Home Office revises definition of torture after Medical Justice highlights problemsMonday, September 23rd, 2019
Medical Justice has agreed to ‘stay’ its case against the Home Office in the High Court of Justice regarding the definition of Torture in the ‘Adults at Risk’ policy.
This is the second successful challenge that Medical Justice has brought against the definition of torture in relation to this policy.
Following the introduction of the Adults at Risk policy we started to see that the new narrower definition of torture was excluding some victims of torture from the protection of the policy – for example, those tortured by traffickers.
As a matter of urgency, we lodged a judicial review against the Home Office. We collected evidence from our casework, and from medical professionals to support our argument. The judicial review contended that the definition of torture was unlawfully restrictive, and had no rational justification concerning the identification of those particularly vulnerable to harm in immigration detention. A year later, in October 2017, the judge ruled in our favour finding the definition of torture used at that time was unlawful.
The updated definition was still unsatisfactory as it still served to exclude some victims of torture at increased risk of harm in detention from protection, it still laid the evidential burden on detainees and increased the threshold for release from detention. Following the introduction of the new definition of torture we continued to see cases where torture survivors had been detained counter to the stated intention of the policy, including detainees who were deemed to have been victims of torture under the old definition but were re-evaluated under the new policy and found no longer to qualify under the new definition.
Again we lodged another Judicial Review on the grounds that the new torture definition was contrary to the purpose of the policy, and there had been no fair and lawful consultation.
Medical Justice was granted permission to file a judicial review on all grounds. Rather than go back to the courts, the Home Office made concessions and a consent order was agreed with Medical Justice. This included policy changes such as an amendment to the Adults at Risk Caseworker Guidance; a review of and consultation on the Detention Centre Rules when the new Detention Centre Rules are laid before Parliament; and finally that an equality impact assessment is carried out as soon as reasonably practicable.
“We see this as a significant win for the protection of already vulnerable people in detention. By making these concessions, the Home Office is admitting that more needs to be done to protect survivors of torture – we just have to wait and see how significant those deeds will be.”
– Emma Ginn, Director
Response to the consultation on the Detention Centre RulesMonday, September 23rd, 2019
We welcome the opportunity to feed into the consultation on the draft Removal Centre Rules (RCR). We are concerned about a number of aspects of the draft RCR. As the rules are long and complex we have provided a summary of our primary concerns here.
Tragic death of detainee in detentionWednesday, September 18th, 2019
This death is a tragedy and is acutely felt by detainees left behind, locked in immigration removal centres.
We have clients, including vulnerable torture and trafficking survivors, who have witnessed self-harm by fellow detainees and become immensley distressed by the experience. After a death in detention, some of our clients call us, frightened, in severe distress and inconsolable.
Medical Justice sends volunteer doctors to visit immigration detainees to document scars of torture and challenge instances of medical mistreatment. The continued detention of a number of our clients has been found by the High Court to have amounted to inhuman and degrading treatment. Inquests have found neglect contributing to other deaths in immigration detention.
Indefinite detention, coupled with inadequate healthcare can exacerbate detainees’ existing medical condition and be the cause of mental illness. The Home Office is well aware of the issues – our report “Death in Immigration Detention” documents that year after year investigations into deaths in immigration detention reveal ongoing systemic healthcare failings.
Each death occurring in immigration detention is avoidable as immigration detention is optional. The majority of detainees are released back into the community, making this damaging practice all the more senseless.
The ever-rising death toll and suffering is the human consequence of the UK’s dehumanising and unjust detention system. We agree with the British Medical Association’s call to phase out immigration detention otherwise the deaths and harm will continue.
Read more: The Guardian
A look back at 2018 – Annual ReviewMonday, September 2nd, 2019
We released our Annual Review 2018-19 in July, at our AGM.
In the week the report went to print, 7 of our clients were scheduled to be removed from the UK (one of them twice). None of them ultimately were. Two had been released by the end of the week. Most of them are likely to be granted leave to remain eventually. This is an indication of the effectiveness of our casework and fantastic volunteer doctors and interpreters, carrying out assessments and writing up reports at all hours. It also indicates how many people the Home Office attempts to remove who are medically unfit to fly or who have scars of torture which they have not had the opportunity to documented until they got within days of being removed.
