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Submission to SLSC about changes to the Adults at Risk in Immigration Detention policy

In early May, Medical Justice submitted evidence to the House of Lord’s Secondary Legislation Scrutiny Committee (SLSC) about changes to the Adults at Risk in Immigration Detention Statutory Guidance (AARSG) that significantly reduce already inadequate protections for vulnerable people in detention. 

The changes were published by the government in draft form, and were brought into effect on 21 May 2023 via secondary legislation. 

The changes include: 

  • removing a previous commitment to reducing the number of vulnerable people in detention and their period of detention. 
  • granting the government the power to seek a second opinion on medical evidence from external providers documenting a person’s vulnerability. Such a provision risks prolonging individuals’ periods of detention and exposing them to further deterioration and harm.  
  • removing a provision whereby victims of torture with a Medico Legal Report from a reputable provider such as Medical Justice were automatically granted the highest level of protection against continued detention. 

Concerns raised by Medical Justice to the SLSC included: 

  • the damaging likely impacts of the AAR SG changes, including more vulnerable individuals being detained, for longer periods or time, with an increased risk of suffering harm including human rights violations (e.g. breaches of Article 3 ECHR). 
  • that the changes run entirely counter to the recommendations of the recent Brook House Inquiry. The Inquiry found that safeguards for vulnerable people in detention should be strengthened, not reduced. 
  • the deficiencies in the Home Office’s ‘consultation’ with NGOs on the changes, including lack of necessary information being provided and too short a time-frame. 

As a result of Medical Justice’s submission, the SLSC put a detailed list of questions to the Home Office about the AARSG changes.  

The SLSC has also issued a report criticising the government’s amendments in a number of different areas. The SLSC’s concerns include that the data provided by the Home Office “does not provide compelling evidence either way on the need for the second opinion policy” and that “the Government has not set out how it will monitor and report on the policy”, despite the fact that the “possible adverse impact of detention on vulnerable people makes these changes controversial”. 

You can read Medical Justice’s submission here, and the SLSC’s questions / Home Office’s answers here 

The SLSC’s full report is available here (pp. 1-5) 

Joint briefing for parliamentarians on changes to the Adults at Risk in Immigration Detention policy

In collaboration with ten other NGOs, Medical Justice has produced a joint briefing for parliamentarians about alarming recent changes made by the government to the Adults at Risk in Immigration Detention Statutory Guidance (AARSG) that further reduce the already inadequate protections for vulnerable people in detention. 

You can download and read a copy of the briefing here

The revised AARSG was published in draft form in April, and came into effect on 21 May 2024. You can read more about the changes here and here (paywall). 

Our joint briefing explains the changes in detail and highlights key concerns, including that: 

  • the revised AARSG is likely to result in more vulnerable individuals being detained, for longer periods or time, with an increased risk of suffering harm including human rights violations (e.g. breaches of Article 3 ECHR). 
  • the changes run entirely counter to the recommendations of the recent Brook House Inquiry. The Inquiry found that safeguards for vulnerable people in detention should be strengthened, not reduced. 
  • there were deficiencies in the Home Office’s ‘consultation’ with NGOs on the changes, including lack of necessary information being provided and too short a time-frame. 

The briefing is jointly badged with Bail for Immigration Detainees (BID), Jesuit Refugee Service (JRS) UK, Refugee Council, Women for Refugee Women, the Helen Bamber Foundation, Detention Action, Association of Visitors to Immigration Detention (AVID), Immigration Law Practitioners’ Association (ILPA), Freedom from Torture, and Gatwick Detainees Welfare Group (GDWG) 

Medical Justice plans to continue work to oppose the changes once Parliament returns following the general election.

Vacancy | Clinical Assessor (Doctor)

We are recruiting for an exciting opportunity to join the Medical Justice team as soon as possible as a Clinical Assessor – Doctor.

Please see the Application Pack for more details.


Clinical Assessor – Doctor

 

Salary: £12,253.83 per annum per day (for 1 to 2 days a week; £61,269.13 per annum pro-rata).

Reports to: Clinical Advisor

Responsible for: Volunteer clinicians who may accompany your clinical assessments in a training/observer role

Job purpose: To carry out assessments for people detained in immigration removal centres (IRCs). To write Medico-legal reports in accordance with the Istanbul Protocol.

Working hours: 1-2 day a week ([please indicate your preference on the application).

The post-holder will be expected to be flexible and to occasionally be available out of hours where urgent action is required regarding of one of their assessments (for example, if information is needed urgently for the client’s legal case, they might be asked to write a letter. There is no other requirement to provide on-call cover).

