"If [the conclusion] differs from the stated age, clear reasons for this disagreement should be given. Please remember this process is not an exact science and that conclusion should always give the benefit of the doubt"
"[A], presented as being confident, during the assessment interview, his appearance and behaviour indicated that he may be aged at least 18+ years. [A] has provided very little information during the assessment interview, to confirm that he was born on the date of birth which he claims to have been born. Giving him the benefit of the doubt his estimated Date of birth is09 November 1990 "
"it is more likely than not that the client is 17 years old. It is possible that the client is 16 or 18 years old. It is highly unlikely that the client is either 15 or 19 years old"
"I refer to the "minded to" letter dated10 October 2008 . I have now considered the further representations made by yourselves in your letter dated 20 October and the Report of Dr. Michie dated28 April 2008 . I have given full and careful consideration to the information before the Authority. I have completed [my] review of the decision dated4 March 2008 and conclude that [A] is 17 years old"
"Current placement and comments of those who deal with [A]"
"Conclusion 28 In my view, no reliable documentary evidence has been produced to determine [A]'s age. I have set out my concerns about the Report of Dr. Birch above; I cannot agree with her conclusions. 30 Further, the report of Dr. Michie, commissioned on behalf of [A], supports the Authority's age assessment. 31 In reaching my conclusion I have taken in account all the factors in the pool of relevant material and have reached a composite assessment. These factors include the credibility of the history given, his physical appearance, his behaviour at the time of the age assessment, and subsequent interaction from his social worker and others over a period of approximately 6 months. It also includes, of course, consideration of the reports of Dr. Birch and Dr. Michie, although neither of these is per se determinative. 32 My conclusion is that [A] is 17 and that the age assessment by the Authority dated 4.3.08 was correct, and should not be interfered with."
“5.6 Puberty and the Assessment of Age. Paediatricians may be asked to give their opinions whether the young person is a child under the age of 18. This request may be made by the child’s legal representative, who may be seeking to show that the young person in question is under the age of 18, as those accepted as such should not normally be held in detention. The Paediatrician’s assessment should only be done in the context of a holistic examination of the child. When making their assessments, Paediatricians may find it useful to be aware of the Asylum Casework Instructions used by the Immigration Nationality Department of the Home Office. An excerpt from these is given at the end of this section of the guidelines… In practice, age determination is extremely difficult to do with certainty and no single approach to this can be relied upon. Moreover for young people aged 15 – 19, it is even less possible to be certain about age. There may also be difficulties in determining whether a young person who might be as old as 23 could, in fact, be under the age of 18. Age determination is an inexact science and the margin of error can sometimes be as much as 5 years either side. Assessments of age measure maturity, not chronological age. However, in making an assessment of age, the following issues should be taken into account. Paragraph 5.6.3 addresses dental age in the following terms: “The dental age of the human from birth to 18 years can be judged by consideration of the emergence and development of the primary and secondary dentitions. Thereafter estimates have to be based on wear of the dentition and are much less accurate. There is not an absolute correlation between dental and physical age of children but estimates of a child’s physical age from his or her dental development are accurate to within + or - two years for 95% of the population and form the basis of most forensic estimates of age. For older children, this margin of uncertainty makes it unwise to rely wholly on dental age.”
“Due weight must be attached to any medical assessment of age that is received, but it should be noted that age determination is an inexact science and the margin of error can be substantial, sometimes by as much as 2 years either side. As the paediatrician can only offer an estimate of age, all estimates should also refer to the margin of error associated with that particular estimate.”
“The determination of age is a complex and often inexact set of skills where various types of physical, social and cultural factors all play their part, although none provide a wholly exact or reliable indication of age, especially for older children. Assessments of age should only be made in the context of a holistic examination of the child. As there can be a wide margin of error in assessing age; it may be best to word a clinical judgment in terms of whether a child is probably, likely, possibly or unlikely to be under the age of 18.”
