The idea for the conference grew from an ongoing partnership between the Primary Care Department, HSE West, the Department of General Practice, NUI Galway and the Galway Refugee Support Group. The conference provided a forum to showcase examples of participatory approaches in research, service delivery and community health initiatives. Almost one fifth of the 150 delegates were ethnic minority community members, with the remainder drawn from statutory and non-statutory agencies.
Speaking at the launch Diane Nurse of the HSE said: "It is clear that there is a growing awareness at European, national, regional, and local level that people affected by policy decisions have a right to be consulted about issues and decisions that affect their lives. Participation of ethnic minorities is not just an "add on". It is not down to individuals, individual projects or services. It comes through at national, regional and local level. It is informed and mandated by policy at government and organisational level. It is supported by a range of approaches including community development which has a lot to teach us in terms of participation. There are many examples to build upon and learn from. Participation strengthens and improves service for all of us. "
The report identifies four key areas which featured strongly in presentations and group discussions and which conference delegates felt warranted particular consideration in the forthcoming National Intercultural Health Strategy and the implementation of the strategy thereafter.
1. GP services are the first point of contact with the health services for asylum seekers and ethnic minority communities. At this time many ethnic minority community members are having difficulty in general practice. Key recommendations are to improve the systems by which an asylum seeker 'finds' a GP and is 'accepted' on a GP list as a GMS patient. GP services need to be culturally appropriate with supports in place for both GP and patient (e.g. interpretation services and cultural competence training).
2. The mental health of asylum seekers is a cause for concern. For asylum seekers, mental health issues arising from experiences in their home countries are being compounded by experiences of direct provision accommodation and the prohibition on the right to work. Existing support services are either centrally based (i.e. Dublin), under resourced (e.g. Galway Rape Crisis Centre) or not always appropriate to the needs of individuals (e.g. psychiatric services for people requiring psychological services and supports). Appropriate psychological services should be in place around the country.
3. Language is a major barrier to effective healthcare for people from ethnic minority communities who have limited English. The main recommendation is for the development of a national interpretation service, staffed by trained interpreters and subject to on-going monitoring and evaluation. In addition, health information should be made available in a range of languages and individuals should be supported to attend English language classes as a longer term strategy.
4. Participatory approaches are strongly recommended as a suitable way of working for the development of culturally appropriate primary care services. The GMS modernization programme, training for GPs and other healthcare staff, and the development of an accredited and regulated interpretation service were just some of the service developments that would benefit from the 'voice' and 'expertise' of ethnic minority communities.
At the same time, it was recommended that participatory approaches are developed and monitored in a critical manner. This report of conference proceedings has been sent to the HSE Social Inclusion Unit as a submission for the developing of the National Intercultural Health Strategy. The Intercultural Strategy aims to ensure that provision of health services is equal, accessible, culturally sensitive and appropriate in meeting the needs of minority ethnic communities. This includes improving access to health services, and reducing the risks of social exclusion and health inequalities experienced by minority ethnic groups, including travellers, asylum seekers, refugees and migrant workers.