Asylum seekers and vulnerable migrants

Failed Asylum Seekers / Vulnerable Migrants and Access to Primary Care

RCGP Position Statement, Updated January 2013

Despite clear statement from the Department of Health [1] and the other bodies [2], there is still considerable misunderstanding at a local level who is eligible to register with a General Practitioner.

General Practice should remain the main access to health care within the NHS.  Based on the principle that General Practitioners have a duty of care to all people seeking healthcare, the Royal College  of General Practitioners believes that General Practitioners should not be expected to police access to healthcare and turn people away when they are at their most vulnerable. [3] Further, it is important to protect individual and public health. [4] All vulnerable migrants, including refugees and asylum seekers, have the right to be fully registered with a NHS general practice. In fact the Department of Health’s Table of Entitlement to NHS Treatment [5] states that asylum seekers are entitled to NHS primary medical services without charge. Note that General Practitioners have the discretion to register refused asylum seekers, to the same extent that they have this discretion to registering any patient, irrespective of residency status  - unless the list is full or the person resides outside the practice boundary.

Practices are not required to check the identity or immigration status of people registering to join their lists. [4] However, there may be practical reasons why General Practitioners might want confirm the identity of prospective patients but they must ensure that requests for identity are asked of all new patients to avoid discrimination. Persons applying for registration cannot be turned down for reasons relating to the applicant’s race, gender, social class, age, religion, sexual orientation, appearance, disability or medical condition.

We advise practices to use their discretion and consider the individual circumstances of each patient who cannot provide documents that they would normally require for registration.

Any person who does not require emergency or immediately necessary treatment and has not been accepted onto a patient list or accepted as a temporary resident; can be directed to contact the appropriate local health body who can advise on what services are available locally.

Note that it is not the responsibility of General Practitioners to make decisions on the eligibility of patients for free NHS hospital care. [4]

1.Guidance on implementing the overseas visitors hospital charging regulations (June 2011) http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_127393
 2.Overseas visitors accessing NHS primary medical services (February 2011) http://www.bma.org.uk/employmentandcontracts/independent_contractors/providing_gp_services/overseasvisitors.jsp

3.World Health Assembly Resolution on Health of Migrants, 2008.
http://apps.who.int/gb/ebwha/pdf_files/A61/A61_R17-en.pdf

4.Access to health care for asylum seekers and refused asylum seekers – guidance for doctors (January 2012)
 http://www.bma.org.uk/ethics/asylum_seekers/accessasylumseekers.jsp

5.The Table can be accessed at: www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_079284.pdf

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