Under Section 23 IPA, a report in relation to the health of the applicant may be furnished if required by the officer of the IPO. This may occur if an officer of the IPO or a member of the IPAT has a question regarding the physical or psychological health of the applicant. The applicant can choose a nominated medical practitioner from a panel established by the Minister for such health reports. The IPA is silent on how the results of the health report will be used and no reference is made to the consent of the applicant being required for such health examinations to be carried out.
It is the duty of the applicant to cooperate in the investigation of their application and to furnish to the IPO any relevant information. Applicants may approach an NGO called Spirasi, which specialises in assessing and treating trauma and survivors of torture, to obtain a medical report. The approach is made through their solicitor. If an asylum seeker is represented by the Legal Aid Board, then the medico-legal report will be paid for through legal aid. If the request is made by a private practitioner, the report must be paid for privately. Spirasi reports receive a fee of €492 per report from the State through the Legal Aid Board’s Refugee Legal Service while the cost to produce each report is €1,190. For clients who have private legal representation the cost of a medico-legal report (MLR) can be a barrier to access.
Spirasi’s services include the provision of MLR to the protection process, multidisciplinary assessments of survivors of torture, therapeutic interventions, psychosocial support, outreach and early identification, language and vocational training and training to third parties on survivors of torture. SPIRASI puts the waiting time for appointments for reports at eight-ten months from the date of referral, however it is understood that applicants waiting for a report for an IPAT appeal hearing will be prioritised. Following the onset of COVID-19, Spirasi’s service experienced a 35% decrease in medico-legal report production owing to public health restrictions.
In their 2017 submission to the UN Committee against Torture, Spirasi expressed concern at victims of torture not being able to access reports to support their asylum application in advance of a first-instance decision in the envisaged shorter process under the single application procedure. Additionally, Spirasi indicated at that time that due to the drain on resources in a climate of reduced funding, they were restricted in their capacity to provide the additional rehabilitative supports required by victims of torture.
Picking up on these concerns, the UN Committee against Torture in its Concluding Observations on Ireland in August 2017 recommended that the State: ‘Provide adequate funding to ensure that all persons undergoing the single procedure under the International Protection Act have timely access to medico-legal documentation of torture, ensure that all refugees who have been tortured have access to specialised rehabilitation services that are accessible country-wide and to support and train personnel working with asylum-seekers with special needs.’
 Information provided by Spirasi, March 2021.
 ibid, 15.