• UK’s top medical bodies calling for urgent meeting with Home Secretary and Health Secretary
• Tens of thousands of children could be locked up indefinitely if Illegal Migration Bill becomes law
• Medical professionals warn of PTSD, suicidal ideation and other mental and physical risks
• Detaining minors would cause “unimaginable levels of harm”
• The development of the mass detention estate will cost billions of pounds of taxpayer money, and the complexity and risk involved in this operation render it unworkable.

Leading medical voices are today (Monday 19th June 2023) – at the start of Refugee Week – joining forces with Together With Refugees to raise their concerns about the plan to detain refugee children, without a time limit, in the new Illegal Migration Bill.

The Royal College of Paediatrics and Child Health, the British Medical Association, the Royal College of Psychiatry and the Faculty of Public Health are sending a letter coordinated by campaign coalition Together With Refugees to Home Secretary Suella Braverman, and Health Secretary Steve Barclay. The letter calls for an emergency meeting to outline the serious harm and risks these children would face, drawing on their collective expertise on children’s health and echoing calls made by refugee and children’s rights organisations (1).

A Refugee Council impact assessment found that this could affect over 45,000 children in the first three years of the Bill coming into force, including nearly 15,000 children who have been separated from their parents and have come to the UK alone (2).

Professor Kevin Fenton, president of the Faculty of Public Health, said:

“There should be no place for locking up children who have fled terrible circumstances to find safety in the UK. The evidence is clear that it causes horrific harm to their physical and mental health with lifelong consequences. We cannot stand by and allow this bill to put vulnerable children through such cruelty. That’s why we are calling for an urgent meeting – to urge the government to put an end to these appalling proposals.”

Dr Jan Wise, BMA ethics committee chair, said:

“Evidence is clear that immigration detention is unsafe for children. While no time in detention is safe, placing children in indefinite detention can have a catastrophic impact on their development and psychosocial health. Many of these children have already endured a traumatic migration journey and detention risks exacerbating any ongoing issues they may have. For medical and humanitarian reasons, it is essential that these children and young people are spared detention and provided with appropriate care and treatment.”

Professor Andrew Rowland, Officer for Child Protection at the Royal College of Paediatrics and Child Health, said:

“In 2010 RCPCH argued against the routine detention of children for immigration purposes and the government rightly ended that practice, agreeing that the risk of mental and physical injury was unacceptable. It is beyond belief that now over a decade later we find ourselves in that position again.

“Detaining children for indefinite periods of time can cause unimaginable levels of harm and trauma. Children currently undergoing vital initial health assessments often have serious illnesses or injuries identified, many of which require prompt treatment. Any delay in them receiving the healthcare they need will adversely affect their health, in potentially catastrophic ways. The proposals set out in this bill will merely exacerbate this issue by preventing children from being promptly placed in an appropriate environment to meet their needs; and by not providing children with the level of healthcare that they deserve, need, and are entitled to. This is cruel, dangerous and a flagrant violation of their children’s rights.”

Dr Adrian James, President of the Royal College of Psychiatrists, said:

“This Bill’s potential to permit detaining children for indefinite periods is wholly unacceptable, especially when they are already some of the most vulnerable members of society. Before they arrive, asylum seekers and refugees are likely to have experienced significant trauma both in the country they have left, and on their journey to the UK. Once here being detained heightens their risk of developing, or worsening, a mental illness. In previous years Government policy sought to enact strict limits on child detention. It is alarming to witness such a gigantic step backwards, returning to a way of thinking that is outdated and just plain wrong. We call on the Government to immediately remove any provisions from the Bill that would allow this to happen and instead focus on the support and safeguards that should be established to meet children’s needs.”

Ali Ghaderi was a teenager when he arrived in the UK as a refugee from Iran about five years ago. He is a performer and activist and has founded the Babylon Project to support other refugee and asylum seeking young people through drama and art. He said: “I was just a teenager when I was forced to leave my home in fear for my life and came to the UK for safety. Arriving in a completely new country at such a young age was incredibly frightening. The idea that I could have been locked up is terrifying, and not knowing for how long unthinkable. I had already been through so much as a child – I hate to think of the impact this would have had on me. This bill is cruel in so many ways but the plan to detain children is beyond anything I could have imagined.”

