Foster and kinship carer experiences of accessing healthcare: A qualitative study of barriers, enablers and potential solutions

Children living in out-of-home care are known to have more health needs than same-aged peers. Routine health assessment with subsequent management of need is recommended by health experts. In Victoria, Australia, the out-of-home care system relies upon home-based care through kinship (with family) and foster carer placements, placing some of the healthcare access and utilisation burden upon foster and kinship carers. This paper explores the experiences of Victorian foster and kinship carers accessing timely health assessment and ongoing healthcare for a child placed in their care; identifying barriers and enablers. Through interviews with 19 carers, we found that while carers play a significant role in facilitating healthcare, it is often difficult to navigate a complex health system especially while concurrently navigating the child protection system. Although some carers had faced few challenges, barriers were frequently reported at every step in accessing healthcare: receiving necessary paperwork (including child Medicare numbers); obtaining past medical history including immunisations; knowing what appointments were required; gaining appropriate authorisation for healthcare; identifying appropriate healthcare services; accessing timely appointments; attending appointments and paying for services. Carers had often been strong advocates for children in their care and had found support from case managers or carer support workers to be instrumental in enabling healthcare. Carers identified potential solutions to help children in their care receive timely healthcare.