“I think they are actually a bit racist in not giving us everything that we need in terms of medication”: Racialised governance and asylum seeker access to healthcare in England

This paper critically examines the lived experiences of asylum seekers accessing primary and secondary healthcare in England. We employ a framework of racialised governance to assess how historical and political processes of racialisation can manifest in healthcare. It draws upon longitudinal interviews with asylum seekers currently living in the North and South of England. Our findings evidence the multiple barriers to healthcare for asylum seekers in England, including the complexity and opacity of the English healthcare system; significant difficulties accessing face-to-face appointments; denial of access to interpreters; and being dismissed and disbelieved by administrators and clinicians. We demonstrate how these barriers to healthcare can be racialised, marking asylum seekers as a racialised ‘Other’ and contributing to inadequate care. We do also, however, find positive experiences of healthcare and document cases in which poor access to healthcare among asylum seekers aligns with wider institutional resource constraints within the NHS. Nevertheless, we argue that the racialisation of healthcare is fuelled by a politically racist policy agenda, accompanied by complex and often opaque healthcare entitlements for asylum seekers, which together legitimate misinformed and, at times, prejudicial attitudes within the NHS, leading to inconsistent care for asylum seekers across NHS Trusts. We argue it is essential to listen carefully to the healthcare experiences of asylum seekers to understand how equitable and accessible services can – and should – be provided.