Prosecutor General's Office (Lithuania) v Michail Michailov

Mr Justice Linden : Introduction

1. This is the Judicial Authority’s (“JA’s”) appeal from an order for the discharge of the Respondent requested person (“RP”) made on 15 November 2021 by District Judge Callaway, sitting at the Westminster Magistrates’ Court. The District Judge held that the extradition of the RP would be contrary to Article 3 of the European Convention on Human Rights (“ECHR”) given certain mental and physical conditions from which he suffers. He considered that there was a real risk that, by reason of these conditions, the RP would be subjected to inhuman and degrading treatment in the Lithuanian prison system because the facilities and the care available to him would be inadequate. Such assurances as were before him were generic in nature and he did not consider that there was any further information which the JA might provide which would allay his concerns.

2. At a rolled up hearing on 18 October 2024, Sir Peter Lane held that the District Judge’s view that, in effect, there was no assurance which the JA could give which would satisfy Article 3 ECHR, was irrational. Given his view that the assurances which had been provided were generic, the District Judge should have sought further, specific, information before coming to a decision in relation to Article 3. Sir Peter’s reasons are set out in a helpful judgment under neutral citation number [2024] EWHC 3001 (Admin) .

3. Sir Peter therefore gave the JA permission to appeal and directed that the parties agree a list of questions to be put to the Lithuanian Prison Service which he then approved. On 10 December 2024, Mr Linas Nanartavicius, Deputy Head of the Lithuanian Prison Service, then provided a response to these questions. On 5 February 2025, the RP’s representation order was extended administratively to provide for a medical report by Dr Mark Burgin (General Practitioner and Disability Analyst), and a timetable for the provision of further information and evidence was directed, without prejudice to any objection to the admissibility of such materials.

4. In the event, neither party objected to me taking into account any of the evidence and information relied on by the other party. In the light of Sir Peter Lane’s conclusion as to the rationality of the District Judge’s decision, and his order that further information be sought, it was common ground that I am required to make a fresh decision on the Article 3 ECHR point. The issue in the appeal is whether, in the light of the evidence which is currently available and the further information provided, the District Judge’s decision was wrong. The Requested Person

5. The RP is a Lithuanian national whose date of birth is 28 May 1969. He says that he served in the Soviet Army including in Afghanistan in 1988-1989, as a result of which he suffers from post traumatic stress disorder (“PTSD”). He has various other conditions and impairments to which I refer below.

6. The RP has five convictions for six offences in Lithuania and the Netherlands: four offences against the person and two public order offences. The offences against the person include an attempted murder committed in the Netherlands in July 2012, for which he received a custodial sentence of 3 years. The Arrest Warrant

7. The arrest warrant (“AW”) which is the subject of these extradition proceedings is an accusation warrant which was issued on 22 January 2020 and certified by the National Crime Agency on 5 April 2021. The RP is accused of three offences, two of which are offences against the person. The third is a public order offence. In summary, the allegations are that, on 3 April 2017, whilst drunk and in the communal area of shared accommodation, he stabbed another person in the back of the head with a knife and caused a wound which corresponded to slight bodily injury. The next day, he stabbed the same person in the head again and caused further injury. This incident is also charged as an affray. The offences against the person carry a maximum sentence of 2 years’ custody and the public order offence carries a maximum of 5. The hearing before the District Judge and his decision

8. The RP was arrested on 6 April 2021 at his home address near Bognor Regis and was bailed after his first appearance on 7 April 2021.

9. The extradition hearing before District Judge Callaway took place on 10 September 2021. Until the day before the hearing, the RP’s objections to extradition were based on section 14 of the Extradition Act 2003 (passage of time) and section 25 (the physical or mental condition of the person in respect of whom the warrant is issued is such that it would be unjust or oppressive to extradite him), as well as section 21/Article 8 of the ECHR. However, the Article 3 argument was then raised after Ms Hinton for the JA had filed her Opening Note. The District Judge therefore asked for post hearing written submissions on this issue.

10. At the hearing before the Magistrates’ Court, the RP gave evidence with the assistance of an interpreter. His evidence included that he had made a number of suicide attempts and he showed the District Judge scarring on his arms as evidence of this. The RP also relied on a statement from his partner which supported his evidence as to his mental and physical health, and said that she assisted him with his daily needs. In particular, she supported his evidence that he had suffered a knee injury in a cycling accident around 2 years earlier which left him with constant pain and affected his mobility, as well as giving rise to issues with his lower back.

11. The District Judge also had before him a telephone assessment report from a Dr Petra Makela dated 10 July 2020, and a psychiatric report prepared by a Dr Krishna Balasubramaniam dated 19 October 2020. And there were more up to date reports from Dr Liliya Korallo, a psychologist, dated 27 August 2021, and Ms Margaret Ellis, an occupational therapist, dated 7 September 2021. Dr Korallo and Ms Ellis, both gave evidence. The District Judge noted that Dr Korallo’s evidence was that: “I would conclude that (the RP) suffers from mild General Anxiety Disorder and moderately severe depression, with PTSD emerging only under severe acute stress. … there are several important factors, in combination, that would be likely to provoke suicide were (the RP) to be returned to (the JA).”

12. He also noted Dr Korallo’s evidence that the RP tended to minimise the impact of his combat experiences.

13. Ms Ellis recorded the RP’s physical issues arising out of his cycle accident, and that he was walking with the assistance of one elbow crutch. The District Judge noted her evidence that: “The Three Standardised Assessments which I have undertaken… demonstrate a general weakness and inability of independence of this man. He is highly dependent on his partner and on physical and mental support she constantly provides him every day and night. There is no doubt that since his accident (the RP) has become totally dependent on his partner for most of his physical and mental functions.”

14. On the basis of the evidence as it then stood the District Judge held that, notwithstanding the issues in relation to the RP’s mental health and the evidence as to the risk of suicide, it would not be unjust or oppressive to extradite the RP for the purposes of section 25 of the Extradition Act 2003 . The RP’s objection based on section 25 failed accordingly. However, he did not take the RP’s physical health into account in coming to this conclusion. The objections under section 14 and Article 8 ECHR were also rejected.