Flexible working hours and flexible arrangements for remote working are possible.

Where based: The post-holder will visit Immigration Removal Centres (IRCs) to carry out assessments for people who are detained. Report writing can be done from our office in Finsbury Park or remotely. The post holder will be expected to attend occasional team meetings, trustees’ meetings, training events and other gatherings as required.

Length of contract: Length of contract Permanent. The probation period will be 6 months.

Terms: Pro rata 24 days per annum holiday, plus statutory bank holidays and 4 additional days’ holiday associated with bank holidays which may be decided on by your manager (usually associated with the office closure during Christmas and New Year).

Deadline for application: Midnight, Sunday 11th August 2024 (we may close the vacancy early if a suitable candidate is found before the deadline)


For more information about Medical Justice, the full job description and application form, please download the Application Pack

BBC reveals massive scale of Use of Force training for forcing vulnerable people onto Rwanda deportation flights

Medical Justice exposes Home Office dangerous Use of Force policy ignores Brook House Inquiry recommendations

The BBC has filmed inside aircraft fuselages in a massive hangar where the Home Office is training 800 staff on forcing people into deportation flights to Rwanda. The BBC filmed guards pretending to escort a passive person onto a plane. This is far from the reality of what took place on the (later aborted) 2022 flight to Rwanda; evidence shows how guards forced a suicidal detained person into a waist restraint belt and physically attached them to a seat. Medical Justice’s clients targeted and detained for that 2022 flight included a child, someone who attempted suicide twice, and someone who was likely to have a psychotic disorder and lacked mental capacity.


Watch the BBC TV News footage below

Credit: BBC Breakfast

Read BBC online: “Inside the secret government Rwanda training base”


On May 1st, just before the local elections, the Home Office paraded on social media footage of rounding up and detaining asylum seekers for deportation to Rwanda. Medical Justice has been assisting 36 of them; men and women from Iran, Iraq, Afghanistan, Syria, Sudan, and Eritrea.  Even though it’s been announced that there will be no flight to Rwanda before the general election – and likely ever – many remain detained. We demand their immediate release – to not do so, given the medical evidence of abuse in detention, means the harm the government is inflicting is basically premeditated.

This month the Home Office ‘consulted’ Medical Justice on its new Use of Force policy. The policy is as dangerous as ever. It ignores recommendations of the recent Brook House Inquiry into mistreatment of detained people in an immigration removal centre (IRC), finding wonton inhuman and degrading treatment; 19 instances in just one IRC in just 5 months.

The public inquiry found extensive, unnecessary, excessive Use of Force – findings included;

  • A toxic culture and normalisation of the infliction of pain, suffering and humiliation of detained people
  • Staff using force to provoke and punish detained people
  • Unauthorised techniques, including one used by guards who unlawfully killed a detained man on a deportation flight
  • Riot gear used routinely, including when detained people offered little threat of violence
  • Force used against people who were physically and/or mentally unwell and against naked people being dragged out of their cell to be taken to a flight
  • Many detained people who have deteriorated in detention wrongly treated as non-compliant and disruptive, taken to segregation – often by force – as a means to manage distress, self-harm and mental illness symptoms
  • IRC healthcare staff often facilitated use of force by pre-authorising it and not intervening when it became dangerous
  • Evidence of pervasive, derogatory and violent verbal abuse and racism revealed an underlying lack of any empathy, even when people were at their most distressed and vulnerable – even in life-threatening situations
  • Mistreatment in IRCs is ongoing, evidenced in our report “If he dies, he dies”, a callous mantra amongst guards

The Home Office’s new Use of Force policy does not consider the impact of force on those with mental illness at all, ignoring a key recommendation of the Inquiry – established by the Home Secretary – to undertake a review on the use of force on the mentally ill. The policy allows for the use of pain-inducing techniques when these are contraindicated for those with mental illness and, in particular, those who lack mental capacity. Most clients targeted for Rwanda deportation in 2022 that Medical Justice assessed were torture survivors for whom use of force can be experienced as a terrifying re-enactment of past abuse.

The Inquiry found that wholly dysfunctional clinical safeguards were likely to have led to vulnerable detained people deteriorating in their mental and physical health, putting them at risk of mistreatment. Its recommendations included strengthening safeguards, yet the Home Office has just weakened its ‘Adults at Risk’ policy which will allow more vulnerable people to be held in detention, just as the dangerous Use of Force training is rolled out to 800 staff, and at a time when the Illegal Migration Action calls for a massive expansion of immigration detention.


