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The Health of Julian Assange: A Case of State-sponsored Neglect


Nina Cross
21st Century Wire

It is known that Assange’s removal from Belmarsh healthcare unit was a result of the combined effort by his legal team, public campaigning and a petition lodged by fellow prison inmates. It followed seven months of unofficial segregation in the unit during which he was removed from association without legitimate grounds to do so, and in breach of prison rules and legislation.  There was no established reason for this treatment, making it arbitrary, and also deprived Assange of recourse, effectively throwing him into a lawless hole at the whim of the prison authorities. 

It should be noted, however, that despite the fact he has been transferred out of healthcare to a wing where he can associate with others, reports indicate that he is still locked up for most of the time.

The full force of the state apparatus constantly targets Assange while others just pass through

To show the arbitrary and unfair treatment of Assange, we have compared the way Belmarsh has treated him to the way it treated Tommy Robinson, founder of the English Defence League, where Robinson spent nine weeks there last year, officially segregated. In his case, the governor was said to have personally intervened to ensure he did not miss a social visit, and that he had unlimited phone calls between 9am and 11am every morning, according to reports.  In contrast, Assange, an unconvicted prisoner, presumed innocent, has had devastating restrictions of access to his lawyers, was not allowed possession of his legal documents for a prolonged period of time, or the means with which to prepare his defence – all of which are breaches of legislation protecting the rights of the prisoner.

Comparisons can also be made in the way Belmarsh treated multi-millionaire novelist and former Tory MP Lord Jeffrey Archer.  Archer was sentenced to 4 years in 2001 for perjury and perverting the course of justice.  In contrast to Assange, Archer was convicted by a jury. He still retained the title Lord Archer, and was processed as a prisoner through Belmarsh in textbook fashion. Belmarsh, despite being a Category A high security prison, is also a local prison serving courts in South East London and South West Essex,  and is used as a temporary stop for prisoners of all categories.  Usually, after a few months or weeks, men are released or moved to other prisons (more suitable for their category).  According to Archer’s memoirs, on his arrival at Belmarsh following his sentencing, he was visited by the deputy governor who made this whole process clear, reassuring him that normal procedure should for him mean a short stay:

You will be moved onto an induction block tomorrow,’ she assures me, ‘and just as soon as you’ve been categorized A, B, C, or D, we’ll transfer you to another prison. I have no doubt you’ll be Category D – no previous convictions, and no history of violence.’

Due to procedure, he spent his first night in the healthcare unit under suicide watch.  Although only there for one day, Archer was allowed to use the general exercise area, and mix with the other inmates.  He was then moved from healthcare to a wing, and after 3 weeks he was moved to a category D prison. This was textbook processing.

But on arrival at Belmarsh, Julian Assange had no record of violence, or previous convictions, and the offence of skipping a police bail for which Judge Deborah Taylor sentenced him to 50 weeks, thus ignoring the UN decision that he sought asylum, which means it should’ve been a minor offence – much less serious than the crimes of Archer.  Yet, Assange was made a B category prisoner and has never left Belmarsh prison, and was unofficially segregated for many months.  He has been denied basic rights as an unconvicted prisoner since being held on remand, including continued restrictions of access to his lawyers which has impaired his ability to prepare for his historic legal defence. Undoubtedly, he is being treated like a terrorist and murderer.

By simply comparing the way the prison authorities processed another high-profile inmate in Lord Archer, we can again see the exceptional vitriol and impunity of the authorities towards Assange.

Diversion tactics of the prison authorities and the lack of accountability for Assange’s health

As we have illustrated, the prison authorities’ response to public complaints about the mistreatment of Assange ignores the statements by Nils Melzer, UN Special Rapporteur on torture,  that Assange has been held in solitary confinement in healthcare.

