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Immigration (Detention of Pregnant Women)

Volume 567: debated on Thursday 5 September 2013

Motion made, and Question proposed, That this House do now adjourn.—(Mr Evennett.)

I am grateful for the opportunity to introduce this debate and to call for the ending of the detention of pregnant women for immigration purposes. In making my case, I want to challenge my hon. Friend the Minister on the numbers; on the efficacy of current Government policy; and on the ethics of the Government’s policies on the detention of pregnant women for immigration purposes. However, in those challenges, I want to encourage him in making the change; it is an achievable change in the context of the Government’s policies to reduce immigration. Such a change will say more about the morality of the Government and the country and our handling of our immigration policies than any other change within his control as Minister for Immigration.

I am motivated in introducing the debate because I believe profoundly that there is no incompatibility between effective control and limited numbers, and the standards of our behaviour and how we treat people caught in the historical mess of the UK immigration system. I am motivated because of the excellence of the Medical Justice report, “Expecting Change”, which, for the first time, pulls together information that can provide a clear picture of the reality of the situation for pregnant women in detention in the UK.

I am also motivated by news that has come to me today from Yarl’s Wood Befrienders—Yarl’s Wood is a detention centre for women just outside Bedford—that directly contradicts the Government’s stated policy on the detention of pregnant women. Today, a lady who was 28 weeks’ pregnant was released from Yarl’s Wood after six weeks’ detention. That detention was in complete contradiction of the current UK Border Agency policy on the detention of pregnant women. I will point out the reasons for that discrepancy.

This debate is core because of the consequences of the disastrous open-door immigration policies pursued under the previous Labour Government, and the efforts of this coalition Government to deal with them. This debate is often held in the context of people talking about statistics and numbers, or the effectiveness of current Government policies to deal with that open-door policy. It is right that we have a debate about the number of people allowed into this country, the growth of our population and whether public services can manage. That is exactly right; we should be doing that. Equally, it is right that we talk about the efficiency and effectiveness of our border controls, so that we can hear the Minister—as he did yesterday so admirably—explain how we are managing to improve the situation and get our borders under control.

We must also ensure, however, that we do not lose sight of the individual people caught up in this bureaucratic mess, and its impact on them and their children. The Government recognised that when they ended the policy of detaining children for immigration purposes. That was the right thing to do: it was right from the point of view of effectiveness and right from the point of view of morality. It is important that we recognise morality in our immigration policies. Imprisoning children was not only ineffective; it was morally wrong. It should not be seen as just an inconvenience of bureaucratic policy.

I am grateful to the hon. Gentleman for giving way. He makes a compelling case that, in practice, when it comes to pregnant women, the policy of not detaining is not enforced. Is he aware that the same is true of children, who are also being detained at present, despite Government policy to the contrary?

The hon. Lady makes a good point. I am sure she would want to welcome the changes the Government have made after the previous Government’s policies on detaining children. There are always things that need to be done to improve policies. The issue here is this: how are our bureaucratic systems harming children, whether they have been born or are being carried by pregnant women?

The report produced by Medical Justice provides the most effective understanding of the current situation for pregnant women, and is why 334 organisations and charities support its recommendation to end the detention of pregnant women. I would also like to point out to the Minister that that position is supported by the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists—the experts in this field. They have set a challenge for the Minister. Ahead of his response, I want to explain that challenge.

Let me start with some statistics. Every year, about 27,000 people are detained for immigration purposes, of whom 4,000 are women. Of those, approximately 100 are pregnant women. One hundred women—that is what this debate is all about. In the grand picture of immigration control, that number barely registers, but in an assessment of what type of people we are, and how we manage and care for those 100 women and the children they are carrying, it matters a great deal.

The reason for detaining pregnant women is to achieve their removal. Home Office policy states that:

“Pregnant women should not normally be detained. The exceptions to this general rule are where removal is imminent and medical advice does not suggest confinement before the due removal date.”

However, the stated policy is not, in my view, and according to the evidence that I have been given, being implemented in practice. In practice, pregnant women are not being detained in exceptional circumstances only. This concern has been raised by Medical Justice and Her Majesty’s inspectorate of prisons, and the pregnant women are not detained for periods of time that would match any description of what an imminent removal would be.

It concerned me that the UK Border Agency was not collecting information on the detention of pregnant women, so questions could not be answered about whether policy was being followed. With no information, how are we to understand whether this important policy relating to vulnerable people is being pursued correctly? I asked Medical Justice to review the 20 cases in its report. It found that the average detention period was 11 weeks, and that in four of the 20 cases the women were detained for 20 weeks or more. By no stretch can that be described as pursuing the stated policy of the UK Border Agency.

