Asylum seeker health crisis in London

A refugee and her child beg on London's Tube

By Dominic Casciani BBC News Online community affairs reporter

Thousands of asylum seekers in London are being "failed" as the NHS struggles to cope with the scale of their problems, it has been warned.

We fail them, we fail them in health terms

Dr Vivienne Nathanson, BMA

The British Medication Association (BMA), which represents doctors, said the health of asylum seekers was actually worsening two or three years after they had arrived in the capital.

The problem has now got so bad the NHS is dealing with childhood diseases such as rickets which doctors thought they had eliminated from the UK.

The BMA called on the government to do more to get hundreds of unemployed doctors among the asylum seeker community into the NHS, rather than rely on expensive international recruitment campaigns.

'Vulnerable and marginalised'

Dr Vivienne Nathanson, director of professional activities at the BMA, told a hearing at the London Assembly that asylum seekers were "vulnerable and marginalised" when they arrived in the UK.

She said: "We fail them in health terms. At the port of entry it's very difficult to pick up problems."

Dr Nathanson said the doctors were hampered by a lack of translators, community advocates and the time needed to build trust.

She said poor housing for asylum seekers exacerbated their health problems.

Refugee doctors want to work - they want to give something back to the country that gave them sanctuary

Sallie Nicholas, BMA

Dr Kate Adams, an east London GP with expertise in the area, said the NHS had to do more to bring asylum seekers into the service rather than expect them to be dealt with by fringe specialists.

"We have evidence that health for asylum seekers gets worse after they have been here two or three years," said Dr Adams.

She said: "London has a long history of caring for people from around the world.

"We want to integrate people into the services so that we understand the health issues.

"But there are a lot of GPs in London who don't understand that asylum seekers have a right to register with them."

Dr Nathanson told the hearing one of the major concerns was the number of children not receiving immunisations or suffering from diseases long linked to poverty.

Tuberculosis was "rising significantly" in London because of poor housing provided to asylum seekers and other marginalised groups in some areas of the capital.

Refugee doctors

Figures collected by the BMA suggest there are at least 770 doctors who have arrived in the UK as asylum seekers in recent years - but only 34 are allowed to work in the NHS.

More than half of these unemployed doctors live in London which is suffering the worst recruitment crisis of any area, particularly for GPs.

Sallie Nicholas, head of the BMA's international department, said leaving these doctors on benefits was a missed opportunity.

"Refugee doctors want to work. They want to give something back to the country that gave them sanctuary, she said. "They don't want to be on benefits while their skills lapse."

Dr Nathanson added: "If it costs [the government] £2,000 to get them through the courses [for NHS qualification] then it has to be worth it in comparison to trying to recruit doctors from Spain or wherever."

The hearing at the London Assembly was the first in a series examining the impact of asylum seekers on the capital.

The majority of asylum seekers arriving in the UK, currently running at about 70,000 a year, remain in London and south-east England.

The assembly will publish a major report in Spring 2003.