2) What is the practice of NPMs and challenges faced in monitoring forced returns? 3) What is the role of NPMs and CSOs in contributing to greater transparency, accountability and respect for human rights (including guaranteeing the best interest of the child) in the design and implementation of return policies (incl. formulation of external agreements with third countries)? 4) How could NPMs and CSOs advocate for effective remedies for wrongful returns, taking into account specific vulnerabilities of persons subjected to this practice? Working Group 3: Material conditions of immigration detention and ensuring access to healthcare and social services in detention Immigration detention being administrative in nature, it shall never be punitive in either purpose or effect. States are obliged to avoid prison-like environments, and to guarantee certain standards concerning the material conditions, the length of detention, and the respectful treatment and regime, in accordance with the non-criminal status of migrants in detention. Addressing material conditions of detention, however, must be accompanied by an unequivocal reaffirmation that administrative detention should remain the exception rather than the rule.41 As such, accommodation, sanitation, hygiene, drinking water, food, clothing, bedding, safe custody of and access to personal property and effects must all be provided to an adequate standard and in a manner that is safe and respectful of the dignity of individual detainees. In addition, the design and physical environment of detention facilities ought to ensure that all detainees have adequate privacy.42 Elements to be looked at by monitors include: access to health care, including access to a doctor of one’s choice, selection and profile of staff (gender-mixed staff), activities, outdoor exercise and leisure, access to newspapers, periodicals and other publications, radio or television transmissions. The physical and mental health of immigration detainees is particularly important and access to healthcare should be guaranteed, regardless of their legal status. First of all, immigration detainees may suffer from trauma, in particular victims of torture, who will need to be identified upon arrival. According to the CPT, this includes that, whenever injuries are recorded that are consistent with allegations of ill-treatment, such information should be brought to the attention of the relevant prosecutor 43 and that a person alleging previous torture should be referred to an independent medical examination free of charge, in accordance with the Istanbul Protocol.44 At the same time, regular access to psychological care should be provided. Medical screening upon arrival is therefore key to detect those needs. Second, because there is a high chance that immigration detention have a detrimental impact on the persons’ physical and mental health. Monitors should pay particular attention to this and to the consequences of lack of access to healthcare, in light of the specific needs of certain groups or persons (children, women, victims of torture and persons with disabilities). Questions for discussion: 1) What are the key recommendations of NPMs and CSOs regarding material conditions and issues related to health in immigration detention? 2) What should adequate access to healthcare entail in the context of immigration detention? What are the main barriers to ensure this access and how to overcome them? How have NPMs and CSOs addressed this? 3) What are the specific vulnerabilities with regard to immigration detainees’ physical and mental health, and how to respond to the specific needs of different persons? What is the role of NPMs and CSOs in addressing those needs? 41 See e.g. UNHCR, Guidelines on the Applicable Criteria and Standards relating to the Detention of Asylum-Seekers and Alternatives to Detention (UNHCHR Detention Guidelines): https://www.unhcr.org/publications/legal/505b10ee9/unhcrdetention-guidelines.html. 42 https://www.apt.ch/content/files_res/monitoring-immigration-detention_practical-manual.pdf. 43 CPT, Factsheet on Immigration Detention (2017), page 8. 44 Committee against Torture (CAT), General Comment No. 4 (2017), para. 18 (d). 21