OpenCharities

This text was generated using OCR and may contain errors. Check the original PDF to see the document submitted to the regulator.

2022-01-31-accounts

Charity registration number 1132072

Company registration number 06073571 (England and Wales)

MEDICAL JUSTICE NETWORK LIMITED ANNUAL REPORT AND UNAUDITED FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 JANUARY 2022

MEDICAL JUSTICE NETWORK LIMITED

LEGAL AND ADMINISTRATIVE INFORMATION

Trustees E Norton S Tonmi H G Pickles L M Burke J Sivanathan B Banda R Talbot (Appointed 14 October 2021) A Hussain (Appointed 1 November 2021) P Haywood (Appointed 3 November 2021) Secretary E Ginn Charity number 1132072 Company number 06073571 Principal address 86 Durham Road London N7 7DT Registered office 86 Durham Road London N7 7DT Independent examiner F J Wilde FCCA MBA DChA Warner Wilde 4 Marigold Drive Bisley Surrey GU24 9SF Bankers CAF Bank Limited 25 Kings Hill Avenue Kings Hill West Malling Kent ME19 4TA TSB Bank 296-302 High Holborn London WC1V 7JH

MEDICAL JUSTICE NETWORK LIMITED

LEGAL AND ADMINISTRATIVE INFORMATION

Staff team in Financial Year 2021-22

Emma Ginn

Theresa Schleicher Lisa Incledon Emily Lawton Milly Arnott Robin White Naomi Olaniyi Elspeth Macdonald Ariel Plotkin Idel Hanley

Dr Rachel Bingham Dr Mary Kamara Dr Kathryn Allinson Dr Joe Bourdillon-Schicker Anthony Omar

Director

Casework Manager Senior Caseworker Caseworker Caseworker (left September 2021) Caseworker (joined Novermber 2021) Caseworker (joined December 2021) Parliamentary & Research Analyst Researcher (joined June 2021) Policy, Research and Parliamentary Manager (joined May 2021) Clinical Adviser Clinical Adviser (left June 2021) Clinical Trainer (joined April 2021) Clinical Trainer (joined April 2021) Office Manager

MEDICAL JUSTICE NETWORK LIMITED

CONTENTS

Page
Trustees' report 1 - 20
Independent examiner's report 21
Statement of financial activities 22 - 23
Balance sheet 24
Statement of cash flows 25
Notes to the financial statements 26 - 37

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 JANUARY 2022

The trustees present their report and financial statements for the year ended 31 January 2022.

The financial statements have been prepared in accordance with the accounting policies set out in note 1 to the financial statements and comply with the charity's governing document, the Companies Act 2006 and "Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019)".

Objectives and activities

Summary of the purposes of the charity;

Related parties / subsidiaries

Medical Justice does not have any related parties or subsidiaries.

The trustees have paid due regard to guidance issued by the Charity Commission in deciding what activities the charity should undertake.

Achievements and performance

Casework

Medical Justice takes referrals for people detained under immigration powers in all the UK’s Immigration Removal Centre (IRCs) and from prisons. Our dedicated team of volunteer clinicians offer clinical assessments assess to our clients in detention and write medico-legal reports documenting scars of torture, serious medical conditions and injuries sustained during deportation attempts. Our casework also includes assessing fitness to fly, challenging instances of medical mistreatment and helping detained people access the healthcare they need. We use medical evidence from our casework to document the toxic effect of indefinite detention.

In the financial year ending 31st January 2022 (2021-22), 340 people held in detention were referred to Medical Justice; men and women whose histories may include being survivors of torture, trafficking, and rape. Many of those detained are traumatised, having survived war, detention without charge or trial in their own country. Many endure perilous journeys only to get unexpectedly detained in the UK, where they may relive past traumas of imprisonment. Some have serious physical and mental conditions.

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 JANUARY 2022

At the start of 2021 there were relatively few people in immigration detention due to the Covid pandemic, but it soon became clear, sadly, that this was not to be a general trend towards decreasing the use of detention. This was later confirmed by the New Plan for Immigration announced in March 2021.

Many people in immigration detention we worked with in early 2021, particularly those held in prisons, had spent significant period of times detained during the pandemic. Many of the people held in detention reported being worried about contracting Covid in IRCs and indeed, there were a number of outbreaks. People detained in prisons (including torture survivors and those with serious vulnerabilities) were locked in their cells for over 22 hours a day, most often 23.5 hours, with people sometimes being held in their cells for days at a time and unable even to take a shower. Some self-harmed, attempted suicide and had difficulty sleeping or eating. Some who did not have any previous mental health problems eventually left detention with a mental illness. Our clinicians documented the impact of detention and the extreme level of isolation (as well as the sequelae of previous torture or other trauma) which proved invaluable for the clients’ applications for release. The mental health impact of having spent long periods in near-total isolation as immigration detainees in prisons during the pandemic are likely to be ongoing, long after being released.

In spring 2021 we worked with a number of people who were not detained but nevertheless being held at Tinsley House, usually an IRC. It turned out that the Home Office was using Tinsley House as accommodation for people who had sought asylum and who were not technically detained yet suddenly found themselves behind multiple lawyers of locked doors (which had to be opened for them by members of staff when they wanted to go out or come back in), surrounded by CCTV cameras and with little information about their status or rights at the facility. The men were initially screened by the on-site IRC healthcare team on arrival but subsequently told that they had no access to the healthcare facility and should make use of 111, 999 and their registered GPs, despite none of the men having a registered GP in the vicinity. For many of the men, the prisonlike setting triggered memories of previous traumatic experiences, causing a deterioration in their mental health.

From May 2021 onwards referrals to Medical Justice suddenly increased sharply, as the Home Office started detaining large numbers of people who arrived in the UK by small boats. The majority of people referred to Medical Justice during this period were Vietnamese nationals. Many reported histories of trafficking over several months spanning many countries. Many told us that they found being detained extremely difficult, struggling with memories of past trauma including being held captive and ill-treated by traffickers. Many found it difficult to access healthcare in detention, including due to language barriers and feelings of the healthcare team not being interested in their distress. Eventually all these clients were released from detention – but, to our great concern, very many disappeared from contact, feared re-trafficked.

During this period, we strengthened our working relationships with organisations specialising in counter trafficking work and in supporting survivors of trafficking. We worked to build supportive relationships with our clients and referred them to other organisations who could offer more support on release and raised the alarm about the risk of re-trafficking – but it was not enough, and many disappeared on release, feared re-trafficked.

During the summer of 2021 charter flight operations increased and we saw many people detained for mass deportations on charter flights to countries including Vietnam, Nigeria and Zimbabwe. They included people with serious health problems and many who had lived in the UK for several decades. It is often difficult for people to access legal advice in the run-up to a charter flight because there are then many people all seeking help urgently ahead of the same deportation date. For the same reason it is difficult for us: we receive many referrals for people needing medical evidence urgently often within a few days.

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT)

FOR THE YEAR ENDED 31 JANUARY 2022

Regular charter flights continued, often with significantly fewer people finally deported than were originally scheduled; some of those taken off the flights are our clients who have had their removal directions cancelled because we have been able to provide medical evidence of past torture or persecution - evidence they have not been able to access previously, often despite having lived in the UK for many years. Some are acutely ill, either mentally or physically and are not able to fly due to their health. Nevertheless, they are put through the distressing process of being detained and sometimes taken all the way to the airport, before their removal is ultimately cancelled.

