Seriously ill people released from immigration detention without crucial medication, senior doctors warn

Seriously ill people are being released from immigration detention without crucial medication as the Home Office insists on “rapid” discharge times, top doctors have warned.

Writing in the British Medical Journal (BMJ), a group of medical professionals states that current discharge requirements in removal centres are “clearly unsafe” and can result in detainees being at serious risk of relapse or deterioration following their release.

In one case, a detainee with serious and potentially life-threatening conditions was left without medication after discharge because no handover was arranged, while PTSD sufferers have seen their symptoms markedly worsen because arrangements have not been made for the continuation of their prescriptions, doctors said.

Unlike in prisons, where release dates are generally set in advance and where prisoners are required to be registered with a GP before their release, discharges in removal centres are ordered by the Home Office or the courts, usually without warning, leaving less time to prepare for their post-detention medical care.

The contract between the Home Office and removal centre management requires that released detainees depart within four hours of the department or the courts ordering a release, with centres that breach this contract risking a substantial fine.

This is likely to be a consequence of the Home Office’s desire to avoid accusations of unlawful detention, which cost the department £8.2m in compensation pay-outs last year.

The authors, who include the chair of the Medical Ethics Committee John Chisholm, called on the Home Office and NHS England to ensure existing contracts do not prevent doctors in removal centres from complying with their professional duties when discharging detainees.

They said formal complaints by former detainees about “unduly hasty or dangerous” discharge have elicited “dismissive” written responses insisting that doctors must adhere to Home Office requirements for rapid discharge.

In many cases, detainees needed prescribed drugs such as psychotropic, anti-epileptic or antiretroviral agents, and were at risk of relapse or deterioration when treatment was discontinued.

This can be exacerbated by the fact that released detainees may be vulnerable because of language difficulties, lack of knowledge about how UK healthcare systems work, or traumatisation by their experiences before or during detention.

One of the authors, Dr Frank Arnold, a forensic physician and member of the Medact Migrant Solidarity Group, said he had examined several former detainees who had been released with neither medication, nor a letter for a GP, nor any advice about how to register with one.

He said: “Two had been on treatment for PTSD, and reported that their symptoms became markedly worse before they were able to have the prescriptions re-filled; one had three distinct serious and potentially life-threatening conditions for which no handover was arranged.

“None of them spoke much English or understood their rights to NHS care. In some of these cases, doctors working in immigration removal centres have reminded the Home Office of the need to make arrangements for continuity of treatment. However, their pleas for safer processes appear to be falling on deaf ears. This is dangerous.”

New contracts for healthcare services in immigration removal centres are due from June 2020, which the authors said provided an opportunity for a “rethink” and the opportunity to review current discharge requirements.

A Home Office spokesperson said: “All immigration detention centres have trained medical staff on hand to provide medical care to those in detention. Where necessary, they are able to recommend further treatment at a hospital or other care centre.

“Those leaving detention have always been able to have at least a week’s worth of medication to help them after release.”