Healthcare: Yarl’s Wood

Nusrat Ghani Excerpts

Wednesday 6th January 2016 Westminster Hall

[Kate Osamor]

The right hon. Lady makes a valuable point. I agree that pregnant women should not be detained at all.

Meeting women in Yarl’s Wood allowed me to hear the concerns that they do not have the power to voice to the outside world by themselves. I am here today as their voice. This debate is for them. They told me, unprompted, that the worst thing about Yarl’s Wood is the healthcare. The women I met were depressed and exasperated by healthcare, but they were trying their best to stay positive about being released. They told me that the culture of disbelief in detention centres extends to healthcare staff as well, who are reluctant to take their illnesses seriously, and they assume that the staff are pretending to help with their asylum case. That feeling is compounded by the complaints process. Whereas the majority of complaints receive comprehensive replies, usually on time, healthcare complaints in the months prior to the HMIP inspection had either not been responded to or were extremely late.

I want to highlight how damaging such healthcare systems are for detainees who are victims of torture and those who have mental health issues. Unsurprisingly, those groups are often intertwined. They represent a significant proportion of those in detention. According to Medical Justice, 50% of those held in detention are asylum seekers or have sought asylum at some point in the immigration process. More than 80% of those surveyed by Women for Refugee Women for “I am Human” stated that they had experienced gender-related persecution, and 30% had been on suicide watch at some point during their detention. During the previous HMIP inspection, 49% said that they had problems of feeling depressed or suicidal on arrival, compared with 39% at the last inspection. Despite those needs, there is no counselling. Only 68% of staff said to HMIP that they received adequate training in safeguarding adults, and only one said that they were aware of the national referral mechanism for victims of trafficking.

Rule 35 is in place to protect the most vulnerable and ensure that they are not unsuitably detained, but it is failing in Yarl’s Wood. The most recent HMIP report states:

“Yarl’s Wood is failing to meet the needs of the most vulnerable women held. These are issues that need to be addressed at a policy and strategic management level.”

The report reiterates demands that rule 35 processes are appropriately followed. It states that Yarl’s Wood’s rule 35 reports were among the worst HMIP had seen. This included an exceptionally poorly handled rule 35 case in which a woman who had been raped was not considered to have met the criteria for torture even though she had clear symptoms of post-traumatic stress. Thanks to HMIP and independent organisations, the Government are aware of such concerns.

However, at the same time that the Government and Serco have announced reviews of operations at Yarl’s Wood detention centre, access to healthcare is limited. In October 2015, Yarl’s Wood informed Medical Justice that rooms in healthcare would be available only during a short lunch break on weekdays, severely restricting access for independent doctors, most of whom work in the NHS during the week and visit detainees on weekends. Such doctors therefore now have to visit detainees in inappropriate rooms with large windows and without examination facilities. That is wholly unsuitable. External medical assessments are most frequently carried out in order to assess whether someone has medical evidence of torture, which needs to be documented for their asylum case. If the doctor does not have a room where they can offer the woman the dignity of being able to undress and not feel threatened, how can that work?

[Nusrat Ghani (Wealden) (Con)]

Returning to the “I Am Human” report mentioned by the hon. Lady, these women are already feeling quite vulnerable. If they are pregnant, they will feel doubly vulnerable. If they have access to medical treatment, but with a male member of staff, that is another issue. Perhaps we need some information on the male to female staff ratio. These women are already vulnerable and they are being managed by male members of staff.

--- Later in debate ---

[Mrs Spelman]

My hon. Friend makes a very important point. I just do not think that the bulk of people in our society have any idea that the UK is the only country in Europe with no time limit on immigration detention and that one can be detained for an indeterminate period without charge. Most people in British society would think that impossible, but we are the only country in Europe that currently does it. My hon. Friend is right that people who are detained indefinitely without charge should not be denied the healthcare they need. That is one of the key reasons why securing this debate was so important.

The detention inquiry that took place in the last Parliament made six important recommendations to Government, one of which I want to reiterate:

“Decisions to detain should be very rare and detention should be for the shortest possible time and only to effect removal.”

Those recommendations were made to the coalition Government and I sincerely hope that the present Government’s Minister will be able to say in his response what the Home Office is doing about those recommendations and the ones being made today.

We have heard about the types of health problems that women suffer from, but I will highlight the high percentage of suffering associated with sexual violence and the plight of pregnant women. Women for Refugee Women, an organisation already referred to, collected evidence from detainees in Yarl’s Wood and, frankly, as a mother it makes my hair stand on end. For example, a woman recently detained while pregnant said that she had only one hospital appointment while in Yarl’s Wood, which was for a scan at 20 weeks—as hon. Members know, that is late for a first scan. Even then she was escorted by officers who brought the lady to her appointment 40 minutes late. How anxious and frustrated she must have felt—even when she was brought to the necessary scan, she was not presented in time and was not able to speak to the midwife after the scan because no time was left. As a woman who has been through pregnancy, I would expect such basic healthcare provisions for people.

[Nusrat Ghani]

On the issue of pregnant women, the contrast is between the treatment available to women in my constituency at an award-winning midwifery unit and what women in detention get. Pregnant women in detention cannot even request access to a midwife—surely that has to be discussed further.

[Mrs Spelman]

I could not agree more and that is why we are laying it on with a trowel today.

A further example from Women for Women Refugees distressed me greatly when I heard about it, just as the hon. Member for Edmonton was distressed by describing what women in detention have to go through. One woman had to wait three and a half hours for an ambulance while she was bleeding from a miscarriage. I suffered from multiple miscarriages and they can be a matter of life and death. If our constituents knew that a 999 call for someone suffering a miscarriage had taken three and a half hours to be responded to, they would soon be writing to the Secretary of State for Health.

We are at this debate to emphasise to the Government the urgency required to address the situation. What is it that deters the Home Office from taking a different approach to detention? In other countries, pregnant women or any of the people whom we would detain are detained in the community and kept at large there. Is the Home Office worried about the cost? I doubt it, because our system seems to be both expensive and unnecessary—holding someone in detention costs almost £40,000 a year and some of the detainees are held for a very long period. Community programmes are consistently found to be significantly cheaper. International evidence also demonstrates that such alternatives to detention support high levels of compliance. Perhaps the Home Office is worried about the risk of absconding? The Home Office is evaluating the UK’s new family returns process, which makes minimal use of detention, and the evidence is that there has been no rise in absconding since the introduction of the new community-orientated process.

I urge the Minister, when he responds to the debate, to address such urgent matters of basic rights. We should expect all UK citizens and guests in our country to be able to rely on such rights and on an emergency service and proper healthcare to a standard that we would all expect to be available when needed. As far as possible, we should move away from how so many women are being treated.