A trimester ago, I asked the Minister to ask the UK Border Agency to check its facts. I appreciate his response, but I would like to ask him again today, because collecting information is so important. Does he know how many pregnant women are currently in detention? Can he advise the House what the detention period has been for each of those women and for all other pregnant women detained in the past 12 months? Is he satisfied that the procedures for identifying pregnant women and applying the UK Border Agency’s policies are being implemented fairly? Only 5% of pregnant women who are detained are deported, with 95% released back into the community. I would be interested to hear whether the Minister could confirm those numbers. If he can, what is his assessment of their implications for the efficacy of the UK Border Agency’s policy? Spending more than £700 a week to keep a pregnant woman in detention when we are going to release her, compared with spending £150 a week to keep that lady in the community with people who can support her, is the complete opposite of an efficient and effective policy.

There is another issue: our ethics. In my view, a pregnant woman who is in detention is vulnerable almost by definition. The circumstances that led her to that position will already be associated with heightened vulnerability. She might have been seeking asylum or she might have been trafficked. She might have been left on the streets and made vulnerable in terms of accessing housing, which might then have made her vulnerable to the actions and motivations of people who wanted to provide her with housing. Then, while she is pregnant, she is put in prison—we can use the language of “detention centres” all we like, but it is a prison. That tells us something about how we are treating people.

It seems utterly wrong to ignore the moral and ethical arguments. I am concerned about the response of the UK Border Agency when ethical issues are presented. Let me present two ethical differences and concerns of mine. The first concerns the use of force to remove a pregnant woman, which has now been resolved. In 2012, Her Majesty’s inspectorate of prisons said:

“Force should never be used to effect the removal of pregnant women or…children.”

However, only in February 2013, and only after a High Court case, did the Government yield on that point. I do not understand the ethics of that. That leads to another question. If we have accepted that force cannot be used in the removal—as we have heard, only five out of 100 women are removed—why detain pregnant women at all?

The second ethical question relates to the medical guidelines for pregnant women who are deported to countries with a high risk of malaria. That issue was given particular focus in Medical Justice’s report. The NHS guidelines for British citizens are quite clear: “If you’re pregnant, do not travel to a country with a high risk of malaria.” However, the UK Border Agency guidelines say: “It’s okay to go, but take your tablets”—have pill, will travel. Why the double standard? It is important that the Minister is clear. Do we want to treat the health of those who have come here in that way—I understand that they are here illegally—differently when we deport them to other countries, or do we think that the United Kingdom Government should take the same approach in their treatment of all pregnant women? If he accepts that point, which I hope he does, he must accept it as another strike against the ethics and morality of detaining pregnant women for immigration purposes.

I am no expert on pregnancy and the issues that may arise. The Minister may have more understanding than me—you yourself may have more, Mr Speaker—but I am sure we would all yield to the experts on this issue. Let me quote the director for midwifery at the Royal College of Midwives:

“The very process of being detained interrupts a woman’s fundamental human right to access maternity care. The detention system makes it very difficult for midwives to put women at the centre of their care. We believe that the treatment of pregnant asylum seekers in detention is governed by outmoded and outdated practices that shame us all.”

The previous Government lost control of our immigration system. That has led to major concerns around the country about immigration levels, and this Government are rightly focusing on reducing them and ensuring that we control our borders. However, I urge the Minister to recognise that it is morally wrong for a bureaucracy to act wilfully to harm a child’s prospects when there are superior alternatives available that would reduce or eliminate any such harm. Those alternatives exist.

I urge my hon. Friend to listen to the experts who understand the care of pregnant women, to understand the facts—which we have and he does not—as they are presented, to consider that the ethics involved here are the same as those that motivated this Government to end the detention of children, and to end now the detention of pregnant women for immigration purposes.

I am grateful to my hon. Friend the Member for Bedford (Richard Fuller) for securing this debate. As he acknowledged, he and I have had detailed discussions on this issue. Yarl’s Wood, the principal immigration removal centre holding female detainees, is located in his constituency, so I completely understand his interest in this particular issue, both from a policy and a constituency perspective.

First, I would like to emphasise that the decision to detain someone is never taken lightly and only as a last resort. My hon. Friend acknowledged that in his speech. Generally, when we decide that detention is appropriate, we ensure that we take care of detainees’ welfare. That obviously includes pregnant women, who have particular needs. He set out the Government’s policy quite fairly. It is that we do not, in general, detain pregnant women except in two sets of circumstances. The first is when a woman’s removal from the UK is imminent and medical advice suggests that her baby is not due before the expected removal date. The second is, under the asylum system, when the decision not to grant asylum would allow for the woman to be removed.

I thought that the statistics that my hon. Friend cited suggested that we were doing as the policy required. He described the significant number of people who were detained, then said that only 100 of those were pregnant women. I think I have got that figure right; I was listening carefully to his speech. That shows that we detain very few pregnant women and that we do so only in the circumstances that I have described.

