Immigration, Asylum and Nationality Bill

My Lords, the one thing that I have never thought the noble Baroness, Lady Anelay, as being is picky. Far from it; indeed, I think that the noble Baroness captured a really important issue, which I hope the noble Lord, Lord Hylton, will reflect upon: the difficulty for medical practitioners of trying to prove a negative. I doubt that we would have many offers of support from the medical world. In my experience as chair of a health authority, I have dealt with some amazing and fantastic doctors, who felt very strongly about what their role was and how best to fulfil it. It is incredibly difficult, not only in the time available, but in any event, to prove that point, so I have some difficulties with it. I rise to the challenge of the noble Baroness, Lady Anelay, which is to set out what the Government will do. I hope that the noble Lord will feel that we recognise what I think is of the essence in this amendment, which is to make sure that people have proper access, at the appropriate moment, to medical support, and that we are fully aware of the condition that those people are in and of the appropriateness of what we are proposing. The noble Lord himself referred to those who are considered unsuitable for detention. That is covered within the operational instructions, where there is clear guidance to immigration service staff about who would normally be considered unsuitable for detention: pregnant women; victims of torture; those with serious medical conditions; the mentally ill; the seriously disabled; and the elderly. I think that is quite a substantial group of people to be normally considered inappropriate for detention. They would not be ruled out completely, because there might just be circumstances—and I think that noble Lords on both sides would understand why we do not rule out detention in all circumstances for all people—where it was appropriate. The officers who deal with these cases have to weigh up the different factors for and against detention and make an individual judgment as to whether it would be appropriate, within the guidelines that I have indicated. When a detainee arrives at a removal centre they receive a medical examination and have access to good-quality healthcare throughout their detention, including secondary care at a hospital, should they need it. Any concerns that a person’s physical or mental health may be affected adversely by detention must be reported on arrival or at any point during the course of detention. Any such reports have to be considered very carefully in deciding whether to maintain that detention. We believe that to be the best and most appropriate way of dealing with this. The logistics, aside from what I have already said about the medical profession, of where one would try to put the amendment into action would be very difficult. Who would fund the medical practitioners? Where would they be? How many of them would we need? Where would they conduct their examinations—at every port, enforcement office, screening unit and police station across the country? What if somebody said that they did not want to be examined? What should we do then? As I have already indicated, there is the difficulty for the medical practitioner of trying to prove what is essentially a negative. We think that once we have decided—within the guidelines that I have described—to detain someone, giving them a medical examination on arrival, ensuring that they have good access to healthcare and addressing all concerns both on arrival and in the course of their detention is the right way of involving the medical services that we wish to involve and of providing proper and appropriate care for those individuals who are being detained, I hope for as short a time as possible. I agree completely with the spirit of what the noble Lord is seeking to do; I also agree with the noble Baroness, Lady Anelay, who said that the noble Lord always brings us back to the humanitarian aspect. I think that we have resolved it in—dare I say it—a more practical way: involving the medical services appropriately and supporting vulnerable people. On that basis, perhaps the noble Lord can withdraw his amendment.