“…been denying his HIV status and has declined to attend appointment with consultant with regard to treatment. Consultant is very concerned as without treatment soon [MXV’s] immune system will be severely compromised and he will be at serious risk of infection.”
“Confirmed HIV pos and bloods suggest active disease… Doesn’t want any medication for HIV as tried before and made him feel sick. … having treatment is not contrary to his faith but feels as if he doesn’t have HIV and has never had it. Has never been poorly with it. Knows it can make him poorly without treatment. … happy to take risk that without treatment he could die young… Difficulty to fully assess capacity but I think he does have capacity but has some underlying health beliefs that are causing him to deny reality…”
“November 2020 last tablets. Did not want to tell staff due to it being confidential but he is eager to recommence.”
“I would like to stay in the UK with my daughter who is a UK citizen. I also suffer from multiple illness such as paranoia [schizophrenia] and HIV. I do not have any family in Zimbabwe so won’t have any support.”
“The previous concern was that he was not attending clinic for his depot injection but that has now been switched to tablets; unfortunately [there] is no way to monitor if he is compliant with his meds, but the report states he has capacity and good insight into the need for medication; therefore we have to assume he is taking appropriate responsibility… He has been given a supply of 28 tablets and they have stated they will continue to provide these so I am sure he will be given a supply to return to Zimbabwe with.”
“Prior to providing a removal date, we will need to ensure he will receive [a] supply of medication for HIV as he would not be accepted by [detention gatekeeper]/IRC without this. If he is barrier free, and once confirmation [is] received of his HIV medication we can look at a suitable removal date in line with an EV.”
“His situation remains exactly the same, he continues to take illicit substances [and] is currently prescribed oral antipsychotic medication for residual symptoms of schizophrenia. In relation to his physical health, [he] completed some physical health observations and a further appointment was booked with the GP this morning which he refused to attend.”
“[MXV] was referred to the Mental Health Team with a diagnosis of paranoid schizophrenia which is currently stable and he was prescribed Zuclopenthixol 400mgs in tablet form every four weeks. This will be available for his removal. Other risks to highlight are that he hears voices and is HIV Positive. RL Complex cases and Aeromed have been advised what medication he currently has for this condition, this will be made available for his removal.”
“Would it be possible to ensure that [MXV] has at least a 30 day supply of all of his prescribed medication and antiretroviral drugs (ARV) on the day of his detention otherwise it will not be possible to detain him as the IRC he will be taken to will not have a supply.”
“[MXV] was given a 28 day supply of Zuclopenthixol 20mg oral tablets on 22/02/24, the next P-10 is due 21/03/24. We question if he [is] even taking the medication, the depot injection was discontinued due to pervasive illicit substance misuse (Crack cocaine). His presentation remains unchanged if medicated or unmedi[c]ated , this gentlemen has capacity to make decisions around his care. In relation to anti-viral drugs he is not currently prescribed this medication at this time, he attended the GP last week for a physical health check but I am unable to see the blood results. No medication has been prescribed from their service.”
“As previously mentioned [MXV] was given a 28 day supply of Zuclopenthixol 20mg oral tablets on 22/02/24, the next FP-10 is due 21/03/24. Therefore if detained tomorrow he will have a 13 day supply. If detained and he has no medication on his person, please do not hesitate to contact myself and I will write a repeat prescription.”
“In relation to anti-viral drugs he is not currently prescribed this medication at this time, he attended the GP last week for a physical health check but I am unable to see the blood results. No medication has been prescribed from their service.”
“Medical Issues: [MXV] was referred to the Mental Health Team with a diagnosis of paranoid schizophrenia which is currently stable and he was prescribed Zuclopenthixol 400mgs in tablet form every four weeks. Other risks to highlight are that he hears voices and is HIV Positive. RL Complex cases and Aeromed have been advised what medication he currently has for this condition, this will be made available for his removal. He should have medication/prescription with him as the police are picking him up and taking him to the ICE team at the Custody Suite.”
