QUEEN'S BENCH DIVISION
ADMINISTRATIVE COURT
Strand, London, WC2A 2LL |
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B e f o r e :
Sitting as a Deputy High Court Judge
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THE QUEEN (on the application of SARRAR SUBAHI IBRAHIM) |
Claimant |
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- and - |
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SECRETARY OF STATE FOR THE HOME DEPARTMENT |
Defendant |
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Sasha Blackmore (instructed by Government Legal Department) for the Defendant
Hearing dates: 20 January 2016
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Crown Copyright ©
Philip Mott QC :
i) Between 19 August and 29 September 2014, as a breach of the Defendant's published policy not to detain those where there is independent evidence that they had been tortured, save in very exceptional circumstances.ii) Between 27 August and 29 September 2014 as a breach of the Hardial Singh principles, as removal was no longer imminent once these judicial review proceedings had been started.
The facts
"30/9/2012 left Sudan and travelled to Turkey by lorry. Stayed 2 mths and 9 days. Travelled to Bulgaria by car. Stayed till 4/11/13. I was forced to give fingerprints. It was difficult to leave; the police caught me and beat me up. I travelled to Serbia by car, stayed 8 days. Travelled by car and caught in Hungary. 2 weeks in Hungary. Then to Italy by car, 8 days in Italy, then to France by train. 4 mths 10 days in France in Jungle in Calais. I was arrested by police and fingerprinted. Then lorry to UK. Arrived 22/4/14. Underneath a lorry for 5 hours."
"I will be arrested, tortured and killed. I have a problem with security police because of my ethnicity, they accused me of supporting the opposition military organisation in Sudan."
"27/7/12 – because I was accused of supporting the opposition in Darfur. Held for 32 days, held in Jamaa Al Kabr in Bahri. Released with conditions not to seek medical treatments and provide them with information."
"I hereby report in relation to the following section (please mark as appropriate) of Rule 35. Please tick all those that may be relevant, as some detainees may be affected by multiple issues.
(1) This detainee's health is likely to be injuriously affected by continued detention or any conditions of detention.
(2) I suspect this detainee may have suicidal intentions, and should be managed within the ACDT process.
(3) I have concerns that this detainee may have been the victim of torture."
"1. Please set out the clinical reasons leading to your conclusion at (1), (2) and/or (3) above. This should include relevant medical and psychiatric history; current concerns; and findings from a mental state examination and physical examination. Where relevant, a risk assessment of suicidal ideation/intent should also be conducted.
2. Please ensure that a body map is completed and attached in cases involving scarring or other physical marks."
"Seen in this Health Care Centre. He alleges he caught hepatitis B in Bulgaria. However I put it to him that his GP put it to him that the condition was chronic and he says that he was aware of it in Sudan. So it is evident that he was Hepatitis B positive in Sudan. He is Hepatitis C negative at screening by the GP. Test dated 18.06.14.
He says if he is sent to Bulgaria he will not go but will die in the UK. I have initiated an ACDT.
He was asked about ill-treatment in Sudan but refused to talk about it. He only wanted to talk about catching Hepatitis B in Bulgaria – because he was starving in Bulgaria living on bread and dates. I explained this would not cause Hepatitis B.
Difficult to assess but I felt that his threat to die in UK was credible."
"The doctor has produced the report on the basis that he suspects you may have suicidal intentions and should be managed within the ACDT process in the Detention Centre. However, the doctor has not set out any clinical reasons to suggest there is evidence to consider you to be a victim of torture. Therefore the Rule 35 report will not be treated as independent evidence of torture.
As it is the intention of the Third Country Unit to return you to Bulgaria and not Sudan, your issues and concerns of any ill treatment there should be raised with the Bulgarian authorities on your arrival.
It has been decided that your detention will be maintained."
"Your removal from the United Kingdom is imminent.
You have used or attempted to use deception in a way that leads us to consider you may continue to deceive.
