Last weekend, the condition of refugees on Manus Island became too much to tolerate for the Australian Medical Association. Its members had lost the ability to gauge and monitor the health of the asylum seekers, let alone intervene to give them medical care.
"The situation on Manus Island appears to be becoming quite desperate," says AMA secretary-general Anne Trimmer. "But until two or three months ago, the AMA worked quite closely with a chief medical officer in the Department of Immigration and Border Protection, Dr Brayley. He's no longer with the department, and so we no longer have that ability to understand what's happening with individual refugees, or more broadly what's happening with the men in the closed centre, so federal council unanimously passed a resolution really asking the government to answer questions to reassure that the men's health was being appropriately looked after, and offering to provide a group of independent doctors to make an assessment of the health situation."
Dr John Brayley was appointed chief medical officer and surgeon-general of the Australian Border Force in September 2015 and resigned in September 2017. He has not been replaced.
"We've tried to get information from the department since," says Trimmer, "but with no real outcome. The benefit we'd had with Dr Brayley was, often information would be brought to the AMA about the particular circumstances of an individual asylum seeker or refugee, and we were able to act as interveners to get appropriate care for the people. Often, they were circumstances where the individual had to be brought off the island - either Nauru or Manus - because their particular condition required more treatment than was available on the island. It was very much a behind-the-scenes attention to the health needs of these people, without it being a media production. But we were able to assist individuals on quite a number of occasions, going back quite a few years."
Trimmer describes her designation as secretary-general as "just a rather grand title for CEO". She looks after finance, governance, strategy and risk, acts as an adviser to the elected AMA president, and chairs the federal council.
She is four years into her five-year contract, and says she "lives" in Sydney but works in Canberra. She joins me for lunch at Lilotang, a Japanese restaurant that's eight minutes' walk from her office in Barton but a 3??-hour drive from her house in Elizabeth Bay.
"I have this kind of bifurcated life," she says. "Home is Sydney, which is weekends. Canberra is work, during the week. When I'm here, I don't have social distractions. We often have evening phone-call meetings, teleconferences or video conferences, because that's when doctors are available. So I really, literally, come here and work."
Polished and poised in Armani and Hugo Boss, Trimmer does not look like she lives out of a suitcase. In fact, when she took the AMA job in 2013, she bought a unit one street away from its federal headquarters.
"My work wardrobe is here in Canberra and my weekend wardrobe is in Sydney," she says. "But all the things I use in the bathroom I've got exactly the same in both places. What's in my kitchen for cooking is all very similar. In Sydney, I tend to cook a lot more, with access to fresh seafood which you don't really have here. In Canberra, I'll make something quick for myself at night."
She would not normally have lunch in a place like Lilotang, which recently retained its chef's hat in The Sydney Morning Herald Good Food Guide. She usually makes something at her unit and eats at her desk. In winter, it tends to be a soup, in summer a salad.
To my surprise, the chef at Lilotang has prepared a feast for us. If I mentioned every dish, there would be no space left to talk about the AMA. But the chargrilled wagyu has won a special place in my heart (somewhere between my pulmonary valve and right atrium, I think).
Trimmer was born in Launceston, Tasmania, where her father was an executive with a household goods company. The family moved around Australia as her father was promoted through different roles, until they reached Sydney "which is where I did my growing up", says Trimmer. She went to St Ives High School and became head prefect, house captain, an A-grade hockey player, state-level sprinter, and won a scholarship to study law at the Australian National University.
Her success was all the more remarkable considering her age.
"I started school in Hobart and there was no preliminary year," she says, "so I went straight into grade 1 at five, and I never had to repeat a year. I just kept moving through the system being a year younger than my cohort, so I finished when I'd just turned 17."
ANU was "a big shift", she says. "It meant that I left home quite young. I think, in retrospect, it would've been hugely advantageous to have had a growing-up year between school and university. It would have improved my engagement with my studies. I was not a diligent student at university. I did a lot of other things."
She was heavily involved in student radio, and says if she hadn't entered the law, she would have gone into media. She did commercial legal work for many years, and in 1995 became the first woman to be elected president of the Law Society of the ACT, a position she held until 1997. In 2000, she was voted in as president of the national Law Council (the second woman to hold the role).
It was at the Law Council that she first dealt publicly with refugee issues. In response to the 2001 MV Tampa crisis, when the Australian government refused to allow a boatload of rescued asylum seekers to land on Christmas Island and instead sent elite troops from the SAS to persuade the Norwegian-registered vessel to leave Australian territorial waters, the council declared that "any person within the territory of Australia, whether an unauthorised arrival or not, must have a right of access to the courts".
"We as lawyers don't look at it in terms of the political issue about protecting our borders," she says. "These are people in need. They are fleeing circumstances that they need to be protected from. We have an obligation under our international treaties to do that."
When she returned to full-time legal practice, she felt "unchallenged", she says. She had become interested in influencing, lobbying, using argument to affect the decisions of government. (Her husband, Jeff Townsend, is a prominent corporate lobbyist with Endeavour Consulting.) Trimmer became chief executive of the Medical Technology Association of Australia in 2006, and moved into her role at the AMA in August 2013.
Isn't it nerve-racking to represent such a vociferous, diverse, wealthy, articulate and educated sector of society as doctors and medical students?
"They might be highly opinionated," says Trimmer, carefully, "but they're also clear thinkers, generally, about the issues they're dealing with, and they generally can be articulate in expressing their views about those issues. So, you're clear on where you stand with them. And - don't forget - I had that experience of leading lawyers. I was president of the lawyers, now I'm CEO of the doctors. One prepared me for the other."
Which is the easier job?
Trimmer, diplomatically, refuses to be drawn.
