In its Annual Report 2025 published 10^th June 2026 (see its press release below), the Independent Monitoring Boards (IMB) warns of systemic failings across immigration detention that continue year after year and that these issues are becoming more acute.  It is beyond comprehension that we are in a position where longstanding issues – some of which a public inquiry found could amount to inhuman and degrading treatment – could get any worse.

Yet Medical Justice is sounding the alarm once again that the severity and prevalence of harm is indeed set to worsen as the government opens more immigration detention sites and plans to decimate already-failing safeguards. Medical Justice has been providing undisputed medical evidence of the severe harm caused by immigration detention for over two decades; the government cannot pass the harm off as accidental.

We should all be deeply troubled by the devastating and avoidable harm caused to vulnerable people who may never recover from it and as a society we should not accept it. Together with experts such as the British Medical Association, Medical Justice calls for immigration detention to be phased out.

Medical Justice receives 400-500 referrals a year from people in detention.  Our latest audit of medico-legal reports shows that of those assessed by our independent doctors:

• 82% were survivors of torture.
• Healthcare screenings on arrival in detention failed to identify critical vulnerabilities, missing 77% of the survivors of torture and 89% with a reported history of trafficking.
• 99% had at least one mental health condition, including post-traumatic stress disorder.
• 97% suffered a deterioration in their mental state while in detention.
• 74% had an increased risk of suicide since they were detained.
• Only 6% of clients that Medical Justice clinicians assessed as having been harmed by detention had a safeguarding report as required by Rule 35 (1) of the Detention Centre Rules.

 

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IMB 2025 National Annual report.   

Harm without accountability: force, failed safeguards and prolonged detention in the immigration system

In the 2025 national annual report published today (10 June 2025), Independent Monitoring Boards (IMBs) present a troubling picture of systemic failings across immigration detention that continue year after year, exposing detained people to avoidable harm while falling short of the minimum standards that are meant to be upheld in detention.

Drawing on evidence from immigration removal centres (IRCs) and short‑term holding facilities (STHFs), Boards report that practices intended for use only under exceptional circumstances, including the use of force and isolation, are increasingly applied as a matter of routine, often for operational convenience rather than necessity. Despite repeated scrutiny, many of the most serious concerns raised by IMBs in previous years remain unresolved. Boards increasingly encountered challenges in discharging their statutory scrutiny role: access to information was at times lacking or curtailed, subject to undue delays and questioning, or denied altogether.

In 2025, 22,996 people entered immigration detention, an increase of 11 per cent on the previous year. As detention numbers rose,  existing weaknesses were compounded.  The issues identified by IMBs, and their impact on people in detention, were such that my predecessor did not always wait for the annual reporting cycles of individual Boards to raise these concerns. Instead, they were escalated in real time, in line with our statutory duty to safeguard people in detention, leading to the publication of our first thematic review on immigration detention, focused on the use of force.

The IMB reports the following:

Prolonged and unnecessary detention caused avoidable harm

Despite a rise in enforced removals, most people detained were ultimately released, often after prolonged periods in detention.

• IMBs flagged excessive stays in detention, including one individual detained for more than 15 months, raising concerns about whether the conditions required for detention to remain lawful – namely a realistic prospect of removal within a reasonable time – continued to be met.
• Many people remained in detention long after being granted bail, including one person who was held for well over a year whilst local authorities and health agencies disputed responsibility for providing care.
• Boards repeatedly identified administrative inefficiencies that unnecessarily prolonged detention, including for individuals who were willing to return to their country of origin voluntarily.

IMBs concluded that lengthy, indefinite and unnecessary detention drove much of the emotional distress observed across the immigration detention estate.

Force used as routine practice rather than a last resort

IMBs found that fundamental principles governing the use of force, including necessity, proportionality and the requirement that force be used only as a last resort, were frequently overlooked. Detained people were routinely subjected to force for reasons of operational convenience, with limited effective oversight.

• Routine handcuffing during transfers, including hospital visits, was widespread, with little evidence of meaningful, individualised risk assessments.
• At Brook House IRC, detained people told the IMB they would only be taken to hospital if they agreed to be handcuffed. The Board considered this practice coercive.
• Boards documented cases in which people avoided healthcare appointments altogether because of the stigma, distress and humiliation of being handcuffed in public.

Isolation and confinement increasingly used for operational ease

Separation, which is intended to be used only as a last resort safety measure, was frequently applied to manage removals and anticipated disruption.

