Medical Justice press release 19th Sept 2023 for immediate release
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 – despite the systemic failures continuing, the government plans expansion of detention
Today the Brook House Inquiry (BHI) has published its report on its investigation into allegations that people held in immigration detention were subjected to torture, inhuman and degrading treatment following undercover footage as broadcasted by the BBC in 2017. Medical Justice was appointed a Core Participant (CP) due to its extensive experience of the clinical safeguarding failures and understanding of the inadequate healthcare provision in IRCs.
Key findings of the BHI Report (the Report)
The BHI Inquiry has exposed the inexcusable and unconscionable dehumanising abuse of vulnerable people held in immigration detention by the Home Office. The Inquiry has found the safeguarding system in detention to be “dysfunctional”, resulting in a failure to protect detained people as intended. Vulnerable people were exposed to the risk of mistreatment and were subjected to actual harm; there were 19 incidents of credible breaches of Article 3 of the ECHR, which prohibits torture, inhuman and degrading treatment within a 5 month period.
The “wholesale failure” of the detention safeguards was found likely to have caused actual harm to detained people. As a result, people were found to have been “allowed to deteriorate” in their mental and physical health. Such failures were found to be interlinked with the inappropriate use of segregation and a quick resort to the use of force to manage incidents of self-harm and mental health crises. Healthcare failures put vulnerable people at risk of deteriorating in their health, and of instances of mistreatment. These systemic problems in the adequacy of safeguards have not evolved and remain in place today.
Healthcare staff were found not to understand their safeguarding obligations. There was a tendency to view detained persons as “wilfully disobedient and obstructive instead of countenancing the idea that behaviour may be manifestation of mental anguish or ill health”. Specific findings were made in relation to the acts and omissions of individuals, including some who are still in post who were described as ‘unapologetic’ and ‘intransigent’. The Inquiry has stated that it will provide a copy of the report to the General Medical Council, indicating the severity of such findings.
A “toxic culture” prevailed at Brook House, fuelled by the “prisonisation” of the centre. Brook House was found to be a “breeding ground for racist views” with a routine use of racial stereotyping, abusive and derogatory language by custodial staff. The Chair described this as a “culture of dehumanisation of detained people”.
The Chair criticised how force was used unnecessarily, inappropriately and excessively in widespread cases. Amongst the concerning practices were the use of force on detained people who were mentally or physically unwell, and sometimes used as a way to manage symptoms of mental illness. Unauthorised techniques were being used, including a dangerous technique that had previously led to a death by asphyxiation. Approved techniques were being used incompetently in a way that became dangerous and increased the risk of injury. It has gone without proper scrutiny until the Inquiry, because of a “culture of silence” amongst officers. Body-worn cameras were not turned on without credible explanation as to why.
The Inquiry unequivocally finds the crucial safeguarding responsibility lies with the Home Office, yet that there were a “comprehensive range of failings” spanning detention safeguards, healthcare, the use of force, segregation and the management of a toxic culture. Further responsibility lay with the various contractors:
- G4S, who were the contractor responsible for the operation of Brook House, failed to comply with their contractual obligations, relevant rules and guidance, at the management and corporate level, not just the individual level.
- Such failings were found to continue today, despite Serco taking over the contract. The Chair raises concern about several individuals remain in post and more senior roles, casting doubt on how far cultural changes have occurred.
- The Practice Plus Group, the healthcare provider at a number of IRCs, were found to have made some improvements but not the fundamental changes to the operation of safeguards necessary to protect vulnerable people from suffering likely or actual harm. PPG’s failure to correct the deficiencies in the failure is a “further indication of an abdication of corporate responsibility”.
The Inquiry chair made 33 recommendations for ‘necessary’ changes at Brook House and immigration detention more widely, the vast majority of which are directed to the Home Office or the government more generally. These included:
- A 28-day time limit on immigration detention given the negative impact of detention on detained person’s health and wellbeing.
- A fundamental review of the safeguarding framework under Rule 35 of the Detention Centre Rules 2001. The Inquiry found a wholesale failure of the safeguard in 2017 and no significant improvement since.
- A comprehensive review of the use of force.
- Training for healthcare staff on their safeguarding role including in relation to the use of force, Rule 34 and Rule 35.
- Review of range of policies including on segregation, food & fluid refusals.
