s. 47E(d)
s. 47E(d)
s. 47E(d)
s. 47E(d)
s. 47E(d)
s. 47E(d)
UNDERTAKING TO OPERATE WITHIN THE BOUNDS OF AUSTRALIAN
PANEL MEMBER INSTRUCTIONS FOR CONDUCTING AUSTRALIAN
IMMIGRATION MEDICAL EXAMINATIONS
I, __________________________________ (insert full name) confirm I have received a copy of the
Australian Immigration Medical Examinations - Panel Member Instructions and have familiarised
myself with its content.
I accept as a result of requesting panel membership of the Australian Panel Physician Network for
conducting Australian Immigration Medical Examinations, I am not an employee and have no legal
contractual obligation to work for the Australian Federal Government as a Panel Member.
Should I be granted panel membership of Australian Panel Physician Network, I accept that I will operate
within the bounds of the Instructions listed above and the instructions on use of eMedical if I am given
access to use the eMedical system.
I will comply with the requirements of the Australian Privacy and confidentiality provisions and obtaining
client consent for disclosure of personal information to third parties by the Department. I will also accept
responsibility for informing all panel clinic staff, including panel radiologists completing/assisting completion
of Australian Immigration Medical Examinations, of the Australian privacy and confidentiality provisions and
ensuring that they comply with these provisions.
I accept that my work as a Panel Member will be audited and I agree to fully cooperate with all audit
requirements. I understand that the ongoing membership of the Australian Panel Physician Network is
contingent on the information obtained through the conduct of these audits.
I understand that the Department of Home Affairs can suspend or cancel my membership of the Australian
Panel Physician Network at their sole and absolute discretion.
I confirm that I have no existing conflicts of interest which may affect my ability to work as a Panel Member
and I will bring any conflicts of interest which may arise to the immediate attention of the Department.
Full Name:
_______________________________________________________________________
(As per identity documents attached)
Signature: __________________________________________ Date: _______________
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AGREEMENT TO COMPLY WITH MIGRATION 5 HEALTH WORKING
GROUP (M5HWG) CODE OF CONDUCT FOR PANEL MEMBERS
I, _________________________________________ (insert full name) confirm I have received a copy of the
Migration 5 Health Working Group (M5HWG) Code of Conduct for Panel Members and have
familiarised myself with its content:
Should I be granted panel membership of the Australian Panel Physician Network, I will comply with the
M5HWG Code of Conduct (the Code) for Panel Members. I will operate as per the required standards of
behaviour and conduct as outlined in the Code.
I understand this Code of Conduct does not replace nor supersede each M5 country’s specific Immigration
Medical Examination (IME) requirements and expectations contained within their respective Panel/Technical
Instructions and other guidance documents.
I am aware that this Code of Conduct does not imply a contractual or employer-employee relationship
between an M5HWG partner and a Panel Member, or affect in any way the designation, relationship or
governance of each M5HWG partner's Panel Members.
I am aware that Panel Members who breach the Code may be subject to action at the discretion of the
relevant Migration 5 country.
I understand that if a Panel Member becomes de-registered or restricted, including changes to the conditions
under which they operate in their country of practice, they must immediately inform all of the M5HWG
countries to which they are empanelled and cease undertaking any M5HWG Immigration Medical
Examinations.
Full Name:
_______________________________________________________________________
(As per identity documents attached)
Signature: __________________________________________ Date: _______________
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PRIVACY NOTICE AND CONSENT TO DISCLOSE PERSONAL
INFORMATION, AUSTRALIA
The Australian Panel Physician Network
The Department of Home Affairs (the Department) manages the Australian Panel Physician Network to
administer the global composition of panel physicians who perform Immigration Medical Examinations (IME)
of clients intending to travel or migrate to Australia. The panel network management also involves performance
monitoring and support in the development of skills or knowledge required for IMEs and in particular, to build
expertise in the screening, detection and treatment of tuberculosis (TB).
Privacy Notice
The Department is required to notify an individual of certain matters when the Department collects, uses or
disclose personal information about them. Under privacy laws, the Department is required to take steps to
protect and ensure the confidentiality of the personal information held. Please see Attachment A for further
information about the Australian Privacy Principles, including laws related to the disclosure of information to
overseas recipients/stakeholders.
Collection of Information
The Department will collect your personal information from you and other relevant third parties (see details
below), for the purpose of:
a) Assessing your suitability for empanelment as a panel physician; and
b) Ongoing membership of the Australian Panel Physician Network.
This may also include information about the clinic you are associated with in your role as a member of the
Australian Panel Physician Network.
Use and Disclosure of Information
Personal information collected about you may be used or disclosed to third parties.
Personal information collected about you includes:
o your contact details
o your qualifications, work experience, affiliations and registration details
o your practice history, particularly as a panel physician
Information about the clinic where you are authorised to perform IMEs.
Information about your performance based on the results of audits (onsite and desktop) conducted by
the Department of medical examination reports completed by you, as a panel physician and your
professional and personal conduct.
Details about your conduct in complaints made against you, and any resulting actions against you.
Any administrative, civil or criminal proceedings and findings.
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Your personal information could also be used and disclosed for the following purposes of:
improving the quality and consistency of Australian Panel Physician Network members’ output.
investigating complaints and issues relating to you and your associated clinic.
action related to possible suspension and/or cancellation of your Australian Panel
Physician Network membership.
setting up internal management processes and systems, which require details about you.
responding to enquiries from Visa Processing Officers to resolve issues for clients.
meeting obligations in respect of sharing information arising out of legal obligations or
agreements with entities listed below.
