GPs need training and funding in caring for refugees and asylum seekers

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

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.