The inquiry report notes that many of the findings and recommendations ‘closely mirror’ those from previously investigations and reviews and calls for a ‘culture of change’: ‘Lessons must be learned’. It finds that the Home Office had failed to act on ‘serious issues and concerns’ previously, making ‘inadequate excuses’ (including on the complexity of detention and polarised debate on migration) on these fronts ‘where basic issues of human rights and welfare are at issue’.
This comes at a time when the government are planning a large expansion in immigration detention. The Chair notes that ‘any expansion or other change [in immigration detention] should be considered in the context of learning lessons from past failures’.
Emma Ginn, director of Medical Justice:
“The evidence shows that the Home Office has presided over the inhuman and degrading treatment of vulnerable detained people in its care.
This comes as no surprise to us or the Home Office – Medical Justice has been presenting evidence of abuse to the Home Office for the last 18 years.
At every turn the Home Office has reacted with indifference and intransigence.
It’s a travesty that it’s taken a public inquiry for detained people’s harrowing testimony to be taken seriously. They have at last been vindicated.
Urgent action is needed ; the evidence could not be clearer – the harm and horror of detention is being experience right now in IRCs across the UK.
Despite knowing the harm it causes, the government plans a massive expansion of detention – wilfully allowing the inevitable harm to the hundreds of thousands of men, women and children it aims to indefinitely detain.
This country must take a stand – if we fail to halt this abuse it means we have completely lost our way.
If not now – with this inquiry’s findings- then when?”
Dr Rachel Bingham, Clinical Advisor, Medical Justice:
“This inquiry makes clear what Medical Justice, the medical community, and others have been warning about for a long time – that immigration detention is an intrinsically harmful environment.
Urgent action is needed to protect the health of vulnerable people in immigration detention.
Our experience and our clinical evidence shows that the same circumstances exist in other IRCs, as were behind the abuses in Brook House.
The detention of a population with high rates of vulnerabilities in a prison environment creates conditions which are high risk for people to be harmed, through harm to their mental health, experiences of use of force, clinically inappropriate use of segregation and experiences of racism.
Any high-risk environment requires adequate safeguarding processes, but this was absent from Brook House in 2017 and remains absent, across the detention estate and in Brook House specifically. The perfect storm of detaining highly vulnerable people in prison conditions with inadequate safeguards allows abuse to happen. Our clinical evidence shows that to date there have been no significant improvements. Detention remains unsafe and harmful.
This is not new to the medical community, as medical bodies have consistently called for an end to detention, noting the overriding health harms.”
Valentin, Medical Justice client:
“I felt that I had to reach rock bottom before my mental health was taken seriously- it wasn’t until after my overdose that I felt like I got some treatment and staff called an ambulance. …That was how bad it had to get, that’s how far down I had to go, to get any care. I was in detention for 10 months. It felt like prison. The only fresh air was air that came under the door to my cell. My toilet was inside my cell, it was like a proper prison cell. I was scared. It was so hard in the night-time. People were banging on the walls. I don’t think detention is any place for a human being and it’s not a solution. We are human. We have families. The best value in life is freedom.
Hamish Arnott, Bhatt Murphy Solicitors, representing Medical Justice:
“This inquiry has provided a unique opportunity to see the reality of life in immigration detention centres. Its findings are clearly alarming and show that again and again the Home Office has failed to learn lessons about how unsafe and degrading its detention system is. Of even more concern is that the government, before even considering these findings, has recklessly announced its intention to introduce, on 28th September, statutory powers designed to allow the Home Secretary to detain more people for longer and with less scrutiny by the courts.”
Alison Thewliss MP, chair of the All Party Parliamentary Group on Immigration Detention, Shadow SNP Spokesperson (Home Affairs):
“Today’s report on conditions at Brook House highlights the urgent need for meaningful change within our asylum system.
The findings of this report are deeply concerning, and it is imperative that the UK Government takes these recommendations seriously.
This report has shown how horrific conditions are in asylum accommodations across the country. It would be completely unacceptable for this UK Tory Government to proceed with their proposed expansion of detention centres.
The UK Government must prioritise reforms and accountability to ensure that lessons are learned from these findings.
If ever there was a time to throw the Illegal Migration Act out the window, this report provides a key opportunity to do just that.”
