Tribunal decisions

The decision

IN THE UPPER TRIBUNAL
IMMIGRATION AND ASYLUM CHAMBER Case Nos: UI-2024-000604
UI-2024-000605
UI-2024-000606
UI-2024-000608
UI-2024-000613

First-tier Tribunal Nos:
HU/50661/2023
HU/50662/2023
HU/50663/2023
HU/50664/2023
HU/50666/2023
LH/03894/2023
LH/03895/2023
LH/03898/2023
LH/03900/2023

THE IMMIGRATION ACTS

Decision & Reasons Issued:

25th August 2026

Before

UPPER TRIBUNAL JUDGE GREY

Between

A1, A2, A3, A4, and A5
(ANONYMITY ORDER MADE)
Appellants
and

THE SECRETARY OF STATE FOR THE HOME DEPARTMENT
Respondent

Representation:
For the appellants: A1 represented himself and the other appellants
For the respondent: Ms L. Clewley, Senior Home Office Presenting Officer

Heard at Field House on 4 August 2026

Order Regarding Anonymity

Pursuant to rule 14 of the Tribunal Procedure (Upper Tribunal) Rules 2008, the appellants are granted anonymity. No-one shall publish or reveal any information, including the name or address of the appellants, likely to lead members of the public to identify the appellants. Failure to comply with this order could amount to a contempt of court.

