Trouble expressing themselves, not understanding the service or their own illegal status… These are just some of the reasons for the low hospital and clinic attendance of Latinos.
“One in every five Latin Americans has never visited a general practitioner (GP)” – this is just one of the conclusions drawn by “Invisible No More”, a study analysing the situation of the Latin American community living in the UK.
The report, prepared by Professor Cathy McIlwaine and Juan Camilo Cock, a member of the Migrant’s Rights Network, delves into the reality of an ethnic minority completely ignorant to the ways in which the British health system operates.
“It would be troubling if the EU passed Spain’s plans to limit undocumented immigrants’ access to health care, because the UK could mimic this action.”
Cock says that “The NHS is the pride of society. People would like it to be a public, universal, free service. Changing this to make it a restricted service goes against the very values upon which it was founded.”
He clarifies that the way in which the health service operates “creates confusion” among Latin American immigrants.
Why are Latinos making such little use of medical services in the UK?
20% of Latin Americans have never been to a GP, otherwise known as the gateway to the health system. This is a very high figure. Care is universal here, and in order to access said care, all you need to do is pre-register.
A profile of those who have never gone to the doctor has been established: 45% of those had an official immigrant status and 55% had an unofficial status.
One of the reasons for the low attendance is this lack of legal immigration status, although it is not the only reason. Many Latino immigrants are young, in good health, and have only recently arrived in the country.
There appears to be a lack of information about how the health service works. The Latin American people have a habit of going to the doctor the day they are actually sick, whereas here people go as soon as they experience any symptoms.
What affects both the unofficial status and access to the system?
In theory, their immigrant status shouldn’t be a barrier, but this is how it ends up in practice. This is partly because there are doctors who mistakenly ask for papers to register people in their system, and partly because people incorrectly assume that they cannot use the NHS.
These kinds of attitudes can lead to serious health complications. There are those who are afraid to be identified, and only go to the NHS when their condition is serious. I’ve known pregnant women who have miscarried and TB cases which have worsened. There are mixed messages in the migrant community. Another problem is the degree of dissatisfaction with the way in which the system operates. Treatment of health issues starts within the communities, where qualified doctors offer their services legitimately. However, there are also cases where unqualified individuals work illegally, not to mention those who bring drugs without a prescription into their home countries and sell them.
Many Latin Americans live in the UK, and about 40% of them have attended private practices.
Many people feel uncomfortable with the British health system. In many Latin American countries, people go directly to the specialist. Here, you have to go to a GP first, who then refers you to the specialist, but this takes time, creates dissatisfaction and the patients can’t understand it.
Some people prefer to pay for their health care. Some look for Latin American doctors because of language barriers, others because they want a specialist’s prognosis directly. Another thing we’ve found is that many people are looking for treatment in their country of origin. When they take a trip, they want to take advantage of it and get a check-up – they even schedule their trips accordingly.
What can we do to make the health service more open to immigrants?
We need to publicise how the NHS works. We need to let people know that it is universal and caters to everyone, although you need to register prior to becoming ill. People need to understand that the service is divided into primary and secondary care, and in order to access the latter, you must first visit a doctor, who then determines whether you need to see a specialist. This would avoid all the frustration. Another message we should make clear is that there are no barriers when it comes to health, all you have to provide is proof of identification and residence, not your immigration status.
What role do partner organisations play in health issues?
Immigrant associations in particular are trying to spread a healthy lifestyle amongst the immigrant community, as well as projects supported by the NHS itself. We also provide advice and support to many individuals who have had troubling registering. We provide an interpreting and translation service, although these people need to be qualified, able to deal with confidential issues and know the medical jargon.
Economically, what does health mean for immigrants?
The NHS is built on the principle that healthcare is free when people need to use it, although there are cases when payments is required for specialised treatments. If you have no means of paying, some funding is available to access treatments urgently required for health reasons. However, one problem is that those who receive the funding cannot afford it. If it’s more than £1000, it affects any immigration applications made, for example, you may be unable to change your visa, or reapply for entry into a country.
How do austerity measures affect the health service for immigrants?
The Government is currently revising the system, making access more difficult, even for Europeans. There are many people who think and argue that the NHS is spending a lot of money on people who have no right to be heard. We believe that immigrants contribute more to the system than they take out.
What could happen is that they start to charge for services in the primary zone. Anyone settled here is a national responsibility. The question becomes at what point a person is considered a resident or not. The requirements will become stricter, which will hurt immigrants. The idea is to end health tourism, and restrictions are being made to curb this activity, which will certainly affect any undocumented immigrants.
If a doctor refuses to register a citizen, who can they turn to?
There are so-called PALS, a kind of citizen group monitoring the operation of the health service and defending people in this kind of situation. Patients may also request in writing the reasons why they have not been registered to the service.
(Translated by Marie-Thérèse Slorach – Email: firstname.lastname@example.org)