In the same way the authorities have ignored Melzer’s findings following his extensive physical and psychological assessments of Assange last May, which revealed:

“Mr. Assange showed all symptoms typical for prolonged and sustained exposure to severe psychological stress, anxiety and related mental and emotional suffering in an environment highly conducive to major depressive and post-traumatic stress disorders (PTSD)…

Melzer clearly identified the cause of the symptoms:

It was obvious that Mr. Assange’s health has been seriously affected by the extremely hostile and arbitrary environment he has been exposed to for many years,” … “Most importantly, in addition to physical ailments, Mr. Assange showed all symptoms typical for prolonged exposure to psychological torture, including extreme stress, chronic anxiety and intense psychological trauma.

He warned that Assange’s health could deteriorate dramatically in the event of his extradition or similar major stressors:

“…and that his current condition is likely to deteriorate dramatically, with severe and long-term psychological and social sequels, in the event of prolonged exposure to significant additional stressors, such as those expected to arise in the event of his extradition to the United States or any other country refusing to provide guarantees against refoulement to the United States.”

As his reports and appeals to the UK government were effectively dismissed, Melzer issued a further statement to the government in October, warning that Assange’s continued arbitrary detention in oppressive conditions could put his life at risk:

“Based on the information made available to me, the detention regime currently imposed on Mr. Assange appears to be unnecessary, disproportionate, and discriminatory and to perpetuate his exposure to psychological torture or other cruel, inhuman or degrading treatment or punishment. I am very concerned that, if the UK does not take urgent remedial measures to alleviate Mr. Assange’s situation, his health may soon reach a critical stage, including the risk of death.”

Yet it would appear that none of the authorities involved in the health or care of prisoners has responded.  Not only that, they seem to have also ignored the repeated appeals to the government by a global collective of doctors, Doctors 4 Assange, for independent assessment and treatment.  The doctors have asked for:

“…urgent expert medical assessment of both his physical and psychological state of health. Any medical treatment indicated should be administered in a properly equipped and expertly staffed university teaching hospital (tertiary care). Were such urgent assessment and treatment not to take place, we have real concerns, on the evidence currently available, that Mr Assange could die in prison. The medical situation is thereby urgent.”

So how has it come to pass that the medical findings and concerns of a UN special rapporteur and the concerns expressed by a global network of doctors, regarding the life of a prisoner, have been readily dismissed? This question is especially important given UK prison rule 21:

Special illnesses and conditions

21.—(1) The medical officer or a medical practitioner such as is mentioned in rule 20(3) shall report to the governor on the case of any prisoner whose health is likely to be injuriously affected by continued imprisonment or any conditions of imprisonment. The governor shall send the report to the Secretary of State without delay, together with his own recommendations.

(2) The medical officer or a medical practitioner such as is mentioned in rule 20(3) shall pay special attention to any prisoner whose mental condition appears to require it, and make any special arrangements which appear necessary for his supervision or care.

A thorough report was sent to the government by Melzer in May,  and a second statement was sent in October, making the urgency of Assange’s health needs clearly known.  The question must therefore be asked: how is it that not a single health or care institution charged with the health of prisoners has intervened?

Nils Melzer, UN Special Rapporteur on torture, has explained how the assaults Julian Assange, founder of Wikileaks, is designed to create a sense of powerlessness and helplessness: the purpose of torture.  This piece focuses on the arbitrary treatment of Assange by the prison authorities and asks how those state institutions claiming to protect health and well-being of people held inside the UK prison system have stood by and allowed a prisoner to be tortured in full public view. Watch:

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The state’s accountability in the neglect of Assange’s care

In its response to the public concerns about Assange’s health, the prison authorities have attempted to divert attention onto the NHS:

“On the wider issue of matters of public health, the Ministry of Justice is not responsible for the commissioning of healthcare services in public prisons as this is the responsibility of NHS England and the Welsh Government. The commitment to working with health and justice partners is set out in the National Partnership Agreement for Prison Healthcare in England…” 

The partnership agreement to which the prison authorities refer, is an agreement between five public bodies which include the Ministry of Justice, the Prison and Probation Service, the Department of Health and Social Care, Public Health England and NHS England.  It uses the words ‘partnership’ and ‘collaboration’ to illustrate that each body has a commitment and responsibility to safeguard the health of prisoners:

“We commit to collaborate and co-operate at all levels within our organisations to achieve our shared priorities and deliver our joint workplan.”

