Refugees, asylum seekers and migrants reported higher levels of bad health and inadequate housing during pandemic
Doctors of the World UK (DOTW UK) and the University of Birmingham on Tuesday released a report on the barriers migrants faced accessing healthcare in the UK during the Covid-19 pandemic.
The 20-page report, which was funded by the Nuffield Foundation, is available to read here.
It examines the wellbeing of vulnerable migrants during the early months of the pandemic (from March to September 2020) and explores the characteristics of individuals at risk of vulnerability during that period.
DOTW UK is a medical charity providing healthcare and advice to excluded people such as destitute migrants. The data used in the report comes from service user data collected by DOTW UK from their London-based clinic.
The report found the following key differences when comparing the pre-pandemic and pandemic periods:
• The number of average monthly consultations held by DOTW UK dropped from 170 to 50 after the move to a telephone based service.
• Service users were much more likely to find themselves in inadequate housing.
• A greater number of service users had some form of health coverage but still found it difficult to access care.
• The percentage of undocumented service users decreased while the percentage of asylum seekers increased (potentially due to more asylum seekers living in contracted/hotel accommodation).
• There was a significant increase in service users reporting 'bad' or 'very bad' health.
DOTW UK added that many service users reported barriers to accessing healthcare and requested help to register with a GP. Help with GP registration was found to be the most common reason why people approached DOTW UK for a consultation during the period under study.
The report notes: "Compared to the period right before the pandemic, and consistent with previous years, GP registration is the main reason mentioned for consultation. The percentage of GP registration was at 86.7% before, and 76.4% during, the pandemic. During the pandemic, the percentages of GP registration are 77.27%, 86.02%, and 61.9% from undocumented, asylum and others. Before the pandemic, the percentages are 89.61%, 88.46%, and 78.05%."
Anna Miller, Head of Policy and Advocacy at DOTW UK, said the report makes for stark reading and shows just how difficult the pandemic has been for people with insecure immigration status.
Professor Jenny Phillimore of the University of Birmingham said: "Our analysis clearly indicates that the shift from face to face to virtual or phone services risks excluding the most vulnerable migrants. We are also concerned about the increase in numbers of asylum seekers accessing the service – this demonstrates, as several organisations have suggested, that the accommodating asylum seekers in hotels makes access to much needed healthcare services difficult."
The report makes a number of policy recommendations, including increasing migrants and practitioners knowledge of the healthcare system, especially of the NHS charging regulations and exceptions.
DOTW UK noted: "Undocumented migrants are subject to the NHS Overseas Visitor Charging Policy. However due to the complexity of the regulations confusion around eligibility exists on the part of service providers and other migrant groups. The fear of unaffordable bills and data sharing by the NHS with the Home Office deters many migrants at risk of vulnerability from accessing healthcare. While COVID-19 diagnostic tests and treatment are exempt from the NHS Overseas Visitor Charging policy this is not widely known and fear persists amongst some migrant communities."