Migration and the Media: the effect on healthcare access for asylum seekers and refugees

Problem

In Scotland asylum seekers and refugees (ASR) are entitled to free healthcare at all stages of the asylum process, even if asylum is refused. However, whilst there is solid policy regarding this, a subtler discourse of deservingness is found within the public narratives of the mainstream media. Newspapers can be very powerful in forming and informing public opinion about many political and social issues, and migration is no exception. It is theorised that media messages are also internalised by those whom they discuss and may affect feelings of entitlement and deservingness to healthcare. Hence, in this study we explore how discourses in mainstream media affect ASR women’s and healthcare worker’s ideas of deservingness for healthcare.

Approach

A five-year (2008-2013) media analysis examined articles from eight UK newspapers. This period covered multiple important political moments which were mapped out in conjunction with the analysis. The newspapers chosen reflected a range of quality of newspaper, readership and political leanings. Thematic analysis explored the general portrayal of migrants in the media in the first wave of analysis, and reporting around health and migration in the second wave. Qualitative interviews performed with ASR women(n=16) and primary healthcare staff (n=5) then explored how media portrayals affect them. These were analysed using thematic analysis by AM, with support from NB,FM and KOD. Identified themes were then mapped to the theoretical framework of candidacy.

Findings

Migration had a constant presence in the UK media. Politically right-leaning newspapers were more critical of all migration in general and harsher in their reporting; left-leaning newspapers tended to sympathise with ASRs and discuss the contribution of economic migrants. All newspapers tended to have a more positive tone with regards to individual migrants compared to migration as a political issue. Through the systematic repetition of themes in the media ‘truths’ were constructed about migration and migrants. Through the interviews it was found that these truths, often unfair, are internalised by ASR women, affecting their confidence in accessing services and disclosing their asylum status. They also felt confused by the media portrayal of entitlement to healthcare. GPs felt that the media did not affect their care of ASR women but were aware of headlines and felt they influenced the attitudes of other patients.

Consequences

The UK media is very concerned and generally negative in its portrayal of migration. As a result of this ASRs can feel judged, unsure about entitlement and discouraged from disclosing asylum status when accessing healthcare. Whilst the media appears disconnected from everyday clinical practice, it can affect interactions with GPs, other staff and patients. It is important that healthcare staff recognise this. Regular staff training to ensure all know the legislation surrounding entitlement would be valuable.