Asylum Detention Challenges

posted: 23/03/2010

The harsh treatment faced by detained women and children seeking asylum - including women and children with HIV - who are held at Yarl’s Wood will now be closely considered by both the High Court and the British Medical Association.
 

Three Human Rights Abused
"Lawyers have been granted permission to challenge the government's detention policy, which they claim amounts to "cruel, inhumane and degrading" treatment of women and children.

The High Court has given the go-ahead for a judicial review of the cases of four women held at the Yarl’s Wood detention centre after lawyers claimed their treatment breaches articles three, five and eight of the European convention on human rights. This comes very soon after many women have ended a 5 week hunger strike in protest at the conditions and their treatment.

Jim Duffy, a solicitor at Public Interest Lawyers, which is bringing the case, welcomed the decision. "The case confronts the policy and practice of the Home Office and the private company running Yarls Wood, Serco."
 

Three Yarl's Wood doctors investigated
Three doctors working at Yarl's Wood immigration detention centre are facing investigation by the General Medical Council, amid calls for healthcare at the centre to be transferred from the private sector to the NHS. Alistair Burt, Tory MP for North East Bedfordshire, (containing Yarl’s Wood) described healthcare as the weak link and that this weakness can only be ended by transferring healthcare to the NHS.
 

As he points out: "If there is an issue over fitness to travel and the decision is made by a contracted company inside Yarl's Wood, what chance is there of having confidence that it has not been influenced by the contract given to the contractors to get people out of the country?"

More details from Medical Justice 1 and Medical Justice 2 and Medical Justice 3
 
 

Asylum Applications Falling

posted: 27/11/2009

The latest asylum figures show a further fall in the number of fresh claims for refugee status between July and September this year, to 5,055 – a decline of 24%, compared with the same period in 2008.
 

Refugee welfare groups said the fall in asylum numbers raised fears that the tightening up of Britain's borders was denying sanctuary to those who needed protection. The top three countries from where asylum seekers came were Afghanistan (790), Iran (540) and Zimbabwe (525).
 

Immigration detention for asylum and children
A total of 7,110 people were held in immigration detention between July and September this year – more than half of them asylum seekers. They included 315 children, 240 of them under 11. Of those detained, 365 had been held for more than 12 months.
 

More leaving
Net migration – the number of people who come to live in Britain minus the number who move abroad – fell by more than a third to 163,000 last year, its lowest level since Poland joined the European Union.
 

The Office for National Statistics said the fall from 233,000 in 2007 was mainly driven by a rise in emigration to a 17-year high: 427,000 people left Britain to live abroad, up from 341,000 the previous year. The increase was mainly due to the number of Poles returning home.
 

Immigration reached 590,000, with the largest single group comprising 85,000 British citizens returning to live in the UK. That total compares with 574,000 in 2007 and 596,000 in 2006.
 

The level of emigration is the highest since 1991, the first year with comparable records. The ONS said there had been a large increase in the number of people emigrating for work-related reasons, particularly those with a fixed job to go to. The number going to a definite job rose from 100,000 in 2007 to 136,000.
 

Source
 

image              Refugee Week was in mid June.

Investigate HIV and Immigration Detention

posted: 20/11/2009

Medical Justice want a volunteer researcher for its Investigation into the treatment of people with HIV in detention. They want to produce a report that

• Explores the healthcare available for detainees with HIV
• Analyses the experiences of detainees with HIV
• Investigates whether the guidelines for treating detainees with HIV work.

Detailed case studies based on the experiences of detainees and ex-detainees with HIV will be used including examples from Medical Justice.

Apply by       24th November 2009
Interviews     1st December 2009
Job details     Role description, person specification, and application details from Medical Justice

About Medical Justice
Medical Justice is a network of volunteers who expose and challenge medical abuse in immigration detention. Their volunteers include ex-detainees, doctors, lawyers and other experts. They have no formal funding and no paid staff; they rely on private donations and unpaid work by members. Medical Justice is not a charity, nor is it government-funded.
 

Some people with HIV recently helped by Medical Justice
Three of four women who had been receiving anti-retroviral drugs in the community, had an unplanned disruption to their treatment in detention, because of problems in arranging appropriate and timely hospital care. Some detainees were not given the results of their positive HIV test until taken to the airport for deportation. Some rape survivors have been denied an HIV test.