• At Heathrow IRC, one individual was held in a separation unit for eight nights prior to removal.
• Boards observed people with complex mental health needs spending prolonged periods in isolation, including one individual at Heathrow who had yet to be transferred to a psychiatric unit after five weeks.

Safeguards repeatedly failed vulnerable people, including children

IMBs continued to raise serious concerns about the effectiveness of safeguarding systems intended to prevent further harm. Boards found that shortcomings in screening processes frequently allowed extremely vulnerable people to enter detention.

• At Heathrow IRC, children remained detained for nearly two weeks while awaiting age assessments, despite clear policy expectations that their detention should be avoided at all costs.
• Boards across the estate identified additional failures, such as detained people being left without proof of welfare checks for hours.
• Mechanisms intended to ensure medical considerations are central in decisions to detain or release those deemed unfit for detention are often ineffective; in most cases, people remain detained even when doctors warn that continued detention would cause serious harm to their health.
• Under the UK – France returns pilot scheme, the IMB at Gatwick found that 12% of cases involved age disputes, of which over 20% were later assessed to be children, indicating serious safeguarding gaps.
• Many individuals included in the pilot were recognised as highly vulnerable, from asylum seekers to victims of modern slavery, yet were held in detention for longer than average, unclear as to what would happen to them when returned to France.
• Other vital safeguards such as access to interpretation and legal advice were severely hampered: detained people struggled to access information in a language they could understand.

Healthcare delays caused deterioration

Access to healthcare was frequently delayed or obstructed, with significant consequences for detained people’s health.

• Even in emergencies waits could be excessive: in one case it took nearly three hours to secure an emergency medical response for a suspected stroke.
• Another individual had to wait one month to see a doctor for a broken finger.
• In STHFs, people continued to be systematically denied access to their prescribed medication, regardless of whether these may be for serious and life‑threatening conditions.
• Boards also reported breaches of medical confidentiality, and that healthcare staff sometimes assessed individuals’ mental health needs as manageable in detention until deterioration reached a level requiring sectioning under the Mental Health Act.

Distress, self‑harm and suicide attempts remained widespread

Across immigration removal centres, IMBs reported high levels of serious self‑harm and suicide attempts.

• Uncertainty about case progression and length of detention was a major driver of distress, with Boards observing an increasing number of people requiring constant supervision.
• At several sites, incidents linked to attempts to avoid removal, including self‑harm and climbing on the netting.
• Across Boards, increased levels of self-harm are raising questions as to whether the care available was sufficient, despite prompt responses from staff in many cases. Practical measures to prevent furnishings being used for ligatures were at times delayed or ineffective.

Interim IMB National Chair, Jane Leech MBE says:

“Having monitored immigration detention for just under two decades, and having served on local Boards, and the National Board, I have a well-grounded understanding of the issues that have shaped the immigration detention estate over time. While IMBs do identify individual examples of good practice, these are unfortunately not reflected consistently across the system.  We have seen patterns repeat, warnings ignored, and risks re-emerge in different forms. The evidence available to us strongly suggests that many of these longstanding issues are not only unresolved but are becoming more acute. We repeatedly see health deteriorating in closed settings, delays in accessing medical care, rising distress, and vulnerable individuals becoming more unwell the longer detention continues. These are outcomes we observe directly, not theoretical risks.

This is not a moment for complacency. It is a moment that requires honesty about the deterioration of conditions, and confidence in the evidence.

The Home Office must exercise stronger oversight and clearer accountability in how detention is used in practice. Without decisive action to address problems that have been evident for many years, people in immigration detention will continue to experience avoidable harm.”

Download the IMB Annual Report 2025 here.

