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Australia enjoys some of the best health standards in the world. In order to maintain these standards people who want to migrate permanently, or stay in Australia temporarily, must satisfy the health requirement specified in the Migration Regulations.
The health requirement is designed to:
- minimise public health and safety risks to the Australian community
- contain public expenditure on health and community services, including Australian social security benefits, allowances and pensions
- maintain access of Australian residents to health and other community services.
In line with Australia's global non-discriminatory immigration policy, the health requirement applies equally to all applicants from all countries, although the types of health examinations required will vary according to the circumstances of each applicant.
Health checks required
Permanent visa applicants
All applicants for permanent visas, including the main applicant, partner and any dependants, must be assessed against the health requirement. Even if the applicant's partner and dependants are not included in the visa application, they must still be assessed against the health requirement.
Applicants for a permanent visa will be asked to undergo a medical examination, an x-ray if 11 years of age or older and an HIV/AIDS test if 15 years of age or older, as well as any additional tests requested by the Medical Officer of the Commonwealth (MOC).
Temporary visa applicants
Applicants for temporary visas may be required to undergo a medical examination, chest x-ray and/or other tests depending on how long they propose to stay in Australia, their intended activities in Australia, their country's risk level for tuberculosis (TB) and other factors.
The department will provide applicants with details of the health checks required.
The decision process
For those applicants who require a medical and/or x-ray examination and a significant medical condition is identified, a MOC will provide the department with an opinion on whether the health requirement has been met.
In doing so they will take into account:
- the results of the medical examination(s) and x-ray(s)
- medical history, age and period of intended stay in Australia
- other relevant considerations.
Under the Migration Regulations, officers deciding visa applications must accept the opinion of the MOC on whether applicants meet the health requirement.
Only TB is mentioned in migration legislation as precluding the grant of a visa, but the applicant is given the opportunity to undergo treatment in most cases. Other health conditions are assessed on the potential cost and impact on the Australian community resulting from the possible use of health and community services.
Some of the visa subclasses within the family and humanitarian migration schemes, as well as a limited number of onshore permanent skilled visas, have a waiver component. Visa applicants must still undertake their required health examinations and be assessed against the health requirement. The waiver allows the visa decision-maker to waive the health requirement after the visa applicant has been assessed by a MOC if they are satisfied that granting a visa would not result in 'undue' health care or community services costs, or 'undue' prejudice to Australians' access to such services. Where a waiver is available, the decision-maker will take into account the applicant's personal circumstances, including their ability to mitigate potential costs and care requirements, and any compassionate and compelling circumstances.
The waiver cannot be exercised where the visa applicant is assessed by a MOC as representing a risk to public health or safety in Australia.
If the applicant does not meet the health requirement and the waiver is unavailable or not exercised, then under the Migration Regulations the application must be refused.
Specific diseases or tests
TB is a serious disease which has been declared an epidemic and a global emergency.
Visa applicants aged 11 years or older must undergo a chest x-ray. Applicants under 11 may be required to have an x-ray if there are indications they have TB or have a history of contact with a person with TB. The purpose of the x-ray is to determine whether there is any evidence of either active or previous TB.
Evidence of active or previous TB will not, in itself, adversely impact on the outcome of the visa application.
Where x-rays show possible evidence of TB, the applicant will be asked to undergo more specific tests to establish whether or not active TB is present.
If active TB is found, Australian migration law does not allow a visa to be granted until the person has undergone treatment and been declared free of active TB. A course of treatment usually lasting between six to nine months is required, plus further testing to show that the treatment has been successful.
If the x-ray shows evidence of previous but now inactive TB the applicant may be asked to sign an undertaking at the time of visa grant.
By signing the undertaking, the applicant agrees to contact the Health Undertaking Service on a free call number on arrival in Australia. The applicant also agrees to report for follow-up monitoring to a state or territory health authority, as directed by the Health Undertaking Service. The visa is not at risk, once in Australia, no matter what status of tuberculosis is diagnosed as a result of the monitoring.
Although health authorities consider the risk of hepatitis transmission from newly arrived migrants to be low, screening for hepatitis is mandatory where the applicant is any of the following:
- a child for adoption
- an unaccompanied refugee minor child
- a temporary visa applicant intending to work as, or to study to be, a doctor, nurse, dentist or paramedic in Australia.
Examining doctors or MOCs may also ask an applicant to undergo tests for hepatitis where they consider it necessary. If the applicant is assessed as having hepatitis a decision on whether the applicant meets the health requirement will be made on the same grounds as any other pre-existing medical condition. The main factor to be taken into account is the cost of the condition to the Australian community for health care and community services.
The applicant may also be asked to give an undertaking to report to the Health Undertaking Service for referral to state or territory health authorities on arrival in Australia.
Permanent visa applicants aged 15 years or older must take an HIV/AIDS test. Permanent applicants less than 15 years old must also take this test if being adopted or there is a history of blood transfusions or other clinical indications.
Temporary visa applicants who intend to work as, or study to become, a doctor, nurse, dentist or paramedic in Australia are required to take an HIV/AIDS test.
If the applicant is found to be HIV positive, a decision on whether the applicant meets the health requirement will be made on the same grounds as with any other pre-existing medical condition. The main factor to be taken into account is the cost of the condition to the Australian community for health care and community services. Standard pre and post-test counselling must be provided by the doctor who examined the applicant.
Any other tests may be requested at any time by a MOC.
Fact sheet 22. Produced by the National Communications Branch, Department of Immigration and Border Protection, Canberra.