Campaign dilemma

I'm really annoyed with myself because really, I should be studying! So many chapters and notes to read and memorize and yet I can't help blogging away here...

Anyway I just want to talk about the issue of the right to healthcare among the immigrants in the UK. In Manchester, Gemma, a friend of mine and I started a student group called Crossing Borders, which addresses healthcare issues among refugees and asylum seekers. The main reason I was involved was because I had experience working with the refugees community and kind of understand what problem they face. In our group we have about 10 enthusiastic members. Just before christmas, we successfully hosted a peer education workshop about refugees and healthcare for medical students, which was very encouraging.

At a national conference with the same student group from other medical schools in the UK, we agreed that we would take up the campaign of defending primary healthcare for asylum seekers. Just a background information: the government is expected to come up with a regulation to put a stop to failed asylum seekers accessing NHS primary healthcare services. This would mean that failed asylum seekers will not be allowed to register with a GP, not receive antenatal care, not get immunisation etc. When I first learn about it, I thought this is wrong, and no doubt the I would get people to sign up for the campaign.

Then over time I swayed. The public response generally doesn't favour our stand. Many people put up comments like 'why are we paying for their healthcare?', or 'why are these people not deported in the first place?', which was not pleasant, but I can see some truth in them. I tried to convince myself - these people had fled to the UK to seek refuge, not to take advantage of the welfare system here.

Then what this consultant told us about her encounter with some dialysis patients who came to the UK for free dialysis treatment really shoke my belief. She said normally these patient would be transported from the airport straight to the hospital with symptoms of severe ureamia. They dialyse them, then the doctor breaks the bad news 'I'm sorry but you have kidney failure'. The patient would appear as though they were not surprised by the news, but denied that they knew that they've got the condition. A few weeks into dialysis, it would transpire that they actually knew that they have renal failure before arriving and coming to the UK is literally a gamble on their life, either they are going to receive dialysis and live, or they will be deported and die. Now this is really a difficult dilemma. If you have to know, as the saying goes back at home, living with kidney failure is not an option the poor, because the cost of treatment is just so ridiculously high. For a person to undergo haemodialysis for a year, taxpayers would have to fork out a whooping £35,000! Is it fair to the british taxpayers to be funding the treatment of these foreigners when some of the british patients don't get their life-saving cancer drugs which is just about the same price? And when a patient is on dialysis, their almost always would be put on the transplant list as having a transplant is much cheaper in the long run generally speaking. Yet, this would only make the waiting list longer than it already is, and making the british patients wait even longer for a donor and face higher risk dying while more time is spent 'waiting'. Is it fair that the british patient who has contributed to the economy die while the foreigner, though arguably to survive, who is here to take advantage of the free health service here live for another 10 years with improved quality of life with the transplanted kidneys? The answer is obvious. It isn't fair. But as doctors, who are we to turn away the patient to let him literally just, die? I hate to think about what will happen to this girl http://news.bbc.co.uk/1/hi/wales/7178416.stm.

So back to the campaign, I actually felt that I would be very naive indeed to be saying that the goverment is being heartless, cruel to the vulnerables; and to gain public sympathy telling some sob stories. The group of students working on this campaign nationally are very passionate about the issue, but I think the shortcoming of the way they work was that there was no debate. All they do was lobbying the politician and look out for people who said something against their stand, and come up with argument to rebute them. What about the other side of the arguement? Why can't they acknowledge the legetimacy of the simple fact that the NHS has limited budget and can't be pleasing everyone in the country, let alone outsiders? If this is how campaigning is like then I don't think I'll ever be involved in any kind of campaign ever again. I don't mind signing a petition, but I'm not prepared to be the lead advocate and refusing to understand from alternative angles. Maybe I'm a born fence sitter. And I much prefer doing something more direct and practical like volunteering.

Today is Yee Leng's birthday - Happy 21st birthday!