James Clark on health provision for asylum seekers

James Clark The person I was speaking to turned to me with tears in her eyes and whispered, in her broken English: “I’m scared. I been scared for so long.”

I had never counted myself among those who read the Daily Mail, but knew so little about asylum seekers that my views had long been distorted by the headlines that pervade the national consciousness. “Bombers are all spongeing asylum seekers” the Daily Express proclaimed on its front page back in 2005 – no wonder I was worried about telling my mum that my upcoming four week project  on refugee and asylum health.

The realities of seeking asylum in the UK are not reflected in the tabloids – people are dispersed around the country, often detained in centres with minimal monetary support and no right to work, all of which contribute to the significantly higher levels of mental health problems, already hugely impacted by the trauma of being uprooted and persecuted in their home countries.

Approximately 3 in 4 applications for asylum are denied and, although many will return home, some are told they cannot do so. They are left very much in limbo, with no support apart from that offered by friends.

Asylum seekers, including those whose claims or appeals are being processed, are currently guaranteed health care, but failed asylum seekers have minimal access, unless they are in urgent need of care. Current guidance to the health care profession in England is equivocal, and leaves many doctors in the unenviable position of being forced to make political rather than health care related decisions.

It also lacks much evidence in its formation, even one of its central tenets – as a supposed means of preventing “health tourism” – has been described as lacking in supporting data in 2005.

The lady I was speaking to during my project had had her claim for asylum rejected three months previously. Having fled her country following persecution of her ethnic group, including abuse and rape, she endured a traumatic journey organised by a family friend and claimed asylum in the UK.

She was forced to relive her story many times over for immigration officials and has been told that, not only can she receive no support here, she cannot return home. She is destitute, has been staying with friends and seems without hope. In all that time she has not once felt safe, due to the uncertainty of life in the asylum system. She is not eligible for any but emergency healthcare provision; a poor state of affairs for the sixth richest country in the world, and supposedly one of the most ethically aware.

The health minister for Wales made clear last year that all asylum seekers including those who have failed to attain refugee status will have access to free healthcare whilst still in the country; though it did take the case of cancer patient Ama Sumani for doctors to push politicians to such a measure – will it take another such tragedy for the NHS in England to fall into line?

James Clark is a second year medical student at Liverpool University.