Derwentside IRC in County Durham opened in December 2021 to detain women. Medical Justice had some existing clients who were transferred from Yarl’s Wood IRC to Derwentside when it opened, and received its first new referrals for a woman held at Derwentside IRC in January 2022. The IRC’s remote location makes it hard for many of our volunteer clinicians to get there, increasing waiting time for face-to-face assessments and necessitating more remote assessments. Our clinicians have also raised concerns about the room provided for medical assessments being inadequate and too small.

Referrals to Medical Justice by detention site, Feb 2021 – Jan 2022

Monthly referrals to Medical Justice, Feb 2021 – Jan 2022

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 JANUARY 2022

Clinical work

Medico-legal assessments

Alongside our employed doctors, 23 volunteer doctors and psychologists carried out medical assessments for Medical Justice clients in this period.

Because of the pandemic, for much of the year we continued to do most of our assessments online, our clinicians having adapted to doing complex assessments via video call, just as they had to in their NHS practices. We were unable to do scarring assessments in video consultations, so we assessed the medical information available and where appropriate recommended that this took place when possible.

Unmet health needs

People in detention at Harmondsworth IRC began to report being given a set of self-help leaflets entitled a ‘trauma pack’ and told that psychological therapy was not available. In lieu of support or mental health intervention, this pack provided written advice, largely suggestions for passing the time in detention. Our volunteer clinicians continued to identify instances of healthcare in detention falling well below the standard they expected in their work in the community.

Advocacy: research, policy work, litigation

As the only charity that sends independent clinicians to visit detainees, the medical evidence generated through our casework is unparalleled and enables us to document the prevalence and harm of systemic failures in healthcare. We use our research to confront the Home Office with the severe impact that detention can have on detainees’ health. When the Home Office fails to improve a policy, our correspondence may add to the ‘document trail’ needed to launch a legal challenge.

Research

Analysis of failures in identifying vulnerability and reviewing continued detention

An analysis of medical assessments carried out between July and December 2021 for 45 clients detained in various IRCs across the UK found that their histories included severe trauma, significant mental health issues, and being at risk of suicide. Many deteriorated in immigration detention and safeguarding mechanisms that are meant to identify vulnerability and trigger a review of continued detention often did not function effectively.

- “ ” Research report Every day is like torture : Solitary Confinement & Immigration Detention

Medical Justice co-wrote and published a joint report with Bail for Immigration Detainees (BID), titled “Every day is like torture”: Solitary Confinement & Immigration Detention in July 2021. It looks at how the lockdown regimes in prisons since March 2020 have resulted in the confinement of our clients. Some have spent 24 hours a day in their cells, for days or weeks at a time. The government suggest that the use of solitary confinement is a public health response to COVID-19. However, this cannot be justified; prolonged solitary confinement is a practice that has been prohibited internationally by the UN in their ‘Mandela Rules’. The report evidences the profound harm that solitary and shared (i.e. with a cell-mate) confinement causes.

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT)

FOR THE YEAR ENDED 31 JANUARY 2022

The report was covered by the Independent, the Guardian and the British Medical Journal. We went on to raise the concerns documented in the report, and concerns that the more restrictive regime will be normalised, in meetings with the Chair of the Independent Monitoring Board, and HM Inspector of Prisons, as well as through a joint submission with BID to the Ministry of Justice’s Prisons Strategy White Paper.

Policy submissions

Medical Justice submitted to a number of Home Office consultations, including on the Detention Service Order (DSO) on ‘Hospital Admissions’ and ‘Release of detained individuals from immigration detention’. We made a submission to the Independent Chief Inspector of Borders and Immigration inspection of the use of hotels and barracks as contingency accommodation.

DSO on the ‘Management of Adults at Risk in Immigration Detention’ and the draft Vulnerable Adult Care Plan

In September 2021, Medical Justice submitted comments to the updated DSO, raising concerns about the indicators that a person may be an adult at risk, sufficient medical screening at healthcare reception and the basis on which individuals are considered for a Vulnerable Adult Care Plan. Our overarching recommendations centred on the Home Office’s need to operate a system where vulnerability and increasing risk are identified and reported, and that the provisions for the appropriate Rule 35 process to be used are strengthened throughout the policy, rather than relying on ‘part C’ forms which do not trigger a review of continued detention.

The Home Office gave extremely limited timeframes and tight deadlines for policy consultations. For this consultation, the Home Office initially gave two weeks over the August bank holiday for stakeholders to respond to the DSO on the Management of Adults at Risk in Immigration Detention. We were granted an additional two weeks to respond.

Standards for External Medical Reports

The Home Office has introduced new Standards for External Medical Reports (‘the Standards’) in the Adults at Risk guidance, in May 2021. Through creating more onerous steps for the reports to satisfy, the Standards are likely to lead to the continued detention of vulnerable people, where the external medical report is deemed to not comply with the new requirements.

Along with others, including Freedom from Torture, the Helen Bamber Foundation, and the Immigration Law Practitioner’s Association, we jointly wrote to the Home Office in July 2021, outlining our concerns. We are monitoring the impact of the Standards on our work and Medico-Legal Reports.

New competent authority

In November 2021, the Home Office announced a new decision-making body (Competent Authority) for identifying victims of modern slavery - the Immigration Enforcement Competent Authority (IECA), which will make identification decisions for those subject to immigration control, including immigration detention. All other potential victims of modern slavery will continue to have identification decisions made by the existing Single Competent Authority.

We are concerned that this is a retrograde step, reinstating a system of two decision making bodies, which has previously been shown to undermine the safety of victims of trafficking in detention. We are concerned that the IECA’s interests in immigration enforcement raises a serious conflict of interest.

This change came in with immediate effect and there was no consultation or prior notification given to NGOs and statutory authority stakeholders who provide frontline support to potential victims. Even the UK’s own Independent Anti-Slavery Commissioner was not consulted. Medical Justice published a joint statement as part of the Detention Taskforce outlining our concerns.

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT)

FOR THE YEAR ENDED 31 JANUARY 2022

Stakeholder meetings

Medical Justice continues to attend stakeholder meetings with the Home Office (through the National Asylum Seeker Forum sub-groups on Detention and Decision-Making), with NHS England, with the Independent Chief Inspector of Borders and Immigration and with HM Inspector of Prisons.

Reconnect Service and research on the discontinuity of care

The Reconnect service, is an NHS England and NHS Improvement service aiming to ensure continuity of healthcare from prison to the community. The plan to roll this out to IRCs was put on hold due to Covid. Medical Justice continued researching the discontinuity of care that people in detention experience upon release, interviewing clients, gathering case studies and reviewing casefiles. Alongside this research, we have continued with advocacy work on the Reconnect service, which has since started to be rolled out nationally in IRCs.

Evidence for the challenge regarding operation of the Detained Duty Advice Scheme (DDAS)

The DDAS provides detained people in IRCs with 30 minutes of free legal advice, and further legally aided services if they qualify. In 2018 the number of DDAS providers was increased from 9 firms to 77, including 38 with no prior experience of legal aid work and 64 with none of DDAS. Medical Justice and others were concerned about the quality of services through the DDAS, including the lack of expertise and failure of providers to take on cases with merits.

Medical Justice provided a witness statement for the challenge brought by Detention Action, detailing our concerns and some of the experiences of our clients. Although the challenge was dismissed by the High Court, the litigation led to clarification that only the 30-minute advice surgeries are subject to exclusive contracting arrangements, not the conduct of all legally aided work for a detained person, so they are not forced to engage solely with firms on the DDAS, and are able to seek alternative legal aid representation instead.

Medical Justice acts as a Core Participant in the Brook House IRC Public Inquiry (BHI)

The dehumanisation of detainees was captured by BBC Panorama’s undercover cameras between April and August 2017 in Brook House IRC, including a G4S guard kneeling on a detainee’s neck, strangling him, threatening “I am going to put you to sleep”, whilst a G4S nurse stood by and colluded in falsifying records.

