Many detainees shouldn’t be there in the first placeBMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2365 (Published 16 April 2013) Cite this as: BMJ 2013;346:f2365
I welcome the transfer of healthcare from the UK Border Agency to the NHS in immigration removal centres.1 I am a retired GP and have been visiting such centres as a volunteer doctor for the past six years. I have been involved with more than 370 asylum seekers, 306 of them in immigration removal centres, and at least 180 of these detainees had medical problems that were not being properly dealt with by the healthcare centres.
Many of the detainees tell me that the medical staff do not believe them when they consult with serious symptoms. Examples include, headaches in someone later admitted with meningitis; haemoptysis in a patient previously diagnosed with tuberculosis; and blood pressure, asthma, and diabetes out of control. Some detainees fear that the medical staff are “in league” with the UK Border Agency and determined to pronounce them “fit to fly,” despite being very sick or in the middle of treatment.
Asylum seekers who have been tortured in their home country are so terrified of return that they seriously self harm—cutting themselves, attempting suicide, refusing food. They have limited access to psychiatric help despite such profound despair.
The medical care of these extremely vulnerable people deserves to be a specialty on its own, with healthcare providers receiving specialist training on these patients’ medical and psychological needs.
However, it would be infinitely better if these people were not imprisoned in the first place, especially as many are eventually released back into the community. A study by South Bank University, London, concluded that at most 8-9% of asylum seekers who get bail (after being released from an immigration removal centre) subsequently attempted to evade the asylum system.2 It seems extreme to incarcerate people who are very sick, have mental health problems, or are in wheelchairs.
Cite this as: BMJ 2013;346:f2365