In the first instance requests for reports should be addressed to the Medico-Legal Reports Team at the Medical Foundation for the Care of Victims of Torture, 111 Isledon Road, London N7 7JW. This applies to referrals from anywhere in the UK, including the North West and Scotland.

Instructing an expert or an organisation of experts to produce a medico-legal report is a complex matter. Without clear instructions the desired report may not address all the issues that arise and, in all cases, the expert is bound by a duty to the courts to confirm (amongst other things) that the duty in providing written reports is to help the court and that this duty overrides any obligation to the party who has commissioned the report. The report writer has a duty to "endeavour[ed] to include in this report those matters of which I have knowledge or of which I have been made aware, that might adversely affect the validity of my opinion." (See Civil Procedure Rules). In other words, we need to know as much as possible about the client, including matters pertinent to the case that they dispute. Link [1].

In addition the Medical Foundation has its own criteria which determine whether or not we will be in a position to prepare a report. Essentially, a medico-legal report must, in the view of the Medical Foundation, have the potential to make a material difference to the outcome of the asylum claim for which it is requested to be written.

 

Given the complex nature of these issues we always advise those who consult us about medico-legal reports to seek expert legal advice and for this reason, as a general rule, the Medical Foundation accepts instructions only from legal representatives. It should be added that we recommend, and in some cases the law requires, that a representative be registered with the Office of the Immigration Services Commissioner (OISC), or enrolled as a solicitor with the Law Society of England and Wales or the Law Society of Scotland, or as a barrister with the Bar Counsel. If the legal representative is conducting immigration and asylum work paid from public funds, she or he must hold a contract for that purpose with the Legal Services Commissioner (in England and Wales) or the Scottish Legal Aid Board. The following web sites may be of help:

• http://www.oisc.gov.uk/ [3]
• http://www.lawsociety.org.uk/home.law [4]
• http://www. lawscot.org.uk/ [5]
• http://www.barcouncil.org.uk [6]
• http://www.legalservices.gov.uk/ [7]
• http://www.slab.org.uk/ [8]
• http://www.clsdirect.org.uk/index.jsp [9]

The last link will direct you to pages where you can find help locating a legal representative.

 

The Medical Foundation has an interest in the documentation of all torture cases, but, because of resource constraints, we have to prioritise, and this limits our involvement to between 1000 and 1200 cases a year. We are aware that the proportion of torture survivors among the asylum seeking/refugee population in the UK will always be greater than those we can assess, examine and document. Not all torture requires documentation. We would always expect the Home Office and the Asylum and Immigration Tribunal to remember that. It may also be that a report will be unnecessary because the history of torture is not contested" (Source: paragraph 2.1 Home Office Asylum Policy Instruction (API) on the Medical Foundation [10]).

Given the complexity of this field we are always ready to discuss cases which do not appear to be clearly covered by this broad outline. Such discussions should begin in writing with a letter addressed to the Legal Officer.

The procedure and manner in which cases should be referred for our consideration is as follows.

Requests for reports should be addressed to the Medico-Legal Reports Team at the Medical Foundation for the Care of Victims of Torture, 111 Isledon Road, London N7 7JW. This applies to referrals from anywhere in the UK, including the North West, North East and Scotland.

 

We are aware that the asylum process is now "multi-track". If the case in question is being "fast-tracked", concerns an immigration detainee or is being considered through any expedited process, or you have an interview or hearing date you must bring this to our attention prominently.

We expect to be provided with the following basic information about your client:

• Full name, date of birth, current address and asylum status.
• Name and practice address of GP.
• Is an interpreter required? If so, in what language?
• We need the following papers:
• The client's SEF (Interview) and SEF (Self-Completion)
• A typed, coherent, chronological Statement (unless severe time constraints prevent this from being prepared)
• Home Office Refusal Letter (if post-refusal)
• Immigration Judge/Adjudicator's determination (if post-appeal)
• Relevant correspondence from the Home Office
• Any other supporting documents - to include:
  (i)External medical reports
  (ii)Details of contacts with other medical institutions
  (iii)Any medical interventions
  (iv)Details of any other specialist NHS professionals involved, plus their reports.

These documents are essential to enable our doctors and clinicians to understand the context in which the reported ill-treatment and physical and psychological sequelae are to be understood. Our staff cannot work without these documents, and a request for a report without them, or an explanation as to why they are not available, will hamper preparation of the report.