Our clinicians remain troubled by the inadequate healthcare in detention and the risks to people’s lives that are taken – for example, delays in obtaining clinical results and a failure to share them with the patient, including cases of inadequate monitoring for cancer of the blood, anticoagulant medication, and diabetes. Another of many examples is a reluctance to transfer patients to hospital as an emergency when this is indicated.
A volunteer visiting an immigration removal centre for the first time said “I have been a doctor for over 10 years and am used to seeing patients who may be vulnerable or are suffering physically or mentally. But there was helplessness, despair and fear most apparent in these patients that was totally alien to me. It is hard to see how the environment would not adversely affect any person’s physical and mental health, let alone the most vulnerable.”
In his second Home Office commissioned review of the detention of vulnerable detainees, Stephen Shaw found that 44% of detainees were classed as Adults at Risk. Identifying people as being at risk without releasing them is indefensible in our view. Shaw noted : ‘Every [immigration removal] centre manager told me they had seen no difference in number of vulnerable detainees and in some cases it had increased’. Clearly the Home Office’s incongruously named “Adults at Risk” policy is failing to protect vulnerable people.
Medical Justice successfully challenged the “Adults at Risk” policy, again. Detainees previously acknowledged by the Home Office as a torture victim were later not accepted as such using the newer definition.
We intervened in the Supreme Court case of KV, a Sri Lankan who had scars ‘highly consistent’ with having been burnt with hot metal rods. Lower courts said the scars could have been ‘self-inflicted by proxy’ and that the medical expert had ‘trespassed beyond their proper remit”. The Supreme Court questioned the ‘self-infliction by proxy’ reasoning and reasserted the role of the medical expert in documenting torture scars.
We initiated a legal challenge of the “no-notice” removals policy which enabled the Home Office to refuse a migrant’s case and forcibly deport them, within hours and in many cases without access to legal representation.
Medical Justice was quoted 30 times in the media, including by the Times, the Huffington Post, the International Bar Association, the British Medical Journal, the Independent, the Guardian, BBC News and Channel 5 News.
We ended the financial year with an uplifting agreement from parliamentarians that establishing an All Party Parliamentary Group was apt, and that Medical Justice is well placed to act as the secretariat.
COMMENT: Home Office responsibility for women miscarrying in immigration detentionTuesday, August 20th, 2019
The Home Office was recently made to accept their responsibility in the tragic miscarriage of a rape survivor. The woman was unlawfully held in immigration detention which amounted to inhumane and degrading treatment.
This case shows precisely why the Home Office must, finally, heed of our advice and that of the medical profession, and actually ban the detention of pregnant women.
Medical Justice sent volunteer midwives to visit pregnant women in immigration detention for a decade. We warned the Home Office that women and their unborn children were suffering from inadequate healthcare and that they should ban the detention of pregnant women immediately. The Home Office paid little attention.
One of our clients had complained for three weeks about abdominal pains was sent to A & E where she miscarried with two guards in attendance. She subsequently attempted suicide and was admitted into a psychiatric ward.
In 2013 we published “Expecting Change: The case for ending the detention of pregnant women”, a dossier which called for the end of detention for pregnant women. This call was backed by the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists, as well as 337 organisations.
In 2015 Channel 4 News undercover cameras revealed the callous treatment of pregnant women in detention. In 2016 the Home Office commission Stephen Shaw, a former Prison and Probation Ombudsman to review the use of immigration detention – he too called for a ban on the detention of pregnant women.
The detention of pregnant women was curtailed to 72 hours, extendable up to a week with ministerial authorisation, following a concerted campaign by non-governmental organisations, medical professionals and parliamentarians in 2016. But as we can see from this case, this is not enough. A time limit will only go so far, which is why we must end detention for pregnant women.
When asked by the Home Office for a follow-on review in 2018, Shaw called again for a total ban on the detention of pregnant women, an option the Home Office chose again not to implement.
Immigration detention is optional so the Home Office is responsible for any woman miscarrying in detention. The Home Office must do the right thing, urgently, and actually ban the detention of pregnant women as they run the real risk of another miscarriage in detention, for which they will be responsible.
- This text is an expanded version of ‘Ban the detention of pregnant women’ which appeared in The Guardian, Tues 20 August 2019