The lack of notice and coordination by the Home Office before moving asylum seekers means their health outcomes could be considerably compromised, says Dr Dominik Metz
I’m a GP who looks after 250 asylum seekers at a hotel in Oxford, which opened in November. On Wednesday, I got a text message from a charity saying that 10 of my patients had been notified that they would be moved to the Bibby Stockholm barge in Dorset. I was shocked and immediately concerned about my patients who I know well, as the barge is completely unfit for the intended purpose.
I went through all of their medical notes and that’s when I saw that one patient had latent TB. As he was midway through his treatment, moving him without sufficient notice could interrupt it given that it is administered one course at a time in secondary care. And if his treatment is interrupted, it could have adverse outcomes, which include him developing pulmonary TB or multidrug-resistant TB.
Meanwhile, a second patient was waiting for an urgent operation – which will now be blown out of the water with potential lifelong implications – and a third patient has been on a waiting list for specialist psychotherapy for around six months and was finally getting nearer the front of the wait list.
Sadly, there has been a continuous problem with patients being moved from one place to another without notice. When patients moved into the hotel, many had pre-existing health conditions but because they came from all over the country, they were under secondary care in different places, which could be potentially dangerous.
One of our patients, who had been living in an accommodation centre in Manchester, was diagnosed with cancer. There was a huge delay in getting him back into secondary care from our side because there was no transfer of his medical records, and this essentially delayed his cancer management by months. We also had two patients with symptoms of pulmonary TB, and moving them into cramped conditions has significant public health risks.
The challenges of caring for asylum seekers
As GPs, it can be difficult for us to organise care for asylum seekers as we’re not aware of all their health conditions. At least half the time, there’s a delay in the transfer of their medical records. The NHS numbers often don’t match up. And because of language barriers and first registrations, they often have multiple medical notes, and the data is slightly different. We might never have their records and details about where they’ve been previously as they’ve never been able to locate them.
Also, when the hotel first opened, 250 patients all presented at the same time, and it took weeks if not months to see each individual. There has therefore been a delay in seeing people about a medical problem that is often pre-existing, and when you finally come about something that is already under secondary care in a different area and refer them here, they go back to the back of the wait list.
These patients will usually have multiple mental health needs: around 30% will have PTSD, with increased depression and psychotic disorders. But then there are also undiagnosed chronic diseases and increased infectious diseases. Around 20% of our patients test positive for TB, and although most of them have latent TB and are not infectious, they still need treatment and follow-up in secondary care. If we move patients around without notice and coordination, we will likely see infectious disease outbreaks like the one at my hotel where there was a scabies outbreak. Asylum seekers have already been moved off the Bibby Stockholm barge after traces of Legionella bacteria was found in the water.
Now, if you look at what the National Farmers Union says about livestock and compare the rights that asylum seekers have with what livestock in transport have, it’s shocking. When livestock are being transported, they have rights – they have sickness passports and they have to be fit to travel – but asylum seekers don’t.
There are, of course, conditions where it’s appropriate for people to move. For example, we sometimes support people to move back to the areas they have been dispersed from if their families are there. But on the whole, continuously moving people from one place to another is having a huge impact on their physical and mental wellbeing – and that has a huge knock-on effect on the NHS.
Although the Home Office cannot access medical records, I think they should consult with a medical professional before moving anyone to check if they are fit to travel. Otherwise, the potential negative health outcomes could be huge.
Dr Dominik Metz is GP in Oxford and lead GP clinical mentor for the Oxford Refugee Health Initiative
The fact that it is a barge is not a problem (well, not so long as you don’t get seasick!)
The fact that it is in (or near) Dorset, is not a problem.
Hotels sometimes have Legionaires too; and may spread TB – they certainly spread covid!
But moving asylum seekers around the country several times while taking ages to process their applications – That IS a problem.
Once they have been accomodated, barring any emergencies, they should not be moved about, because it interrupts their processing and medical and social care.
It makes the process more costly, more complicated, more prolonged, and more traumatic.
