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Author: anthony

Politics over people?

How the UK’s “one in one out” scheme knowingly harms and forcibly removes torture and trafficking survivors to France

Medical Justice press release 21 January 2026 for immediate release

Medical Justice today publishes “Politics over people? How the UK’s “one in one out” knowingly harms and forcibly removes torture and trafficking survivors to France”, the first comprehensive analysis of the backgrounds, experiences and mistreatment of 33 clients detained in immigration removal centres (IRCs) under the ‘one-in one-out’ UK-France Treaty since August 2025. These clients are men, women and age-disputed young people whose nationalities include Eritrean, Iranian, Palestinian and Sudanese.  

Independent clinicians from Medical Justice who assessed 20 clients in detention found that all 20 had clinical evidence of a history of torture, ill-treatment and/or trafficking, and all 20 had serious mental health conditions. Our clinicians document the clinical consequences of the use of force and segregation to facilitate removals.

A Medical Justice spokesperson said: 

“Medical Justice has been documenting the harm experienced by people held in immigration detention for two decades – what sets the mistreatment of clients detained under this scheme apart is the combination of an especially high proportion of trafficking and torture survivors, alarming levels of suicidality, and the fact that almost all of them experienced dysfunction of the clinical safeguarding system, exposing them to the severe harm detention in the UK is known to cause. 

The number of people released by the Home Office in response to safeguarding reports from healthcare units inside IRCs is so low that it risks rendering the whole process of clinical safeguards meaningless. 

We fear the government wants to remove these people come what may. 

The scheme should be scrapped and all people be allowed to have their asylum claims processed in the UK.” 

Medical Justice found:   

  • Of the 20 clients our clinicians assessed, only two had an appointment with a GP at the IRC within 24 hours of arrival there as they should have done. 
  • Only three had a report by the IRC GP identifying those who are likely to be injuriously affected by detention as they should have done. Those who did not have one of these reports included people whose health had already deteriorated in detention, one of whom had been hospitalised.  
  • 12 out of the 20 people our clinicians assessed had suicidal thoughts. One person attempted to take their own life and two self-harmed in detention. Five were identified as being at risk of self-harm and/or suicide by the IRC, with one put on suicide watch (“constant supervision”), yet only one had a safeguarding report as they should have done from the IRC to flag suspected suicidal intentions to the Home Office who should review if detention is to be continued.  
  • We had access to 14 Home Office responses to safeguarding reports – in only one case was the person released.  
  • Clients were detained for between one month and over three and a half months. 16 of the 33 clients were released in the UK, with several subsequently re-detained for removal. Some have been forcibly removed to France.   
  • Many clients have not been able to access adequate and timely legal advice.       

Based on expert medical evidence, the report details the harm and distress caused and compounded by detention, as well as by the accelerated process of forced removal and the anticipation of removal. Many clients described having experienced severe violence and highly traumatic events in France – including witnessing the violent death of another person at the hands of traffickers, and being threatened by traffickers that they would be killed if they returned to France. Some clients had suicidal thoughts when thinking about being returned to France and expressed intent to die by suicide if they were to be removed. 

Clients describe being arbitrarily selected after arriving by small boat to be in the scheme. Neither their claims for asylum nor their risks of harm from detention in UK IRCs were considered when they were ‘selected’ for detention – they were instead subjected to inherently harmful detention. At the time of publication, the Home Office had decided to remove six clients, including an age-disputed child, from the inadmissibility procedure and they are now able to process their asylum claim in the UK. 

Successive governments have been continuously warned by their own monitoring bodies, by Medical Justice, and in a public inquiry, of the danger and harm of detention in the UK, yet is knowingly harming torture and trafficking survivors and age-disputed young people by subjecting them to this scheme and locking them up in detention.   

Hamid* was detained under this Treaty and had clinical evidence of a history of torture. He  describes the excessive force and violence he was subjected to during a removal attempt to France. Hamid told Medical Justice:

“The belt that was tied around my shoulders got stuck in my throat. I started screaming and saying I want to die, untie the belt from my neck, but they thought I just wanted to be let go. After a few minutes, I became dizzy, and my voice became weak and my strength was limited to just tears. They saw me struggling for air and honestly, my eyes were turning white and my breathing was difficult. I said in a low voice, I can’t breathe, and I thought to myself, Oh, my God.”  