 

Trigger warning : this article mentions a suicide attempt and levels of suicidality in detention. The serious suicide attempt on Tuesday of a man detained under the ‘one-in one-out’ policy – as covered by the Guardian – can come as no surprise to the Home Office because there have been so many warnings. There is a risk of increasing suicidality amongst others in immigration detention and we call for their immediate release. The Eritrean man who attempted to take his own life was to be removed from the UK yesterday – his removal was cancelled and he was placed under ‘constant supervision’. Vulnerable people, including those at risk of suicide, need appropriate clinical support, and we know that healthcare in immigration removal centres (IRCs) is inadequate. The Royal College of Psychiatrists say that IRCs are likely to precipitate a significant deterioration of mental health in most cases, greatly increasing suffering and the risk of suicide. ‘Constant supervision’ is not always helpful – as explained by Dr Mma Yeebo, a Medical Justice clinical psychologist ; “Our clinicians frequently encounter the prolonged use of constant one-to-one observations for individuals at high risk of self-harm or suicide, which is referred to as ‘constant supervision’ in the context of immigration detention.  NICE guidance is clear that this should be a short-term intervention delivered by appropriately trained clinical staff who can use their observations therapeutically to inform ongoing assessment and treatment planning. In immigration detention, however, these observations are often carried out by custodial staff without the necessary clinical training. Seeing highly distressed individuals monitored in this way, without meaningful therapeutic engagement, raises serious concerns about the systemic normalisation of practices that would likely not be considered acceptable in other care environments.” Lisa Incledon, our Head of Casework describes how ‘constant supervision’ can make detained peoples’ mental state worse; “We see clients who are suicidal, and suffering from conditions such as post traumatic stress disorder, schizophrenia and psychosis – many find ‘constant supervision’ intrusive and distressing, as well as sometimes exacerbating paranoia and fear of guards who are imprisoning them. At the same time, crucial safeguarding reports that should be completed by healthcare staff for people suspected of having suicidal intentions are often simply not done”. Alarmingly high levels of suicidality amongst those detained for the one-in one-out policy – our independent clinicians have assessed torture and trafficking survivors detained under this policy and found alarmingly high levels of self-harm and suicidality. Medical Justice has received at least 68 referrals for people detained for the ‘one-in one-out’ scheme. Of 20 assessed by its independent clinicians, all 20 had clinical evidence of a history of torture, ill-treatment and/or trafficking, and all 20 had serious mental health conditions. 12 out of the 20 people had suicidal thoughts yet only 5 were identified as being at risk of self-harm and/or suicide by IRC healthcare staff. Only one had a Rule 35 (2) safeguarding report, as they should, from the IRC doctor to flag suspected suicidal intentions to the Home Office who should review if detention is to be continued. The number of people released by the Home Office in response to safeguarding reports is so low that it risks rendering the whole process of clinical safeguards meaningless. The severe harm caused by immigration detention is not accidental – for over 20 years Medical Justice has provided evidence to the government that clinical safeguards in detention are completely dysfunctional and that the lives of people in its care in detention are at risk. The severe harm known to be caused by immigration detention cannot be described as accidental. Immigration detention is optional – suicide attempts and deaths in immigration detention are avoidable. The Home Office’s contempt for human life – the Home Office has issued plans to effectively decimate clinical safeguards in IRCs, which along with its planned expansion of immigration detention, risks making already vulnerable people even more so.  The ‘one-in one-out’ pilot was to conclude next month, followed by an evaluation which may have provided some level of scrutiny.  This has been side-stepped by the government which told the Guardian that the pilot has been extended until October, providing no reasons. Notes The Medical Justice report “Politics over people? How the UK’s “one in one out” knowingly harms and forcibly removes torture and trafficking survivors to France” is 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. These clients include men, women and age-disputed young people whose nationalities include Eritrean, Iranian, Palestinian and Sudanese. Many have not been able to access adequate and timely legal advice. Of 20 clients assessed by our independent clinicians, only three had a report by the IRC GP which is used to identify those who are likely to be injuriously affected by detention. All 20 should have had one. Those who did not included people whose health had already deteriorated in detention, one of whom had been hospitalised. 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.  Dangerous detention conditions In 2024, HM Inspector of Prisons (HMIP) found conditions at Harmondsworth IRC were the ‘worst inspectors have seen’, that detained people were at “imminent risk of harm”, that 48% of detained people surveyed said they had felt suicidal, and noted that a ligature point used in 3 suicide attempts had not been removed. Harmondsworth Immigration Removal Centre: drugs, despair and decrepit conditions – HM Inspectorate of Prisons In December 2025, HMIP reported that at Dungavel IRC only three detained people had Rule 35-2 safeguarding reports noting their suicidality, even though 36 had been placed on constant supervision . Concerns for one man were so high that he was put on constant supervision for 4 days and was twice placed in anti-ligature clothing, yet no Rule 35-2 report was submitted. Dungavel House IRC – HM Inspectorate of Prisons Frank Ospina died by suicide in immigration detention in 2023 – no Rule 35-2 report was submitted. Asked at the inquest into his death why no Rule 35-2 report had been generated, the Practice Plus Group (PPG) head of healthcare at Colnbrook said: “It was not done. Healthcare missed that …  I can confidently say that if we had done the Rule 35 on the 22nd or 23rd [of March], then we wouldn’t have had that outcome.” If you have been impacted by this content, please know you are not alone, Samaritans are there – day or night, 365 days a year. You can call them for free on 116 123, email them at jo@samaritans.org, or visit samaritans.org to find your nearest branch.

