Joint letter on the health consequences of the Illegal Migration Bill

Dear Secretary of State,

As leading medical and humanitarian organisations in the UK representing medical professionals and patients, we are writing to raise concerns about the health implications of the Illegal Migration Bill. Rather than fulfilling its stated aim of breaking the business model of people smugglers operating in the Channel, the Bill will cause lasting and profound harm to the health, wellbeing and dignity of people seeking safety and survivors of trafficking in the UK.

The Bill dramatically increases the current powers of immigration detention. It will result in vast numbers of people, including people seeking asylum, children, pregnant women, and survivors of torture and trafficking, being detained, for longer periods of time, with significantly fewer safeguards and protections. This expansion of powers contradicts medical evidence that immigration detention is damaging to the mental health of those detained, and particularly for survivors of torture and trauma. Organisations including Women for Refugee Women, the BMA and medical royal colleges have also warned that undoing the vital protection of the time limit on the detention of pregnant women will “put individual women and their unborn babies at great risk of harm.”

The situation on the Greek islands of Lesvos and Samos should act as a warning against the use of large containment sites to accommodate people seeking safety. Médecins Sans Frontières previously witnessed high levels of mental health suffering among men, women and children held in such isolated containment sites. These were exacerbated by deplorable conditions, lack of information on the length of their confinement or on their legal status, as well as a lack of access to appropriate healthcare.

Experience to date of using large centres in isolated areas to accommodate people seeking asylum in the UK has been associated with extremely poor, unsanitary and inappropriate living conditions. It has also led to high rates of psychological and other health conditions amongst residents, unmet medical needs and inadequate access to medical and dental care.

The Bill would further expand the offshoring programme, which as the UK medical community has previously warned, risks leaving people who are vulnerable, fleeing dangerous situations and who have often experienced trauma, subject to an environment where they are re-traumatised and unable to access the medical attention many desperately need.

This is evidenced by Australia’s unworkable offshoring and indefinite detention policy on Manus and Nauru Islands which resulted in widespread and well-documented harm and abuse. It catalysed a mental health epidemic amongst those asylum seekers and refugees on the islands, including high rates of self-harm, suicidal ideation and suicide attempts. In the UK, clinicians have found that the prospect of removal to Rwanda has exacerbated the mental health conditions (including post-traumatic stress disorder and depression) of the men, women and age-disputed children threatened with removal, causing increased risks of self-harm and suicide.

Of further concern are new powers in the Bill that disregard interim measures issued by the European Court of Human Rights under Rule 39 of the rules of the court in relation to the treatment of migrants. The World Medical Association has expressed its grave concern that if enacted the legislation will remove important protection for people seeking asylum and those health workers caring for them.

We are further concerned that the Bill is unworkable and would be in breach of the United Nations Refugee Convention. The United Nations High Commissioner for Refugees has warned it will “amount to an asylum ban” and will not achieve its stated objective of stopping asylum seekers from coming to the UK. People seeking safety may be forced to turn to more dangerous routes, placing them at serious risk of injury and potentially death. Instead, the Bill will result in thousands of people stuck in perpetual limbo in the UK, denied the right to a fair hearing of their protection claim and recognition of their refugee status.

All the harms described above will place unnecessary pressure on NHS services at a time when the healthcare system is under unprecedented stress.

We warn the Government that if this Bill passes it will knowingly be inflicting damage to people's health and wellbeing, which will ultimately cost lives. As bodies representing patients and health professionals committed to alleviating suffering, we oppose it on medical, ethical and humanitarian grounds.

We collectively urge the Government to abandon this Bill and replace it with a compassionate, fair and effective asylum system that protects the health, wellbeing and dignity of people seeking safety.

Yours Sincerely,

Professor Martin McKee CBE, President, British Medical Association

Dr Latifa Patel, British Medical Association Representative Body Chair

Sheila Sobrany, President, Royal College of Nursing

Professor Kevin Fenton CBE, President, Faculty of Public Health

Professor Delan Devakumar, International Child Health Group

Sonya Sceats, Chief Executive, Freedom From Torture

Ros Bragg, Director, Maternity Action

Simon Tyler, Executive Director, Doctors of the World UK

Sampson Low, Head of Policy, Unison

Dr Coral Jones, Chair Doctors in Unite

Dr Katy Robjant, Executive Director of Clinical and Counter-Trafficking, Helen Bamber Foundation

Dr Natalie Roberts, Executive Director, Médecins Sans Frontières UK

Emma Ginn, Director, Medical Justice