Tribunal decisions

The decision

IN THE UPPER TRIBUNAL
IMMIGRATION AND ASYLUM CHAMBER
Case No: UI-2025-001535
First Tier Tribunal: PA/01816/2023

THE IMMIGRATION ACTS

Decision & Reasons Issued:
On 2 July 2025

Before

UPPER TRIBUNAL JUDGE BRUCE
DEPUTY UPPER TRIBUNAL JUDGE RUTH

Between

AS (BANGLADESH)
(anonymity order made)
Appellant
And

SECRETARY OF STATE FOR THE HOME DEPARTMENT
Respondent

Representation:

For the Appellant: Mr Nazim, Counsel instructed by Winston Rose Solicitors
For the Respondent: Ms Nwachuku, Senior Home Office Presenting Officer

Heard at Field House on 3 June 2025

Anonymity

Unless and until a tribunal or court directs otherwise, the Appellant is granted anonymity. No report of these proceedings shall directly or indirectly identify him. This direction applies to, amongst others, both the Appellant and the Respondent. Failure to comply with this direction could lead to contempt of court proceedings

DECISION AND REASONS
1. The Appellant is a national of Bangladesh born in 2003. He appeals with permission against the decision of the First-tier Tribunal dated 10th December 2024 to dismiss his protection and human rights appeal.
2. It is not in dispute that the Appellant was a minor when he arrived in the United Kingdom in February 2020. He had made his own way from Bangladesh to Greece where he had claimed asylum; having informed the Greek authorities that he had an adult sister living in the UK, the Greek authorities requested a transfer under Dublin III which the United Kingdom had accepted. The Appellant’s consequent protection claim was refused in April 2023, and the Appellant appealed to the First-tier Tribunal.
3. On appeal the Appellant argued that he had been subject to persecution and/or serious harm in Bangladesh at the hands of family members, in particular his father, stepmother and an aunt. He averred that he had been held against his will in a situation of forced labour and had been physically and mentally ill-treated. In 2018 his sister had returned to Bangladesh from the United Kingdom for a visit. Seeing the conditions that her brother was being held in, she made arrangements for him to escape. He now fears that he will once again be held in such conditions if he returns to his home area; if he were forced to internally relocate to avoid such harm he would encounter unduly harsh circumstances including a breakdown in his mental health and/or potential destitution. This factual matrix was also relevant to his argument that there were ‘very significant obstacles to his integration’ in Bangladesh such that he qualified for leave to remain on ‘private life’ grounds under the provisions of the Immigration Rules. Further and in the alternative, the Appellant argued that his relationships in the United Kingdom with his sister and her family amounted to a ‘family life’ for the purposes of Article 8, and that in all the circumstances it would be a disproportionate interference with that life to refuse to now grant him leave.
4. The First-tier Tribunal found against the Appellant on all three of these heads of claim. It disbelieved the narrative about events in Bangladesh, rejected medical evidence about the extent of the Appellant’s mental ill-health, and found no Article 8 family life between him and his sister. The appeal was accordingly dismissed.
5. On the 26th of March 2025 the Appellant was granted permission to appeal on four grounds, two of which the newly-instructed Mr Nazim wisely chose not pursue. The first of these was that the Tribunal had made a material mistake of fact when it recorded, in its consideration of proportionality, that the Appellant had “no leave to remain”: it was submitted that this was wrong, because he was brought to the United Kingdom under the Dublin procedures. As Mr Nazim agreed the Tribunal had in fact been correct, as a matter of law, to characterise the Appellant as having “no leave”. Being granted entry under the Dublin Regulations does not confer any kind of leave upon a claimant. They are simply admitted to the country in order to pursue their asylum claim. The second of the obviously unmeritorious grounds concerned whether or not the Tribunal had given sufficient recognition to the Appellant’s young age. This is not made out because the Tribunal plainly had regard to this matter at its paragraph 14 where it says this: “in considering the Appellant’s evidence, I have taken into account his age, his vulnerability, and his stressful journey to the UK.”
6. That leaves two grounds: whether the Tribunal properly engaged with the medical evidence before it, and whether it considered whether there were very significant obstacles to his integration in Bangladesh. It is convenient that we deal with each of these in turn.