A Medical Justice clinician documented evidence of Hamid’s physical injuries and psychological harm. Hamid has since been removed. 

This report comes shortly after a group of more than 80 people detained under the scheme at Harmondsworth IRC spoke out about the psychological distress, fear and harm they are suffering, and just days after reportedly passive protests by more than 100 asylum seekers at two IRCs. A video circulated of protesters being dispersed by officers using riot shields, PAVA spray and dogs.

*Not his real name  

Vacancy | Head of Clinical Evidence & Casework

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Medical Justice is recruiting for a new Head of Clinical Evidence & Casework, a senior leadership role that manages a team of caseworkers and clinicians to develop high quality medical evidence and support vulnerable people detained in immigration detention.

About the role

Casework is at the heart of everything Medical Justice does. We assist vulnerable people mistreated in immigration detention and the medical evidence we produce forms the basis of our advocacy work to secure lasting change. As Head of Clinical Evidence & Casework, you will play a key role in strengthening and developing our ability to reach more people in detention. Leading a team of caseworkers, employed and volunteer clinicians and interpreters, you will oversee the development of high-quality medical evidence, facilitate access to healthcare for people in detention, and collaborate closely with our Advocacy team and external organisations to challenge and end medical mistreatment in immigration detention.

Head of Clinical Evidence & Casework

Salary: £47,500 – £51,500 per year with cost-of-living adjustments (if relevant) three times a year plus an annual increase of £500 for 5 years and 5% pension contribution.

Reports to: The Director

Working hours: Full time (37.5 hours per week). Flexible working patterns can be considered.

Office: North London, near Finsbury Park, with some flexibility for remote working.

Contract Type: Permanent

Terms: 28 days holiday per year, plus statutory bank holidays, plus 2 Wellbeing days

Benefits: Include sick pay from day one, enhanced parental leave, one-to-one counselling sessions and group reflective sessions with a psychologist, ‘cycle to work scheme’, weekly staff lunch, flexible working considered.

Informal online information sessions

We are holding informal online information sessions to learn more about the role and Medical Justice on:

  • Monday 22 December at 12:30
  • Friday 9 January at 13:00

Email recruitment@medicaljustice.org.uk to sign up.

Closing date

Tuesday 20 January 2026, 23:30

Further information

Further information about the role is included the this candidate pack and once you are ready, apply via CharityJobs

 

 

Medical Justice’s Work in Parliament – Update

With MPs and Peers back in Westminster after their summer recess, we share some updates below about Medical Justice’s work in Parliament this year, and what’s coming up.

All Party Parliamentary Group (APPG) on Immigration Detention

The APPG on Immigration Detention is a cross-party group of MPs and peers that advocates for evidence-based reforms to immigration detention policy, and the welfare of detained people. Medical Justice was instrumental in setting up the group in 2019 and has acted as its secretariat since then.

Following last year’s general election, Medical Justice helped to re-establish the APPG with Labour’s Bell Ribeiro-Addy MP elected as the group’s Chair. So far this year the group has delivered a number of high-profile activities – you can read more about each below.

 

Meeting with Dame Angela Eagle DBE MP, Minister for Border Security and Asylum (March 2025)

The APPG met with Dame Angela Eagle on 12 March 2025 in the House of Commons. The meeting was attended by the Minister, Bell Ribeiro-Addy MP, Baroness Lister of Burtersett, Baroness Ludford, and Elspeth Macdonald from the Secretariat, and Home Office officials.

APPG members raised issues of interest and concern, including the Home Office’s plans to expand the detention estate, alternatives to detention, implementation of the Brook House Inquiry’s recommendations, and detention-related aspects of the Border Security, Asylum and Immigration Bill 2025.

During the discussion the Minister indicated her willingness to continue engaging with the APPG, and this is something the groups plans to pursue with her successor Alex Norris MP.

 

Panel discussion on the current state of immigration detention in the UK (March 2025)

The APPG’s panel discussion took place on 20 March, and looked at the current state of immigration detention in the UK and its impacts on detained people.

APPG Chair and speakers at panel event on 20 March 2025

Click here to access a full summary of the meeting, including Q&As

 

Speakers included Joel Mordi, a Nigerian LGBTQI+ and human rights activist currently working with Rainbow Migration on their  No Pride in Detention campaign. Mr Mordi was previously detained at Harmondsworth Immigration Removal Centre (IRC) and spoke about the devastating and lasting impacts that detention can have on those subjected to it, including members of the LGBTQI+ community. Mr Mordi’s speech is available in full on the APPG’s website.