“History of homelessness… States he [has been] homeless for 2.5 year[s]… Diagnos[is] of paranoid schizophrenia. no It is not clear whether this record correctly reads “no” medication or whether it should read “on” medication. The next day, MXV was recorded to be taking oral medical for paranoid schizophrenia and that he had the medication in custody. medication. … Referral to mental health team… HIV screening test… is not receiving prescribed medication… no[t] on any medication currently. have tablets in his bag but no name of medication… Referral to GP … – mental health issues… On his movement, order recorded that he take[s] Zuclopenthixol 400mg tablets form [sic] every four weeks. Also has been diagnosed [with] paranoid schizophrenia and he hears voices and HIV positive he states that he not take medication for HIV. Positive cocaine and THC Tetrahydrocannabinol related to cannabis. ”
“RL Complex cases and Aeromed have been advised what medication he currently has for this condition, this will be made available for his removal”
“1. HIV – not on any meds 2. Schizophrenia, paranoia – … He said he was homeless hence, he did not have an injection. He said that he would like to go back on depot…”
“It was not clinically appropriate to restart a depot injection about 5-6 days before he leaves UK as it is not possible to monitor him for any side effects and the medication has a slow onset of action. It is therefore prudent to start him on oral medication with quick action. He has been asymptomatic for several weeks.”
“[MXV] has flight for tomorrow 19.03.2024. During MDT meeting it was agreed that healthcare should chase his appointment for blood/ and his HIV appointment and prescription. Blood is out, however, need appointment with the specialist for prescription. The specialist will be back on Thursday 21.03.2024. After the appointment he need[s] to take his tablet for some days before he is allow[ed] to go to monitor the side effect[s]. He needs urgent blood tomorrow.”
“Normally, after the appointment, the medication can be prescribed. Patient needs to take the medication for a few days to make sure patient has no complication[s]. Please do not move him/her to another centre.”
“Medical Hold – [MXV] is diagnos[ed] with paranoid schizophrenia, his antipsychotic medication zuclopethixol 500mg (injection) was switched to risperidone 3mg (tablets) on14/03/2024 to prepare him for deportation. This needs to be monitored and stabilised before flying. [MXV] has medical diagnosis of Human Immunodeficiency Virus he is currently going under investigations in order to re-start his medication for his illness. He has an appointment with the specialist clinic on02/04/2024 .”
“I accept there are no barriers to removal. An ETD has been agreed by the Zimbabwe High Commission and removal direction[s] were previously set for19th March 2024 . Removal directions can be reissued once the applicant is in receipt of his prescribed medication.”
“08.04.2024 - LR/CD review - age 42, from Zimbabwe, previous HIV care in Crewe under Dr. Wood, according to patient. Disengaged from care since 2021, ARV interrupted then. HX of schizophrenia on Risperidone. Unsure about ARV Hx, no medical summary yet. Blood results: VL: 20000, cd4: 560, vit D: 22, Hep A immune, needs Hep B booster, Hep C neg. Rest unremarkable. Awaiting genotype and HLA. Plan: Dr. Wood contacted directly by email, Consider Biktarvy initiation for discussion at MDT. Needs consultant follow up. L. Rubinstein”
“[MXV] was reviewed recently in the Hillingdon HIV clinic. He has been living with HIV since 2007 but unfortunately has disengaged from care and is not currently on anti-HIV medication. His blood test indicated high viral load, 20893 copies/ml, associated with high risk of morbidity, mortality and transmission. Furthermore there is also the potential risk that his HIV virus may have become resistant to standard treatment following this period of treatment interruption. He has an appointment with one of the HIV consultants at the end of the month to discuss initiating medication. Until he is stable on antiretroviral therapy and the viral load is undetectable should not be considered stable and therefore is not fit to travel. We would also advise against relocating him to a different service to avoid disrupting his care even further.”
“Spoke to admin team and requested appointment be brought forward urgently so resident can be seen and be started on medication ASAP”
“I understand that he has a GUM appointment on 30.4.2024 with a view to restarting antiretroviral therapy. I recommend that BHIVA guidelines ‘Detention, Removal People Living with HIV June 2009’ are followed, including that no-one is removed whose condition is not stable having just started ART.”
