The Home Office has told an asylum seeker with tuberculosis they are going to be moved onto the Bibby Stockholm barge, i can reveal.
The doctor treating the migrant is trying to prevent the move and has warned of a “public health catastrophe in the making”.
Dr Dominik Metz, a GP for more than 250 asylum seekers in Oxfordshire, told i that 10 of his patients have received letters from the Home Office saying they would be moved to the barge.
Some of the patients are awaiting surgery and mental health support which he fears will be disrupted by the move and one is under “active treatment” for latent tuberculosis (TB), which could pose a public health risk if it became active and spread.
Doctors are also concerned about potential outbreaks of other diseases such as scabies and diphtheria, both of which have been detected in other asylum seeker accommodation, as these spread faster in crowded areas.
The 222-room Bibby Stockholm has attracted criticism for giving asylum seekers little space when it is full to capacity with 500 people.
The GP has contacted Home Office officials explaining that in his view the move to the barge would be medically inappropriate.
“I feel they are being treated like livestock, only slightly worse, as livestock are prohibited from being transported with active infection,” he said.
The first 15 asylum seekers were moved onto the Bibby Stockholm on Monday, while a further 20 had their transfers blocked after solicitors threatened legal action. The barge is eventually due to hold 500 asylum seekers.
A consultant at Oxford University Hospital, who has also worked with Dr Metz’s patients and asked to remain anonymous, echoed their colleague’s warning that the barge move “could put others at risk.”
Dr Metz said the Home Office are not able to access medical records so are not aware of the asylum seekers’ medical conditions prior to transferring them to the barge but believes they should be consulting with their GPs.
The GP claimed that the Home Office “don’t have any idea without consulting GPs what the potential health impacts are of this”. He said he was not consulted by the Home Office on the health of any of his patients before they received the letter notifying them of the barge move.
All migrants undergo initial health screenings at Western Jet Foil at Manston in Kent, where they are initially taken after arriving in the UK, before further checks at their onward accommodation.
The Home Office would not say whether it would proceed with moving someone on to the barge if a infection is detected but it has placed asylum seekers who have tested positive for disease in isolation at other sites.
i understands that no one currently on board the barge has presented with infectious diseases, but that there is an isolation facility adjacent to the on-site medical centre in case of infection.
How infectious diseases in migrant sites are a constant risk
A draft “outbreak management plan” for the Bibby Stockholm barge warned that “large numbers” of staff and residents could be affected if a disease spreads.
“Accommodation providers should be aware that in the event of a significant outbreak, large numbers of staff as well as residents may be impacted. Contingency plans for surge staffing to maintain minimum numbers should be in place,” the document, released under Freedom of Information laws to NHS Dorset and shared with The Guardian, said.
In late July, TB was detected at a former RAF base now housing asylum seekers. While the Home Office did not confirm the number of asylum seekers testing positive for the illness, it said that those affected were being isolated at MDP Wethersfield near Braintree in Essex.
Last year, a man died of suspected diphtheria after a stay at Manston asylum processing centre. The Home Office said that initial test results for an infectious disease were negative, but a follow-up PCR test was positive “indicating that diphtheria may be the cause of the illness”.
One boy told i he contracted scabies inside the centre. At the time, the Refugee Council warned of “overcrowding and disease” at Manston.
In November 2022, the Home Office began vaccinating asylum seekers against diphtheria after dozens of cases were discovered within processing centres across England.
TB is a bacterial infection which is spread when someone inhales tiny droplets from the coughs or sneezes of an infected person. It normally affects the lungs, but can affect other parts of the body, and can be fatal without treatment.
Latent TB isn’t transmissible when it is being treated but it can become active if it is left unmanaged or treatment is disrupted. Doctors fear that any disruption in medical care caused by moving asylum seekers across the country raises the risk of latent TB cases becoming active or patients developing drug resistance.
Dr Metz said that moving patients around can hinder treatment by requiring them to re-enroll with GPs and undergo fresh health assessments in a new location.
He said that explaining medical problems to new healthcare professionals when there are language barriers can be an issue and that some asylum seekers can end up dropping back down waiting lists for specialist care.
“Constantly relocating asylum seekers from one big hotel to another, especially in this way, is a public health catastrophe in the making. I have had to provide mass treatment for scabies in two local hotels due to outbreaks. They are under control now, but it will happen again if they are being moved,” he told i.
“There is also a huge resource burden: there has also been Diphtheria scares [in local hotels] that needed screening.”
“It’s extremely disruptive for patients but also extremely wasteful in terms of NHS resources,” he added. “If they’ve been through a process already and been seen by specialists, that’s going to get disrupted. There’s also potential public health implications if treatment for TB is stopped part way through.”
The consultant at Oxford University Hospital who has also worked with Dr Metz’s patients said: “People with complex infectious diseases are compromised if their care is moved from unit to unit, and that’s particularly the case when you are dealing with a vulnerable population.
“Infectious diseases are just that: they’re infectious, so they have public health implications. That means that others are put at risk when infections are not managed appropriately. The third point is that this public health impact can be compounded if a patient develops drug resistance, and the likelihood of that is much greater where you have poor continuity of care.”
They added: “Just simple things like getting patients from the hotel to the hospital, you would think that would be very simple. Well, the logistics are extremely difficult. So if that’s difficult, you can imagine what it’s like when people are moved around the country. The issue of providing care for infectious diseases are just so fundamental for everyone’s health.”
Professor Graham Bothamley, Honorary Professor at the London School of Hygiene & Tropical Medicine, said for that people being treated for TB, “it’s always best to continue with the same health care team, making sure to include advocates for those whose first language may not be English.”
“The long treatment for TB requires regular doses of medication and this is usually taken over a 6 month period,” he said. “Prevention of the spread for any infectious disease is clearly always more difficult in settings where a number of people are in close physical proximity.”
A Home Office spokesperson said: “The welfare of asylum seekers being housed on the vessel in Portland is of the utmost priority.
“The Bibby Stockholm has an on-site medical facility to help mitigate the impact on local NHS services and we continue to work closely with health professionals and the UK Health Security Agency (UKHSA) to ensure all appropriate health protocols are followed.”
Asylum seekers have access to a GP and nurse on site so do not have register with local practices, with a medical facility on the barge staffed five days a week. Health records will be available to onboard providers in line with data sharing policies.