Poduval Shoba, Howard Natasha, Jones Lucy, Murwill Phil, McKee Martin, Legido-Quigley Helena
London School of Hygiene & Tropical Medicine Keppel Street London, WC1 United Kingdom.
London School of Hygiene & Tropical Medicine Keppel Street London, WC1 United Kingdom
Int J Health Serv. 2015;45(2):320-33. doi: 10.1177/0020731414568511. Epub 2015 Feb 21.
Immigration is a key political issue in the United Kingdom. The 2014 Immigration Act includes a number of measures intended to reduce net immigration, including removing the right of non-European Economic Area migrants to access free health care. This change risks widening existing health and social inequalities. This study explored the experiences of undocumented migrants trying to access primary care in the United Kingdom, their perspectives on proposed access restrictions, and suggestions for policymakers. Semi-structured interviews were conducted with 16 undocumented migrants and four volunteer staff at a charity clinic in London. Inductive thematic analysis drew out major themes. Many undocumented migrants already faced challenges accessing primary care. None of the migrants interviewed said that they would be able to afford charges to access primary care and most said they would have to wait until they were much more unwell and access care through Accident & Emergency (A&E) services. The consequences of limiting access to primary care, including threats to individual and public health consequences and the additional burden on the National Health Service, need to be fully considered by policymakers. The authors argue that an evidence-based approach would avoid legislation that targets vulnerable groups and provides no obvious economic or societal benefit.
移民是英国的一个关键政治问题。2014年《移民法案》包含一系列旨在减少净移民的措施,其中包括取消非欧洲经济区移民享受免费医疗保健的权利。这一变化可能会加剧现有的健康和社会不平等。本研究探讨了英国无证移民获取初级医疗服务的经历、他们对拟议的获取限制的看法以及对政策制定者的建议。对伦敦一家慈善诊所的16名无证移民和4名志愿者工作人员进行了半结构化访谈。归纳主题分析得出了主要主题。许多无证移民在获取初级医疗服务方面已经面临挑战。接受采访的移民中没有人表示他们能够支付获取初级医疗服务的费用,大多数人表示他们将不得不等到病情严重得多时,通过事故与急救(A&E)服务获取医疗服务。政策制定者需要充分考虑限制获取初级医疗服务的后果,包括对个人和公众健康后果的威胁以及对国民医疗服务体系的额外负担。作者认为,基于证据的方法将避免针对弱势群体且无明显经济或社会效益的立法。