DECISION AND REASONS
1. The appellants are citizens of Nigeria. They appeal against the decision of First-tier Tribunal (“FtT”) Judge Hamilton (the “Judge”) dated 13 November 2023, dismissing their human rights appeal.
2. The appellants arrived in the UK on 18 May 2021. A2 had been granted entry clearance on medical grounds for the birth to her third child (A5). A1 (the husband of A2), A3 and A4 (the children of A1 and A2) were granted visit visas to accompany A2 to the UK. The appellants’ visas expired on 15 November 2021. A5 was born on 9 June 2021 in the UK. Following the birth of A5, A2 required medical treatment including an appendectomy in September 2021 and surgical removal of part of her thyroid in June 2022.
3. On 10 November 2021, the appellants applied for leave to remain. The applications were refused by the respondent in separate decision letters dated 6 January 2023. The appellants appealed the decisions on human rights grounds and the appeal was heard in the FtT on 26 September 2023, by which time A2 was again pregnant. The Judge determined that the appellants could not meet the requirements of the Immigration Rules and the refusal decisions did not amount to a disproportionate interference with the appellants’ Article 8 rights, and dismissed the appeals.
The FTT decision
4. In relation to A2’s health and medical needs, at [29] the Judge found that A2 had experienced serious complications that required significant medical intervention during her first two pregnancies in Nigeria, and that there were concerns regarding the positioning of the baby in her third pregnancy, which was why she had sought a medical visa to give birth in the UK with the ability to access specialist care if complications arose. However, the Judge recorded that there were ultimately no complications with the birth of A5 in June 2021. The Judge recorded that A2 was now pregnant again and was 17 weeks pregnant.
5. The Judge also noted A2’s emergency appendectomy in September 2021 and that she underwent investigations in relation to the enlargement of her thyroid in October 2021. The investigations ruled out any malignancy and A2 had surgery in June 2022 for removal of part of her thyroid. A2 was now having regular thyroid function tests.
6. At [30] it is recorded that A2 stated in oral evidence that private ante-natal care and thyroid function testing would be available to her in Nigeria.
7. The decision states at [33]:
I accept A2 has clearly had some serious medical issues and concerns regarding her health remain. However, I do not find the appellants have shown A2’s current medical needs, including her pregnancy, prevent her from returning to Nigeria or that adequate medical treatment would be unavailable to her in Nigeria. There was no medical evidence to show her current pregnancy is likely to be problematic or require medical intervention that is not available in Nigeria. I accept that A1 and A2 have had very bad experiences with medical treatment in Nigeria. A1 asserted that the doctors in Nigeria were of poor quality because the good ones have gone to work abroad. However, no independent or other reliable evidence was produced to show that adequate medical treatment provided by competent medical professionals would be unavailable to A2 in Nigeria.
8. The Judge found that the appellants were relatively well-off and could pay for private healthcare in Nigeria, would be able to afford accommodation, and had family in Nigeria to support them on return. He found that A2 would be able to have her thyroid monitored on return to Nigeria, as accepted by her in evidence, and that there was no independent evidence to show that adequate treatment for any medical issues that may arise would not be available in Nigeria.
9. The Judge accepted that A3 and A4 were doing very well at school and that their education would be disrupted if forced to return to Nigeria. However, he found that the children were young and adaptable, had not been in the UK for a long time and that their education is at a very early stage. The Judge found that Nigeria has a functioning education system and that A1 and A2 intended, and would be able, to send the children to private school in Nigeria. He concluded that any disruption to the children's education caused by requiring the family to return to Nigeria would not have significant or long-term adverse consequences for them.
10. The decision states at [39], under the heading “The family’s likely circumstances in Nigeria”:
I found A1 and A2 to be open and honest. A1’s submissions were articulate, heartfelt and touching. I fully accept that if they remained in the UK, he and his family are likely to be productive members of society. I also accept that broadly speaking, the standard of medical care available in the UK may well be superior to that available in Nigeria. However, overall, the evidence did not show that A2’s health would be significantly compromised or that the children's education would be adversely affected. Furthermore, I am satisfied that A1 and A2 will have retained family, social and cultural links to Nigeria and that if their children returned there, they would grow up in a country that reflects their culture and heritage and where they enjoy the rights of full citizens.
11. In relation to the children’s best interests, in view of their ages (then 8, 5 and 2 years of age), the Judge found that the children of the family would not have developed a private life separate from those of their parents and their best interests would be met by being cared for by both parents, whether in Nigeria or the UK.
12. In view of the Judge’s findings of fact, he found that the appellants had not demonstrated that they would face very significant obstacles to their integration into Nigeria and were unable to meet the requirements of the Immigration Rules. At [43] to [50] the Judge conducted the Article 8 proportionality exercise. He concluded that the appellants had been in the UK for a relatively short period of time, they would be returning as a family unit, the best interests of the children would not be adversely affected if returned to Nigeria, the appellants are familiar with the culture and society in Nigeria, have family there and can support themselves financially. The health of A2 would not be significantly compromised if she returns to Nigeria. The appellants had only ever been in the UK on a temporary basis. Although the appellants could speak English and could support themselves financially, these were neutral factors in the balancing exercise. Weighing all relevant factors, the Judge concluded that obliging the appellants to return to Nigeria was not a disproportionate interference with their Article 8 private life rights.
The grounds
13. The appellants are unrepresented. Permission to appeal was refused in the FtT. In the application for permission to appeal to the Upper Tribunal the appellants state as follows:
The First-Tier tribunal admitted that we had been through a lot of difficulty and facing serious medical issues. The First Tier tribunal did not fully consider the impact of this difficulty in its decision given the fact that the original intention for coming to the UK was to seek medical help. The First-tier tribunal in its decision would have sent us back to a system that led to the death of my dad and almost killed my wife.
14. Permission to appeal was granted in a decision of Upper Tribunal Judge Kamara dated 25 March 2024. The decision states:
3. The appellants are not legally represented. Consideration of the judge’s decision reveals a Robinson obvious point. (R v SSHD, IAT ex parte Anthony Pillai Francis Robinson [1997] EWCA Civ 2089). In finding that A2’s health would not be seriously compromised if she had to return to Nigeria, it is arguable that the judge did not take into consideration his earlier acceptance that when A2 gave birth to A3, A4 and A5 she experienced serious complications.
4. Given that A2 has recently undergone a serious operation in the United Kingdom, is expecting a further child as well as the fact that the appellants have concerns as to the availability of adequate treatment in Nigeria (as opposed to the cost), it is arguable that the decision of the First-tier Tribunal failed to take account of relevant considerations.
The error of law hearing, discussion and reasons for decision
15. At the error of law hearing, I heard oral submissions in support of the grounds from A1. Although A1 is not legally qualified, he can be assured that it was apparent that he had prepared thoroughly for the hearing and he effectively represented himself and his family. I sought clarification from A1 as to the focus of his challenge to the decision and he submitted that the Judge had failed to provide sufficient reasons for the decision in circumstances where he had accepted that the appellants had entered the UK lawfully having been grated entry clearance on medical grounds, and in light of the accepted medical evidence. Ms Clewley relied on the respondent’s Rules 24 response dated 10 April 2024 and made oral submissions that the Judge had directed themselves appropriately when dismissing the appellants’ appeal and provided sufficient reasons for the decision.