15. In relation to Article 3 ECHR, however, the District Judge held that the RP was “far from being able bodied”, that he had “significant disabilities as reflected in the unchallenged evidence of Ms Ellis”, and that factoring in the psychological evidence as well, the RP was “exceptionally vulnerable not only in a general sense, but also within the context of a prisoner (sic) and whether on remand or serving a sentence”. The JA had provided two assurances dated 3 April 2020 which dealt with the treatment of all people extradited to Lithuania by the United Kingdom and provided guarantees as to, for example, minimum space in a specified remand prison (Siauliai). But the District Judge noted that these assurances did not deal with the individual circumstances of the RP’s case, the issues with his health, and the type and quality of the care which he would receive in prison in Lithuania. He therefore considered whether to request further information from the JA pursuant to Criminal Proceedings against Aranyosi [2016] QB 921 and said the following at [46]: “46. I am mindful that proceedings need to be resolved within a reasonable time scale. Necessarily, for the court to seek further information will, a fortiori, delay the conclusion of the application, what should the court do in this instance? In my judgment, the generic nature of these assurances are deficient, and are incapable of rectification in this particular case whatever information is sought from this JA. It is clear that this JA is unable to detain this RP in such a way as to secure his Art. 3 rights. Any requests for further information would be unlikely to assist this question and I am of the view that the matter should be brought to a close.”

16. Accordingly, he discharged the RP on the basis of Article 3 ECHR. The decision of Sir Peter Lane

17. Part of the reason for the delay in the JA’s appeal is that the outcome of Suceava District Court (Romania) v Gurau [2023] EWHC 439 (Admin) was awaited. In that case the Divisional Court held that it is not possible to cross appeal in proceedings under section 28 of the Extradition Act 2003 . The RP in the present case therefore was unable to cross appeal on the section 25 issue, for example and, as a consequence, the arguments before Sir Peter Lane and before me are framed in the context of Article 3 ECHR only.

18. By the time of the hearing before Sir Peter Lane on 15 October 2024, the RP had been convicted in this country of wounding/inflicting grievous bodily harm with intent contrary to section 18 of the Offences Against the Person Act 1861 . On 13 April 2023 he had been sentenced to a 9 year extended determinate sentence comprising a 4 year custodial term and a 5 year extension. He is currently serving that sentence and his early release date is scheduled to be in the spring of 2026.

19. At [29]-[35] Sir Peter Lane considered Aranyosi [77]-[95] as explained by Chamberlain J in Bacau District Court Romania v Andy-Richard Iancu [2021] EWHC 1107 (Admin) at [15]-[17]. Sir Peter noted that although the court must obviously be satisfied that there is a need to seek further information if stage 2 of the Aranyosi procedure is to be engaged, there is no evidential threshold which requires to be crossed before it can do so. In particular, it is not necessary to show that on the information available there is a real risk that Article 3 will be breached or that a prima facie case to that effect has been made out. Nor is it implicit in the making of a request for further information that the court has found that, on the information available, Article 3 has been breached. District Judge Calloway was therefore entitled to consider that the combination of problematic prison conditions in Lithuania and the evidence of the RP’s mental and physical health meant that he could seek "supplementary information on the conditions in which it is envisaged that" the RP respondent would be detained ( Aranyosi [95]).

20. Sir Peter then set out [46] of the judgment of the District Judge (as I have at [15], above) and said this at [37]-[39]: “37. Ms Hinton has characterised these passages as irrational. With respect to the district judge, I am compelled to agree. The finding that the assurances before the district judge, which I reiterate were provided for a different purpose, were "incapable of rectification in this particular case whatever information" was sought from Lithuania is wholly remarkable, particularly in the case of a State which is a member of the Council of Europe and the European Union. So, too, is the sentence, "It is clear that this JA is unable to detain this RP in such a way as to secure his Art 3 rights".

38. In so finding, the district judge appears to have accepted uncritically the submission in paragraph 49 of the respondent’s post-hearing written submissions of 15 October 2021, that "this RP cannot be imprisoned whether in the UK or elsewhere because of his vulnerabilities". Those vulnerabilities were described in the most recent medical report before the district judge by Dr Korallo as "mild general anxiety disorder and moderately-severe depression, with PTSD emerging only under severe stress". In addition, the occupational health practitioner, Ms Ellis, had referred to the respondent as having become totally reliant on his partner, with the result that he would "struggle to survive in any jail without the close personal support he currently has".

39. One does not need the benefit of hindsight to see the complete unreality of the proposition that the respondent could never be imprisoned anywhere in the world, no matter what the offence and no matter what measures might be put in place to address his needs, without a real risk of him suffering Article 3 ill treatment. But, in any event, hindsight is available. After the hearing before the district judge, the respondent was able to inflict grievous bodily harm on another individual, despite all [his] problems. As a result, he is currently serving a lengthy sentence of imprisonment in HMP Maidstone. As far as I am aware, it has not been submitted on his behalf that the respondent is currently being subjected to Article 3 ill-treatment.”

21. Sir Peter then considered the additional evidence which had become available since the hearing before the District Judge. This included a letter from the JA dated 18 March 2022, and a letter dated 31 August 2024 from HMP Maidstone which confirmed that the RP was a wheelchair user, that the wheelchair was not provided by prison healthcare, that the RP was not registered disabled and that there was a personal evacuation plan in relation to him. There were also updating proofs of evidence from the RP and his partner and an updated report from Dr Korallo dated 11 June 2024. And there was evidence from the RP’s solicitor that the RP was being assisted by a fellow prisoner on the same landing at HMP Maidstone, including by getting his food for him, pushing him around the prison, helping him to clean his cell and helping him to get in and out of the shower. Ms Nice also sought to rely on the 18 July 2024 report of the European Committee for the Prevention of Torture and Inhuman and Degrading Treatment or Punishment (“CPT”) which Sir Peter considered de bene esse but declined to admit in evidence given that it had been proffered far too late.

22. The upshot of Sir Peter’s consideration of these materials was that, at [49]-[50], he concluded that on the basis of then current admissible evidence the JA had failed to show that the appeal should be allowed and the case remitted to Westminster Magistrates' Court under section 29 of the 2003 Act , with a direction for the District Judge to proceed as he would have been required to do if he had decided the Article 3 question differently. On the other hand, the RP had failed to show that the District Judge, despite the error in his judgment which had been identified, would still have decided the Article 3 issue in favour of the RP.

23. At [51], Sir Peter noted: “The position of a wheelchair user in prison is, I find, a matter of concern; at least where imprisonment is to be in a country where this court has found prison conditions to be problematic. This point emerges from the recent judgment if McGowan J in Giana v. Romania [2024] EWHC 1613 (Admin) . In the light of the witness statement of the respondent’s solicitor mentioned earlier, I note, in particular, what McGowan J had to say at paragraph 35 of her judgment about the possibly problematic nature of another prisoner being deployed to assist the wheelchair-using prisoner with various personal matters. This is a matter which may need to be addressed in due course.”