We factor into our decisions the timing issue that my hon. Friend raised. Obviously I do not have the details of the specific case that he mentioned, but I will explain in a minute why I do not think that that case would have contravened our existing policy. We factor into the decision on timing the International Air Transport Association’s guidelines to airlines on carrying pregnant women, which provide for travel up to 28 weeks or, if medically certified, up to either 32 or 36 weeks depending on the circumstances of the pregnancy. Women who are less than 24 weeks pregnant may also be detained under the fast-track asylum process operating at Yarl’s Wood, which would allow for a case to be processed and, if appropriate—that is, if asylum is not granted—for removal to take place within those time frames.

In regard to the case that my hon. Friend described, I can give him only a general answer as I do not have the details. If he would like to write to me after the debate with those details, however, I will of course look into the specifics of the case and correspond with him about them. We might have detained the woman for removal, and the removal might then not have gone ahead for a reason that was not anticipated at the time. There might have been a further legal challenge, for example, or perhaps a travel document was unavailable. Alternatively, she could have been detained under the fast-track process prior to the 24-week point. All those circumstances would fall within published policy, but it would be better if my hon. Friend could furnish me with the details of the specific case so that I can look into it.

The Minister has just indicated in his answer the very reason the current policy does not work. It is based on imminence, and imminence cannot be predicted, for the very reason that he has just set out. He has therefore just stated why ending the detention of pregnant women would be a clearer, fairer, better and more moral policy. We are talking about 100 women. That is it. Would it not say more about the ethics of his policy if he were to accept that reality and stop the policy now, rather than pretending that the policy is actually happening in practice?

I do not agree with my hon. Friend, for this reason. The use of statistics was mentioned, but we do not collect statistics on this matter because women are not, of course, obliged to tell the Home Office whether they are pregnant. They may tell us, and if they do, the information will be held on their individual case file and they will be provided with appropriate health care, broadly comparable to what is available from an NHS general practitioner. The women are under no obligation to tell us, and I do not think forcing them to disclose the information would be right. That is an issue about the statistics.

Making decisions about the imminence of removal is clearly based on our best intelligence, but as we know, the people who have no right to be in the United Kingdom and who should leave the country voluntarily often throw all sorts of legal obstacles in the way. We may detain a woman when removal is imminent and she may attempt to secure a last-minute legal challenge to throw a roadblock in the way of her removal, and we have no way of anticipating that before she does so. That provides my hon. Friend with an example.

If we were to do what my hon. Friend suggested and have a blanket policy of not detaining women, first, having read many cases, I fear we would find quite a lot of people saying they were pregnant as another method of delaying their departure from the UK. I have seen people throw many obstacles in the way when they have no right to be here, and I do not want this to be one of them. We are committed to treating pregnant women properly, providing proper health care and treating them well. I do not want this to be an excuse that women who are not pregnant dream up in order to throw a legal obstacle in the way. I fear that that would be the result of adopting the blanket policy suggested by my hon. Friend.

A logical follow-on policy from what my hon. Friend suggests would mean not removing the women from the UK when they were pregnant and allowing them to give birth to their child, but then seeking to remove both the woman and the very young child from the UK to their home country or country of origin—and I am not sure that that would be an improvement. If I anticipate correctly, if we did that, we would then be criticised for trying to remove the mother with her very young child back to their country of origin. As I say, I am not sure that that would be an improvement on the present situation, because the fact remains that these women have no right to be in the UK: they should not be here and they should leave voluntarily. [Interruption.] I cannot quite tell whether the hon. Member for Slough (Fiona Mactaggart) is dying to intervene.

I was squeaking—the Minister is right—because I cannot believe that someone is going to get pregnant in order not to be detained. Secondly, it is quite easy to find out whether someone is pregnant, so that bit of the Minister’s excuse proves his hon. Friend’s very powerful argument that this is a moral case. I fear that I hear in the Minister’s response a kind of Home Office “jobsworthness”, which I think he should be above and is usually above.

I am not going to let the hon. Lady put words into my mouth. I did not say—I chose my words very carefully—that women would get pregnant; I said women would say they were pregnant in order to throw a legal challenge. I know it is perfectly easy to test whether women are pregnant, but we do not have the right to do that. The Home Office does not have the right to insist that a women disclose that she is pregnant. We do not have the right forcibly to test people to see whether they are pregnant. If I were to propose that, I doubt whether the hon. Lady would support it. To be clear, I did not say that people would get pregnant; I said that they would say they were to throw a legal obstacle in the way of their removal from the country. I have seen enough cases—and I know the hon. Lady has—to know that there are people who would stoop to doing that to delay their removal from the UK.

However, the Home Office could easily say, “We will release you if you provide evidence of pregnancy.”

