Lauren Starkey#ThisBillHarmsMyPatient
This is based on a true case, but all identifiable information has been removed. It is written as if the Illegal Migration Bill has been passed into law in order to demonstrate its potential impact.
A 17.5-year-old Albanian boy presents to A&E with a broken arm. He has a bruise around his eye and he seems to be in pain from more than just the arm, but he’s resistant to being examined or talking about anything other than his arm. He claims he broke it by falling down the stairs, but the bruises aren’t consistent with his explanation. He’s guarded and defensive, and the doctors are concerned that he doesn’t seem able to give any details of where he is staying or who the men are that brought him to the hospital. He seems anxious to leave as quickly as possible and keeps asking if the men are still waiting for him. As the boy is under 18, the doctors keep him in A&E whilst they make a safeguarding referral to the local children’s services department.
A duty social worker is sent to the hospital to speak to the boy. He doesn’t speak any English and refuses to speak through an interpreter as he worries about confidentiality, so they use Google Translate. Though he is reluctant to talk, the social worker takes time to build a rapport by joking with him about the hospital food. The boy says he doesn’t like any of the food in England, and this helps them to talk about how long he’s been in the country and what he likes and doesn’t like. The social worker is able to establish that he has been in the UK without any family for about 6 months, and he’s staying in different places with lots of different adults. He can’t explain how he’s been supporting himself, but he says he gets by. In addition to his injuries, the social worker notices that he’s very thin and doesn’t make eye contact. All of the indicators tell her that he’s likely to be a victim of trafficking and exploitation, so she tells him that she will need to take him into the care of the Local Authority and make arrangements for his safety.
The boy immediately asks if she will have to tell ‘immigration’ about him. He tells her he has heard that no one who arrives illegally is allowed to stay in the UK anymore and that all Albanians are being sent back. He breaks down, shaking and crying, and tells her that he cannot go back to Albania. He owes people money and, if he goes back without repaying the debt, he will be killed or kidnapped and forced into an even worse situation than he’s in now. Reporting him to immigration is as good as killing him, he says.
The social worker has a duty to protect him by bringing him into care and ensuring safeguarding processes are implemented, but she also knows that he only has a few months before he turns 18, at which point he will be liable to detention and forced removal without any way to seek protection in the UK. He won’t be able to get support through the NRM as a victim of trafficking because the gang brought him to the UK in the back of a lorry, making him an illegal arrival. His options will be returning to Albania, or removal to Rwanda or another country he has no connection to. He’s still just a child, but she knows he understands all of this too. His traffickers were probably the ones who told him in order to keep him under their control.
The social worker wonders whether there is anything she could do that would meaningfully protect this child. Under the UK’s longstanding child protection legislation he should be afforded the same care as any other child, but since the Illegal Immigration Bill was introduced he is now part of a group of children who know that protection may only last a matter of months. Safeguarding trafficked children has always been difficult due to the control their traffickers exert over them, but now the social worker wonders if it is even possible when she can’t offer children like this boy any alternative to exploitation.
Once his arm has been set, the social worker takes the boy to a semi-independent placement where he will live with four other young people who would previously have been waiting for their asylum decisions but are now waiting to find out where they will be sent once they turn 18. Within two days, the boy has disappeared.