My mission statement

The times we are working in now need a great deal of accelerated change and there must be no negotiating that down. So my mission statement for this part of my consultancy career is to be clear that there needs to be and will be a lot of change from the work that I do with individuals and organisations and if organisations don’t want that, then it is probably best to go somewhere else.

Read my statement in full »

Migrant Health Care

Filed Under (Health Improvement, Migrant Health Care) by Paul on 30-09-2011

Last Friday I spoke at a conference organised by the Migrant Rights Network on the subject of migrant access to health care. I was asked to run a session on the role that the new clinical commissioning groups have in improving that access.

My argument was based partly on how the Health and Social Care Bill is framed at the moment – that is a duty of the clinical commissioning group to the population covered by their geographical boundaries, and not just their registered population. In many parts of the country this duty must lead CCGs to seek out the hard to reach groups in their localities to ensure that the CCG is commissioning care for them and not just for a part of their population.

The argument for active commissioning of primary and other early care for migrants is also an economic one. Failure to seek out and provide early care will only lead to the need to provision more expensive care later on down the patient’s disease pathway.

It was an interesting group and once more showed how NHS professionals could develop new forms of organisation of care to meet new populations’ needs.

Because I have lived in London most of my life and in the 1980s worked for pan-London organisations such as the Greater London Council (GLC), the Inner London Education Authority (ILEA) and from 2007-9 the London SHA, the issue of diversity of public services is, for me, a vital one.

Since the Italian migration to London under Julius Caesar, the variety of migrants to the capital has made a major contribution to creating a thriving city, and in the last 20 years the range of migrants from across the world has become even more diverse.

This creates medical problems in particular for general practice, but also for the NHS in general. It is often the case that a patient from a location that is entirely new to the GP will walk into a practice. There will be epidemiological and cultural issues that will be unknown to the GP, and whilst we might expect a GP to be on top of those issues for a number of parts of the world, it is simply not possible to have all world health knowledge at your fingertips.

Of course the internet can give you access to a lot of information but in the 10 minutes you have with your patient it’s not an easy task to trawl through it all. So I have been hoping that someone would come up with a site that would help improve this situation.

And last Friday such a site was brought to my attention and now, in return, I want to bring it to the attention of as many people as possible.

The Health Protection Agency has created a free online resource that is aimed at assisting primary care practitioners to look after people who come to this country from all over the world. It is organised on a country by country basis and outlines a range of health issues that might affect someone coming from each, and identifies which of their needs would be different from someone born in the UK. It also provides practical guidance and resources to assess and manage a wide range of health needs and has been developed in consultation with the RCGP and the RCN.

You can find it at

Please tell others.

Leave a Reply