I am grateful, Mr. Winterton.
I want to make it clear that, although I am chairman of the Britain-Nepal all-party parliamentary group, I am initiating this debate solely in my constituency capacity.
In 1997, my constituents, Mr. and Mrs. Davey, were in Pokhara, Nepal, where Mr. Davey was taking part in the excellent British Executive Services Overseas scheme, under which retired business executives give their expertise and skills free to developing countries. During the course of that assignment, Mrs. Davey received an invitation to go to a nearby primary school to give the children some practice in speaking the English language. When she went there on the first day, she broke the ice by asking each child in the class what they wanted to do when they grew up. One boy wanted to be an airline pilot, a girl wanted to be a nurse, others wanted to be doctors and so on. She went round the class until she came to a very small girl in the front row. When Mrs. Davey asked that small girl what she wanted to be when she grew up, she replied that she wanted to grow like the other children. When the class ended and the children got up to go out, Mrs. Davey could see that this child was much smaller than the other children.
The little girl's name was Gitanjali Shrestha. At that time, she was aged 10 and had ceased growing at the age of five. I am glad to say that she is listening to this afternoon's debate, as are Mr. and Mrs. Davey. Mr. and Mrs. Davey made inquiries in Nepal with the school, with Gitanjali's parents and with local doctors, which revealed that there was no medical treatment available in Nepal for a child with Gitanjali's condition. Indeed, there was no possibility of making an accurate diagnosis in Nepal. If Gitanjali remained untreated, she would suffer serious social disadvantages as an adult in Nepal. Those disadvantages were already appearing in her relations with other children at her school.
Mr. and Mrs. Davey returned to the United Kingdom, where they got in touch with Great Ormond street hospital for sick children. They were referred to a leading British expert in the field, Professor Brook, who pointed out that under NHS provision rules, it would be impossible to provide free treatment for Gitanjali as a child citizen in Nepal. However, he said that if Gitanjali were brought to this country, he would make a diagnosis.
Mr. and Mrs. Davey, entirely at their own expense and with the full support of Gitanjali's family, brought Gitanjali to this country on a two-month medical visa in May 1998. Professor Brook saw her and diagnosed Turner syndrome, which is a growth-retarding disorder. He prescribed a complex medical regimen of tablets in a particular combination and dosage. The regimen required careful and accurate monitoring in the interests of the child. Mr. and Mrs. Davey initially thought and hoped that it would be possible for Gitanjali to return to Nepal with a suitable long-term dosage of tablets where she could continue with Professor Brook's regimen under medical supervision.
Gitanjali returned to Nepal but sadly the arrangements that Mr. and Mrs. Davey had carefully put in place to ensure that Gitanjali had the correct medical supervision broke down. The medication was not administered correctly and Professor Brook's good work was reversed. Mr. and Mrs. Davey concluded that if Gitanjali were to get the medical treatment she required, the only place she would get it was the United Kingdom. They brought Gitanjali back to the United Kingdom on a six-month medical visa in December 1998 at their own expense.
Since Gitanjali has been back in this country—her stay has not been entirely continuous for reasons to which I shall come in a moment—her care, treatment and education have cost the British taxpayer not one penny. Gitanjali's board and lodging is provided entirely by Mr. and Mrs. Davey, who are her adopted grandparents with the full knowledge and appreciation of her family back home. Her medication is financed partly by Mr. and Mrs. Davey and partly by a generous contribution from the Kadoorie Charitable Foundation in Hong Kong. Mr. and Mrs. Davey pay for all Gitanjali's education at the Beechwood Sacred Heart school in Tunbridge Wells. As hon. Members will understand, Mr. and Mrs. Davey are not people of limitless resources by any manner of means, but they are people of magnificent generosity and wonderful compassion.
Professor Brook informed the Home Office at an early stage that it was essential that Gitanjali's medical treatment was made continuous. In a letter dated
"The patient returned to this country for further assessment and reinstitution of a proper medical regimen, which is now in place. It would be in her interest for this status to be maintained for the foreseeable future."