“Hx of poor adherence and engagement with care. Last seen by services in 2021, whilst in prison in Liverpool, on Biktarvy then… Off ARV since then. History of Schizophrenia…I contacted the duty manager of the IRC who confirmed he is not to be uncuffed. They argue it is their policy following risk assessment.”
“Prescription from another organisation – arrived from hospital today added to gp ledger to prescribe 3 x 30 dolutegravir/lamivudine 50mg/300mg (Dovato) – 1 daily … 3x30 Tenofovir Dispoproxil 245mg – 1 daily … enough medication to cover until 29/7/24”
“Spoke with consultant Dr Rub[i]nstein from Wakely centre. Advised medication to be restarted and in 2 weeks time 15/5/24 FBC U&Es HIV viral load LFTs. Plan@ Booked for BTs – we need to communicate results to them once this is done so they can decide on plan going forward.”
“It is essential that reception screening and the initial medical examination in IRCs… prioritise continuity of ART for people who have already been prescribed HIV treatment. Clinical guidelines state that people who receive an HIV diagnosis should start treatment immediately. … If a person is diagnosed with HIV after arriving in immigration detention and their clinician prescribes ART, IRC healthcare staff must ensure that measures are taken to support the person to adjust to their diagnosis and to adhere to therapy.”
“The HIV service should provide the appropriate ART within 24 hours of the health screening”
“If a person receives an HIV diagnosis within the IRC, they should have access to appropriate post-test counselling, referral to an HIV specialist as soon as possible, and a baseline assessment to clarify their clinical condition. The decision on whether to start treatment should be determined by an HIV clinician in association with the patient, and in line with current UK treatment guidelines. A newly diagnosed person must see an HIV specialist before a date is set for removal.”
“Every effort should be made to ensure that people can attend their appointments at the HIV service. It is not appropriate for appointments to be cancelled for operational reasons, such as a lack of escorts, unless in exceptional circumstances. Detainees should be put on ‘medical hold’ prior to their appointment, to avoid transfer to another IRC and the inevitable delays while medical records are forwarded and new appointments are made. People should not be routinely handcuffed during transport to medical appointments. Restraints should only be applied if a risk assessment indicates a specific risk of escape or threat to safety for staff or the public. To preserve patient confidentiality and the individual’s confidence in their patient rights, handcuffs should be removed during appointments and the guard should leave the room. Any exceptions to this protocol must be justifiable under home Office policy on the use of restraints.”
“A person should not be removed if their condition is not stable. Operational staff should inform the GP of a detainee’s intended removal with sufficient time that the GP can communicate with the HIV specialist, conduct an examination if necessary, and raise any concerns identified about the fitness to travel of a person living with HIV. The final judgment regarding whether a person living with HIV is medically stable and fit to travel rests with the IRC GP in consultation with the individual’s HIV specialist. … While not an exhaustive list, a decision on fitness to travel should take into account if the person living with HIV is: • Awaiting an HIV test result or appropriate post-test counselling and a baseline assessment to clarify their clinical condition • In receipt of a recent HIV diagnosis, or has just started ART or a new drug regimen • … • Experiencing mental health issues…” • Awaiting an HIV test result or appropriate post-test counselling and a baseline assessment to clarify their clinical condition • In receipt of a recent HIV diagnosis, or has just started ART or a new drug regimen • … • Experiencing mental health issues…”
“It is for the Defendant to consider what policy or guidance to adopt, and then to adopt and disseminate it properly. It is not for the Court to dictate that this should be the BHIVA guidance. However, if the Defendant were to form the view that the BHIVA guidance is suitable, then there appears to be no obstacle to its adoption.”
“Since the [IIG] was first issued … a situation had not been encountered whereby an individual referred for detention had stated that they were no longer taking their prescribed medication. If an individual has been prescribed HIV medication, it needs to be clearer that medication must be available prior to detention regardless of whether an individual states they are/are not using it – when detention proceeds, responsibility for the care of the individual transfers to the Home Office and that medication should be available (at the IRC) even should an individual refuse to take it.”
“This should be factored into any consideration of detention and, indeed, into consideration of their general management through the immigration process.”