Medical Justice 86 Durham Road London N7 7DT           0207 561 7498         email
 

Hospital Detention for HIV

posted: 07/09/2009

How many people now remember that 24 years ago a Manchester gay man with HIV was locked up for 10 days in the  hospital by order of the city's Magistrates, just because he had AIDS?

It has never happened since in this country, but HIV lock-ups often happen in Sweden, and might even happen once again in this country, if Parliament allows the Department of Health and the Health Protection Agency to get their way.

The government is consulting on changing the infectious diseases regulations which could allow it to force people into hospital isolation wards and more, if they have infectious diseases. The deadline for comments on the proposed rules is at the end of this month.

We are campaigning to make sure people living with HIV cannot be touched by any updated public health law and regulations.

What happened almost 25 years ago in Manchester?
There is a very brief mention in our history page for 1985,  but it was an event that rocketed Manchester and HIV onto the front page of the papers locally and nationally. Manchester AIDS-line, which became George House Trust, was closely involved and (now Councillor) Paul Fairweather, a gay rights worker at the former Gay Centre in Bloom Street, was in the thick of the campaigning. There were pickets outside the Town Hall and the old Monsall Isolation Hospital, and a national demonstration was held here. We’ve never forgotten it, and at Secrets and Lives, Cllr Paul Fairweather reminded our audience about it.

Old files and papers

We've dusted off old files and the papers to find out exactly what happened and tell the story again here. We’ll be reminding the government that they didn’t get away with discriminating against people with HIV in 1985, and shouldn’t even be thinking of making laws and regulations that would allow this again today.

What was it like in 1985?
It’s a bygone age in UK HIV history. For a start no-one talked about HIV - if people ever talked about the virus, they called it HTLV3. There were no tests available at clinics for it in Manchester, only in London.

There were only two people known to have AIDS in the city, and both gay men were ill in Monsall Hospital. In the whole of the UK there were only 100 people, gay men and haemophiliacs, with AIDS at the start of 1985. Now there are over 70,000 with HIV.

We knew the virus was sexually transmitted but not how exactly - so oral sex was thought to be high risk, as well as anal and vaginal sex. The connection between the virus and AIDS wasn’t properly understood. Gay men were struggling to get to grips with the idea of using condoms.

Hysteria and Panic

It was at the height of AIDS hysteria, but the first public campaign - the tombstone and leaflet campaign warning Don’t Die of AIDS - didn’t start until the following year, 1986.

In the UK press, AIDS was in the headlines and caused alarm. In most newspapers such as the Sun and Manchester Evening News, and on radio stations (Piccadilly Radio - now Key 103 and Magic), the prejudice was obvious.

Haemophiliacs were "innocent victims," whereas gay men and injecting drug-users brought it upon themselves. Firemen banned the kiss of life, and holiday makers cut short cruises on the QE2 for fear of getting AIDS from a passenger. A 9-year old haemophiliac was allowed to go to school, but some parents kept kids away. Actor Rock Hudson died of AIDS in the first days of October. He was the first major public figure known to die of AIDS. Almost as much of a shock to most people was to discover such a butch film star was gay.

Swirling in a cesspit of our own making - Manchester Chief Constable

And the Chief Constable of Greater Manchester Police, James Anderton, preached that gay men were "swirling about in a human cesspit of their own making". Gay papers, like Capital Gay and Mancunian Gay, provided the most accurate news and information.
 

Can I go home please, just for the weekend?

One of the two men in Monsall Hospital decided in the middle of September 1985 that he wanted a weekend break from hospital, to go to his home in South Manchester, where he would be looked after by his friends and family, and then he’d go back in the hospital. He asked his doctor if he could do this one Saturday morning. The doctor refused. In fact the doctor couldn’t stop him leaving the hospital and knew this, but didn’t tell the man.

Whirlwind of events that Saturday

A whirlwind of events followed that Saturday. We don’t know why, but the doctor panicked. He called the Council’s medical officer and asked her to stop him leaving the hospital. She called the Chair of the Environmental Services Committee, who authorised the making of an emergency application to the Magistrates Court.

The City Solicitor was called in and a special sitting of the Magistrates was held. The Magistrates, in open court, granted an Order for 3 weeks detention in the hospital, named him and said it was to protect the public from AIDS.

The hostile local press and independent radio were tipped off and his name and the details were broadcast and published - including in the national press.

The man has no idea any of this is going on behind his back, until he was presented with the Court Order.

10 days detained by Court Order

He spent the next 10 days in compulsory detention at hospital before he and his friends could get a solicitor and the Crown Court could review the decision. No doubt the stress added to his health problems.

