title: Access to primary health care services by community-based asylum seekers.
abstract: OBJECTIVE
  To determine whether community-based asylum seekers experience difficulty in gaining access to primary health care services, and to determine the impact of any difficulties described.
  
  
  METHODS
  Qualitative study using semi-structured interviews between September and November 2010. Participants were community-based asylum seekers who attended the Asylum Seekers Centre of New South Wales, and health care practitioners and staff from the Asylum Seekers Centre and the NSW Refugee Health Service.
  
  
  RESULTS
  We interviewed 12 asylum seekers, three nurses, one general practitioner and one manager. Asylum seekers' responses revealed that their access to primary health care was limited by a range of barriers including Medicare ineligibility, health care costs and the effects of social, financial and psychological stress. Limited access contributed to physical suffering and stress in affected asylum seekers. Participants providing care noted some improvement in access after recent government policy changes. However, they noted inadequate access to general practitioners, and dental, mental health and maternity care, and had difficulty negotiating pro-bono services. Both groups commented on the low availability of interpreters.
  
  
  CONCLUSIONS
  Access to primary health care in Australia for community-based asylum seekers remains limited, and this has a negative effect on their physical and mental health. Further action is needed to improve the affordability of health care and to increase the provision of support services to community-based asylum seekers; extending Medicare eligibility would be one way of achieving this.
authors.affiliation: Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW.
authors.forename: Erin A
authors.initials: EA
authors.lastname: Spike
authors.forename: Mitchell M
authors.initials: MM
authors.lastname: Smith
authors.forename: Mark F
authors.initials: MF
authors.lastname: Harris
mesh_terms: D000328:Adult; D003144:Communication Barriers; D003149:Community Dentistry / Q000458:organization & administration; D003153:Community Health Services / Q000458:organization & administration; D003695:Delivery of Health Care / Q000458:organization & administration*; D054242:Emigrants and Immigrants; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006301:Health Services Needs and Demand / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration; D009517:New South Wales; D011320:Primary Health Care / Q000458:organization & administration*; D012036:Refugees