Ground 1: Medical Evidence
7. The medical evidence before the Tribunal consisted of printouts from the Appellant’s GP records dated between 2022 and 2024, letters confirming that he had been referred for talking therapy, and an expert medical report from a Dr Ruhin Karim. It is the Tribunal’s treatment of the latter which was the centrepiece of Mr Nazim’s critique of its decision. The relevant passages read:
“20. AB2 contains an expert medical report from Dr Ruhin Karim who states he is licensed to practice family medicine (general practice), practices as a private GP and works with insurance companies for creating expert medical opinions and as a flight doctor. His main experience is as a family doctor. He does not profess to have any psychology or psychiatric qualifications. I noted that the report does not fully comply with the Senior President of Tribunals Practice Directions as it is 39 pages (more than the directed 20 maximum pages without a prior written application), does not contain a copy of the letter instructing him, is vague about the specific GP records provided to him and arguably, does not focus on issues in dispute within the area of the author's field of expertise. Dr Karim appears to have been able to converse with the appellant in Sylheti however did not specify how long the interview lasted (he saw the appellant on one occasion, being the same date as his report). Dr Karim noted in his report that the appellant came to the interview on his own. Dr Karim administered the GAD-7 and PH-9 tests, MTS (Mental Test Score) questionnaire and PTSD screen for DSM-5 (5 questions). The MTS score of 8/10 did not indicate that a further assessment was required. Given his high test scores on the other tests, Dr Karin opined that the appellant requires further evaluation and management of his undiagnosed PTSD, undiagnosed depression as well as his diagnosed anxiety. He concluded that ‘on today's assessment' he fulfils the criteria for anxiety and depression. His PTSD score of 5/5 indicates PTSD and should be formally evaluated by a mental health team. His present risk assessment places him at moderate risk of self harm and low-moderate risk of suicide.
21. When assessing these reports, I have taken into account the decision of HA (expert evidence, mental health) [2022] UKUT 00111. The expert evidence accepted by the Upper Tribunal in HA was that “...self administered tests such as the PHQ-9 and GAD-7 are not diagnostic. In medico-legal settings...it is wholly possible to provide whatever answers someone wants in order to appear as ill, or as well, as the person wants to...", GP records are likely to be regarded by the Tribunal as directly relevant to the assessment of an individual's mental health and should be engaged with by the expert in the report. Otherwise the expert takes the appellant's word at face value without cross-referencing to accessible medical records, I have taken into account that accurate diagnoses, especially in psychiatry when based on a limited number of sessions, are influenced by the histories obtained from patients or their families. Unless there is a specific reason for not doing so, physicians generally assume that patients are being truthful. In HA, the Upper Tribunal stated that in the case of human rights and protection appeals it would be naive to discount the possibility that an individual facing removal from the UK might wish to fabricate or exaggerate symptoms of mental illness in order to defeat the respondent's attempts at removal.
22. For all of the above reasons, I give little weight to the export medical report before me which is primarily based on the appellant's account (which was also inconsistent with the one he gave at the hearing) and/or self administered tests on one occasion. The appellant has been under the care of a GP since shortly after his arrival and the GP records do not support the conclusions of Dr Karim. I accept that the appellant has been suffering with symptoms of anxiety, stress and low mood however I am not satisfied that this was as a result of his experiences in Bangladesh as he has claimed rather than from the stress associated with his uncertain immigration position, I am not satisfied that the appellant's claim on mental health grounds reaches the minimum threshold under Article 3 ECHR”.
8. The written grounds are drafted in broad terms, submitting that the “judge has not given sufficient weight” to the medical evidence. It is argued that Dr Karim is an experienced private GP who had provided details of his “credentials”. As Mr Nazim recognised, this was going to get him nowhere. Absent perversity, weight is classically a matter for the trial judge, and there is certainly no perversity here. With our permission Mr Nazim instead argued a more nuanced point, building on the reference to the judge’s credentials. The Tribunal had diminished the weight to be attached to the report by relying on HA; HA was concerned with the limitations or otherwise of expert reports prepared by psychiatrists; Dr Karim is not a psychiatrist, therefore the criticisms based on HA cannot apply to him. He further submitted that the Tribunal had not explained in what way the diagnoses made by Dr Karim were inconsistent with the GP records.