Outrage and Uproar

Meanwhile absolute uproar broke out in the city’s gay community. The Council had already promised to do what it could to dampen down AIDS hysteria. But here was the council using the courts in a way which just poured petrol on the flames of that hysteria. The Public Health (infectious Diseases) Act had been rushed through Parliament only in the summer of the year before (1984) and in February of 1985, AIDS was quickly added to the official list of infectious diseases. Now the Council was using that panic list and law to detain a gay man who posed no health threat to anyone.

There were demonstrations and pickets outside the hospital and Town Hall.

Crown Court frees man

The Crown Court decided to approve the application by the man's solicitor for the order to be withdrawn 'by consent.' The man was spared the rest of the 11 days of forcible detention.

Withdrawal ‘by consent’ means the Council didn't attempt to defend its application, and it could not have produced a shred of evidence to justify the man's continued detention, because legally it was indefensible - he was no health risk to anyone.

A city behaving badly - but then it promises: never again
The city’s gay men’s consultative committee demanded the city council promise never to use the law again, and to campaign for its repeal. The vote was tight, but it agreed not to use the law again.

All involved - hospital doctor, city health officer, chair of social services, city solicitor, magistrates clerk, magistrates, the radio and press, all behaved badly. They had no legal power to act as they did in the circumstances and all were swept up in the panic and power-rush of taking emergency action. Nobody stopped to think and ask questions. No-one told the man in Monsall. He had no solicitor to say the law doesn’t allow you to do this to me.

Why are we concerned now?
In Sweden a man with HIV was ordered to be detained and isolated under their public health laws for an incredible seven years. Detention and isolation happens to quite a number of people with HIV in Sweden. Fortunately the European Court of Human Rights said in 2005 that this is illegal and breaches people's human rights under Article 5.

They ruled that detention for HIV always has to be a last resort, after everything else has been tried and has failed to prevent the person from passing it on. We don't think that judgement goes far enough - after all the criminal law can be used against reckless sexual transmission of HIV and that's more than enough protection for public health. But at least the European Court has drawn a useful line in the sand to protect people with HIV from unreasonable detention on health grounds.

There are some infectious diseases that are passed on easily by day to day contact. If they are serious - for example multiple drug-resistant TB - then there is a case for using the law to prevent its spread and protect the public, but only if the person doesn’t agree to temporary isolation for treatment, until they are no longer a risk to others.

Why are Sexually Transmitted Infections even on the list of infectious diseases?

Sexually Transmitted Infections (STIs) are not public health hazards like drug-resistant TB. HIV and other sexually transmitted infections aren’t passed on by touching, sneezing and the like. People need to have sex with the person and even then the risk of HIV transmission is pretty low. We think there is no case at all for any STI to be included in public health powers in the 21st century in the UK.

HIV - we take action and we fight back

The government seems not to have learnt anything from Manchester's shameful behaviour in 1985 - you mess with people with HIV at your peril. We won’t stand for it again. We take action and we fight back. And we hope Manchester City Council will now do as it was asked 24 years ago and campaign to remove any possibility of this happening again under public health laws and regulations. 

Here’s a full transcript of the 1985 reports in Mancunian Gay - written by the campaigners in the thick of the action. You can see this for yourself, along with other papers in the local history collection, in Manchester central library, St Peter’s Square.

The European Court of Human Rights judgment Enhorn v Sweden 2005

A useful article on the Enhorn v Sweden and its application to UK Public Health law and the detention of people living with HIV 

[Medical Law Review 2006 14(1):132-143; doi:10.1093/medlaw/fwi038
© The Author [2005]. Published by Oxford University Press; all rights reserved.
The online version of this article is published under open access. Users are entitled to disseminate etc. this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given.]
 

Using HIV Detention and Removal Guidelines

posted: 01/09/2009

Advice on how to make full use of the NAT-British HIV Association (BHIVA) new guidelines on 'Detention, Removal and People Living with HIV' has been circulated by Medical Justice. Migrants living with HIV should not be removed if this breaks these guidelines. Using the guidelines has halted some recent removal attempts.

A number of removals of HIV+ detainees that Medical Justice are involved with have been stopped because the NAT and BHIVA guidelines were breached.

Below Medical Justice explains how to help someone living with HIV by using the guidelines.

The new NAT-BHIVA guidelines (page 13) state that;

• 3 months supply of anti-retroviral medication should be supplied to people with HIV on removal
• they should also be given a letter for their future treating physicians, and
• contact details of trusted HIV support organisations in the country the detainee is being removed to.

