Listen to Resonance FM's report about Project:London.
The major barriers to healthcare access we found were:
Lack of information - Some people do not know how to access NHS services. For new migrants, for example, who already have to adapt to a new culture and language, information in their own language is necessary to understand how the NHS works and how to register with a GP. Similarly, some are not clear about their rights to NHS treatment and some NHS staff are unclear about entitlements to healthcare. People with an uncertain immigration status may be afraid of any contact with official authorities, including the NHS.
Lack of communication - Good communication is vital to effective primary care. This communication can be hampered by a difference in language or culture. There can also be problems when there is a clash of agendas which can happen with homeless people, drug users or sex workers. These groups have complex health needs and a chaotic lifestyle which is not always compatible with over-worked and over-burdened health services.
Legal obstacles - At the beginning of the needs assessment, anyone who had been residing, legally or not, for a year or more in the UK was entitled to secondary care treatment. Since April 2004, only legal residency is now taken into consideration. Further moves have been proposed to restrict primary care in the same way. This will exclude a larger group of people from accessing healthcare.
Organisational barriers - there is a shortage of GPs and other primary care services. Additionally, organisational barriers can include a lack of appropriate services available in a place or at a time which is suitable. Some GP surgeries, for example, are said to refuse to register people who do not have a fixed address within their catchment area. This presents a problem for people without a fixed address.
TARGET POPULATIONS
Doctors of the World UK has identified three vulnerable groups who have difficulty accessing healthcare.
Vulnerable migrants - The target populations include refugees, asylum seekers, vulnerable migrants and other newcomers.
Rough sleepers - 'Hidden' homeless who live in extremely vulnerable conditions and who often experience drug/alcohol addiction and mental health problems.
Street sex workers - Women who are socially vulnerable because of their drug problems, homelessness and their chaotic life. They also have additional health needs because of the work they do - as a result of sexually transmitted infections or the psychological or physical violence they are subjected to.
