Upper Tribunal (Immigration and asylum chamber), 2024-03-11, UI-2022-004812
| Appeal Number | UI-2022-004812 |
| Hearing Date | 14 November 2023 |
| Date | 11 March 2024 |
| Published date | 26 March 2024 |
| Status | Unreported |
| Court | Upper Tribunal (Immigration and Asylum Chamber) |
Appeal Number: UI- 2022-004812
|
IN THE UPPER TRIBUNAL IMMIGRATION AND ASYLUM CHAMBER |
Case No: UI-2022-004812 First-tier Tribunal No: PA/56168/2021 IA/18282/2021 |
THE IMMIGRATION ACTS
Decision & Reasons Issued:
On 11th March 2024
Before
UPPER TRIBUNAL JUDGE BRUCE
Between
PJ
(Anonymity order made)
Appellant
and
Secretary of State for the Home Department
Respondent
Representation:
For the Appellant: Mr Caswell, Counsel instructed by Sriharans Solicitor
For the Respondent: Mr Tan, Senior Home Office Presenting Officer
Heard at Manchester Civil Justice Centre on 14 November 2023
DECISION AND REASONS
-
The Appellant is a national of Sri Lanka born in 1969. He seeks leave to remain in the United Kingdom on human rights grounds.
-
His appeal first came before me on the 22nd February 2013 when he brought, with permission, a challenge again the decision of the First-tier Tribunal (Judge Saffer) to dismiss his appeal on human rights grounds.
-
The core of the Appellant’s case before Judge Saffer was that if returned to Sri Lanka he would face a serious, rapid and irreversible decline in his mental health and general living conditions such that would result in intense suffering and/or a loss of life and thereby violate the United Kingdom’ obligation under Article 3 ECHR. The substance of that claim was that the Appellant is living with paranoid schizophrenia. He had for many years received treatment for that condition in Sri Lanka, but the situation there had markedly changed. An economic crash had led to a concomitant collapse in the provision of healthcare; the drugs that he takes to manage his condition are no longer available to buy or are prohibitively expensive; his father had died, and his mother is elderly and unable to offer support; his brother cannot provide for him; he is estranged from his own family and his ex-wife does not allow him any contact with his son. The Appellant relied on a medical report from Consultant Psychiatrist Dr Saleh Dhumad who was of the opinion that if returned to Sri Lanka his “mental health will deteriorate very quickly after stopping his medication for a few days, and it is likely he will take his own life”.
-
In the alternative the Appellant argued on the same facts that the refusal to grant him leave would result in a disproportionate interference with his Article 8 rights: he placed particular reliance on paragraph 276ADE(1)(vi) of the Immigration Rules which provides that leave will be granted where it can be shown that there are “very significant obstacles” to his integration in Sri Lanka. Although this is not now a matter before me, I note that the Appellant also pursued protection grounds before the First-tier Tribunal. The appeal was dismissed on these grounds and the Appellant makes no onward challenge to that.
-
The Respondent did not dispute that the Appellant suffers from paranoid schizophrenia. She was however of the view that the medication that he requires would be available to him in Sri Lanka and that he would there receive the care he needs to ensure that he does not suffer a catastrophic decline in his mental well-being. He left Sri Lanka as an adult and is familiar with the culture and society. He still has family members there. No violation of his human rights would therefore occur if he were to leave the UK.
-
Judge Saffer agreed with the Respondent, and dismissed the appeal.
-
The Appellant appealed against that decision on the grounds that in doing so Judge Saffer failed to take material evidence into account, and/or conducted an impermissibly narrow reading of the evidence before him, in particular that relating to the availability of medicines in Sri Lanka. The Respondent contended that the Tribunal had taken all available evidence into account and was entitled to reach the decision that it did. This was the matter in issue at the hearing before me in February, when the Respondent was represented by Senior Presenting Officer Ms Z. Young. For reasons that I set out below under the heading ‘error of law’ I found that the First-tier Tribunal had erred in its approach and that its decision must be set aside. I gave instructions that the matter be relisted before me. Unfortunately there was then a significant delay, the matter being adjourned on at least two occasions. The hearing resumed on the 14th November 2023 and the parties made submissions relying, where appropriate, on new evidence about the Appellant’s mental health and availability of care in Sri Lanka. I reserved my decision which I now give, under the heading ‘the decision re-made’ below.