“103. In certain circumstances the State owes a positive protection or “operational” duty underECHR article 2 In Rabone at §104, Lady Hale described the operational duties under articles 2 and 3 as “similar if not identical”. (which protects the right to life) or under article 3, to take measures to protect individuals who are at risk of death or of harm which is sufficiently serious to engage article 3. 104. In Rabone v Pennine Care NHS Trust[2012] UKSC 2 ;[2012] 2 AC 72 , para 22, Lord Dyson JSC said: “the operational duty will be held to exist where there has been an assumption of responsibility by the state for the individual's welfare and safety (including by the exercise of control). The paradigm example of assumption of responsibility is where the state has detained an individual, whether in prison, in a psychiatric hospital, in an immigration detention centre or otherwise. The operational obligations apply to all detainees, but are particularly stringent in relation to those who are especially vulnerable by reason of their physical or mental condition: see, for example, Keenan v United Kingdom33 EHRR 913 (prisoner suffering from a mental disorder) and Tarariyeva v Russia(2006) 48 EHRR 609 (person detained in a prison hospital suffering from a serious physical illness).” 105. That duty will arise where there is a real (not fanciful) and immediate (present and continuing) risk of the relevant harm: ibid at paras 38–39.” “the operational duty will be held to exist where there has been an assumption of responsibility by the state for the individual's welfare and safety (including by the exercise of control). The paradigm example of assumption of responsibility is where the state has detained an individual, whether in prison, in a psychiatric hospital, in an immigration detention centre or otherwise. The operational obligations apply to all detainees, but are particularly stringent in relation to those who are especially vulnerable by reason of their physical or mental condition: see, for example, Keenan v United Kingdom33 EHRR 913 (prisoner suffering from a mental disorder) and Tarariyeva v Russia(2006) 48 EHRR 609 (person detained in a prison hospital suffering from a serious physical illness).”
“In my view, one must guard against the dangers of using other words to explain the meaning of an ordinary word like “immediate”
“107. The nature of the operational duties under articles 2 and 3 is the same: Rabone at para 104 per Baroness Hale of Richmond JSC. The obligation is to take all reasonable steps to avoid a real and immediate risk of the relevant harm. In an article 3 case, that means substantial and significant harm. 108. As I said in the context of the systems duty above, a claimant need not show that a breach of the duty resulted in actual harm. 109. However, it is necessary to show a material breach of the operational duty. The “all reasonable steps” test does not mean that any shortcoming will be sufficiently serious to infringe article 3 .”
“100. It is agreed that, in order to show a material breach of that duty, the claimant does not have to show that he actually suffered serious harm as a result of the breach, though a lack of harm may mean that there is no right to damages. The Court of Appeal ruled that this is the correct approach to a breach of the article 2 operational duty in Sarjantson v Chief Constable of Humberside Police[2013] EWCA Civ 1252 ;[2014] QB 411 , per Lord Dyson MR at paras 27–29. I see no reason why a more stringent test should be applied to the systems duty and, as I have said, the relevant duties under articles 2 and 3 are essentially the same.”
“116. I bear in mind the BHIVA guidance that the occasional missed dose, though strongly contra-indicated, may be tolerated. But as I have said, the question is not whether harm was caused, but whether there was a failure to take reasonable steps to avoid a risk of harm. 117. In view of the medical evidence to which I have referred, it seems to me that the failure was material. Therefore there was a breach of the operational duty. 118. However, there is again no evidence that the breach caused any harm. It satisfies a test of materiality by a narrow margin, given the short period of time which was involved. I do not consider that any damages of a compensatory nature should be awarded for that breach of duty, or indeed for the breach of the systems duty considered above.”