Despite the fact that Gitanjali has cost the British taxpayer not one penny, and despite the fact that there is the clearest possible medical advice that it is in her medical interest to remain in this country, the six-monthly medical visa renewal process in which Mr. and Mrs. Davey have been engaged with the Home Office has been an absolute nightmare. Home Office officials advised them that the visa would not be renewed, but it subsequently was renewed. Officials delayed issuing the renewal visas; so much so that, on two occasions, Mr. and Mrs. Davey had no alternative but to return Gitanjali to Nepal to enable it to be renewed there, causing stress and anxiety to Gitanjali and incurring hundreds of pounds of additional expenditure for no needful reason.
In desperation, Mr. and Mrs. Davey came to see me. On
"Further extensions of stay for private medical treatment will normally be granted provided the requirements of the Immigration Rules, which were outlined in my previous letter, continue to be met."
That was extremely helpful. Equally helpfully, he went on to point out that it was open to Mr. and Mrs. Davey to make a special application to the Secretary of State for Gitanjali to remain in the United Kingdom for longer than six months outside the immigration rules.
When Gitanjali's last medical six-monthly visa came up for renewal—the one that expired on the
Did the application to remain outside immigration rules take the form of an application to stay for reasons of study, or was it in the form of another application?
So that there is no misunderstanding between us, let me make it plain that the terms of the application are as set out in Mrs. Davey's letter of
From my standpoint, and that of Mr. and Mrs. Davey and Gitanjali, the Home Office's handling of that double application was frankly shocking. Lord Bassam gave me a clear undertaking that the medical renewal visa would normally be granted, but we still await a decision from the Home Office on the application for renewal almost five months after the date of Mrs. Davey's letter.
Not only was the decision to turn down the application for leave to remain outside the immigration rules disappointing, but the terms in which it was explained, in a personally addressed letter to Gintanjali Strestha, were shameful. The final paragraph of the decision letter of
"You should leave the United Kingdom at the end of 10 working days from the date when you received this notice. If you fail to leave you may be prosecuted for an offence under the Immigration Act, the penalty for which is a fine of up to £2,500 and up to 6 months imprisonment and you will also be liable to be removed from the United Kingdom."
I must say to the Minister that to address a letter containing threats of fining and imprisonment to a 13-year-old girl who is suffering from a serious medical disorder, has been in this country since December 1998 and is from Nepal—a country with which we have a special relationship—is scandalously and outrageously insensitive. I urge the Minister to review the practices of her Department when addressing such letters to children of Gitanjali's age.
I have two specific requests to put to the Minister. First, I hope that she will, perhaps in today's answer to the debate, state that the application for the renewal of the medical visa has been granted in accordance with the undertaking, given to me by Lord Bassam, that it would normally be granted given the medical circumstances. Secondly, I make a clear request to the Minister—I would like her complete attention because these points are profoundly important—that she and her right hon. Friend the Home Secretary give further consideration to putting aside immigration rules and enabling Gitanjali Shrestha to remain in this country for longer than six months. I do so on two grounds that have not been considered before by Ministers at least, and perhaps not even by officials.
The first ground is medically and personally sensitive, but I have the assent of Gitanjali and Mr. and Mrs. Davey to refer to it. As a result of Turner syndrome, Gitanjali will be unable to bear children. In Nepalese terms, she will therefore almost certainly be unable to marry and have a husband to support her financially through her adult life. The employment and financial security that she subsequently obtains in Nepal will depend wholly on the level of education she secures in this country while undergoing medical treatment. I put that key consideration in the Minister's mind as she contemplates whether the Secretary of State should grant, as I hope he will, Gitanjali leave to remain outside the immigration rules. That decision is fundamental to Gitanjali's educational opportunities and level of attainment, which will in turn be vital to her adult life in Nepal.
