APPENDIX 1
Memorandum by the Medical Foundation for
the Care of Victims of Torture (HA2)
NEW DEVELOPMENTS
IN HIV/AIDS AND
SEXUAL HEALTH
POLICY
— The Medical Foundation for the Care
of Victims of Torture (the "Medical Foundation") is
a human rights organisation that works with survivors of torture
and organised violence, providing them with a range of psychological,
medical and rehabilitative services.
— The majority of Medical Foundation
clients are asylum seekers and refugees. However, increasingly
the Medical Foundation is seeing its clients not being granted
international protection, even though they are survivors of torture.
— A significant proportion of Medical
Foundation clients (men and women) are survivors of rape and other
forms of sexual violence. This year the Medical Foundation published
"Rape as a Method of Torture", a book written by a multidisciplinary
team from the Medical Foundation, which reflects on significant
clinical experience working with victims of persecution which
has included rape. It includes a chapter on sexually transmitted
infections as a consequence of rape.
THE CONSEQUENCES
OF THE
NEW AND
PROPOSED CHANGES
IN CHARGES
FOR OVERSEAS
PATIENTS WITH
REGARD TO
ACCESS TO
HIV/AIDS SERVICES
1. In its response to the Department of
Health Consultation on proposals to exclude overseas visitors
from eligibility to free NHS primary medical services, Medical
Foundation noted its concern that HIV/AIDS treatment was not exempt.
2. The Medical Foundation does not believe
that restricting access to free HIV/AIDS treatment will reduce
the number of people claiming asylum in the UK. There is no good
evidence base to suggest that asylum seekers are "health
tourists"; often they are fleeing civil war, political persecution,
torture and other extreme stressors. The inclusion of asylum seekers
of any category (including those whose claims have failed) is
not a sensible step in combating "health tourism", but
rather will exacerbate the hardship for an already vulnerable
group.
3. The Medical Foundation does not believe
that a policy where patients can be tested, but not treated, for
HIV/AIDS is an ethical, safe (in terms of public health) or logical
one. Clients are unlikely to deem testing for HIV acceptable if
there is no realistic hope of treatment (based on their experiences
in their countries of origin where a diagnosis of HIV equates
to a death sentence because of the lack of available treatment).
Without knowledge of their HIV status they may not make changes
in behaviour which would prevent onward transmission.
4. Medical Foundation believes that as far
as possible the management of HIV, other sexually transmitted
infections and TB must be integrated, accessible and delivered
by methods designed to minimise stigmatisation of this patient
group. It further believes that access to free primary care has
a key role to play in identification and referral of patients
at risk.
5. Medical Foundation regularly treats women
who have conceived through rape, who may also be HIV positive
(either through rape or otherwise). It is Medical Foundation's
strong belief that pregnant women must be offered free HIV care
in order to minimise the risk of vertical transmission to the
child.
RECOMMENDATION
6. Asylum seekers of any category should
be entitled to free treatment for HIV/AIDS. The Medical Foundation
does not believe that those who come to the UK to claim protection
from persecution in their countries of origin are so called "health
tourists". As a group they already face significant barriers
to accessing health care, and (by nature of government restrictions
not allowing them to work in the UK) are without the means to
pay for treatment.
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