Medical Justice calls for:
- We call on the government to issue an apology to those who experienced abuse in its care at Brook House and elsewhere.
- To have any real meaning, an apology must be accompanied by the necessary changes to ensure that no one else is abused or harmed in immigration detention like this again.
- Rather than expanding the use of detention, we agree with the British Medical Association that the only solution is to phase out detention and consider credible alternatives (as identified by UNHCR).
- If immigration detention is to continue at all, its use should be truly an exception rather than routine. The government must (1) commit to implementing the recommendations from the Brook House Inquiry including introducing a strict time-limit of no more than 28 days and (2) ensure the safety and welfare of detained people, by taking real action on the dangerous use of force and dysfunctional safeguards.
- There must be accountability – the inquiry report raises concern about some of those involved in the abuse in 2017 still being in post or having moved to more senior roles. The same is true for Home Office Officials who have presided over this system and failed to take action. Brook House was identified as a ‘breeding ground for racism’. It follows a number of investigation since 2005 finding racist abuse in immigration detention. The risk of racism and racist abuse is inherent in immigration detention, particularly in a hostile political context where migrants are scapegoated and dehumanising rhetoric used in politics and the media. Without fundamental change it appears inevitable that another future undercover report would uncover the same.
Medical Justice publishes today its dossier evidencing ongoing failures in clinical safeguards – our dossier published today includes an analysis of medical assessments by Medical Justice clinicians of 66 people held in Immigration Removal Centres between 1 June 2022 and 27 March 2023. Three case-studies are also included. Of the 66 clients, 52 had evidence of a history of torture, 29 had evidence of a history of trafficking and 25 had evidence of a history of both torture and trafficking. Detention had already caused the mental state of 64 clients and had caused harm to all 66 clients. 63 had a diagnosis of at least one mental health condition and 49 people 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 appointments.
The Illegal Migration Act (IMA) is set to massively ramp up detention – The Refugee Council estimates that 190,000 people, including 45,000 children could be detained in the first 3 years. The IMA means drastically reduced access to the courts and the Home Secretary, rather than the courts, determining what is a reasonable length of detention. The IMA disallows most asylum seekers from having their cases considered, and with nowhere to remove most of them, many more vulnerable people are set to languish in detention, deteriorating.
The Home Office has plans to hold 25,000 asylum seekers in quasi-detention sites such as disused military bases and barges. As these sites have emerged, there have been outbreaks of infectious diseases and people held there becoming suicidal – the harmful conditions and inadequate healthcare provision has become evident. The IMA means the Home Secretary can define any site she sees fit as a detention facility.
Contact : Emma Ginn on email@example.com / 07786 517379
Medical Justice is the only charity that sends independent volunteer clinicians to visit clients detained in IRCs to document their scars of torture, deterioration of health and injuries sustained during violent incidents. It has handled 3,589 referrals for people in detention since the 2017 BBC broadcast. We publish research, undertake policy work and strategic litigation, and act as the secretariat for the APPG. Medical Justice was appointed as a CP due to its extensive first-hand experience of the clinical safeguarding and healthcare failures in IRCs. Our comprehensive evidence submitted to BHI was pivotal in demonstrating a causal link between the complete failure of clinical safeguards and the violent abuse.
Background information about immigration detention
There are 7 Immigration Removal Centres across the UK.
In the year ending June 2023, Home Office statistics show that:
20,354 people entered immigration detention (of those, 7 were pregnant women and 66 were children)
22% of those held in detention were ‘removed’ from the UK in the year ending June 2023.
1.3% of people released from detention absconded in the first 6 months of 2022 according t figures obtained through Freedom of Information (see page 4 of this report). Home Office data indicates that the average cost of detention per person at the end of June 2023 was £107.71 per day.