Notes

1. The reality of the brutality of the 2022 Rwanda flight – Liberty Investigates reported extracts from official Use of Force forms; one man was bleeding and would not stop cutting himself until officers seized his arms, that he was treated by a nurse before being handed over to guards to take him by force to the plane. After boarding, another man whose wrists, arms, and head were restrained was screaming, hitting his head against the seat in front – after he started biting his tongue, officers applied a “mandibular angle” pain technique to make him release it. The Independent Monitoring Board reported that one man offering no physical resistance was put in a waist restraint belt (WRB). Two men in WRBs started to scream out their fear and distress, each trying to hurl his torso and head backwards and forwards. Each was seated with an escort on either side, his arms tightly held, his head controlled by an escort facing him. The legs of one had been ‘secured’.

2. “Who’s Paying The Price” report evidences vulnerability of 51 clients targeted for Rwanda in 2022 – Out of 17 people Medical Justice doctors conducted clinical assessments for, 14 had evidence of torture histories and 6 of trafficking. 15 had a diagnosis or symptoms of Post Traumatic Stress Disorder. One required urgent investigations regarding a brain tumour. 11 people had suicidal thoughts, including one who attempted suicide twice.

London Legal Walk 2024 | Medical Justice

 

We will be walking 10km on Tuesday 18th June to help fund Medical Justice.

We are walking with the Lord Chief Justice and thousands of lawyers who are raising funds in aid of free legal advice and support for everything from Law Centres and Citizens Advice services to refugee specialist support services. We are walking to 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.

Your support is needed more than ever. 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 London Legal Walk.

 


Join the walk

As well as donating you can join us on the 10km walk on 18th June to raise funds for Medical Justice. The Medical Justice team will include staff, trustees, former detained people, volunteer clinicians, interpreters, supporters, family and others who are fanatical about ending the injustice suffered by people detained under immigration powers. Children and dogs are also welcome!

We are planning to start at 3pm and finish with the street party, street food vendors and entertainments on offer!

London Legal Walk 2024 – London Legal Support Trust – LLST

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

 


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 Anthony at a.omar@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 Anthony (a.omar@medicaljustice.org.uk) or call us on 0204 551 1280.

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

Government’s response to the Brook House Inquiry report – analysis for parliamentarians

On 19 March 2024, the government published its response to the findings and recommendations of the Brook House Inquiry 

 Medical Justice, who was appointed as a Core Participant to the Inquiry, is extremely concerned by the government’s response. We have created the briefing below to draw these concerns to the attention of parliamentarians. 

DOWNLOAD our Government’s response to the Brook House Inquiry report – analysis for parliamentarians

The analysis shows that of the Inquiry’s 31 recommendations directed to the government across ten sub-topics:  

 

  • Only one recommendation appears to have been fully accepted (Recommendation 14). It is important to note that this recommendation only requires the Home Office to ensure staff are aware of a current policy (that the technique of handcuffing detained people with their hands behind their back while seated is not permitted, given its association with positional asphyxia). It does not require any change to policy or practice.  
  • One recommendation (Recommendation 7) has been explicitly rejected by the government 
  • For five recommendations (Recommendations 5, 16, 19, 22, and 27), no information is provided at all 
  • For one recommendation (Recommendation 30) the information provided suggests the recommendation has been rejected 
  • For the remaining 23 recommendations, the information provided either appears to simply state already existing policy (Recommendations 2, 4 and 20), does not relate to Home Office activity (Recommendations 8 and 20,) and/or does not offer enough detail to allow a conclusive assessment (Recommendations 1-3, 6, 9-13, 15, 17, 18, 21, 23, 24, 26, 28, 29, 31, and 32). 

 

Medical Justice is extremely troubled by how few of the Inquiry’s recommendations appear to have been fully accepted, and how little information has been provided by the government in its response. When establishing the Inquiry, the government committed to ensuring “that lessons are learnt to prevent these shocking events happening again”. The government’s response to the Inquiry suggests that this commitment to learning lessons is not being upheld.  

Medical Justice urges parliamentarians to seek further information as quickly as possible from the Home Secretary and relevant senior officials regarding the government’s response. We hope that the briefing can be of help ensuring this. 

BMA says immigration detention is a “national disgrace” and must be “phased out and abolished”

Recording now available of the recent Medical Justice joint event with the British Medical Association (BMA) about findings of the Brook House Inquiry in relation to healthcare, safeguards and vulnerable people in immigration detention.

