The BMA has reiterated calls for the abolition of indefinite detention and IRCs (immigration removal centres), warning of the deleterious effect they have on health.

The Government has been urged to take steps towards phasing out and replacing IRCs and adopting a humane approach for responding to asylum seekers and migrants’ needs, a meeting at the BMA has heard.

The event, which took place at BMA House and was organised in conjunction with the charity Medical Justice, sought to examine the lessons learnt from the inquiry into failings of care at Brook House IRC.

The inquiry, which was launched in 2019 and published its findings last September, identified 19 incidents showing credible evidence of mistreatment of people detained at Brook House.

The report also highlighted a range of other concerns including a failure by staff to understand or to follow rules around safeguarding of vulnerable individuals and, among healthcare staff, to act in the best interests of their patients.

Vulnerable people

The inquiry’s findings echo many of the warnings outlined in the BMA’s 2017 report into health in detention centres Locked up, Locked out which sought to provide guidance to doctors, while warning that staff working in IRCs often saw their clinical independence being challenged.

Speaking at the event, association international committee deputy chair John Chisholm said the BMA believed IRCs should ultimately be abolished adding the Government’s policy of indefinite detention was often hugely damaging to the health and wellbeing of incredibly vulnerable people.

He added that, until the use of IRCs was abolished, the Government had to meet its obligation to ensure standards of care delivered in detention settings were equivalent to those found in the community.

He said: ‘The BMA believes that immigration detention should be a measure of last resort and should only ever be contemplated when an individual poses a threat to public order or safety. We believe that immigration detention should be phased out and abolished it should be replaced with an alternative more humanely means of monitoring.’

‘Indefinite detention exacerbates vulnerability and causes deterioration in physical and mental health, and we have policy from our BMA annual policy making meeting, deploring the inhumane conditions which migrants suffer when imprisoned in detention centres, calling for an end to indefinite detention and calling to for the closure of detention centres.’

He added: ‘Detainees should have full access to high-quality health care, and we’ve heard this evening how that very much is not the case currently.

‘In my view, the current arrangements which continue as part of a deliberate policy of hostility to immigrants, refugees and asylum seekers are a national disgrace. Our country is demeaned by this affront to justice, fairness or human rights and we must continue to lobby, advocate and campaign for change and to rid our country of this performative cruelty.’

BBC investigation

Concerns over abuse and mistreatment of people held at Brook House uncovered by a BBC investigation in 2017, led to a judicial review and a subsequent inquiry.

Last month’s joint event heard from numerous speakers, including inquiry chair Kate Eves, GP and clinical adviser to Medical Justice Rachel Bingham and mental health and learning disability nurse practitioner Dr Brodie Paterson.

Dr Bingham told the event that, while the inquiries’ findings into the failures of care at Brook House were damning, they were sadly not unique nor something that could simply be confined to the past.

She said: ‘[The] catastrophic failures in 2017 were not because the safeguards themselves were poor, but because there was too often a widespread disregard and lack of understanding of how to implement them. Unfortunately, our data shows that this continues today.

‘Home office rules specify that every person [entering detention] would receive a physical and mental examination within 24 hours, which should identify those at risk. Medical Justice recently audited the files of 66 clients in the last year, who'd had significant mental health issues in detention.

‘Of those 66, only 37 had had an appointment with the doctor within 24 hours for the others, the waiting times went up to two months, and three were not seen by a doctor at all while detained.’

Injury threat

Dr Paterson said that the lessons from Brook House demonstrated how not ensuring adequate resources, training and ethical infrastructure in such settings would ultimately result in such services failing and vulnerable people getting hurt.

Meanwhile inquiry chair Ms Eves said that one of the issues identified by her report was that doctors working within removal centres often found their professional obligations to be at odds with the approach being taken by other IRC staff and the Government.

She said: ‘One of the recommendations that I made in was the need for [medical] professionals to be really clear about what their obligations are as registered clinicians, and that they’re not there at the behest of the home office to rubber stamp certain actions, they’re there as clinicians.’