for treatment, and some described the delays as contributing to a worsening of those symptoms. to reduce the risk (such as wearing masks and undertaking rapid antigen tests).74 The Commonwealth Ombudsman has similarly identified IHMS staff having trouble procuring dental care for people in detention who require significant treatment as being ‘a recurring theme’.73 At the time of the inspection of the Brisbane APOD, the Commission was advised by staff that detainees returning from off-site medical appointments were required to quarantine for between 5 – 7 days, although exemptions from this requirement could be requested. The Commission was informed that the majority of individuals attending off-site medical appointments had been exempted over the It is acknowledged that there can be lengthy waiting times under the public health system for the general Australian public. IHMS staff advised that waiting times were equivalent to those experienced in the Australian community by those seeking similar treatment through the public health system. These delays have been exacerbated by the ongoing impact of the COVID-19 pandemic, and it was advised that this similarly reflects increased waiting times being experienced by the broader Australian community. An additional factor in the case of individuals detained in immigration detention facilities (including hotel APODs) has been the impact of operational quarantine during the COVID-19 pandemic, where detainees returning from an external appointment were often required to undertake a period of quarantine. The specific quarantine requirements varied across facilities and at different periods. As an example, the Commission was advised that in early 2022 individuals detained at BITA were required, as a matter of course, to undertake seven days operational quarantine upon returning from an external appointment. Reduced operational quarantine periods had been approved in limited past few months, however there were no figures available to quantify this. There appeared to be some confusion about these requirements amongst detainees, with at least one individual informing us that they had been told they would be required to quarantine if they attended an external medical appointment, but that they were not told they could request an exemption. The Commission does not know how many individuals have been subject to operational quarantine, either at hotel APODs specifically or immigration detention facilities more broadly. A number of individuals detained at hotel APODs confirmed with us that they had refused to attend external appointments because they did not want to be required to quarantine, which then exacerbated the delays in being able to access medical treatment. These individuals did not appear to be aware of any level of discretion being available with respect to the application of operational quarantine. cases where the medical appointment was considered critical, and the detainees were willing to adopt additional precautionary measures The Use of Hotels as Alternative Places of Detention (APODs) • 2023 • 41

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