Harmful combination ;

Vulnerable detained population to start with

Detention is in and of itself harmful – it can exacerbate existing conditions and can be the cause of mental illness

Inadequate healthcare in detention.

The British Medical Association recommends: “immigration detention should be phased out”. Medical Justice agrees.

Vulnerable detained population to start with

Many people in detention have complex health needs because of past or present trauma and may not have been able to get the healthcare they needed before they were detained. Some have arrived in detention with fresh injuries, e.g. those taken from dinghies in their wet clothes with untreated chemical burns on coach trips hundreds of miles away to IRCs. Detention can also disrupt ongoing treatment, for example, meaning people are unable to attend scheduled hospital appointments.

Unsafe release of extremely vulnerable, unwell people without adequate support

Medical Justice 2022 research report “Detained and Discarded” shows that Home Office failings have led to the unsafe release of extremely vulnerable and unwell people into the community, without adequate support, care plans or referral to community healthcare.

One woman whose delay in treatment “could potentially have life or limb threatening consequences”, struggled to re-arrange an orthopaedic oncology appointment that she missed because she had been detained. One released Medical Justice client described how he ended up a number of times in Accident & Emergency, having been unable to secure a recommended cardiology appointment.

Some released from immigration detention had pre-existing vulnerabilities and medical conditions exacerbated by their time in detention, whilst other had attempted suicide, self-harmed or suicidal thoughts in detention.

Healthcare commissioning

Until September 2014 healthcare was the responsibility of the Home Office. Now NHS England is responsible for commissioning healthcare for those detained in immigration removal centres and short term holding facilities.

Medical Justice hopes that this transfer may lead to more improvements in the long term. It should be noted that healthcare delivery is still contracted to a small pool of private companies. Moreover, healthcare in immigration detention is commissioned by the same people who commission prison healthcare and much of the central guidance applying to healthcare in prisons has been applied inappropriately to immigration detention. That said, Medical Justice has been included in NHS England’s consultation of its service specification and we were pleased that many of our recommendations were incorporated, benefiting potentially all people held in immigration detention.