Blog post by James Smith, Module Convenor, Displacement, Healthcare and Humanitarian Action, MA in Refugee Protection and Forced Migration Studies.


Reports of overcrowding, hunger, inadequate sanitary conditions, and outbreaks of vaccine-preventable diseases propelled the UK government’s now infamous Manston detention facility in to the public spotlight in late October.  

Following an inspection in late July 2022, the HM Chief Inspector of Prisons raised multiple concerns regarding conditions in the Manston and Western Jet Foil detention facilities, citing weaknesses in “safeguarding and health care, and inconsistent practices affected detainees’ welfare and dignity”.

In the absence of immediate efforts to address these findings and belatedly implement a person-centred approach to immigration and asylum reception, it is unsurprising that the situation has continued to deteriorate. On 24 October the UK government’s own Chief Inspector of Borders and Immigration visited the facility and described it as “dangerous” and “wretched”.

Incidents that meet a threshold for concerted indignation, such as those in the Manston facility, should not be viewed as isolated or unpredictable. Rather, they exemplify the long-standing and politically intentional “hostile environment” that defines the current UK government’s approach to immigration. Consecutive right-wing Home Secretaries – and notably since Theresa May, who first brazenly declared a commitment to the creation of a “hostile environment” for migrants in the UK – have amplified anti-migrant rhetoric and progressively undermined systems for protection and the movement of people.

It is also important to recognise that immigration and asylum processes in the UK are applied differently to different people. Racialised and gendered experiences of current UK immigration and asylum systems have been highlighted, while ease of access to the UK is largely mediated by nationality and socioeconomic status. In relation to access to asylum processes, these differences were particularly apparent in early 2022 as the UK government relatively quickly established systems for hosting and support for pre-dominantly white Ukrainian refugees while simultaneously devising plans to deport asylum seekers of Sudanese, Iranian, Iraqi, Syrian and other nationalities to Rwanda. Since senior government representatives have continued to defend the scheme, it remains necessary to reiterate that the first deportation flight to Rwanda was cancelled on the tarmac in June 2022 due to credible concerns that the scheme would contravene human rights and cause irreversible harm to asylum seekers.

In relation to small boat arrivals, the UK government continues to falsely claim that people are arriving “illegally” by such means. On the contrary, in international refugee law there are no illegal means by which individuals can seek protection worldwide. Rather, there are only safe routes and unsafe routes: compassionate systems and degrading and inhumane systems. The International Organization for Migration have identified at least 205 individuals who have died on the English Channel route to the UK since 2014, of whom at least 57 are known to have drowned. The absence of safe routes to seek sanctuary leave people with few options but to embark on dangerous journeys and to live through situations of protracted marginality.

For those who reach the UK it is increasingly clear that immigration detention is not only degrading and inhumane but also harmful to health. Evidence from several countries has identified high rates of mental health problems among adults and children during and after immigration detention. Detention can increase the risk of the spread of communicable diseases, and of violence and other traumatic events. Detention can also exacerbate – and generate new – vulnerabilities particularly as systems of detention regularly fail to identify vulnerable or “at risk” people (e.g. survivors of trafficking, sexual violence or torture) and ensure they receive adequate specialist support. These issues are further compounded by a lack of access to appropriate healthcare services for people held in detention.

Strict international standards and legal frameworks exist to avoid systems of arbitrary detention, and to limit the duration of detention in exceptional circumstances. The Home Office Immigration (Places of Detention) Direction 2021 policy paper established a limit of five consecutive days in detention. International human rights frameworks strictly prohibit the immigration detention of children. Each of these safeguards have been breached in Manston, which is only intended for use as a short-term holding facility. While the Home Office has reported that 636 of 4161 people who transited through Manston between April and June 2022 were held for more than 24 hours, inaccurate record keeping has underestimated the total length of time in detention. Some unaccompanied children have since reported being held for up to 19 days.

Having adopted the New York Declaration for Refugees and Migrants, the UK government must uphold the commitments contained therein, namely that measures are in place to “provide for adequate, safe and dignified reception conditions, with a particular emphasis on persons with specific needs”, and that states will “pursue alternatives to detention”.

For public health practitioners specifically, the centrality of equity and justice to the discipline requires that we adopt an active, consistent and politically engaged stance that does not shy away from the identification of – and resistance to – the political determinants of ill health. In relation to the intersection between migration, displacement and health, we must collectively expose systems, policies and practices that have contributed to the progressive erosion of migrant rights and refugee protection as exemplified by recent events in the Manston and Western Jet Foil detention facilities. Further, we must be outspoken in advocating for approaches to immigration and sanctuary-seeking that foreground community-based care, safety and dignity, and which sees an expedited end to all forms of immigration detention.


The views expressed in this article belong to the author/s and do not necessarily reflect those of the Refugee Law Initiative. We welcome comments and contributions to this blog – please comment below and see here for contribution guidelines.

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