Select Committee on Health Written Evidence


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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