me in jail’. While the majority of the Medevac cohort have subsequently been released from hotel APODs into the community, the challenges and delays in accessing health care have continued subsequent to their release. This is further discussed below.72 These continuing delays mean that the recommendations previously made by the Commission remain relevant and are repeated here, noting that the urgency has further increased given that it is now over two years since the recommendations were initially made. 40 RECOMMENDATION 14: The Department should ensure immediate and expedited access to medical treatment through the public health system for the Medevac cohort to ensure that the medical conditions that led to their being transferred to Australia are appropriately treated. RECOMMENDATION 15: Where the Medevac cohort cannot access the medical treatment they require through the public health system within a reasonable time, the Department should ensure immediate access to health care through the private health system and provide funding for this. The length of time that individuals detained in hotel APODs are waiting to access medical services continues to be of significant concern. The delays appear to be particularly significant with respect to dental services, with examples given to the Commission of individuals waiting over six months for a dental appointment, and a number of individuals indicating that the delays had left them experiencing significant pain and affecting their ability to eat. Individuals reported that they had difficulty in managing their symptoms while waiting