HIV Migrants Detained and Denied

posted: 14/03/2011

UPDATED  4 April 2011

In their new report Detained and Denied: The clinical care of immigration detainees living with HIV, the charity Medical Justice produce evidence showing that their experience is that most HIV+ immigration detainees are denied HIV medication and care.

This study is the first ever comprehensive analysis of the UK's treatment of 35 HIV+ immigration detainees who were supported by Medical Justice. Eight independent expert clinicians assessed the detainees's health and needs, and there are also legal documents and testimonies from detainees.

Is HIV detention illegal? - Appeal Court will decide

The evidence in this report will be heard in the Court of Appeal in April when three HIV-positive migrants seek to have their detention ruled unlawful because of the centres' failure to treat them properly.

The key findings in Detained and Denied are :

• The British government treats HIV+ detainees’ health beneath contempt : 60% had breaks in their HIV treatment due to their detention, and many developed drug resistance. 77% were deported with little or no medication.
• The government may well have shortened detainees’ lives and prematurely orphaned children
• The process of detaining people who are HIV+ inherently puts them at risk
• The denial of medication has in some cases meant that detainees developed drug resistance, necessitating more complex drug combinations, which are rarely available in many countries
• The government is willing to deport people who may die within a few years as a consequence of that drug resistance.

Detained and Denied - Medical Justice report 

Chronic Indifference is a similar study, about the experience of HIV+ migrants who were detained and denied in the USA.

NAT (National AIDS Trust) points out that the Government has a special duty of care to people it detains. All detainees and prisioners are entitled to the same level of healthcare as is available to everyone else, particularly for a serious life-threatening condition like HIV.

Instead the report shows people with HIV are continuing to face unacceptable neglect. NAT worked with the British HIV Association (BHIVA - the professional association for HIV clinicians) to produce best practice advice on HIV treatment at Immigration Removal Centres precisely to prevent these problems. It is a disgrace that the advice is being ignored in so many cases.

Deborah Jack, Chief Executive of NAT (National AIDS Trust), said:

'NAT welcomes the important report from Medical Justice, 'Detained and Denied', on the treatment of people with HIV in immigration detention, and deplores the continuing failures in care. The NAT/BHIVA best practice advice is there to assist those responsible to provide equivalent high quality care to that available in the community - not to do so is inexcusable.

‘NAT has asked the UK Border Agency to work with us on a 12-month audit of every person with HIV who goes through the immigration detention process, to assess the quality of their care. We are still waiting for a response. The Medical Justice report underlines how urgent it is for such an audit to take place and concerted action to be implemented to address problems identified. We urge the Government to agree to the HIV audit as soon as possible.'

NAT call on the Government:
 

• To investigate the breaches of care outlined in the Medical Justice report 'Detained and Denied’
• In particular, to investigate the failures at Yarl's Wood and in advance of this and any resulting action, to immediately stop using Yrarl's Wood for detaining anyone with HIV
• To commission centrally healthcare in Immigration Removal Centres through the planned NHS Commissioning Board
• To agree to a 12-month collaborative audit with NAT of all those with HIV detained at any Immigration Removal Centre

Medical Justice Is Open

posted: 23/12/2010

During Christmas and New Year, (Thursday 23 December to Sunday 2 January, inclusive) Medical Justice staff will provide emergency cover of their phone, fax and email. Medical Justice campaign for decent healthcare for immigration detainees.
 

Contacting Medical Justice  over Christmas and New Year

Referrals

General inquiries
 

Phone      0207 561 7498
Fax           08450 529370

They may not be able to do very much and they ask people to only contact them for help where this cannot wait until they reopen for normal service on 3rd January.

They are very grateful to the doctors and lawyers who have very generously volunteered to support staff and detainees during the holiday period.

Medical Justice

Public Health Watch

posted: 29/10/2010

Updating of public health rules means public authorities in England and Wales have powers they can use against individuals with HIV to protect the public health from 'infection or contamination'. Magistrates can make compulsory public health orders (known as Part 2A orders) on people. Similar powers were used in Manchester against a man with HIV in 1985.

Late in 1985, just after Manchester AIDS-Line (later George House Trust) was set up with the help of a small grant from Manchester City Council, the same council used its public health powers backed by a magistrate. It compulsorily detained a man with HIV at Monsall Hospital. Major protests followed and, after a court case, he was freed to leave hospital a few days later.

This was the first and only time public health powers have been used against someone with HIV in this country. You can read more about this here.

New Health Protection Regulations

These old public health powers have now been updated in new Health Protection Regulations. Helpful guidance has been produced by the Department of Health on how to use (and not use) these powers.

This makes clear that in almost all cases using these powers to manage the risk of HIV or STI transmission would be inappropriate and should only be considered, if at all, in the most exceptional of circumstances.

