a project funded by dg sanconowhereland at the center for health and migration/duk. 1 right of...

A Project funded by DG SancoNOWHERELAND at the Center for Health and Migration/DUK. 1

Right of access health care for irregular migrants in the European Union:

is it congruent with human rights standards?

Carin Björngren Cuadra, senior lecturer

SWSD, Stockholm 11 July 2012

A Project funded by DG SancoNOWHERELAND at the Center for Health and Migration/DUK.

Health care in NowHereland – Improving Services for

Undocumented migrants in EU


Irregular migrants in the EU context

• Third-country nationals without a valid permit authorising them to reside in the European Union (EU) member states

»been unsuccessful in asylum procedures (rejected asylum seekers)»who have violated the terms of their visas (‘over stayers’)»who have entered the country illegally.

3


Work package – policy compilation

• Aim: collect data on policy approaches regarding access to health care for irregular migrants in the EU 27

• To identify the extent to which these entitlements are congruent with human rights standards

• Deliver 27 Country Reports and offer a clustering of the states

4


Rational

• Irregular migrants have gained increasing attention in the EU due to lack of social protection» deprived living conditions» substandard working conditions» exploitation» lack of access to health and welfare services.


Methods

• ‘Desk research» available research and information

• a questionnaire (in English) sent to experts and NGO• five topics

» context of migration» policies regarding irregular migrants» welfare system» health care system» health care for irregular migrants

• statistical information (numbers of irregular migrants, etc.) was obtained from official websites (national authorities) and from secondary sources.

6


How to cluster?

• The Council of Europe, resolution of the Parliamentary Assembly. Council of Europe Resolution 1509 (2006) on Human Rights of Irregular Migrants, article 13.2

» as a minimum right, emergency care should be available for irregular migrants.

• Less than rights

• Minimum rights

• More than minimum

7


Cluster 1. Less than minimum rights

• Member states in which entitlement is restricted to an extent that makes even emergency care inaccessible for irregular migrants

• member states offering health care only within detention centres• Ten member states • ‘implementation gaps’ - a better level of care is sometimes provided in practice; however, such

exceptions are arbitrary and not predictable from the patients’ perspective or in return of the full cost

8


Cluster 1. Less than minimum rights

RIGHT OF ACCESS MEMBER STATES

Tax Insurance

May access emergency care for an unclear cost Finland

Ireland

May access emergency care in return for payment of the

full cost

Sweden

Austria

Bulgaria

Czech Rep.

Latvia

Right to access emergency care, provided they are

affiliated to insurance, via employment or privately

Luxembourg

State medical care and services free of charge within the

framework of detention centres

Malta

Romania

9


Cluster 2. Minimum rights

• Member states in which irregular migrants are entitled to emergency care (‘immediate’ or ‘urgent’)

• From the patients’ perspective, the provision of care is predictable

• Twelve member states

• health care of a more extensive kind might be accessed under certain unpredictable circumstances (e.g. at the discretion of the professional involved), or in return for payment of the full cost.

10


Cluster 2. Minimum rights

11


Cluster 3. More than minimum rights

• Member states in which entitlement to health care includes services beyond emergency care

• The relevant provisions are laid down in legislation which explicitly refers to irregular migrants

• Entitlement might be impaired by administrative procedures

• Five member states can be found to be applying this level of rights.

12


Cluster 3. More than minimum rights

RIGHT OF ACCESS MEMBER STATES

Tax Insurance

Right to access health care free of charge. Access involves an

administrative procedure.

Italy

Netherlands

Right to access healthcare for no, or a moderate, fee. Access

involves an administrative procedure and is subject to a

prerequisite involving the period of stay.

Portugal

Spain

France

13


Conclusion 1

- right of access to health care differs considerably- international obligations articulated in human rights standards are not fully met in the majority of member

states- the variations are independent of the health care financing system and the numbers of irregular migrants- level of rights seem to relate to the intersection between practices of control of migration, the main

categories of IM and the ‘moral economy’ of the work society

15


Conclusion 2

• ‘moral economy’ of the society; the basic collective norms and obligations, concerns which risks should be covered and who are eligible and what are legitimate practices

• countries in the ‘generous’ cluster mainly harbour irregular migrants whose pathway into irregularity is related to the (informal) working market

• countries found in the more restrictive cluster mainly harbour irregular migrants who are largely ‘produced’ by the asylum system (rejected asylum seekers)

16


Conclusion 3

- irregular “work migrants” tend to be more favourable received than those who are “rejected asylum seekers”

- a more complete understanding of the differing policies might be obtained by considering the relationship between the formal and informal economy

- the role of human rights standards within the current ‘moral economy’ of the work society.

17


Thank you!

http://www.nowhereland.info/

[email protected]


• Project funded by DG Sanco, Austrian Federal Ministry of Science and Research, Fonds Gesundes Österreich, MIM.

• Running time: January 2008 – December 2010

• Centre for Health and Migration at the Danube University, Krems (AT) (main coordinator)

• Platform for International Cooperation on Undocumented Migrants (BE)

• Azienda Unità Sanitaria Locale di Reggio Emilia (IT)• Centre for Research and Studies in Sociology (PT)• Malmö Institute for Studies of Migration, Diversity and Welfare

(SE)• University of Brighton (UK)


Collaborative partners

• University of Geneva (Sandro Cattacin)• European Hospital and Healthcare Federation (BE)• International Centre for Migration Policy Development (AT)• International Organization for Migration (BE)• Swiss Forum for Migration and Population Studies (CH)• UNITED for Intercultural Action (NL)• University of Vienna, Institute for Nursing Science (AT)• WHO European Office for Integrated Health Care Services

a project funded by dg sanconowhereland at the center for health and migration/duk. 1 right of...

Documents