You can read the British Medical Journal’s coverage here

Speakers included;

  • Mr M – formerly detained person
  • Kate Eves – Chair of the Brook House Inquiry
  • Dr Brodie Paterson – Honorary Senior Lecturer, Queen Mary’s University
  • Dr Andrew Green – Deputy chair of the BMA Medical Ethics Committee
  • Professor Cornelius Katona – Hon Medical and Research Director, Helen Bamber Foundation
  • Dr Rachel Bingham – Clinical Advisor at Medical Justice
  • Dr John Chisholm CBE – BMA International Committee Deputy Chair
  • Stephanie Harrison KC – Joint Head of Garden Court Chambers

The event exposed how the dysfunctional safeguards, inadequate healthcare provisions and human rights abuses that were exposed by the Brook House Inquiry and highlighted how little has changed.


M, a client of Medical Justice who was detained for 52 days in 2023: 

M, explained the mistreatment, suicidality and use of force he experienced and witnessed whilst in UK immigration detention.

Speaking about his experience, M said:

“It’s hard to speak about this. I went to my room. I was having panic attacks, and at one moment I was almost feeling quite suicidal. 

I witnessed a lot of mistreatment during my time there. The guy who died by suicide … I remember his birthday, because I was the one who helped him write a letter to the Home Office about his situation. They were his words, but in English, because he didn’t know how to write in English. That’s never going to leave my mind. There was another guy who set himself on fire. He had been kicked out of the medical centre when he went to request help. 

I also witnessed the officers using an excessive amount of force with one of the guys, damaging his jaw and leaving a scar on his throat. He couldn’t eat or swallow for a week. I think he’s still in detention. 

It seemed like the doctors were against you. There were humans in there, but there was no humanity.” 

 

Kate Eves, the Chair of the Brook House Inquiry

Kate Eves outlined the 19 instances of credible evidence of mistreatment capable of amounting to a breach of Article 3 of the ECHR. She raised concerns around the approach to the use of force, the systemic failures of detention safeguards, a lack of understanding from healthcare staff of their responsibilities and duties, and the concerning involvement of healthcare in the use of force.

She urged that her findings and recommendations must be taken seriously, saying:

“it would be in my view, completely unacceptable not to respond in a meaningful way. One of the annexes in my report is essentially setting out all of the previous recommendations that have been made and its really palpable just how often we’re repeating the same things. We’re spending public money to look at the evidence, and saying the same things”.

 

Dr Brodie Paterson, Honorary Senior Lecturer, Queen Mary’s University

Speaking about mental health and the use of force, Dr Brodie Paterson emphasised that the starting point should be that restraint should not happen and should be prevented. He explored the importance of cultivating a positive culture, of trauma-informed care, of sufficiently robust governance for the use of force, and of adequate staffing and training.

He explained how the phenomena of staff perceiving the behaviour distressed detained people as wilful rather than a function of their mental distress.

Dr Paterson explained:

“Brook House had an inappropriate culture, an inappropriate physical environment, inappropriate training, inappropriate leadership and inappropriate oversight. If you were trying to create a service that would go wrong, then Brook House is a recipe for how to do that”.

If we fail to put the ethical infrastructure, the resources, the culture, the training in place, such services will fail. The lesson from Brook House is that unless we get it right: services will fail, and vulnerable people will get hurt”.

 

Dr Andrew Green (Deputy chair of the BMA Medical Ethics Committee) chaired a panel discussion of the healthcare and safeguarding in immigration detention

 

Professor Cornelius Katona MD FRCPsych (Hon Medical and Research Director, Helen Bamber Foundation and Hon Professor, Division of Psychiatry, UCL) discussed the mental health conditions and high levels of trauma amongst detained people.

Professor Katona spoke of why it is that detained people have high rates of mental health conditions:

“there is a diminished sense of safety, a diminished sense of freedom from harm and […] often painful reminders of traumatic past experiences of detention and sadly often of ill-treatment. There is an aggravated fear of the imminence of return” as well as a separation from support networks and disruption to their continuity of care.

He outlined that in immigration detention, the:

“primary purpose is administrative, and the length of detention is uncertain […] that is one of the key elements, the terrible uncertainty. In prison you count the days down, in detention, you count them up”.