The mistreatment shown by Panorama was widespread and only came to light because of the undercover filming. No concerns about this level of widespread mistreatment or its severity at the time was raised by the Independent Monitoring Board or Home Office staff located at Brook House, nor by HM Inspectorate of Prisons.

This is the only public inquiry there has been into immigration detention. The purpose of the BHI is to understand what happened and learn lessons for the future. To this end, BHI gathered all relevant evidence, including unbroadcasted BBC footage, CCTV, body-worn and hand-held camera footage, pages of transcripts and approximately 40,000 documents, amounting to around about 250,000 pages of material. BHI made disclosure to Core Participants on a regular basis.

All the parties involved at Brook House, as well as a number of NGOs, were asked to provide written and oral evidence, including the Home Office, G4S, Serco, IRC healthcare providers including doctors and nurses, the guards, people who had been detained, HM Inspector of Prisons, and the Independent Monitoring Board. The first phase of public hearings were in November 2021. The Medical Justice Casework Manager and the Clinical Advisor went on to give oral evidence on the second phase, between February and April 2022.

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 JANUARY 2022

Medical Justice was granted Core Participant status in October 2020, and as such was able see all the witness statements and disclosed evidence from the all the parties prior to publication. We were able to make submissions regarding Experts appointed by BHI, including a detained report in response to the statement from the Clinical Expert whose expertise was linked more to his prison background and less to safeguarding policies for IRCs. Medical Justice comments were submitted to BHI’s legal team, influencing the questions and follow-up questions put to witnesses. Additionally, Medical Justice witness statements and oral evidence were referenced extensively – it’s hard to overstate just how extensively.

Through the questioning of witnesses and the evidence collated, the picture BHI pieced together included:

The medical evidence was hugely compelling, with significant admissions made about systemic safeguarding and clinical failures. The IRC doctors and nurses gave evidence that they did not properly understand the Detention Centre Rules and safeguards, had never fully complied with them, were still not complying with them, were wrongly sanctioning the use of force on their detained patients, not intervening as they should have done when observing excessive and dangerous use of force, and colluded in falsifying documentation regarding the use of force. BHI’s clinical expert accepted a causal link between the failure to identify and release highly vulnerable individuals leading to their mistreatment.

All this evidence pieced together how the interlinked systemic safeguarding failures led to the mistreatment of detained people. There was repeated evidence that systems supposed to prevent harm being caused to detained people were ineffective and that the Home Office has been studiously uninterested in evidence flagged to it over many years by Medical Justice and others that safeguards simply do not work. And, that the Home Office had specifically drafted safeguarding policies to downgrade the level of protection for people likely to be harmed by detention.

Medical Justice evidence pointing to systemic failures and severe mistreatment in detention from 2017 was derived from its casework, policy work, research and litigation. Recent evidence shows the mistreatment is ongoing and occurring across many IRCs. Our analysis of medical assessments for 45 clients carried out between July and December 2021 shows that the complete deprivation of safeguards in the system still do not protect those unsuitable for detention because of their pre-existing mental illness and past histories of torture and trauma from being exposed to harm in detention and, in too many occasions, suffering actual harm.

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 JANUARY 2022

MEDICAL JUSTICE NETWORK LIMITED

Parliamentary activity

All Party Parliamentary Group (APPG) on Immigration Detention

Quasi-Detention Sites

A key focus for the APPG throughout 2021 was the government’s use of ‘quasi-detention’ sites - large-scale institutional settings including former military barracks and IRCs - to accommodate people seeking asylum. These sites replicate many of the features and negative impacts of immigration detention. For this reason, the APPG includes them in its remit. The similarities include for example the sites’ military and/or prison-like nature which, for survivors of torture, trafficking and other serious forms of violence, can be re-traumatising, and the physical and social isolation induced by the sites, making access to support in the community much more difficult.

As an initial activity in this area, the APPG held a meeting in March 2021 with the Independent Chief Inspector of Borders and Immigration (ICIBI), David Bolt, and HM Inspector of Prisons (HMIP) to discuss their recent inspection of Napier Barracks and Penally Camp, which described conditions at the sites as ‘impoverished’. Based on the information shared, the group sent a cross-party letter to the Home Secretary calling for the immediate closure of Napier Barracks (Penally Camp’s closure had already been announced). The letter was covered by a number of media outlets, including the Daily Mail.

Inquiry into Quasi-Detention

The use of military barracks and IRCs as asylum accommodation began in 2020, with the government claiming it was a temporary measure necessitated by the Covid pandemic and a rise in the number of small boat crossings. In 2021 however the government revealed its intention to make institutional accommodation into a permanent, wide-spread feature of the asylum accommodation system. Proposals to this effect were included in the New Plan for Immigration, published in March 2021, and subsequently in the Nationality and Borders Bill, introduced into Parliament in July 2021.

In light of these developments, the APPG decided to launch an in-depth inquiry into the topic - with a view to better understanding the concerns about the fundamental suitability of such sites for accommodating people seeking asylum, bearing in mind their particular vulnerabilities, and health and legal needs.

Led by a cross-party panel of 10 parliamentarians, the inquiry gathered evidence, both written and oral, from over 30 contributors, including former and current residents at the sites, NGOs, lawyers, medical experts and key contractors.

The inquiry’s interim report was published in September 2021. A full final report followed in December 2021 which included a number of recommendations to the government, including calls to close Napier Barracks with immediate and permanent effect, and to refrain from opening any further such sites.

Both the interim report and final report were covered by various media outlets. Evidence from them - including testimony from residents at the sites - was also used in parliamentary debates on the government’s plans for asylum accommodation centres during the passage of the Nationality and Borders Bill.

Additionally, the interim report was submitted as evidence to the Lords’ Secondary Legislation Scrutiny Committee (SLSC) during its consideration of Statutory Instrument (SI) 2021/962 - a piece of legislation laid by the government in August 2021 which extended its use of Napier until 2026. The role of the SLSC is to highlight SIs that are of particular interest or concern, such that parliamentarians can then conduct further scrutiny of them. In part as a result of our evidence, the Committee highlighted SI 2021/962, and issued a report criticising both the SI’s content (extending the use of Napier), and also the way in which the SI had been presented to Parliament (at very short notice and allowing little time for scrutiny).

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT)

FOR THE YEAR ENDED 31 JANUARY 2022

Based on the SLSC’s report, the Liberal Democrats tabled a motion opposing the SI in the House of Lords. A debate on the motion was held up due to litigation around planning permission for Napier; however the debate was expected to take place once the court hearings had finished.

In January 2022 the government ran a ‘post-hoc’ consultation on their decision to extend their use of Napier. The genuineness of the consultation was questionable, given that it was carried out several months after the Home Office had made its decision and in the context of the Home Office facing a JR over its lack of consultation. Nonetheless, the APPG submitted a response, drawing on the evidence and findings from the APPG Inquiry final report. (Medical Justice also submitted as response to this consultation highlighting the detrimental impact of Napier on residents’ health and well-being drawing on our clinician’s medical assessments, the inadequacies of the facilities, the failures to identify vulnerabilities and the Covid-19 risks).

The Chair and three other Members of the APPG visited Napier Barracks in February 2022. The visit to the site was preceded by a meeting off-site with the Jesuit Refugee Service UK and the Humans for Rights Network (two NGOs working directly with residents at the site), as well as two former residents to discuss concerns. The Members found that conditions were still extremely concerning and had not improved since the APPG took evidence in June/July 2021.

