New policy will focus on managing needs in detention rather than identifying people at increased risk of harm
Medical Justice has described Home Office plans to reform safeguards for vulnerable people in immigration detention as "shocking", warning that the changes would weaken existing protections rather than address longstanding failures in how the current system operates.
Image credit: WikipediaIn a statement issued on Tuesday, the charity said the changes "will inevitably lead to more vulnerable people being detained for longer periods, with an increased risk of harm, including harm that meets the threshold of inhuman and degrading treatment under Article 3."
As we reported on EIN in March, the Minister for Border Security and Asylum, Alex Norris, announced a major overhaul of the Adults at Risk in Immigration Detention policy in a letter to the Home Affairs Select Committee. The Home Office said the policy would be renamed the "Assessing Detention for Vulnerable People" policy and would move to an "evidence of needs" model focused on assessing whether a detainee's needs can be met in detention.
The Home Office also announced changes to Rule 35 of the Detention Centre Rules, which currently requires doctors in immigration removal centres (IRCs) to submit reports in three circumstances: where detention is likely to injuriously affect a person's health, where a detainee may have suicidal intentions, and where there are concerns a person may have been a victim of torture. The completion of a Rule 35 report triggers a review of detention by the Home Office.
Under the proposed reforms, there would be a single category of Rule 35 report and a report would only be required where, in the opinion of a medical practitioner, "a person's needs may not be met in detention".
Medical Justice said this would create "a far higher threshold" and encourage "a 'wait and see' approach leading to those at risk of harm in detention being left to deteriorate until such time as their needs become unmanageable in detention".
The charity linked its concerns to the High Court judgment in R (AH and IS) v Secretary of State for the Home Department [2025] EWHC 3269 (Admin), handed down in December. The Court found there had been a breach of the Article 3 "systems duty" in relation to the operation of Rule 35 at Brook House IRC between July 2023 and March 2024.
Medical Justice said the case reflected problems it had raised "for over 20 years", including the low number of Rule 35(1) and Rule 35(2) reports being completed and what it described as a disconnect between Rule 35 procedures and the Assessment Care in Detention and Teamwork (ACDT) process used to manage the risk of self-harm and suicide in detention.
The charity noted that both AH and IS had been placed on ACDT monitoring and "constant supervision" while detained at Brook House IRC, but neither had Rule 35(1) or Rule 35(2) reports completed.
Quoting from the judgment, Medical Justice highlighted Mrs Justice Jefford's finding that: "The statistics as to the numbers of Rule 35(1) and (2) reports speak for themselves particularly when compared with the numbers of ACDTs and constant supervisions. It is inconceivable that if the system were operating effectively, the numbers would be so low."
The charity also cited the judge's conclusion that there was "a clear and persistent picture of a failure of the system intended to protect Article 3 rights of adults at risk… characterised by a failure to apply properly or at all the provisions of Rule 35".
Medical Justice further noted that the Court found that "the system was capable of working effectively but was not working effectively." The charity added that despite the judgment, it continues to sees safeguards failings and there has been no significant change since the period when AH and IS were detained.
The statement also referred to the forthcoming inquest into the death of Théophile Kaliviotis at Brook House IRC in 2024, where lawyers for his family argued at a pre-inquest hearing that staff had failed to comply with Rule 35 procedures. Medical Justice additionally cited evidence given at the inquest into the death of Frank Ospina, who died by suicide at Colnbrook IRC in 2023. According to the charity, the Head of Healthcare said that if a Rule 35(2) report had been completed before his death, "then we wouldn't have had that outcome".
Medical Justice called on the Home Office to abandon the planned reforms and instead ensure that "existing safeguards are properly and effectively implemented, with a focus on preventing harm, rather than only responding once it has already occurred."