Intended for healthcare professionals


Transferring healthcare for immigration detainees in England to the NHS

BMJ 2013; 346 doi: (Published 22 March 2013) Cite this as: BMJ 2013;346:f1884
  1. Hilary Pickles, public health adviser ,
  2. Naomi Hartree, medical adviser
  1. Hilary.pickles{at}

Should improve services, particularly for those with mental illness

Of the organisational changes that will come into force on 1 April 2013, one is most welcome. The NHS in England will become responsible for the healthcare of people detained in all immigration removal centres. This change could improve services for a vulnerable group of patients. Until now, healthcare provision for those detained under the Immigration Act has mostly been provided by private companies contracted to the UK Border Agency—in effect, a backwater of publicly funded healthcare that many would describe as failing. From April, the NHS Commissioning Board becomes responsible for the contracts, alongside those for healthcare in prisons. This has been a long time coming.

Asylum seekers and “irregular” migrants (those without a valid visa) can be held in immigration removal centres indefinitely while their cases are determined. For asylum seekers, this may occur at any stage of the asylum process, but mostly at the start (if claims are “fast tracked”) or at the end (if the asylum claim has been refused). The number of places for detainees has increased in the past two decades from 250 in 1993 to more than 3200. Private companies run …

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