24. He went on to consider submissions as to the effect of a post hearing letter from Mr Nanartavicius dated 16 October 2024 (“the October 2024 Further Information”). This said: “ RE: INFORMATION ON THE ACCOMMODATION OF PRISONERS WITH DISABILITIES In response to your request of 16 October 2024, which was forwarded by the Ministry of Justice of the Republic of Lithuania, for confirmation there are adjustments in place to accommodate detainees in wheelchairs, we kindly inform you that there is a unit for prisoners with disorders of independence - a separate (local) unit in the penitentiary institution for prisoners serving a custodial sentence who, due to their physical disabilities, chronic illness, age or other reasons, need the assistance of other persons in the areas of mobility and self-care. This unit is in Pravieniškės prison No 2. Please inform us in advance of the planned transfer of the prisoner so that we can prepare for his/her reception and accommodation.”

25. Ms Nice objected to this letter being admitted in evidence and argued that in any event it appeared to refer to prisoners who had been convicted, whereas the RP was wanted on an accusation warrant. She said that the production of this letter was a tacit admission that the JA could not succeed under Article 3 and that the time had now come to dismiss the appeal given the delays that there had been. Sir Peter nevertheless concluded that, in order to adjudicate the appeal properly, it was necessary to seek further information as to the conditions in which the RP would be held in Lithuania given his current situation. The Request for Further Information

26. A request for further information (“the RFI”) was therefore agreed between the parties, approved by the Court and sent to the Lithuanian authorities on 3 December, with a deadline for a response of 18 December 2024. This document set out the background and enclosed relevant materials as at the date of the request i.e. the key materials which were before Sir Peter Lane including the RP’s evidence, the evidence from his solicitor about assistance in prison and the June 2024 report by Dr Korallo, as well as the key expert reports which were before the District Judge. The request stated that “we already have your response [dated 25 March 2022]” and went on to say the following: “6. We note that you have also provided confirmation (your letter 16 October 2024) that “there are adjustments to accommodate detainees in wheelchairs”. This letter refers to prisoners serving custodial sentences and detention in a Unit at Pravieniškės No 2.

7. As Mr Michailov would be a remand prisoner initially and now also requires a wheelchair and adjustments to support him using his wheelchair in custody, we invite you to consider the material and answer the following questions (you may refer to information already given):

1. What would be put in place to ensure Mr Michailov could be safely managed in a custodial setting, given his particular physical and mental health needs?;

2. What reasonable adjustments will be provided to him to ensure he is safely detained?;

3. What access to nurses, doctors, psychologists and/or psychiatrists will he have and how often?

4. What adjustments are in place for prisoners in wheelchairs while on remand?

5. What adjustments are in place for prisoners in wheelchairs while serving a sentence?

6. To the extent not covered above, please explain the likely type of cell he would be detained and the sanitary and hygiene facilities available.

7. Can the Lithuanian authorities confirm his detention whether on remand or serving a sentence will comply with Article 3 of the European Convention upon Human Rights?” The reply from the Lithuanian Prison Service

27. The reply from the Lithuanian Prison Service, dated 10 December 2024, (“the December 2024 Further Information”), so far as material, is set out in the “Discussion” section of this judgment, below. Dr Burgin’s report

28. Dr Burgin’s report dated 12 March 2025 is based on an examination which took place approximately a month earlier. At [43]-[48] he gives his opinion on the RP’s functional restrictions. These include: i) Mild restrictions in his mobility. “He has weaknesses in both legs. He is able to transfer with pain and weakness. He…struggles to maintain himself in a standing position even holding on..” ii) Mild restrictions in bending owing to back issues. “He is not able to squat or kneel due to leg pain and weakness”. iii) Mild to moderate restrictions in terms of his emotional control, which are occasional but serious, and difficulties with social interaction, probably due to unrecognised anxiety. He also lacks insight into his psychological issues. iv) Diarrhoea, vomiting and occasional faecal incontinence owing to urgency. These are, however, described as “minimal restrictions”. v) Mild restrictions to vision. He struggles to read, even with glasses, and is sensitive to light. vi) He is assessed as 6 “moderately frail” i.e. needs help with all outside activities and keeping house, often has problems with stairs and needs help with bathing and might need minimal assistance with dressing. vii) He has swollen ankles and other symptoms which may indicate heart or liver problems. If he has a heart or a liver condition he is likely to have a shorter life expectancy. This may be as short as five years given his frailty, subject to whether any condition was treatable. viii) There is evidence of sarcopenia (i.e. loss of muscle mass, strength and function). This can increase the risk of falls and fractures.

29. Under the heading “Muscular skeletal”, Dr Burgin says this: “He struggles to support his weight on his good (right) leg and he has frailty which would be restrictive in any event. His upper body strength is likely to have worsened but he previously had high strength so is still able to transfer. If there is a significant deterioration of his frailty and sarcopenia he will require lifting from bed to chair and need help with self-care however the likelihood is difficult to predict on the current evidence. Although the most likely timescale is 2 years for a significant deterioration of his frailty (see prognosis) it could be a few months to a decade.”

30. In the “Summary and Conclusions” section, Dr Burgin says that the RP “lives the life of a moderately disabled person” and refers to “mild physical functional restrictions to mobility, bending, exercise tolerance likely due to frailty, back pain radiating to the leg and possible liver or heart disease”. Dr Burgin also says that the RP tends to understate his symptoms and that he is a proud man who is likely to avoid asking for help unless he really needs it. He may also have difficulties in interacting with others which means that he does not always get the help that he requires, and there is evidence of angry and sometimes aggressive behaviour which may affect the willingness of others to assist him.

31. Dr Burgin also refers to the RP’s psychological functional restrictions which, he says, are likely to be due to complex PTSD and Autistic Spectrum Disorder (“ASD”) since childhood. In this connection I note that Dr Burgin’s references to PTSD and ASD go beyond the opinion expressed by Dr Korallo, who appears to have greater relevant expertise. She says, in her 24 June report, which was based on an in person assessment on 2 May 2024: “19. There is no doubt that Mr Michailov suffers from moderate Depression and mild Anxiety though the depression may be episodic. He shows some elements of Post-Traumatic Stress Disorder (PTSD), such as hypervigilance, impulsivity, irritability, occasional nightmares, and occasional flashbacks. These are intermittent (twice a year, by his account). When I assessed him he would not, therefore, have met the full criteria for PTSD, as I said in my previous report dated 27/08/2021. Symptoms of PTSD were triggered by acute stress associated with the prison environment or the threat of extradition.”

32. Having said this, she also says that: “[the RP’s] suicidal likelihood increases when he feels hopeless and helpless, and when he has suffered pain and lack of sleep. In those circumstances he can become impulsive and will use any available means to attempt to commit suicide.”

33. And she goes on to note that the RP has attempted to hang himself in his cell and to say: “…he would need to be under a 24 hour watch, especially were he to think that he is likely to be extradited. In Lithuania he would also need to be monitored on a regular basis, at least initially, before he adjusts to the new reality.”

