A Death at Manston: Questions for the Home Office
The news that a man who died after being held for a week at the Manston migrant processing centre may have had the highly contagious bacterial infection diptheria raises serious and urgent questions for the Home Office.
Let's look at the timeline.
By the end of October, there were 4,000 people at Manston, a facility in Kent designed to hold no more than 1,600, while unconfirmed reports emerged of outbreaks of infectious diseases.
On November 1, the Immigration Minister, Robert Jenrick, was asked on BBC Breakfast News about possible cases of diptheria, MRSA and scabies at the site.
He replied: "Those reports are not correct. They’ve been exaggerated. I spoke to the doctors who are on site and there is a very good medical centre there with – when I was there – three doctors plus paramedics supporting people with medical conditions. There have been four cases of diphtheria in a population of around 4,000. But those are all individuals who came into the site with that condition. They didn’t pick it up there as far as we’re aware. They’ve been isolated and they’re being treated appropriately."
Over the following week there was a concerted effort to transfer people from Manston to other accommodation, principally hotels.
On November 7, the Home Office said there were 117 children still at the centre, with their families, and on November 8, after an official visit, the Commons Home Affairs Committee reported that the overall number was down to around 1,200.
So, the numbers were coming down, but concern about disease was escalating - because on November 11, the UK Health Security Agency (UKHSA) published updated guidance on diptheria, with a new document specifically targeted at those involved in the health and welfare of asylum seekers.
In the 22-page document, the UKHSA said that by November 10 there had been 39 confirmed diptheria cases among asylum seekers in 2022 and that it had already issued a "national briefing to alert colleagues including NHS staff on the evolving epidemiology and highlight the importance of early diagnosis and prompt treatment of suspected cases."
The guidance went on: "Due to low vaccine uptake reported in this population (that is, inadequate or unknown vaccination status), complex health needs of many residents and mixing patterns, accommodation settings should be considered high-risk for infectious diseases. In light of the increase in cases of diphtheria and the challenges of contact tracing in asylum seeker accommodation settings, it is important additional measures are put in place to quickly identify suspected cases and minimise the risk of further transmission."
By November 12, therefore, in spite of Jenrick's earlier insistence that the outbreak of diptheria had been "exaggerated", urgent medical guidance about the disease had been distributed and then published on the UKHSA website. Work was also taking place at Manston to roll out vaccines and anti-biotics, according to a report in the Guardian.
“The UKHSA has been working closely with the Home Office at the Manston reception centre, where there have been a number of cases of diphtheria and other infections,” Dr Gayatri Amirthalingam, the UKHSA’s deputy director of public health programmes, was quoted as saying.
“We recommend that diphtheria vaccination and antibiotics are offered to people at the centre and all those who have moved on recently. This is currently being operationalised and we are working with the Home Office and the NHS to make this happen,” she reportedly added. Did this happen by November 12?
November 12 was significant because it was on that day that the man who died had been taken to Manston after travelling across the Channel on a small boat. The individual, who has not been named because his next of kin have not yet been traced, spent seven days at the site, Dan O'Mahoney, the Clandestine Channel Threat Commander, confirmed to the Home Affairs Committee . He died in hospital in the early hours of November 19.
People can be kept at Manston for more than 24 hours only if there are "exceptional circumstances", O'Mahoney said. Extensions have to be signed off at Home Office "director level". As the Home Office seemed to have had some success by November 12 in cutting numbers at Manston, by sourcing other accommodation, why was the man held for seven days, and who authorised that prolonged period of detention?
When the man's death was announced by the Home Office, on November 19, the department said there was "no evidence at this stage" that he had died from an infectious disease. That may have been correct at the time, but why did the Home Office decide to put any such information into the public domain, particularly when it was only provisional?
On November 24, the Prisons and Probation Ombudsman's office said that it would be carrying out an investigation into the man's death. It declined to provide any further comment. (It's worth noting here that the Ombudsman's role has been filled on a temporary basis for almost five months since Sue McAllister retired in June. It's not clear why the Government has failed to appoint someone permanently to this important job, but there is a pattern here: the posts of Victims Commissioner and Anti-Slavery Commissioner are also currently vacant.)
The Home Office has now revealed that the man who died did have diptheria and it may have been the cause of his fatal illness. In a statement on November 26, a spokesperson said: "Initial test results processed by a local hospital for an infectious disease were negative, but a follow-up PCR test was positive, indicating that diphtheria may be the cause of the illness."
It is of course welcome that these details have been made public, though arguably it should have been the Ombudsman's role to do that. Their office is responsible for the investigation, which should be, and must be seen to be, independent. It is also usually the case that medical information relevant to a death is disclosed at an inquest hearing, after a post-mortem examination has concluded. In this case, post-mortem tests are continuing and the inquest has not yet been opened.
What's more, the Home Office's latest disclosure only serves to highlight its poor judgment in the first place, by making an initial statement which has turned out to be wrong. Why was the department apparently so keen last week to scotch the notion that the man may have had diptheria?
In its November 26 statement, the Home Office added that it was offering diphtheria vaccinations to people at Manston. But by November 23 the centre was empty. So, what steps are officials taking to inoculate the thousands who have passed through Manston and may now be in hotels or other accommodation, potentially catching or spreading the disease?
That would appear to be the more pressing issue right now.