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D.8 Healthcare


  1. Detained people are entitled to the same range and quality of healthcare services as the general public receives in the community – this is known as ‘equivalence of care’. This requirement is set out in the Detention Services Operating Standards Manual for Immigration Service Removal Centres.1 To reflect this, since 2013 NHS England has been responsible for commissioning healthcare in immigration removal centres (IRCs) in England.
  2. This chapter considers a range of issues in relation to healthcare. These include the approach of healthcare staff to detained people, the role of healthcare staff in the use of force by detention staff, incidents of food and fluid refusal, the assessment of the mental capacity of detained individuals and the handling of complaints. (Matters relating to initial health screening are considered separately in Chapter D.5.)
  3. The Inquiry is aware that this is a complex and technical area, and that there are challenges in the provision of healthcare services in immigration detention, given the nature of the environment and the vulnerabilities of the detained population. However, it is also important to recognise that inadequacies in the provision of healthcare to detained people (particularly those who are vulnerable) risk deterioration in their health as well as misinterpretation of their conduct, and may potentially expose them to incidents of abuse.


  1. Detention Services Operating Standards Manual for Immigration Service Removal Centres, January 2005, p34[]