Dossier de presse   First European Observatory o access to Health Care

« It’s necessary to forge respect, not fear »

F., MDM France patient, Lyon, February 2006

Contents

• WHO ARE THE UNDOCUMENTED MIGRANTS IN EUROPE?
  • Migrant profiles
  • Health problems

• UNEQUAL RIGHTS TO HEALTH CARE ACCESS
  • What rights exist in European countries?
  • Effective access: the practical reality
  • Obstacles to health care access

• PROPOSALS PUT FORWARD BY MÉDECINS DU MONDE IN EUROPE
  • Promoting non-discrimination towards migrants
  • Should we allow ill people to be sent back to die in their own countries?

• APPENDICES
  • Health care charter for all foreign nationals residing in Europe

Contact Presse :
Florence Priolet / Annabelle Quénet
Tél. : 01 44 92 14 31 / 14 32 – 06 09 17 35 59
infomdm@medecinsdumonde.net

Summary

The "Health and Migrations in the EU" conference will be held in Lisbon on 27and 28 September 2007 under the auspices of the Portuguese presidency. It will bring together health ministers from across the European Union, each of whom will be presented with a set of 25 “best practices” in the field of migration and health care. Featured among them will be the European study performed by Médecins du Monde on access to health care for undocumented migrants.
In 2005, the MDM European network created a European Observatory on Access to Health Care to look objectively at access to health care for people living in precarious situations in different countries in the EU. The aim is to identify the most favourable measures for a real public health policy before they are implemented in each country, enabling the entire EU to move forward. For this first Observatory, the network has chosen to focus its attention on the most vulnerable groups with which the 12 Médecins du Monde organisations work: migrants, and in particular undocumented migrants, since these groups are among the poorest, most excluded and most discriminated against in Europe. To what extent do they have access to health care in the EU countries studied, both in terms of their rights but also in practical terms ? The information presented here is unique; there are no national or, more
importantly, international studies that have compiled information about these groups.
The report is based mainly on seven countries: Belgium, Spain, Greece , France, Italy, Portugal and the United Kingdom. The report also includes testimonies from the Netherlands.

The living conditions of the people interviewed are difficult: 40% consider their housing situation precarious, 11% are homeless and none of them have an income. 1 In the survey population as a whole, two out of ten people perceive their health as poor or very poor. Only one third of people suffering from a chronic health problem are currently receiving treatment. Almost half of the people who stated that they had at least one health problem had to wait before receiving care. While experiencing a health problem, one person in ten was refused treatment by health professionals.

Based on existing legislation, 78% of the people interviewed have a theoretical right to health coverage. It is notable that the situation differs widely from country to country, both in terms of access to health coverage and the level of care provided. For example, in Spain, as long as a person is registered on a municipal register, they are entitled to the same access to health care as residents. In contrast, undocumented migrants are entitled to almost nothing in Greece.

In reality, only 24% of people benefit in practical terms from health coverage. In France, only 7% of people managed to exercise their right to health care. Similarly in Belgium, only 14% of people benefit in real terms from health coverage.

People are generally not informed about their rights: a third of people are not informed about their entitlement to health coverage.

Most people do not know they are entitled to free HIV screening and of those who are entitled to HIV treatment, nearly two-thirds are unaware of the fact.

Child immunisation is another area where information is lacking. Out of the population concerned by this issue, only a small majority know that their child can benefit from free vaccination and/or where to go for them.

This report also shows that part of the population of the European Union does not have access either to the most basic prevention or to essential medical care, even though they are living in conditions that are particularly harmful to their health.

The MDM European network, based on its experience and on those reliable figures, aims to make the case for an improvement in access to care for everyone living in the EU, whatever their administrative status.

In addition, based on its international experience and its observation of the lack of health care in the countries that the migrants resident in Europe come from, the MdM network calls for the non-expulsion, regularisation and enhanced access to health care for seriously ill foreign nationals who do not have effective access to treatment in their own countries.

Our experience in European countries where both regularisation of status on medical grounds and access to health care are a reality shows that sick people do not come to Europe to obtain treatment: those who are sick are unable to cope with the difficulties of migrating. Access to care and health is an essential first step towards attaining the values of the European Union. Neglecting to integrate the poorest populations into the process of improving health systems would be a major mistake in human, public health and

financial terms