Tribunal decisions

The decision

IN THE UPPER TRIBUNAL
IMMIGRATION AND ASYLUM CHAMBER Case No: UI-2026-001993
First-tier Tribunal No: HU/55949/2023

THE IMMIGRATION ACTS

Decision & Reasons Issued:
On 24 July 2026

Before

UPPER TRIBUNAL JUDGE HOFFMAN

Between

PANJAVARNAM VEERAPUTHIRAN
(NO ANONYMITY ORDER MADE)
Appellant
and

SECRETARY OF STATE FOR THE HOME DEPARTMENT
Respondent

Representation:
For the Appellant: Mr M Sowerry of counsel, instructed by ABN Solicitors
For the Respondent: Ms L Clewley, Senior Home Office Presenting Officer

Heard at Field House on 13 July 2026

DECISION AND REASONS
1. The appellant appeals, with permission, against the decision of First-tier Tribunal Judge Howorth (“the judge”) promulgated on 7 January 2026. In that decision, the judge dismissed the appellant’s appeal against the respondent’s decision dated 16 April 2023 refusing her application for leave to remain on human rights grounds.
2. For the reasons set out below, the appeal is dismissed.
Background
3. The appellant is a national of Sri Lanka born in 1954. She entered the United Kingdom on 10 October 2021 using a visit visa valid until 25 March 2022. However, the day before her visa was due to expire, she applied for leave to remain on human rights grounds outside of the Immigration Rules. It was asserted on her behalf that the appellant had developed strong private and family life ties to the United Kingdom on account of her close relationship with her adult son, his wife, and her grandchildren, with whom she lived. Subsequently, a psychiatric report dated 1 February 2023 written by Dr Razia Hussain, a locum consultant psychiatrist, was sent to the Home Office. In summary, the report said that the appellant suffers from high blood pressure, diabetes, high cholesterol, arthritis and depression and took several different types of medication. Dr Hussain recommended that, in order to live a normal life, the appellant should benefit from the continued support of her family in the United Kingdom, which would have a positive therapeutic impact on her mental state. Furthermore, it was stated that her prognosis was likely to be satisfactory if she complies with the recommended treatment plan and could be reassured that she would not be separated from her family.
4. However, in the decision dated 16 April 2023, the respondent refused the appellant’s application. The respondent found that the appellant did not meet the requirements of leave to remain under the Immigration Rules and that there were no exceptional circumstances to her case that would warrant a grant of leave outside of the Rules on Article 8 grounds. In particular, the respondent took into account that the appellant had lived in Sri Lanka for 67 years and found that she could access medical treatment there, and be financially supported by her family in the United Kingdom.
5. The appellant exercised her right of appeal to the First-tier Tribunal.
The appeal before the First-tier Tribunal
6. The appeal was heard on 17 December 2025. In dismissing the appeal, the judge found that the appellant had not established that there would be very significant obstacles to her reintegration in Sri Lanka. Although she accepted that the appellant suffered from a number of physical and mental health conditions, and attached weight to Dr Hussain’s evidence concerning her care needs and the therapeutic benefit of family support, the judge found that appropriate medical treatment and care remained available in Sri Lanka. In the alternative Article 8 assessment, the judge accepted that the appellant enjoyed family and private life with her children and grandchildren in the United Kingdom and that her family were best placed to provide her with love and support. However, she concluded that care for the appellant was both possible and feasible in Sri Lanka, that there were practical arrangements available to meet her needs there, and that the public interest in maintaining effective immigration control outweighed the interference that would be caused to the appellant’s family and private life by her return.
The appeal to the Upper Tribunal
7. Permission to appeal was granted by First-tier Tribunal Judge Lawrence on the basis that it was arguable that the judge had either failed to consider, or had given inadequate reasons for finding, that the respondent’s decision was proportionate in light of the undisputed evidence that the maintenance of support from the appellant’s family was recommended because of its therapeutic impact upon her mental health.
The hearing
