Healthcare for Vulnerable People Flashcards
(39 cards)
Why is migrant access to healthcare important
- its a human right
- It is important for public health
- cost effective
- there are barriers for this group in accessing healthcare
What are the NHS views to access to healthcare
NHS treatment “based on clinical need, not ability to pay” (1948).
NHS value: “everyone counts: make sure nobody is excluded, discriminated against or left behind.”
what makes access to healthcare a basic human right
International Covenant on Economic, Social and Cultural Rights.
What are SDGs
- Sustainable development goals
why is access to healthcare financially efficient
- early diagnosis and treatment save lives and cut treatment costs
- health inequalities cost - in England the cost of treating illness and disease arising from health inequalities has been estimated at £5.5 billion a year
- Resource burden of checking and charging patients - operating an overseas visitors charging system is costly
How much does migrants cost the NHS
£1.95 billion during 2012-13
- Estimated cost to the NHS of EEA and non-EEA visitors, temporary migrants, students, British ex-patriots, “deliberate health tourists” and those “taking advantage”
What does doctors of the world do
Primary care clinic in East London for people with difficulty accessing mainstream NHS;
Staffed by volunteer GPs, nurses & support workers;
Advocacy service for GP registration and secondary care;
they try to influence health police and practise
What is the definition of an asylum seeker
A person who has left their country of origin and applied for asylum in another country but whose application has not yet been concluded
What is the definition of a refugee
Someone whose asylum application has been successful; the Government recognises they are unable to return to their country of origin owing to a well-founded fear of being persecuted for reasons provided for in the Refugee Convention 1951 or European Convention on Human Rights.
What is the definition of a refused asylum seeker
A person whose asylum application has been unsuccessful.
What is the definition of an undocumented migrant
Someone who enters or stays in the UK without the documents required under immigration regulations.
Who are undocumented migrants
Survivors of trafficking
Refused asylum seekers
People who don’t claim asylum due to lack of legal advice.
People who come to work without a visa.
People whose visa has expired (student/working)
Domestic workers on expired visas which employer doesn’t renew
People on spousal visas whose relationship breaks down
What problems do unregulated migrants have accessing primary care
- Lack of ID/proof of address - dont need a home address to register at a GP
- Immigration status
- Fear of the home office/arrest
- language
How many patients were refused by GP clinics after attempts were made after the doctors of the world
Out of the 2873 attempts by DOTW to register patients with their local GP in 2019, 787 were refused
What is not relevant to GP registration
Nationality and immigration status are not relevant to GP registration
Why is nationality and immigration status not relevant to GP registration
“anybody in England may register and consult with a GP without charge”
“all asylum seekers and refugees, overseas visitors, students, people on work visas and those who are homeless, whether lawfully in the UK or not, are eligible to register with a GP practice”
“A patient does not need to be ‘ordinarily resident’ in England to be eligible for NHS primary medical care
Why do you not need documentation for registration with a GP practise
“there is no regulatory requirement to prove identity, address, immigration status or the provision of an NHS number in order to register”
Lack of proof of address/ID “would not be considered reasonable grounds to refuse to register a patient” or withhold appointments
“Where necessary, (e.g. homeless patients), the practice may use the practice address to register them if they wish”
What happens when you refuse to register
“If a practice suspects a patient of fraud (such as using fake ID) then they should register and treat the patient but hand the matter over to the NHS Counter Fraud Authority (NHSCFA)”.
“If a practice refuses any patient registration then they must record the name, date and reason for the refusal and write to the patient explaining why they have been refused, within a period of 14 days of the refusal”.
“This information should be made available to commissioners on request.”.
What are the 7 steps for safe patient registration
- Don’t insist on proof of address
- Don’t insist on ID
- Never ask about immigration status
- Keep information safe
- Use an interpreter
- Display Posters
- Empower frontline staff
Why are safe patient registration protections important
Some patients living in the practice area will be unable to prove it.
Some patients will not have any proof of ID.
Immigration status queries deter undocumented patients.
New rules (charging and checks) in hospitals limit access to specialist care.
Fear of being reported to the Home Office is justified
In secondary care what do undocumented migrants have to pay for and what services are free
Paid for
Undocumented migrants are charged for some services – this includes refused asylum seekers in England
- Charges must be paid before treatment.
Free
Some services are always free - A&E, communicable diseases and family planning.
“Urgent or immediately necessary” treatment to be provided regardless of ability to pay
What are the groups of undocumented migrants that are exempt from charges
- Refugees and asylum seekers
Refused asylum seekers receiving “section 4” support - those destitute and prevented from returning to country of origin
Survivors of trafficking
Children looked after by a local authority
People treated under the Mental Health Act
People in immigration
detention.
Treatment caused by sexual or domestic violence, FGM, or torture
What is immediately necessary care
Life saving, will prevent a condition becoming life-threatening or will prevent permanent serious damage
- E.g. maternity services are always immediately necessary
- everything else is based on the treating clinicians decision
What are examples of immediately necessary care in childhood
- acute renal disease requiring 3 times dialysis a week
- maternity services