Error of Law
-
The argument before me centred on the following passage in the First-tier Tribunal’s decision:
9. Dr Dumad does not indicate in his CV any knowledge of the health system in Sri Lanka. There is no evidence he has spoken to a colleague in Sri Lanka or visited Sri Lanka. The background evidence relied on is limited. It amounts to part of an article in the British Medical Journal (29 June 2022 – it is only part as it is a subscription service) and an article in the Guardian (31 May 2022). The articles do not refer to medication used to treat psychiatric illnesses not being available. They refer to 80% of the medication being imported. That means 20% is not. It does not refer to what stock is available, but there is plainly some as prices have increased. Nor is the information current as the articles are 5 weeks old and 9 weeks old respectively. It has not been established what humanitarian efforts to deliver medication in the last few weeks have occurred.
-
Read with this:
32. Dr Dumad has asserted that the mental health support in the United Kingdom is far more advanced and inclusive than Sri Lanka. However the background evidence makes it clear that prior to the recent difficulties in Sri Lanka there was excellent mental healthcare provision in Sri Lanka which the appellant accessed in 1999 through a 4 month in patient stay and medication and it is clear from the CPIN that it has developed since then. Dr Dumad does not explain what source he has accessed upon which to base his opinion. Dr Dumad asserts that the appellant is not fit to fly, but he has not considered what additional mechanisms can be put in place to ameliorate the risk before and during the process. I accept that the fear is delusional and unshakable and has not settled despite treatment in the United Kingdom, However, as it has not been established that there is real risk that there will be a withdrawal of medication, there is no risk there would be a swift decline in his mental health.
-
Mr Caswell submitted that these passages reveal a fundamental error in approach. The CPIN referred to by the Tribunal was the July 2020 document Sri Lanka: Medical Treatment and Healthcare, which is summarised in the decision as detailing “the provision of treatment, medication, and access to specialist hospitals and community services and its provision in public and private sectors”. As I read it, it is this evidence that the Tribunal relies upon when it refers elsewhere to “the extensive infrastructure shown to have been created in Sri Lanka for treatment and support”. That evidence, all obviously pre-dating the publication of the CPIN in July 2020, is consonant with the Appellant’s own evidence that he had received adequate treatment for his condition before he left Sri Lanka in 2009.
-
Absent a change in circumstance, the Tribunal would have been quite entitled to find on the basis of this evidence that the Appellant would have access to treatment in Sri Lanka today. The complaint made on the Appellant’s behalf was however that there has been such a change in circumstance, that the Tribunal failed to recognise that fact, and diminished the evidence of it in an unreasonable manner.
The evidence before the Tribunal adduced on the Appellant’s behalf consisted of three documents. The first was part of an article from the British Medical Journal dated the 29th June 2022: it was incomplete, because as the Tribunal observed, the rest of it appeared to be behind a paywall. The part that could be seen nevertheless referred to the “devastating health consequences of Sri Lanka’s economic collapse”. The second was an article from the Guardian dated 31st May 2022. I need only set out the headline to convey a flavour of the report: “People are going to die: Crisis-hit Sri Lanka runs out of medicine”. The third was another article from the Guardian, this time dated 5th August 2022 and reporting that martial law had been declared in a response to protests about the collapse of the economy. Mr Caswell pointed out that none of this evidence was contentious. Although none of it squarely addressed the availability of the particular drugs that the Appellant takes to manage his condition, it could – in Mr Caswell’s submission should – have reasonably been inferred from this evidence that it would now be very difficult for him to obtain that medication. The articles conveyed a clear picture: that the Sri Lankan health sector was experiencing a sudden and overwhelming collapse, brought...
To continue reading
Request your trial