This report directly raises the conflict in healthcare departments in IRCs between a duty of care towards detainees and the Home Office’s desire to enforce removal. It notes examples of poor quality primary care, references inadequate clinical information systems in detention and that detainees often complain of a culture of disbelief. Additional inadequacies in healthcare include poor emergency care and cancelled hospital appointments. Deficiencies in the care of people with a mental illness, also applied to those lacking capacity and the absence of independent advocacy in detention.

Use of force was also raised in the report concerning the regular use of handcuffs at external medical appointments and a lack of examination and recording of the physical effect of the use of force. The findings of the Institute of Relations are included which comprised patterns of alleged racist incidents and poor investigation of this type of misconduct.

The report also noted detainees faced difficulties in making complaints, with criticism of the system by independent bodies such as HMIP and the IMB. The healthcare complaints system had also been criticised by the CQC.