Medical Justice statement on today’s (29th April 2020) publication of the Independent Chief Inspector’s audit report on the Home Office’s Adults at Risk policy and the government’s response.

“This shameful policy is riddled with systemic issues, fails to protect vulnerable people and serves to prop up a detention regime that inflicts severe harm on torture victims and other vulnerable detainees.

Medical Justice has warned the Home Office of the failures for years and has successfully challenged the policy’s definition of torture in the High Court, twice.

The Coronavirus pandemic shows these failures now reach beyond detention into the community. The same systemic issues Medical Justice have been warning of for years are now putting detainees and the wider public at risk. Right now the Home Office continue to rely on this flawed policy in assessing detainees for release which means our clients who suffer from COVID-19 co-morbidities, such as asthma, continue to be detained despite the increased risk of severe illness. There have already been three confirmed cases in immigration removal centres. If COVID-19 continues spreading, immigration removal centres will act as ‘epidemiological pumps”, with staff serving as conduits between the centre and the wider community. “

The Home Office stubbornly refuses to learn the lessons of the Windrush scandal, placing enforcement over protection”.

Case-study : Z- Torture and Trafficking victim self-harming in detention

Z was detained having been encountered by immigration after he overstayed a visa and was detained. Shortly after entering detention, he claimed asylum. In his screening interview he disclosed a history of having been trafficked and forced to work. He was referred into the National Referral Mechanism as a Potential Victim of Trafficking. This disclosure did not trigger any further investigations into his vulnerability. He received negative decisions in his asylum and trafficking claim. He was given a ‘removal window’. The same day he cut himself and was placed on constant watch (which is intended to manage a suicidal crisis). There is no evidence that a Rule 35(2) report or IS91 RA Part C were completed at that point. He was referred for a mental health assessment. He first requested a rule 35(3) appointment around 22/01/19 and was placed on a waiting list. After Medical Justice contacting the IRC healthcare unit an appointment was allocated for him a couple of weeks later. The report identified evidence of torture and found he was likely to be harmed by continued detention. He was released a few days later.

(This case study also illustrates the failure to investigate further any potential vulnerability disclosed in the screening interview or NRM interview for example by referring for a Rule 35 report, the underuse of Rule 35(2), and our concerns regarding vulnerable detainees being given Removal Window notices.)



  • Medical Justice has successfully litigated twice on the definition of torture used in AAR in July 2019 and in Oct 2017 (media coverage including Channel 4 News and BBC News is here).
  • On 20th March the Home Office said that all immigration detainees will have their cases reviewed and underlying medical conditions increasing a person’s risk of severe illness following infection with COVID-19 will lead to them being treated as an Adult at Risk.
  • Medical Justice has clients continue to be detained despite having those underlying medical conditions, including asthma, diabetes, hypertension, and a range of mental health issues from anxiety, depression through to psychosis and schizophrenia.
  • The Medical Justice and Immigration Law Practitioner’s Association joint submission to the ICIBI on 25/02/19 is here.  And the accompanying set of case-studies of how AAR failed vulnerable clients is here.  The Medical Justice submission to the Home Affairs Committee 21st April 2020 is here.
  • Our “Failure to Protect” report catalogues how vulnerable detainees are failed by the AAR policy, including a section with case-studies.
  • We note that the ICIBI’s audit report on the Adults at Risk policy has sat on the Home Secretary’s desk since last July and is now published just hours after she has eventually given evidence to the Home Affairs Select Committee, meaning the committee members have no chance of questioning her on the report.


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