HOUSE OF LORDS
 UKHL 27
on appeal from:  EWCA Civ 840
OF THE LORDS OF APPEAL
FOR JUDGMENT IN THE CAUSE
Regina v. Secretary of State for the Home Department (Appellant) ex parte Razgar (FC) (Respondent)
THURSDAY 17 JUNE 2004
The Appellate Committee comprised:
Lord Bingham of Cornhill
Lord Walker of Gestingthorpe
Baroness Hale of Richmond
HOUSE OF LORDS
OPINIONS OF THE LORDS OF APPEAL FOR JUDGMENT
IN THE CAUSE
Regina v. Secretary of State for the Home Department (Appellant) ex parte Razgar (FC) (Respondent)
 UKHL 27
LORD BINGHAM OF CORNHILL
1. Mr Razgar is an asylum seeker from Iraq whom the Secretary of State proposes to remove to Germany under the provisions of the Dublin Convention. Mr Razgar resists such removal on the ground that it would violate his rights under article 8 of the European Convention on Human Rights. The Secretary of State does not accept that removal would violate Mr Razgar's rights under article 8, and has certified under section 72(2)(a) of the Immigration and Asylum Act 1999 that the claim is manifestly unfounded. The consequence of that certification, if it stands, is to preclude any appeal by Mr Razgar against his removal from within this country. In these proceedings Mr Razgar has challenged the Secretary of State's certification and has succeeded before Richards J ( EWHC 2554 (Admin) and the Court of Appeal (Judge and Dyson LJJ and Pumfrey J:  EWCA Civ 840,  Imm AR 529). In this appeal by the Secretary of State two main questions arise, one of pure principle and one directed to the facts of this case so far as they are now known and the process of review. The question of principle is agreed to be:
"Can the rights protected by article 8 be engaged by the foreseeable consequences for health or welfare of removal from the United Kingdom pursuant to an immigration decision, where such removal does not violate article 3?"
The second issue is whether the judge was right to quash the Secretary of State's certification of Mr Razgar's claim as manifestly unfounded.
2. This appeal was heard immediately following the appeals in R (Ullah) v Special Adjudicator and Do v Immigration Appeal Tribunal. The opinions of the House in those appeals are directly germane to the issue of principle in the present case (see  UKHL 26 and should be read, to the extent that they are relevant, as incorporated in this opinion. In this appeal it is, however, necessary to give more detailed consideration to article 8 of the Convention.
3. In the course of argument both sides made generous reference to authority, but each side relied on one authority in particular as encapsulating the pith of its argument. For the Secretary of State, the Attorney General placed strong reliance on a recent admissibility decision of the Strasbourg court in Henao v The Netherlands (Application No 13669/03, 24 June 2003, unreported). The applicant was a Colombian national who was arrested, tried and imprisoned for carrying drugs into the Netherlands. While serving his sentence he was found to be HIV-positive and received appropriate treatment. He resisted deportation to Colombia at the end of his sentence on the ground that he would face difficulties in obtaining treatment for his condition in Colombia, placing reliance on article 3 of the Convention. In holding that the application was manifestly ill-founded, the Court said:
"The Court reiterates at the outset that Contracting States have the right, as a matter of well-established international law and subject to their treaty obligations including the Convention, to control the entry, residence and expulsion of aliens. However, in exercising their right to expel such aliens, Contracting States must have regard to Article 3 of the Convention which enshrines one of the fundamental values of democratic societies.
It is precisely for this reason that the Court has repeatedly stressed in its line of authorities involving extradition, expulsion or deportation of individuals to third countries that Article 3 prohibits in absolute terms torture or inhuman or degrading treatment or punishment and that its guarantees apply irrespective of the reprehensible nature of the conduct of the person in question.
While it is true that Article 3 has been more commonly applied by the Court in contexts where the risk to the individual of being subjected to ill-treatment emanates from intentionally inflicted acts by public authorities or non-State bodies in the receiving country, the Court has, in the light of the fundamental importance of Article 3, reserved to itself sufficient flexibility to address the application of that Article in other contexts which might arise. It is not, therefore, prevented from scrutinising an applicant's claim under Article 3 where the risk that he runs of inhuman or degrading treatment in the receiving country is due to factors which cannot engage either directly or indirectly the responsibility of the public authorities of that country, or which, taken alone, do not in themselves infringe the standards of that Article. To limit the application of Article 3 in this manner would be to undermine the absolute character of its protection. In any such contexts, however, the Court must subject all the circumstances of the case to rigorous scrutiny, especially the applicant's personal situation in the expelling State (see Bensaid v the United Kingdom, no. 44599/98, §§ 32 and 34, ECHR 2001-I).
