During the April 2014 informal EPSCO Council meeting in Athens, the Health Ministers decided to improve the access to healthcare for all migrants, and stressed the need for “special health services for particularly vulnerable migrant groups “. Which initiatives were put in place to ensure these objectives?
I remember this EPSCO meeting as I was myself a Lithuanian Health Minister then. Since I became Commissioner for Health and Food Safety which was in November 2014, the question of extraordinary influx of migrants and refugees is a priority for the European Commission. No EU country should be left alone to face the huge pressures, and no person – refugee, migrant, anyone – should be left without access to basic healthcare.
As part of its response to the crisis, the Commission has repeatedly mobilised emergency funding to support the front line Member States’ capacity to host migrants, including healthcare capacity. For example, the Asylum, Migration and Integration Funds (AMIF) can help finance healthcare for migrants – along with providing shelter and food.
Under my health portfolio, I have mobilised more than € 15 million in funds from the Commission’s Health Programme for projects that help these countries address the immediate needs of migrants and refugees. This includes a grant to the International Organization for Migration (IOM) to develop and test the Personal Health Record to help build the medical history of migrants and identify their immediate needs, and a grant to the World Health Organization (WHO) to produce guidance for health professionals.
The Health Programme also provides funding to develop training programmes and clinical guidelines for healthcare professionals, and complement existing ones, for example with new modules on communicable diseases and mental health. These tools help healthcare professionals learn about diseases that they are not familiar with and provide them with important cultural perspectives and information on the specific needs of people arriving. In addition, a Joint Action allows EU countries to share best practices for better integration of migrants and refugees.
Our longer term priorities are to ensure that migrants and refugees are integrated into primary healthcare systems so as to receive the healthcare they need, to provide tailored training to health professionals, and help protect migrants and refugees against stigma and health inequalities. The Health Programme will continue to prioritise projects with these aims.
Since 2015, the European Union has been experiencing an unprecedented influx of refugees, asylum seekers and migrants. What are/will be the effects of this phenomenon on health systems?
Despite certain fears and misinformation, migrants and refugees entering the EU are generally in good health. However, their health status may vary depending on the route of their arrival to the EU, the length of the trip, the country of origin, the reason for migration and the time they spend in transition places.
The burden on health systems is shared unequally in the EU. Some countries accept more asylum applications than others both in terms of overall number, and proportion of their population. However, the number of migrants in proportion with the population is relatively small, and the majority of first time asylum seekers (83%) are aged 35 and under and therefore relatively healthy in general.
The main challenge is integration. We need to integrate migrants and refugees into our societies and into our regular health care systems as soon as possible, and not rely on parallel structures that care for migrants as a separate category. These people should be offered the healthcare they need, including preventative healthcare, and this entails that the migrants themselves make the effort to integrate and adapt to the conditions, values and organisation of the host countries.
Allow me to also point out that there are bigger burdens on the sustainability of health systems in the EU than the integration of refugees and migrants. We are experiencing an ageing population and a related increase in chronic diseases in Europe, and another of my key priorities is to support EU countries in ensuring the accessibility, effectiveness and resilience of their health systems.
According to the Action Plan on integration of third country nationals (2016), “ill health and lack of access to health services can be a fundamental and ongoing obstacle to integration”. How does the European Commission ensure the proper provision of healthcare to third country nationals?
Firstly, there are legislative measures that require health care measures for regular migrants, asylum seekers and refugees.
Secondly, the EU has invested significantly in integration through its various funding mechanisms. For example, the “RE-HEALTH 2” project funded under the Health Programme, aims to promote and ensure continuity of care for migrants. It provides an electronic platform so that data, such as on communicable diseases and other conditions, can be shared between countries. Also, as I mentioned, we are investing in training so that health professionals better understand the needs of migrants and provide better, more adapted, care.
Thirdly, the Commission has worked in the area of migrants’ health since 2003. Since then, we have funded several projects to protect against stigma and health inequalities, and have continually sought ways to enshrine migrants’ health issues within our work in this area. Establishing networks of health professionals that work in the area of refugees’ mental health, training less experienced colleagues or other professions (for example social workers or law enforcement officials, that work with refugees in reception centres) to identify and cope with the problems, could help to improve the health status and integration in the EU of all these arriving populations.
When it comes to responding to health-related challenges, which projects/initiatives have been put in place by the European Union to help countries that host high number of migrants?
Since the beginning of this crisis, together with other European Commissioners, I have done everything in my power to channel all possible EU tools and funds to help to improve the situation of refugees.
The Commission has put forward legislative proposals, currently under discussion by the European Parliament and Council, which include the proposal that refugees benefit from the same health care as EU nationals.
As I have mentioned, the Commission also provides considerable financial support to those Member States under particular pressure. For example, various EU funds have channeled over € 1 billion to Greece which can be used to provide shelter and healthcare of migrants and address humanitarian needs. There are also specific projects for Greece, like “PHILOS”, just for health care support.
The budget of the Health Programme seems modest in comparison, but the actions on refugees’ health that it supports are nevertheless valuable. This funding has helped the International Organisation for Migration (IOM) to develop the “Personal Health Record” which helps build the medical history of migrants and identify their immediate needs and also accompany them during the transit until they are established definitively in an EU Member State. The Personal Health Record is currently being used in Greece, Slovenia, Italy, Cyprus, Croatia and it is now being extended to Norway.