Medical Justice welcomes the Supreme Court’s decision to refuse the Home Office permission to appeal a ruling that its failure to consult with Medical Justice on changes to guidance for immigration detention caseworkers was unlawful.
Our judicial review challenged the Home Office’s ‘Second Opinion’ policy which allows it to disregard a medico-legal report from Medical Justice for a detained client while it seeks a second opinion from a doctor it contracts. There is no requirement for the Home Office doctor to ever actually meet the detained person or have any expertise in documenting deterioration of health in detention. In one case a second opinion report took weeks to be produced, during which time a detained person could deteriorate further in detention.
In January 2024 the High Court found that there had been an unlawful failure by the Home Office to consult Medical Justice regarding changes to its Adults at Risk Caseworker Guidance which lays out the Second Opinion policy. The Home Office appealed and in March 2025 the Court of Appeal upheld the High Court’s decision. The Home Office sought to appeal to the Supreme Court which was refused permission on 4th July 2025.
In most cases, the Home Office does consult NGOs on immigration detention policies, and when it does, Medical Justice has sometimes been able to secure improvements to policies, making them less harmful for thousands of detained people. The Home Office failed to consult on the Second Opinion policy (other than with their own contractors) and that closed the door to the possibility of improvements before it started having an impact on detained people.
This is an important victory for Medical Justice – we want to work constructively with the Home Office to improve policies for people held in detention, and for the Home Office to pay full attention to our expert evidence and analysis based on our clinical assessments of those who have already been severely harmed by its policies.
The courts, inquiries and inspection bodies have repeatedly found that vulnerable people have been subjected to inhuman and degrading treatment in UK immigration detention. The Home Office should be welcoming our input, not shutting the door on policy consultation.
Now the Home Office must consult us on its Adults at Risk policy, the door to policy improvements is permanently wedged open, potentially benefitting many thousands of detained people. Our lawyer said
“I am not aware of another NGO succeeding in a judicial review in establishing a duty to consult … certainly in the context of the immigration system. It is at least very rare, if not unique.”
We thank our very able lawyers – Jed Pennington at Wilsons who instructed Shu Shin Luh and Laura Profumo, who were led in the Court of Appeal and Supreme Court by Angus McCullough KC.
