BMA concerned that health needs of migrants and asylum seekers cannot be met in detention centres
A comprehensive new report published yesterday by the British Medical Association (BMA) says detention for immigration purposes should be a measure of 'last resort' and should be phased out.
The 88-page report, Locked up, locked out: health and human rights in immigration detention, can be downloaded here. The report is intended to provide guidance for doctors and practitioners working in immigration removal centres, and also aims to help inform the decisions of government and policy-makers that affect the care and treatment of individuals in immigration detention.
The BMA says in the report: "In our view, the detention of people who have not been convicted of a criminal offence should be a measure of last resort. Detention should be reserved for individuals who pose a threat to public order or safety. Ultimately, we believe that the use of detention should be phased out and replaced with alternate more humane means of monitoring individuals facing removal from the UK.
"As long as the practice continues, however, we believe that there should be a clear limit on the length of time that people can be held in detention, with a presumption that they are held for the shortest possible time. The state must also meet its obligations to those it detains: detained individuals should not experience infringements of their health-related rights and must be able to access high-quality healthcare, commensurate with their needs. Where doctors are unable to meet their obligations to patients, systems and processes must be scrutinised and restructured. These principles underpin this report."
Mental health in immigration detention forms a key part of the report, and the BMA warns that the environment of an immigration detention centre can worsen or contribute to mental illness. Many of those detained are highly vulnerable and some have been victims of torture.
The BMA says the fact that the UK has no time limit on immigration detention is a key cause of distress and anxiety. One detainee is quoted as saying: "It is the worst part of it as you don't know when/if you will get out. You can't say to yourself tomorrow I'll be OK. Tomorrow you will be locked in, or flown back to the country where you are afraid for your life"
The report states: "Evidence of the impact of detention on mental health and wellbeing warrants careful consideration by the Home Office. If the detention environment cannot adequately protect the needs and interests of those held within it, there should be a serious reconsideration of current policy and practice."
The report also covers the challenges doctors face when providing healthcare in detention settings.
Dr John Chisholm, BMA medical ethics committee chair, said: "Healthcare is one part of the wider practice of immigration detention, but a part that is fundamental to the state meeting its obligations to those detained. Migrants and asylum-seekers shouldn't have their health-related human rights infringed and must be able to access healthcare adequate for their needs.
"The BMA hopes to work with policy-makers and other organisations to restructure and develop policies that meet the health needs of people in detention and ensure doctors can meet their ethical and professional obligations. A fundamental rethink of current policies is required."
In the report, the BMA makes the following five recommendations:
1. Revise detention policies to address the significant health effects indeterminate detention can have on individuals.
2. Address aspects of the detention environment which affect the health and wellbeing of those detained.
3. Reconfigure current healthcare provision to better achieve equivalence of care.
4. Provide training and continued support in health and wellbeing issues for all those working with detained individuals.
5. Recognise the importance of doctors acting with complete clinical independence and ensure that that principle is enshrined and respected across the immigration detention estate.