Appalling failures of UK government in health care of children in detention centers

November 20, 2008

The appalling failures in the health care of children in detention centres, which are the ultimate responsibility of the UK Home Office, are discussed in the lead Editorial in this week's Lancet.

About 2000 children up to the age of 18 years are held in UK detention centres every year. Many are children of families who have been refused asylum or have overstayed their visas; some are asylum seekers or are detained on arrival because they have no identification papers. Often families are taken from their homes with no time to pack even essential medicines and clothes. Once at a detention centre, which for families is usually Yarl's Wood Immigration Removal Centre, children are essentially imprisoned with little to do, and provided with inadequate education and health care.

Few children in this setting receive appropriate continuity of care during their stay. The Editorial says that routine childhood immunisations are often missed. Children can be returned to countries where measles and meningitis are common causes of death in children under 5 years, and the opportunity for protecting these children while in the UK has been lost. It is a similar position for malaria, with England's Children's Commissioner, Al Aynsley-Green saying that, in May 2008, only two of 14 children from sub-Saharan Africa needing malaria prophylaxis actually received it, and even for those two treatment was inadequate.

When children become ill in detention centres, concerns have been raised by clinicians and advocacy groups that clinical care is not always adequate. Nick Lessof of the Royal College of Paediatrics and Child Health Advocacy Committee told The Lancet that he saw two children with sickle-cell disease, who had both had a high fever, in Yarl's Wood in May this year. The children's prophylactic penicillin had been stopped and they were unable to take fluids, yet had not been admitted to hospital. Earlier this year, Frank Arnold of Medical Justice examined another child with sickle-cell crisis who had not been given adequate painkilling treatment and was expected to walk, despite being in pain, from his room to the health-care facility to obtain the treatment.

The Editorial says: "These appalling failures in the health care of children in detention centres are the ultimate responsibility of the UK Home Office, and are in marked contrast to the UK Government's global health strategy, Health is Global, which emphasises the Government's responsibility 'to improve the health of people across the world, and in particular people in the UK'. It is noteworthy that the Government is committed to halting and reversing the spread of HIV/AIDS, to reducing the incidence of malaria, and other major infectious diseases, and to doing all it can to increase child survival--except it seems in its own detention centres."

The Editorial adds that the UK Government's new Immigration and Citizenship Bill, scheduled for parliament early 2009, which is available for consultation in draft form is 'an opportunity for more radical change.' It concludes: "Routine administrative detention of children should cease. If the courts accept that detention is necessary, those few children should receive the same standards of primary and specialist health care as other children in the UK."
-end-
Lancet Press Office T) +44 (0) 20 7424 4949 E) pressoffice@lancet.com

Frank Arnold, Clinical Director, The Justice Network T) +44 (0) 7786517379 E) arnold_frank@hotmail.com / emma.ginn@medicaljustice.org.uk

For full Editorial, please see: http://press.thelancet.com/editorials2211.pdf

Lancet

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