Victims of torture are routinely being held in immigration detention centres in breach of the government’s own rules. This report investigates Rule 35 of the Detention Centre Rules 2001: the primary safeguard to facilitate the release of torture survivors and vulnerable people from detention.

This report exposes start to end process failure. Of the 50 cases analysed, only one person was released through the Rule 35 process. Torture survivors were failed so badly that two of them were removed and tortured again in their home country before they made it back to the UK to claim asylum again. Apart from these two, no others were removed which begs the question why they were detained for the purpose of removing them in the first place.

“Surviving torture and surviving detention is equally very hard experience. I won’t forget neither as they are like wounds in my heart. I couldn’t talk to anyone about it.”
– Tortured in his home country; detained in the UK

The report is based on 50 people who were held in detention some time between May 2010, when the coalition government took office, and May 2011. All cases included in the sample involved torture and had a medico-legal report (MLR) or medical letter produced for them by Medical Justice independent doctors, which revealed injuries that accorded well with their accounts of torture.

They fled to this country in pursuit of sanctuary. Instead, they were detained for administrative purposes and the safeguarding mechanism that should identify and release them, failed to do so in all but one example.

The primary data sources relied upon in this investigation include immigration case files, healthcare notes, questionnaires completed by (ex) detainees and MLRs. The 50 people reported having endured various methods of torture. For example, beatings with various objects including: gun butts; bats or batons; sticks; cable wires; or metal objects as well as whippings. 16 out of the 50 suffered rape or instrumental rape. Everyone in the sample suffered from ongoing physical and/or mental effects owing to their torture and all have medical evidence supporting their accounts.

The Second Torture also traced the failure by the Home Office to address criticisms of the Rule 35 process by HMIP and stakeholders as well as concerns about the department’s conduct of audits and of refusals and delays in publishing the outcomes. Medical Justice’s analysis was that the procedures surrounding Rule 35(3) were not fit for purpose, there was inadequate training, with ill-considered responses from the Home Office and a lack of overall accountability.

Detained peoples’ experiences, assessed by standardised questionnaires, were reflected as overwhelmingly negative when considering the Home Office’s treatment of their torture claim, detention healthcare’s response to their health concerns arising from the torture and their overall assessment of the quality of healthcare. The report also identified common themes of emotional mistreatment by detention staff, increased psychological symptoms, self-harm and suicidal ideation.

Detailed assessment of medical records showed the Rule 34 process was flawed, with a high level of individuals where no assessment took place. When an assessment was conducted this was generally brief and inaccuracies were noted. There were significant discrepancies between the diagnoses of trauma-related mental illness made in the context of subsequent medico-legal assessments and information obtained at a Rule 34 appointment. There was also a lack of access to medical records from the community with adverse consequences for care.

Overall, Rule 35 was assessed as ineffective, with requests for assessments having to be prompted by external organisations. The standard Rule 35 forms were often incomplete, lacking in clinical information and failed to address the effect of continuing detention. Home Office responses to such reports only led to the release of one individual from the sample. The systemic failures in the responses to Rule 35(3) reports were summarised as failing to provide adequate reasons for continued detention and an inability to properly consider medical evidence. Wider systemic issues referenced in the report included a lack of knowledge and training, as well as attitudinal problems of both Home Office and healthcare staff involved in the Rule 35 process. This was compounded by poor quality healthcare in detention and a lack of accountability for flaws in the process. The report made brief reference to a high proportion of the files considered involving a complaint of assault in detention.

This report features the cases of 35 Medical Justice clients who were being detained at some point in the 18 months between June 2009 and November 2010. They all faced removal to countries where they would potentially be unable to continue treatment for their HIV infection.

80% of the cases are female. There were a small number of children and teenagers. 80% discovered their HIV infection after their arrival in the UK. Some individuals only learned of their HIV infection after they were screened in detention. Several people reported contracting HIV after being sexually assaulted.

Interruptions and disruptions in antiretroviral therapy occur repeatedly in detention. 60% experienced disruptions in their medication as a result of failures by staff in detention centres to provide drugs, failures to facilitate external appointments, failures to ensure that people were given medication en route to detention centres, and administrative errors. One person was given a significant overdose of her medication in detention.

Three people were so afraid of being deported that they hoarded their drugs and, subsequently, attempted to overdose in an effort to end their own lives.

