Intended for healthcare professionals

Rapid response to:


Primary care for refugees and asylum seekers

BMJ 2006; 332 doi: (Published 12 January 2006) Cite this as: BMJ 2006;332:62

Rapid Response:

Health in need is the health indeed - medical services to refugee population

Health is wealth. A healthy tissue leads to a healthy individual and
this in turn leads to a healthy community and consequently a healthy
country. The arrival of Médecins du Monde1 to help marginalised people in
UK is no doubt a strong step taken towards creating a healthy community.
However, there are some issues as to why this has become important and
their future implications on the society. There are many asylum seekers,
migrants and refugees who are staying in various pockets in the country.

The questions that health service providers have to answer should always
be medical and never political. The latter can be tackled by the
government bigwigs. The NHS should be able to provide health services to
any person irrespective of his social status or political origin. There
are many people who have been refused registration at the GP offices
simply because they are not eligible or the practices are completely full.

Although the efforts of Médecins du Monde are commendable, in the
long run there will be questions raised on the efficiency, adequacy and
appropriateness of their services. Other aspects that this organisation
needs to answer are the plans they have taken in dealing with
investigations and higher referrals2? Individuals from the vulnerable
groups come from varied backgrounds. Asylum seekers and refugees are not a
homogenous group of people3. Accidents, communicable diseases and mental
illnesses to name a few are quite common among them. If these individuals
are denied treatment, it can not only have physical and psychological
impact on these people but can also seriously affect the local population.
Sexually transmitted diseases are very rampant and ever increasing. There
will always be contact with local crowd. Some individuals, due to their
isolation, unemployment and poverty will be suffering from anxiety and
depression. Without treatment, all these lead to further deterioration of
their condition.

The implications of denied health service can be far reaching. The
individuals will be pushed further down the social ladder. Sexually
transmitted diseases will be travelling on an upward curve and
consequently the health of the local people will be on a downward spiral.
Desperation and depression lead to suicide or even harming others. An
increase in crime rate will follow suit.

National Health Service should hence dig deep into the matter and
look out for optimal solutions. Also, there has been widespread confusion
about the rules and therefore the asylum seekers and refugees have wrongly
been denied access to primary and secondary health care4. Not that all
individuals of these groups be treated for all conditions. There has been
serious misuse of health services in the past. Individuals have queued up
for treatment of conditions which are not at all life threatening and
there have been numerous instances of surgeries being performed when they
could have got it done elsewhere with time not necessarily being a factor.
This grossly affected the waiting list for procedures. Some of the ways to
tackle these issues would be to provide a temporary registration with the
local GP till their stay, adequate information and education, free
treatment on the first couple of visits and also for emergency and life
threatening conditions. There should also be a decision taken on a case-to
-case basis so that relevant and important conditions are not missed and
are adequately treated. Although it may strain the resources in treating
more people than desired, if all the above consequences are taken into
account, it may prove beneficial and economical in the long run.


1. Médecins du Monde.

2. Sally A Hull and Kambiz Boomla. Primary care for refugees and asylum
seekers. 2006;332;62-63 BMJ

3. Burnett A, Peel M. Health needs of asylum seekers and refugees. BMJ

4. Karen McColl, Sarah Pickworth and Isabelle Raymond. Project: London.
supporting vulnerable populations. BMJ 2006;332;115-117

Competing interests:
None declared

Competing interests: No competing interests

19 January 2006
Senior House Officer
Shivakumar Shankaranarayan, and Pawankumar BC Raju
Addenbrooke's Hospital, Cambridge, CB1 8EF