8. Mr Sowerry relied on the grounds of appeal as developed in the grant of permission by Judge Lawrence. He submitted that, although the judge referred to Dr Hussain’s report, she failed properly to engage with the evidence concerning the deterioration in the appellant’s condition and mental health. Counsel argued that the decision was effectively silent on those aspects of the medical evidence and that this omission was material because the judge failed to incorporate that evidence into the Article 8 proportionality assessment. In reply, he further submitted that there was no consideration of the appellant’s best interests, and that, as a matter of fact, the judge had failed to take account of the risk of deterioration in the appellant’s depressive condition when assessing proportionality.
9. Ms Clewley relied on the respondent’s Rule 24 response and submitted that the grounds disclosed neither a failure to consider all of the evidence nor a failure to give adequate reasons. She argued that the critical parts of Dr Hussain’s report, namely paragraphs 8(iii) and 9, were expressly taken into account by the judge at [15] and [20]. The respondent’s position was that the report indicated that family support in the United Kingdom would have a positive therapeutic effect on the appellant’s mental health, but did not establish that such support was fundamentally necessary. Ms Clewley submitted that the judge had specifically referred to the medical evidence and to the availability in Sri Lanka of the essential elements of the appellant’s care, including medication, carers and support. She further noted that it was not disputed that care homes were available in Sri Lanka. The respondent argued that the issue was not who could provide the best level of care, but whether removal was proportionate. The judge had recognised the family’s ability to provide support in the United Kingdom, but, having considered the evidence as a whole, was entitled to conclude that the appellant’s needs could be met in Sri Lanka and that the public interest outweighed the appellant’s preference for family-provided care. Ms Clewley submitted that the grounds amounted to no more than a disagreement with the weight that the judge attached to the evidence.
10. At the end of the hearing, I reserved my decision.
Discussion
11. As the appellant’s grounds of appeal explain, she does not dispute that medical treatment, care homes and professional carers may be available to her in Sri Lanka. Rather, the argument advanced on her behalf was that her interests would best be served by remaining in the United Kingdom so that she could continue to be cared for by her family. The principal evidence relied upon in support of that contention was the report of Dr Hussain. In particular, Dr Hussain stated at paragraph 8(iii) that the appellant “should need continuous support from hr family to have a positive therapeutic impact on her mental health” and, at paragraph 9, stated:
“There is a risk of a deterioration in her depressive state if Ms Panjavarnam loses the support of her family. She needs continuous support from them to live a normal life and to overcome her mental health issues. The prognosis is likely to be satisfactory if she complies with the recommended treatment and if she can be reassured of the elimination of her future risks and insecurities, concerning her detachment from her family, which is surrounding and dominating her thoughts. However, the worsening of her symptoms is likely if she does not comply with the recommended treatment and the support provided by her family is withdrawn for any reason.”
12. When considering whether there were very significant obstacles to the appellant’s reintegration in Sri Lanka, the judge addressed the appellant’s medical circumstances in sufficient detail. At [13], she noted the appellant’s medical conditions. At [14], she referred to Dr Hussain’s report, including the evidence that the appellant had suffered episodes of confusion, had become dependent upon her family, experienced poor sleep and appetite, and often required prompting in relation to meals and self-care. The judge expressly stated that she attached weight to Dr Hussain’s report “in respect of the Appellant’s health ad [sic] care needs”. At [15], she recorded Dr Hussain’s recommendation that the appellant commence sertraline and undertake cognitive behavioural therapy and, importantly, noted the recommendation that support from the appellant’s family be maintained because it had a therapeutic impact upon her mental health.
13. Having considered that evidence, the judge concluded at [16] that there were no very significant obstacles to the appellant continuing her private life in Sri Lanka, noting that she had previously lived in different parts of the country and that medication and care support were available there.
14. The judge then returned to the appellant’s care needs when undertaking the freestanding Article 8 assessment. At [18], she took into account that the appellant did not meet the requirements of the Immigration Rules because she had not established that care was unavailable to her in Sri Lanka. At [19], the judge recorded counsel’s submission that the Tribunal was required, in accordance with BritCits v SSHD [2017] EWCA Civ 368, to consider who was best placed to provide that care.
