Medical Justice has published a new report examining the impact of the UK’s “one in, one out” agreement with France on people detained for removal, finding that the policy has caused severe harm to survivors of torture, trafficking, and other trauma.
The 28-page report, Politics over people? How the UK’s ‘one in one out’ knowingly harms and forcibly removes torture and trafficking survivors to France, is available for download here.
The agreement, implemented in July 2025, allows the UK to detain people arriving by small boat and seek their removal to France, in exchange for accepting an equal number of people from France to claim asylum in the UK. While the government states the scheme aims to deter illegal migration, Medical Justice warns that it results in the arbitrary detention of highly vulnerable individuals, whose asylum claims are not assessed before removal decisions.
“People with serious mental health conditions and traumatic experiences arriving by boat are being detained under this scheme. Their protection claims are ignored, as are the risks they face in detention. Survivors of torture and trafficking are harmed by detention, the anticipation of forced removal, and the removals themselves,” the report states. It adds that clinical safeguards are failing, with alarmingly high rates of suicidality and inadequate access to legal advice.
The report is based on the cases of 33 Medical Justice clients detained under the UK–France treaty since August 2025. The individuals, including men, women, and age-disputed young people, were held in immigration removal centres for periods ranging from one month to over three and a half months. Nationalities included Eritrean, Iranian, Palestinian, Sudanese, Afghan, Syrian, and Ethiopian. All had arrived by small boat and claimed asylum upon arrival.
Independent Medical Justice clinicians assessed 20 of the clients, producing medico-legal reports showing histories of torture, ill-treatment, and trafficking, alongside serious mental health conditions such as PTSD, depression, and anxiety. Many reported severe trauma before arrival in the UK, including violent incidents in France.
The report finds that clinical safeguards in detention are largely ineffective. Only two of the 20 individuals had a GP appointment within 24 hours, and neither assessment met safeguarding requirements. Only three had safeguarding reports documenting likely harm from detention.
High levels of suicidality were reported: 12 individuals experienced suicidal thoughts, one attempted suicide, and two self-harmed. Despite this, only one safeguarding report led to release, with 14 cases showing minimal Home Office response.
Medical Justice also documents the use of force and segregation during removal attempts. One client, referred to as Hamid, with a history of torture, described being restrained in a way that obstructed breathing. Following removal to France, clinical evidence confirmed both physical injuries and psychological harm.
The report further notes that many detainees lacked timely legal advice due to the accelerated removal process. By the time of publication, 16 of the 33 clients had been released in the UK, while 14 were forcibly removed to France.
Particular concern is raised for age-disputed young people, who were disproportionately affected by the scheme. The report highlights systemic failures in protecting vulnerable people and argues that the UK government is knowingly detaining and removing survivors of trauma immediately after perilous journeys, without considering their asylum claims.
Medical Justice calls for an immediate end to the scheme, the release of those currently detained, and the full processing of asylum claims in the UK.
At LawSentis, we provide expert guidance on UK asylum law and offer professional immigration support for vulnerable individuals. As an IAA-regulated organisation, we assist with asylum claims, detention issues, and legal representation, ensuring every client’s rights are protected under UK immigration law.