34. Under Prognosis, Dr Burgin says this: “ Physical In my opinion, on the balance of probabilities the mild physical functional restrictions are likely to worsen over the next 2 years to moderate as the frailty progresses, he would then require assistance with self care and transfers. Psychological In my opinion, on the balance of probabilities the mild psychological functional restrictions will not worsen significantly over the next five years.”

35. Dr Burgin goes on to recommend the following reasonable adjustments: “He should have a disabled accessible cell with enough space with an adapted shower, toilet, grab bars and wheelchair on the ground floor of the prison. He should have access to helpers who are paid for by the prison and can help if he falls on the floor or is unwell and needs help getting his medication and food. He should be given a regular dose of antidepressant and pain killers (not NSAIDs) for symptomatic control of his symptoms.” The requested person’s updated proof of evidence

36. There is also an updating proof of evidence from the RP which states the position as at June 2025. He says that he is only just able to reach the toilet in his cell but this requires a lot of effort. His left leg provides him with no support at all and his right leg is still very weak and unstable. There is also severe pain in the left leg, which is often swollen and there was issues with his back. He takes co-codamol for pain relief but is not able to collect is owing to issues with his mobility and therefore is currently not taking any pain relief at all. He says that he does his best to maintain basic hygiene and to shower at least once a week but he needs help to do so. He continues to rely on other prisoners for assistance. The RP’s medical records

37. The additional material included the RP’s medical records from April 2024 to 10 June 2025 to which Ms Nice made brief reference. I have taken this material into account, albeit Dr Burgin’s evidence appeared to me to be the key evidence for present purposes. Legal framework The basis of the appeal

38. Section 28 of the Extradition Act 2003 gives the JA a right of appeal to the High Court in the present case, with the leave of the Court, “on a question of law or fact”. Section 29(2) provides, so far as relevant to the present case, that the High Court may only allow the appeal if the conditions in subsection (4) are satisfied. Sections 29(4) to (6) provide that: “(4)The conditions are that— (a) an issue is raised that was not raised at the extradition hearing or evidence is available that was not available at the extradition hearing; (b) the issue or evidence would have resulted in the judge deciding the relevant question differently; (c) if he had decided the question in that way, he would not have been required to order the person's discharge.” (5) If the court allows the appeal it must— (a) quash the order discharging the person; (b) remit the case to the judge; (c) direct him to proceed as he would have been required to do if he had decided the relevant question differently at the extradition hearing. (6) A question is the relevant question if the judge's decision on it resulted in the order for the person's discharge.”

39. As noted above, the parties agreed that the effect of these provisions in the circumstances of the present case is that I should decide the Article 3 ECHR question afresh on the basis of the materials currently available to me. The duty of the extraditing state under Article 3 ECHR

40. Article 3 ECHR provides that: “No one shall be subjected to torture or inhuman or degrading treatment or punishment”.

41. In Aranyosi (supra) the European Court of Human Rights said this: “90. In that regard, it follows from the case-law of the ECtHR that Article 3 ECHR imposes, on the authorities of the State on whose territory an individual is detained, a positive obligation to ensure that any prisoner is detained in conditions which guarantee respect for human dignity, that the way in which detention is enforced does not cause the individual concerned distress or hardship of an intensity exceeding the unavoidable level of suffering that is inherent in detention and that, having regard to the practical requirements of imprisonment, the health and well-being of the prisoner are adequately protected…..

91. Nonetheless, a finding that there is a real risk of inhuman or degrading treatment by virtue of general conditions of detention in the issuing Member State cannot lead, in itself, to the refusal to execute a European arrest warrant.

92. Whenever the existence of such a risk is identified, it is then necessary that the executing judicial authority make a further assessment, specific and precise, of whether there are substantial grounds to believe that the individual concerned will be exposed to that risk because of the conditions for his detention envisaged in the issuing Member State.

93. The mere existence of evidence that there are deficiencies, which may be systemic or generalised, or which may affect certain groups of people, or which may affect certain places of detention, with respect to detention conditions in the issuing Member State does not necessarily imply that, in a specific case, the individual concerned will be subject to inhuman or degrading treatment in the event that he is surrendered to the authorities of that Member State.

94. Consequently, in order to ensure respect for Article 4 of the Charter in the individual circumstances of the person who is the subject of the European arrest warrant, the executing judicial authority, when faced with evidence of the existence of such deficiencies that is objective, reliable, specific and properly updated, is bound to determine whether, in the particular circumstances of the case, there are substantial grounds to believe that, following the surrender of that person to the issuing Member State, he will run a real risk of being subject in that Member State to inhuman or degrading treatment, within the meaning of Article 4.

95. To that end, that authority must, pursuant to Article 15(2) of the Framework Decision, request of the judicial authority of the issuing Member State that there be provided as a matter of urgency all necessary supplementary information on the conditions in which it is envisaged that the individual concerned will be detained in that Member State.”

42. As Sir Peter Lane noted, in Iancu (supra) Chamberlain J confirmed that it is not a pre-condition to the seeking of further information from the requesting state that a real risk of a breach of Article 3 has been established. The Aranyosi procedure is more flexible than this. Key caselaw of the European Court of Human Rights where issues are raised as to healthcare in prison

43. In Helhal v France (App no 10401/12, 19 February 2015) the European Court of Human Rights set out the following principles which are relevant to the present case: i) “The duty of care towards sick prisoners imposes the following specific obligations on the State: to verify that prisoners are fit to serve their sentence, to provide them with the necessary medical treatment and, where appropriate, to adapt the general conditions of detention to their particular state of health….” [47] ii) “As regards the third obligation, the Court requires the prison environment to be adapted, where necessary, to the prisoner’s specific needs so that he or she can serve the sentence in conditions that do not undermine his or her psychological well-being” [48] iii) “Where the national authorities decide to place or maintain a person with disabilities in detention, they should demonstrate special care in guaranteeing such conditions as correspond to the special needs resulting from the detainee’s disability…” [50]

44. Helhal itself concerned a wheelchair user, albeit the prisoner had more serious conditions and impairments than the RP in the present case. At [63] the Court concluded that: “In view of his severe disability and the fact that he suffers from urinary and faecal incontinence, the length of time during which he was detained without receiving any rehabilitative treatment, and his inability to take a shower without the help of a fellow prisoner, are factors that have subjected the applicant to hardship exceeding the unavoidable level of suffering inherent in detention. Those circumstances amount to degrading treatment and thus to a breach of Article 3 of the Convention. The absence of any indication that the authorities acted with the intention of humiliating or debasing the applicant does not alter that finding in any way…”

45. As to assistance available to the prisoner to meet his or her personal needs, a theme in the caselaw of the European Court of Human Rights is a concern about the use of unqualified or untrained assistants. Reliance on voluntary assistance by fellow prisoners may also contribute to a finding that Article 3 has been breached. In Potoroc v Romania (App no 37772/17) the Court said this: “76….several medical reports as well as findings by the domestic courts…..confirmed the fact that the applicant needed constant help for current tasks, help that was to be provided by a personal assistant…. In spite of this assessment, the applicant did not have the benefit of such assistance, except for when he was helped on an official basis by some inmates who provided collective assistance…or unofficially by fellow inmates….. However, the Court reiterates that it has already voiced doubts as to the adequacy of assigning unqualified people responsibility for looking after an individual suffering from a serious illness….. Furthermore, the Court has already found a violation of Article 3 of the Convention in circumstances where prison staff felt that they had been relieved of their duty to provide security and care to more vulnerable detainees whose cellmates had been made responsible for providing them with daily assistance or, if necessary, with first aid…..