Charlie Taylor, HM Chief Inspector of Prisons and Dr Hindpal Singh Bhui OBE, Inspection Team Leader at HM Inspectorate of Prisons  also spoke. In 2024, Mr Taylor warned of a “worrying deterioration in safety” across UK IRCs, with an inspection of Harmondsworth IRC finding “the worst” conditions inspectors had ever seen in UK immigration detention, and serious concerns likewise reported at Brook House IRC. Mr Taylor and Dr Singh Bhui discussed these findings in more detail. They also provided an update from a recent visit to Harmondsworth where, despite good progress in some areas, a number of key concerns remain, in particular in relation to the safeguarding of vulnerable people.

Over 40 guests attended the event including parliamentarians, people with lived experience of immigration detention, and representatives from the Royal College of Nursing, the Independent Monitoring Boards, and front-line immigration and asylum charities.

 

Visit to Harmondsworth IRC (July 2025)

The APPG conducted a visit to Harmondsworth IRC on 24 July, attended by Bell Ribeiro Addy MP and Baroness Lister of Burtersett (pictured below).

Prompted by HMIP’s report on the IRC in 2024 (see above), the visit was an opportunity to better understand how the Home Office and current contractor Mitie have responded to the Chief Inspector’s findings. Central to the visit was a meeting with men currently held at the site who shared valuable insights about their ongoing experience of being detained at Harmondsworth and current conditions.

Prior to the visit, both the Chair and Baroness Lister also met with Bail for Immigration Detainees, JRS UK, and Medical Justice and were briefed on the organisations’ current key concerns regarding the facility.

The APPG plans to continue its engagement with Home Office and contractors, including following up on issues raised during the visit, in the coming months.

Border Security, Asylum and Immigration Bill 2025

The Border Security, Asylum and Immigration Bill was introduced in Parliament in January 2025, with the stated aim to “improve UK border security and to strengthen the asylum and immigration system”. You can read more about the Bill and the planned changes it will (and won’t) make to detention here.

As the Bill made its way through the House of Commons earlier this year, Medical Justice shared its concerns about the draft legislation and how it needs to be changed in a number of parliamentary briefings and evidence submissions.

The Bill now being looked at by the House of Lords, and Medical Justice has continued to highlight its damaging effects and advocate for key changes. This has included producing a number of briefings as part of the Coalition for Asylum Rights and Justice (CARJ):

We have also joined calls for the introduction of a time limit on immigration detention. Medical Justice remains firm in its view that the use of immigration detention must be ended, given the known harm it inflicts on those subjected to it. We see the introduction of a time limit, which has been backed by the UK Parliament’s Home Affairs Committee and Joint Committee on Human Rights, HM Chief Inspector of Prisons, the British Medical Council and the Brook House Inquiry amongst others, as an important interim step towards achieving that ultimate goal.

An amendment to the Bill introducing such a time limit was tabled by Liberal Democrat peer and APPG members Lord German, supported by Labour’s Baroness Lister of Burtersett and the Lord Bishop of Chelmsford. Jointly with other NGOs, Medical Justice produced a detailed briefing about the amendment and why it is needed:

The amendment was debated in the Lords on 3 September 2025. In his speech, which you can watch here or read in full, Lord German said:

“I tabled this amendment because….I believe that it is a change that needs to happen. When I visited an immigration removal centre last year and spoke to detainees and staff, it was made clear to me that case progression for immigration detainees is slow and hampered by staff shortages. Further to this, detainees were unaware of the progress on their cases and when they could expect to leave detention or be removed. Communication to them was minimal and this clearly led to despair and frustration with the lack of hope for the future.”

While the Home Office Minister Lord Hanson’s response made clear that the government does not intend to support such a change, Medical Justice will continue to keep working with MPs, peers and NGO colleagues to make the case for a 28-day time limit wherever possible in Parliament and more widely.

Basic Training Day For Clinicians – November 2025

 

We are very pleased to announce details of our next Basic Training Day which will take place on Saturday 08 November 2025. The training day will start from 9.30am and end at 5.30pm.

