Health care for detainees

Abstract

Your Editorial, “Health care for prisoners and young offenders” (Feb 21, p 603)1The LancetHealth care for prisoners and young offenders.Lancet. 2009; 373: 603Summary Full Text Full Text PDF PubMed Scopus (9) Google Scholar describes recent Healthcare Commission (HCC) reports about the deplorable care of prisoners and young offenders in the UK. The situation of 25 000 people (including 2000 children2The LancetHealth care for children in UK detention centres.Lancet. 2008; 372: 1783Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar) subjected to administrative immigration detention annually is, if anything, worse.We and colleagues in the Medical Justice Network have examined and documented the medical conditions of more than 500 such detainees in the past 3 years. We have found: (a)Failure to examine, diagnose or refer serious disorders including tuberculosis, AIDS, epilepsy, sickle-cell crises, post-traumatic stress disorder, and psychoses.(b)Transfer to detention centres without medical notes or essential medication.(c)Unlawful failure to document blatant evidence of torture (which should usually prohibit detention3Anon Statutory instrument 2001 no 238: the detention centre rules 2001. Stationery Office, London2001http://www.opsi.gov.uk/SI/si2001/20010238.htmGoogle Scholar, 4UK Borders AgencyRule 35: reports of special illnesses and conditions (including claims of torture) received from immigration removal centres, regarding detainees.http://www.bia.homeoffice.gov.uk/sitecontent/documents/policyandlaw/asylumprocessguidance/detention/guidance/rule35reports.pdf?view=BinaryGoogle Scholar) and of assault by staff contracted to the Home Office.5Wistrich H Ginn E Arnold F Outsourcing abuse: the use and misuse of state-sanctioned force during the detention and removal of asylum seekers.http://www.medicaljustice.org.uk/images/stories/reports/outsourcing%20abuse.pdfGoogle ScholarMore than 75% of the people we have seen have been released shortly thereafter, suggesting that their original detention was inappropriate. In many cases compensation has been paid to them, at tax-payers' expense.Detention centre health care (unlike that in ordinary prisons) remains the responsibility of the Home Office, which has no known clinical competence. Most of the 10 UK immigration detention centres registered with the HCC in 2008, some 2 years later than promised by the then Immigration Minister.There is an urgent need for: (a)Transfer of responsibility for detainees' health care to the Department of Health.(b)Investigation of detention centres by the HCC or its successor.(c)An end to the detention of children.Signatories of this letter are: Frank Arnold, Miria Beeks, Jonathan Fluxman, Indrajit Ghosh, Charmian Goldwyn, Cornelius Katona, Nick Lessoff, Joseph O'Neill, Ben Robinson, Emily Spry, and Felicity de Zulueta. All of the signatories receive referrals through the Medical Justice Network; some of us are sometimes paid for medicolegal reports as a result. Your Editorial, “Health care for prisoners and young offenders” (Feb 21, p 603)1The LancetHealth care for prisoners and young offenders.Lancet. 2009; 373: 603Summary Full Text Full Text PDF PubMed Scopus (9) Google Scholar describes recent Healthcare Commission (HCC) reports about the deplorable care of prisoners and young offenders in the UK. The situation of 25 000 people (including 2000 children2The LancetHealth care for children in UK detention centres.Lancet. 2008; 372: 1783Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar) subjected to administrative immigration detention annually is, if anything, worse. We and colleagues in the Medical Justice Network have examined and documented the medical conditions of more than 500 such detainees in the past 3 years. We have found: (a)Failure to examine, diagnose or refer serious disorders including tuberculosis, AIDS, epilepsy, sickle-cell crises, post-traumatic stress disorder, and psychoses.(b)Transfer to detention centres without medical notes or essential medication.(c)Unlawful failure to document blatant evidence of torture (which should usually prohibit detention3Anon Statutory instrument 2001 no 238: the detention centre rules 2001. Stationery Office, London2001http://www.opsi.gov.uk/SI/si2001/20010238.htmGoogle Scholar, 4UK Borders AgencyRule 35: reports of special illnesses and conditions (including claims of torture) received from immigration removal centres, regarding detainees.http://www.bia.homeoffice.gov.uk/sitecontent/documents/policyandlaw/asylumprocessguidance/detention/guidance/rule35reports.pdf?view=BinaryGoogle Scholar) and of assault by staff contracted to the Home Office.5Wistrich H Ginn E Arnold F Outsourcing abuse: the use and misuse of state-sanctioned force during the detention and removal of asylum seekers.http://www.medicaljustice.org.uk/images/stories/reports/outsourcing%20abuse.pdfGoogle Scholar More than 75% of the people we have seen have been released shortly thereafter, suggesting that their original detention was inappropriate. In many cases compensation has been paid to them, at tax-payers' expense. Detention centre health care (unlike that in ordinary prisons) remains the responsibility of the Home Office, which has no known clinical competence. Most of the 10 UK immigration detention centres registered with the HCC in 2008, some 2 years later than promised by the then Immigration Minister. There is an urgent need for: (a)Transfer of responsibility for detainees' health care to the Department of Health.(b)Investigation of detention centres by the HCC or its successor.(c)An end to the detention of children. Signatories of this letter are: Frank Arnold, Miria Beeks, Jonathan Fluxman, Indrajit Ghosh, Charmian Goldwyn, Cornelius Katona, Nick Lessoff, Joseph O'Neill, Ben Robinson, Emily Spry, and Felicity de Zulueta. All of the signatories receive referrals through the Medical Justice Network; some of us are sometimes paid for medicolegal reports as a result.