Expertise

Providing offender healthcare in a wide variety of settings and countries has given us ample opportunity to develop expertise in the determination of clinical quality behind bars. Sadly, we have also had to become experts in the prevention and detection of torture & ill-treatment.

Our expertise service has two arms - professional opinion and expert opinion - and trades via Integridad: Heart for Detainees as the Gerry Serrano Centre. And in setting our terms and conditions, we have been mindful of the wide variation in clients’ financial circumstances.

Mr Gerry Serrano was a detained patient who we were privileged to care and advocate for. Following more than 20 years awaiting trial for a crime that he did not commit, he was eventually found innocent and released. He died around a year later. Our expertise and advocacy work aims to honour his memory.

Housed within our larger Philippines base, our reference library and resource centre bears Gerry’s name. It contains many multi-media works to help those working with us to develop sufficient expertise and advocacy skills. And we are particularly grateful to the British Medical Association and Health Books International (formerly Teaching Aids At Lost Cost (TALC)) for two generous joint donations of specialist textbooks and other valuable resources.

Professional opinion

In medico-legal work there is a clear difference between a clinician acting as a professional witness and the same clinician acting as an expert witness. If (s)he is actively treating the patient, then (s)he may serve as a professional witness about his/her patient.

Nonetheless, it is reassuring for our patients, partners and commissioning lawyers to know that our professional clinicians are led by those who have a great deal of experience/expertise in the fields of offender healthcare and the detection and prevention of torture and ill-treatment.

We distill this ethos of experience/expertise to every student, junior and senior healthcare professional who volunteers with us or works for us in a paid capacity.

Expert opinion

independence

We take the principle of expert witness independence very seriously.

Ideally, a clinician acting as an expert witness should not be currently involved in treating the patient whose case (s)he has been commissioned to assess. If assessing a healthcare service, secure environment or system rather than a particular patient, (s)he should not be involved in the commissioning, running or governance of that same establishment.

We pride ourselves on complete transparency in these and all other expert witness matters. And we are always clear that, regardless of who is commissioning (and therefore paying) us, our findings will be impartial. Sometimes this means that we end up criticising those we then invoice.

patient

Sometimes an individual patient’s case needs an independent review. Patients, relatives and legal representatives contact us. And we also cooperate with the embassies of countries concerned that their citizens detained overseas are receiving appropriate healthcare and are not being torture or ill-treated.

Clinician

Sometimes we are asked to investigate allegations about a particular clinician’s performance. Other times we are tasked with investigating whistleblowing concerns raised by a clinician working within a system (s)he believes may be unsafe.

Secure environment

We have reviewed the healthcare within particular prisons & other secure environments, and also within clusters of facilities.

Healthcare provider

Often a particular healthcare provider runs healthcare services for several different secure environment. And so, depending upon the terms of reference of a particular commission, our reports may reveal issues that extend far beyond the care of a particular patient or the competence of a particular clinician.

Healthcare system

When there is a crack in one corner of a system, there are likely to be pressure points and cracks elsewhere too. We are able to review regional and national secure environment healthcare systems. And we also free up some of our more experienced doctors so as to enable them to serve other institutions in their undertaking of such work.

TERMS & CONDITIONS

high income countries

Whilst not having hard and fast rules, our high income country expertise work is usually priced along two tiers - one for commercial cases and the other for cases that are being assisted by UK Legal Aid or other nations’ equivalent systems.

• Private cases:-

  • Enquiries: first two hours are complimentary

  • Calls & emails: £133.33/hour

  • Court attendance: £1600/day or part-day

  • Desk-based or patient-facing work: £200/hour

  • Field-based work: minimum 8 hours/day

  • Lectures & talks: price on application

  • Payment terms: 30 days of invoicing

  • Research support: £50/hour plus cost of accessing papers

  • Secretarial support: £25/hour

  • Team-based expert witness work: price on application or as per service level agreements

  • Travel expenses:-

    • car: £0.40/mile

    • flights: business class

    • hotels: 4 star on half-board basis

    • meals: £20/meal whilst in the field, travelling or in court

    • parking & taxis: as required

    • trains: first class, Eurostar business premier class

  • Travelling fees:-

    • >3 hours’ travel within the UK: £100/hour

    • long haul journeys: negotiable

• Legal aid cases:-

  • Enquiries: first two hours are complimentary

  • Calls & emails: £100/hour

  • Court attendance: £1200/day or part-day

  • Desk-based or patient-facing work: £150/hour

  • Field-based work: minimum 8 hours/day

  • Payment terms: 60 days of invoicing regardless of Legal Aid settlement

  • Research support: £37.50/hour plus cost of accessing papers

  • Secretarial support: £18.75/hour

  • Travel expenses:-

    • car: £0.40/mile

    • flights: premium economy class

    • hotels: 3 star on bed & breakfast basis

    • meals: £15/meal whilst in the field, travelling or in court

    • parking & taxis: as required

    • trains: economy class, Eurostar standard premier class

  • Travelling fees: £75/hour

low & middle income countries

• Low cost & pro bono cases:-

  • We waive a huge percentage of our fees & costs, and sometimes do cases pro bono - depending upon the case, client and country.

• Humanitarian cases:-

  • However, the vast majority of our expertise work is done quietly on an entirely humanitarian basis, without even charging pro bono costs.

“Thanks again for your excellent work and support…”
(Anonymous client writing to one of our doctors, 2019)