We are very excited to be able to offer this training in person in London. The training day is supported by self-study modules in the assessment of mental health and scarring which we recommend those new to this field complete in advance of the day (approx 4 hours).

Our Basic Training Day is for doctors and psychologists who are interested in volunteering for Medical Justice as medico-legal report writers, visiting detained people in detention centres or conducting remote assessments, assessing their health and documenting clinical evidence of torture and other health issues.

The aim of this course is to gain an understanding of the health and legal needs of asylum seekers and other people detained under immigration powers. The skills learnt will focus on assessing persons detained under immigration powers, as well as medico-legal report writing

The training covers the relevant legal processes, assessing scarring and mental health and report writing skills.

Requirements from Doctors:

  • ST4 or above, or with equivalent clinical experience (i.e. completed 5 years’ post-qualification)
  • Full registration from the GMC with a licence to practice
  • Indemnity insurance
  • Clinical experience at ST1 level or above with adults or adolescents age 16 or over within the last 3 years. This may include clinical experience with adults in non-NHS or overseas settings.

Requirements from Clinical Psychologists:

  • At least two years’ post-doctorate experience (or relevant extensive experience in a specialist refugee or trauma service)
  • Professional registration with the HCPC
  • Indemnity insurance
  • Clinical experience with adults or adolescents age 16 or over within the last 3 years (slightly less recent experience may be acceptable if extensive).

 

Participation fees

On request, fees are reimbursed after the doctor has written an MLR for a Medical Justice referral

 

£120 – Consultant/GP

£80 – Trainee doctors (ST4 onwards), retired doctors and psychologists

Free – Medical Justice volunteer (carried out one detention visit in last 12 months)

 

Note: please tell us if you would have difficulties paying a fee – we can help.

How to apply

Please follow link below and provide the information requested and we will be in touch once your details have been reviewed by our Clinical Advisors.

If you are unable to attend in person, please let us know.

If you have any questions, please contact Anthony on a.omar@medicaljustice.org.uk

Submit Registration Details

 

Medical Justice is a small charity that sends volunteer clinicians into the UK’s 7 IRCs to visit men and women detained arbitrarily and indefinitely. We assist about 1,000 detained people a year, most of whom are asylum seekers, and most are later released. Our volunteer doctors write medico-legal reports (MLRs) documenting the scars and mental health consequences of torture, identify unmet health needs and challenge instances of inadequate healthcare provision. We are the only charitable organisation in the UK that does this. Our training is therefore unique and provided by experienced doctors in the field.

Induction Training Day For Interpreters – November 2025

Our Induction Training Day is for new volunteer interpreters who are joining Medical Justice. By joining Medical Justice as a volunteer interpreter, you can have a positive impact on the lives and health of a vulnerable group of people in the UK. Our interpreters help people in detention seek support and advice despite the language barriers and provide crucial interpretation for medical assessments with our volunteer clinicians.

Volunteers can make a difference by donating time remotely by phone/video or by attending immigration detention centres in person to provide skilled and accurate interpretation. You can volunteer your time flexibly and taken on interpreting at the times that are most suited to you.

The training contains sessions on working with medical professionals as well as an introduction to immigration detention, visiting an IRC and interpreting in a mental health context. We also have ongoing opportunities for feedback and support for volunteers.

This training day will be taking place in person near our offices in Finsbury Park, London.

 

 

 

How to join

If you are interested in joining our interpreter team, please contact Lisa at interpreting@medicaljustice.org.uk for an application form. If you are unable to attend in person, please let us know.

 

 

Medical Justice is a small charity that sends volunteer doctors (and other health professionals) into the UK’s 7 IRCs to visit men and women detained arbitrarily and indefinitely. We assist about 1,000 detained people a year, most of whom are asylum seekers, and most are later released. Our volunteer doctors write medico-legal reports (MLRs) documenting scars of torture and challenge instances of inadequate healthcare provision, including denial of medication and access to hospital. We are the only charitable organisation in the UK that does this.

 

Medical Justice updates Home Office Immigration Detention statistics collated through Freedom of Information Requests

Medical Justice collates Home Office Immigration Detention statistics through regular Freedom of Information requests. These statistics have now been updated to the end of December 2024.  

The statistics cover the following thematic areas: 

The statistics are available here.  

