Sushila Dhall , the BMA and Medical Justice call for the routine use of immigration detention to end, while Lee Jones says we need a system that is fairer for everyone, not just those with the saddest stories

Arbitrary imprisonment without time limits is not the only misery inflicted on those who believe they may find sanctuary on English shores (Flawed system failing to protect vulnerable migrant detainees, 11 October). The system of claiming asylum is in itself a kind of torture; of extreme poverty, uncertainty and fear. In intrusive Home Office interviews where case workers have targets for rejection, lost and grieving people’s claims fail almost routinely, with reasons given such as: “You could not say what day it was when you emerged from under the bodies of the family you claim was massacred”, and “Your dislocated limbs could have been caused by heavy sports activities [rather than torture]” or “You claim you fled to your uncle’s house and then say he was just a family friend [common in many cultures]”.

Some people wait 10-15 years for their claim for asylum to be resolved, during which time they cannot work, study, rent or claim benefits. On turning 18 many young people are deported to countries such as Afghanistan and Sudan, their obvious terror ignored. The service I work for was set up to help survivors of war and torture, complex loss and extreme trauma to recover, but we often find people finally broken, and kept broken, by our own hostile and disbelieving UK immigration system.

Sushila Dhall

Oxford

• The Guardian’s recent series of articles on vulnerability in immigration detention makes for concerning reading.

The British Medical Association (BMA) has worked for many years, both nationally and internationally, to draw attention to infringements of health-related human rights. As part of this work, we are all too aware of the problems that exist in the immigration detention estate in the UK, which underlined the development of our report on health and human rights in immigration detention, Locked Up, Locked Out, published last year.

We recognise not just the magnitude of vulnerability among those detained, but the scale of the challenges facing the healthcare professionals who care for them. Staff shortages, variation in services (particularly mental healthcare), and problems with the processes designed to act on concerns raised by doctors about their patients’ vulnerability, all hinder their ability to provide the best possible care.

We are one of the many organisations who have called for the routine use of immigration detention to end. Until that time, those detained must be able to access high-quality healthcare, equivalent to that available to the general public. Shortcomings in the current system must be urgently addressed.

Dr John Chisholm Chair of BMA Medical Ethics Committee

Dr Alan Mitchell BMA lead on healthcare in immigration detention

• Your article (Legal aid access and no family separations: an immigration detention wishlist, 10 October) rightly mentions that many want to see an end to detention. Interim reforms benefiting detainees should precipitate the end of immigration detention rather than prop up the regime – known and premeditated harm to human beings for administrative convenience is unethical and unconscionable.

Medical Justice shares the view of the BMA that indeterminate immigration detention can have significant health effects, and that it should be replaced with something more humane.

The Home Office knowingly puts more detainees at risk through its incongruously named “Adults at Risk” safeguard with its narrowed definition of torture which patently excludes many torture victims from its ambit. The tragic extent of harm to detainees is demonstrated over and over again by its own “reviews” and statistics. Meanwhile, some immigration detainees suffer catastrophic mental deterioration and end up being transferred from immigration removal centres to secure psychiatric units, and back again.

NHS England must get a grip on its healthcare providers and ensure they actually deliver adequate healthcare. They must end the practice of not taking providers’ past performance into account when awarding the multimillion-pound healthcare contracts and get rid of those whose employees have played a part in the medical mistreatment and sexual molestation of detainees.

Emma Ginn

Director, Medical Justice

• I am a British citizen with an American wife and daughter. My daughter has a UK passport, but my wife is on a temporary spousal visa.

We have spent years navigating the Home Office immigration system (and the US federal system). The UK system is unnecessarily cruel and unfair and we had to jump through frankly ridiculous levels of bureaucracy so we could live together as a family. But we have always stuck to the rules. We got our visas because we followed the rules and requirements to the letter, however painful or financially straining.

The issue I have is that many of your stories focus on cases where the rules are being followed. The case of the sick man being sent back to Australia (Home Office to put four medics on flight in case man being removed has stroke, 13 October; Family refuses deportation flight over fears father may suffer stroke, 16 October) is a good example of this. His visa has ended, he has no legal right to be here. The rules are clear. It’s an unfortunate circumstance, but the family must have understood the nature of his work-based visa in 2012 when it was announced he must leave.

By focusing on those who wish the rules to be bent to help their unfortunate situation, you do a disservice to the millions of us who live by the same rules. We cannot have a system that can be edited by circumstance. We need a system that is more democratic, transparent and fair for everyone, not just for those with the saddest stories.

Lee Jones

London

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