15. At [20], the judge found:
“immediate family are in the best position to provide her with love and support in her old age, either in the UK or overseas, as is the case in many families. However, I also take into account that the Appellant has lived her entire life in Sri Lanka, she speaks the language there and can converse freely. I do find some level of care is necessary, as is medical care, but it is [sic] not been a submission before me that either care or treatment is unavailable in Sri Lanka.”
16. The judge continued at [21]:
“Care for the Appellant is possible and feasible in Sri Lanka. Despite the lack of desirability of the family to use paid carers outside the family, or for her immediate family to choose to return to Sri Lanka with the Appellant there are eminently feasible solutions to ensure that the Appellant remains safe and cared for in Sri Lanka. The Appellant arrived in the UK on a visitor visa and in doing so, there was an expectation she would return.”
17. Having considered the best interests of the grandchildren at [22], the judge concluded at [23] that the appellant’s removal would not amount to a disproportionate interference with her Article 8 rights.
18. Reading the decision fairly and as a whole, I am satisfied that the judge plainly understood the essence of the appellant’s case. The decision demonstrates that the judge was aware that, although medical treatment and care were accepted to be available in Sri Lanka, the appellant contended that only her family in the United Kingdom could provide the level of emotional and practical support she required. The judge expressly recognised that contention, accepted that the appellant’s family were best placed to provide her with love and support, and attached weight to Dr Hussain’s opinion that family support had a therapeutic benefit.
19. In my judgment, the judge was nevertheless entitled to conclude that the proportionality balance fell in the respondent’s favour. As the respondent observed in the Rule 24 response, the issue was not simply who was best placed to care for the appellant. The question was whether it was disproportionate to expect her to return to Sri Lanka notwithstanding the availability there of medical treatment and care. The judge was entitled to conclude that it was not. As she correctly observed at [20], it will often be the case that family members are best placed to provide love and support to elderly relatives. The fact that family-provided care may be preferable does not, without more, render removal disproportionate where a person does not meet the requirements of the Immigration Rules and entered the United Kingdom on a temporary visa with no legitimate expectation of being allowed to settle here.
20. Nor do I accept that BritCits required the judge to reach a different conclusion. Even accepting that the appellant’s emotional and psychological needs formed part of the assessment, the judge expressly accepted that the appellant’s family were best placed to provide her with love and support. The judge was therefore plainly alive to the qualitative difference between care provided by family members and care provided by others. Having accepted that proposition, she was nonetheless entitled to conclude that adequate care and treatment remained available to her in Sri Lanka and that removal would be proportionate when viewed in the round.
21. Likewise, I do not accept the submission that the judge failed to engage with the passages in Dr Hussain’s report concerning the risk of a deterioration in the appellant’s mental health. Those passages formed part of the same body of evidence that the judge expressly summarised and took into account at [14] and [15]. The judge was not required to rehearse every aspect of the report. The decision demonstrates that she accepted family support was beneficial and therapeutically important, but ultimately concluded that the availability of treatment and care in Sri Lanka meant that removal remained proportionate.
22. Paragraphs 15.4 and 15.5 of the Practice Direction of the Immigration and Asylum Chamber of the First-tier Tribunal dated 1 November 2024 explain that First-tier Tribunal decisions should be concise, proportionate and focused on the issues in dispute, and that reasons “need refer only to the issues and evidence in dispute, and explain how those issues essential to the Tribunal’s conclusion have been resolved”. In the present case, I am satisfied that the judge adequately explained why, notwithstanding the support available from the appellant’s family in the United Kingdom, her removal would not be disproportionate. The ground of appeal is therefore not made out.

Notice of Decision
The decision of the First-tier Tribunal did not involve the making of an error of law. The decision shall stand.
The appeal is dismissed.

M R Hoffman

Judge of the Upper Tribunal
Immigration and Asylum Chamber

15th July 2026