 

Dr Rachel Bingham, Clinical Advisor at Medical Justice, showed how detention safeguards fail at every stage from a lack of pre-detention screening and systemic flaws in healthcare screening, and the Rule 34 and Rule 35 processes. Outlining Medical Justice’s recent audit of their clients. Dr Bingham drew comparisons with Kate Eves’ findings from 2017 to show that the catastrophic failures were because there was too often a disregard and lack of understanding of how to implement safeguards.

Dr Bingham emphasised that:

“the bottom line is not only that health is harmed in this situation or that suicide risk increases […] but [there are ongoing failures in the safeguarding processes designed] to prevent mistreatment and to prevent the kinds of abuses that happen when health is not managed.”

 

Dr John Chisholm CBE, BMA International Committee Deputy Chair, echoed that:

“detainees are vulnerable. They’ve often been the victims of torture, yet they’re detained in an environment that is detrimental to their health and wellbeing.”

He called the current indefinite detention system a “national disgrace” and said that it must be “phased out and abolished”.

Dr Chisholm urged that:

“we must continue to lobby, advocate, and campaign for change and to rid us, our country, of this performative cruelty.”

 

Stephanie Harrison described how healthcare staff “put the Home Office’s priorities of enforcement over the welfare of their patients” and “remained silent in the face of human rights abuses committed against individuals in the care of them as healthcare professionals”.

She called on IRC doctors to “stop being complicit in these forms of mistreatment [including safeguarding failures, inappropriate use of force and the misuse of segregation] by failing to report, to identify, and to call it out.” Instead, IRC healthcare must call out the culture of dehumanisation and racism “which is still entrenched within those institutions.”

Join Us As A Trustee!

Trustee vacancy: Medical Justice Treasurer

(We also need other trustees, so do apply if you would like to be a trustee even if it’s not as the Treasurer)

Though not a requirement, we particularly welcome and encourage applications from people with lived experience of the asylum process and/or immigration detention.


Medical Justice is seeking a Treasurer to join our Board of Trustees.

Medical Justice was set up in 2005 by a man on hungerstrike in an Immigration Removal Centre (IRC) and the volunteer doctor who visited him and wrote a medical report that helped secure his release. People with lived experience have been trustees of Medical Justice ever since. Today we have a team of 38 volunteer clinicians, 20 volunteer interpreters and 18 members of staff.  Medical Justice remains the only charity sending volunteer clinicians into all the UK’s IRCs to document clients’ scars of torture and deterioration of health in detention, and to expose instances of medical mistreatment.  We use medical evidence to secure lasting change through research, strategic litigation and policy, parliamentary and media work.

“It has strong characteristics and a highly respected reputation. It is regarded as principled, expert and evidence based, tenacious in its casework and policy work, fierce and ferocious when needed and brave in the way it speaks truth to power.” – Ceri Hutton, author of the independent Evaluation of Medical Justice

“They stand out as an uncompromising advocate. A loud voice in a clearly identified niche.” – Funder, interview for the independent Evaluation of Medical Justice.

The trustee role

Being a trustee is a rewarding role. You will be joining a strong team of experienced Trustees who include people with lived experience of detention.  Our trustees bring their expertise to shape the strategic direction of Medical Justice, ensuring our decisions are guided by our mission, our values and the best interests of our beneficiaries. Trustees have overall legal responsibility for our charity, making sure our finances and resources are well used and are required to participate fully in the governance of the charity. For more information see the Government Guidance  or watch this video

The Treasurer will take the lead in financial governance and in shaping our financial strategy, supporting our Director in financial forecasting and budgets, and in liaising with our auditors.  We have external accountants and our end of year accounts are audited so that our Treasurer does not need an accountancy background, but does need to be able to comment on our financial records and financial strategy and communicate effectively on these matters with other trustees.  The pivotal responsibilities of this role means that the Treasurer is also a member of the Executive Committee of Trustees which meets online between full trustee meetings and when needed at times of crisis.

Where is it based?

The Medical Justice office is in Finsbury Park, London, N7 7DT.  We would ideally like you to attend Board meetings in person in the office though some trustees attend some meetings online.

Expenses

The role of trustee is a voluntary position. Expenses incurred in relation to fulfilling trustee duties can be paid by the Medical Justice, e.g. travel, phone top-ups.

What is involved?

We expect that that trustees prepare for (read papers, which involves a time commitment of between one to three hours) which are provided several days in advance and attend 4 Board meetings per year.  The Treasurer is additionally expected to attend Executive Committee meetings 4 times a year – in person or online.  Board meetings are on a weekday evening and Executive Committee meetings are during the day. You may need to attend occasional other ad-hoc meetings.

