Healthcare: Yarl’s Wood

Catherine West Excerpts

Wednesday 6th January 2016 Westminster Hall

[Kate Osamor (Edmonton) (Lab/Co-op)]

I beg to move,

That this House has considered healthcare in Yarl’s Wood.

I am grateful for the opportunity to debate this issue today. Access to healthcare is a human right that is not adequately offered to the women of Yarl’s Wood. I formerly worked as a practice manager in the NHS, so I have seen for myself the importance of delivering good quality healthcare to communities, including providing access to consultation rooms where people are treated with respect and dignity. That is particularly important for detainees, who often have to undergo intimate examinations to document past torture.

Across immigration detention centres, there have been six High Court findings of inhumane and degrading treatment and nine deaths in custody in the past three years. According to Her Majesty’s inspectorate of prisons, the situation in Yarl’s Wood has worsened since G4S took over the contract for providing healthcare in September 2014. I want first to highlight the poor standard of healthcare provided, and secondly, to draw attention to the limitations that have recently been placed on independent doctors who are trying to work in Yarl’s Wood.

My demands to the Minister are as follows. First, the Government must lift the restrictions on access to Yarl’s Wood for independent doctors. The restrictions were put in place in October 2015, in contravention of detention rules. Secondly, they must ensure that legal rooms are refurbished, as has been done in other detention centres, to make up the extra space that Yarl’s Wood management says is necessary to accommodate independent medical visits. Thirdly, they must ensure that rule 35 is properly used. Rule 35 processes are meant to protect people from detention when they have been tortured, traumatised or are extremely vulnerable in other ways. I share the British Medical Association’s view that rule 35 reports should be written only by clinicians with relevant medical experience or appropriate training in identifying, documenting and reporting the physical and psychological signs of torture. Lastly, the Government must end the detention of pregnant women and those who are detained under the Mental Health Act 1983.

I want to start by highlighting the pervasive lack of confidence in the healthcare system. The detention services operating standards stipulate:

“All detainees must have available to them the same range and quality of services as the general public receives from the National Health Service.”

[Catherine West (Hornsey and Wood Green) (Lab)]

I thank my hon. Friend for bringing this excellent debate to Westminster Hall. Will she comment briefly on the recent debate in the Commons about the lack of a proper sentence, for want of a better word, which makes the question of healthcare even more important? If an individual does not know how long they will be in Yarl’s Wood, their healthcare issues will be even more intense and difficult to cope with.

[Kate Osamor]

My hon. Friend highlights an important point. I know from first-hand experience that if women do not know how long they will be detained, it has an impact on their mental health. I want the Government to take that fact very seriously. I will discuss it later in my speech. I thank my hon. Friend for raising that issue.

In 2014, the report “Detained” by Women for Refugee Women found that 62% of those surveyed described healthcare in detention as “bad” or “very bad”. In its latest report, “I am Human”, 17 out of 38 interviewees raised the issue of healthcare without being prompted. The urgent need to review healthcare was also voiced by HMIP. In its most recent report on its unannounced inspection, which was published in May 2015, it stated that healthcare in detention centres has declined severely. One of the two concerns it identified is healthcare, which needs to be improved. The second is that staffing levels are too low to meet the needs of the population, which links to healthcare. The report shows that staff do not have the time to build meaningful connections with detainees, and no counselling is available. It states:

“Detainees’ perceptions of health care were overwhelmingly negative. Their main concerns included poor access to prescribed medication, a poor overall standard of care, a poor attitude from health care staff, a corrosive culture of disbelief, and a lack of support with emotional and mental health needs.”

The Care Quality Commission issued three requirement notices following the inspection.

In November last year, I went inside Yarl’s Wood to meet women who had been detained. The two women I met were victims of trafficking; one was pregnant. Pregnant women are a particularly vulnerable group in detention. I call on the Government to review urgently their policy of detaining pregnant women in exceptional circumstances. In 2014, just nine of the 99 pregnant women who were detained in Yarl’s Wood were removed from the UK. The removal of pregnant women is rarely medically safe, due to potential pregnancy complications and increased levels of severe malaria on arrival.

The human reality has never been so clear to me as when I went inside the detention centre. I know that the Minister has already visited Yarl’s Wood, but I encourage him to do so again, if possible, on a healthcare visit.

--- Later in debate ---

[Stella Creasy (Walthamstow) (Lab/Co-op)]

I pay tribute to my hon. Friend the Member for Edmonton (Kate Osamor) for securing the debate. For me, as for her and for the right hon. Member for Meriden (Mrs Spelman), this is a powerfully emotive subject. It is a debate about pride and shame.

I am proud to be the Member for Walthamstow. When I was elected, the then Member for Blackburn told me that there were two divides in the House: between left and right; and between those who have to deal with the UK Border Agency and those who do not. That was a pretty accurate description.

I am also proud to be a member of the Set Her Free campaign and to work with Women for Refugee Women—some of those women live in my community and I have been proud to campaign with them about Yarl’s Wood. Set Her Free is above all about giving voice, as my hon. Friend the Member for Edmonton did so eloquently, to those women detained at Yarl’s Wood now and whose voices we cannot hear unless others speak out for them. We are here today to speak out for those 2,000 women, the majority of whom we know to be the victims of rape and sexual torture and of persecution in their own countries. Yet when they come to our shores, this is how we treat them.