78. In the present case, it cannot be ascertained whether the prisoners who agreed to assist the applicant were qualified to provide appropriate support or whether the applicant actually received such support. Nor does it appear from the case file that the applicant received appropriate psychological support during his periods in hospital or prison, given that he displayed severe psycho-organic syndrome and at times symptoms of depression... Such help cannot therefore be considered suitable or sufficient.

79. Furthermore, the Court cannot ignore the applicant’s submissions, uncontested by the Government, that the wheelchair was provided to him at own expense…., in the lack of any assistance to that effect from the prison authorities…”

46. As I read the Strasbourg authorities, there is no absolute rule against reliance on untrained/unqualified or voluntary assistance for a prisoner with health issues, whether from fellow prisoners or otherwise. Each case should be determined on its facts including the nature of the prisoner’s condition, the nature of the assistance required, the level of expertise of the people providing the assistance and whether they can be depended upon to provide it. Ultimately the question is whether, having regard to the prisoner’s needs, the assistance is effective to ensure that the prisoner is detained in conditions which are compatible with respect for his human dignity. Thus, for example, in Epure v Romania (2021) 73 EHRR 22 , which concerned a prisoner with severe mental health issues, the Court said this at [80]: “…although …the applicant had the assistance of various fellow inmates, the Court is particularly concerned about the quality of their assistance, as they had neither been trained nor have the necessary qualifications to provide… assistance to a person such as the applicant with a complex condition in the area of mental disability; ….In that connection, the Court refers to the medical evidence…showing that the applicant’s seizures were frequent and could occur at any time of the day or night, and involved episodes of high irascibility, aggressive behaviour and complete loss of self-control. Therefore, the applicant must have known that at any moment he risked a medical emergency with very serious effects and that no qualified medical assistance was available. Hence, leaving him without specialised assistance in such situations must have given rise to considerable anxiety on his part.”

47. However, in Semikhvostov v Russia [2014] ECHR 2689/12 the Court noted that: “74. The Court has also held that detaining a disabled person in a prison where he could not move around and, in particular, could not leave his cell independently, amounted to degrading treatment… Similarly, the Court has found that leaving a person with a serious physical disability to rely on his cellmates for assistance with using the toilet, bathing and getting dressed or undressed, contributed to its finding that the conditions of detention amounted to degrading treatment…..”

48. The basis for the view that reliance on untrained/unqualified and/or voluntary assistance may contribute to a breach of Article 3 ECHR may be that, as a result, the assistance is not sufficiently effective to meet the prisoner’s needs, but it may also be the anxiety which the prisoner feels about the availability of the assistance because it is not sufficiently organised, and therefore reliable (see e.g. [81] Epure ), or about the fact that the helpers are not qualified to provide the necessary assistance (e.g. Semikhvostov at [73] and [81]-[83] Epure). Being dependent on voluntary assistance from fellow prisoners, particularly with intimate personal care, may also be sufficiently humiliating to contribute to a finding of breach of Article 3 ( Helhal [62], Topekhin v Russia [2016] ECHR 78774/13 at [86]). The approach of the English Courts where extradition is said to be contrary to Article 3 ECHR

49. I gratefully adopt the summary of the applicable principles provided by the Divisional Court (Lewis LJ and McGowan J) in Urbonas v The Prosecutor General’s Office of the Republic of Lithuania [2024] EWHC 33 (Admin) at [4]: “….. Article 3 imposes an obligation on a state not to remove a person to a country where there are substantial grounds for believing that the person would face a real risk of being subjected to ill-treatment contrary to Article 3 in that country. In order to come within Article 3, the ill-treatment must attain a minimum level of severity, which depends upon all the circumstances of the case including the duration of the treatment, its physical and mental effects and, in appropriate cases, the sex, age and health of the victim…… Where the requesting state is a signatory to the Convention and a member of the Council of Europe (as is Lithuania, the requesting state in the present case), there is a presumption that that state will comply with its obligations under Article 3 of the Convention. That presumption may be rebutted by clear, cogent and compelling evidence, amounting to something approaching an international consensus, identifying structural or systemic failings. If the benefit of the presumption is lost as a result of such authoritative evidence, the requesting state must show by cogent evidence that there is no real risk of a contravention of Article 3 in relation to the particular requested person in the prisons in which he is likely to serve his sentence. Assurances as to the treatment of individuals may be given by a non-judicial authority and those assurances will then need to be evaluated…..” Domestic caselaw in relation to Lithuanian prison conditions

50. In Urbonas the Divisional Court considered the issue of inter prisoner violence in the Lithuanian prison estate, including the aspects of the 2023 CPT report which dealt with this issue, and accepted that this was “a real, long-standing and continuing problem” but that the Lithuanian authorities accepted this and were taking steps to address it. The Court concluded that the presumption of compliance with Article 3 had not been rebutted on the evidence. In Barkauskas v Prosecutor General’s Office of the Republic of Lithuania [2024] EWHC 2815 (Admin) Fordham J revisited the matter in the light of the 2024 CPT report and concluded that the contrary was not reasonably arguable. No further information was required, and permission to appeal was refused.

51. As Pepperall J accepted in Dambrauskas v Prosecutor General’s Office of the Republic of Lithuania [2025] EWHC 463 (Admin) at [32], however, Urbonas and Barkauskas were focussed on the issue of a breach of the RP’s Article 3 rights as a result of violence from fellow prisoners. Neither is therefore authority for the proposition that there is currently no real risk of a breach of Article 3 arising from general conditions in the prison system in Lithuania. Pepperall J therefore considered the 2023 and 2024 CPT reports, although principally the 2023 Report, with a view to deciding whether the available evidence about aspects of the Lithuanian prison system other than the risk of inter prisoner violence was such as potentially to rebut the presumption of compliance with Article 3 by Lithuania. These aspects included the question of overcrowding, the use of dormitory accommodation, ill treatment of prisoners by staff, the state of repair of the prisons inspected, work and education in those prisons, healthcare, visiting time and the disciplinary regime.

