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Thursday, 7 November, 2002, 13:07 GMT
Analysis: GPs and asylum seekers
Asylum seekers have special health needs

A Birmingham GP has hit the headlines after deciding to close his surgery to asylum seekers living in the city.

Dr Vijayakar Abrol says he does not have the resources to treat them, and that they are putting a serious strain on his practice.

His decision to exclude asylum seekers has caused outrage in some quarters.

GPs should not be turning asylum seekers away

Dr Michael Peel, Medical Foundation
However, his motives are not all that unusual. Many GPs have similar complaints.

Last year, 88,300 people applied for asylum in the UK. Under the government's dispersal programme most of these were sent to live in cities and towns across the country.

Under pressure

In some areas, the sheer numbers have put enormous pressure on education and health services.

"One of the problems has been that asylum seekers tend to be dispersed to the areas of the country where GPs and the NHS are already under pressure," says Dr Michael Peel, of the Medical Foundation for the Care of Victims of Torture.

That situation is compounded by the fact that individual GPs rarely receive any extra money to provide medical care to this group.

Many GPs are unable to take on new patients
According to the Department of Health, it is expected that an asylum seeker will be treated like any other UK resident as soon as they have submitted their application.

"They are treated as an ordinary resident," a spokesman said. "They have the same rights to access healthcare as anyone else."

However, this means that the cost of their medical care is expected to come from existing budgets. There is no additional government funding available.

A number primary care trusts have succeeded in getting around this problem by appointing salaried GPs to run dedicated clinics. This new breed of GP sometimes qualifies for extra government funding irrespective of whether they are treating asylum seekers or not.

Dedicated clinics

Dr Angela Burnett is one such GP. She works at The Sanctuary in Hackney, North London - a dedicated clinic for asylum seekers, which opened five months ago.

It does take more time to deal with asylum seekers

Dr Angela Burnett, London GP

She acknowledges that GPs who do not have dedicated clinics in their areas are under considerable pressure.

"I have sympathy for primary care workers. I appreciate that it does take more time to deal with asylum seekers."

She believes the government must do more to help the NHS deal more effectively with the needs of asylum seekers.

"I think there needs to be more central commitment," she says.

Doctors in Derby have recently decided that they are no longer able to cope with the influx of asylum seekers.

Many in the city have closed their surgery doors to all new patients. However, they too have managed to obtain money for doctors to staff a new dedicated clinic for asylum seekers.

"In Derby, we are taking the view that we need to set up a special practice for asylum seekers," says Dr John Grenville, secretary of the local GPs' committee.

Dr Simon Fradd, BMA
Dr Fradd: More government money is needed
"Many have special needs. Many have been tortured or persecuted in their home countries. This produces its own health problems, particularly mental health problems.

"Some come from parts of the world with infectious diseases that many British doctors would not be familiar with.

"We feel these people deserve to have care from people who have the time to learn about their problems and to give them tailored treatment."

But Dr Grenville believes the onus for providing proper medical services for asylum seekers must lie with the government.

"I do think it is important to encourage primary care trusts to develop services for people who are being excluded from adequate services. It is very important that we have more central funding," he says.

Patchy services

Hackney and Derby remain exceptions to the rule. Dedicated clinics for asylum seekers are by no means commonplace.

"The delivery of healthcare to asylum seekers is patchy. Some primary care trusts have treated it as a priority. Others have not," says Dr Peel.

We would not be in favour of discriminating against any group of patients

Dr Simon Fradd, BMA
The British Medical Association has urged the government to make more money available to help doctors meet the needs of asylum seekers.

Dr Simon Fradd, deputy chairman of its GPs' committee said money must follow those who are dispersed around the country.

"The government has a responsibility here. Primary care trusts already have their budgets stretched to the limit.

"If the population is growing because we are quite rightly taking in asylum seekers then the money must come with them."

However, in the mean time, the BMA is adamant that asylum seekers should not be discriminated against within the NHS.

"We don't like any patient to be turned away," says Dr Fradd.

"It is a reality, however, that in many parts of the country GPs are unable to take on any new patients. But we would not be in favour of discriminating against any group of patients."

That view is shared by the Medical Foundation for the Care of Victims of Torture.

"GPs should not be turning asylum seekers away," says Dr Peel.

"They may have high demands in the short term because they may not have had access to healthcare in the past. But once they become settled their demands are no more than the general population."

Angela Burnett believes that refusing medical care to asylum seekers could also have serious implications for public health.

"Barring asylum seekers from using services is not the route to go down," she says.

"It also doesn't make any sense in terms of public health. These patients have to have access. If they have TB or another infectious disease the consequences could be very serious."

See also:

07 Nov 02 | England
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