I turn to the second ground for the Minister's close consideration. Gitanjali now requires growth hormone treatment, and Professor Brook has confirmed that it will cost up to £50,000. As I have said, such treatment is not available to Gitanjali through the NHS. Mr. and Mr. Davey are trying to raise the money by approaching charities in the UK and elsewhere. However, the charities, understandably, will not contemplate making available such a sum unless they can be sure that Gitanjali will remain in the UK to receive treatment during the next few years; the period in which it must be administered. Gitanjali's visa status will prove critical in obtaining funding for growth hormone treatment through the charitable sector.
I ask the Minister to give the most careful consideration to the points that I have made. At certain times, and with some justification, my remarks have been somewhat critical of her Department's handling of a case in which she may be personally involved for the first time. I hope that she will bring a new look, a new sensitivity and a new compassion to the matter, and that she and her right hon. Friend the Home Secretary will agree to my requests concerning visas for Gitanjali Shrestha. 1.49 pm
First, I congratulate Sir John Stanley on securing this debate. This is a very difficult subject that has caused great distress to those who have acted with enormous generosity in assisting a little girl desperately in need of help when she was discovered in Nepal.
Miss Shrestha, who is only 12 years old and a national of Nepal, suffers from Turner syndrome, as the right hon. Gentleman said. He has given in great detail its effects on her and the medical treatment that she needs. I accept that she needs to remain in the United Kingdom for private medical treatment, under the supervision of Professor Brook at the Middlesex hospital, where the growth hormone that she needs can be properly monitored and the dose adjusted until she stops growing in a few years' time.
The right hon. Gentleman is correct in saying that a dual application was made, but only one aspect was determined; the application for student status, rather than the application to stay for medical treatment. I was, therefore, slightly puzzled when he said that an application had been made for leave to remain further, outside the immigration rules. I wonder whether there is a mix-up between the application for student status, which would grant a much longer-term right to stay, and a formal application outside the immigration rules. It will probably be better for the right hon. Gentleman and me to chat about that after the debate.
One part of the application was, in error, determined separately from the other by a caseworker who made a mistake that should not have been made. A standard letter is sent to people who have come into Britain under one regime and wish to switch to student status in order to stay. There is no leeway under immigration rules for that switch to be made in this country; the person must return to their country of origin and re-apply. I can understand the distress that receiving that letter caused.
I apologise on behalf of the caseworker, who saw the application, on an initial reading, as an application for student switching, came to an erroneous decision and sent the standard letter, which is clearly not meant for children. I take the opportunity to apologise publicly for that error, and let the right hon. Gentleman know that the caseworker concerned is distressed also by the mistake, and is being guided by retraining to ensure that such an error does not occur again.
We have still not determined the medical application. The immigration rules in that area are strict, and we may need to examine the process; the right hon. Gentleman has certainly got me thinking about that. Under the way in which the rules work for medical applications, we must have re-confirmation that the condition is persisting for the six-month visa to be re-issued. There is no reason why that should not happen as soon as we get that confirmation, perhaps in another letter from Dr. Brook.
The answer to the right hon. Gentleman's more important question is that yes, it is in order for an application outside the immigration rules to be made for Miss Shrestha to be allowed to remain in Britain for a period longer then six months. Unfortunately, we do not have a record of such an application being made, and I have been trying to clarify that point during the debate. I wonder if there has been a misunderstanding over the application made for student status, and that it has been assumed that the dual application was an application outside immigration rules. With a little liaison, the right hon. Gentleman and I should be able to sort the matter out. I am happy to confirm that it is possible for such an application to be made outside the immigration rules and looked at on compassionate grounds.
I hope that, with those clarifications, the right hon. Gentleman and I can work together to ensure that, in the future, we can do better than Mr. and Mrs. Davey's experience of the process as he described it.
Question put and agreed to.
Adjourned accordingly at five minutes to Two o'clock.