Page 12 of the guidelines states that

'Upon notification that an HIV positive detainee is to be removed, IRC [immigration removal centre] healthcare staff should inform the local HIV specialist of the detainee's pending removal and ensure the detainee is provided with sufficient medication. Normal NHS clinical practice is to dispense three months' supply of ARV medication. This will cover detainees during the removal process and arrival in their destination country.'

In the case of Yarl's Wood, the local clinic is Bridge House GUM clinic, at Bedford Hospital, 01234 792146.

Less than three months medication?

These guidelines are endorsed by Dr Celia Grummit of the IRC Healthcare Steering Group (see page 4 of the guidelines). Given her position, and the Secretary of State's avowed policy to provide NHS equivalent care to immigration detainees (see Home Office Operating Standards Manual for IRCs), if a person facing removal has not been provided with 3 months medication, removal might be stopped on the basis that the guidelines have been breached.

Need to start treatment?

If it is clear that someone needs to start anti-retroviral (ARV) treatment but cannot do so before removal (e.g. because the necessary resistance tests have not been done yet), legal representatives might be able to make representations to the effect that the person should not be removed until it is possible to provide them with 3 months appropriate anti-retroviral medication.

Indications that someone may need to start on ARVs may include -

• the person is HIV+,
• has a low CD4 count,
• has a letter from a specialist that they need or may need ARVs (this could include a letter following their HIV diagnosis), or
• they have been on ARVs in the past.

Tests have to be done before someone is started on ARVs.

Stopping Removals that Breach the Guidelines

What you can do when someone is scheduled to be removed in breach of the guidelines ;

• Call up the local specialist clinic (listed in the BHIVA guidelines p 20-21) and find out whether they have been informed of the removal and whether they are supplying 3 months of appropriate medications.
• If they have not been informed and can't provide the necessary medication, provide the detainee's legal representative with a copy of the BHIVA guidelines and information on the person's medical condition and possible complications, and ask if legal representations can be made.
• If there is no legal representative or the legal representative is not able/willing to make epresentations on the basis of the BHIVA guidelines, you could contact the MP (either the MP in whose constituency the detainee was living prior to detention or the MP in whose constituency the detention centre is) and/or the detainee could directly make their own representations to the responsible home office caseworker.

Fitness to travel / is the detainee medically stable?

Page 10 of the guidelines says "At least 95% adherence to treatment is required , as even one or two missed doses can seriously compromise both the efficacy of therapy and lead to drug resistance. This means missing no more than one dose a month if a detainee is taking once-daily therapy, or two doses a month if a detainee is taking twice daily therapy. IRC healthcare staff should ensure that every detainee in need gets their medication each day."

If medication has been missed then removal may need to be delayed until it has been established that the medication is still effective.

Page 13 says "Final judgement as to whether an HIV positive detainee is medically stable and is fit to travel must be determined on a case-by-case basis and should always rest with the IRC GP in consultation with HIV specialists." Here are some of the main medical issues that should be considered -

• the person is pregnant or has given birth less than six months previously
• the person is awaiting an HIV test result or appropriate post-test counselling and a baseline assessment to clarify clinical condition
• the person has had a recent, new HIV diagnosis, or having just started ARV therapy or a new drug regime
• the person has a co-infection with another sexually transmitted infection or tuberculosis
• the person has co-existing mental health issues
• there are ongoing medical complications

Referring a case to Medical Justice / getting advice from Medical Justice

Please complete a referral form (a link to which can be found at the bottom of the About making referrals to Medical Justice webpage). Please note that making a referral means you are making a commitment to gather all necessary information and progress the case yourself as far as possible.

So you must ensure that you ascertain all relevant information about the detainee mentioned in these 'using the BHIVA guidelines' and include it in the referral form.

email contact   

phone 07807 726546

Note on children detained with an HIV+ parent
Some removals of families with a parent who is HIV+ have been stopped by the European Court of Human Rights (ECHR).

Medical Justice has no information on ECHR's basis on stopping these removals, if they are stopping all such removals, or for how long ECHR may stop such removals. You may want to contact ECHR or make an application to ECHR about such removals.

Medical Justice does not give immigration advice
Medical Justice is not qualified to give immigration advice and suggests that immigration advice is always sought in every case from a qualified advisor.

This advice on using the BHIVA guidelines is from Fadiga & Co
Advice is available from Hani Zubeidi at Fadiga & Co 0208 673 6699