‘Uneven spread’ of refugees putting strain on GPs as search for fresh housing continues

The Department of Health has highlighted how the “uneven geographic spread of refugees is causing a significant strain on local GP capacity”.

It said the HSE and the Irish Medical Organisation have responded by making provision for “a range of options to deliver GP services for over 1,000 widely dispersed facilities accommodating Ukrainian and other refugees across the country”.

A statement added: “These options are necessary, given the significant constraints in GP provision in both urban areas and certain rural locations.”

It said that temporary sessional GP clinics are being established to deliver regular services and more are planned in 2023 “in line with available GP capacity and allocated funding”.

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The need to prepare the delivery of health services for as many as 90,000 more refugees and asylum seekers in 2023 has been flagged with the new Minister of State for Public Health Hildegarde Naughton.

Separate ministerial briefing papers, drawn up for incoming minister of state for integration Joe O’Brien, outlined that the present model of accommodation provision is “unsustainable”, partially because of “continued concentration of available accommodation in particular areas where service provision pressures exist (health, education)”.

It comes amid ongoing warnings of a homelessness crisis among refugees who face arriving into the country but being given no bed – and some instead being given meal vouchers and contacted when a bed becomes available.

The Irish Times understands that the Department of Integration is considering using large buildings that have been offered to it for use as temporary accommodation to stave off the risk of mass homelessness among international protection (IP) applicants. Non-governmental organisations have warned that many could be left on the streets with the anticipated closure of the Citywest transit hub in the coming days.

Liam O’Dwyer, an adviser to the Red Cross in Ireland, said sufficient numbers of vacant industrial and office complexes exist to immediately house IP applicants until more suitable space is found. He said that premises on the outskirts of cities, brought to their attention by commercial providers, could deliver a solution to the pending emergency.

“We would be confident with the amount of buildings that are being made available, and I would say there is a number each week,” he said.

The Red Cross continues to place Ukrainian refugees into pledged accommodation but has no role in allocating IP accommodation. However, it has become an informal conduit for commercial offers to Government for both, giving them insight into what is potentially available.

“The larger warehouses … the larger industrial buildings are the only way to go if you need emergency [accommodation],” he said.

“The Red Cross wouldn’t be promoting this type of accommodation at all, normally, but in this desperate situation the choice of putting people out in the cold is simply not acceptable.

“The intel that we would have from meeting with a number of developers would be that those buildings are there, as are the office buildings.”

Such commercial accommodation is generally located in industrial estates on the outskirts of the larger cities, he said, adding that it could be available from next week.

Meanwhile, the Irish Refugee Council (IRC) was briefed on the situation by Government on Thursday and said despite “trojan work” by Minister for Children Roderic O’Gorman and his officials, it was not completely satisfied with the response.

“They have said that they will do their very best to accommodate the most vulnerable people … [but] we are still worried that people will fall through the cracks,” said policy and advocacy officer Ciara Ross, of the pending Citywest closure.

“We have young men that come from Afghanistan or Somalia who might be extremely traumatised or extremely vulnerable.”

The IRC has pushed for the appointment of a refugee response lead to co-ordinate efforts and communicate strategy.

Fr Peter McVerry, whose charity has been battling housing needs for years, said he did not see an immediate solution to the international protection crisis given accommodation shortfalls, generally, had been building for 15 years.

“Three into two doesn’t go. They just don’t have the accommodation. I don’t see where they are going to get it from,” he said.

In a statement on Friday, Doras, the refugee and migrant rights organisation, demanded action to prevent hundreds of refugees from facing homelessness in the near term.

“This is a worrying new low for the international protection system in Ireland,” said its chief executive John Lannon.

“We already have a situation where people are sleeping in tents in freezing conditions, despite promises this practice would end. We appreciate that the Department of Children is under huge pressure but we simply can’t throw the towel in and ignore our moral and legal obligation to offer refuge.”

Albert Llussa, a partner at Daly Lynch Crowe & Morris Solicitors who has specialised in international protection law for more than 20 years, said the State is exposed to legal action if it fails to provide accommodation in line with the EU reception conditions directive.

“What they cannot do is expect people to stay homeless on the streets for one day or two days or for a week. They just can’t, especially in these temperatures,” he said.

The Department of Health said it has been allocated an additional €50 million for the provision of healthcare services for Ukrainian refugees in 2023.

A statement did not identify locations where there is strain on GP capacity.

It said refugees from Ukraine are a “mobile population” given the current pressure on accommodation “which can result in changing need and demand for services within and across community healthcare organisations”.