According to established case-law aliens who are subject to expulsion cannot in principle claim any entitlement to remain in the territory of a Contracting State in order to continue to benefit from medical, social or other forms of assistance provided by the expelling State. However, in exceptional circumstances an implementation of a decision to remove an alien may, owing to compelling humanitarian considerations, result in a violation of Article 3 (see D v the United Kingdom, judgment of 2 May 1997, Reports of Judgments and Decisions 1997-III, p. 794, § 54). In that case the Court found that the applicant's deportation to St. Kitts would violate Article 3, taking into account his medical condition. The Court noted that the applicant was in the advanced stages of AIDS. An abrupt withdrawal of the care facilities provided in the respondent State together with the predictable lack of adequate facilities as well as of any form of moral or social support in the receiving country would hasten the applicant's death and subject him to acute mental and physical suffering. In view of those very exceptional circumstances, bearing in mind the critical stage which the applicant's fatal illness had reached and given the compelling humanitarian considerations at stake, the implementation of the decision to remove him to St. Kitts would amount to inhuman treatment by the respondent State in violation of Article 3 (see D v the United Kingdom, cited above, pp. 793-794, §§ 51-54).
The Court has therefore examined whether there is a real risk that the applicant's expulsion to Colombia would be contrary to the standards of Article 3 in view of his present medical condition. In so doing, the Court has assessed the risk in the light of the material before it at the time of its consideration of the case, including the most recent information on the applicant's state of health (see S.C.C. v Sweden (dec.), no. 46553/99, 15 February 2000, unreported).
The Court notes that the applicant stated on 16 August 2002 that he felt well and had worked, although he did suffer from certain side-effects of his medication. The Court further notes that, according to the most recent medical information available, the applicant's current condition is reasonable but may relapse if treatment is discontinued. The Court finally notes that the required treatment is in principle available in Colombia, where the applicant's father and six siblings reside.
In these circumstances the Court considers that, unlike the situation in the above-cited case of D. v the United Kingdom or in the case of B.B. v France (no. 39030/96, Commission's report of 9 March 1998, subsequently struck out by the Court by judgment of 7 September 1998, Reports 1998-VI, p. 2595), it does not appear that the applicant's illness has attained an advanced or terminal stage, or that he has no prospect of medical care or family support in his country of origin. The fact that the applicant's circumstances in Colombia would be less favourable than those he enjoys in the Netherlands cannot be regarded as decisive from the point of view of Article 3 of the Convention."
4. As is clear from this judgment, the applicant in Henao placed reliance on article 3 alone. Read in isolation, the judgment might suggest that only article 3 can be relied on to resist a removal decision made by the immigration authorities. But the House has held in Ullah and Do that that is not so, and it seems clear that the Court confined its attention to article 3 because that was the sole ground of the application. The case does however illustrate the stringency of the test applied by the Court when reliance is placed on article 3 to resist a removal decision. It also shows, importantly for the Secretary of State, that removal cannot be resisted merely on the ground that medical treatment or facilities are better or more accessible in the removing country than in that to which the applicant is to be removed. This was made plain in D v United Kingdom (1997) 24 EHRR 423, paragraph 54. Although the decision in Henao is directed to article 3, I have no doubt that the Court would adopt the same approach to an application based on article 8. It would indeed frustrate the proper and necessary object of immigration control in the more advanced member states of the Council of Europe if illegal entrants requiring medical treatment could not, save in exceptional cases, be removed to the less developed countries of the world where comparable medical facilities were not available. I do not understand the Court of Appeal to have proposed a test based on relative standards of treatment, when it said in paragraph 22 of its judgment, with reference to article 8:
"22. We prefer a somewhat different test. We suggest that, in order to determine whether the article 8 claim is capable of being engaged in the light of the territoriality principle, the claim should be considered in the following way. First, the claimant's case in relation to his private life in the deporting state should be examined. In a case where the essence of the claim is that expulsion will interfere with his private life by harming his mental health, this will include a consideration of what he says about his mental health in the deporting country, the treatment he receives and any relevant support that he says that he enjoys there. Secondly, it will be necessary to look at what he says is likely to happen to his mental health in the receiving country, what treatment he can expect to receive there, and what support he can expect to enjoy. The third step is to determine whether, on the claimant's case, serious harm to his mental health will be caused or materially contributed to by the difference between the treatment and support that he is enjoying in the deporting country and that which will be available to him in the receiving country. If so, then the territoriality principle is not infringed, and the claim is capable of being engaged. It seems to us that this approach is consistent with the fact that the ECtHR considered the merits of the article 8 claim in Bensaid. It is also consistent with what was said in paragraphs 46 and 64 of Ullah  1 WLR 770."
