Dr. Angela Skuce:

The clinics that we have are easy to access, especially for migrants. They are based in areas or organisations where those people tend to be anyway. We go to where people congregate. The Cappuchin clinic is based in the Cappuchin day centre which is mainly a dinner hall for people in need. Years ago that centre identified a need for healthcare so we started a small GP clinic there. More and more Roma people who were living in homeless accommodation, in squats in the inner city or in very poor quality private rental accommodation came to the clinic and the service grew out of that. We realised that we needed an interpreter, for example. Now we have a big clinic and we see between 70 and 100 people per week. The Tallaght clinic started in response to demand in Tallaght hospital. There were Roma people living in Tallaght who did not have GPs and they were using the hospital's emergency department as their GP service which was not appropriate for them or for the hospital. The HSE provided funding for a clinic which we run in Tallaght once a week in a building quite near the hospital. It is supported by the Tallaght Roma integration project and volunteers from the local Roma community come and act as intermediaries. People can just turn up at both of those clinics. They are open-access, walk-in clinics and people find out about them through word of mouth. In the Cappuchin clinic, we used to get people coming in from Carrickmacross because they had friends or relatives in Dublin who told them about it. People come to the clinics from the local community.

We have very strong links with local community organisations like Pavee Point. There is also a national Roma Covid information line that was set up in response to the pandemic because we realised that Roma people who do not speak English could not seek healthcare when they had Covid-19 or symptoms of Covid. We get referrals through that information line. We also have links with organisations like Mendicity which works a lot with people from eastern Europe and with people who have addiction and homelessness problems. Mendicity refers people to us. We also have very strong links with the local hospitals.

In reference to the maternity hospitals, there is a really good recent initiative involving the three Dublin maternity hospitals which have created a new post of inclusion health social worker. We have met the three of them in the last few weeks and they are our direct line in and out for people who are vulnerable for many reasons including being homeless, having addiction issues, not being able to speak English, being undocumented and so on. We had a problem recently where one of the maternity hospitals, in a drive to modernise and become more efficient and user-friendly, had developed an online registration form for pregnant women. In one of the maternity hospitals now people do not need a GP referral but can just refer themselves but they must do so by filling in an online registration form in English and uploading documents. We can now bypass that system by emailing the inclusion health social worker and she will make the appointment. At the other end, when people have had a baby and are leaving hospital, they may want long-acting contraception because their family is complete or they want to delay another pregnancy but if they do not have a medical card, they do not have access to that. The inclusion health social workers can refer them directly to one of our clinics, we can book an interpreter and get that sorted. That works really well.