UK-France "One in, One Out" agreement: a disastrous scheme for people seeking sanctuary, warns MSF

Paris–London, 30th Sept 2026 - As the “One in, One Out” pilot agreement expires on Thursday October 1st, Médecins Sans Frontières (MSF) warns this agreement has inflicted serious harm on hundreds of people seeking safety and should not be replicated with France or form the basis of any wider EU deal.

Since August 2025, more than 1,400 people – including survivors of torture, trafficking and people with serious mental health conditions - have been detained, sometimes for months, and then forcibly removed from the UK to France, where reception conditions are precarious.

Between January and September 2026, Médecins Sans Frontières (MSF) carried out weekly visits to the Parisian accommodation centres to provide psychological consultations to people returned to France from the UK under the ‘One in, One Out’ agreement. ​ MSF treated more than 60 people, mainly from Sudan, Afghanistan, Yemen, Palestine, Somalia, Eritrea, Ethiopia and India.

What MSF observed is deeply concerning. ​ Among those returned to France, clinicians documented people in severe psychological distress, suffering from flashbacks, acute anxiety, nightmares, sleep disturbances, withdrawal, severe disorientation, with some experiencing self-harm and suicidal thoughts. ​ In addition, MSF observed physical injuries on some patients: for example, our clinicians were in direct contact with a young man in his twenties who was returned to France under the scheme and who presented with injuries consistent with multiple blows, including nasal oedema, a head injury and maxillofacial trauma. ​

According to multiple consistent accounts from patients assessed by MSF psychologists, detention conditions in UK immigration removal centres are extremely poor with people reporting being deprived of their liberty from 8pm to 8am, with their mobile phones confiscated and no lighting in the shared cells. ​

“The ‘One, In One Out’ agreement has added another layer of trauma to life experiences of people who are already deeply marked by war, persecution, displacement and previous experiences of violence. This is not an isolated scheme. It is the latest in a series of dangerous agreements between France and the UK spanning more than 20 years trying to stop people seeking sanctuary in the UK, which were the subject of intense criticism by a recent French Parliamentary inquiry” says Camille Niel, Head of MSF France mission.

Furthermore, according to MSF patients’ testimonies, access to mental health care in UK detention centres was almost non-existent, even for people at very high risk of suicide. Alarmingly, some people our clinicians assessed reported being given medication in the detention centres without any information about its nature or effects. People also reported that when taken from detention to be removed to France, they were not told what was happening to them and were handcuffed throughout the removal flight.

“As discussions between UK Prime Minister and EU Member States are being planned for the coming months, our message is clear: a ‘One In, One Out' style returns deal should not be Europeanised. It has generated huge suffering and has not prevented deaths at sea. People continue to die at the UK-France border. Governments on both sides of the Channel and in Europe need to face up to reality. They need to completely reshape migration policies to focus on protection and care rather than violence and exclusion.” concludes MSF UK’s Forced Displacement and Protection Advocacy Advisor Sophie McCann.

Note to editors:

In July 2025, the United Kingdom and France signed a new migration agreement, commonly known as “One In, One Out”: people seeking asylum crossing the English Channel in makeshift boats are arrested, detained – sometimes for months - ​ and in some cases, forcibly returned to France. In exchange, the United Kingdom promises a legal pathway to enter into its territory. ​

But the criteria for the ‘in route’ are so restrictive that it remains inaccessible to the vast majority of people in France. Unaccompanied minors and stateless persons are theoretically excluded from this agreement, although there are reports of more than 100 age disputed young people being detained in the UK under the scheme, some of whom have been removed to France. ​

This agreement has been condemned by numerous organisations, including MSF, which views it as a cynical bargaining over human lives.

Watch the MSF documentary “One in, one out: thousands of lives at risk,” filmed in March 2026 in Calais. ​

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