 

We also ask the referrer to include with these documents a formal letter of instruction, outlining in detail how and why an MF report would be helpful and any physical or psychological sequelae observed. This enables us to prioritise requests and to begin the process of determining which clinician should meet with your client.

Further advice on medico-legal reports generally can be obtained on request, in writing, to the Legal Officer at the Medical Foundation for the Care of Victims of Torture, 111 Isledon Road, London N7 7JW. Fax Number 0207 697 7740. We regret that we are unable to deal with telephone enquiries on this detailed matter.

Please also note that the Medical Foundation does not provide advice to the public on asylum issues. Torture survivors seeking information on claiming asylum are referred to the Torture survivors' Handbook available from REDRESS, a human rights organisation that helps torture survivors obtain justice and reparation. They are at REDRESS, 3rd Floor, 87 Vauxhall Walk, London SE11 5HJ. Tel: +44 (0)20 7793 1777. Fax: +44 (0)20 7793 1719. The Handbook can be downloaded from the following website address:

• http://www.redress.org/publications/Handbook_En.pdf [11]

Fees & Terms of Payments for Reports :

Medico-legal reports are charged for as follows: £450 for a client seen at the Medical Foundation and - £700 when we attend at removal centres and prisons. The Legal Services Commission are aware of our fees and the basis upon which these figures are arrived at. If public funding is unavailable, then the issue of our fees may be discussed in writing with our Legal Officer. Fees are payable and will be invoiced accordingly unless there is prior written agreement to the contrary.

 

Payment is due within six months of the invoice date. We allow such an unusually lengthy period because we are aware that it can take quite some time before legal representatives receive payment for a case. However, following consultation with our auditors, we cannot extend payment terms beyond six months. For queries regarding payment terms, please contact Iain Corry, Accounts Officer, Finance Department, tel 020 7697 7777. Naturally we will remain flexible and responsive to any new needs that may be imposed by changing legislation.

Stopping the Clock: A Warning

An appointment with the MF can "stop the clock" so far as the Home Office are concerned for a detained asylum seeker whose legal representative has requested a medico-legal report.

A Home Office Asylum Policy Instruction states that "cases that have been accepted for preassessment by the Medical Foundation will be placed on hold pending the outcome of the pre-assessment, as long as evidence of the appointment is provided in writing."

 

If the MF is advised that a case is pre-refusal and we are adequately instructed so that we can provide an assessment appointment or a doctor's appointment as a priority, we will endeavor to do so.

However, the representative MUST notify the Border and Immigration Agency (BIA) in writing (we recommend recorded delivery) of the date of the appointment otherwise IND is entitled to assume that the MF did not provide an appointment and proceed to the refusal as they did in the following case. This extract is from an IND letter in reply to one from the MF asking why a particualr client had been refused when an MLR was pending.

"The [representative] wrote to NAM on 31st October 2006 (received on 2/11) that they were in the 'process of referring their client to the Medical Foundation...and that they would request a delay on our client's claim until such time as we are able to get the medico-legal report'. No specific confirmation was submitted that an appointment had been made and on the 14th November the case was refused. On the 03/01/07, the [representative] sent a fax to the POU in Manchester confirming that the app(licant) 'has been approved for an appointment with the MF'. This appears to be the first notification to IND of any specific appointment being made.

"In this instance therefore it would appear that there was no breach on the part of IND with regards to the MF API which states that 'It is essential that the applicant or legal representative submit written evidence, at the earliest opportunity, confirming an appointment at the MF. If this is done, the case will be placed on hold pending the outcome of the 'pre-assessment'."

 

The explanation continues, "In the absence of this evidence in writing, Case Owners should process the case as normal."

The MF will use its best endeavours to get appointments out as quickly as we can a) when we are notified that they are urgently required, b) why there is a need for urgency, c) the deadline within which we should work, and d) if we are adequately instructed to commence the process. In respect of d) if, for example, representatives do not provide the MF with enough information for us to be confident that the case comes within our remit then there may be a need for correspondence to clarify matters. BIA will not stop the clock because the representative is 'in correspondence' with the MF. The API requires appointments.

The API can be found here [12]

Other useful links: The Asylum and Immigration Tribunal: http://www.ait.gov.uk [13]