Refugee health

Question 1

What is a refugee?

Answer 1

Person who has been forced to leave their country of citizenship in order to escape
- War
- Natural disaster
- Persecution of race, religion, nationality, membership of particular social group, politics

Question 2

What is an asylum seeker?

Answer 2

Person who has left their country of origin and applied for asylum in another country, but whose application has not yet been concluded

Question 3

Asylum seekers’ rights to work and benefits

Answer 3

• Not legally allowed to work
• £45.00 per week benefit entitlement

Question 4

What is an undocumented migrant?

Answer 4

Person who enters or stays in the UK without the necessary documentation required under immigration regulations

Question 5

What sort of people could undocumented migrants be?

Answer 5

• Person who has been trafficked into the country
• Someone who has not received legal advice about their claim to asylum
• Someone who has outstayed their visa

Question 6

When do we engage moral reasoning?

Answer 6

Every time we think about why something is the right or wrong thing to do

Question 7

Kohlberg’s stages of moral development

Answer 7

• Stage 1 = authority punishment
  > “If I don’t let them in, the UN will get me”
• Stage 2 = egoistic exchange
  > “I’ll let them in if there’s something in it for me”
• Stage 3 = “being good” (interpersonal conformity)
  > “Well everyone seems to say that this is the right thing to do…”
• Stage 4 = societal maintenance
  > “In order to keep the system running, we should accept refugees”
• Stage 5 = the greatest good
  > “What will bring the most good to the most people”
• Stage 6 = commitment to ethical principles
  > “This is the right thing to do because it satisfies the demands of justice”

Question 8

How does care ethics see the ‘ultimate ethic’?

Answer 8

• “This is the right thing to do because it fulfils the needs of this person”
• Instead of “justice reasoning” being the pinnacle of Kohlberg’s model

Question 9

What is a reductionist approach?

Answer 9

Ignores the complexity of the situation, reducing the complex human framework to something easy to work with

Question 10

What are people worried about with regards to refugees?

Answer 10

• Terrorism
• Demand on services
• ## Crime

Question 11

Legal entitlements of refugees

Answer 11

• Become a citizen of the UK, with the same entitlements as other citizens (passport, NI number, etc.)
• Once granted refugee status, have 28 days before eviction from asylum accommodation
• Granted ‘leave to remain’ for 5 years

Question 12

How can GPs support refugees?

Answer 12

• Use interpreter
• Flag up if vulnerable/homeless
• Think about how to get them referral letters/test results (eg. address of friend)
• Be aware they are at risk of not attending appointments
• Consider wider social needs (food, housing, etc.)
• Signpost to local support groups
• Mental health needs

Question 13

Which NHS services are exempt from charge for undocumented migrants/refused asylum seekers?

Answer 13

• A&E
• Communicable disease (inc. covid-19)
• Family planning (not maternity or TOP)

Question 14

Which groups are exempt from NHS charges?

Answer 14

• Victims of trafficking or modern day slavery
• Victims of (domestic/sexual) violence, torture and FGM (for treatment relating to their vulnerability only)
• Children under care of a local authority
• Treatment under the Mental Health Act

Question 15

What is immediately necessary care?

Answer 15

• Life saving
• Will prevent a condition from becoming life-threatening
• Will prevent permanent serious damage

Question 16

What is urgent care?

Answer 16

Care that cannot wait until they can return to their country of residence

Question 17

Do urgent care and immediately necessary care need to be paid for?

Answer 17

No, must be given regardless of ability to pay

Question 18

What charges are free for asylum seekers?

Answer 18

• Prescription charges
• NHS dental care
• Eye tests + glasses
• Schooling and school meals for their children