We are looking for someone who can commit to being the treasurer for at least three years. All trustees have to be re-elected every three years. The successful applicant will be required to disclose any unspent criminal records and be willing to undergo a basic DBS check.

The support you will receive

Medical Justice provides resources and can provide training for trustees on good governance and the duties of a trustee, as well as on charity finance. Trustees will also receive training on safeguarding and other key policies.  Training costs are covered by Medical Justice. You will also have induction meetings with Medical Justice staff.

‘Buddying up’ with an existing trustee can also be arranged, and this is encouraged for those for whom this is their first time serving as a trustee. This involves meeting up with a longer-serving trustee outside of board meetings, occasionally or regularly, to discuss:

  • The format, style and content of board meetings generally
  • Papers submitted to upcoming trustee board meetings
  • Experiences serving on the board

Who we are looking for

An understanding of the UK asylum system and immigration detention is particularly important and we welcome applications from those with lived experience.  We have a strong commitment to equity, diversity and inclusion.

Your relevant skills and experience could be from working, training, volunteering, interests or life experience – in the UK or outside the UK.

  • A finance professional, ideally with knowledge of charity finance.  Otherwise someone with an enthusiasm to learn, drawing on sound commercial experience and an understanding of small/medium-sized enterprise
  • A strategic thinker with the ability to balance risk and opportunity
  • A clear communicator able to bring financial information alive to non-specialists
  • A willingness to play an active role in areas such as financial forecasting, reviewing budgets and liaison with external auditors
  • An ability to take on responsibilities and liabilities as a Trustee and to act in the best interests of Medical Justice
  • A capacity to think creatively and strategically and to exercise good independent judgement
  • Effective communication skills
  • A personal commitment to equity, diversity and inclusion
  • Enthusiasm for our mission and vision
  • A commitment to lead according to the values of Medical Justice
  • A commitment to the Nolan principles of public life: selflessness, integrity, objectivity, accountability, openness, honesty and leadership

Our current trustees have skills and experience covering lived experience of immigration detention, the asylum system, law, medicine, and marketing.

What difference will you make?

The current context of asylum and immigration is challenging, particularly with the increasing use of both detention and quasi-detention and uncertainty about how government policy will develop.  The need for Medical Justice has never been more urgent, both in terms of case work with individuals and our endeavours to secure lasting change.  Our responsibility is to work in the most effective way possible, using our resources wisely.  The role of the Treasurer is therefore of vital importance to us.

“When someone tells you the doctor is coming it is like a saviour coming to save me from this hell that I am in” – former client

“[If Medical Justice had not made contact] I would have died. I was on suicide watch. I wanted to die. If Medical Justice wasn’t there, I would have been in the ground today” – former client

Valuing Lived Experience

Medical Justice has an organisational commitment to improving the representation of people with lived experience at all levels of organisation, especially the trustee role. We recognise that some potential candidates who bring the voice and lived experience that we need, may have had less opportunity to develop a track record in this role. We are keen to look beyond the traditional review of your qualifications and work experience to what relevant knowledge and skills you may have acquired through your life experience. Medical Justice considers lived experience as real expertise and as vital to the organisation.

To reflect the composition of our client group, and in any case, we welcome and encourage applications from refugees and other migrants, and in particular from people with lived experience of detention – this could include detention in another country, or in the UK (immigration detention in an immigration removal centre, prison or institutional asylum accommodation such as military barracks). Whilst the fact that your lived experience will be of relevance, there will be no expectation that you talk about your personal experiences.

Completed applications must be received by 28th February 2024

Please email your CV to our chair of trustees, Ruth Talbot on ruthtalbot10@gmail.com. If you do not have a CV, you may provide a written, audio or video summary of your education, experience and skills.

Ruth will email you back an application form which should be completed and returned by 28th February 2024. This will include an explanation as to why you are interested in being a Medical Justice trustee.

If you are an expert by experience (with direct, first-hand experience of immigration detention or the UK asylum or immigration system), we may be able to arrange for independent and confidential support for your application from the Experts by Experience Employment Network (of which Medical Justice is a member) who may be able to provide a mentor to support your application.

You can ask for an informal conversation about the role and about Medical Justice before you make an application. Shortlisted candidates will be invited to an informal interview with the one of the Chair of Trustees, current Treasurer or Director. The costs of participating or attending can be paid by Medical Justice, e.g. travel or phone data. The preferred candidate will then be invited to observe a board meeting so that both they and the organisation can feel confident that the role and organisation is right for them.