You have not produced satisfactory evidence of your identity, nationality or lawful basis to be in the UK."
"Continued detention approved but I will expect to know the AOS due date by next detention review. Continued detention approved on the basis that we still intend to expedite the JR." [underlining added]
"As TCU [Third Country Unit] have not served the HR [Human Rights] decision before the AOS deadline, I have informed Tsols that we will not be expediting this JR. TCU conclusions team informed. JR will now be subject to normal timescales. SGs [Summary Grounds of Defence] will be filed after HR decision is served."
The course of these proceedings
The law
i) The Secretary of State must intend to remove the person and can only use the power to detain for that purpose;ii) The person can 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 removal within a reasonable period, she should not seek to exercise the power of detention;
iv) The Secretary of State should act with reasonable diligence and expedition to effect removal.
"The following are normally considered suitable for detention in only very exceptional circumstances, whether in dedicated immigration detention accommodation or in prisons:
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- Those where there is independent evidence that they have been tortured."
"20. If the medical practitioner is concerned that a detainee may have been a victim of torture, he/she must always submit a Rule 35(3) report. Rule 35 places medical practitioners at the centre of the process and fundamentally it is for the medical practitioner to decide if he/she has concerns in a professional capacity that a detainee may have been the victim of torture. The medical practitioner should always state clearly the reasons why he/she has concerns arising from the medical examination – specifically the medical evidence which causes these concerns, including all physical and mental indicators.
21. The medical practitioner has no obligation to report an allegation from a detainee if this allegation does not cause the medical practitioner him/herself to be concerned, in the context of the overall medical examination, that the person may be a victim of torture. However, if an allegation does cause the medical practitioner to be concerned, then he/she should report it. The medical practitioner should set out clearly if their concern derives from an allegation with no or limited medical evidence in support.
22. Where there is medical evidence in support of an allegation, the medical practitioner must set out clearly all physical and mental indicators in support of his/her professional concerns. He/she should record any mental or physical health problems that are relevant to the torture allegation.
23. Where possible, the medical practitioner should say why he/she considers that the person's account is consistent with the medical evidence. This means that the medical practitioner should ask to see any scars and record what he/she sees, including on a body map and, where possible, assess whether it is in his/her view medically consistent with the attribution claimed by the detainee. The medical practitioner should consider whether the injury, health problem or other indicator may have other possible explanations which do not relate to torture. The medical practitioner must identify any medical evidence which may be contrary to the account given by the detained person.
24. To help decide whether there is cause for concern, it may also be helpful to ask detainees about:
- When the torture allegedly took place;
- How the injuries/mental health issues arose;
- How the torture is currently affecting them.
25. A Rule 35 report is a mechanism for a medical practitioner to refer on concerns, rather than an expert medico-legal report and so there is no need for medical practitioners to apply the terms or methodology set out in the Istanbul Protocol. Medical practitioners are not required to apply the Istanbul Protocol or apply probability levels or assess relative likelihoods of different causes but if they have a view, they should express it."
- A report which simply repeats an allegation of torture will not be independent evidence of torture;
- A report which raises a concern of torture with little reasoning or support or which mentions nothing more than common injuries or scarring for which there are other obvious causes is unlikely to constitute independent evidence of torture;
- A report which details clear physical or mental evidence of injuries which would normally only arise as a result of torture (e.g., numerous scars with the appearance of cigarette burns to legs; marks with the appearance of whipping scars), and which records a credible account of torture, is likely to constitute independent evidence of torture.
