GPs need training and funding in caring for refugees and asylum seekers
http://www.100md.com
《英国医生杂志》
EDITOR—UK asylum seekers and refugees have the same rights to health care as the settled population. None the less, refugees report difficulties accessing health care—for example, in registering with a general practitioner.1 They are also sometimes registered as temporary residents, which is detrimental for continuity of care.2
We sent a postal questionnaire to all 129 general practitioners in Lothian, an area in Scotland with an estimated 3000 refugees. It focused on the need for extra funding for general practices with refugees, the best place for providing primary care services, and the need for training.
Ninety five responses were received (a response rate of 73.6%). The table summarises the results (see bmj.com for more details).3
British general practitioners' experiences, training, behaviour, and views on aspects of care for refugees and asylum seekers
About one third of general practitioners had treated refugees, but few staff had undergone training. Of 82 general practitioners (86%) who had not received training, 17 (21%) wanted training. Nearly one fifth were unsure or incorrect about refugees' entitlement to free NHS treatment. Respondents were divided on whether refugees should be treated at normal practices or by specialist services. Most general practitioners thought that practices with a high caseload of refugees should receive additional funding. Thirty one general practitioners' suggestions on funding per refugee ranged from ￡20-￡1000, with a mean of ￡131 and a median of ￡100.
General practitioners supported extra funding and suggested about ￡100 per refugee; many favoured treating refugees in normal practices, but many had no relevant training. Some were unaware of refugees' NHS entitlements, as has been previously reported.4 To our knowledge, these are the first published data on the views of general practitioners (or their international equivalent) on funding, training, and the place of care for refugee primary healthcare. A need exists to develop approaches to health care in urban centres with varying numbers of refugees.
Srinivasa Vittal Katikireddi, final year medical student
22 Appletree Close, Liverpool L18 9XN S.V.Katikireddi@sms.ed.ac.uk
Raj Bhopal, professor of public health
Public Health Sciences Section, Division of Community Health Sciences, University of Edinburgh, Edinburgh EH8 9AG raj.bhopal@ed.ac.uk
Julia A Quickfall, nurse director
Queen's Nursing Institute Scotland, Edinburgh EH1 2EL
Competing interests: None declared.
We thank Sumra Dar, Scott Murray, Judith Simms, Katie Hacking, Dr K Rao Katikireddi, and Vanisree Katikireddi for their help.
References
Jones D, Gill PS. Refugees and primary care: tackling the inequalities. BMJ 1998;317: 1444-6.
Hargreaves S, Holmes A. Refugees, asylum seekers, and general practice: room for improvement? Br J Gen Pract 2000;43: 531-2.
Katikireddi SV, Bhopal R, Quickfall JA. Experience, behaviour and views of general practitioners in relation to refugees and asylum seekers: a survey in a region with a rising population. Electronic response to: Health care for asylum seekers. bmj.com 2000. bmj.bmjjournals.com/cgi/eletters/321/7265/893#51675 (accessed 18 Mar 2004).
Dar S. General practitioners' knowledge of issues relating to asylum seekers is poor. BMJ 2000;321: 893.
We sent a postal questionnaire to all 129 general practitioners in Lothian, an area in Scotland with an estimated 3000 refugees. It focused on the need for extra funding for general practices with refugees, the best place for providing primary care services, and the need for training.
Ninety five responses were received (a response rate of 73.6%). The table summarises the results (see bmj.com for more details).3
British general practitioners' experiences, training, behaviour, and views on aspects of care for refugees and asylum seekers
About one third of general practitioners had treated refugees, but few staff had undergone training. Of 82 general practitioners (86%) who had not received training, 17 (21%) wanted training. Nearly one fifth were unsure or incorrect about refugees' entitlement to free NHS treatment. Respondents were divided on whether refugees should be treated at normal practices or by specialist services. Most general practitioners thought that practices with a high caseload of refugees should receive additional funding. Thirty one general practitioners' suggestions on funding per refugee ranged from ￡20-￡1000, with a mean of ￡131 and a median of ￡100.
General practitioners supported extra funding and suggested about ￡100 per refugee; many favoured treating refugees in normal practices, but many had no relevant training. Some were unaware of refugees' NHS entitlements, as has been previously reported.4 To our knowledge, these are the first published data on the views of general practitioners (or their international equivalent) on funding, training, and the place of care for refugee primary healthcare. A need exists to develop approaches to health care in urban centres with varying numbers of refugees.
Srinivasa Vittal Katikireddi, final year medical student
22 Appletree Close, Liverpool L18 9XN S.V.Katikireddi@sms.ed.ac.uk
Raj Bhopal, professor of public health
Public Health Sciences Section, Division of Community Health Sciences, University of Edinburgh, Edinburgh EH8 9AG raj.bhopal@ed.ac.uk
Julia A Quickfall, nurse director
Queen's Nursing Institute Scotland, Edinburgh EH1 2EL
Competing interests: None declared.
We thank Sumra Dar, Scott Murray, Judith Simms, Katie Hacking, Dr K Rao Katikireddi, and Vanisree Katikireddi for their help.
References
Jones D, Gill PS. Refugees and primary care: tackling the inequalities. BMJ 1998;317: 1444-6.
Hargreaves S, Holmes A. Refugees, asylum seekers, and general practice: room for improvement? Br J Gen Pract 2000;43: 531-2.
Katikireddi SV, Bhopal R, Quickfall JA. Experience, behaviour and views of general practitioners in relation to refugees and asylum seekers: a survey in a region with a rising population. Electronic response to: Health care for asylum seekers. bmj.com 2000. bmj.bmjjournals.com/cgi/eletters/321/7265/893#51675 (accessed 18 Mar 2004).
Dar S. General practitioners' knowledge of issues relating to asylum seekers is poor. BMJ 2000;321: 893.