HIV community and clinical organisations like BHIVA and BASHH oppose the use of these powers against people with HIV. They would cause more harm than good, damaging trust in STI and HIV clinic confidentiality, increasing HIV hate and discrimination, and would only ever be a short-term fix for someone with a life-long health condition.

More information

More information on the new public health powers and HIV can be found at the NAT website.
 

The official guidance makes clear that Part 2A orders 'are not a tool for managing long-term problems' and that the orders:

• are not meant in any way to change the current system and culture of confidentiality within sexual health services
• are not to be a routine part of managing those with HIV who present with evidence of ongoing unsafe sex (for example by presenting with repeated STI infection)
• are not generally appropriate for contact tracing
• could have harmful consequences for wider trust in sexual health services
• and that in the very exceptional circumstances where a Part 2A order might be considered, advice should be sought from the treating clinician and clinic director as to the possible consequences of such an order, and confidentiality must be respected at all times.

Even with this guidance, these powers could be misapplied to people with HIV or another sexually transmitted infection.

We, and NAT, are keen to hear about any attempts to coerce someone with HIV, through the use or threatened use of these powers. We do not expect the powers to be used, because the old powers were only used once against someone with HIV, 25 years ago, and have not been used again since. But it could happen. 

Department of Health: Health Protection legislation guidance 2010, laws and regulations

Court Action to End HIV Immigration Detention

posted: 31/08/2010

The campaign to end the locking up of people with HIV in Immigration Detention centres, like Yarls Wood, is now moving to the Court of Appeal.
 

This follows a judge’s decision to turn down three test cases heard at the High Court.
 

The Judge decided that the Home Secretary's policy that people who are "suffering from a serious medical condition" should not be in immigration detention except for very exceptional cases does not normally apply to people living with HIV. In particular, the judge decided that whilst HIV is  a serious medical condition, the three HIV+ claimants were not "suffering", because their HIV treatment was working well enough.
 

Detained almost three years
One of the three people has now been in immigration detention for close to three years, (since October 2007) and the other two, since November 2008 and August 2009.
 

The court summed up their case like this:
"Each of the three claimants is HIV positive. They have been subject to immigration detention. The length of detention in each of their cases is different. For each, the stage of their illness and the degree of symptoms associated with it has varied over time. What is common to each ... is that the management of their condition has been adversely affected by their detention and by the management failings by the Secretary of State and those operating immigration detention on her behalf. The effect of this ... has been to put their health in jeopardy in ways that could have serious long term consequences for their ability to survive in the United Kingdom or in their home countries when or if they are removed."
 

Judgement
The judge decided aginst the three people. "It almost goes without saying that the liberty of persons is jealously guarded by the courts. Thus, the courts will scrutinise closely immigration detention to ensure that it is in accordance with the legislative purpose and that, generally speaking, the Secretary of State complies punctiliously with her policy on the matter.
 

“At some point, the treatment of those with HIV status in immigration detention may be sufficiently mis-managed so that the person suffers and falls within paragraph 55.10 of the Enforcement and Immigration Guidance. That mis-management might also constitute a breach of ‘Hardial Singh’ principles, ….. , or of the standards laid down by the Strasbourg Court. In my view, however, on the facts of these cases those standards were not breached in relation to any of these claimants."
 

All three people are disappointed with the ruling and have told their solicitor to appeal the decision in the Appeal Court. The case is not likely to be considered by the Appeal Court for months.

The case is being dealt with by Louise Whitfield and Gareth Mitchell in PierceGlynn’s Public Law and Human Rights team.
 

Full High Court judgement is here
 

Unlawful HIV+ Migrants Detention

posted: 19/04/2010

Two people with HIV are claiming that the Home Office (and UK Border Agency) are illegally failing to provide them with adequate HIV treatment and care while they are held in detention for months. The same solicitors who took the Department of Health to courts for charging refused asylum seekers and other migrants for their HIV treatment, Pierce Glynn, are dealing with these two cases.

HIV+ migrants detention not ' very exceptional'

Home Office guidance says that someone with a serious medical condition (like HIV) should only be detained if there are “very exceptional circumstances.” Despite this, the Home Office has failed to justify detention of either person as ‘very exceptional’. Additionally, the standard of healthcare provided in immigration removal centres falls well below that which is essential for people with a serious condition such as HIV. For both people, during many months of detention, their HIV treatments have run out several times, and they have not been taken to appointments with their HIV consultant.

These two cases illustrate the concerns raised repeatedly by HIV organisations and HIV clinicians. These Judicial Review hearings should take place in the next two months.

Released after 8 months
In a related case, the same solicitors, Pierce Glynn, obtained the release of another HIV+ detainee who was held for eight months, again with no exceptional circumstances to justify this detention. After solicitors letters threatened a judicial review, the Home Office released the person. The solicitors are now suing the Home Office for damages due to the lengthy and unnecessary detention, and their failure to provide appropriate medical care.

Source