The healthcare problems are only the pinnacle of the injustice that Yarl’s Wood represents in our community. Many of the detainees have mental as well as physical healthcare problems: one in five has tried to kill themselves and 40% of them self-harm. Those figures come from the valiant work done by Women for Refugee Women to hold us to account for the existence of Yarl’s Wood. That work was cruelly disbelieved by the Home Office, so the report from Her Majesty’s inspectorate of prisons showing a tripling in the number of women self-harming in Yarl’s Wood should be testament to the work done by Women for Refugee Women to uncover just what the truth is about such a place in our society here in Britain in 2016.

[Catherine West]

My hon. Friend is making a passionate and excellent speech. Will she join me in underlining that when there is no statutory limit on the period of detention those mental health issues such as the self-harming become worse?

[Stella Creasy]

I am grateful to my hon. Friend for saying that, because she brings me to exactly what shames me. I feel shame about what is happening today in our country. I am ashamed that the UK is the only European country with no limit on detention, which absolutely compounds the mental health distress felt by many of those in Yarl’s Wood. I am ashamed that the HMIP report also reveals that male members of staff are supervising women on suicide watch—as Women for Refugee Women warned us was happening. What does that mean in layman’s terms? Vulnerable women are being watched as they sleep or as they use the lavatory. How is that happening in our country, on our shores?

I am also ashamed that all of that is futile, because two thirds of the women whom we lock up in Yarl’s Wood are then set free and, as Members have talked about, 90% of the pregnant women are set free. What is the point of putting them through that torture? I am ashamed, because it is not even value for money. As the right hon. Member for Meriden pointed out, it costs us £40,000 a year to hold those women in detention. We could find much cheaper, much more humane and much more dignified ways in which to manage our asylum system.

Above all, I am ashamed that we do not hear the voices of those women. I therefore want to read directly from their testament. The right hon. Member for Meriden cited a case, but I will read from the account of a woman who was not pregnant. The best way in which to guarantee the healthcare of women in Yarl’s Wood is to close the place down altogether. Let me read this out:

“When I came to England I was destitute, I was homeless. I went to Croydon to the Home Office to explain my situation. Before I could say anything, the lady said to me, you are lying. I said, God knows if I am lying…Then they took me to a room. Nobody told me they were taking me to detention. A lady said to me, they are taking you to another immigration office. They put me in handcuffs. I did not know what was going on. Since I was born I had never left my country before. They put me in the van and took me to Yarl’s Wood. They searched me. I wasn’t able to ask what was going on, because I was too scared of them. Nobody told me what was going on. They said, you are in fast track, but I didn’t know what that was.

While I was in detention, I was seriously sick, I was dying. My body collapsed. There were times when I could not walk. They took me to healthcare, they said you must eat, but I couldn’t eat the food. I was skinny, I was dying.”

This is 2016. We have had such debates for a number of years. It is not cost-effective, moral or effective in the modern world to have somewhere such as Yarl’s Wood in Britain. It should shame us all that it is happening on our shores. I ask the Minister, please, set her free.

--- Later in debate ---

[James Brokenshire]

I assure the hon. Lady that risk assessment takes place. There is sometimes a mix of different people within an immigration removal centre: some of them will be foreign national offenders, and others will be there as a consequence of the removal process. It is worth underlining that we are talking about immigration removal centres. The primary purpose is the removal of people from this country, but there will be public protection issues, and risk assessment is clearly a core part of the operation of any immigration removal centre.

I am conscious that I now have four minutes left to respond to the various points made, so I will try to make as much haste as I can. Several Members mentioned indefinite detention. It is not possible to detain under immigration powers indefinitely. There are significant, long-standing and, we believe, appropriate protections against the arbitrary use of administrative detention by the state in this country.

I say to my right hon. Friend the Member for Meriden (Mrs Spelman) and other Members that we are carefully considering alternative options to detention. Our published policy is clear that alternatives to detention should be used wherever possible. As I indicated on Report of the Immigration Bill, we are considering the overall issues of the detention estate more broadly and are examining alternatives as part of that ongoing work. Members referred to the family removals process.

[Catherine West]

rose—

[James Brokenshire]

I will make some progress, as I now have three minutes remaining.

On the specific complaints issues raised, our detention centre rules are designed to ensure that female detainees’ rights, dignity and privacy are upheld. Should we receive complaints that contractors are breaching those rules, I assure hon. Members that such cases will be investigated fully and firmly.

On the issue of female members of staff and the availability of care and support, nurses are available 24/7 in Yarl’s Wood but, as in the community, they will not always be female. Detainees have the right to request to be seen by a female doctor or nurse, which will be arranged wherever possible. Midwives from Bedford Hospital NHS Trust visit the centre once a week, and the frequency and length of attendance is determined by demand.

The hon. Member for Edmonton mentioned independent medical examinations. Detention centre rules require that a registered medical practitioner selected by or on behalf of a detainee is given reasonable facilities for examining detainees. IRC suppliers rightly take requests very seriously and seek to accommodate them in accordance with the rules, but I am aware that some groups have made representations and expressed concerns. We are examining those closely and considering this issue carefully. I assure the hon. Lady that I recognise that issue, and we are examining how best to address it.

The Home Office will be revising the template form that IRC doctors are required to use when completing rule 35 reports, in order to make it clearer what information the Home Office requires of doctors when they complete such reports. We have consulted on the proposed changes with the relevant stakeholders. The intention is to make the forms easier for doctors to use, thereby improving the content of rule 35 reports. That is an important aspect, in order to ensure we act on those reports and consider them appropriately.

On the CQC report, an action plan is very much in place, and I have had discussions with NHS England about that. It is being worked through, and we take these issues very seriously.

I am grateful to the hon. Member for Edmonton for the constructive discussion today. I confirm the importance we attach to this issue and, if I may, I will seek to write to her on the other issues that time has unfortunately prevented me from addressing.