“71. The state has a positive duty to put in place a legislative and administrative framework to secure the health and well-being of those in detention so as to avoid harm of a kind which would engage article 3. 72. An analogous duty under article 2 requires health authorities to protect the lives of patients in hospitals. In Savage v South Essex Partnership NHS Foundation Trust (MIND intervening)[2008] UKHL 74 ;[2009] AC 681 , the scope of the duty was described by Lord Rodger of Earlsferry at para 69: “In the first place, the duty to protect the lives of patients requires health authorities to ensure that the hospitals for which they are responsible employ competent staff and that they are trained to a high professional standard. In addition, the authorities must ensure that the hospitals adopt systems of work which will protect the lives of patients. Failure to perform these general obligations may result in a violation of article 2.” 73. The context in Savage was different, but the systems duty in relation to protecting immigration detainees from article 3 ill treatment is of the same broad nature. Deputy Judge Saggerson in Watling v Chief Constable of Suffolk Constabulary[2019] EWHC 2342 (QB) ; [2020] RTR 23 described the article 3 duty in the context of police custody, at para 71: “This general duty requires that legislative and administrative systems are put in place which will make for effective prevention of the risk to the health and well-being of those under the control of public authorities.” “In the first place, the duty to protect the lives of patients requires health authorities to ensure that the hospitals for which they are responsible employ competent staff and that they are trained to a high professional standard. In addition, the authorities must ensure that the hospitals adopt systems of work which will protect the lives of patients. Failure to perform these general obligations may result in a violation of article 2.” “This general duty requires that legislative and administrative systems are put in place which will make for effective prevention of the risk to the health and well-being of those under the control of public authorities.”
“The provisions of Schedule 3 to this Act have effect with respect to the removal from the United Kingdom of persons against whom deportation orders are in force and with respect to the detention or control of persons in connection with deportation.”
“Where a deportation order is in force against any person, he may be detained under the authority of the Secretary of State pending his removal or departure from the United Kingdom (and if already detained by virtue of sub-paragraph (1) or (2) above when the order is made, shall continue to be detained unless he is released on immigration bail under Schedule 10 to theImmigration Act 2016 .”
“(i) The Secretary of State must intend to deport the person and can only use the power to detain for that purpose; (ii) The deportee may only be detained for a period that is reasonable in all the circumstances; (iii) If, before the expiry of the reasonable period, it becomes apparent that the Secretary of State will not be able to effect deportation within a reasonable period, he should not seek to exercise the power of detention; (iv) The Secretary of State should act with reasonable diligence and expedition to effect removal.”
“47. Principles (ii) and (iii) are conceptually distinct. Principle (ii) is that the Secretary of State may not lawfully detain a person “pending removal” for longer than a reasonable period. Once a reasonable period has expired, the detained person must be released. But there may be circumstances where, although a reasonable period has not yet expired, it becomes clear that the Secretary of State will not be able to deport the detained person within a reasonable period. In that event, principle (iii) applies. Thus, once it becomes apparent that the Secretary of State will not be able to effect the deportation within a reasonable period, the detention becomes unlawful even if the reasonable period has not yet expired. 48. It is not possible or desirable to produce an exhaustive list of all the circumstances that are or may be relevant to the question of how long it is reasonable for the Secretary of State to detain a person pending deportation pursuant to paragraph 2(3) of schedule 3 to theImmigration Act 1971 . But in my view they include at least: the length of the period of detention; the nature of the obstacles which stand in the path of the Secretary of State preventing a deportation; the diligence, speed and effectiveness of the steps taken by the Secretary of State to surmount such obstacles; the conditions in which the detained person is being kept; the effect of detention on him and his family; the risk that if he is released from detention he will abscond; and the danger that, if released, he will commit criminal offences.”
“It is clear from that review: (1) that the “grace periods” are granted for practical purposes, reflecting the facts of each case and applying a test of reasonableness; (2) that this court has declined to set any overall or absolute limit to such a period as a “long-stop” for all purposes; (3) that the periods have more usually been short, often a few days, but running up to a month, and (4) that there has been some tendency for the periods to increase.”
“Everyone has the right to liberty and security of person. No one shall be deprived of his liberty save in the following cases and in accordance with a procedure prescribed by law: … (f) the lawful arrest or detention of a person to prevent his effecting an unauthorised entry into the country or of a person against whom action is being taken with a view to deportation or extradition.”
“all that the Hardial Singh principles do is that which article 5(1)(f) does”) and R (A) v SSHD[2007] EWCA Civ 804 (§§74-5). This is consistent with the recognition by the European Court of Human Rights in JN v UK (Application No. 37289/12) (19 May 20216) that (§97): “…The test applied by the United Kingdom courts is therefore almost identical to that applied by this Court under Article 5 § 1(f) of the Convention in determining whether or not detention has become “arbitrary”.”