AGM - implications of planned new IRC for women

The APPG held its AGM in April 2021. Speakers from Women for Refugee Women (W4RW) and the Royal College of Psychiatrists (RCPsych) explained the implications of the government’s planned new IRC for women at Derwentside in County Durham (which has since opened). The discussion focused particularly on the impacts of detention on people’s mental health. RCPsych presented its newly agreed Position Statement on the detention of people with mental disorders in IRCs, which argues that detention centres are likely to precipitate a significant deterioration of mental health in the majority of cases, and that people with mental disorders should only be subjected to immigration detention in very exceptional circumstances.

Following the meeting, with the support of the secretariat and W4RW, Alison Thewliss MP and Mary Foy MP (Member for the City of Durham) co-ordinated an open letter to the Home Secretary urging her to reverse her decision to open the new centre. The letter was signed by 76 MPs and peers and was covered by media including the Independent.

Other parliamentary work

Medical Justice continued its engagement with the Home Affairs Committee (HAC) throughout the year. This included Theresa Schleicher, our Casework Manager, speaking at an oral evidence session in February 2021 on the Home Office’s response to Covid-19 within institutional accommodation, including IRCs. We also submitted two sets of written evidence on the topic, and at the Committee’s request provided additional information about the use of Tinsley House IRC as asylum accommodation for a period in early 2021. Our evidence was drawn upon in subsequent correspondence between the Committee Chair and the Home Secretary, and referenced several times in the Committee’s final report.

In late February 2021 the government published a draft revised Guidance on adults at risk in immigration detention, downgrading the protections afforded to potential victims of trafficking (PVOTs). Shortly afterwards the government laid a statutory instrument (SI) in Parliament that would, unless opposed, automatically bring the revised Guidance into effect in late May 2021.

Medical Justice raised awareness in Parliament about the changes and held the government to account on its decision by working closely with others, including After Exploitation, an anti-trafficking NGO.

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 JANUARY 2022

We submitted evidence to the SLSC about the change and its likely impacts which led the SLSC to issue a report highlighting the SI as one which may be of interest of concern to Parliament. The report included a remarkable admission from the Home Office that the SI would have exactly the effect we predicted in our evidence, i.e. that more trafficking victims would be detained and for longer periods.

We issued a joint briefing for parliamentarians, and as a result, Labour tabled an Early Day Motion opposing the change which was signed by over 80 MPs. We also helped to organise two parliamentary debates on the topic - one led by Richard Fuller, Conservative MP for Bedford, and another by Shadow Immigration Minister Holly Lynch MP. The issue was also covered in the media, including by the Independent.

Medical Justice in the Media in Financial Year 2021-2022

Media coverage included:

BBC Look East TV News (1 piece)

BBC Online (1 article) BBC Radio 4 Today Programme (1 piece)

BBC Radio Kent (1 article)

British Medical Journal (3 articles) Byline Times (1 article) Daily Mail (1 article) Daily Mirror (1 articles) Evening Standard (3 articles) Guardian (11 articles) Independent (12 articles) ITV News (1 article) Justice Gap (2 articles) KentOnline (3 articles) Metro (1 article) Morning Star (1 article) National (2 articles) National News (1 article) Observer (3 articles) Sky News (2 articles)

Medical Justice AGM 28th July 2021

Our Annual General Meeting was held on 28th July 2021 and conducted online.

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 JANUARY 2022

Medical Justice objectives and performance

In Financial Year 2021-22 our strategy for achieving our objectives remained the same.

Medical Justice performed well against all its objectives for the year, which included:

Our objectives for Financial Year 2022-23 include:

Independent Evaluation of Medical Justice

In 2020 - 21, an independent evaluation took an in-depth look at Medical Justice’s achievements and strategic direction as the organisation reached 15 years of operation. This drew findings from extensive fieldwork including interviews with 57 key organisational stakeholders. A summary is provided below by the evaluator.

“Medical Justice is a uniquely-placed organisation which changes the course of over 1,000 lives a year through expert medical support and advice to those held in immigration detention. Its input is described as meticulous, dogged and professional by those in the field and it gets results, which not only allows detention and deportation to be challenged, but also enables individuals to use the medical evidence and support to gain asylum and regularise their status. Beyond its direct impact on individuals it also achieves policy changes which have an indirect benefit on the lives of thousands more. Such policy work is grounded in an unparalleled body of evidence and the policy changes gained - for example on the use of medical evidence in asylum claims - produce long-lasting benefits for those in detention or at risk of being in detention. Such policy and research is complemented by a litigation strategy described as ‘quiet but fierce’, which adopts a highly tactical approach to ensure bad law and policy is challenged wherever needed and possible in the courts - with vigour, principle and professionalism.

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 JANUARY 2022

Medical Justice is also widely regarded as having had a critical role in ensuring that the mistreatment of those in detention is acknowledged. Its relentless presence and activity have meant that this easily ‘out of sight’ issue has been kept in the spotlight. To do this it has built a network of aware allies, including key sectoral partners, and galvanized a wide range of medical professionals across the country, convincing many, including the BMA, that detention centres should be closed down as a result of its evidence-based lobbying. Setting up the APPG has now also provided a platform to engage and educate parliamentarians and others. Their work is widely regarded as brave, inspiring, respected and tenacious with most feeding back that the organisation ‘punches well above its weight’.

After 15 years of work, Medical Justice’s activity and ambition have outgrown its structure. The organisation is embracing change where it is needed, and refreshing commitments where these are a key strength, such as its continuing involvement of people with lived experience in all aspects of its operations, including significant representation at board level. Other areas, such as IT, communications and data capture need to evolve to keep up with the strategic needs of the organisation. With such a willingness to evolve, a strong profile and reputation and an acute eye on the need to maintain an agile strategy, Medical Justice looks set to play a key, punchy and highly effective role for the next decade. “

Financial review

Principal funding sources and expenditure areas

Review of the financial position of Medical Justice

The overall financial picture is little changed from that seen in recent years. The immediate income has been maintained and is looking secure in the short term. There are many uncertainties over the longer term, both in terms of the charity’s ability to sustain income and in those activities that might be demanded of us as we try to deal with shifts in the hostile environment in which we operate. However, sadly, there is confidence that there will remain to be an important need for Medical Justice for many years to come.

Over the last year, the shift to a more hybrid pattern of working due to the covid pandemic has proved effective and efficient, though has not permitted any reduction in the costs of maintaining the office base. There are no immediate plans to change the space we currently rent and the capacity for all the current staff to work in the office at the same time remains important, not least because the government plans for Accommodation Centres may mean seeing clients in the office.

Compared to previous years, there has been a reduction in the fees received for Medico-Legal Reports (MLRs). This reflects in part the changed nature of the types of report possible when most clinician encounters with detainees have had to be remote. This may continue, with many assessments being done at short notice for people in detention with imminent removal dates, with clients held at detention facilities that are largely inaccessible. The latest accounts include an increase in charges for professional services, some supported by specific grants. This includes legal research support for the extensive preparation for the Brook House Inquiry, expert help in assessing the organisation, and support for staff through these especially difficult times.

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 JANUARY 2022

Looking ahead, the low value attributed to tangible fixed assets reflects the urgent need to upgrade our IT, planned for the coming year. Increasing inflation means the currently low interest earned from sums in deposit may need to be looked at again. We continue to be awarded grants in a competitive environment, helped by the ability to point to evidence of our impact, recently reinforced by the evaluation completed last year. As a condition of a new grant for 5 years, one generous funder, the Oak Foundation, asked for a full financial audit after the first year: normally our accounts are just subject to independent examination. We welcome this as reassuring the Oak Foundation as well as reinforcing the confidence of other existing and potential funders.