Please email our chair of trustees, Ruth Talbot, on ruthtalbot10@gmail.com if you would like further information about the role or to have an informal discussion with her, or an existing trustee, or the Director.

Email your application by 28/02/2024


Support from Experts by Experience Employment Network

We are proud to be a member of the Experts by Experience Employment Network, which aims to increase representation of people with lived experience in the charitable sector. Please feel free to use information and resources at https://www.ebeemployment.org.uk/ebe which may help in preparing your application.


About the need for Medical Justice

Immigration Removal Centres (IRCs) in the UK are so harmful that Medical Justice believes the only solution is to close them down.  Meanwhile, we aim to assist as many people held in immigration detention as we can and to campaign for lasting change.

Immigration detention in the UK is arbitrary and indefinite. It is not part of any criminal sentence nor is it ordered by a judge, yet 20,354 people were detained in year ending June 2023 in IRCs, mostly run by private companies, and in mainstream prisons. Many have mental and physical scars of torture and other forms of persecution. Their medical conditions are often exacerbated by, and sometimes caused by, prolonged detention and inadequate healthcare.

Medical Justice clients include men, women and children who are survivors of war, torture, trafficking, and rape. Many have fled persecution due to their political activity, religion, and sexual orientation. Many end up being trafficked and during long, perilous journeys to the UK, get detained, raped, extorted, and sold, some a number of times over. Some arrive with untreated injuries, are extremely sick, mentally ill and left with complex medical needs. Immigration detention can exacerbate medical conditions and be the cause of mental illness, yet healthcare in IRCs is inadequate.

Medical mistreatment in detention is rife and inquests have found that neglect has contributed to deaths, including an 84 year old who died in handcuffs. One man died after 6 days in detention, in a segregation cell, naked and emaciated, having suffered psychosis, dehydration, malnourishment and hypothermia – he had received no medical treatment whatsoever. Last year there was a ‘mass suicide attempt’ after a Colombian man – Frank Ospina  – died in detention, reportedly by suicide.

Our latest audit of medico-legal reports for 66 detained clients show that ;

  • 79% had of a history of torture, 38% of both torture and trafficking. The mental state of all had been harmed by detention
  • 95% of the clients had a diagnosis of at least one mental health condition
  • 74% clients were recorded as having self-harmed, suicidal thoughts and/or attempted suicide
  • Uses of force included during transfer to segregation, removal from suicide netting and transfer to hospital

Abuse in detention – BBC Panorama undercover filming exposed widespread mistreatment inside Brook House IRC, including a vulnerable detained person being choked by an officer who threatened to kill him, and being demeaned and threatened by other officers with further violence after a suicide attempt.  A subsequent public inquiry found a dangerous use of force, a wholesale failure of safeguards and a culture of dehumanisation led to 19 instances of inhuman or degrading treatment at Brook House during a 5 month period. Dysfunctional safeguards were found likely to have caused actual harm to vulnerable detained people who were allowed to deteriorate in their mental and physical health, putting them at risk of mistreatment.

Healthcare staff in IRCs do not understand their safeguarding obligations and have a tendency to view detained persons as wilfully disobedient and obstructive instead of understanding their behaviour may be manifestation of mental anguish or ill health. This is interlinked with the inappropriate use of segregation and a quick resort to the use of force on people who are physically unwell and to ‘manage’ symptoms of mental illness, self-harm and mental health crises.  Force is used unnecessarily and excessively in widespread cases. Unauthorised and potentially lethal “control & restraint” techniques were being used. Approved techniques were being used incompetently, becoming dangerous and risking injury. It has gone without proper scrutiny until the Inquiry.

There was found to be normalisation of the infliction of pain, suffering and humiliation, even whilst detained people were naked, and in one case where a man was emaciated and could barely hold his own body weight. Use of force against naked detained persons was “unusually high” and was a direct consequence of the “no notice removal window” policy. The Inquiry found a “toxic culture” at Brook House, a “culture of dehumanisation of detained people”, and a “breeding ground for racist views”. Evidence of pervasive derogatory and violent verbal abuse and racism revealed an underlying lack of any empathy even when people were at their most distressed and vulnerable – even in life-threatening situations.

Despite Medical Justice and others reporting these issues to the Home Office for many years, the abuses continue. Home Office and IRC staff, including some who are still in post, were described by the Inquiry as ‘unapologetic’ and ‘intransigent’.

