Access to Adequate Medical Treatment for Vulnerable Asylum Seekers in Direct Provision

KOD LyonsHuman Rights in Ireland welcomes this guest post from Colin Lenihan. Colin is a trainee solicitor for KOD Lyons Solicitors a leading human rights & public interest law firm, who represent asylum seekers and other vulnerable migrants. 

Earlier this week a client of KOD Lyons, who is awaiting an appeal to the Refugee Appeals Tribunal, arrived in our office in a distressed state. He was informed by the Reception & Integration Agency (RIA) that he was to be transferred from his direct provision centre in Dublin city centre to a centre in Foynes, Co. Limerick, by the end of the week. He was naturally upset at the prospect of being dispersed to a remote centre in another part of the country, with only 3 days notice.

He is a recovering heroin addict who was receiving daily drug rehabilitation treatment in Dublin. This consisted of daily methadone treatment, weekly medical checkups and he was also seeking regular counselling for his ongoing mental health problems. His medical needs were so strict and continuous, we were immediately concerned at the prospect of him being uprooted and being dispersed to another centre where no such treatment programme was put in place.

KOD Lyons were informed by the HSE drug treatment services in Limerick, which our client was instructed by RIA to link in with, that no system had been put in place to deal with our client’s medical needs. KOD Lyons were informed that due to the short notice of the transfer, an adequate medical treatment programme to address our clients’ needs would not be in place for up to 7 days. We were immediately concerned that if our client were to be dispersed to the direct provision centre in Foynes, the withdrawal of his specific daily medical needs would result in serious risk to his health & safety  and the safety of other residents in the centre.

We sought clarification with RIA as to the procedure which would be in place once our client was dispersed to Foynes. KOD Lyons  specifically requested whether our client would have to travel to Limerick City each day, a 90 minute round trip, to receive his methadone treatment. We argued that such a journey would be unreasonable and detrimental to his health. We argued that while our client was in the direct provision system, the State owed a duty of care to him and that he was entitled to adequate and accessible medical treatment to meet his needs. We sought a stay to the proposed dispersal until such adequate procedures were in place.

The Reception & Integration Agency, when made aware of our concerns and the specific needs of our client, decided that a stay on his transfer would be appropriate, and, once all medical procedures were in place, he would be dispersed to a more suitable direct provision centre in Limerick City where his medical needs would be easier to access.

This case raises a lot of issues in relation to the assessment of individual medical needs of asylum seekers who are residing in the direct provision system. It underlines that a “one size fits all” system is not appropriate to address the needs of vulnerable asylum seekers. The ESRI have noted that there are no specific reception facilities allocated to vulnerable asylum seekers who enter the direct provision system.

The Minister for Justice has stated that, while residents in the direct provision system are not ‘in the care of the State’ there is still a ‘duty of care’ owed to all residents. The right to adequate and reasonably accessible medical treatment is one such example of this duty of care.

There is a significant deficiency in the access to adequate medical treatment for asylum seekers in the direct provision system. The physical and mental health difficulties of those fleeing persecution lead to higher levels of post traumatic stress disorder than those experienced by their voluntary migrant or Irish counterparts. The continued isolation, segregation and hopelessness suffered within direct provision only exacerbate already traumatic livelihoods.

The Free Legal Advice Centres (FLAC), Irish Refugee Council and others have expressed there concerns at the mental health impact of asylum seekers residing in direct provision centres and have repeatedly requested that due consideration be placed on the specific medical needs of asylum seekers when any decision on dispersal is considered. A viable alternative to the current system is long overdue.


Access to Adequate Medical Treatment for Vulnerable Asylum Seekers in Direct Provision

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