Physician denied permanent visa over son's disability

Australia's refusal renews outrage against policy

Bernhard Moeller and his wife, Isabella, have vowed to fight a decision by Australia's immigration officials to deny their residency application because son Lukas has Down syndrome. (Paul Carracher/Wimmera Mail-Times via Associated Press)

SYDNEY - In a country with a serious shortage of doctors, many Australians are perplexed by their government's decision to reject the residency application of a German physician on the grounds that his son's Down syndrome would place too great a burden on the national healthcare system.

Dr. Bernhard Moeller moved to Australia nearly three years ago after answering an international advertisement seeking a specialist in internal medicine to work in Horsham, a working-class town of 20,000 people in the southern state of Victoria.

Moeller and his wife, Isabella, were looking for a quiet home in a friendly community. But most of all, they wanted a normal life for their 13-year-old son, Lukas, who has Down syndrome.

The couple chose Australia because of its reputation for allowing children with Down syndrome, a chromosomal abnormality that causes varying degrees of intellectual disability, to attend mainstream schools with their nondisabled peers.

Moeller took a job as the sole internal medicine specialist at Wimmera Base Hospital, a public facility that serves about 55,000 people in western Victoria, and the family began settling in. Lukas learned to play cricket and joined an Australian-rules football club.

"We were thinking right from the beginning that if we liked it here, if it worked out well for us, that we would like to stay," Moeller said. "We had a house. I had a good job. We are Germans, so it was a big move, a big change, but we didn't regret it. It was all good."

So good, in fact, that the family decided to apply for permanent residency.

But last month, the Moellers were shocked to discover that their application had been rejected because Lukas did not meet Australia's stringent health requirements.

Australia, which provides free healthcare to its citizens and permanent residents, has a longstanding policy of factoring medical conditions into its visa decisions. Residency applicants are required to take a battery of tests, including screening for HIV and tuberculosis, and must be rejected by law if they are found to have any health condition that would incur a significant cost to Australian taxpayers.

"This is not discrimination," a spokesman for the Department of Immigration and Citizenship said in a statement. "It is a question of the cost implications to the community."

The case has caused an outcry across Australia, where doctors and nurses are in short supply.

The Australian Medical Association, disability groups, talk radio hosts, and politicians across the ideological spectrum have called for a review of Moeller's case. In an editorial, the Melbourne newspaper The Age called the decision an "echo of Nazism," while a headline in the rival Herald Sun declared, "Let the Good Doctor Stay."

Foreign medical staff make up about 40 percent of the workforce in Australia's regional hospitals and clinics, according to the Rural Doctors Association of Australia. Still, the organization estimates that some 17,000 medical positions, including 1,800 vacancies for doctors, remain unfilled in rural areas.

"Overseas-trained doctors should get all the gratitude and support we can offer, because without them the pressure on the health system would be enormous," the association's president, Dr. Nola Maxfield, said in a statement supporting a review of the Moeller case. "We should be doing everything possible to ensure that the 1,800 hole gets smaller rather than larger."

The staff shortage is no news to Pam Clarke, mayor of Horsham. If the Moellers are forced to leave when their temporary visas expire in 2010, local residents would have to drive up to four hours to see another specialist.

"We have a need for three physicians, and we have one," Clarke said. "If we aren't able to keep him, then we're back to square one."

Clarke is among the many state and federal politicians calling on Immigration Minister Chris Evans to review the decision. The Victoria state premier, John Brumby, and the federal health minister, Nicola Roxon, both said the ruling should be overturned because it fails to take into account Moeller's work as a doctor in an underserved community.

"It's really about a federal government policy that says that if you have a member of your family that has a disability that may be a burden on the taxpayer in the future, you may not stay here," Clarke said. "We're wanting the government to review that black-and-white policy in light of the contribution his family will make to our community."

This is not the first time Australia has been taken to task for its sometimes contradictory approach to immigrants with disabilities.

In 2004, immigration officials used the health requirement to reject the residency application of an Indian social worker whose 12-year-old son was autistic. Six months later, the immigration minister at that time, Amanda Vanstone, overturned the decision.

Moeller said he hopes for a similar outcome. Nevertheless, he believes the damage to Australia's reputation has been done.

"It makes us even more sure we want to stay, because we've had so much support," Moeller said. But, he added, "It will not make skilled people, qualified people, well-trained people, more prone to migrate to Australia.

"I think it is internationally very damaging."