7 | Health Services IHMS is contracted by the Department to provide primary and mental health care services in Australia’s immigration detention facilities. The IHMS health service in each facility is ‘nurse-led’: nurses triage all requests for health care; all appointments are initially made with a nurse; nurses undertake health assessments, planning of health care, delivery of treatments, ongoing monitoring of treatment and management of medicines; and the service is led by managers and team leaders who are also nurses. 7.1 Staffing IHMS has 15 staff at YHIDC which includes general nurses, mental health nurses, and general practitioners. Only one staff member is locally engaged, and most staff fly in from the east coast, for a maximum period of 3 months. Interviews with people in detention revealed a general mistrust in IHMS because of this frequent change in staffing. People in detention also described problems with continuity of their care and loss of information because of staffing changes. For example, one person disclosed that they were informed that they required an ultrasound by a general practitioner, but were then told there was ‘nothing in the system’ about booking the ultrasound at the next appointment, three months later. The Commission acknowledges an observation previously made by the Commonwealth Ombudsman that ‘there is difficulty in recruiting and maintaining detention centre staff due the nature of the work and remote locality, particularly for Yongah Hill …’.74 Nevertheless, more effort should be made to ensure consistency among IHMS staffing given the comments about mistrust of the health service. RECOMMENDATION 9: The Department and IHMS should make further efforts to attract and retain locally engaged health staff at the centre. Where this is not possible, IHMS should review their contracting arrangements to ensure there is a greater level of consistency in the staffing personnel at the centre. Yongah Hill Immigration Detention Centre Inspection Report • 2024 • 35