The detention of people who have not been convicted of a crime should be a measure of ‘last resort’ and should be phased out, a new report on health and human rights in immigration detention1 from the British Medical Association states.
‘Locked up, locked out’, published today, outlines how aspects of current detention policies and practices, such as no clear time-limits on how long people will be detained, are detrimental to the health of migrants and asylum-seekers, and also sets out the challenges doctors face when providing healthcare in detention settings.
The report, from the BMA medical ethics committee, is part of the Association’s aims to reduce health inequalities and defend human rights, ensuring access to healthcare for all, and standing up for vulnerable groups. It uncovers how doctors, immigration centre staff and detainees feel a ‘deep frustration’ with healthcare provision; staffing levels, and the availability of and access to on-site services and referrals to specialists, vary and are often inadequate.
The report also highlights concerns about individuals with mental health problems and asserts that the environment of an immigration detention centre can worsen or contribute to mental illness. Many of those detained are highly vulnerable and some have been victims of torture.
Dr Alan Mitchell, immediate past chair of the BMA’s civil and public services committee (CSPC), works as a part-time GP in an immigration removal centre, and contributed to the BMA’s report.2
He said: “One of the most distressing cases I came across recently was in relation to a young man who was in an immigration detention centre who had been sexually abused. He came to the United Kingdom and while an asylum seeker was able to access community mental health services.
Dr Mitchell added: “He was a vulnerable adult and he was unsuitable to be in immigration detention.
“I made a report to the Home Office, and the Home Office released him shortly afterwards but because his status remained that of a failed asylum seeker, he was unable to access the help that he needed. That definitely contributed to him falling into a downward spiral.”
The report aims to resolve failures such as this with a series of policy recommendations including:
• Revising detention policies to address the significant health effects indeterminate detention can have on individuals
• Addressing aspects of the detention environment which affect the health and wellbeing of those detained
• Reconfiguring current healthcare provision so as to better achieve equivalence of care
• Providing training and continued support in health and wellbeing issues for all those working with detained individuals
• Recognising the importance of doctors acting with complete clinical independence and ensuring that principle is enshrined and respected across the immigration detention estate
The UK has one of the largest immigration detention estates in Europe, with 11 immigration removal centres across the country, holding up to 3,500 individuals at any one time.3 It is only one of a handful of European countries where no time-limits are imposed on detention.4
Commenting on the report, Dr John Chisholm, BMA medical ethics committee chair, said:
“Healthcare is one part of the wider practice of immigration detention, but a part that is fundamental to the state meeting its obligations to those detained.
“Migrants and asylum-seekers shouldn’t have their health-related human rights infringed and must be able to access healthcare adequate for their needs.
“The BMA hopes to work with policy-makers and other organisations to restructure and develop policies that meet the health needs of people in detention and ensure doctors can meet their ethical and professional obligations. A fundamental rethink of current policies is required.”
Notes to Editors
The British Medical Association (BMA) is the voice of doctors and medical students in the UK. It is an apolitical, professional organisation and independent trade union, representing doctors and medical students from all branches of medicine across the UK and supporting them to deliver the highest standards of care
1. Immigration detention is the practice of detaining migrants and asylum seekers for administrative purposes – typically to establish their identity, process their immigration claim or, where applications have been rejected, to facilitate their removal from the UK.
2. Watch our interview with Dr Alan Mitchell here.
3. Immigration detention in the UK: an overview, House of Commons Library briefing paper - http://researchbriefings.parliament.uk/ResearchBriefing/Summary/CBP-7294
4. Review into the Welfare in Detention of Vulnerable Persons: A report to the Home Office by Stephen Shaw. - https://www.gov.uk/government/publications/review-into-the-welfare-in-detention-of-vulnerable-persons