52. At [26] Pepperall J found that “clearly the 2023 report raised serious concerns about the Lithuanian prison estate” but that only three matters arguably required closer analysis as potentially meeting the threshold of severity required to establish a breach of Article 3. The most obvious of these was inter prisoner violence, which had been considered in Urbonas and Barkouskas . There were then issues as to four temporary detention cells and the use of dormitories, specifically at the Marijampole prison. Having considered these issues, at [32] Pepperall J concluded that “there is no up to date evidence of anything approaching an international consensus of structural or systemic failings in the wider Lithuanian prison estate that could properly rebut the presumption of compliance” with Article 3 ECHR.

53. The 2023 and the 2024 CPT reports considered by Pepperall J in Dambrauskas included passages which deal with healthcare in the prisons inspected. Moreover, he referred to material about healthcare and evidently did not consider that this material gave rise to material concerns (see [24.7] of his judgment). No domestic authority was drawn to my attention where the issue of the adequacy of healthcare provision and/or provision for wheelchair users in the Lithuanian prison system was the subject of specific submissions which led to a specific determination of this issue by the courts in relation to Article 3. I note that in the context of section 25 of the 2003 Act the Divisional Court accepted, in Bartulis v Panevezys Regional Court Lithuania [2019] EWHC 3504 (Admin) at [140], that adequate healthcare would be provided to the applicant on the evidence in that case. However, that was some time ago, the Article 3 argument was confined to the issue of inter prisoner violence, and the section 25 point was raised late in the day. Domestic caselaw on the approach where an issue is raised in relation to healthcare in prison

54. In Magiera v District Court of Krakow, Poland [2017] EWHC 2757 (Admin) Julian Knowles J made the following points in the context of a challenge to extradition which had been brought by a stoma user, albeit relying on section 25 of the 2003 Act and Article 8 ECHR: i) “there must be an intense focus on what that medical condition is and what it means for [the RP] in terms of his daily living, so that a proper assessment can be made of what effects upon him and his condition extradition and incarceration would have. Once that exercise has been carried out the court must assess the extent to which any adverse effects or hardship can be met by the requesting state providing medical care or other arrangements.” [32]; ii) The approach must be intensely fact specific [33]; iii) There is a range of medical conditions, some of which are well understood and easily treatable (though they may be serious) and others of which are more complex and less easily managed where a person is a serving prisoner [33]; iv) This means that where a requesting state is asked to respond to concerns about the health of a person whose extradition from the United Kingdom they have requested, and to supply details of how they would propose to manage that person in a prison environment: “34….they must provide, so far as is reasonably practicable, a response which meets the concerns in respect of that specific individual. That is not to say that very lengthy documents or care plans need always be provided by way of reply. The starting point must be that in the case of an EU member state there is a rebuttable presumption that there will be medical facilities available of a type to be expected in a prison….From that starting point it might not necessary to say very much more….

35. However, in other cases, where the treatment or management of the illness or condition is more complex, more detail may be required… The reason is that it is self-evident that the range of medical care that is provided in prisons is necessarily and inevitably more limited than that which is available in the outside world … and it is also obvious that the sort of medical care which can be provided in prisons is subject to constraints arising from security requirements and the like. Thus, in some cases it may be necessary for the requesting state to provide specific details of what concrete steps will be taken to address the specific issues arising from the defendant's illness to ensure that he does not suffer severe hardship or oppression by reason of his incarceration resultant on extradition. In such a case, broad generalised assertions to the effect that the prison has a clinic, or that prisoners are entitled to health care, or that (unspecified) medicines are available, may not be enough.”

55. In A v France [2022] EWHC 841 (Admin) the Divisional Court (Stuart Smith LJ and Jay J) applied these observations in the context of a challenge to extradition based on both section 25 and Article 3 ECHR: see [85]. This is unsurprising given that they amount to common sense guidance (albeit from an expert in the field) on how to approach the evidence where an issue arises as to the healthcare which will be available to the RP in the context of deciding whether they should be extradited. Such an issue may arise in relation to various suggested bars to extradition including section 25 , Article 8 ECHR and Article 3. Albeit the legal issue to which the evidence may be relevant may be different in each case, and without deciding the point, it would be surprising if there were a case in which the issue was the availability of healthcare for the particular prisoner in the requesting state and the answer under section 25 (in relation to oppression) was different to the answer under Article 3 (in relation to inhumane and degrading treatment). An application of the principles set out above: Giana v Romania

56. In Giana v Court of Roman, Romania [2024] EWHC 1613 (Admin) McGowan J dealt with the case of a prisoner who was a wheelchair user. The judgment does not refer to any other conditions from which he suffered. She considered Magiera and a number of decisions of the European Court of Human Rights on the subject of assistance or support for an offender who is ill and/or disabled. These included Rooman v Belgium (App no 18052/11 31 January 2019) and Potoroc v Romania (supra). McGowan J said this at [34] and [35]: “34. There may be circumstances in which the offer and acceptance of assistance between prisoners is a commendable thing. Assistance with literacy, language or communication may be beneficial and appears to be unlikely to affect the dignity of the recipient of such help. However that is not to say that unqualified fellow prisoners should be required to provide care and support to a detainee confined to a wheelchair. It is not difficult to see how that would detrimentally affect the dignity of the individual, particularly in showering or bathing.

35. In this case the Judge did not deal adequately with the material available to her at the hearing. The “appointment of a supporting convict” is not an adequate substitute for professional care. The Judge did not find there to be any concerns arising from the lack of adequate day to care-paramedical care, rather she concentrated on the provision of care by a GP. It is apparent that the Appellant needs regular care and help with getting to a bathroom, (possibly on a different floor), and other mundane tasks which should not be provided by an untrained fellow convict. There is a real risk that that is capable of “humiliating and debasing him”. He is vulnerable by virtue of his physical disability, that vulnerability could only be aggravated by any dependence on a fellow prisoner.”

57. At [38]-[39] McGowan J went on to say: “As Julian Knowles J set out in Magiera….. ¸ the court is required to undertake an intensely fact specific approach. That exercise can only properly be undertaken where the requesting state has provided a response which deals with the specific concerns and needs of the individual…. The court would have been assisted by information about the location of bathroom facilities, provision of safely rails and other adjustments. Particularly in light of the apparent complaint that the shower facilities are on the first floor, if that is right, this Appellant might only have access to the shower or the exercise yard but not both. 39……. In this case the provision offered was the help of a "supporting convict" backed up by recourse to Art 598 so that the sentence would be postponed if it became "impossible" for the individual to continue. As is clear from Magiera the requesting state should not be expected to provide a detailed care plan or similar but information about the special measures available must be part of the Judge's assessment.”

