Why does access to healthcare matter?

Access to healthcare is one of our basic rights – we all accept that we cannot thrive unless our health needs are addressed and treated. Issues relatively trivial, like toothache, can have a profound impact on our health and well-being if they go untreated.

This is particularly important for refugees and people seeking asylum who have experienced unimaginable horrors on their route to seeking safety in the UK and often rely on access to health services to rebuild their lives here.

Providing holistic support to our clients has always been at the heart of our work. An important element includes providing our clients with support in relation to their health needs. As such, we have been one of the pioneers within the refugee sector, providing specialist mental health support to our clients, through our Therapeutic Service. Additionally, many of our clients present with complex health needs, however, they find it challenging to access health services and understand how the NHS works. We have set up a Health Access to Refugees Programme (HARP) project to empower people we work with to access the UK health system while also ensuring health services are better equipped to support them.

Barriers with access and need for action

Unfortunately, too often refugees face barriers to accessing even basic health services. There is, therefore, an urgent need for better provisions and cooperation between health professionals and relevant government departments so that those gaps are understood and addressed.

We know, through our direct work with people seeking asylum, that the asylum support model creates a degree of uncertainty and distress, and that people find it extremely challenging to access health services. They are often wrongly refused access to primary care, like GP registration, as well as routinely refused interpreting by GPs, dentists or even at the hospitals, even when this is essential to an understanding of their health problems. The Covid-19 pandemic highlighted these and additional issues which our clients are facing when they require health assistance. Many of them are digitally excluded, don’t have mobile phones (of if they do, they cannot afford top-up credit) or access to the internet which are instrumental in accessing health services and information, especially during lockdowns.

Although refugees have access to the mainstream health and support systems, they are often incorrectly refused secondary healthcare or are asked to pay upfront for assistance that is not urgent and immediately necessary. This often happens when the administration and medical staff are not familiar with refugees’ rights and treat them as foreign visitors. Many of our female clients, who are pregnant, would not access antenatal care and eventually present themselves at the point of delivery. This is because they fear they will be charged or even detained and deported if they engage with health services, which they see as an extension of the work of the Home Office, tasked to blindly enforce immigration controls.

On top of the above issues, both refugees as well as people seeking asylum, face the consequences of the government’s policy of hostile environment, which cascades to the health sector. Many of our clients are traumatised by their past experiences, some even experienced abuse and torture at the hands of medical professionals in their home country. It is, therefore, not surprising that they are already reluctant to approach health professionals. The current governmental approach goes against their agenda to level up and improve populations’ overall health and well-being.

It is vital that access to health is free from immigration control and that there is a firewall between the Department of Health and Social Services and the Home Office on issues like patient data sharing. Harmful and populist rhetoric has a ripple effect, targeting refugees and people seeking asylum but also putting each one of us at risk when we look at this issue from a wider lens. We are living in a society with growing health inequalities and, as the experience of the pandemic proved already, we cannot afford to ignore the health needs of anyone in our society if we are truly all in this together.

How we address health inequalities

We know that providing health support through our service delivery is one of the ways in which we can assist our clients to have better health outcomes and make it easier for them to integrate. Our frontline experience and hearing directly from our clients allow us to identify and address those emerging issues through our advocacy and policy work.

We have worked on a range of resources that we hope are going to be useful to our clients, health professionals, NGO stakeholders and decision-makers in understanding barriers and seeking solutions so that refugees and people seeking asylum can access health support when they need it.

1. Refugee Council’s policy note on health barriers – outlines the main issues our clients are experiencing when they access health services, including issues arising in the course of the Covid-19 pandemic. PDF version.
2. Therapeutic IAHC Communication Card – a double-sided card with useful vocabulary and phrases with translations. It can be used to speed up and clarify communication about health problems with the doctor, nurse, reception staff, in the hospital, with people who work in supporting organisations and to members of the public; translated to five languages: Albanian, Arabic, Dari, Farsi, Tigrinya.
3. Maternity guide for women on asylum support. Print version | PDF version.
4. Maternity guide for professionals. PDF version.
5. Films – we have produced five video films to share learning and good practice based on our experience of delivering the HARP project:

• Film 1 – It is different over here: access to healthcare in the UK.
• Film 2 – Experiencing the asylum process in the UK and impact on health.
• Film 3 – Access to health for people seeking protection in the UK.
• Film 4 – The right to be understood: the importance of interpreting.
• Film 5 – Experts by Experience.

You can also view all the videos in our video hub: HARP video resources: accessing healthcare in the UK.

We like to thank the talented filmmaker, Pishdaad Monderessi, and Stand and Be Counted Theatre Company for making it possible to create those films.

Please refer to our resource and policy pages for more information.