Thank you for the opportunity to provide comments in response to the National Assembly for Wales Equality, Local Government and Communities Committee inquiry into refugees and asylum seekers in Wales.

 

Public Health Wales welcomes this opportunity to contribute to this important subject, which has clear links to the Well-being of Future Generations (Wales) Act goals, particularly ‘a Globally Responsible Wales’, ‘a More Equal Wales’ and ‘a Wales of Cohesive Communities’.

Please find below our response to the specific points raised by the inquiry.

The pace and effectiveness of the Welsh Government approach to resettling refugees through the UK Government’s Syrian Vulnerable Persons Relocation Scheme (SVPRS)

1.   Public Health Wales wishes to highlight that the sooner refugees and asylum seekers are settled in a country with appropriate support, the better their health and well-being outcomes are likely to be. In addition, we would like to highlight two pieces of work that could support those working in this field:

 

2.   In November 2015, Public Health Wales produced a brief guide for service providers in Wales regarding Screening of New Entrants arriving via the Syrian Vulnerable Persons Relocation Scheme (VPRS). This document provides brief guidance for health boards, local authorities, service providers and clinicians involved with the provision of health care to new entrants to Wales arriving via the Syrian VPRS programme. This guidance provides an overview of the health care needs of new entrants to Wales, but concentrates on those aspects of new entrant health care relating to screening for infectious   diseases and the provision of vaccinations.

 

3.   In January 2016, Public Health Wales’ Primary Care Quality department produced a guide for General Medical Practices (GMPs), which provides advice about access to GMP services from potential patients wishing to register and who are also seeking asylum, or are failed asylum seekers or refugees. It looks at their rights and responsibilities and the medical and social issues that need to be addressed at, and preceding, the point of registration.

 

 

The effectiveness of the Refugee and Asylum Seeker Delivery Plan

4.   The Refugee and Asylum Seeker Delivery Plan refers to the need to ensure relevant training is delivered to professionals in order to better support refugees and asylum seekers in Wales. Training requirements identified cover a number of aspects including barriers, challenging discriminatory practices, female genital mutilation, honour-based violence and forced marriage. It is reassuring to note from the delivery plan that training for key professionals will be funded in order to help them understand particular issues relating to asylum seekers and refugees. We would welcome the development of a national approach to the delivery of this training for NHS staff to cover the diverse and complex needs of asylum seekers and refugees so that professionals are able to identify any issues and support individuals as required.

 

5.   Under ‘Action Area 2: Health, Wellbeing and Social Care’, the plan refers to the development of the ‘Guidance on healthcare provision for asylum seekers and refugees’. This guidance will be aimed at service providers and will raise awareness amongst NHS Wales and other public service staff of the rights and entitlements of asylum seekers and refugees to access mental health services. When considering this, services should be fully equipped to deal with individuals who have experienced significant trauma. They will need to consider how they will support the linguistic, cultural and religious beliefs/needs of people. Service providers will also need to consider how they are able to provide services in a timely manner, especially for those individuals who have experienced trauma and require specialist counselling or other therapies or for those whose mental health has deteriorated due to other factors, for examples those individuals under significant stress when going through the complex and lengthy asylum process. We believe that refugee and asylum seekers should be able to access general mental health and specialist Post Traumatic Stress Disorder (PTSD) services and that those who have experienced torture or organised violence should be able to access specialist mental health services.

 

6.   We believe that it is important that refugees and asylum seekers are provided with accessible information about the healthcare system in Wales, as well as more general healthcare and support information.  There is also a need for this information to be shared with partner agencies that are supporting refugees and asylum seekers so that they are fully informed of available services. 

 

7.   Under Action Area 6: Employment, the documents states that refugees and asylum seekers are:

-          empowered to utilise their skills and knowledge to achieve their full potential as members of Welsh society;

-          have more prospects to engage with volunteering and employment opportunities; experience less unemployment

It may be opportune to consider how public sector bodies can create openings and opportunities to proactively support people in terms of volunteering opportunities, work experience, apprenticeships etc so that individuals can gain the necessary experience and confidence which may enhance their knowledge, life skills and employability.

 

The support and advocacy available to unaccompanied asylum seeking children in Wales.

8.   The Looked After Children (LAC) Steering Group, which links in to the NHS Safeguarding Network, is developing guidance for health professionals regarding Unaccompanied Asylum Seeking Children (UASC) http://howis.wales.nhs.uk/sitesplus/888/document/388106 to aid health professionals undertaking health assessments.

 

9.   We are aware of the Scottish Guardianship Service as an example of good practice. The service works to help young asylum seekers feel supported and empowered throughout their journey whilst their claim is assessed and their status determined. It enables them to access the assistance they need, when they need it and helps them to make informed decisions about their future. On referral, the young person is appointed a guardian, who will represent a point of contact and continuity through their progress through the asylum and immigration system. The guardian is there to make the young person aware of their rights, explain aspects of the asylum and welfare system to them, introduce them to social opportunities and to begin to integrate them into community life.

 

The role and effectiveness of the Welsh Government’s Community Cohesion Delivery Plan in ensuring the integration of refugees and asylum seekers in Welsh communities. 

 

10.        Whilst the Welsh Local Government Association, together with Local Authority and Health Board dispersal areas, and Community Cohesion Co-ordinators are well placed to respond to this point, we note that Community Cohesion Delivery Plan activities appear to be centred around Cardiff. This may be where larger numbers of refugees and asylum seekers are resettled, but it will also be important to ensure that integration of refugees and asylum seekers resettled elsewhere in more remote, rural areas across Wales is similarly facilitated.

 

 

Other comments

 

11.        In addition to the specific points raised by the inquiry, we would like to highlight a briefing produced by Public Health Wales, through its International Health Coordination Centre (IHCC). The IHCC’s briefing on ‘Refugees and Asylum Seekers: Public Health implications for Wales’, published in November 2015 at the height of the European Union’s refugee crisis, provided a focus on the impact the crisis has had in the UK and Wales.

 

12.        We wish to highlight the important links between community cohesion and the Well-being of Future Generations (Wales) Act Wellbeing Plans and also the Strategic Equality Plans, which present opportunities to embed community cohesion issues across key plans and strategies.