"Every local authority shall provide accommodation for any child in need within their area who appears to them to require accommodation as a result of - (a) there being no person who has parental responsibility for him; (b) his being lost or having been abandoned; or (c) the person who has been caring for him being prevented (whether or not permanently, and for whatever reason) from providing him with suitable accommodation or care"
"More importantly, Dr. Birch takes whatever [A] tells her to be as fact. For example, in relation to family background, it is stated that [A]'s parents were of average height and this is take[n] as a fact. This information is later used in relation to [A]'s physical development. Whilst it is not the role of Dr. Birch to assess [A]'s credibility, there is nevertheless no documentary record of [A]'s family history for her to rely on."
"The BMI calculations tend to contradict Dr. Birch's conclusions. ... It is true that GPs use the BMI calculation to assess whether a person is of healthy weight, underweight, overweight or obese. Nonetheless, a BMI may give some indication of a young person's age. Although it is not a calculation specifically designed for this purpose, it may constitute one useful piece of material in the general pool of factors. I do not find Dr. Birch's conclusions on this point helpful"
"In relation to the evaluation of [A]'s teeth, the conclusions drawn are based on Dr. Birch looking into [A]'s mouth. I cannot attach any weight to this as it is carried out in a non-clinical setting and dental x-rays do not support it. Furthermore, it is not Dr. Birch's area of expertise. I would normally expect that a clinician who does not have a relevant area of expertise, would refer a subject to someone who does."
"As regards medical practitioner reports generally: the Authority's approach is in accordance with the views of the Royal College of Paediatrics and Child Health in their Guidelines for Paedriaticians dated November 1999, and that recently set out in the ILPA report dated May 2007. In summary, there is no reliable medical or other scientific test to determine a young person's age with any degree of accuracy. As the RCPCH points out, age determination is an inexact science and the margin of error can sometimes be as much as 5 years either side. The ILPA report states that medical assessment methods (bone age, dental age assessment (with x-rays), anthropometric measurements) are associated with a margin of error of at least 2 years in either direction. My view is that the lack of reliable medical or scientific test to determine age, and the large margin of error of the current medical scientific methods used, means medical practitioner reports can only provide a general guide to an applicant's age. The Authority considers they are only of limited assistance in the assessment of where, in the range of 15-20, years a young person falls"
"5. The UMT has developed a general approach to medical practitioner reports. It most commonly receives report [sic] from Dr. Birch. Previously, the Authority received numerous reports from Dr. Michie. ... ... 10. The UMTs concerns about medical practitioner reports generally are that it does not accept, consistent with the view of the Royal College of Paediatrics and Child Health in their Guidelines for Paediatrics date[d] November 1999 that there is any reliable medical or other scientific test to determine an applicant's age and in particular whether he is under 18. Further, it accepts the view set out by the RCPCH that age determination is an inexact science and the margin of error can sometimes be as much as 5 years either side. The UMT considers that medical practitioner reports can only provide a general guide to an applicant’s age and that within a wide range. ... 12. It is my view, shared by the assessing social workers and reviewing officers within the Authority's UMT that medical practitioner reports can only provide general guide to an applicant's age within a wide range"
"b) Dr. Birch uses a range of +/- 2.1 years which is not consistent with the views of the RCPCH and no scientific or medical reason is given for this. The reason given - practical value - is unhelpful where the assessing social workers are trying to assess the age of a particular applicant. c) Dr. Birch's assessment starts from the statistical premises that an applicant is 'average'. This is an unfounded assumption, and she declines to go on to consider where, in the range she puts forward an individual falls as to do so would introduce an unjustified subjective element into a scientifically objective assessment. Croydon considers that it is necessary to go on to analyse the statistics put forward by taking into account other factors, which emerge during the assessment."
“41. As can be seen at paragraphs 5 and 10 above, Mr Moore appears to have rejected, or at the least to have reduced the weight that he attached to Dr. Michie’s reports, on the basis that although Dr. Michie gave a margin of error of plus or minus 2 years, the Guidelines give a margin of error of plus or minus 5 years. 42. The first point to be made is that the introduction to the Guidelines states the purpose for which they had been produced, namely “… to assist paediatricians who are caring for refugee children.”
"In my view, the Report of Dr. Birch dated16 June 2008 is subjective and aimed specifically at supporting [A]'s claimed age. The Report fails to provide any compelling factual information or other material, that would lead me to conclude that the age decision of4 March 2008 is wrong"