58. Given that Romania has lost the presumption of compliance with Article 3, and assurances are therefore required if a requested person is to be extradited to that country [40], these considerations led McGowan J to uphold the RP’s case under section 25 and Article 3 ECHR. The arguments of the parties

59. On behalf of the JA Ms Hinton agreed that I should consider all of the information which is currently available including the report of Dr Burgin and the other updating materials. She submitted, that the December 2024 Further Information is sufficient for the court to be satisfied that there are not substantial grounds for believing that the RP will face a real risk of being subjected inhumane or degrading treatment contrary to Article 3

60. On behalf of the RP, Ms Nice submitted that the evidence which is currently available would not have led the District Judge to reach a different decision on the relevant question for the purposes of section 29(4) of the Extradition Act 2003 . She particularly emphasised the following arguments: i) First, that the RP’s condition had deteriorated since the District Judge considered the matter. She relied on the District Judge’s findings (in 2021) as to the RP’s mental and physical health, and his level of vulnerability at that stage and submitted that the position is now worse. ii) Second, that the information provided by the Lithuanian prison authorities was no more than that. This was a lower category of material as it did not amount to a assurances and it did not come from the JA itself. In Marinescu v Romania [2022] EWHC 2317 (Admin) , the Divisional Court characterised an assurance as being in the nature of a “solemn promise, binding as between the states concerned”. And in Stanciu v Procurator General’s Office of Armenia [2022] EWHC 3368 (Admin) at [20] the Divisional Court recognised the difference between “information or evidence about prison conditions” on the one hand, and “assurances or guarantees from the relevant authority as to where the Appellant would be detained and how specifically he would be treated” on the other. Ms Nice also submitted that the information provided was undermined by the 2024 CPT report. iii) Third, it is unclear which prison the RP would be surrendered to. The December 2024 Further Information refers to Kaunas and Pravieniškės but it does not say, in terms, that he would be detained in a cell which was adapted to his needs at the initial stage of his extradition. Nor does the Further Information say how long the process of identifying a longer term prison might take: there is a real risk of inhuman and degrading treatment whilst that process is ongoing. The Further Information states that there is “a” wheelchair accessible cell at Kaunas which raises the distinct possibility that no adapted cell will be available if this is the remand prison. It is also unclear whether, post conviction, the RP would be assigned a suitable adapted cell. iv) Fourth, the Further Information does not address the issue of the RP’s dependence on others to assist him. It is silent on this issue. Nor is any information provided about how risk assessments would be carried out and/or how the risks for the RP would be addressed. The issues include: a) Transfer arrangements, assessments, placement (for example on ground floor), access to facilities (showers, exercise yards, activities pre conviction) and other aspects of daily prison life; b) When or how the RP will be assessed to ensure his dignified detention; c) Adaptations, such as a shower chair, bathroom rails, ramps etc in all relevant prisons; d) Reassurance, or any information, about the appropriate use of a supporting detainee, or similar; e) Reliable and respectful assistance to wash and take the opportunity to move around outside his cell; f) Whether or not the RP would or might be accommodated in dormitory style accommodation given that the 2024 CPT Report indicates at [26] that on the main site at Pravieniškės most of the 20 units have dormitories equipped with 21 beds; g) Whether the wheelchair would be provided by the prison service; h) Prompt repairs to wheelchair/access to a chair that does not cause pressure sores; i) An emergency evacuation plan; j) Prospective access to operation and assessments for liver/heart issues given the RP has a combination of conditions that will need treatment especially if detained for many months. v) Fifth, serious concerns persist in relation to the Lithuanian prison system. In this connection Ms Nice referred to the 2024 CPT Report which was based on visits in February 2024 to Alytus, Marijampolė, Pravieniškės 2nd Prison and Vilnius. She relied on passages which address the question of inter prisoner violence and which show that the issue persists owing to “illicit drug use, informal prisoner hierarchy, and catastrophically low staff presence inside detention areas, in the broader context of a largely prevailing dormitory-type accommodation, as well as a lamentable lack of trust by the prisoners in the staff’s ability to guarantee their safety,” [47]. She also referred to passages on the persistence of the caste system/hierarchy amongst prisoners ([63]-[73]) and disastrously low staffing levels ([76]). And she relied on [81] of the Report, which says that the Committee was concerned to learn that “despite a high number of suicides in prison [23 in 2023], none of the prisons visited had a suicide prevention programme in place.” Discussion

61. Dealing, first, with Ms Nice’s submission that less weight should be given to the December 2024 Further Information and the other information provided by the JA because it does not amount to an assurance or assurances, in Stanciu (supra) on which she relied, the Divisional Court recognised that there is a distinction between the provision of information and evidence and the giving of an assurance in the context of extradition. However, it said, at [77], that “the line of demarcation between the two may not always be that bright”. The present is a case in point. In any event, the principle of mutual trust would require cogent evidence before I would decline to accept the information provided.

62. Secondly, I consider that the December 2024 Further Information should be read in the context of the position being that, as Ms Nice accepted, the presumption of compliance with Article 3 by Lithuania has not been rebutted. This is not a situation, like Giana , where the Court is reading what is said on the basis that the onus is now on the JA to establish that no breach will occur, albeit I accept that the context includes the concerns about the Lithuanian prison estate which are set out in the 2023 and the 2024 CPT Reports and the evidence provided by the RP about his specific health related needs.

63. Thirdly, as to Ms Nice’s submission that the credibility of the December 2024 Further Information is undermined by the 2024 CPT report, I do not accept this. Whilst there are continuing concerns about other aspects of the Lithuanian prison system, albeit falling below the Article 3 ECHR threshold, the thrust of the 2024 Report is generally favourable in relation to the healthcare system within the prisons inspected. Albeit certain specific failings were found, it does not provide any evidence of concerns about the position of wheelchair users or the use of volunteer or unqualified/untrained assistants to provide personal or health care.

64. The principal respect in which there may be a tension between what is said in the 2024 CPT Report and what is said in the December 2024 Further Information is in relation to [81] of the Report, where it is said that there is no suicide prevention programme in place at any of the prisons which were inspected, including Pravieniškės. The CPT recommends that the Lithuanian authorities develop, as matter of urgency, a comprehensive and robust suicide prevention policy and ongoing suicide prevention programme which ensures, amongst other things, that “all persons identified as presenting a risk of suicide benefit from mental health assessment and treatment, counselling and support, and appropriate monitoring and association with other inmates”.

