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Stop denying migrants their fundamental right to healthcare, says doctor

Countries are in a 'race to the bottom' to make themselves look as unattractive as possible to migrants


European countries must stop denying migrants their fundamental right to healthcare, argues a doctor in The BMJ today.

Europe is experiencing the largest mass migration of people since the Second World War, according to estimates from the Nations High Commissioner for Refugees.

Jonathan Clarke, a doctor and Kennedy Scholar at the Harvard TH Chan School of Public Health, says that "many people think that all migrants to Europe have meaningful access to healthcare, but the reality is different."

Earlier this year, Dr Clarke visited six clinics run by the charity Médecins du monde (MdM), also known as Doctors of the World, across Europe as part of his research project. The charity has been caring for Syrian migrants and refugees since the early days of the conflict in Syria.

He says two thirds of the 15,648 migrants attending clinics run by MdM throughout Europe last year had no access to healthcare. And in the UK, four in five (1154 of 1395) migrants had been unable to access a GP.

While the media tends to report that generous healthcare access promotes migration, only 3% of 15,648 migrants were motivated to travel for health reasons. And on average, migrants sought healthcare for the first time 6.5 years after arriving in Europe, and only a tenth with chronic illnesses knew about their condition before migration.

Around 85% of Doctors of the World's patients have experienced violence before, during or after their migration, and a third of asylum seekers have been tortured. Therefore, he says "migrants have considerable healthcare needs that must be recognised and respected by European nations."

But Europe is "taking a series of regressive, harmful political steps" and "states are 'in a race to the bottom' to make themselves look as unattractive as possible to migrants," he warns.

Denmark, Switzerland, the Netherlands and Germany "deprive migrants of their assets before they may access state support", while the Spanish government removed rights to healthcare for undocumented migrants in 2012.

The UK Department of Health is consulting plans to start charging for emergency and primary care for migrants. Dr Clarke says this move would make the NHS one of the most restrictive healthcare systems for undocumented migrants in Europe.

"Increasingly unwell, unhappy, and isolated migrant communities are an almost inevitable consequence of these discriminatory actions," he explains, and calls on "governments [to] seize the opportunity to reverse their recent regressive political course."

"Only then can they honour their humanitarian obligations to provide care to the people in greatest need," he concludes.

Anders Björkman, representing Doctors of the World International Network, will speak about delivering healthcare to migrants in Europe at the BMJ / IHI International Forum on Quality and Safety in Healthcare, next week (13 April) in Gothenburg, Sweden.


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