That may be the case, but our objective is not to let the people out of detention, but to remove them from the UK. That it is the point, and it is one I think my hon. Friend is missing, too. The fact is that these women have no right to be in the UK and should leave. I am not sure that a policy that allowed them stay in order to give birth to their child, when we would immediately want to remove both the woman and the child from the UK, would be a better policy than the one we have today.

If the purpose is to remove people, will the Minister counter my statistics with statistics of his own, and explain why only five out of 100 women have been deported and 95 have been returned to the community? I am not sure that his argument stacks up.

I am not sure that I agree with my hon. Friend’s statistics, but I do not have the details. Because, as far as I know, the Home Office has not been given the details of the 20 people to whom Medical Justice referred, it is difficult for us to validate its assertions. The difficulty with giving my hon. Friend overall statistics is that although when women provide the information that they are pregnant, that information is held on their health records, we do not log it statistically, and obviously we can do so only when they disclose the information to us. Of course, in the early stages of pregnancy they may not even be aware of the fact themselves.

When a pregnant woman is detained she will, like all other detainees, have access to free on-site health care facilities and medical advice broadly equivalent to that which is available from national health service GPs in the community. At Yarl’s Wood, for instance, all midwifery services are provided by Bedfordshire NHS Trust. Midwives from the trust visit the centre every week. At Dungavel immigration removal centre, where women may also be detained, midwifery services are provided by NHS Lanarkshire. In line with practice in the community, the visiting midwives will determine how frequently they need to see patients.

Women can make requests for additional midwife appointments through the health care centre if they wish. The centre is staffed by nurses around the clock, and the GP can be called upon seven days a week when necessary. In the event of a particularly difficult medical problem, health care staff can refer women to the antenatal clinic or early pregnancy unit in the local hospital, or to another appropriate health care service. I therefore do not agree with my hon. Friend that there is a health care issue.

My hon. Friend asked about pregnant women being returned to countries where malaria is prevalent. We take steps to ensure that they are given the appropriate course of anti-malaria medication before their removal, but decisions about that medication must, of course, be made by doctors.

As for my hon. Friend’s point about advice to British nationals who are travelling, he should bear in mind that these women are nationals of their home countries, the countries where they should live. The NHS is a national health service whose purpose is to provide health care for citizens and residents of the United Kingdom. It is not an international health service. I do not think that the comparison between the health care that a woman would receive in the United Kingdom if she lived here and the health care that is available in her home country is relevant. Her home country is the country in which she should live. It is not the job of the national health service to become a health service for everyone in the world. If it were to do so, it would rapidly collapse, and I do not think we want that to happen.

The Minister is right to say that the NHS is a national and not an international health service, but that is not quite the point that I was making. One of the consequences of losing control of immigration is that people have been in this country for a long period, and when people have spent a long period in another country, their immunity to malaria is lowered. We are sending back pregnant women with low immunity. Their health condition is not the same as the health condition of a lady who becomes pregnant in her country of origin. That is the comparison that I was trying to make. I certainly do not want us to have an international health service, but I think the Minister must accept that delaying the repatriation of people who are here illegally has consequences in terms of their health status, particularly when it comes to malaria. That is a key point for pregnant women.

And that is exactly why we ensure that pregnant women are given a course of anti-malaria medication. We also provide them with mosquito nets, free of charge, to use in their countries of origin. I am not sure that I follow the logic of my hon. Friend’s argument. If we allowed those pregnant women to remain in the United Kingdom and give birth here, we would still later be removing both mother and child to that same country of origin where malaria may be prevalent.

The fact is that we will not allow women to stay here when they do not have a right to do so. Not only will their cases have been judged by the Home Office, but a number of appeal routes will have been open to them, and only when all those routes have been exhausted will we be in a position to remove them from the country. We try to persuade people to return home voluntarily, and that includes providing assistance when they are in their home countries. Those whom we do detain—those to whom my hon. Friend is referring—will be people who have no right to be here. We will have tried to persuade them to leave voluntarily, and to give them support that would help them to do so. Only when they have refused all those offers of assistance and help from the United Kingdom will we seek to enforce their removal. Therefore, by definition they are people who are not co-operating in their removal from the United Kingdom. That is why I anticipate that if we change the policy to the one my hon. Friend suggests, people will use that to throw legal obstacles in the way—not to do what the hon. Member for Slough said, but at least to suggest to us that that is the case, which would at least delay, if not stop, their removal.

I am therefore unable to give my hon. Friend the outcome he desired. I am very happy to continue this dialogue with him and to look into the case he has raised with me, and if he thinks there are other cases where the Government are not following the policy we have set out, I will look into them. On his central request, however, I am afraid the Government have no plans to change the current policy.

Question put and agreed to.

House adjourned.