Meeting the healthcare needs of refugees and asylum seekers

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7193.1291 (Published 08 May 1999) Cite this as: BMJ 1999;318:1291
  1. David Barr, Clerk (david.barr{at}virgin.net),
  2. J B Ashton, Medical secretary
  1. Kent Local Medical Committee, Suite 1, First Floor, Tenacre Court, Herrietsham, Kent ME10 1AH

    EDITOR—Kent has around 4000 asylum seekers, many of whom are not registered with a general practitioner. The local medical committee recently wrote to all the members of parliament (MPs) in Kent seeking separate central funding to provide adequate services for refugees and asylum seekers. The committee was concerned that an effective service was unlikely to be provided unless funds were separately identified and also that funds for general medical services would be used to provide a service that takes money from the population as a whole. The response from local MPs was overwhelmingly supportive, but Frank Dobson ignored the plea for a properly funded service, stating that the policy of dispersion and the proposed policy of fast tracking refugees would solve the problems.1

    We remain sceptical. Currently, East Kent has a large number of refugees and asylum seekers and is popular with London boroughs for its cheap and available accommodation and its proximity to London. In addition, landlords with vacant rooms in the area are encouraging London boroughs to lodge refugees in their rooms.

    In consultation with the local medical committee and with the support of local general practitioners the health authority has instigated a scheme to provide a service directed at the specific needs of refugees and asylum seekers. It consists of one and a half whole time equivalent general practitioners, three nurses, and reception staff in three surgeries (Dover, Folkestone, and Thanet). All staff have appropriate skills and access to translating and other services. The service should lead to the registration of many more refugees and asylum seekers with a general practitioner and to an understanding of the use of services by these patients so that they can in time be properly integrated into the NHS.

    The scheme is funded by the NHS modernisation fund, and the cost of nursing is met by an allocation from the health authority's service and financial framework, with agreement that any overspend will come directly from cash limited funds for general medical services. In the future the local medical committee will need to consult with primary care groups, five in the case of East Kent. We wonder how each will respond as refugees and asylum seekers are currently concentrated in comparatively small and deprived areas.

    Although general practitioners in Kent might support the government's aim of dispersal, the reality is likely to be much more difficult to achieve than a properly funded initiative that addresses the problems faced by refugees and asylum seekers and the health and social services that are trying to support them.


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