Refugees Need Better Access To Health Care

November 19, 1998

Refugees and primary care: tackling the inequalities

The refugee population in Britain is highly diverse and is likely to remain large, as conflicts around the world continue. Currently there are 230,000 refugees living in the UK and almost half of these are in London. Refugees have had to leave their countries of origin to escape persecution, imprisonment, torture and even death, and when they arrive in Britain they are often in poor health. Grief and worry about relatives they have left behind can cause mental health problems, which can be worsened by various factors including language difficulties, family separation, hostility from the host population and traumatic experiences before displacement.

In this week's BMJ Dr David Jones from the Royal Free and University College Medical School in London and Dr Paramjit Gill from the University of Birmingham propose a series of steps that could be taken to improve access to health care for refugees in the UK. These suggestions include initiatives such as intensive courses in spoken English; a Department of Health information pack containing a certificate of entitlement to NHS treatment; the development of a telephone interpreting service and guidelines for general practices on the process of registration for a refugee patient.

The authors also suggest that the 60 million extra funds negotiated for GPs by the General Medical Services Committee (now the General Practice Committee) should be used to reward doctors for caring for refugee patients. They say that this additional workload is not covered by the current system of deprivation payments. They conclude that a truly effective solution requires the political will to develop a comprehensive strategy at a national level, which they recognise will be difficult when other groups (such as the mentally ill and the elderly) are also in need of greater resources.


Dr David Jones, Lecturer, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London. email:


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