International Journal of Health Policy and Management

International Journal of Health Policy and Management

National Health Service Principles as Experienced by Vulnerable London Migrants in “Austerity Britain”: A Qualitative Study of Rights, Entitlements, and Civil-Society Advocacy

Document Type : Original Article

Authors
Elham Rafighi 1
Shoba Poduval 1
Helena Legido-Quigley 1, 2
Natasha Howard 1
1 Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
2 Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
10.15171/ijhpm.2016.50
Abstract
Background
Recent British National Health Service (NHS) reforms, in response to austerity and alleged ‘health tourism,’ could impose additional barriers to healthcare access for non-European Economic Area (EEA) migrants. This study explores policy reform challenges and implications, using excerpts from the perspectives of non-EEA migrants and health advocates in London.
 
Methods
A qualitative study design was selected. Data were collected through document review and 22 indepth interviews with non-EEA migrants and civil-society organisation representatives. Data were analysed thematically using the NHS principles.
 
Results
The experiences of those ‘vulnerable migrants’ (ie, defined as adult non-EEA asylum-seekers, refugees, undocumented, low-skilled, and trafficked migrants susceptible to marginalised healthcare access) able to access health services were positive, with healthcare professionals generally demonstrating caring attitudes. However, general confusion existed about entitlements due to recent NHS changes, controversy over ‘health tourism,’ and challenges registering for health services or accessing secondary facilities. Factors requiring greater clarity or improvement included accessibility, communication, and clarity on general practitioner (GP) responsibilities and migrant entitlements.
 
Conclusion
Legislation to restrict access to healthcare based on immigration status could further compromise the health of vulnerable individuals in Britain. This study highlights current challenges in health services policy and practice and the role of non-governmental organizations (NGOs) in healthcare advocacy (eg, helping the voices of the most vulnerable reach policy-makers). Thus, it contributes to broadening national discussions and enabling more nuanced interpretation of ongoing global debates on immigration and health.
Keywords
Migrant Health
National Health Service (NHS)
England
London
Austerity
Subjects
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International Journal of Health Policy and Management
Volume 5, Issue 10
2016
Pages 589-597

  • Received Date 17 October 2015
  • Revised Date 29 April 2016
  • Accepted Date 30 April 2016
  • First Published Date 01 October 2016
  • Published Date 01 October 2016