As always, we thank our donors for their continued support, without which our work would not be possible.

Summary of Income and expenditure

Income FY2021-22 FY2020-21 FY2019-20
Donations 20,060 22,988 31,969
Grants 465,349 406,694 352,633
Other 4,201 239 392
MLR* + Trainingfees 20,140 53,169 53,002
Income 509,750 483,090 437,996
Donatedprofessional services 129,932 119,749 222,438
Grand Total 639,682 602,839 660,434

----- Start of picture text -----
Donations
Grants
Other
MLR + Training fees
----- End of picture text -----*

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT)

FOR THE YEAR ENDED 31 JANUARY 2022

Expenditure FY2021-22 FY2020-21 FY2019-20
Salaries 371,423 337,626 336,966
Rent and rates 31,615 25,778 20,679
Volunteer expenses 155 485 588
Interpreter costs 19,580 25,836 8,946
Other runningcosts 93,964 74,685 52,652
Running costs 516,737 464,410 419,831
Donatedprofessional services 129,932 119,749 222,438
Grand Total 646,669 558,323 633,323

----- Start of picture text -----
Salaries
Rent and rates
Volunteer expenses
Interpreter costs
Other running costs
----- End of picture text -----

Reserves policy

Medical Justice has a policy of holding the equivalent of 9 months’ operating costs as Reserves to weather financial unpredictability and an increasingly challenging funding environment. Factors leading to this financial uncertainty include:

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT)

FOR THE YEAR ENDED 31 JANUARY 2022

Medical Justice is posting a small deficit for the year ending 31st Jan 2022 and faces a much larger deficit in the coming years

The landscape of immigration detention for 2023 and beyond is unclear, with the government talking of large-scale quasi-detention sites, the expansion of existing traditional detention sites, and deporting asylum seekers to Rwanda. It may be harder for Medical Justice to fundraise when there less clarity about our activity. The general trend is that there will be more detention and a greater need for Medical Justice - we may have to step-up to respond at short notice, with reliance on our Reserves.

At the close of the financial year ending 31[st] January 2022 Medical Justice had £314,960 unrestricted funds – 5.8 months’ operating costs ; somewhat short of the 9 month target.

Inadequate healthcare in immigration detention

24,497 people entered immigration detention in 2021, 65% higher than the previous year when there was a large fall following the COVID-19 outbreak. By the end of the calendar year, the number of people entering detention was similar to pre-pandemic levels.

Immigration detention in the UK is not part of any criminal sentence and is not ordered by a judge. Many detainees have mental and physical scars of torture and other forms of persecution. Detained peoples’ medical conditions are often exacerbated by, and sometimes caused by, prolonged detention and inadequate healthcare.

Issues in immigration detention in recent years have included:

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 JANUARY 2022

Our clients’ histories may include being victims of torture, trafficking, and rape. Many are traumatised, having survived war, detention without charge or trial, torture, or rape in their own country. Many endure perilous journeys only to get unexpectedly detained in the UK, where they may relive past traumas of imprisonment. Some have serious physical and mental conditions.

Medical Justice’s aims and objectives

The harm being suffered by detained people is widely acknowledged to be endemic and severe – the only way to eradicate it is to end immigration detention, a view shared by the British Medical Association. In time we will succeed in that aim. In the interim, our objectives are to work to reform the institutions and to stand up for the rights of those incarcerated within them.

Our Vision: Immigration detention is unable to harm anybody’s physical or mental health as it no longer exists in the UK.

Our Mission: Medical Justice works to uphold the health and associated legal rights of people in immigration detention, and provides medical evidence so the devastating health harms of detention are understood and acted on.

Standing up for the rights of detainees

Medical Justice sends independent volunteer clinicians to IRCs to visit detained people and document their scars of torture, injuries sustained during attempts to remove them from the UK, and any medical conditions, as well as challenge instances of medical mistreatment. We link detained people to good quality legal representatives who can make good use of our medical evidence.

Interim reform

The Medical Justice strategy is to use evidence from our casework to challenge inadequate healthcare and safeguards in immigration detention and to document the deterioration of health in detention. We hold the government to account and campaign for lasting change through policy work, strategic litigation, public and parliamentary awareness raising, and mobilising medical professionals. We do this as long as interim reforms help precipitate the end of immigration detention rather than prop up the regime – known and premeditated harm to human beings for administrative convenience is unethical and unconscionable.

Medical Justice was founded in 2005 by someone with lived experience of detention

In 2005 a volunteer doctor visited a detained hunger-striker on the verge of organ failure and provided medical evidence for a legal challenge which secured the man’s release to hospital - the first time an independent doctor had gained access into an IRC. Later, the doctor and the released man founded Medical Justice and negotiated a protocol with the Home Office formalising access for independent doctors.

By the end of January 2022 we had 14 paid workers, responded to referrals regarding 340 detained individuals during the year and organised medical visits in all the UK’s IRCs.

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 JANUARY 2022

The environment in which we operated in FY2021-22

The Home Office “hostile environment” strategy towards unwanted migrants was as evident as ever in 2021-22. We were greatly concerned by developments including detaining people during the pandemic, especially those with Covid-19 co-morbidities, locking people in prison cells for 23 hrs a day despite their imprisonment being beyond any criminal sentence, and the increased use of charter flights.

Risk Register

The Risk Register documents the major risks that the trustees have identified to which Medical Justice is exposed. Each area of risk is rated in terms of probability, impact to the organisation, how it can be mitigated, and who in the organisation is responsible for systems or procedures that have been established to manage those risks. The Risk Register is periodically reviewed.

The areas of risk have been grouped into the below areas:

External factors outside Medical Justice’s control

Medical Justice has grown slowly but steadily since it was founded in 2005. It was registered as a company limited by guarantee in 2007 and gained charity status in 2009. Its first employed a member of staff in 2008 and has added roughly one staff member each year. Its number of volunteers has also risen steadily. Most importantly, the number of people in immigration detention that Medical Justice has assisted and the systemic changes it has secured has grown significantly.

A key part of its success depends on its partnerships with funders and its ability to raise evergreater amounts of funding each year. Funding can never be assured and assisting people held in immigration detention is not a popular cause. Funding is an external factor beyond Medical Justice’s control that is relevant to the achievement of its objectives.

Medical Justice has built and enjoyed good relationships with employees and also with nongovernmental organisations which work in the same field. The relationship between Medical Justice and the Home Office is challenging. The Home Office controls access to immigration detainees. Medical Justice had to legally challenge an obstruction of access by independent doctors in 2009; the obstruction was removed.

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 JANUARY 2022

Structure, governance and management

The charity is a company limited by guarantee and without any share capital and is governed by a memorandum of association. Trustees of the charity are also directors of the company. The company obtained Charitable Status on 12 October 2009. New trustees are selected according to criteria laid out in the charity’s Handbook for Trustees and Staff and are appointed by the Board; during the year in question there were 9 Trustees, including a solicitor, a barrister, a public health doctor, a Non-Executive Director at Hillingdon Hospital, and three trustees with lived experience of detention – one is a student, another is a care-giver with marketing management experience, and another is a law graduate who works for the Joint Council for the Welfare of Immigrants. Officers are elected or re-appointed at the Annual General Meeting.

The Executive Group : comprises the Chair, the Vice-Chair, the Treasurer, and the Director.

The Senior Management Team : comprises the Director and the Casework Manager.

