Ten out of 25 EU countries restrict health care for asylum seekers to
http://www.100md.com
《英国医生杂志》
Almost half of the European Union抯 countries restrict health care for asylum seekers to emergencies only, a study comparing health care in 25 countries has shown. Medical screening also varies widely between the countries, with little more than half providing mental health screening, say researchers.
"European health policy makers should ensure access to health care for asylum seekers comparable with the medical rights of citizens," said Marie Norredam and colleagues from the University of Copenhagen in the European Journal of Public Health (17 Oct 2005, doi: 10.1093/eurpub/cki191). "The provision of health care for asylum seekers in the EU countries appears heterogeneous and often based on minimum standards."
The United Kingdom is cited as a country where although care is not yet restricted to emergencies only, the rules of entitlement are being tightened: "Britain is one of the countries using increasingly restrictive measures towards failed asylum seekers. Failed asylum seekers used to have free access to the NHS, but since 2004 they cannot obtain free secondary health care, and primary health care may also soon be withdrawn," say the authors from the University of Copenhagen.
The questionnaire based study of ministries and non-government organisations involved in healthcare in all 25 EU countries was done last year and was designed to compare standards of care available. Portugal was the only country from which there was no response.
The results show that although medical screening of newly arrived asylum seekers exists in all the 24 responding EU countries except Greece, there were wide variations. In some countries, medical screening was offered to all new asylum seekers, but in others, including the United Kingdom, Austria, France, and Spain, it was only done in reception centres. Newly arrived asylum seekers who do not enter these centres receive medical screening randomly, say the authors.
HIV screening existed in 19 countries, and was compulsory in five. Tuberculosis screening was done in 22 countries, and was compulsory in 12. In some, including the United Kingdom, Austria, and Spain, it was compulsory only for those in reception centres.
The results also show that access to specialised treatment for tortured and traumatised asylum seekers is available in all EU countries except Latvia, Luxembourg, and Cyprus.
When the authors looked at access to healthcare for three groups, adults, children and pregnant women, they found legal restrictions, the vast majority of which limited care to emergencies only, for one or more in 10 countries (Austria, Denmark, Estonia, Finland, Germany, Hungary, Luxembourg, Malta, Spain, and Sweden).
Restriction to emergency care only for pregnant women was found in five countries, for children in seven countries, and for all adults in 10 countries. In all countries except Austria the legal restriction was an entitlement to emergency care only.
The authors say that such a restriction is not without problems: "It may lead to an accumulation of health problems, which may prove expensive for societies if inpatient treatment is required at a later date," they say.
"Moreover, excluding patients with communicable diseases such as HIV from treatment is against the public health policy of most countries. In Britain, an alternative way of restricting access for some asylum seekers was recently introduced by charging for services. Charging, however, seems unethical and unrealistic as asylum seekers in many EU countries are prohibited from working."(Abergavenny Roger Dobson)
"European health policy makers should ensure access to health care for asylum seekers comparable with the medical rights of citizens," said Marie Norredam and colleagues from the University of Copenhagen in the European Journal of Public Health (17 Oct 2005, doi: 10.1093/eurpub/cki191). "The provision of health care for asylum seekers in the EU countries appears heterogeneous and often based on minimum standards."
The United Kingdom is cited as a country where although care is not yet restricted to emergencies only, the rules of entitlement are being tightened: "Britain is one of the countries using increasingly restrictive measures towards failed asylum seekers. Failed asylum seekers used to have free access to the NHS, but since 2004 they cannot obtain free secondary health care, and primary health care may also soon be withdrawn," say the authors from the University of Copenhagen.
The questionnaire based study of ministries and non-government organisations involved in healthcare in all 25 EU countries was done last year and was designed to compare standards of care available. Portugal was the only country from which there was no response.
The results show that although medical screening of newly arrived asylum seekers exists in all the 24 responding EU countries except Greece, there were wide variations. In some countries, medical screening was offered to all new asylum seekers, but in others, including the United Kingdom, Austria, France, and Spain, it was only done in reception centres. Newly arrived asylum seekers who do not enter these centres receive medical screening randomly, say the authors.
HIV screening existed in 19 countries, and was compulsory in five. Tuberculosis screening was done in 22 countries, and was compulsory in 12. In some, including the United Kingdom, Austria, and Spain, it was compulsory only for those in reception centres.
The results also show that access to specialised treatment for tortured and traumatised asylum seekers is available in all EU countries except Latvia, Luxembourg, and Cyprus.
When the authors looked at access to healthcare for three groups, adults, children and pregnant women, they found legal restrictions, the vast majority of which limited care to emergencies only, for one or more in 10 countries (Austria, Denmark, Estonia, Finland, Germany, Hungary, Luxembourg, Malta, Spain, and Sweden).
Restriction to emergency care only for pregnant women was found in five countries, for children in seven countries, and for all adults in 10 countries. In all countries except Austria the legal restriction was an entitlement to emergency care only.
The authors say that such a restriction is not without problems: "It may lead to an accumulation of health problems, which may prove expensive for societies if inpatient treatment is required at a later date," they say.
"Moreover, excluding patients with communicable diseases such as HIV from treatment is against the public health policy of most countries. In Britain, an alternative way of restricting access for some asylum seekers was recently introduced by charging for services. Charging, however, seems unethical and unrealistic as asylum seekers in many EU countries are prohibited from working."(Abergavenny Roger Dobson)