In addition, your personal information contained in the following, may also be used or disclosed for the
purposes above:
aspects of reports, desktop or onsite audits completed/undertaken by staff employed or appointed by
the Department, that identify you.
reports written by you, in which you are identified as the panel physician who created the report.
details about you and your conduct in complaints made against you as part of the panel, and any
resulting actions against you
the status of your empanelment with the Department or other Migration 5 partners, where relevant
details about you, in any documentation in regards to the IME work undertaken by you.
The third parties to whom your personal information may be disclosed are:
medical councils and/or registration authorities.
Australian departments, any service providers and agencies that are involved in the management of
immigration and/or public health including agencies and service providers assisting in settlement of
migrants particularly refugees.
law enforcement bodies, tribunals and other bodies assessing decisions made by the Department or
where Department are required to provide this information by law.
the government departments and agencies, who are part of the of the Migration 5 including Australia,
Canada, New Zealand, United Kingdom and the United States of America, with whom we may have
an agreement and with whom we may share panel physicians, that are involved in the management
of immigration medical examinations.
members of the public – information disclosed is limited to your name and contact details and your
associated clinic’s name and contact details.
Consent
In order to participate in and to remain a member of the Australian Panel Physician Network, you are asked to
sign the below consent form, which confirms that you understand that your personal information could be
collected, used and disclosed for the reasons outlined above.I understand that consideration of my
empanelment and ongoing membership as a panel physician is subject to my consent for collection, use and
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disclosure to the third parties outlined above of my personal and sensitive information (including information
relating to the clinic with which I am associated) as outlined in this document.
I understand that by providing consent for the Department to use and disclose my personal information to an
overseas recipient, the Department will not be required to take steps to ensure that the overseas recipient
does not breach the Australian Privacy laws in relation to the information, as otherwise required by privacy
laws.
Full Name:
_______________________________________________________________________
(As per identity documents attached)
Signature: __________________________________________ Date: _______________
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Attachment A
Australian privacy notice
The Privacy Act 1988 (Commonwealth) (Privacy Act) and the Australian Privacy Principles guidelines (APPs),
which provide guidance to Australian Government agencies and organisations covered by the Privacy Act,
require the Department of Home Affairs (the Department) to notify an individual of certain matters when we
collect personal, including sensitive, information about them. This Privacy notice and consent to disclose
personal information form and this Attachment are your notification of those matters.
What is considered ‘personal information’?
Personal information is defined in section 6 of the Privacy Act as ‘information or opinion about an identified
individual, or an individual who is reasonably identifiable whether the information or opinion is true or not;
and whether the information or opinion is recorded in a material form or not’.
What is considered ‘sensitive information’?
a) Sensitive information is defined in section 6 of the Privacy Act as Information or an opinion about an
individual’s:
i.
Racial or ethnic origin; or
ii.
Political opinions; or
iii.
Membership of a political association; or
iv.
Religious beliefs or affiliations; or
v.
Philosophical beliefs; or
vi.
Membership of a professional or trade association; or
vii.
Membership of a trade union; or
viii.
Sexual orientation or practices; or
ix.
Criminal record;
That is also personal information; or
b) Health information about an individual; or
c) Genetic information about an individual that is not otherwise health information; or
d) Biometric information that is to be used for the purpose of automated
biometric verification or biometric identification; or
e) Biometric templates.
Who is collecting your personal information?
The Department will collect your personal information. The reasons for which, type of information collected by
the Department, and third parties to which your information may be disclosed, are outlined in the Privacy notice
and consent to disclose personal information form. This is referred to as the primary purpose.
The Department may disclose or use personal information for a secondary purpose under the following
circumstances:
If the information is sensitive information – directly related to the primary purpose; or
If the information is not sensitive information – related to the primary purpose.
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Disclosure of personal information overseas
As outlined in the Privacy notice and consent to disclose personal information form, by providing consent for
the disclosure of your personal information to an overseas recipient, the APPs of the Privacy Act will not apply
to that disclosure, which means that the Department will not be accountable under the Privacy Act and you will
not be able to seek redress under the Privacy Act.
The Department may disclose personal information to an overseas recipient without complying with the APPs
where the disclosure is ‘required or authorised by or under an international agreement relating to information
sharing to which Australia is a party.’
Permitted general disclosure of panel physician information that may also apply to the sharing of information
are in relation to lessening or preventing a serious threat to life, health or safety or taking appropriate action in
relation to suspected unlawful activity or serious misconduct.
How do you access and/or correct your personal information?
Under the Privacy Act (APPs 12 and 13), you have the right to ask for access to the personal information
that we hold about you.
You are also able to ask that we correct that personal information. You can ask for access or correction by
contacting us and we must respond within 30 days. If you ask, we must give you access to your personal
information, and take reasonable steps to correct it if we consider it is incorrect, unless there is a law that
allows or requires us not to. If you wish to access and/or correct your personal information please email
s. 22(1)(a)(ii)
with the subject: Australian Privacy Access and/or Correction Request and
provide the details of and reasons for the requested correction.
How will the department store your personal information?
The Department takes steps to protect the security and confidentiality of personal information it holds.
Files are disposed of in strict accordance with the General Disposal Authorities issued by Australian
Archives.
How do you find out more about our privacy practices?
For more information about how the Department will use and disclosure your personal information please
refer to:
The Department’s Privacy Policy:
https://www.homeaffairs.gov.au/access-and-accountability/our-commitments/privacy
Our Privacy Policy describes how we protect and manage personal and sensitive information consistent with
our obligations under the Privacy Act and contains a link to the Department’s Form 1442i – Privacy Notice.
https://www.oaic.gov.au/resources/individuals/privacy-fact-sheets/general/privacy-fact-sheet-17-
australian-privacy-principles.pdf
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