Main obstacles are inflexibility of NHS and bureaucracy of support systems

EDITOR—Asylum seekers often receive poor health care, according to the Audit Commision.1 In east Kent we care for many resident asylum seekers and for many more who arrive at the Channel ports and move to accommodation in other parts of the country. Since February 1999 we have tried to meet the medical needs of people from 43 different countries. In our part of Kent there are no trained interpreters, and, indeed, to expect to have an interpreter on hand at a moment's notice for this number of languages is unrealistic. We have found that even commercial telephone translation services are not able to supply some of the languages we require. Despite this, we hope that we are not guilty of offering a poor service. Listening to patients, careful body language, and the use of diagrams and written material (some of which has been translated by the asylum seekers themselves) are all techniques that have enabled us to communicate to a reasonable level. It is not difficult to show that you are trying to help, and with encouragement people will often find ingenious ways of expressing themselves.

The main obstacles to providing appropriate care are the inflexibility of the NHS and the delays and bureaucracy inherent in …