A briefing released today by Médecins sans Frontières examining the impact of detention on refugee children in Greece and Nauru island found that it caused a range of serious medical issues, with a significant number of children suffering from trauma- and fear-induced symptoms including sleep disturbances and nightmares, behavioural issues and developmental regression, helplessness and detachment, skin conditions, self-harm and more, compounded by the containment and appalling living conditions.

Between 2019 and 2020, MSF medical staff providing care for people trapped in Moria reception centre on Lesvos island declared a mental health emergency, with alarmingly high rates of self-harm and suicidal acts among children. Out of the 180 MSF patients who had experienced self-harm, suicidal ideation or had attempted suicide, more than two thirds were children, the youngest of whom was a six-year-old child. Alarmingly, 10 of MSF’s child patients in Nauru were diagnosed with ‘Resignation Syndrome’, a rare and life-threatening psychiatric condition where patients enter a comatose state that requires medical care to keep them alive (also known as traumatic withdrawal syndrome or pervasive refusal syndrome). (3)

Baroness Arminka Helić, who fled from war-torn Bosnia when she was 23 and came to the UK as a refugee, and who has tabled amendments to retain existing time limits on the detention of children, said:

“I share the concerns of leading medical bodies about the government’s plans to reintroduce child detention. Even short spells in detention can cause trauma and long-term mental health risks for children. That is why I have supported amendments to maintain the existing limits on child detention.”

Enver Solomon, CEO of the Refugee Council and Together With Refugees spokesperson, said:

“Most people in the UK would rightly be appalled by the idea of locking up thousands of children who arrive here in search of safety, having fled war zones and persecution. We know from our work that they are scared and deeply traumatised, in dire need of being looked after with great care. Putting them behind bars will only compound their trauma and cause huge distress.

“As a nation, we must stand firm in our commitment to uphold children’s rights and show care and compassion to every one of them who reach our shores in need of protection.”

MSF UK’s Executive Director, Dr Natalie Roberts, said:

“There is absolutely no justification for locking up children who have reached the UK either alone or with family to seek safety. The UK government has publicly stated that it is using the Greek and Australian models for this plan, but MSF has worked in both contexts, and we have seen that detaining and containing children inflicts severe, lasting damage to their physical and mental health. The government’s plans to replicate these models in the UK are unconscionable.”

The Illegal Migration Bill hugely expands the Home Secretary’s powers to detain people. Alongside the new duty to remove, the Home Secretary has the power to detain anyone who arrives in the UK without prior permission, including children, whether they are lone children or with their family. The government has not ruled out the use of force on pregnant women and children. There is no time limit for how long someone can be detained for. Current time limits were introduced following serious harm that vulnerable people faced in detention centres (4). Under the new law, these vital safeguards would no longer apply. This in effect allows for the indefinite detention of children, including unaccompanied children.

Before the routine detention of children in the UK ended in 2014 under the current government, medical experts found that almost all detained children suffered a significant deterioration in their mental and physical health as a direct result of their detention. Reported child mental health difficulties included emotional and psychological regression, post-traumatic stress disorder (PTSD), clinical depression and suicidal behaviour. Significantly, the consequences of being detained continued to impact children’s lives and well-being long after they were released (5). Children who are detained also don’t have access to appropriate education that meets their needs and are cut off from interacting with peers, which can have long-term effects on their development. ■

Notes to editors:

1. A joint release by the Refugee Council and Barnardo’s is available here: UK Government’s new asylum bill threatens to lock up thousands of refugee children who come to the UK alone.
2. The Refugee Council’s impact assessment is available here: Illegal Migration Bill – Assessment of impact of inadmissibility, removals, detention, accommodation and safe routes.
3. The MSF briefing is available here
4. Current time limits for detention are: 24 hours for separated children; 72 hours for children in families; and 72 hours for pregnant women. Detention beyond those limits requires ministerial approval.
5. Evidence from pre-2011 UK child detention is available here: Intercollegiate Briefing Paper: Significant Harm – the effects of administrative detention on the health of children, young people and their families.

• The Bill is currently in the Committee stage of the House of Lords. Some amendments have been put forward to retain existing limits on the detention of children.
• The Bill gives the Home Secretary new detention powers, which apply to both unaccompanied children and children with their families, are without time limit and without the possibility of bail for 28 days, and may be exercised in any place that the Home Secretary considers appropriate, potentially circumventing and undermining existing safeguarding mechanisms.