Immigration detention is indefinite.  It is not part of any criminal sentence. Many trafficking survivors are wrongfully convicted of crimes they were forced to commit, jailed, and then held in indefinite immigration detention in mainstream prisons. 78% of the 20,354 people held in immigration detention in 2023 were eventually released back into the community.

The Home Office uses charter deportation flights.  There were 3 such flights on one day alone.  Charter flights to Albania have ramped up, especially since the Home Office signed an agreement with Albania to expedite removals, we are dealing with distressing levels of suicide attempts. Most of our Albanian clients are trafficking survivors. In November there was a protest after two detained Albanian attempted to kill themselves in Brook House  – one died and the other was swiftly deported but immediately returned to the UK and detained again.

On the horizon : The Illegal Migration Act (IMA) is set to ban asylum seekers entering the UK via an ‘illegal’ route from claiming asylum, to detain them indefinitely, and to deport them to a ‘safe third country’ – with few returns agreements other than with Rwanda (which has been found unlawful), this would mean mass incarceration of people held in perpetual limbo. The Refugee Council estimates 190,000 (including 45,000 children) could be detained over 3 years. The government is developing new IRCs and asylum seekers are being held in emerging quasi-detention sites, including military barracks and the Bibby Stockholm barge where an Albanian man died last month.


Some points relevant to trustees from a 2021 independent Evaluation of Medical Justice

  • “They have been bold enough to take litigation against the government in ways which others haven’t and basically not set a limit to the challenge they make through their policy work. That’s something which is not just a credit to the staff at but also to the trustees – I know the debates which go on in small organisations and the risks such decisions entail.” (Lawyer)
  • A commitment to making hard-nosed judgement calls in favour of using resources well. Staff and trustees are constantly considering whether or not engaging in various forums, policy issues or cases uses their expertise to best effect or whether others are best left to do the job.
  • “As a doctor, the quality of the medical reports we did was really integral to my happiness at being a trustee. I was proud of what we produced, and still am even after having left the board. I felt as a doctor my reputation was never in jeopardy, and that the reports were of outstandingly high quality.” (Volunteer doctor, former trustee)
  • The staff team at Medical Justice are viewed as a team of highly committed individuals with a strong commitment to the issue, guided by individuals (both at senior staffing level and on the trustee board) with institutional memory and long experience in judging tactics and approaches within policy and legal fields.

Joint briefing with the Chair of the Brook House Inquiry

Places of detention are the hidden spaces in our society… They are places where communication is restricted, rights and freedoms are curtailed, where isolation from loved ones is a fact of life, and where the toll of detention can have an impact on people’s mental and physical wellbeing. For anyone who has been detained by the State, it is a profoundly life-altering experience.

(Brook House Inquiry Report, Vol. 1, p.1)

 

On Tuesday 29 November 2023, the APPG on Immigration Detention – for which Medical Justice provides the secretariat – and APPG on Migration jointly held a briefing for Members on the Brook House Inquiry Report, with the Chair of the Inquiry, Ms Kate Eves.

The Brook House Inquiry is the first ever statutory inquiry on immigration detention in the UK. Set up to investigate abuse revealed by the BBC at Brook House Immigration Removal Centre (IRC) in 2017, the Inquiry has also gathered evidence on the systemic failings – in terms of policies, practice, and culture – which allowed that abuse to occur.

The Chair of the Inquiry, Ms Kate Eves, published her final report in September 2023. Its carefully evidenced analysis shines a vital light into the “hidden space” of immigration detention.

Many of the problems identified within the report are continuing today across the UK’s detention system. It is crucial reading for anyone seeking to understand the ongoing failures in detention, their devasting effect on detained individuals, and what needs to change.

The joint APPG event was an opportunity for Members to learn more about the important issues raised in the Inquiry’s final report, and to assess its implications for the use and operation of immigration detention in the UK going forward. Members also discussed ways to raise awareness of the Report in Parliament, and to monitor government implementation of its recommendations.

 

Access a full copy of the meeting minutes here.

 

The Inquiry Report and APPG event have come at a particularly salient time, with the Illegal Migration Act 2023 granting the Home Secretary even greater powers to detain individuals, including children, whilst at the same time dramatically reducing the avenues available to people to challenge their detention. Alongside these legislative changes, the Home Office has also announced plans to significantly expand the detention estate – including increasing capacity at current sites and opening new ones. Based on these developments, it appears that the government going forward intends to detain greater numbers of people under immigration powers in the UK, for longer periods of time.

Additional links of interest:

  • Further correspondence published by the Inquiry can be accessed here.

Induction Training Day For Interpreters – March 2024

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.