An audit of UK Border Agency (UKBA) officials’ responses to medical reports concerning vulnerable detainees, including torture survivors, demonstrates a frightening lack of care.
The UKBA report, Detention Centre Rule 35 Audit, ‘seeks’, in its own words, ‘to address the perception among some NGOs that the UK Border Agency fails to comply with … policy and detains thousands of torture victims every year’. The findings of the audit provide no comfort to critics and vindicate concerns that torture allegations are not taken seriously.
For years now, campaigners have argued that the UKBA does not follow its own policy whereby vulnerable people including torture survivors should not be detained. A 2006 test case exposed the routine failure of detention centre medical staff to screen new arrivals for signs of torture or physical and mental illness, as required by the immigration rules – because UKBA refused to pay them to do the screening. As a result, signs of torture were not being picked up and torture survivors were unlawfully being detained. Since then the issue of detention of torture victims has received more scrutiny. Both Medical Justice and the The Medical Foundation for the Care of Victims of Torture urged the UKBA to audit its procedures to see whether torture survivors were in fact being inappropriately detained. The UKBA audit was conducted a year ago but was only released on 1 March 2011.
The somewhat obscure title of the report refers not to the on-arrival screening duty (Rule 34 of the 2001 Detention Centre rules), but to Rule 35, which imposes duties on medical staff to report to managers whenever they become aware of detainees whose health is likely to be affected badly by detention, including those suspected of having suicidal intentions, as well as on persons who may have been victims of torture. Under the rule, managers of detention centres must send copies of ‘Rule 35’ medical reports to the UKBA ‘without delay’. In practice, medical staff give a copy of Rule 35 reports to on-site UKBA staff, who are required by Detention Services Order 03/2008 to send it on within 24 hours to the detainee’s ‘case owner’ with responsibility for the decision to detain, who must review the person’s detention within 48 hours. Clearly, the purpose of the exercise is to remove extremely vulnerable people from the harmful environment of detention as quickly as possible.
The audit looked at all the cases in November and December 2009 when a Rule 35 report was submitted to UKBA, to see whether UKBA officials responded promptly and appropriately. It found that in only 35 per cent of cases did UKBA officials respond within the 48-hour time limit.
It is unclear whether all Rule 35 reports were examined or just those where torture was alleged: the executive summary suggests that all cases where medical staff reported on the health of detainees were included, while the text of the audit suggests that it was limited to allegations of torture. In any event, during the two months covered by the audit, a total of 216 Rule 35 reports were received, in respect of 190 detainees (out of the total of 6,666 people who were detained during the period). In only sixty-seven cases (35 per cent) did UKBA staff respond within the required 48-hour period, and in one-third of the cases ‘case owners’ failed to respond to the medical report. The audit states that in all but ten cases, there was evidence from the case file that the allegation of torture had been taken into account, although there had been no formal response, but it is not clear how – in particular, whether there was a detention review.
This is bad enough, indicating as it does a fairly devastating failure on the part of UKBA officials to respond promptly to serious medical concerns – but the most shocking findings are left until last. The review of detention resulted in release in only 9 per cent of the cases; in the other 91 per cent of cases, the information contained in the Rule 35 report made no difference to the decision to detain. We are given no explanation whatever for this extraordinary finding, which suggests that case owners are simply disregarding medical evidence – after all, they are not medically qualified – or that they are not applying policy which states that torture survivors and those for whom detention carries unacceptable risks should not be detained. The other shocking statistic is that only twenty-six of individuals subject to a Rule 35 report – 14 per cent – were granted any form of status, whether refugee status or humanitarian or discretionary leave, while ninety – 47 per cent – were refused and removed, and another seventy-four – 39 per cent – were refused or claims are still ongoing.
These latter findings go to the heart of UKBA decision-making. They suggest that case owners are either provided with inadequate medical information, or that they are simply not equipped to take vital decisions about the detention of asylum claimants or about the strength of their claims. But the report fails to discuss the implications of its own findings. It is full of management-speak about ‘improving communications across business areas to drive up performance’, ‘sampling and data quality checks’, arranging ‘roll-out of improved recording and monitoring systems’. With this kind of language, it is perhaps not surprising that elementary human truths are lost. Nowhere does the report ask: Do the medical reports provide enough information for case owners? What is the quality of the information provided? Or is it that case owners have no understanding of the reports they read? Why do those responsible for people in detention appear not to care about their welfare, even where there is evidence that they have been tortured? The audit demonstrates that the business model of performance indicators and box-ticking is fundamentally flawed when it comes to dealing with damaged and vulnerable people. The meaning of torture, the experience of asylum seekers, the inhumanity of current detention practices – all these the audit signally fails to address.
Since the audit was carried out, things have got even worse, according to Medical Justice, which points out that the latest HM Inspector of Prisons report on Colnbrook detention centre (August 2010) noted that of 125 Rule 35 reports UKBA had received, only sixty-one had been replied to (49 per cent). HMIP reports: ‘The paucity of information provided by health services staff gave case owners little reason to consider release and most replies were equally brief and unhelpful.’
In a statement, Medical Justice expressed its bitter disappointment with the audit, which it says ‘fails miserably and is symbolic of UKBA’s lack of commitment to safeguarding vulnerable detainees’. The organisation intends to lodge a complaint about the inadequacy of the audit and to demand disclosure of the raw data on which the audit was based. According to Medical Justice’s Clinical Advisor, Dr Frank Arnold, they ‘regularly see the outcome of Rule 35 failures; torture survivors and people with serious medical and psychiatric conditions who are routinely and inappropriately detained. Many people fleeing from regimes our government says it abhors are routinely subjected to being wrongfully and harmfully detained each year.’
Read the 2001 Detention Centre rules here
Download a copy of the Detention Centre Rule 35 Audit report here (pdf file, 180kb)