Access to health care is provided for asylum seekers as part of material reception conditions.1 It covers essential medical services and corresponds to free medical services provided to legally residing third-country nationals.2 Asylum seekers have a right to examinations and treatment by general practitioners, but all specialised treatment conducted in policlinics and hospitals is free only in case of emergency and upon referral by a general practitioner.
According to Decree 301/2007,3 asylum seekers with special needs are “eligible for free of charge health care services, rehabilitation, psychological and clinical psychological care or psychotherapeutic treatment required by the person’s state of health.”
In practice there are no guidelines for identifying vulnerable asylum seekers and a lack of specialised medical services. Furthermore, only few experts speak foreign languages and even fewer have experience in dealing with torture or trauma survivors. Cordelia Foundation, an NGO, is the only organisation with the necessary experience in providing psychological assistance to torture survivors and traumatised asylum seekers in some of the reception centres. Their capacity is, however, limited and every year the question arises whether it will continue to provide these much needed services, as its activities are funded on a project basis and not under the framework of a regular service provider contracted by the IAO. The therapeutic activities of the Foundation include verbal and non-verbal, individual, family and group therapies, and psychological and social counselling.
Asylum seekers have access to a general physician within all reception centres several times per week and to nurses on a daily basis. However, their access to effective medical assistance is hindered by language problems because translators are not always available or provided by IAO, as well as due to capacity problems. Specialised health care is provided in nearby hospitals in all major towns where, however, similar language problems occur in case of the unavailability of social worker to accompany asylum seekers to the hospital to assist in the communication with doctors.
The emergency health care services must be provided even in the event of the reduction or withdrawal of reception conditions.4
Decree 301/2007 states that asylum seekers residing in private accommodation are eligible for health services at the general physician operated by the competent local government and determined by the residency address of the applicant. In practice, these asylum seekers are struggling to access to medical services since physicians systematically refuse the registration and treatment of asylum seekers on the ground that they lack a health insurance card. According to information provided by the IAO, asylum seekers can be registered with their number of the humanitarian residency card and have to be treated in accordance with the law.