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Old problemsNew challengesMigrantsLanguage Initially Difficulty identifying translators/ interpreters forTransiencyPressure onservicesRights andentitlementsInability tounderstandinstitutionalcultureCultural needsnot metPopulations tended to be morefixedInitiallyFree access to NHS – assumed inthe UK legallyInitially“new” languages”Break in continuity of carePressure of numbers means limited GeneralPractitioner spacesOver-use of A&EEnd of free access - health problems neglecteduntil acuteOthers incorrectly denied free access“Misuse” of servicesInitially but later specialist For “old” migrants but not newservices developedDestitution No In hiding and no income so health seeking isIsolationNorestrictedFragmentation means lack of critical mass