65. However, the CPT Report was based on an inspection in February 2024 whereas the Further Information states the position as at 10 December 2024. The latter specifically says what will happen in the case of the RP i.e.: “Upon his arrival at the place of pre-trial detention, as soon as possible, but no later than within 5 working days, M. Michailov will be examined by a psychologist. During the initial examination, an assessment of suicide risks, relevant stressors and emotional state will be carried out. Having identified a suicide risk, the psychologist must, within 3 working days, carry out a psychosocial assessment of the person and, if necessary, together with the person in question make a self-protection plan. The psychologist will also make recommendations to the staff responsible for the supervision of the detainee regarding the specific elements of the supervision (intensified individual supervision and its intensity levels are determined).”

66. Fourthly, leaving aside the issue of the RP’s mobility and the fact that he is a wheelchair user, I see no reason to conclude that the level of healthcare which will be available to the RP in relation to his mental and physical health issues is such as to give rise to a real risk of inhuman and degrading treatment of him. This is not a case in which the RP has a specific but unusual or unusually complex health condition which might not be catered for within the Lithuanian system. Moreover, the December 2024 Further Information specifically states that: “After Michail Michailov is placed in pre-trial detention, his state of health will be thoroughly assessed by health professionals, the need for treatment, nursing and care will be identified, and an action plan will be set up to ensure the necessary health care services for the person. Depending on the identified specific health needs of Michail Michailov, upon recommendations of the medical practitioner who will have assessed his condition, certain measures appropriate to M. Michailov's physical and mental health condition may be provided/arranged/installed/adapted. …. As regards the access to personal health care services by a person having the status of a detainee, please note that personal health care services for both detainees and convicts are provided in accordance with the general national legislation on health care system, i. e. the same as for persons living in freedom. The frequency of visits at health care professionals will depend on the M. Michailov's state of health and the need for health care considering the identified health problems. All prisons, including those where pre-trial detention is carried out, have Primary Health Care Units where heath care services are provided by general practitioners, dentists and psychiatrists. Outside the working hours, health care services shall be provided by nursing specialists within the scope of their competence. Primary health care services shall be provided 12 hours a day on working days, 5-6 hours a day on non-working days, and at other times they shall be provided in other health care institutions (Operating outside the prison). In case of acute medical conditions, an ambulance is called. If a person needs personal health care services, which are not provided at the place of detention, the person may be referred to a specialised health care unit of the Lithuanian Prison Service or to another health care institution (outside prison) capable of providing the necessary health care services.”

67. Fifthly, dealing specifically with the position of the RP as a wheelchair user, the December 2024 Further Information clearly states that there are adapted cells available at Kaunas and Pravieniškės: “ To answer your questions , we would like to inform you that there are cells specially adapted for persons in wheelchairs in Kaunas Prison and Pravieniškės Prison No 2. These cells and access to them have been installed in accordance with the laws of the Republic of Lithuania regulating the adaptation of structures and infrastructure to the special needs of disabled persons. (emphasis added) …. In Kaunas Prison there is a wheelchair-accessible cell with a WC, sink and shower, equipped with armrests, a chair in the shower and a widened entrance. Convicts in a wheelchair shall serve their sentence in a unit of Pravieniškės Prison No 2 which is specially adapted to the convicts who due to their physical disability, chronic diseases, age or other reasons require assistance in mobility and personal care. This unit is equipped with ramps, has widened entrances to the premises, there are armrests installed in the cell, WC and shower. Convicts (detainees) in wheelchairs are usually assigned to the cell with a WC, sink and shower having armrests equipped there, a shower chair and a widened entrance. The minimum personal space for a detainee in the cell must be at least 3.6 sq. m. The minimum personal space for a convict serving his sentence in a specialised social care unit must be at least 5 sq. m.”

68. Bearing in mind that the RFI specifically asked about the treatment of the RP when he was on remand (see [24], above), and bearing in mind the presumption of compliance with Article 3 ECHR, the implication is that the RP will be housed in one of these prisons if he is a wheelchair user and will be allocated an adapted cell if appropriate. I take Ms Nice’s point that there appears to be only one adapted cell at Kaunas, which appears implicitly to be a prison which takes remand prisoners. But the 2024 CPT Report states, at [26], that “The Personal Health Care Unit (capacity 348) [at Pravieniškės 2nd Prison] was accommodating 177 adult male prisoners (six of them on remand)”. This is the Unit referred to in the October 2024 Further Information and the December 2024 Further Information. On the evidence, it takes remand prisoners and it has capacity. There does not appear to be any reason to think that the RP cannot or will not be accommodated there, if necessary and appropriate, whilst on remand. Nor is there any evidence that, in making decisions about the RP’s care and support, the Lithuanian authorities will fail to make the assessments of his needs advocated by Ms Nice or, for example, fail to provide him with a working wheelchair.

69. Sixthly, Ms Nice’s submission in relation to assistance with personal care gave me pause for thought but, as I have noted, the October 2024 Further Information (see [26], above) specifically states that the Personal Health Care Unit at Pravieniškės is for prisoners with “disorders of independence…who due to their physical disabilities, chronic illness, age or other reasons, need the assistance of other persons in the areas of mobility and self-care”. I also do not think that one can ignore the fact that, having been provided with the evidence about the RP as it then stood, including that he is a wheelchair user and has other physical and mental health issues, the December 2024 Further Information specifically concludes: “….Michail Michailov, if surrendered to Lithuania on the basis of the European arrest warrant, would be provided with the conditions in accordance with the requirements of Article 3 of the European Convention for the Protection of Human Rights and Fundamental Freedoms of 4 November 1950.”

70. It seems to me that the December 2024 Further Information confirms that the Lithuanian prison estate has the facilities required to ensure compliance with Article 3 ECHR in relation to wheelchair users and that they will be available to the RP as a remand prisoner. This was the central issue which the Lithuanian authorities were asked by the RFI to address. The Personal Health Care Unit at Pravieniškės also provides appropriate assistance to those who need it, and the Further Information confirms that the Lithuanian authorities understand their obligations to the RP under Article 3 and intend to comply with those obligations. Conclusion

71. For all of these reasons, then, on the evidence before me I do not accept that there are substantial grounds for believing that the RP will face a real risk of being subjected to inhuman and degrading treatment if he is extradited. He has a number of needs related to his mental and physical health, and to the fact that he is a wheelchair user. However, I am not persuaded that the Lithuanian prison authorities will fail to address them in a way which complies with Article 3 ECHR.

72. The JA’s appeal is therefore allowed. I will consider proposals as to the order and any directions which I should make, including any request that I should direct that the Lithuanian prison authorities are provided with the up to date evidence about the RP, including Dr Burgin and Dr Korallo’s reports and his medical records, as well as a copy of this judgment.