Written evidence submitted by Dr. Frank Arnold, Prof. Cornelius Katona and
Prof. Jason Payne-James (COR0114)
As independent doctors working with a variety of NGOs, in January 2020, we published our concerns (1) about medical problems faced by migrants undergoing and after release from administrative detention in Immigration Removal Centres (IRCs) and in prisons. These include both asylum seekers awaiting resolution of their asylum claim or removal, and foreign national ex-prisoners held after the completion of their sentences, whom the Home Office intends to deport.
The COVID-19 pandemic has greatly exacerbated these difficulties.
Custodial environments are known to be environments in which COVID-19 is liable to spread rapidly – with implications both for the health of the individuals so detained and for the public health. Though this needs to be balanced against the risks and problems of release, the issues are very different where the detention is for administrative reasons rather than punishment, rehabilitation, deterrence or retribution (as is the case for people serving a prison sentence).
There is a marked scarcity of publicly available information about the effectiveness of government policies and practices in reducing the risks and harms created by COVID-19 in custodial environments in general and in IRCs in particular.
We recommend a series of questions whose answers might help the Committee to formulate its views.
These may appear confusing because the procedures and rights that apply to ex- foreign national prisoners held under immigration powers differ according to whether they are in prison or a detention centre; these differ again from those applying to prisoners serving a sentence (whether British or foreign); and those which apply to other detainees differ yet again.
People held under immigration powers after completion of sentence in prisons (ex-FNPs in prison)
A1) How many ex-FNPs are currently held in prison?
A2) How many have i. been released and ii. transferred to IRCs since 24/03/2020?
B) Access to communications:
On 20/03/2020, the Council of Europe’s Committee for the Prevention of Torture published principles for custodial practice in the context of COVID-19 (2) stating:
“Protective measures must never result in inhuman or degrading treatment of persons deprived of their liberty….the fundamental rights of detained persons during the pandemic must be fully respected…..any restrictions on contact with the outside world, including visits,
should be compensated for by increased access to alternative means of communication (such as telephone or Voice-over Internet-Protocol communication).”
Before the pandemic, the government had experimented with controlled in-cell telephony and was reported to be planning expansion of the programme. Since the decision to lock down prison visits, the government has committed to increasing in-cell phones.
B1) How many ex-FNPs in prison had access to telephones in their cells as of January 1, 2020 and as of May 1, 2020?
B2) Of those prisoners who do not have such access, how much time are they allowed per week on prisoners’ shared phones?
B3) Have they, their families and their lawyers raised concerns about the sufficiency of current measures for telephone communications, including time, cost, privacy, or safety of distancing and disinfection measures in getting to and using the phones?
C) Risk assessment:
Rule 21 of the prison rules requires that prison doctors “shall report to the governor on the case of any prisoner whose health is likely to be injuriously affected by continued imprisonment or any conditions of imprisonment. The governor shall send the report to the Secretary of State without delay, together with his own recommendations.”
C1) How many “Rule 21” reports have been received by the SoS from prisons regarding vulnerability of ex-FNPs in prison since March 24, 2020? Of these how many referred to COVID-19-related risks?
C2) What risk assessment has been implemented to evaluate COVID-19-related risk in people held under immigration powers in prison?
C3) How many such prisoners have been released?
People held under immigration powers after completion of sentence in immigration detention (ex-FNPs)
D) Numbers of ex-FNPs in IRCs:
D1) How many ex-FNPs are currently held in IRCs?
D2) How many ex-FNPs have been released from IRCs since March 24, 2020?
D3) How many ex-FNPs have been transferred from prison to IRCs since March 24, 2020?
D4) What procedures have been put in place to consider alternatives to IRC detention for such ex-FNPs?
E) Medical evidence of vulnerability from healthcare providers
In assessing medical risks of maintaining detention, the Home Office relies on reports supplied by IRC healthcare using IS91 RA Part C forms. Unlike Rule 35 reports, copies of these are often not present in the medical notes, nor is a copy usually given to the detainee or their legal representative. In short, confidential medical information about patients is being sent by clinicians to a state authority without the patient’s knowledge or consent. When this happens, errors or ambiguities in them are not available to challenge.
E1) What risk assessment has been implemented to evaluate COVID-19-related risk in ex-FNPs held under immigration powers in IRCs?
E2) How many such ex-FNPs have been released?
E3) Will the Secretary of State agree to provide to detainees and their representatives copies of all and any IS91 RA part C reports written by healthcare staff about detainees, to rectify this violation of patients’ rights?
People other than ex-FNPs currently held in detention and/or released from immigration detention since March 2020:
F1) How many detainees in total have been released since 24/03/2020?
F2) How many are still held in detention?
F3) How many people (other than ex-FNPs) have been admitted to detention since 24/03/2020?
F4) What procedures have been put in place to consider alternatives to IRC detention for those still held and/or newly admitted into detention?
G1) Given the impracticality of reporting in person, what means is the HO using to maintain contact with people released from detention as a result of the COVID-19 pandemic?
G2) What proportion of ex-detainees are maintaining the requisite contact?
G3) How many of these people were tested before release for COVID-19 infection, and according to what protocol?
G4) Is it known whether any have shown signs indicative of the illness since release?
G5) Is there a mechanism for tracing in place for their contacts which is wholly separate from immigration enforcement?
H1) How many ex-detainees have been offered accommodation on release?
H2) Is the Secretary of State satisfied that those people who have been released are now in circumstances where it is possible to achieve social distancing while accessing the necessities of life?
NHS England (Health and Justice Commissioning) has established the Reconnect programme to ensure that people released from custody are enabled to register with GPs and to obtain continuity of care.
I1) How many detainees released since 26/03/2020 were given assistance through the H+J Reconnect programme to register with GPs and gain access to repeats of needed prescriptions?
I2) If no such arrangements have been made heretofore, will the Home Office commit to working with NHS England, to require IRC healthcare providers to review their electronic patient prescription records to identify those who may be at high risk of harm through lack of medication after release and take steps to ensure that this problem is prevented or minimised?
Our affiliations include those cited in reference 1 below. However, we make the present submission in our personal capacities.
1) Arnold FW, Chisholm J, Cohen J, Katona C, Payne-James J. Release arrangements for immigration detainees are medically unsafe. British Medical Journal 2020; 368 (Published 13 January 2020)
2) European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment. Statement of principles relating to the treatment of persons deprived of their liberty
in the context of the coronavirus disease (COVID-19) pandemic