The Staff Team

The Volunteer team

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 JANUARY 2022

Consultant: Responsible Officer for Medical Justice in its role as a ‘Designated Body’. all bar a handful of the volunteer clinicians have paid jobs in the NHS or other employers who act as their ‘Designated Body’, providing a regulated framework of periodic appraisals and re-validation. The few who are not linked to a ‘Designated Body’ elsewhere are supervised by our Responsible Officer in terms of appraisals and re-validation.

Consultant: Researcher for the Brook House Inquiry work. This work was kindly funded by a funder for 6 months starting in 2020. Since then, Medical Justice has continued to fund the ongoing work which is estimated to last until around the end of 2023.

Internal policies

Medical Justice continued to develop internal policies in Financial Year 2021-22 including:

The trustees, who are also the directors for the purpose of company law, and who served during the year and up to the date of signature of the financial statements were:

T Wozniak Resigned 02 November 2021

E Norton

S Tonmi

T P G Southerden Resigned 14 January 2022

H G Pickles

L M Burke

J Sivanathan

B Banda

A Hussein Appointed 01 November 2021 P Haywood Appointed 03 November 2021 R Talbot Appointed 14 October 2021

Policies and procedures for the induction and training of trustees

Medical Justice further developed several guides for trustees in their role during the year which have been particularly pertinent to three new trustees joining the board during the 2021-22 financial year. The organisation continues to actively consider the most effective ways of recruiting and supporting trustees, with specific regard to the need for a wide and diverse range of skills, knowledge and experience. In particular, Medical Justice continues to focus on recruiting trustees with lived experience of immigration detention.

None of the trustees has any beneficial interest in the company. All of the trustees are members

MEDICAL JUSTICE NETWORK LIMITED

TRUSTEES' REPORT (CONTINUED) (INCLUDING DIRECTORS' REPORT)

FOR THE YEAR ENDED 31 JANUARY 2022

of the company and guarantee to contribute £1 in the event of a winding up.

Medical Justice is not formally affiliated with any umbrella group. In the pursuit of its charitable objectives, Medical Justice does co-operate closely on an ongoing basis with a dozen or so other non-governmental organisations who campaign for the health and wellbeing of immigration detainees. We often form ad-hoc, fluid coalitions to work on specific issues, themes or pieces of work. Medical Justice is a member of the Home Office’s main stakeholder forum which covers immigration detention issues, the National Asylum Stakeholder Forum. It is also a member of the Independent Chief Inspector of Borders and Immigration’s Refugee & Asylum Forum.

The trustees' report was approved by the Board of Trustees.

Dr Ruth Talbot

Chair of trustees Dated: 29th July 2022

MEDICAL JUSTICE NETWORK LIMITED

INDEPENDENT EXAMINER'S REPORT

TO THE TRUSTEES OF MEDICAL JUSTICE NETWORK LIMITED

I report to the trustees on my examination of the financial statements of Medical Justice Network Limited (the charity) for the year ended 31 January 2022.

Responsibilities and basis of report

As the trustees of the charity (and also its directors for the purposes of company law) you are responsible for the preparation of the financial statements in accordance with the requirements of the Companies Act 2006 (the 2006 Act).

Having satisfied myself that the financial statements of the charity are not required to be audited under Part 16 of the 2006 Act and are eligible for independent examination, I report in respect of my examination of the charity’s financial statements carried out under section 145 of the Charities Act 2011 (the 2011 Act) . In carrying out my examination I have followed all the applicable Directions given by the Charity Commission under section 145(5) (b) of the 2011 Act.

Independent examiner's statement

Since the charity’s gross income exceeded £250,000 your examiner must be a member of a body listed in section 145 of the 2011 Act. I confirm that I am qualified to undertake the examination because I am a member of the Association of Chartered Certified Accountants, which is one of the listed bodies.

I have completed my examination. I confirm that no matters have come to my attention in connection with the examination giving me cause to believe that in any material respect:

I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the financial statements to be reached.

F J Wilde FCCA MBA DChA

Warner Wilde 4 Marigold Drive Bisley Surrey GU24 9SF 21 October 2022 Dated: .........................

MEDICAL JUSTICE NETWORK LIMITED

STATEMENT OF FINANCIAL ACTIVITIES INCLUDING INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31 JANUARY 2022

Current financial year
Unrestricted Unrestricted
Restricted
funds
funds
funds
general d esignated
2022
2022
2022
Notes
£
£
£
Income from:
Donations and legacies
3
154,153
-
-
Charitable activities
4
367,810
-
117,679
Investments
5
40
-
-
Total income
522,003
-
117,679
Expenditure on:
Raising funds
6
216
-
-
Charitable activities
7
528,774
-
117,679
Total expenditure
528,990
-
117,679
Net (outgoing)/incoming resources before
transfers
(6,987)
-
-
Net (outgoing)/incoming resources before
transfers
(6,987)
-
-
Gross transfers between funds
(80,000)
80,000
-
Net (expenditure)/income for the year/
Net movement in funds
(86,987)
80,000
-
Fund balances at 1 February 2021
401,947
-
-
Fund balances at 31 January 2022
314,960
80,000
-		 Total
2022
£
154,153
485,489
40
639,682
216
646,453
646,669
(6,987)
(6,987)
-
(6,987)
401,947
394,960		 Total
2021
£
142,737
459,863
239
602,839
418
557,905
558,323
44,516
44,516
-
44,516
357,431
401,947

The statement of financial activities includes all gains and losses recognised in the year.

All income and expenditure derive from continuing activities.

The statement of financial activities also complies with the requirements for an income and expenditure account under the Companies Act 2006.

MEDICAL JUSTICE NETWORK LIMITED

STATEMENT OF FINANCIAL ACTIVITIES (CONTINUED) INCLUDING INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31 JANUARY 2022

Prior financial year

Unrestricted
Restricted
funds
funds
2021
2021
Notes
£
£
Income from:
Donations and legacies
3
142,737
-
Charitable activities
4
216,169
243,694
Investments
5
239
-
Total income
359,145
243,694
Expenditure on:
Raising funds
6
418
-
Charitable activities
7
314,211
243,694
Total expenditure
314,629
243,694
Net (outgoing)/incoming resources before transfers
44,516
-
Net (expenditure)/income for the year/
Net movement in funds
44,516
-
Fund balances at 1 February 2020
357,431
-
Fund balances at 31 January 2021
401,947
-		 Total
2021
£
142,737
459,863
239
602,839
418
557,905
558,323
44,516
44,516
357,431
401,947

MEDICAL JUSTICE NETWORK LIMITED

BALANCE SHEET

AS AT 31 JANUARY 2022

Notes
Fixed assets
Tangible assets
11
Current assets
Debtors
12
Cash at bank and in hand
Creditors: amounts falling due within
one year
13
Net current assets
Total assets less current liabilities
Income funds
Unrestricted funds
Designated funds
15
General unrestricted funds		 2022
£
863
422,485
423,348
(32,824)
80,000
314,960		 £
4,436
390,524
394,960
394,960
394,960		 2021
£
5,258
407,035
412,293
(10,853)
-
401,947		 £
507
401,440
401,947
401,947
401,947

The company is entitled to the exemption from the audit requirement contained in section 477 of the Companies Act 2006, for the year ended 31 January 2022.

The director acknowledges her responsibilities for complying with the requirements of the Companies Act 2006 with respect to accounting records and the preparation of financial statements.

The members have not required the company to obtain an audit of its financial statements for the year in question in accordance with section 476.

These financial statements have been prepared in accordance with the provisions applicable to companies subject to the small companies regime.