If there is any doubt on this point, it should be dispelled. The Convention is directed to the protection of fundamental human rights, not the conferment of individual advantages or benefits.
5. The bedrock of Mr Razgar's case was the decision of the Court in Bensaid v United Kingdom (2001) 33 EHRR 205. This authority featured largely in the decisions of the judge and the Court of Appeal and must be considered in a little detail. The applicant was an Algerian national who entered the United Kingdom in 1989 and was permitted to remain for a period which expired in 1992. In 1993 he married a United Kingdom citizen and was in due course granted indefinite leave to remain as a foreign spouse. In 1996 he left the United Kingdom for a month to visit Algeria, and following his return was refused leave to enter on the ground that his indefinite leave to remain had been obtained by deceptively entering into a marriage of convenience. It was proposed to remove him. Before this, he had been diagnosed as a schizophrenic suffering from psychotic illness of such severity that compulsory detention in a psychiatric hospital was considered. In the event, he responded to treatment and his illness was successfully managed out of hospital save for one brief period. The applicant relied on articles 3 and 8 of the Convention to resist removal. He contended that the nearest hospital at which his psychiatric illness could be treated in Algeria was some 75-80 km from his home village, and adduced evidence that there was a high risk of his suffering a relapse of psychotic symptoms on returning. He had lost all insight into the fact that he was ill and believed the persecutory delusions and abuse which he experienced, including voices telling him to harm other people. He had previously felt so hopeless and depressed as to contemplate suicide. In the opinion of a psychiatrist, there was a substantial likelihood that forcible repatriation would result in significant and lasting adverse effect.
6. In its judgment the Court first considered the applicant's claim under article 3 and concluded that implementation of the decision to remove him to Algeria would not violate article 3 of the Convention. As in Henao, the case was contrasted with the exceptional facts of D v United Kingdom (1997) 24 EHRR 423 (see paragraph 40, page 218):
"40. The Court accepts the seriousness of the applicant's medical condition. Having regard however to the high threshold set by Article 3, particularly where the case does not concern the direct responsibility of the Contracting State for the infliction of harm, the Court does not find that there is a sufficiently real risk that the applicant's removal in these circumstances would be contrary to the standards of Article 3. It does not disclose the exceptional circumstances of the D case
. where the applicant was in the final stage of a terminal illness, AIDS, and had no prospect of medical care or family support on expulsion to St. Kitts."
7. The Court then turned to consider the applicant's complaint based on article 8. For the applicant it was submitted (paragraph 44, page 219) that
"withdrawal of that treatment [NHS treatment since 1996] would risk a deterioration in his serious mental illness, involving symptoms going beyond horrendous mental suffering - in particular there would be a real and immediate risk that he would act in obedience to hallucinations telling him to harm himself and others. This would plainly impact on his psychological integrity. In addition to the ties deriving from his eleven years in the United Kingdom, the treatment which he currently receives is all that supports his precarious grip on reality, which in turn enables some level of social functioning".
The Government (paragraph 45) did not accept that the removal of the applicant from the United Kingdom, where he was illegally, to his country of nationality, where medical treatment was available, would show any lack of respect for his right to private life. Even if there was an interference, such would be justified under article 8(2) on the basis that immigration policy was necessary for the economic well-being of the country and the prevention of disorder and crime.
8. The Court concluded that implementation of the decision to remove the applicant to Algeria would not violate article 8 of the Convention, for reasons set out in paragraphs 46-48 of its judgment:
"46. Not every act or measure which adversely affects moral or physical integrity will interfere with the right to respect to private life guaranteed by Article 8. However, the Court's case-law does not exclude that treatment which does not reach the severity of Article 3 treatment may nonetheless breach Article 8 in its private life aspect where there are sufficiently adverse effects on physical and moral integrity.
47. Private life is a broad term not susceptible to exhaustive definition. The Court has already held that elements such as gender identification, name and sexual orientation and sexual life are important elements of the personal sphere protected by Article 8. Mental health must also be regarded as a crucial part of private life associated with the aspect of moral integrity. Article 8 protects a right to identity and personal development, and the right to establish and develop relationships with other human beings and the outside world. The preservation of mental stability is in that context an indispensable precondition to effective enjoyment of the right to respect for private life.
