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:

The public health perspective

Hull and Boomla rightly point out that inequalities in access to
healthcare for marginalized groups speak profoundly about the kind of
society we live in.

But beyond the moral, the public health perspective speaks in favour
of ensuring adequate health coverage of the entire population for the
benefit of all.

First, many of these marginalized groups also face the challenges of
poor or inadequate housing, malnutrition and socioeconomic deprivation;
and so not surprisingly are vulnerable to infectious diseases, with
consequences not just for those groups but for all of society.

Secondly, from a resource perspective, providing only primary care
and emergency care may mean that medical conditions are allowed to
deteriorate until the individual qualifies for emergency care with
subsequent escalation in costs to the health service.

Government policy on entitlement to treatment must take into account
ethical considerations; but must also be based on good evidence and a
holistic review of resource implications.

Competing interests:
None declared

Competing interests: No competing interests

25 January 2006
Ike Anya
Specialist Registrar in Public Health
Bristol Joint Directorate of Public Health, Bristol PCTs, BS2 8EE