But it also costs more, so you would think Government would leave them put once they are somewhere, and get on with processing their applications and other necessities.
Asylum seekers? From France? The French can be pretty bloody rude, but seriously?
Dr Metz, huge respect, but please keep quiet, at least until you have some understanding of what is happening, from your”clinical leadership” position. Is Bibby Stockholm as dangerous as where these “asylum seekers” come from? Seen enough of them to know most are economic migrants.
What a joke. Apparently moving (them) within this little island is so horrible. You won’t believe: these young men have managed to cross few continents and oceans to be here. And their fear of water didn’t stop them until they saw this barge.
Yep Dr Metz, see where you are coming from, equally though, hope you can see the other side of the coin!
Some of these comments I find to be offensive and have been reported. I have no issue with opposing views however please be mindful to not be inflammatory. I will not accept such vile speech on a public forum amongst doctors. Please feel free to print your name ,like I have, rather than hiding behind a pseudonym. Some of the best doctors that have trained me in the past were former refugees and migrants. I am forever thankful to them.
many GP’s are moving to Australia and the Middle east in search of better pay and conditions. They are also economic migrants. We are not even having bombs and gunfire thrown at us yet many of our colleagues are leaving in their droves.
with regards to moving within the island, this is what the junior doctors are complaining about with regards to their rotations. we feel for them and support them, do we not.
This could happen to any one at any point. Syria and damascus used to be a holiday destination. Kiev was a city break holiday destination. The world is incredibly fragile.
https://www.unhcr.org/uk/what-we-do/reports-and-publications/unhcr-data
https://www.redcross.org.uk/about-us/what-we-do/how-we-support-refugees/find-out-about-refugees
please read these reports. They are sobering and provide context. The major push for asylum is on the surrounding countries to conflict that are not in themselves the strongest position to deal with the issues that are affecting their region. 74% of asylum seekers are hosted in low to middle income countries.
I am very proud of the great work that we do in the UK in terms of accepting people from different cultures into the country and welcoming them into our society and be a part of our shared national identity.
We show all of our patients our kindness in Primary care and in Secondary care and we advocate for all of them. Dr Metz thank you for your amazing work!! you are a legend!!
Here we go. A click bait article. Just waiting for the accusations of racism/ xenophobia by the promoters of illegal migration.
Well said Nasir
I would encourage people to watch “The Swimmers” on Netflix to show how tough it is for these people and it really is last resort
Second that, Dr Nasir. I’d rather have an asylum hotel next door than live next to Lee Anderson or any of his far right fellow travellers. Jenrick, Swella and Anderson, y’all can Fuck Off too, thankyou.
In under utilised accommodation where the taps have not been run for a while there is a risk of Legionella. Advice used to be to run the taps for a few mins after periods of being unoccupied.
Very hard to eradicate so have to look at control measures such as temperature of hot and cold supplies, etc.
Does produce as many clicks or newspaper sales as a sensationalised story to suit whichever political agenda…..
Not sure why it is offensive for someone to point out that travelling across the channel from Europe to UK is not really “escaping danger”. Would seem simply objectionable to another individuals political beliefs.
Regardless it was the type of story that invites polarised viewpoints.
Nasir – “I will not accept such vile speech on a public forum amongst doctors. ” – not sure you understand free speech.
“many GP’s are moving to Australia and the Middle east in search of better pay and conditions. They are also economic migrants.” – The difference is that they don’t expect Australians and Middle Easterners to pay for them. And doctors have skills to offer. Do all of the “asylum seekers” have that? And if their applications are rejected, are they removed from the country?
“74% of asylum seekers are hosted in low to middle income countries.” – Do you think we’re rich? Do you understand debt, deficit, inflation, any economics at all?
Dr No – ” I’d rather have an asylum hotel next door than live next to Lee Anderson or any of his far right fellow travellers.” – Well, you could go to where the “asylum seekers” come from then? Being against illegal immigration is now far right is it?
Shaba – “it really is last resort” – Doesn’t mean you want to encourage them to take a life-threatening journey (by accepting them), does it?