Improving health outcomes for refugees and asylum seekers is a key priority for North Western Melbourne PHN, which encompasses areas that have some of the highest settlement of refugees and asylum seekers in Victoria.
Refugees and asylum seekers may be highly vulnerable, and often have complex health needs. We want this community to easily access high quality primary health care. Our aim as a PHN is to support health care providers to identify this community, understand their needs, and provide timely, culturally-appropriate, evidence-based health care.
What is the definition of a refugee?
The United Nations High Commissioner for Refugees (UNHCR) definition of a refugee is a person who: owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to avail himself of the protection of that country. Source: Article 1, The 1951 Convention Relating to the Status of Refugees (.pdf, 477kb).
What is the definition of an asylum seeker?
An asylum seeker is a person who has left their country of origin, has applied for recognition as a refugee in another country, and is awaiting a decision on their application.
Access to healthcare for refugees and asylum seekers
The system for refugees and asylum seekers can be very complex. Read more in our Service mapping of refugee and asylum seeker health and humanitarian settlement services document.
All have work rights, and access to Medicare – they can therefore be seen by any general practice. Their health care can be billed, like any other patient, under Medicare. They will likely have had support to register with Medicare and get a Medicare card.
Depending on the mode and date of arrival to Australia, the experiences, living arrangements and service eligibility of asylum seekers vary. There are currently around 10,000 asylum seekers living in the community in Victoria. For more information, read the Asylum Seeker Health Information Sheet (.pdf, 106kb) produced by the Victorian Refugee Health Network.
Asylum seeker in a detention centre
Visa status: To be determined Work rights: No Access to healthcare: Not Medicare eligible, Healthcare funded and arranged by IHMS, Can access public hospitals Access to healthcare card: Not eligible Housing: Provided Access to education: Only up to 18 years old Access to legal support and casework: No legal support; can receive case management support from welfare agencies.
Asylum seeker in community detention
Visa status: To be determined Work rights: No Access to healthcare: Not Medicare eligible; Healthcare funded and arranged by IHMS – GPs can apply to IHMS to be a service provider; can access public hospitals Access to healthcare card: Not eligible Housing: Provided Access to education: Only up to 18 years old Access to legal support and casework: No legal support; can receive case management support from welfare agencies.
Asylum seeker on a bridging visa
Eligibility for work and Medicare will vary according to the mode of arrival and the visa that aircraft arrivals had before applying for asylum. The general rule is that if someone has work rights they will have Medicare, but this is not always the case. Visa status: On a bridging visa (temporary) until further determination Work rights: Most have work rights as of 2015 Access to healthcare: Most people will be Medicare eligible – access healthcare like all other Medicare eligible patients. *Note that Bridging Visas are short term and when Visas expire, Medicare Cards also expire. There may be periods where an asylum seeker has an expired Medicare Card due to administrative delays. People without the right to work will often not have access to Medicare. Asylum seekers without Medicare may access state funded health services; asylum seeker health clinics offer limited pro-bono general practice services For more information see the Victorian Refugee Health Network website. Access to healthcare card: Not eligible Housing: Not provided. Some short term support to find private rental housing provided Access to education: Only up to 18 years old Access to legal support and casework: 6 weeks case work – very limited.
Specific pathways written to address the health of refugees and asylum seekers include ‘ Health assessment for refugees and other humanitarian entrants’, ‘Refugee Health in Adults’ , ‘Refugee Health in Children’ and ‘Refugee Health Referrals’. Additionally, there are hundreds of other pathways covering various specific clinical conditions that may be relevant to refugee and asylum seeker populations.
For more information, visit our HealthPathways Melbourne page.
CAREinMIND™ for refugees and asylum seekers
Refugees and asylum seekers, who may receive low/no income, are eligible for CAREinMIND™ free short-term psychological counselling services. Note that a Medicare card is not required – making it useful for asylum seekers who are Medicare ineligible. For more information, and referral information and forms, see the CAREinMIND page. A small number of counselling staff may speak the same language as the refugee or asylum seeker client, though in some cases, an interpreter will need to be used. This will depend upon the location of the client.
Australian Refugee Health Practice Guide
This guide is available online at refugeehealthguide.org.au and can be used by doctors, nurses and other primary care providers to inform on-arrival and ongoing health care for people from refugee backgrounds, including people seeking asylum.
NWMPHN will be distributing printed copies of the guide to general practices in our region. To register your interest email firstname.lastname@example.org.
Contact us to find out more information about Refugee and Asylum Seeker health.
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