The top-line statistics for 2024 show that: 

  • 74 Rule 35 (1) reports, 35 Rule 35 (2) reports and 2,473 Rule 35 (3) reports were completed for people in detention. 
  • There were 715 Use of Force incidents at Brook House Immigration Removal Centre (IRC), 188 at Colnbrook IRC, 43 at Derwentside IRC, 34 at Dungavel IRC, 156 at Harmondsworth IRC, 76 at Tinsley House IRC and 151 at Yarl’s Wood IRC. 
  • 1292 ACDTs and 419 constant supervision ACDTs were opened. 
  • At least 1,340 people were held in segregation under Rule 40 and at least 25 under Rule 42. 
  • While 1292 ACDTs and 419 constant supervision ACDTs were opened in 2024, only 74 Rule 35 (1) reports and 35 Rule 35 (2) reports were completed in detention. This shows that high numbers of individuals have been identified as warranting observation for suicide or self-harm risk, but in all but a few cases, the clinical assessment and reporting process for risk of deterioration and risk of suicide has not been followed.  

For Medical Justice’s analysis of the Home Office statistics for 2024, as well as our own statistics based on our 2024 clients, please see our latest report: Medical Justice Annual Review: The state of healthcare and harm in UK immigration detention in 2024. 

If you do use this resource, please credit Medical Justice as the source. We also would appreciate it if you could let us know when you use this resource, so we are able to keep track of how widely and well-used it is. Please email our researcher, Ariel, to let her know if you use this resource and also if you have any questions a.plotkin@medicaljustice.org.uk.   

Annual review highlights failures to protect vulnerable people in detention

Medical Justice’s annual review, published for the first time today, highlights how failures in clinical safeguards continued to put vulnerable people at unacceptable levels of risk and failed to prevent harm in immigration detention during 2024.  

Medical Justice Annual Review: The state of healthcare and harm in UK immigration detention in 2024 draws on a detailed statistical analysis of clinical and other evidence from 73 clients detained at immigration removal centres (IRCs) who were assessed by independent clinicians working with the charity and who received completed medico-legal reports in 2024. It documents the prevalence of factors that are likely to make Medical Justice clients particularly vulnerable to suffering harm in detention. These factors include having a history of torture, trafficking and other trauma, as well as mental and physical health conditions. The review also considers health deterioration while detained, levels of suicidality, and available healthcare provision in detention. 

A deep dive into the functioning of available safeguarding mechanisms reveals worrying failures in implementation – including of the initial healthcare screening undertaken by IRC healthcare staff, medical examinations mandated by Rule 34 of the Detention Centre Rules, reporting of vulnerabilities under Rule 35, and Assessment Care in Detention and Teamwork (ACDT) – a process intended to manage the risk of self-harm and suicide. The review also highlights the inappropriate use of segregation and of force on vulnerable detained people. 

The findings are stark: 

  • 82% of the clients included in this review were survivors of torture and 63% reported a history of trafficking. However, healthcare screenings on arrival largely failed to identify these critical vulnerabilities – missing 77% of the survivors of torture and 89% with a reported history of trafficking. 
  • 99% had a diagnosis of at least one mental health condition, including post-traumatic stress disorder, according to the Medical Justice clinician. Many of these were new diagnoses that had been missed or not explored by healthcare in detention. 
  • The mental state of 97% of clients deteriorated while in detention and 74% had an increased risk of suicide since they were detained. 23% of clients self-harmed in detention and three people attempted suicide. 
  • Only 6% of clients that Medical Justice clinicians assessed had been harmed by detention had a Rule 35 (1) safeguarding report as they should have had. This is the report IRC GPs are required to complete to alert the Home Office that they suspect a detained person is likely to be injuriously affected by detention and which triggers a detention review.  
  • Clients with mental health conditions were put in segregation for extended periods. More than half of these clients (53%) were not visited daily by the IRC GP, as required by the Detention Centre Rules. 
  • Force was used on 16 clients, with force applied to two clients’ head and neck.  
  • 90% of clients were eventually released, calling into question the justification for their detention in the first place. 

“These findings highlight not only the scale of unnecessary harm that indefinite immigration detention causes vulnerable people on a daily basis, but also the ongoing systemic failure of safeguarding mechanisms that are supposed to protect them,” said Ariel Plotkin, Researcher at Medical Justice.  