“Where the court is concerned with the legality of administrative detention, I do not consider that the scope of its responsibility should be determined by or involve subtle distinctions. It must be for the court to determine the legal boundaries of administrative detention. There may be incidental questions of fact which the court may recognise that the Home Secretary is better placed to decide than itself, and the court will no doubt take such account of the Home Secretary's views as may seem proper. Ultimately, however, it must be for the court to decide what is the scope of the power of detention and whether it was lawfully exercised, those two questions being often inextricably interlinked. In my judgment, that is the responsibility of the court at common law and does not depend on the Human Rights Act (although Human Rights Act jurisprudence would tend in the same direction).”
“If a jailor could justify the detention of his prisoner by saying ‘in my view, the facts necessary to justify the detention exist’ the fundamental protection afforded by a habeas corpus would be severely limited. The court should be astute to ensure that the protection afforded to human liberty by habeas corpus should not be eroded save by the clearest words.”
“…it must be for the court to decide whether or not there is such a breach, as s 6(1) [Human Rights Act 1998 ] requires. Of course, the court will in most cases attach considerable weight to any assessment emanating from a government department about the progress of negotiations with foreign governments or with airlines about securing the return of deportees. But the ultimate decision is, in my judgment, for the court. I therefore would reject the Secretary of State’s submission as to the limited role of the court in cases such as this.”
“(3A) A person liable to be detained under sub-paragraph (1), (2) or (3) may be detained for such period as, in the opinion of the Secretary of State, is reasonably necessary to enable the deportation order to be made, or the removal to be carried out. (3B) Sub-paragraphs (1) to (3) apply regardless of whether there is anything that for the time being prevents the deportation order from being made or the removal from being carried out. (3C) Sub-paragraphs (3A) and (3B) are subject to sub-paragraph (4ZA) andsection 60 of the Immigration Act 2016 (limitation on detention of pregnant women). (3D) Sub-paragraph (3E) applies if, while a person is detained under sub-paragraph (1), (2) or (3), the Secretary of State no longer considers that the deportation order will be made or the removal will be carried out within a reasonable period of time. (3E) The person may be detained under that sub-paragraph for such further period as, in the opinion of the Secretary of State, is reasonably necessary to enable such arrangements to be made for the person's release as the Secretary of State considers to be appropriate.”
“…Every statute other than a pure consolidating statute is, after all, enacted to make some change, or address some problem, or remove some blemish, or effect some improvement in the national life. The court's task, within the permissible bounds of interpretation, is to give effect to Parliament's purpose. So the controversial provisions should be read in the context of the statute as a whole, and the statute as a whole should be read in the historical context of the situation which led to its enactment.”
“…The effect of this section is to clarify that it is for the Secretary of State, rather than the courts, to determine what is a reasonable period to detain an individual for the specific statutory purposes (for example, to effect removal from the UK), subject to any statutory limitations on the period of detention where relevant. If the Secretary of State does not consider that the examination, decision, removal or directions will be carried out, made or given within a reasonable period of time, the person may be detained for a further period that is, in the opinion of the Secretary of State, reasonably necessary to enable arrangements to be made for release that the Secretary of State considers to be appropriate. …”
“Parliamentary sovereignty means that Parliament can, if it chooses, legislate contrary to fundamental principles of human rights . . . The constraints upon its exercise by Parliament are ultimately political, not legal. But the principle of legality means that Parliament must squarely confront what it is doing and accept the political cost. Fundamental rights cannot be overridden by general or ambiguous words. This is because there is too great a risk that the full implications of their unqualified meaning may have passed unnoticed in the democratic process. In the absence of express language or necessary implication to the contrary, the courts therefore presume that even the most general words were intended to be subject to the basic rights of the individual.”
