Medical Justice today publishes “If he dies, he dies”: What has changed since the Brook House Inquiry?’. This research, a comprehensive analysis of clinical evidence from 66 clients detained in Immigration Removal Centres (IRCs), visited by Medical Justice independent doctors between June 2022 and March 2023, demonstrates how unsafe and harmful immigration detention can be.

Undercover footage disclosed to the Brook House Inquiry revealed guards saying “if he dies, he dies” in 2017. The justification that this was part of the culture and a joke was found by the Inquiry to be “not only callous and unacceptable but betrays the extent of desensitisation to detained people’s health issues and vulnerabilities, and the dehumanisation of detained people by some staff”.

The experiences of the 66 people in this report shows that many of the same circumstances that were behind the mistreatment evidenced by the Brook House Inquiry, continue to exist across the UK’s IRCs.

The Brook House Inquiry provided a forensic analysis of how the abuse uncovered by Panorama in 2017 occurred. It found how the dangerous use of force, a wholesale failure of safeguards and a culture of dehumanisation led to 19 instances of inhuman or degrading treatment, breaching Article 3 of the European Convention on Human Rights (ECHR), within a 5-month period at Brook House IRC. It exposed failures, mistreatment and indifference at every level; from nurses and doctors, IRC staff, to Home Office civil servants. Light was shone on the structural deficiencies in detention safeguards and processes around use of force, segregation and responses to self-harm and suicidal thoughts.

Medical Justice has consistently evidenced the harm and dysfunctional safeguards to the Home Office. This report is the latest iteration of this work, which has stretched back over the past 18 years. All the failings documented in this report have taken place after the Inquiry’s public hearings, across the detention estate.

The Brook House Inquiry unequivocally places responsibility on the Home Office, urging action at the highest levels of government. There has been a failure to learn lessons from previous reviews; such a failure is described by the Inquiry’s Chair as a “dark thread” throughout her report. The Home Office publicly state their commitment to learning lessons to ensure that the mistreatment uncovered in Brook House never happens again. Yet, such abuse can only be avoided if there is meaningful change – which has been sorely lacking after previous investigations and reviews over the last two decades. The Inquiry made 33 recommendations which need to be urgently addressed.

The Home Office does not seem to acknowledge the severity of harm ongoing in detention and turns a blind eye to the failures over which it presides. They suggest that these are issues of the past. This ignores the important findings of the Inquiry that many of the factors which allow for mistreatment to occur, are unchanged to date. The Inquiry reached these conclusions after hearing evidence from current Home Office, custodial and healthcare staff and reviewing recent reports from His Majesty’s Inspectorate of Prisons (HMIP), the Independent Chief Inspector of Borders and Immigration (ICIBI) and the Independent Monitoring Board (IMB), as well as from Medical Justice.

This Inquiry cannot be another one for the bookshelves. Our report demonstrates how many of the issues in the Inquiry are still ongoing today, across the detention estate. Action could not be more urgent as the government plans to significantly expand detention and implement the provisions of the Illegal Migration Act, knowing the harm that is still being caused. This ongoing harm is apparent from our evidence, , the death of Frank Ospina in March this year reportedly by suicide, and another recent death in November this year of an Albanian man following a reported attempted suicide, a ‘multiple mass suicide attempt’ and the continuing failures of the Home Office safeguards, including the identification of people at risk of self-harm or suicide.