“We know only too well that ineffective safeguards can lead to life-or-death situations. Yet rather than addressing the failings that we have repeatedly warned them about, the government plans to increase detention capacity and speed up removals, including with the arbitrary and dehumanising new ‘one in, one out’ deal with France. Under these arrangements, more people will be detained and even more pressure will be added to an already broken, dangerous and harmful system.”  

Medical Justice recommends that immigration detention must end and the government should also consider credible community-based alternatives. 

In the interim, the risk of further mistreatment and abuse can be reduced by promptly implementing all 33 recommendations of the Brook House Inquiry and ensuring that the review of the Adults at Risk in Immigration Detention policy currently underway strengthens the available protections rather than further weakening them. 

For more information and to arrange media interviews, please contact: 

Emma Ginn, Director, emma.ginn@medicaljustice.org.uk 

Annual Report | Financial Year February 2024 – January 2025

Read the Annual Report here

 

The Medical Justice Financial Year ending 31st January 2025 Annual Report shows how we changed lives and made detention less harmful. Thank you for making it possible. You can download the report here.

In 2024, inspectors warned of the worst conditions they have ever found in immigration removal centres (IRCs) where detained people continue to be at imminent risk.

20,604 men, women and children were held in detention in 2024. The situation remains urgent – this report details how Medical Justice continues to evidence the severe harm caused to detained clients by the catastrophic failures in safeguards that have led to inhuman and degrading treatment.

In 2024, rather than change direction and strengthen safeguards, the new Labour government continued the previous government’s moves to weaken safeguards and to expand detention, in full knowledge of the severe harm this risks – harm that cannot be described as accidental.

Changing lives

  • 508 referrals for detained people in 2024 – some say we changed the course of their lives.
  • 90% of a set of 73 clients assessed by Medical Justice clinicians and received a medio-legal report were released.

Secured systemic lasting change making detention less harmful for thousands of people

  • Released: research report “You’ll see the outside when you’re in Rwanda” – analysis of harm caused to 48 clients detained for removal to Rwanda. 82% were torture survivors. 78% had suicidal thoughts. All 48 were released.
  • Established: duty to consult Medical Justice on detention policies affecting vulnerable people – our successful litigation means the Home Office must engage constructively with us, and receive our evidence and suggestions for improvements, which, if adopted, potentially benefit thousands of detained people.
  • Secured: improvements to clinical safeguards for thousands of detained people each year – including Home Office Rule 35 training for IRC clinicians, NHS England guidance on Rule 35 safeguarding reports and Adults at Risk Statutory Guidance.
  • Galvanised: Medical Justice evidence quoted by the Royal College of Psychiatrists – our research, analysis and case-studies used in the report “Protecting the mental health of people seeking sanctuary in the UK’s evolving legislative landscape”, covered by the British Medical Journal and galvanising the medical community.

 

Clearly these achievements in FY2025 are stepping stones. Our ultimate vision is that immigration detention is unable to harm anybody’s physical or mental health as it no longer exists in the UK. Certainly, this is a long-term endeavour, and it cannot come about without the stepping stones we are laying down now.

One of the most significant systems changes to make the immigration and asylum system more humane is to end the mistreatment of people held indefinitely in immigration detention. That is unlikely to happen without medical evidence of the harm. Medical Justice is the only source of such medical evidence as it is the only charity to send clinicians to see detained people in all the UK’s IRCs, to document the harm they suffer, to analyse and to present the evidence in a digested format to use in our own advocacy work for system change and by like-minded groups. Medical Justice is recognised as the UK’s expert on deterioration of detained people’s health, with extensive and uncontested evidence of how and why dysfunctional clinical safeguards severely harm detained people.

Medical Justice is a critical actor in the required collaboration of organisations and voices. In 2024, we galvanised the influential voice of the medical community and primed parliamentarians to act by bringing them together with experts, lawyers, detention monitoring bodies, and people with lived experience through the All-Party Parliamentary Group (APPG) on Immigration Detention for which we act as the secretariat.

We thank all our partners, clients and funders for their invaluable support.

Supreme Court favourable decision in Medical Justice’s judicial review

Medical Justice welcomes the Supreme Court’s decision to refuse the Home Office permission to appeal a ruling that its failure to consult with Medical Justice on changes to guidance for immigration detention caseworkers was unlawful.