Examples of mistreatment / abuse in detention since 2002
- Yarl’s Wood IRC – a fire destroys half of the centre, which is not fitted with water sprinklers. Detained children, women and men are left locked in the building as the fire progresses. PPO investigation report
- Oakington IRC – BBC undercover reporting reveals “culture of violence, abuse and assaults” against detained people, as well as racism. BBC article | PPO investigation report
- Yarl’s Wood IRC – Manuel Bravo, detained with his 13 yr old son, commits suicide. Independent article
- Tinsley House IRC – detained 10 yr-old Nigerian girl found trying to strangle herself. Guardian article
- Yarl’s Wood IRC – at least 30 detained people go on hunger strike to protest the detention of children at the IRC and conditions there. Guardian article
- Campsfield IRC – almost half the detained population, including some who have been detained for more than three years, go on hunger strike to protest their prolonged detention and treatment. Guardian article
- Removal flight – Jimmy Mubenga unlawfully killed by security escorts on removal flight following the use of a face-forward restraint. Inquest found evidence of pervasive racism amongst security escorts. INQUEST article:
- Colnbrook IRC – Muhammad Shukat dies of heart attack. Neglect contributed to his death. Guardian article
- Colnbrook IRC – Brian Dalrymple, with schizophrenia and dangerously high blood pressure dies whilst detained. Neglect found to have “compounded” his death. Guardian article
- Harmondsworth IRC – High Court finds that a mentally ill man (“BA”) was subjected to ill-treatment so severe that it breached Article 3 ECHR (prohibition on torture and inhuman or degrading treatment) whilst detained at Harmondsworth during 2011. See p.278 of Stephen Shaw’s report
- Harmondsworth IRC – Ghanaian, Prince Fosu, died 6 days after being detained whilst suffering a psychotic illness. Neglect and multiple failures by every agency involved found to have contributed to his death. INQUEST write up
- Various IRCs – High Court finds that a mentally ill Nigerian man (HA) suffering from paranoid schizophrenia was subjected to degrading treatment whilst detained during 2010 at various IRCs, breaching Article 3 ECHR (prohibition on torture and inhuman or degrading treatment). See p.282 of Stephen Shaw’s report | High Court judgement
- Yarl’s Wood IRC – multiple accounts of sexual assault of detained women by IRC staff. Guardian article
- Harmondsworth IRC – 84 yr-old Canadian man (Alois Dvorzak) with dementia, acute heart disease and diabetes, dies of heart attack whilst shackled to an immigration officer. Independent article
- Yarl’s Wood IRC – A total of 99 pregnant women detained
- Harmondsworth IRC – “A depressing, dirty place… has a destructive effect on the welfare of detainees” (IMB)
- Colnbrook IRC – Moroccan, Amir Siman-Tov, with history of mental ill health dies having ingested painkillers the day before. Inquest jury find that “inadequate information sharing” by IRC staff contributed to his death. INQUEST article
- Brook House IRC – undercover reporting by BBC reveals abuse and mistreatment of vulnerable detainees. BBC Panorama programme
- Yarl’s Wood IRC – more than 120 women go on hunger strike to protest conditions and their indefinite detention. They receive letters from the Home Office threatening them with accelerated removal if they continue with their protest. Independent article.
- Brook House in 2020 –situation at the IRC in the latter half of 2020 was described by the Independent Monitoring Board as amounting to “inhumane treatment of the whole detainee population”, [IMB%20report]IMB report.
- Various IRCs – During Supreme Court case, Home Office concedes that the treatment of a mentally ill Nigerian national (known as VC) who was suffering from a serious psychiatric illness and was detained at various IRCs between 2014 and 2015, breached Article 3 ECHR (prohibition on torture, or inhuman and degrading treatment). [Medical%20Justice%20article]Medical Justice article.
- Harmondsworth IRC – people are not evacuated from the centre during a power cut, and instead held in the centre without light, running water, toilet facilities etc for 2-3 days. Bail for Immigration Detainees report
- Various IRCs – People selected and detained for removal to Rwanda under government’s new policy are found to include many highly vulnerable individuals – such as victims of torture, trafficking and those with serious mental health conditions – and to have not been granted adequate access to legal advice and representation. Medical Justice report.
- Manston Short-term Holding Facility – people, including children and pregnant women, are detained for weeks in what the Independent Chief Inspector of Borders and Immigration described as “wretched” and “dangerous” conditions ; Hussein Haseeb Ahmed dies, possibly of diphtheria, shortly after being detained at the facility. Guardian article.
Harmondsworth IRC – Colombian man (Frank Ospina) dies, possibly by suicide, despite “begging” the Home Office to send him home. BBC article:
Colnbrook IRC – Attempted “mass suicide event” occurs shortly after the death of Mr Ospina at next door Harmondsworth IRC. OpenDemocracy.