When detained, people may be subjected to clinical practices which are demeaning, degrading, and which in some cases may have worsened their condition. 66% had their right to quality primary and secondary clinical care (in ways other than those set out above) violated. These included practices putting people at risk of contracting opportunistic infections, failures to adequately investigate symptoms indicative of HIV.

infection, failures to respect the confidentiality of detainees and failures to carry out or pass on the results of tests to determine resistance to particular medications. Some people were forced to undergo consultations whilst handcuffed to escorts.

This report is the first large scale exploration in the UK of the physical and psychological harms caused and aggravated by the detention of children for immigration purposes. 141 cases are featured in this report, involving children who were detained between 2004 and April 2010. One child had spent 166 days in detention, over numerous separate periods, before her third birthday. 48% of the children were born in the UK.

“The indefinite detention of children who have committed no crime is a source of national shame. Yet, as this report describes, it is exactly what has been happening. It makes for alarming reading, and reveals a catalogue of harm. Not only have children being mentally and physically damaged, they have been denied adequate medical care.

Many of those who have been detained have been left severely traumatised. Some children have been hurt to such an extent that they have tried to end their own lives.

The findings of this report present a picture which, ultimately, suggests that in many cases children’s rights are given less precedence than immigration control. This cannot be acceptable. There is more than enough evidence in what follows to support the recommendation that the detention of children for immigration purposes should end immediately.

There is no need to continue a policy which causes untold suffering. It can stop, and it should do. “
Jeremy Corbyn MP

In all cases in our dossier, what may have started off as ‘reasonable’ force turned into what we consider to be excessive force.

This dossier reached nearly 300 cases of alleged assault. The alleged assaults took place between January 2004 and June 2008. In addition to our findings, 48 detailed case studies are included in Part 2.

One asylum seeker ended up with his leg in a plaster cast and a woman was pushed through airports in a wheelchair after having allegedly been assaulted. The most common form of injury recorded resulted from inappropriate use of handcuffing, including swelling and cuts to the wrist, sometimes leading to long lasting nerve damage. Other injuries included bruising and swelling to the face and fractures to the wrists, ribs or ankles. Often psychological consequences resulted, such as the onset or exacerbation of post-traumatic stress disorder (PTSD), panic attacks, suicidal feelings and depression.

66 % of alleged assaults were against men and 34 % against women. 48% of the assaults occurred at the airport before the detainee was placed on the plane and 12 % took place in the transport van on the way to the airport. 24% of alleged assaults took place on the aeroplane before take-off and 3% after take-off. 7% took place in the van back to the detention centre after the removal had already failed and 6 % took place within detention centres.

There were 27 alleged incidents involving families, comprising a total of 42 children, 5 of whom are alleged to have been assaulted themselves.

Many of those assaulted made allegations of racism against the escort; there are repeated accounts of abusive language used such as “black bitch” and “black monkey, go back to your own country.”

Alleged assaults took place on scheduled airline flights, charter flights and military planes. Private jets have also been arranged to remove people from the UK.

This report was published after Medical Justice had assisted its first 500 clients. Medical Justice doctors recorded their findings on examining the first 56 consecutive cleints treated in a six month period in four UK detention centres, before, or shortly after, their release.

The report was written for the parliamentary launch of Medical Justice, hosted by Lord Ramsbotham.

“Medical Justice has been in existence for almost two years and has grown faster than anyone envisaged. It owes its existence entirely to the extraordinary generosity of everyone involved in working with it. It is an organisation built on people’s kindness to others and on a shared belief in human dignity and freedom.

Medical Justice’s work relies on a unique and exciting collaboration between asylum seekers, ex-detainees, solicitors, barristers, doctors, nurses, campaigners, detention centre visitors and other volunteers.

In my work with Medical Justice as a barrister, my experience has been that a culture has evolved in which people held in detention centres are perceived as having less value than those with legal rights to be in this country. Many detainees describe a feeling of being treated like “nothing” or like “dirt”. Such a perception is hurtful to those involved and it violates their dignity as human beings. But the problem is not only that people in detention are perceived as being of less value, it is that they also come to be treated as such.

All of those who work with detainees share experiences of neglect, discrimination and abuse on a scale that is saddening and frightening. I see Medical Justice’s work as reminding ourselves that we must treat all people with equal value, not just for those people’s sakes, but for the sake of our society.” – Alex Goodman, Chair of Medical Justice