Release arrangements for immigration detainees are medically unsafe

Nearly two thirds of those held in Immigration Removal Centres (IRCs) are released into the community [1] and I would like to thank the authors of this piece for raising awareness of the serious obstacles to accessing ongoing care following release. The disruption to continuity of care has potentially grave and life threatening consequences.

The article recognises that a new contractual basis (service specifications) for primary care in IRCs will be introduced in 2020. Medical Justice, as the only NGO that regularly sends independent doctors into all IRCs in the UK to document medical evidence of past torture and instances of inadequate healthcare, has been involved in the consultation on this document over the last two years. In addition to input from our clinical experts, we organised, together with members of the group Freed Voices [2], a workshop to explore the views of people who had themselves experienced detention. The collaboration led to improvements which could have a positive impact on approximately 25,000 people held in immigration detention every year. It will be crucial to monitor performance indicators following the implementation of the new service specifications to ensure the expected improvements are realised.

The service specifications aim to ensure that all individuals leaving an establishment will get information about engaging with healthcare, including registering with a GP, post release. In addition, the newly established RECONNECT service was specifically set up to identify people with ongoing healthcare needs who require continuity of care. These individuals will be provided with a named RECONNECT worker who can assist with linking to appropriate community based services and clarify entitlement to care in the community. RECONNECT will be introduced in prisons and also in IRCs, starting with a pathfinder service in Yarl’s Wood IRC in 2020 aimed at establishing a template for wider roll out across IRCs.

Medical Justice is currently carrying out research on disruption of care caused by immigration detention and we hope this may contribute towards preventing some of the medically unsafe practices highlighted in this article.

Meanwhile, our volunteer clinicians continue to see instances of inadequate healthcare provision in IRCs and the failings of key safeguards, such as the Adults at Risk policy, are well documented [3]. The seriously deleterious effect of detention on health can never be adequately mitigated; the only way to protect detainees is, as advocated by the British Medical Association [4], to end this harmful practice once and for all.

1. Home Office Quarterly Immigration Statistics Q3 2019 ‘Detention Detailed Dataset’ https://www.gov.uk/government/statistical-data-sets/returns-and-detentio...
2. https://detentionaction.org.uk/freed-voices/
3. Medical Justice (2018) ‘Putting Adults at Risk’ http://www.medicaljustice.org.uk/wp-content/uploads/2018/09/Putting-Adul...
4. British Medical Association (2018) ‘Locked up, locked out: health and human rights in immigration detention’ https://www.bma.org.uk/-/media/files/pdfs/collective%20voice/policy%20re...