Supervisors

Dr Heaven Crawley, Swansea University

Professor Mike Sullivan, Swansea University

Background

 Although there is a presumption that the UK’s National Health Services will be free, the National Health Service Act (1977) gives powers to make charges to those who are not ordinarily resident in the UK. In May 2004, the Welsh National Assembly passed the NHS (Charges to Overseas Visitors) (Amendment) (Wales) Regulations 2004. The regulations are accompanied by Implementing the Overseas Visitors Hospital Charging Regulations: Guidance for NHS Trusts in Wales, updated in August 2005. The 2004 regulations revised the NHS (Charges to Overseas Visitors) Regulations 1989, which apply to England and Wales. The same amendments were made to the Charging Regulations in England in 2004.

The charging regulations place a legal obligation on NHS Trusts in Wales to establish if patients to whom they are providing NHS hospital services are normally resident in the UK. If they are not, then charges may be applicable unless the patient meets one of the exemption categories outlined in the regulations. One of the consequences of the 2004 regulations is that those asylum seekers whose applications have been refused (including those who are unable to return to their home countries) are no longer exempt from NHS charges for hospital treatment. The changes have led to concerns about the ability of asylum seekers to access secondary healthcare in Wales (particularly maternity and HIV services), resulting in unacceptable levels of suffering and hardship amongst some of the most vulnerable people in society and undermining the efforts of the Government to improve overall levels of health. These concerns have been exacerbated by recent plans to limit access to primary healthcare to those with leave to remain in the UK.

Project aims

Although access to secondary healthcare by refused asylum seekers and other immigrants with an irregular immigration status has been the subject of some research (Hogan and Matthews 1999; Montgomery et al 2000; Hargreaves and Holmes 2000), very little is known about the ability of asylum seekers to access healthcare services in Wales or, indeed, the health status of those who arrive (and therefore their needs). To date, the limited amount of research specifically looking at the situation in Wales suggests that asylum seekers have particular unmet health needs, relating to both the access and provision of services, but also to the inequalities in health and service provision for the Welsh population as a whole.

The aim of this project is to better understand the health needs and experiences of asylum seekers in Wales, to explore structural and institutional barriers which limit and/or restrict access to both primary and secondary care services for asylum seekers in Wales and to consider the implications for policy and practice development. The successful applicant will be expected to develop a mixed-method approach to the research, to work closely with refugees and asylum seekers, and to engage with policy makers and practitioners to better understanding the implications of the current approach.

This research project will be based within the Centre for Migration Policy Research (CMPR). The Centre’s mission is to encourage the exchange of ideas about asylum and migration and ensure that policy making is underpinned by empirical evidence about the nature and causes of migration, the impacts on different countries and communities and the effects - both intended and unintended - of policy responses. The project will be undertaken in collaboration with the Welsh Refugee Council (WRC).

Applicant requirements

 The successful candidate will possess at least an Upper Second class degree in Geography or a related social science discipline. Candidates who possess a Masters degree are eligible for +3 funding from the Economic and Social Research Council (ESRC). Preference will be given to applicants who also have policy or practical experience.

Funding

This project is eligible for competitive funding through the ESRC (1+3 or +3 studentship) Other funding opportunities are available and self-funded students are always welcome. Contact your potential supervisor for advice and details of how to apply. The deadline for applications for the ESRC studentship is 12 April 2010 but candidates are advised to contact their potential supervisor well in advance of this date if they wish to enter the ESRC open competition.

Further information

For further information about this project please contact Dr Heaven Crawley (h.crawley@swansea.ac.uk)