Dr Jonathan McAllister is one of the GPs providing primary care for patients detained at a UK Immigration Removal Centre at Heathrow.
His wide-ranging experience includes having worked in community general practice, treating people with drug and alcohol dependencies, as well working as a GP in prisons. But this new role presented professional challenges he’s never encountered before.
“What we see in the immigration removal centre is the most vulnerable people who've had a very challenging few years. These are often people who have been tortured, trafficked, or been victims of modern slavery.
One of the first things I say to them is ‘Has something bad happened to you in the past, either in your own country, on your journey here, or while you've been in the UK?’ That allows us to explore which traumatic experiences have affected their mental health. And of course, people may have significant physical injuries from torture, trafficking, or slavery.”
Many consultations need to be conducted with a translator, usually over the phone. So putting traumatised people at ease and encouraging them to open up requires using all the communication skills GPs develop.
“The way patients knock and walk into the room, how they sit down, how they interact, eye contact – all those non-verbal cues become very important.”
Many people assume Dr McAllister works for the government. In fact, he is employed by Practice Plus Group and contracted by NHS England. He always makes sure his patients know that – and that their health is his priority.
“It’s not easy. But I go home and think, ‘Wow. It’s a privilege to hear those stories, hear people tell you what has happened to them, and how they've survived.’”
GPs in the centres can learn much as part of a multidisciplinary team that includes primary care, mental health and substance misuse nurses, psychiatrists, psychologists, physios, dentists, opticians and more. For example, many patients will show symptoms of PTSD, but GPs are able to take advantage of a comprehensive wraparound service to support them in providing the right care.
“Our job is to offer the best care we can inside the centre. If we feel that isn’t appropriate for the patient, we have a legal duty to raise our concerns to the Home Office and recommend that a patient be better cared for in the community or in another setting. These are potentially life-changing decisions. And I think that's what makes being an IRC doctor more challenging, complex, and more worthwhile.”
Practice Plus Group has opportunities nationwide for GPs interested in working within immigration removal centres and prisons. At the end of the day, as Dr McAllister says, “You can go home knowing you really made a difference.”
See current vacancies at apply.practiceplusgroup.com.