The issues – breach of policy in relation to torture victims
i) The importance of considering whether to tick the box must have been apparent to any doctor carrying out this work. It is explicitly required by Rule 35. It is stressed in the Detention Services Order, which places the doctor at the centre of the process and makes it abundantly clear that he or she is only required to exercise a professional judgment to decide whether he or she has concerns. It is not an expert medico-legal report, and the requirements of the Istanbul Protocol do not apply.ii) The question raised is not whether the detainee is a victim of torture, to which the answer may be Yes, No, or I Don't Know. The question is whether the doctor has concerns. That is a question about the state of the doctor's mind, subjectively, not about any objective truth or evidence. That question, strictly speaking, only admits of the answers Yes or No.
iii) That binary nature of the question is underlined by the low threshold to be applied. It is only if the doctor has "concerns". The doctor is encouraged to delve, and to provide evidence in various forms if it is available. Such evidence may be vital in the determination of whether there is independent evidence of torture. But it is perfectly clear that the doctor can tick the box based on a professional instinct, having examined the detainee, just as a judge or jury may assess the credibility of a witness from his demeanour.
iv) The record of this doctor's findings makes it clear that he understood the difference between that professional instinct, justifying the ticking of the box, and the existence of objective evidence or proof. In relation to Question 2 about suicidal intentions, the box has been ticked, indicating "I suspect this detainee may have suicidal intentions". The narrative acknowledges that this is difficult to assess (there is no specific mental illness, no history of suicide attempts) but the doctor felt able to tick the box based on a professional feeling that the threat was credible.
v) By contrast, the absence of any comment in the narrative about the possibility of torture, save to record that the Claimant refused to talk about it, implies that the doctor had no equivalent difficulty in making an assessment, but had no concerns that the Claimant might have been the victim of torture.
vi) The doctor had no obligation to report an allegation by the Claimant that he had been tortured (see the Detention Services Order paragraph 21). He has not done so, as no allegation was made to him. He has simply recorded that he asked the Claimant about the allegation of ill-treatment in Sudan which had previously been made to a nurse, and the Claimant refused to talk about it. The inclusion of that information does not suggest that the doctor had simply omitted to tick the box about concerns over torture (and Mr Halim did not submit there was any such mistake). In any event, the reference is part of the narrative which is relevant to the assessment of the Claimant's suicide risk.
vii) The narrative does not suggest that the Claimant could not bring himself to speak about ill-treatment in Sudan (as his solicitors suggested in their letter of 12 September 2014). The indications in the doctor's note are that the Claimant considered his treatment in Sudan as much less important than his treatment in Bulgaria. In other words, it was a conscious refusal to talk, not a mental inability to cope with detailing the trauma. At least, the Defendant was entitled to assume that the doctor would have been alive to the different possibilities, and to have taken his or her assessment into account in ticking the box or leaving it blank.
i) It is aimed at assessing the Claimant's current mental state, suicide risk and treatment needs.ii) It reaches a diagnosis of post-traumatic stress disorder ("PTSD") based on the DSM5 criteria set out in his Appendix 1. There are eight different criteria. Professor Katona found six relevant clinical features. Of these, only one related to past experiences, and this aggregates the reported experiences in Sudan and Bulgaria.
iii) That one feature was a stressor involving an exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. The report sets out in detail the alleged treatment in Sudan and Bulgaria. On the face of it, and subject to any expert opinion to the contrary, either experience would have been sufficient to qualify as the stressor criterion. If this is right, it was not crucial to the diagnosis of PTSD that the Claimant's allegations of torture in Sudan were true, nor does the diagnosis amount to independent evidence of such torture.
iv) It is very doubtful whether the alleged treatment in Bulgaria, unpleasant as it sounds, could amount to "torture" as that word is used in the detention policy (see EO at paragraph [82]).
The issues – Hardial Singh
i) This was a Claimant who had travelled widely, and was adept at moving from one country to another illegally when he did not like where he was.ii) Although he clearly wished to stay in the UK, the position had been reached by 27 August 2014 when he had been arrested and was on the point of being forcibly removed to Bulgaria.
iii) He had said to the doctor that there was no way in which he would willingly go back to Bulgaria, and would rather die in the UK. A rather less dramatic way of avoiding being returned to Bulgaria, if he were released from detention, would have been to abscond.
iv) He had no identification papers (although he had been fingerprinted in more than one country). He had no family or other ties in the UK.