48. Turning to the present case, the Court recalls that it has found above that the risk of damage to the applicant's health from return to his country was based on largely hypothetical factors and that it was not substantiated that he would suffer inhuman and degrading treatment. Nor in the circumstances has it been established that his moral integrity would be substantially affected to a degree falling within the scope of Article 8 of the Convention. Even assuming that the dislocation caused to the applicant by removal from the United Kingdom where he has lived for the last eleven years was to be considered by itself as affecting his private life, in the context of the relationships and support framework which he enjoyed there, the Court considers that such interference may be regarded as complying with the requirements of the second paragraph of Article 8, namely as a measure 'in accordance with the law', pursuing the aims of the protection of the economic well-being of the country and the prevention of disorder and crime, as well as being 'necessary in a democratic society' for those aims."
The Court then went on to consider the applicant's complaint under article 13 of the Convention that he had no effective remedy against the expulsion. In its judgment on this point the Court described the applicant's article 3 complaint as "arguable" (paragraph 54) and found (paragraph 58) that in judicial review the applicant had available to him an effective remedy in relation to his complaints under articles 3 and 8 of the Convention concerning the risk to his mental health of being expelled to Algeria.
9. This judgment establishes, in my opinion quite clearly, that reliance may in principle be placed on article 8 to resist an expulsion decision, even where the main emphasis is not on the severance of family and social ties which the applicant has enjoyed in the expelling country but on the consequences for his mental health of removal to the receiving country. The threshold of successful reliance is high, but if the facts are strong enough article 8 may in principle be invoked. It is plain that "private life" is a broad term, and the Court has wisely eschewed any attempt to define it comprehensively. It is relevant for present purposes that the Court saw mental stability as an indispensable precondition to effective enjoyment of the right to respect for private life. In Pretty v United Kingdom (2002) 35 EHRR 1, paragraph 61, the Court held the expression to cover "the physical and psychological integrity of a person" and went on to observe that
"Article 8 also protects a right to personal development, and the right to establish and develop relationships with other human beings and the outside world."
Elusive though the concept is, I think one must understand "private life" in article 8 as extending to those features which are integral to a person's identity or ability to function socially as a person. Professor Feldman, writing in 1997 before the most recent decisions, helpfully observed ("The Developing Scope of Article 8 of the European Convention on Human Rights",  EHRLR 265, 270):
"Moral integrity in this sense demands that we treat the person holistically as morally worthy of respect, organising the state and society in ways which respect people's moral worth by taking account of their need for security."
10. I would answer the question of principle in paragraph 1 above by holding that the rights protected by article 8 can be engaged by the foreseeable consequences for health of removal from the United Kingdom pursuant to an immigration decision, even where such removal does not violate article 3, if the facts relied on by the applicant are sufficiently strong. In so answering I make no reference to "welfare", a matter to which no argument was directed. It would seem plain that, as with medical treatment so with welfare, an applicant could never hope to resist an expulsion decision without showing something very much more extreme than relative disadvantage as compared with the expelling state.
The Secretary of State's certification
A The facts
11. Mr Razgar is aged 26 and is an Iraqi of Kurdish origin. He says that in about 1995 his father was hanged as a communist opponent of the Ba'athist regime then in power and he himself was arrested, imprisoned and tortured for two and a half years. These facts have not been tested, but his body is said to bear marks consistent with severe flogging. At the end of 1997 (he says) he bribed his way out of prison and travelled via Turkey to Germany. On arrival in Germany he claimed asylum but his claim was refused. He remained in Germany for over a year, during which he says that he was detained, subjected to racist abuse and told he would be returned to Iraq. He arrived in the United Kingdom on 22 February 1999 and at once claimed asylum. In April 1999 the German authorities accepted responsibility for examining his asylum claim under article 8 of the Dublin Convention and in May the Secretary of State decided to certify the claim on safe third country grounds. For reasons which need not be explored the relevant notice was not served until May 2000 and the removal directions given in May 1999 did not come to Mr Razgar's notice. In November 1999 he had started to undergo treatment from a consultant psychiatrist of high standing, Dr Sathananthan, whose report dated 16 May 2000 (based on an examination on 29 February 2000) was forwarded to the Secretary of State following service of the safe third country notice. The report described Mr Razgar as suffering from severe depression although not at that time thinking of self-harm. He had nightmares not only of Saddam Hussein's security men trying to torture him but also of the German police. The psychiatrist considered that:
"Incarceration and custody is likely to cause a relapse on the progress he has made so far. Given Mr [Razgar's] subjective fear of ill-treatment in Germany, I feel that he would not make any progress there in rehabilitating from Post Traumatic Stress Disorder, or indeed from his depression."