On Tuesday 9 June, alongside 19,000 legal professionals, the Medical Justice team will be walking 10km across London to raise funds to support our work. 

We support clients to access competent lawyers, harnessing the strength of the medical evidence we generate. Clinical evidence, casework and medico-legal reports are at the heart of what we do. We are the only charity in the UK that sends independent volunteer clinicians to visit people held in Immigration Removal Centres, document the physical and psychological scars of torture and trafficking, and assess serious medical conditions. The evidence produced also forms the basis of our research into systemic failures in healthcare provision, the harm caused by these shortcomings, and our advocacy on the dangerous impact of immigration detention on the health of our clients.  

We are hoping to raise as much as possible to continue our vital work. These funds are needed now more than ever, as we are operating in a particularly challenging funding environment. At the same time, the cost of delivering our services is rising and increasingly hostile policies affecting our clients continue to be announced. 

Your support could make a real difference: 

£10 could fund a phone line for a month, helping our casework team maintain vital contact with people in detention 

£80 could cover the cost of training to a new volunteer clinician  

£100 could cover the travel costs for a volunteer clinician to visit someone in detention and carry out a medical assessment   

£120 could cover the cost of an interpreter during a medical assessment  

You can sponsor us here  

 Other ways to support the team:  

• Raise funds through your firm!

 If you work with a legal firm taking part in the London Legal Walk, please ask whether your firm would consider allocating a percentage of what you raise to Medical Justice. For more information please contact Ariel at info@medicaljustice.org.uk  

• Share our fundraising page

 If you are not in position to sponsor the team, please consider sharing our London Legal Walk fundraising page with your contacts, friends and family.

 

 

Medical Justice joined nearly 150 children’s charities and organisations working with children in writing to the Prime Minister to warn that recently announced Home Office proposals to radically overhaul the immigration and asylum systems would put hundreds of thousands of children, as well as young adults leaving care, at risk. 

The groups condemned new ‘use of force’ plans as part of changes to the Family Returns policy currently under consultation, which risk causing distress, trauma and lasting emotional damage to children. These proposals pave the way for children to be handcuffed or physically handled onto removal flights in circumstances such as “a parent refusing to release a child’s hand” during attempts to forcibly remove them from the UK. For the government to describe such harm to children as “unfortunate but necessary and justified” is abhorrent.  

If the government proceeds with these plans they will be overturning the longstanding policy against the use of force on children for the purposes of removal, which was reinstated following legal action which Medical Justice contributed to in 2013. 

The impact of immigration detention and the risks around the use of force on children have been long-established. Research published by Medical Justice highlighted the impact of excessive use of force on families, including five alleged assaults on children themselves. Further research demonstrated the physical and psychological harms to children caused and aggravated by immigration detention.  

The joint letter also highlights ‘earned settlement’ proposals, which could trap as many as 90,000 children already living in the UK in poverty and keep children in prolonged limbo, as well as moves to make refugee status temporary and make it easier to withdraw financial support from families and young people leaving care who have been refused asylum.  

The groups criticise as “reprehensible” recent suggestions in Home Office policy documents that migrant parents may be “exploit[ing] the fact that they have had children” or seeking a “personal benefit” from migrating irregularly with children. 

The letter concludes: “We urge you to change course, and create policy that reflects simple facts we all know to be true. Children who grow up here belong here. Children need stability and certainty to thrive. Care leavers deserve love, special care and a clear path to a future. And we must do everything in our power to prevent children from experiencing homelessness, distress and trauma. We urge you to put the welfare and rights of children at the heart of asylum and migration policy.” 

Read the full letter here

The letter has received attention in the media, including coverage in the Mirror and the Independent newspapers. 

With sadness, we are alerting Medical Justice partners to the disturbing news that the Home Office has set out plans for changes to the Adults at Risk policy – to be re-named the ‘Assessing Detention for Vulnerable People policy’ to apply to anyone in detention, including children. 

