Migrant Detention and the Inequities in Healthcare Access

Immigration removal centres (IRC) have been deployed by the government in an attempt to secure the nation’s borders. The normalisation of actions in the controlling of migration flows has been initiated by a perception placed on migrants as being a threat to the welfare and security of society and therefore “undeserving” as referred to by Foucault (2003). This research study aims to uncover and critique the political institutional structures that are placing undocumented migrants at health risk whilst going through the process of determining their residential and legal status.
The findings of this research project indicate that equity ceases to exist at the point where border enforcement and the right to healthcare converge. There is a new penal system that is being constructed within immigration detention that has enabled the mechanisms of disempowerment of migrant detainees to be conceived.
The analysis of this research project further reveals the perilous conditions of healthcare for migrants in UK’s IRCs and the characteristics of UK immigration policy in providing healthcare to detainees. This research study explores the nexus of neoliberalism and state power, whereby detainees, deprived of their liberty and rights, become sources of private profits. The withholding of healthcare, the weak implementation of rights and policies, the discretionary use of state power to overrule medical advice and health rights is evidenced in the construction of the “hostile environment”. Agamben’s concepts of the state of exception and the camp, Schmitt’s liberal legality and the social determinants of health (SDH) are used to explore how the hostile environment impacts on the accessing of healthcare for migrant detainees. Interviews with twelve former detainees and five service providers provide the empirical material at the heart of this research project.
The practices relating to health and healthcare in immigration detention highlights how the camp paradigm extends beyond the walls of detention centres through expectations of other public services to do the work of border control. This strange combination of public and private sector responsibilities and interests, contradicts and causes tensions in doctors’ loyalties to the welfare of their patients and to the securitisation interest of the Home Office (HO), and other processes. Doctors are presented as advocates of patients, and of NGOs which use legal expertise regarding detainees’ rights to counter the detention system’s abusive obstruction of detainees’ access to health.