9. As impressive as Mr Nazim’s efforts were to make something of these poorly drafted grounds, we are not satisfied that his HA point is a good one. That case was about psychiatric evidence, but we are quite satisfied that it would also apply to a mental health report by a GP. The broad point made by the then President in that case is that where a diagnosis of mental illness is based entirely on the subject’s self-reporting, and is made after a single consultation, there is a limit to the weight that can be attached to that. Where however such a diagnosis is consistent with GP records, going back over a significant period of time, then such corroboration would considerably strengthen any conclusions reached. That logic would, we are satisfied, apply to any medico-legal report specifically prepared for an appeal in this chamber.
10. In respect of his second point, that, and the decision itself, is a little more difficult to unpick.
11. The Tribunal says two things about the GP records. At its §20 it says that Dr Karim is “vague” about what records he had access to. We agree with Mr Nazim that this is hard to understand. At section 3.2 of his report Dr Karim records that he had access to the ‘NHS GP health records’. Without further qualification we read that as meaning that he had access to the Appellant’s full GP record, these being the same records that appear in the bundle before the Tribunal. We are not however satisfied that anything turns on that.
12. Then at its §22 the decision states that Dr Karim’s conclusions are “not supported” by the GP records. Mr Nazim points out that the GP records do in fact make reference to mental ill health. On the 1st September 2021 the following is recorded: “GAD-7 score 15-21 (severe)”. Looking at Dr Karim’s report we can see that this is a reference to the tool used to diagnose anxiety. On the 23rd February 2022 there is a further reference, to the Appellant being invited to attend talking therapy. Mr Nazim submits that these references show the Tribunal was wrong to characterise the GP records as not supporting the conclusions of Dr Karim. Whilst it seems to us that the Tribunal could have expressed itself more clearly, we do not think any error arises here. All that the decision is saying is that the GP records do not support all of Dr Karim’s conclusions. The records show that the Appellant was diagnosed with severe anxiety in 2021, and that in February 2022 he was referred for therapy. Dr Karim agrees with this diagnosis, and to this extent his opinion is expressly accepted by the Tribunal: “I accept that the appellant has been suffering with symptoms of anxiety, stress and low mood” [§23]. Where Dr Karim goes beyond the GPs records is where he concludes that the Appellant also meets the diagnostic criteria for Post-Traumatic Stress Disorder and severe depression, and that in his opinion he presents a low to moderate risk of suicide if returned to Bangladesh. Given that this appeal was heard in December 2024, a full 34 months since the referral for talking therapy, that being the last reference to mental health in the GP record, we find that the Tribunal was entitled to reach the conclusion that it did. There is no reference to the Appellant having taken up the therapy referral, no reference to any medication being prescribed, or to any further complaint of mental distress.
13. It follows that ground 1 is not made out.
Ground 2: ‘Very Significant Obstacles to Integration’
14. As we note above, the Tribunal accepted a number of salient facts. It accepted that the Appellant left Bangladesh when he was a child: on his evidence he was 15. It further accepted that he suffers from anxiety, stress and low mood. Mr Nazim submits that even if the Tribunal had rejected all of the other points advanced by the Appellant, it was still required to expressly consider whether he faced very significant obstacles to his integration in Bangladesh in light of those facts that it did accept.
15. We agree that the reasoning at §26 of the decision could have been more extensive. Although there is a reference to paragraph 276ADE the Tribunal does not in terms set out its reasoning as to why the test therein is not met. It is however clear from the findings that it has made in the preceding paragraphs, what that reasoning would be. The Tribunal has rejected as untrue the claims that the Appellant is estranged from his family. It has rejected as unproven the assertions that he is suffering from PTSD and is a suicide risk. The Appellant is receiving no formal treatment for his anxiety. It notes at its §26 that he spent most of his formative years in Bangladesh. In those circumstances what could the very significant obstacles be? He would be returning to his country of origin, where he was born and grew up, and where he could resume life with his family. In those circumstances we cannot be satisfied that any omission in the reasoning at §26 is material. For those reasons we must dismiss the appeal.
Decisions
16. The decision is upheld and the appeal is dismissed.
17. There is an order for anonymity in this appeal because it contains reference to the Appellant’s private medical records.

Upper Tribunal Judge Bruce
Immigration and Asylum Chamber
22nd June 2025