 

Team having lunch in Middle Temple Hall after the Court of Appeal hearing. From left to right Theresa Schleicher (Medical Justice), Jed Pennington (Wilsons Solicitors), Laura Profumo and Shu Shin Luh
Team having lunch in Middle Temple Hall after the Court of Appeal hearing. From left to right Theresa Schleicher (Medical Justice), Jed Pennington (Wilsons Solicitors), Laura Profumo and Shu Shin Luh

 

Our judicial review challenged the Home Office’s ‘Second Opinion’ policy which allows it to disregard a medico-legal report from Medical Justice for a detained client while it seeks a second opinion from a doctor it contracts.  There is no requirement for the Home Office doctor to ever actually meet the detained person or have any expertise in documenting deterioration of health in detention. In one case a second opinion report took weeks to be produced, during which time a detained person could deteriorate further in detention.

In January 2024 the High Court found that there had been an unlawful failure by the Home Office to consult Medical Justice regarding changes to its Adults at Risk Caseworker Guidance which lays out the Second Opinion policy. The Home Office appealed and in March 2025 the Court of Appeal upheld the High Court’s decision. The Home Office sought to appeal to the Supreme Court which was refused permission on 4th July 2025.

In most cases, the Home Office does consult NGOs on immigration detention policies, and when it does, Medical Justice has sometimes been able to secure improvements to policies, making them less harmful for thousands of detained people. The Home Office failed to consult on the Second Opinion policy (other than with their own contractors) and that closed the door to the possibility of improvements before it started having an impact on detained people.

This is an important victory for Medical Justice – we want to work constructively with the Home Office to improve policies for people held in detention, and for the Home Office to pay full attention to our expert evidence and analysis based on our clinical assessments of those who have already been severely harmed by its policies.

The courts, inquiries and inspection bodies have repeatedly found that vulnerable people have been subjected to inhuman and degrading treatment in UK immigration detention. The Home Office should be welcoming our input, not shutting the door on policy consultation.

Now the Home Office must consult us on its Adults at Risk policy, the door to policy improvements is permanently wedged open, potentially benefitting many thousands of detained people. Our lawyer said

“I am not aware of another NGO succeeding in a judicial review in establishing a duty to consult … certainly in the context of the immigration system. It is at least very rare, if not unique.”

We thank our very able lawyers – Jed Pennington at Wilsons who instructed Shu Shin Luh and Laura Profumo, who were led in the Court of Appeal and Supreme Court by Angus McCullough KC.

London Legal Walk 2025 | Medical Justice

This year we are celebrating our 20th anniversary and will be walking 10km on Tuesday 17th June to help raise funds for Medical Justice!

Medical Justice is the only charity in the UK to send independent volunteer clinicians to visit people held in Immigration Removal Centres across the UK and document their scars of torture and serious medical conditions.

Evidence from our casework is the platform for our research into systemic failures in healthcare provision, the harm caused by these shortcomings, as well as the toxic effect of immigration detention itself on the health of people in detention. We use our research, policy work, strategic litigation and parliamentary work to secure lasting change.

Please sponsor our walkers as generously as you are able.

You can sponsor us here

£50 could cover the train fare for a volunteer clinician to visit a person in detention to carry out a medical assessment.  

Thank you for supporting our team in fundraising for the 2025 London Legal Walk.

 

Join the walk

As well as donating you can join us on the 10km walk on Tuesday 17th June to raise funds for Medical Justice. The Medical Justice team will include staff, trustees, former detained people, volunteer clinicians, interpreters, supporters, and others who want to end the injustice suffered by people detained under immigration powers. Children and dogs are also welcome!

London Legal Support Trust: London Legal Walk 2025

Email Ariel at a.plotkin@medicaljustice.org.uk if you want to walk with us, or for more details on logistics.

 

Law firms who already have a London Legal Walk team can designate funds to Medical Justice

The London Legal Support Trust allow you to designate up to 50% of the funds you raise to a specific agency (or agencies) if you have a significant partnership with the agency.  This can include on-going pro bono support for Medical Justice.  Please email Elspeth at e.macdonald@medicaljustice.org.uk  if your law firm would like to donate money raised to Medical Justice

 

Any questions?

Email Ariel (a.plotkin@medicaljustice.org.uk) or Elspeth (e.macdonald@medicaljustice.org.uk) or call us on 0204 551 1280.

To set up a monthly donation to Medical Justice click here.