The Home Office states the policy will be changed to an ‘evidence of needs’ model. The circumstances in which a Rule 35 report is to be completed will be greatly restricted compared to the current system, and the focus will be on managing needs in detention, rather than identifying those people who are at increased risk of harm in detention.  

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Currently there are three circumstances in which rule 35 reports should be completed by the GP in the detention centre: 

Rule 35(1) reports should be completed regarding any detained person whose health is likely to be injuriously affected by continued detention 

Rule 35(2) reports should be completed in relation to any detained person suspected of having suicidal intentions 

Rule 35(3) reports should be completed in relation to any detained person where there are concerns that they may have been a victim of torture 

The completion of a rule 35 report triggers a review of detention and a written response from the Home Office. 

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Under the Home Office’s proposed changes Rule 35 reports will only be completed if, in the immigration removal centre (IRC) doctor’s opinion, ‘a person’s needs may not be met in detention’. This applies a far higher threshold and encourages a “wait and see” approach leading to those at risk of harm in detention being left to deteriorate until such time as their needs become unmanageable in detention.  

It is particularly concerning to see the Home Office taking these steps to weaken safeguards, rather than address the significant concerns that have been repeatedly raised about the implementation of the current safeguards. 

Ongoing failings 

In December in AH and IS v Secretary of State for the Home Department [2025], a case brought by formerly detained men, IS, and Medical Justice client, AH, the High Court found that a key safeguarding mechanism for adults at risk in immigration detention had failed at the systems level, echoing warnings Medical Justice has issued to the Home Office for over 20 years. In her judgment  Mrs Justice Jefford ruled that there had in fact been a breach of the Article 3 ‘systems duty’ (the duty to take measures to protect people from the risk of torture or inhuman or degrading treatment) in relation to the operation of Detention Centre Rule 35 at Brook House IRC, at least between 28 July 2023 and 11 March 2024. Evidence from a medico-legal report by a Medical Justice psychiatrist was relied on for AH in the case. 

The case again demonstrated many of the issues Medical Justice has highlighted with the adults at risk policy and implementation of Rule 35 over many years, including the low number of Rule 35(1) and Rule 35(2) reports being completed and the disconnect between the ACDT process and Rule 35. 

The Assessment Care in Detention and Teamwork (ACDT) process is a custodial one used in IRCs, intended to reduce the risk of self-harm and/or suicide, involving regular reviews, with observations and/or periods of constant supervision carried out by detention custody officers. 

Both AH and IS had periods on ACDT and ‘constant supervision’ whilst detained at Brook House IRC, but neither had Rule 35(1) or (2) reports completed. In AH’s case a psychiatrist from Medical Justice visited him for assessment and wrote a letter raising concerns about his declining health and expressly recommending assessment for Rule 35(1) and Rule 35(2). No assessments or reports were completed following her recommendation.  

Numbers of Rule 35 (1) and (2) reports have been remarkably low for years across all IRCs, an issue highlighted by the Brook House Inquiry as well as frequently by HM Inspector of Prisons and Independent Monitoring Boards, and Medical Justice.  

In October the inquest into the death of Théophile Kaliviotis at Brook House IRC in 2024 will take place. The lawyer for his family argued at the pre-inquest hearing that he was ‘vulnerable and unwell’ and staff had failed to comply with Rule 35 in his case. 

At the inquest into the death of Frank Ospina who died by suicide in Colnbrook IRC in 2023, the Head of Healthcare said that if a Rule 35(2) had been done in the days preceding Frank’s death

“then we wouldn’t have had that outcome”. The inquest jury found that “the failure to submit a rule 35 report despite meeting the criteria deprived [Frank] of the opportunity of a detention review.” 

The low number of Rule 35 (2) reports highlighting suicidality is particularly stark when compared with the number of ACDTs opened and the number of people on constant supervision or ‘suicide-watch’. In AH and IS the judge referred to the disconnect that these statistics demonstrate in her judgment, stating:   

“The statistics as to the number of Rule 35(1) and (2) reports speak for themselves particularly when compared with the numbers of ACDTs and constant supervisions. It is inconceivable that if the system were operating effectively the numbers would be so low. […]  

The figures alone called for an answer but there had been no explanation for the figures other than a broad assertion that the system can be seen to be working. Nor has there been any or any satisfactory evidence that, between 2017 (the period covered by the [Brook House] Inquiry) and the period in issue in these cases, any effective steps were taken to address the failure in the system.  