So, how is it possible to reconcile the joint commitment by no less than five public institutions to protect the health of prisoners, with the arbitrary treatment that threatens the life of Assange inside Belmarsh, as made public knowledge by a UN special rapporteur and a global network of qualified doctors?

We asked GP and Producer of the ‘Great NHS Heist,Dr. Bob Gill, about the way in which the authorities have behaved towards Assange and the risks to his health resulting from this.

Q: How is it possible that Nils Melzer, supported by specialist doctors, identified Julian Assange’s specific needs and made specific recommendations, yet these were ignored by the authorities? Should the fact that Melzer and the accompanying specialists were not part of the partnership make any difference to whether Assange’s identified needs should be met?

Dr. Gill: The prison authorities and health providers are hiding procedural complexities to justify the unjustifiable. Assange has not been convicted of a crime. He finds himself in a maximum security prison for exposing the crimes of the state. He is a political prisoner and his treatment is designed to be an example to others who are considering reporting the actions of our leaders. I am in no doubt that under such circumstances the prison administration will not extend Assange the humane treatment he should be receiving.

After years of confinement in the Ecuadorian embassy for fear of extradition to USA for his journalism, then to be dragged out of the embassy into a police van breaching established political asylum protocol and ending up in Belmarsh a series of actions which confirm his fear all along of being persecuted for serving the public interest.

The deeply flawed legal process and his retention in custody to this day amount to intolerable levels of psychological trauma which would inevitably have major health impact on anyone. Leaderships of public bodies implicated in this sorry affair will remain loyal to their paymasters and not truth or justice. If individuals within Belmarsh acted out of conscience and revealed the extent of Julian Assange’s mental and physical condition, they would suffer retribution. The NHS has an appalling record for its treatment of whistlblowers and bullying and harassment of staff is endemic as highlighted in the recent report in the Mirror.  Hence any reassurances from the authorities are worthless. The only reliable assessment of Julian Assange’s condition would be from external, independent sources of which Nils Meltzer is a respected voice.

Q: It is impossible to know what went on regarding internal discussions between the health care provider and the prison management while Julian Assange was in healthcare.  But it was a regime decision to keep him isolated, not a medical one.  But how do you see the position of the NHS here?  Many people have written to the Director of NHS England, Lord David Prior, to complain about Assange’s treatment. As the NHS is a partner should it be held to account to some degree for what has happened to Assange while held in isolation in the healthcare unit?

Dr. Gill: The reports from Nils Melzer are deeply concerning but come as no surprise. Deprivation of liberty, lack of due process, character assassination, threat of extradition and solitary confinement are grossly disproportionate consequences for the allegations made against Julian Assange. The effects of such treatment have devastating effects on mental health and functioning. Chronic stress, poor living conditions, lack of sunlight and human companionship have serious negative physical effects on the body ranging from accelerated cardiovascular disease and neurological deterioration. Given these obvious impacts on Julian Assange’s health, it is remarkable that his authorised medical personnel have failed to identify the harms his continued detention are having. The prison regime have consciously decided to continue with Assange’s torture by not supporting his immediate release from Belmarsh. The NHS and prison management should be held to account for their actions but there seems little chance of this given all normal processes have been ignored in the treatment of Assange for political reasons

Q: We know that prisoners were so concerned about Julian Assange’s treatment that they kept up a campaign to have him removed from effective segregation conditions.  It is reasonable therefore to assume that members of staff may also have concerns.  However, staff are forced to sign the official secrets act and cannot report concerns publicly.  They would have to go through internal channels.  To publicly show concern would be to risk imprisonment – regardless of employer – whether the prison service or the NHS. Would this be a fair assessment of the situation faced by healthcare staff?