The Secretary of State at once rejected the representations made by Mr Razgar's solicitors and declined to defer his removal directions. In a letter dated 23 May 2000 Dr Samananthan reported to Mr Razgar's solicitors that he (now in custody) had telephoned "and appeared to be in great distress. He said that he did not want to return to Germany where he had experienced racist attacks, he said he would kill himself if he was sent back there . . . From what he said over the telephone his score would now be 29 [on the Beck's Depression Inventory whereas it had been 26] indicating a worsening of his depressive mood complicating Post Traumatic Stress Disorder . . . I feel incarceration has caused a setback from the progress Mr [Razgar] has made so far, and this is detrimental to his mental health. One cannot rule out the possibility that he might carry out his threat to commit suicide."
12. Mr Razgar applied for permission to seek judicial review of the Secretary of State's decision to remove, but permission was refused by the judge and an application for permission to appeal was in the end discontinued. In response to Mr Razgar's application a detailed letter dated 4 July 2000 was written on behalf of the Secretary of State, in the course of which it was said:
"13. The Secretary of State accepts that both the prospect and the actual removal of your client to Germany may have a negative impact upon him. In view of your client's mental health problems the Secretary of State has carefully considered whether there are substantial grounds for believing that your client's proposed and/or actual removal to Germany would be a sufficiently compelling, compassionate factor such as to cause him to depart from his normal policy and practice. Although your client may be exposed to psychological stress as a result of his removal to Germany, the Secretary of State does not accept, on all the evidence submitted to him, that the risk to your client reaches that level of severity of physical or mental suffering as to warrant departing from his usual practice in this case. He takes the view that there are adequate, appropriate and equivalent psychiatric facilities in Germany which will be available to your client upon his return to that country.
14. The Secretary of State has also given very careful consideration to Mr Razgar's ties with the United Kingdom, but he is not persuaded that there are sufficient grounds for allowing your client to remain in this country for such compassionate reasons. Mr Razgar does not, in fact, have any family or other close ties with the United Kingdom."
Further representations were made to the Secretary of State on 2 October 2000 on the coming into force of the Human Rights Act 1998, when Mr Razgar became entitled to appeal on human rights grounds under section 65 of the 1999 Act. These were supported by a report by Mr Stefan Kessler, the effect of which was helpfully summarised by Richards J in paragraphs 24 and 25 of his judgment:
"24. Mr Kessler in his first report dated 19 September 2000 stated that he had worked as a refugee adviser for 15 years and had other substantial credentials in the refugee field in Germany. In his view there was little chance of the claimant gaining refugee status in Germany. His legal status, if returned, was that he would receive a 'Duldung', a form of tolerated status giving temporary protection from prosecution for remaining in Germany, though the stay would still be technically illegal. It was not the same as a residence permit. It did not carry with it the normal rights to live and work in Germany and it resulted in restrictions on residence and freedom of movement. The claimant's mental condition would be considered a 'chronic condition' rather than acute and the claimant would therefore have no right to medical treatment by a psychiatrist, nor would he have any right to treatment by a psychotherapist. The relevant authorities would have a discretion to pay for treatment but would be very reluctant to pay for psychiatric or psychotherapeutic treatment save in case of very urgent need, that is to say immediate danger.
25. Mr Kessler also stated that other aspects of the German system might cause stress for the claimant's mental health, namely that the place where he would be allowed to reside might be quite remote, as well as the fact that his freedom of movement could be restricted and there could be limitations on benefits and on the right to work."
In a letter dated 7 February 2001 the Secretary of State maintained his decision to remove, and in a further letter of 9 April 2001 he communicated the decision which is now the subject of challenge:
"4. The Secretary of State has noted that Germany is a full signatory to the Geneva Convention of 1951 and to the ECHR. He routinely and closely monitors the practice and procedures of Member States, including Germany, in the implementation of the ECHR in order to satisfy himself that its obligations are fulfilled. He is satisfied that your client's human rights would be fully respected in Germany and that your client would not be subjected to inhuman or degrading treatment or punishment if removed there. He is also satisfied that your client will be able to raise any continuing protection concerns that he may have under the provisions of the ECHR with the authorities in Germany. In the circumstances, the Secretary of State does not accept that your client's removal to Germany would be in breach of his human rights. Indeed, he regards your continued assertion to this respect, particularly following the consideration already given to the matter which has been supported by the Court, to be merely a device to prevent further your client's proper return to Germany under the terms of the Dublin Convention.
15. In the light of the above, the Secretary of State hereby certifies the allegation of a breach of your client's human rights under the ECHR as being manifestly unfounded. Your client has a right of appeal against this decision under section 65 of the Immigration and Asylum Act, but under section 72(2)(a) of the Act this may only be exercised from abroad. Arrangements for your client's removal to Germany on 12 April 2001 therefore remain in place."