“While, of course, Parliament is entitled to confer powers of administrative detention without trial, the Courts will see to it that where such a power is conferred the statute that confers it will be strictly and narrowly construed and its operation and effect will be supervised by the Court according to high standards”. ii) In R v Home Secretary ex parte Khawaja[1984] AC 74 the House of Lords held that where a statutory provision declared an illegal entrant to be liable to removal, the Court’s function was not limited to deciding whether the appropriate official could reasonably come to the view that the person met that criterion. In the course of his judgment, Lord Scarman said this at 111E: “…faced with the jealous care our law traditionally devotes to the protection of the liberty of those who are subject to its jurisdiction, I find it impossible to imply into the statute words the effect of which would be to take the [relevant] provision, …"out of the 'precedent fact' category" (Lord Wilberforce, Zamir's case at p. 948). If Parliament intends to exclude effective judicial review of the exercise of a power in restraint of liberty, it must make its meaning crystal clear.” iii) Tan Te Lamin which Lord Brown-Wilkinson, giving the judgment of the Privy Council, said this, at 111D-E: “Although these restrictions The limitations on a statutory power of detention identified in Hardial Singh. are to be implied where a statute confers simply a power to detain "pending removal" without more, it is plainly possible for the legislature by express provision in the statute to exclude such implied restrictions. Subject to any constitutional challenge (which does not arise in this case) the legislature can vary or possibly exclude the Hardial Singh principles. But in their Lordships' view the courts should construe strictly any statutory provision purporting to allow the deprivation of individual liberty by administrative detention and should be slow to hold that statutory provisions authorise administrative detention for unreasonable periods or in unreasonable circumstances. Their Lordships are unable to agree with the Court of Appeal”
“Level 2 Professional evidence (for example from a social worker, medical practitioner or nongovernment organisation (NGO)), or official documentary evidence, which indicates that the individual is (or may be) an adult at risk should be afforded greater weight. Such evidence should normally be accepted and consideration given as to how this may be impacted by detention. Representations from the individual’s legal representative acting on their behalf in their immigration matter would not be regarded as professional evidence in this context. Level 3 Professional evidence (for example from a social worker, medical practitioner or NGO) stating that the individual is at risk and that a period of detention would be likely to cause harm, for example, increase the severity of the symptoms or condition that have led to the individual being regarded as an adult at risk, should be afforded significant weight. Such evidence should normally be accepted and any detention reviewed in light of the accepted evidence. Representations from the individual’s legal representative acting on their behalf in their immigration matter would not be regarded as professional evidence in this context. When considering the likely risk of harm for the period identified, decision-makers are entitled not to place decisive weight on assertions that are unsupported by medical evidence. Given the difficulty involved in validating cases in which the only evidence available is the self-declaration of the individual concerned, the distinction between such cases and cases of those who are not considered to be at risk may not be great. However, the expectation, where the weight of the evidence is at level 1, is that this will act as a flag to all those involved in managing the case, and that particular attention will be paid to pursuing voluntary return options and progressing the case. The flag should also act as an alarm should additional risk issues emerge as the case progresses, particularly if the person is already detained or, if not, following their detention.”
“A primary consideration when detaining any individual under immigration powers is the imminence of removal. There are currently no barriers to your removal from the UK. However, you have been assessed at level 2 of the Adults at Risk in Immigration Detention Policy for which detention can be considered if removal can be fixed within a reasonable period or there are public protection or compliance concerns. Your schizophrenia is being treated with medication under the guidance of the IRC Healthcare Team and you have an appointment with an HIV specialist consultant on02 April 2024 . Without prejudice, once your schizophrenia medical treatment is stabilised and your specialist HIV appointment has taken place, you may be removed from the UK within 4-6 weeks using your Emergency Travel Document.”
“(1) The medical practitioner shall report to the manager on the case of any detained person whose health is likely to be injuriously affected by continued detention or any conditions of detention. … (3) The medical practitioner shall report to the manager on the case of any detained person who he is concerned may have been the victim of torture Defined in Rule 35(5) . (4) The manager shall send a copy of any report under paragraphs (1), (2) or (3) to the Secretary of State without delay.”
“Process: To provide staff with the guidance necessary to ensure that appropriate support is offered to: those who lack decision making capacity, those with disability arising from mental impairment and those who have a mental health condition; and that, for those with a disability, adjustments are made to support the individual whilst in immigration detention.”