Dr. Gill: NHS staff in non-prison setting risk retribution if their actions flag up concerns about the performance of their employer. Protections that exist are not fit for purpose and managers can act with impunity as demonstrated with various scandals exposed over the years from Mid Staffs scandal to Gosport. No action taken against the leaders that failed. The additional fear of prosecution for breach of the OSA effectively prevents the abuses of prisoners being made public by staff. Until and unless people can speak out without fear of retribution, institutional abuse will go unchecked.

Q: The UK prison rules state that remand prisoners cannot be released temporarily for medical reasons – the logic being that they will not be remanded for long and so can simply have use of doctors until they are convicted or freed.  However, in Julian Assange’s case, he could be remanded for years.  UK prison rules have a provision that should cover this, but like so many others, could be applied arbitrarily to Assange. 

Dr. Gill: The adherence to the rules for remand prisoners’ access to external medical treatment in Julian Assange’s case is perverse. An exception should be made in Assange’s case given the years of torment he has already endured. Hiding behind procedure under circumstances where we hear of credible fears for his life, is yet another demonstration of the inhumanity of his continued imprisonment and the authorities complicity in his continued torture.

Bob Gill’s ‘Great NHS Heist’ can be watched here.

The UK treats Assange the way Bahrain treats its political prisoners

Although it is the role of the prison authorities to impose regimes and rules,  all members of the partnership claim commitment to the health and well-being of prisoners.  What’s more, the group claims repeatedly to be focused on identifying specific needs of prisoners:

“People in prisons have complex needs.  We are committed to understanding the factors that impact on health and social care outcomes for people in prison. This includes understanding specific needs

Melzer’s report identified Assange’s specific needs clearly.   Yet these were ignored by all five institutions which claim to “…recognise our respective statutory responsibilities and independence,…” 

Not only have they failed to recognise Assange’s health needs identified by Melzer’s report, they have stayed silent while Melzer has brought attention to the continued arbitrary treatment of Assange by the prison authorities and the detrimental and life-threatening effects of this on his health.  These warnings have all been circulated by Melzer in the public forum and officially in his correspondence to the UK government.  Still, they have failed to recognise their respective statutory responsibilities. This failure and apparent complicity by the state health and care systems takes us back to the recommendations made by Melzer in May:

“Both medical experts accompanying my visit agreed that Mr. Assange is in urgent need of treatment by a psychiatrist of his own choice and confidence, whom he does not associate with the detaining authorities,…”

The sustained silence by each member of the partnership demonstrates that Assange’s health and life are not  protected by the state health and care institutions connected to Belmarsh. Whatever the efforts of individuals on the front line, those in charge at government level are towing the line and in doing so are protecting the impunity and vitriol the prison authorities have shown towards Assange.  By ignoring the warnings from the UN rapporteur of risks to Assange’s life surely they have shown an abnegation of responsibility and allowed state-sponsored abuse.  The recent appeal from Doctors 4 Assange warns that complicity by the public health and care institutions in the neglect of Assange could set a dangerous precedent:

“…governments have sidelined medical ethics, medical authority, and the human right to health.   This politicisation of foundational medical principles is of grave concern to us, as it carries implications beyond the case of Assange. Abuse by politically motivated medical neglect sets a dangerous precedent, whereby the medical profession can be manipulated as a political tool, ultimately undermining our profession’s impartiality, commitment to health for all, and obligation to do no harm.”

The UK has, in theory, committed to the UN standards for the treatment of prisoners.  Yet, where Assange is concerned, it is behaving no differently from the way Bahrain, a Gulf State dictatorship, treats many of its political prisoners – by refusing to recognise their arbitrary detention,  by ignoring identified health needs, and by refusing access to specialist diagnostic assessment and treatment.

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Author Nina Cross is an independent writer and researcher, and contributor to 21WIRE. To see more of her work, visit  Nina’s archive.

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