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.”