Feature Asylum Centres

Poor diagnosis for asylum seekers’ health needs

BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c4106 (Published 10 August 2010) Cite this as: BMJ 2010;341:c4106
  1. Margaret McCartney, general practitioner
  1. 1Glasgow
  1. margaretmccartney{at}doctors.org.uk

    Slow improvements in health care for asylum seekers must speed up, argues Margaret McCartney

    “I told them that I had angina, but no one took it seriously,” says a Middle Eastern asylum seeker currently in an immigration removal centre in England. He developed chest pains while in a similar centre and claims that that centre’s medical team ignored his symptoms. “I once had pain for several hours, and I was told that an ambulance had been called—it hadn’t been.”

    When he was taken to hospital he was given treatment that resolved his symptoms before being sent back to the centre to await follow-up investigations. Now he has little confidence in the medical staff at the centre. Recently, he says, it was the detainees who diagnosed an outbreak of tuberculosis. “People were coughing with blood, a temperature, not feeling well. For three weeks they [the medical staff] didn’t do anything.” When the outbreak was diagnosed, some people were moved into isolation, but the asylum seeker is convinced that the outbreak could have been contained better if it had been diagnosed earlier.

    He is one of the 3000 or so people currently held in the UK’s 11 immigration removal centres. There is no time limit restricting how long someone can spend in a centre. Prison medicine is well established in the UK with doctors, especially general practitioners, choosing to specialise and get further training in this area. However, removal centres are not prisons. People within them are being assessed for refugee status and are not criminals. Whereas health care within prisons is commissioned by the Department of Health, that within immigration removal centres is the Home Office’s responsibility.

    Has this led to a schism in the quality of healthcare services available to refugees? There are numerous critics of health care available in …

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