Asylum Seekers and Refugee Health

Question 1

What is a refugee?

Answer 1

A person who owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to avail himself to the protection of that country

Question 2

What is an asylum seeker?

Answer 2

someone who has applied for asylum and is waiting for a decision as to whether or not they are a refugee

Question 3

What support do asylum seekers receive?

What does this terminate?

Answer 3

• entitlement to support based proof of destitution
• initial accommodation
• dispersal on a no choice basis away from London and South East
• Subsidence only or subsistence and accommodation
• Weekly support less than normal benefits
• Entitlement to NHS treatment
• Additional allowances for pregnant women and children under three
• Support terminates after 28 days of a positive decision and 21 days are a negative decision

Question 4

What happens post-asylum decision?

Answer 4

• those granted status, humanitarian protection or discretionary leave able to access employment, welfare and housing as other UK Citizens.
• Lack of support for refugee and integration
• Destitution, desperation and voluntary derparture, deportation - the options for those whose claims are refused
• section 4 support available in limited cases for refused individuals

Question 5

Asylum seekers and entitlement to healthcare

Answer 5

• all individuals who have an ongoing claim for asylum or who receive support from UKVI are entitled to free NHS treatment
• initial accommodation health services and voluntary health assessments
• detention centres - private health provision in these centres
• on dispersal - support and signposting to access GP services
• refused asylum seekers and proposed changes to the NHS visitors charging regulations

Question 6

Content of voluntary initial health assessments

Answer 6

basic demographic questions
health history
symptom screening for TB
baseline measurements, BP, weight, height, urine test
obstetric/sexual health history
brief enquiry about mood and sleeping

Question 7

What are the key issues for health services?

Answer 7

interpretation
confusion of entitlements to healthcare
mobility of this population
expectations of UK health system
access to GP services
limited training on migrating and health
lack of data on migration which feeds into commissioning of services
destitution and its impact on health

Question 8

What are common health issues for asylum seekers and refugees?

Answer 8

mental health issues and experiences of trauma/torture
communicable disease e.g. HIV, TB, Hepatitis
child and maternal health issues - impact of sexual violence, FGM, arrival in late stages of pregnancy
smoking rates in some countries
vitamin D deficiency
high blood pressure and rates of CHD in some countries of migration
mental health issues