Tribunal decisions

The decision

IN THE UPPER TRIBUNAL
IMMIGRATION AND ASYLUM CHAMBER
Case No: UI-2025-005138

First-tier Tribunal No: HU/53535/2024
LH/00451/2025

THE IMMIGRATION ACTS

Decision & Reasons Issued:
On 13th January 2026

Before

UPPER TRIBUNAL JUDGE LINDSLEY

Between

KAMRAN MUNAWAR VARYAH
(ANONYMITY ORDER NOT MADE)
Appellant
and

SECRETARY OF STATE FOR THE HOME DEPARTMENT
Respondent

Representation:
For the Appellant: Mr M Ilami, of Counsel, instructed by Synthesis Chambers Solicitors
For the Respondent: Mr P Dellar, Senior Home Office Presenting Officer

Heard at Field House on 6 January 2026

DECISION AND REASONS

Introduction
1. The appellant is a citizen of Pakistan born on 14th August 1990. He came to the UK in 2011 with entry clearance as a Tier 4 student migrant, and had leave to enter until 2012. He made an in-time application to extend his leave to remain on the basis on his family and private life ties to the UK which was refused on 20th January 2016. He then overstayed. On 8th November 2022 he applied to remain in the UK on the basis of his private life ties with the UK. This application was refused by the respondent on 17th March 2024. The appellant’s appeal against this decision was dismissed by the First-tier Tribunal Judge after a hearing on the 3rd September 2025.
2. Permission to appeal was granted by a Judge of the First-tier Tribunal on 3rd November 2025 on the basis that it was arguable that the First-tier judge had erred in law when considering the medical evidence of Dr Anthony Emezie which went arguably to the issue as to whether the appellant was seriously ill and thus whether he overcame the initial threshold test in Article 3 ECHR medical appeals, as set out in AM (Zimbabwe) v SSHD [2020] UKSC 17. Permission was also granted on the basis of the consideration of the appellant’s access to treatment in Pakistan, although that ground was considered less arguable.
3. The matter now comes before me to determine whether the First-tier Tribunal had erred in law, and if so whether any such error was material and whether the decision of the First-tier Tribunal should be set aside.
Submissions – Error of Law
4. In the grounds of appeal and in oral submissions from Mr Ilami it is argued, in short summary, that the First-tier Tribunal erred in law as follows.
5. Firstly, it is argued in the grounds, that the First-tier Tribunal erred by failing to consider the report of Dr Anthony Emezie dated 24th June 2024 which formed part of the appellant’s bundle and which provided a diagnosis of the appellant’s mental health problems finding that he suffers from PTSD with suicidal thoughts following an accident which killed his father and traumatised him and records that he takes medication as a result: Sertraline 200mg and Promethazine 25mg. It is argued that this evidence was material to consideration as to whether the appellant had a serious medical condition and whether return to Pakistan would result in his having a significant reduction in life expectancy. Mr Ilami added that whilst it might be correct that the First-tier Tribunal Judge had accepted that the appellant was a seriously ill person he had not characterised his ill-health fully at paragraph 26 of the decision as the Judge had focused on his trauma and depression, and not on suicidal ideation, which was mentioned briefly in the report of Dr Emezie and also in the letter from Time to Talk which were both in the bundle before the First-tier Tribunal. Mr Illami accepted however that there was no evidence of active suicidal ideation at the time of the hearing before the First-tier Tribunal Judge.
6. Secondly, in the grounds, it is argued that there is an error of law as the First-tier Tribunal failed to consider the evidence going to whether treatment in Pakistan would be accessible to the appellant. The appellant’s evidence was that he had an elderly mother in Pakistan and married siblings who could not support him and thus the evidence was that he would have no support with the cost of treatment and medication. The finding that the appellant’s family would not abandon him was therefore not a sufficient consideration.
7. In a Rule 24 notice and in submissions from Mr Dellar it is argued for the appellant as follows.
8. With respect to the first ground it is argued that the issue of the appellant’s health condition was not in dispute, so it was not an error not to have considered the supporting medical evidence with respect to this issue in detail. The focus of the medical evidence was that the appellant suffered from depression and trauma, with there being no evidence before the First-tier Tribunal that he was a current suicide risk.
9. With respect to the second ground, it is argued that the availability of suitable health care was the issue on which the appeal turned. It is argued that this is dealt with at paragraphs 24, 25, 27, 32, 34, 36, 37 and 38. It is found that there was no evidence that the appellant’s family could not help with the cost of medication, and that some free health care was available. There was also no evidence that healthcare was not available in the appellant’s town.
Conclusions – Error of Law
10. In relation to the first ground I find that the First-tier Tribunal considered the appellant to be a “seriously ill person”, on the basis of what is said at paragraphs 26 and 36 of the decision, and thus that he fulfilled the first part of the test for Article 3 ECHR health cases as set out in AM (Art 3; health cases) Zimbabwe [2022] UKUT 00131. Mr Ilami could not take me to any me to any medical evidence which was before the First-tier Tribunal which went beyond a diagnosis that the appellant suffers trauma (PTSD) and depression. The Time to Talk letter that Mr Ilami took me to dated 31st January 2023 focuses primarily on his low mood and depression, and only refers to the fact that at that time the psychotherapist was managing a risk of suicidal ideation. I therefore find that there was no error of law in the First-tier Tribunal having not set out a more fulsome analysis of what was contained in the report of Dr Emezie or the other medical evidence. Clearly that evidence had been found to support the conclusion that the appellant was a “seriously ill person”, and there was no need for the First-tier Tribunal to do more than set out the headline diagnosis of depression and trauma.
11. The discussion in the decision of the First-tier Tribunal then goes on to consider the other issues as set out in AM (Art 3; health cases) Zimbabwe so as to consider whether the appellant would face a real risk of inhuman and degrading treatment on account of there being an absence of appropriate treatment in his receiving country, or access to such treatment, which would result in serious, rapid or irreversible decline in his state of health resulting in intense suffering or a significant reduction in life expectancy. The findings of the First-tier Tribunals are that that the appellant’s health would not decline and he would not suffer a reduction in life expectancy, as set out at paragraph 36 of the decision, because: he would have family support as he had not shown his family would abandon him or could not assist with the cost of treatment and medication (paragraph 34); there is some free health care (paragraph 34); there were hospitals local to the appellant where he could get the type of treatment he needs (paragraph 37); and he could also obtain counselling on line (paragraph 38).
12. I find that these findings were rationally available to the First-tier Tribunal on the evidence before it. The only evidence relating to family support to which Mr Ilami took me was that the appellant’s witness statement at paragraph 14, which sets out that his mother is elderly and cannot support him, but says nothing about whether he could not live with her and whether she could not provide him with companionship, and states that his siblings are married and have their own lives, but again says nothing about their financial situations, and thus there is no evidence that they could not provide funds for medication and counselling and other treatment as and when needed. I therefore find that the First-tier Tribunal has made a rational and adequately reasoned decision that, despite the appellant being a seriously ill person, he does not satisfy the Article 3 ECHR medical test, and thus that the second ground of appeal also does not disclose an error of law in the decision of the First-tier Tribunal.

Decision:

1. The making of the decision of the First-tier Tribunal did not involve the making of an error on a point of law.

2. I uphold the decision of the First-tier Tribunal dismissing the appeal of the appellant on human rights grounds.

Fiona Lindsley

Judge of the Upper Tribunal
Immigration and Asylum Chamber

6th January 2026