16. During the hearing it became apparent that the bundle of documents prepared for the error of law hearing (by the Tribunal) did not contain all material that had been adduced at the FtT hearing. I therefore accessed the FtT documentation on MyHMCTS to ensure that I had sight of everything that was before the Judge. As will become apparent, it was important to identify exactly what material was before the Judge in relation to A2’s health and current pregnancy, as opposed to the material which had subsequently been submitted in support of the application for permission to appeal.
17. At the conclusion of the hearing, I indicated that I would reserve my decision which I now give together with my reasons. For the reasons set out below, I find that I am compelled to dismiss the appeal. The outcome of this appeal is no reflection on the bona fides of the appellants. It is accepted that the appellants entered the UK lawfully and that if they remained in the UK they would likely be productive and upstanding members of society. However, this was not the question facing the Judge in the FtT. My focus in determining whether or not the Judge made a material error of law is on the circumstances as they were at the time of the hearing and taking into account the evidence before the Judge at that time.
18. The Judge accepted the evidence of A2’s difficulties with her appendix shortly after the birth of A5 and her problems with her thyroid which necessitated surgery and investigations and which requires that her thyroid function to be monitored. In relation to her thyroid, which was investigated for malignancy, the appellants’ evidence was that A2 was given the “all clear” in 2022. The Judge recorded that A2 gave evidence that thyroid function testing would be available to her in Nigeria.
19. It is accepted that A2 had significant complications with her first two pregnancies when she gave birth to A3 and A4 in Nigeria. I do not have sight of the medical evidence which accompanied the entry clearance applications made in 2021 and this was not before the FtT. However, as recorded by the Judge at [29], the fact that A2 was granted a medical visa indicates that the respondent was satisfied that the appellants had produced medical evidence to show that the concerns that led A2 to want to give birth in the UK were justified. I note that there was no evidence before the FtT to indicate that A2 has a particular health condition which would indicate that all of her pregnancies would automatically be considered to be high risk. In A1’s submissions, he attributed the problems that arose during A2’s childbirth in Nigeria to “medical negligence” and the grounds themselves appear to indicate the appellants’ belief that the healthcare system in Nigeria has systemic issues.
20. In support of the application for permission to appeal the appellants adduced further medical evidence. The evidence included documentation regarding A2’s most recent pregnancy, including a handwritten letter dated 30 November 2023 from a midwife stating that A2’s pregnancy was being treated as high risk; a GP’s letter dated 4 December 2023 stating that A2’s pregnancy was high risk due to “twin pregnancy VTE risk and history of Thyroid Nodules” and stating that travelling outside the UK at this time would potentially be detrimental to A2’s health and that of her unborn twins; and, written confirmation of the birth of twin daughters on 6 February 2024 by caesarean section. A1 accepted that this evidence post-dates the decision under challenge and was not before the Judge. The key question is therefore whether, in the absence of the evidence that is now before the Upper Tribunal, the Judge made a material error of law in finding that A2 could return to Nigeria without putting her health at risk and whether he took account of all relevant considerations in reaching this conclusion.
21. The decision demonstrates that the Judge carefully considered A2’s health and was alert to possibility of potential difficulties during her current pregnancy. The Judge specifically addressed at [33] whether there was any evidence to show that A2’s current pregnancy was problematic or would require medical intervention that would not be available in Nigeria, and found that there was none. He recorded A2’s oral evidence at [30] that private ante natal care and thyroid function testing would be available to her in Nigeria.
22. The Judge records in the decision that A2 was 17 weeks pregnant at the date of the hearing. Evidence was provided at the hearing of a 12-week scan and appointment letters for further scans during the pregnancy. The Judge did not record that this was a twin pregnancy but I note this information was available from the letter dated 23 August 2023 which set out the results of the 12-week scan. Other than the scan and appointment letters there was no further medical evidence relating to this pregnancy and no evidence to expressly indicate that it would be considered a high risk pregnancy. Although I accept that twin pregnancies can carry increased risks compared to single pregnancies, there was no evidence before me to indicate that they should necessarily be considered as high risk.
23. I find that the decision demonstrates that the Judge turned his mind to whether there may have been an increased risk for A2’s current pregnancy, expressly noting at [21(3)] that there had been no complications with A5’s birth, and at [33] that there was no medical evidence to show that her current pregnancy is likely to be problematic or would require medical intervention that is not available in Nigeria.
24. It seemed to me that the appellants’ case on appeal is that the Judge, without any medical training and without any medical evidence identifying a risk in relation to this pregnancy, was required to “join the dots” based on the difficulties A2 had encountered in her first two pregnancies coupled with the fact that, an examination of the scan would reveal that, it was a twin pregnancy. I am unable to reach such a finding based on the evidence that was before the Judge. A1 attributed A2’s difficulties in her first two pregnancies to medical negligence. Although the respondent granted a medical visa for A2 to give birth in the UK in 2021 this seems to have been based, at least in part, on concerns about the positioning of A5 in her womb. However, contrary to the statement in the permission decision of UTJ Kamara, A5 was born without any complications. There was no medical evidence before the Judge that the current pregnancy was considered by healthcare professionals to be high risk at the time of the hearing. I am not persuaded that, in the absence of more, the Judge could assume that because of A2’s previous complications during childbirth, all future pregnancies would be considered high risk, particularly when the Judge had been made aware that there were no complications with the delivery of A3. In relation to the other aspects of A2’s health, although A2 needs to continue to have her thyroid function monitored, she confirmed that this could be done in Nigeria.
25. Although with the benefit of the evidence which was provided with the application for permission to appeal, the outcome of the appeal in the FtT may have been different, the Judge cannot be criticised for failing to consider evidence which was not before him but which post-dated the decision under appeal. The burden of proof was on the appellants and they did not provide any evidence to demonstrate any foreseen or expected complications with the pregnancy. There was no evidential basis for the Judge to conclude that there would not be adequate and appropriate medical treatment available to A2 on return to Nigeria or to support the assertion of systemic problems with Nigerian healthcare.
26. In conclusion, I am satisfied that the Judge did take into consideration his earlier acceptance that A2 experienced serious complications when giving birth to A3 and A4, her operations after the birth of A5, the fact she was pregnant at the date of the hearing, and the availability of adequate treatment in Nigeria. In a careful and balanced decision, the Judge provided adequate reasoning for his sustainable findings and directed himself correctly.
27. For all of these reasons, the appellants’ appeal is dismissed. The grounds and the decision fail to disclose any material error of law.
Notice of Decision
The appellants’ appeal is dismissed.

S. Grey
Judge of the Upper Tribunal
Immigration and Asylum Chamber

14 August 2026