The experiences of AH and IS are properly regarded as emblematic of this failure and the disconnected system and evidence that during the period with which these claims are concerned nothing has changed.”  

Medical Justice’s experience is that there has been no significant change since the period when AH and IS were detained, and we continue to see safeguards failing to protect vulnerable people who are at risk of harm in detention. 

Failure of implementation 

In AH and IS the judge also made the point that the failure to properly implement Rule 35 is not a matter of it being impossible, rather it is a matter of continuing failure by the Home Office to implement their own policy, stating

“there is a clear and persistent picture of a failure of the system intended to protect Article 3 rights of adults at risk…characterised by a failure to apply properly or at all the provisions of Rule 35”

and

“the failure is ensuring the implementation of the system and not in its design…the system was capable of working effectively but was not working effectively.” 

It is shocking that rather than addressing these persistent failures in implementation in order to improve protection of vulnerable people at risk in detention, the Home Office is instead planning to weaken the existing safeguards, especially so in light of its intention to expand the use of immigration detention and the recent re-opening of Campsfield IRC. This will inevitably lead to more vulnerable people being detained for longer periods, with an increased risk of harm, including harm that meets the threshold of inhuman and degrading treatment under Article 3. 

The Home Office should abandon these plans and instead take steps to ensure that existing safeguards are properly and effectively implemented, with a focus on preventing harm, rather than only responding once it has already occurred.  

This week a judicial review brought by trafficking survivors detained under the ‘one-in one-out’ UK-France scheme is being heard. The survivors are challenging the blocking of modern slavery appeals and the case touches on barriers to disclosure faced by trafficking survivors which have been documented by the Detention Taskforce, a consortium of expert organisations chaired by Medical Justice. 

Government ministers insist that “late” or “last-minute” modern slavery claims are being used to frustrate deportation attempts. This narrative, which is being used to justify changes to modern slavery laws, fails to acknowledge the significant barriers that stand in the way of survivors disclosing their trafficking history at the earliest opportunity while held in immigration detention. Treating “late” disclosures as less credible shows a lack of understanding of the impact of trauma on people who have been trafficked. 

In its March 2026 briefing “Barriers to Disclosure: A survivor of trafficking’s journey through the immigration process”, the Detention Taskforce charts the barriers to disclosure that survivors recently detained for removal to France at every stage in their journey face through the immigration process – from their arrival in the UK by small boat and often bewildering screening interview to their arrival and induction at an immigration removal centre. Drawing on Taskforce members’ experience, including Medical Justice’s recent research, the briefing identifies challenges with healthcare screening and clinical safeguards as well as access to legal advice, which are all exacerbated by the nature of the UK-France immigration decision process that is accelerated by design. 

The briefing also highlights our serious concerns about the September 2025 change to the Modern Slavery Statutory Guidance which removes some people’s right to have a negative decision reconsidered, including those detained for removal under the UK-France deal. This policy change, which has been implemented inconsistently so far with some people receiving a reconsideration and others being refused it, is being challenged in the High Court this week by six trafficking survivors who were detained under the UK-France deal and whose reconsideration requests were refused. As barrister Sam Grodzinski KC told the court: “Victim identification is a process that takes time; it can’t be done speedily, not if it is to be done properly.”

Read the full briefing here

The Detention Taskforce on survivors of trafficking in immigration detention works to build a better system for survivors of trafficking in immigration detention, and ensure no victim of trafficking is further harmed by detention. Chaired by Medical Justice, the Taskforce is comprised of 18 expert organisations working with, or for, victims or survivors of trafficking. 

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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.

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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.

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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

 

 

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.

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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.

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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):

• Joint briefing for Lords Second Reading – CARJ, including Medical Justice
• Joint briefing for Lords Committee Stage – CARJ, including Medical Justice

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:

• Joint briefing on detention time limit amendment – Detention Action, Bail for Immigration Detention, ILPA and Medical Justice.

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.

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: 

• Rule 35 reports 

• Self-harm incidents and Assessment Care and Detention Teamwork (ACDT) 

• Segregation 

• Use of Force  

• Comparison between numbers of Rule 35 reports and those on ACDT, including constant supervision  

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.   

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.