The financial statements were approved by the Trustees on 29 July 2022

H G Pickles

Trustee

Company registration number 06073571

MEDICAL JUSTICE NETWORK LIMITED

STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31 JANUARY 2022

Notes
Cash flows from operating activities
Cash generated from operations
18
Investing activities
Purchase of tangible fixed assets
Investment income received
Net cash (used in)/generated from
investing activities
Net cash used in financing activities
Net increase in cash and cash equivalents
Cash and cash equivalents at beginning of year
Cash and cash equivalents at end of year		 2022
£
(4,522)
40		 £
19,932
(4,482)
-
15,450
407,035
422,485		 2021
£
-
239		 £
43,825
239
-
44,064
362,971
407,035

MEDICAL JUSTICE NETWORK LIMITED

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 JANUARY 2022

1 Accounting policies

Charity information

Medical Justice Network Limited is a private company limited by guarantee incorporated in England and Wales. The registered office is 86 Durham Road, London, N7 7DT.

1.1 Accounting convention

The financial statements have been prepared in accordance with the charity's governing document, the Companies Act 2006 and "Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019)". The charity is a Public Benefit Entity as defined by FRS 102.

The financial statements are prepared in sterling , which is the functional currency of the charity . Monetary a mounts in these financial statements are rounded to the nearest £.

The financial statements have been prepared under the historical cost convention, [modified to include the revaluation of freehold properties and to include investment properties and certain financial instruments at fair value]. The principal accounting policies adopted are set out below.

1.2 Going concern

At the time of approving the financial statements, the trustees have a reasonable expectation that the charity has adequate resources to continue in operational existence for the foreseeable future. Thus the trustees continue to adopt the going concern basis of accounting in preparing the financial statements.

1.3 Charitable funds

Unrestricted funds are available for use at the discretion of the trustees in furtherance of their charitable objectives.

Restricted funds are subject to specific conditions by donors as to how they may be used. The purposes and uses of the restricted funds are set out in the notes to the financial statements.

Endowment funds are subject to specific conditions by donors that the capital must be maintained by the charity.

1.4 Income

Income is recognised when the charity is legally entitled to it after any performance conditions have been met, the amounts can be measured reliably, and it is probable that income will be received.

Cash donations are recognised on receipt. Other donations are recognised once the charity has been notified of the donation, unless performance conditions require deferral of the amount. Income tax recoverable in relation to donations received under Gift Aid or deeds of covenant is recognised at the time of the donation.

Legacies are recognised on receipt or otherwise if the charity has been notified of an impending distribution, the amount is known, and receipt is expected. If the amount is not known, the legacy is treated as a contingent asset.

1.5 Expenditure

A liability is recognised when either a legal or constructive obligation is identified. Irrecoverable VAT is classified in the same way as the transaction to which it relates.

MEDICAL JUSTICE NETWORK LIMITED

NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 JANUARY 2022

1 Accounting policies

(Continued)

1.6 Tangible fixed assets

Tangible fixed assets are initially measured at cost and subsequently measured at cost or valuation, net of depreciation and any impairment losses.

Depreciation is recognised so as to write off the cost or valuation of assets less their residual values over their useful lives on the following bases:

Computers

5 years straight line

The gain or loss arising on the disposal of an asset is determined as the difference between the sale proceeds and the carrying value of the asset, and is recognised in the statement of financial activities .

Tangible assets which are not held for investment purposes and are identified as having an enduring value are capitalised if their value on acquisition exceeds £250.

1.7 Impairment of fixed assets

At each reporting end date, the charity reviews the carrying amounts of its tangible assets to determine whether there is any indication that those assets have suffered an impairment loss. If any such indication exists, the recoverable amount of the asset is estimated in order to determine the extent of the impairment loss (if any ) .

1.8 Cash and cash equivalents

Cash and cash equivalents include cash in hand, deposits held at call with banks, other short-term liquid investments with original maturities of three months or less, and bank overdrafts. Bank overdrafts are shown within borrowings in current liabilities.

1.9 Financial instruments

The charity has elected to apply the provisions of Section 11 ‘Basic Financial Instruments’ and Section 12 ‘Other Financial Instruments Issues’ of FRS 102 to all of its financial instruments.

Financial instruments are recognised in the charity 's balance sheet when the charity becomes party to the contractual provisions of the instrument.

Financial assets and liabilities are offset, with the net amounts presented in the financial statements, when there is a legally enforceable right to set off the recognised amounts and there is an intention to settle on a net basis or to realise the asset and settle the liability simultaneously.

Basic financial assets

Basic financial assets, which include debtors and cash and bank balances, are initially measured at transaction price including transaction costs and are subsequently carried at amortised cost using the effective interest method unless the arrangement constitutes a financing transaction, where the transaction is measured at the present value of the future receipts discounted at a market rate of interest. Financial assets classified as receivable within one year are not amortised.

MEDICAL JUSTICE NETWORK LIMITED

NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 JANUARY 2022

1 Accounting policies

(Continued)

Basic financial liabilities

Basic financial liabilities, including creditors and bank loans are initially recognised at transaction price unless the arrangement constitutes a financing transaction, where the debt instrument is measured at the present value of the future p aymen ts discounted at a market rate of interest. Financial liabilities classified as payable within one year are not amortised.

Debt instruments are subsequently carried at amortised cost, using the effective interest rate method.

Trade creditors are obligations to pay for goods or services that have been acquired in the ordinary course of operations from suppliers. Amounts payable are classified as current liabilities if payment is due within one year or less. If not, they are presented as non-current liabilities. Trade creditors are recognised initially at transaction price and subsequently measured at amortised cost using the effective interest method.

Derecognition of financial liabilities

Financial liabilities are derecognised when the charity ’s contractual obligations expire or are discharged or cancelled.

1.10 Taxation

The charity is exempt from corporation tax on its income and gains as long as the income is applied for charitable purposes.

1.11 Employee benefits

The cost of any unused holiday entitlement is recognised in the period in which the employee’s services are received.

Termination benefits are recognised immediately as an expense when the charity is demonstrably committed to terminate the employment of an employee or to provide termination benefits.

1.12 Retirement benefits

Payments to defined contribution retirement benefit schemes are charged as an expense as they fall due.

2 Critical accounting estimates and judgements

In the application of the charity’s accounting policies, the trustees are required to make judgements, estimates and assumptions about the carrying amount of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates.

The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised where the revision affects only that period, or in the period of the revision and future periods where the revision affects both current and future periods.

MEDICAL JUSTICE NETWORK LIMITED

NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 JANUARY 2022

3 Donations and legacies

Unrestricted Unrestricted
funds funds
general general
2022 2021
£ £
Donations and gifts 20,060 22,988
Government grants 4,161 -
Donated professional services 129,932 119,749
154,153 142,737
Donations and gifts
Donations 20,060 22,988
20,060 22,988

Donated professional services

Donated professional services and donated facilities are recognised as income when the charity has control over the item, any conditions associated with the donated item have been met, the receipt of economic benefit from the use by the charity of the item is probable and that economic benefit can be measured reliably.

On receipt, donated professional services and donated facilities are recognised on the basis of the value of the gift to the charity which is the amount the charity would have been willing to pay to obtain services or facilities of equivalent economic benefit on the open market; a corresponding amount is then recognised in expenditure in the period of receipt.

In the accounts for the year ended 31 January 2022, the value of the donation £129,932 (2021: £119,749) is shown in Donations and Legacies, note 3 and the corresponding cost in Charitable Activities, note 7.

