Missing link in vital primary health care

Refugees and migrants are missing out on important health care services across Australia, experts at Flinders University warn.

While Australia has welcomed more than 170,000 refugees in the past 10 years, and almost one-third of the population is born overseas, the new study has found that Primary Health Networks (PHNs) are not able to adequately meet the needs of refugees and new migrants.

This is despite the fact that primary health care services are vital to the health of this group, says Associate Professor Anna Ziersch, from the Southgate Institute for Health, Society and Equity at Flinders, who led the study analysis of 31 Primary Health Networks (PHNs) and 61 Medicare Locals (MLs).

“Particularly in light of generally poorer health status of refugees and migrants, we found much more needs to be done for these groups,” she says.

“Primary Health Networks need long-term investment and organisational stability to build and maintain collaborations with migrant and refugee groups.

“In one part of the study, we found that more than half of the PHNs were not working in migrant and refugee health at all and that only 16% of PHN staff respondents said they had been ‘successful’ or ‘very successful’ in migrant and refugee health.

“Clearly primary health service gaps for both refugees and migrants are not being adequately recognised and met.”

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Language barriers and poor access to interpreters, a limited number of bilingual local doctors (GPs) and health workers, consultation costs and few bulk-billing opportunities, and difficulty navigating the health system are factors confronting refugees and migrants.

As well, major issues of finding housing, social connections, education, employment, and safety (including for people affected by trauma and torture) are other considerations.

Along with workforce capacity and the importance of close collaboration with migrant and refugee communities and organisations, other key recommendations in the report include the need for:
• Prioritisation of migrant and refugee health in population health planning
• More secure and flexible funding models – including funding to work locally to address the social determinants of health – for example, working with other sectors such as housing and education
• Inclusion of migrant and refugee expertise in PHN governance committees

The paper, ‘Regional primary health care organisations and migrant and refugee health: the importance of prioritisation, funding, collaboration and engagement’ (February 2020) by A Ziersch, T Freeman, S Javanparast, T Mackean and F Baum, has been published in the Australian and New Zealand Journal of Public Health.

Associate Professor Anna Ziersch who researches the social determinants of refugee health and wellbeing, and also the links between discrimination and health.
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College of Medicine and Public Health

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