DB, R (on the application of) v Secretary of State for the Home Department

Where removal would expose a person to a serious and rapid deterioration in health because essential treatment is unavailable in the receiving country, the claim may be capable of meeting the exceptionally high N v Secretary of State for the Home Department Article 3 threshold. The tribunal must assess the individual medical circumstances, including consequential suffering and degradation. It must not treat the threshold authority as determining the outcome without undertaking that assessment. In an application to extend time, delay and the absence of a satisfactory explanation remain significant, but they must be weighed against material errors in the underlying decision and the arguability of the human-rights claim. Where the tribunal has failed to address a significant medical condition, its refusal may be quashed and remitted for reconsideration.

The claimant, a Ugandan national suffering from HIV, AIDS and leprosy, challenged the Immigration Appeal Tribunal’s refusal to extend time for an appeal against an Adjudicator’s rejection of his asylum and human-rights claims. The medical evidence indicated that essential compatible treatment was unavailable in Uganda, that the claimant would deteriorate rapidly without it, and that worsening leprosy would cause serious disfigurement, loss of sight and social ostracism.

The Adjudicator had considered the availability of HIV treatment but failed to address the claimant’s leprosy and its consequences. The IAT refused an extension of time, relying on the unexplained delay and its understanding of the Article 3 threshold established in N v Secretary of State for the Home Department. The central issues were whether the IAT’s reasoning was legally flawed and what relief should follow.

1. The IAT’s decision was quashed and remitted. The claimant’s delay was substantial and inadequately explained. That was a significant factor under rule 16 of the Immigration and Asylum Procedure Rules 2003, but it did not dispose of the application without considering the material errors in the underlying decision and the arguability of the human-rights claim.
2. The Article 3 threshold described in N v Secretary of State for the Home Department applies where the complaint is essentially that medical resources in the receiving country are inferior to those in the removing country. Such a claim requires circumstances that are exceptional and extreme, with humanitarian considerations so powerful that they could not reasonably be resisted by a civilised state. The threshold is not confined mechanically to deathbed cases, but ordinary differences in medical provision and a reduced life expectancy are insufficient.
3. The claimant’s case was capable of satisfying that threshold. The evidence was capable of showing more than the loss of optimal treatment. Without the prescribed combination of drugs, he would deteriorate rapidly and die soon. The worsening of his leprosy would cause disfigurement, impaired or lost sight and possible ostracism. The IAT was therefore wrong, or at least legally flawed, if it treated N v Secretary of State for the Home Department as requiring the conclusion that the threshold could not be met.
4. The Adjudicator had failed to address the claimant’s leprosy and its consequences, despite their obvious significance. The IAT’s general reference to the medical evidence did not cure that failure. The High Court could identify that the claim was arguable, but it was not the fact-finding body and could not decide whether the threshold was actually satisfied.
5. The IAT was to reconsider whether, despite the delay and lack of a good explanation, it would be unjust to refuse an extension of time. The claimant could submit all the medical evidence before the High Court, and the IAT was directed to consider it on reconsideration. The interested party was ordered to pay the claimant’s costs, excluding the costs of medical evidence not taken into account.

1. High Court (Administrative Court) — The IAT’s refusal to extend time was quashed and remitted for further consideration.
2. Immigration Appeal Tribunal — Refused to extend time for permission to appeal, relying on the unexplained delay and its assessment of the Article 3 medical-treatment threshold.
3. Adjudicator — Rejected the claimant’s asylum and human-rights appeals.