MEDICAL JUSTICE NETWORK LIMITED

NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 JANUARY 2022

4 Charitable activities

Performance related grants
Medico-legal report fees
Training
Analysis by fund
Unrestricted funds - general
Restricted funds
Performance related grants
The Griffsome Trust
Bromley Trust
Comic Relief (Restricted)
Oak Foundation
Trust for London (Restricted)
Joseph Rowntree Charitable Trust
Lloyds Foundation
Sam and Bella Sebba Charitable Foundation
Sigrid Rausing Trust
Esmee Fairbairn Foundation
AB Charitable Trust
The Baring Foundation (Restricted)
NACCOM
Balcombe Trust
SC & ME Morlands Charitable Trust		 2022
£
465,349
18,540
1,600
485,489
367,810
117,679
485,489
100,000
15,000
99,029
50,000
18,650
21,670
-
40,000
75,000
-
20,000
-
-
25,000
1,000
465,349		 2021
£
406,694
50,269
2,900
459,863
216,169
243,694
459,863
35,000
15,000
61,712
-
18,650
55,332
10,000
-
75,000
75,000
-
30,000
30,000
-
1,000
406,694

Grants are categorised each year as restricted or unrestricted based on the terms of the agreement.

MEDICAL JUSTICE NETWORK LIMITED

NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 JANUARY 2022

5 Investments

Unrestricted Unrestricted
funds funds
general general
2022 2021
£ £
Interest receivable 40 239
Raising funds
Unrestricted Unrestricted
funds funds
general general
2022 2021
£ £
Fundraising and publicity
Other fundraising costs 216 418
216 418

6 Raising funds

MEDICAL JUSTICE NETWORK LIMITED

NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 JANUARY 2022

7 Charitable activities

Staff costs
Medico-legal report fees
Interpretation
Professional services: consulting
Staff recruitment and training
Events
General expenses
Staff expenses
Donated professional services
Former client expenses
Share of support costs (see note 8)
Share of governance costs (see note 8)
Analysis by fund
Unrestricted funds - general
Restricted funds		 2022
£
371,423
9,362
19,580
60,396
1,955
125
35
5,201
129,932
368
598,377
46,756
1,320
646,453
528,774
117,679
646,453		 2021
£
337,626
6,206
25,836
15,173
2,704
723
73
4,303
119,749
101
512,494
44,159
1,252
557,905
314,211
243,694
557,905

Professional services: consulting includes the following: £1,690 for Human Resources, £720 for antidiscrimination training for recruitment practices, £6,550 for Trauma Treatment International (one-to-one counselling for all staff, monthly group supervision sessions, and facilitated discussion sessions), £ 39,960 for 12 months legal research for the Brook House Inquiry, and £11,476 for an independent Evaluation of Medical Justice and a strategy development.

MEDICAL JUSTICE NETWORK LIMITED

NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 JANUARY 2022

8 Support costs

Support
costs
Governance
costs
£
£
Depreciation
594
-
Rent and rates
31,615
-
Communications
2,711
-
Postage, printing and stationery
402
-
Insurance
344
-
Volunteer expenses
155
-
Subscriptions
594
-
Website and IT expenditure
6,187
-
Other office costs
2,163
-
Accountancy and payroll
1,991
-
Independent Examination and accounts
preparation
-
1,320
46,756
1,320		 2022
£
594
31,615
2,711
402
344
155
594
6,187
2,163
1,991
1,320
48,076		 2021
£
460
25,778
5,223
422
297
485
606
9,014
55
1,819
1,252
45,411

9 Trustees

None of the trustees (or any persons connected with them) received any remuneration or benefits from the charity during the year.

10 Employees

The average monthly number of employees during the year was:

Employees
Employment costs
Wages and salaries
Social security costs
Other pension costs		 2022
Number
14
2022
£
313,688
28,672
29,063
371,423		 2021
Number
11
2021
£
295,658
14,602
27,366
337,626

During the year there were 14 posts, 7 full time and 7 part time.

MEDICAL JUSTICE NETWORK LIMITED

NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 JANUARY 2022

10 Employees

(Continued)

Key Management Personnel:

This is defined as the Director and Casework Manager roles (2021: Director role only). The remuneration, including employer's pension and National Insurance costs, of key management personnel amounted to £87,563 (2021: £52,317).

There were no employees whose annual remuneration was more than £60,000.

11 Tangible fixed assets

Cost
At 1 February 2021
Additions
At 31 January 2022
Depreciation and impairment
At 1 February 2021
Depreciation charged in the year
At 31 January 2022
Carrying amount
At 31 January 2022
At 31 January 2021
12
Debtors
Amounts falling due within one year:
Other debtors
13
Creditors: amounts falling due within one year
Other taxation and social security
Other creditors
Accruals		 Computers
£
14,216
4,522
18,738
13,708
594
14,302
4,436
507
2022
2021
£
£
863
5,258
2022
2021
£
£
9,306
6,696
4,043
2,498
19,475
1,659
32,824
10,853

MEDICAL JUSTICE NETWORK LIMITED

NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 JANUARY 2022

14 Restricted funds

The income funds of the charity include restricted funds comprising the following unexpended balances of donations and grants held on trust for specific purposes:

Movement in funds Movement in funds Movement in funds Movement in funds
Incoming Resources Balance at Incoming Resources Balance at
resources expended 1 February resources expended 31 January
2021 2022
£ £ £ £ £ £
Sigrid Rausing Trust 75,000 (75,000) - - - -
Trust for London 18,650 (18,650) - 18,650 (18,650) -
Comic Relief 29,712 (29,712) - 99,029 (99,029) -
The Griffsome Trust 35,000 (35,000) - - - -
Joseph Rowntree
Charitable Trust 55,332 (55,332) - - - -
The Baring Foundation 30,000 (30,000) - - - -
243,694 (243,694) - 117,679 (117,679) -

15 Designated funds

The income funds of the charity include the following designated funds which have been set aside out of unrestricted funds by the trustees for specific purposes:

Movement in funds Movement in funds Movement in funds Movement in funds
Balance at Incoming Resources Balance at Incoming Resources Balance at
1 February resources expended 1 February resources expended 31 January
2020 2021 2022
£ £ £ £ £ £ £
Infrastructure
Fund - - - - 80,000 - 80,000
- - - - 80,000 - 80,000

Designated Fund : £80,000

The independent Evaluation of the effectiveness of Medical Justice in 2021 highlighted a need to strengthen the senior management team and the organisation’s infrastructure in response to the growing size of the team and complexities of its activities. To this end, Medical Justice is creating a Designated Fund in order to be able to create new staff roles needed to strengthen the organisation’s infrastructure.

MEDICAL JUSTICE NETWORK LIMITED

NOTES TO THE FINANCIAL STATEMENTS (CONTINUED)

FOR THE YEAR ENDED 31 JANUARY 2022

16
Analysis of net assets between funds
Fund balances at 31 January 2022 are represented by:
Tangible assets
Current assets/(liabilities)		 General
Funds
Restricted
Funds
Restricted
Funds
2022
2022
2022
£
£
£
4,436
-
-
310,524
80,000
-
314,960
80,000
-		 Total
2022
£
4,436
390,524
394,960		 General
Funds
Restricted
Funds
2021
2021
£
£
507
-
401,440
-
401,947
-		 Total
2021
£
507
401,440
401,947

MEDICAL JUSTICE NETWORK LIMITED

NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 JANUARY 2022

17 Related party transactions

There were no disclosable related party transactions during the year (2021 - none) .

18
Cash generated from operations
(Deficit)/surpus for the year
Adjustments for:
Investment income recognised in statement of financial activities
Depreciation and impairment of tangible fixed assets
Movements in working capital:
Decrease/(increase) in debtors
Increase in creditors
Cash generated from operations		 2022
£
(6,987)
(40)
594
4,394
21,971
19,932		 2021
£
44,516
(239)
460
(4,147)
3,235
43,825

19 Analysis of changes in net funds

The charity had no debt during the year.