Access to health care for asylum seekers is guaranteed in the national legislation to the same extent as for Polish nationals, who have health insurance.1 Health care for asylum seekers is publicly funded. Basic health care is organised in medical offices within each of the reception centres. Moreover, asylum seekers can benefit from medical assistance provided from 1 July 2015 by a private contractor Petra Medica,2 with whom the Office for Foreigners has signed an agreement to coordinate medical care for asylum seekers and monitors the application of this agreement. Before, for many years this medical assistance was granted in institutions contracted by the Central Clinical Hospital of the Ministry of Interior.3 Medical assistance guaranteed by this hospital was ensured on a good level, as assessed by the Supreme Audit Office in 2015.4 After the change of the contractor in 2015, growth of objections towards the medical assistance is noticeable in reception centres.5
In 2012-2014 in all controlled by the Supreme Audit Office (10) reception centres asylum seekers had access to general practitioner’s assistance at least for 10 hours a week and nurse assistance was available at least for 20 hours a week.6 In 2016 the Office for Foreigners confirmed that the medical doctor have 10 duty hours per 120 asylum seekers, while the nurse – 20 hours for the same number of possible patients. Both have 3 hours a week more for every next 50 asylum seekers.
Heath care for asylum seekers includes treatment for persons suffering from mental health problems. Currently, psychologists work in all the centres at least for 4 hours a week for every 120 asylum seekers (it is extended for 1 hour for every 50 asylum seekers more).7 Their help is limited though to basic consultations.8 Asylum seekers can also be directed to a psychiatrist or a psychiatric hospital. According to some experts and many NGOs, specialised treatment for victims of torture or traumatised asylum seekers is not available in practice.9 NGOs still point at the lack of proper treatment of persons with PTSD. The available psychological assistance is considered an intervention, not a regular therapy.10
The biggest obstacle in accessing health care that asylum seekers face is the lack of knowledge of foreign languages amongst doctors and nurses.11 Polish authorities do not provide interpretation free of charge and most of the asylum seekers are not able to pay for such assistance on their own. Accordingly, with regards to the newest agreement with a private medical contractor, concluded in June 2015, the contractor is obliged to ensure a translation during the medical and psychological consultation, if it is needed.12 During the monitoring in Bezwola and Białystok held in 2015, Russian speaking asylum seekers confirmed that doctors and psychologists working in these centres know the Russian language. Even though NGOs informed in 2016 that translation is still problematic in some cases,13 e.g. HFHR observed that asylum seekers speaking French and Arabic could not communicate with doctors in the first reception centre in Podkowa Leśna - Dębak and in a medical point in the Office for Foreigners in Warsaw and translation services were not provided.14
The second problem is the fact that some of the clinics and hospitals, providing medical assistance to asylum seekers, are situated far away from the centres, so an asylum seeker cannot be assisted by the closest medical facility (except for emergency situations).15 Another problem identified by the experts is a lack of intercultural competence amongst doctors.16 The Office for Foreigners noticed that for those asylum seekers living far away from the centres health care is provided in voivodeship cities in Poland and that coordination of visits is conducted by the helpline of the contractor, where the asylum seeker can get to know the time of the visit and ways to get the prescription.17
If an asylum seeker is deprived of material reception conditions or they are limited, they are still entitled to health care.18
- 1. Article 73(1) Law on Protection.
- 2. Information from the Office for Foreigners website: http://bit.ly/1XqYMIQ.
- 3. K. Maśliński, Prawne regulacje w zakresie dostępu do ochrony zdrowia nieudkumentowanych migrantów i cudzoziemców ubiegających się o ochronę międzynarodową w Polsce (Legal regulations on access to health careof undocumented migrants and foreigners seeking international protection in Poland), in A. Chrzanowska, W. Klaus, ed., Poza systemem. Dostęp do ochrony zdrowia nieudokumentowanych migrantów i cudzoziemców ubiegających się o ochronę międzynarodową w Polsce, 2011, available at: http://bit.ly/1T80U8n, 30.
- 4. Najwyższa Izba Kontroli (Supreme Audit Office), Pomoc społeczna dla uchodźców. Informacja o wynikach kontroli (Social assistance for refugees. Information about results of the control), November 2015, 5, available in Polish at: http://bit.ly/2lP90Z4.
- 5. UNHCR’s observation in a framework of the Age Gender Diversity Participatory Assessment 2016 presented during the meeting on 16 November 2016 in Warsaw.
- 6. Najwyższa Izba Kontroli (Supreme Audit Office), Pomoc społeczna dla uchodźców. Informacja o wynikach kontroli (Social assistance for refugees. Information about results of the control), November 2015, 5, available in Polish at: http://bit.ly/2lP90Z4.
- 7. Letter from the Head of the Office for Foreigners from 27 August 2015 no BSZ-0811/1429/15/RW. See also EMN, op. cit., 39.
- 8. The Office for Foreigners claims that those psychologists’ assistance concentrates on psychological support and counseling and also on diagnosis of mental disorders, including PTSD.
- 9. M. Książak, Dostęp do pomocy medycznej i psychologicznej osób ubiegających się o status uchodźcy w Polsce (Access to medical and psychological care of asylum seekers in Poland), in A. Chrzanowska, W. Klaus, Poza systemem. Dostęp do ochrony zdrowia nieudokumentowanych migrantów i cudzoziemców ubiegających się o ochronę międzynarodową w Polsce, 180-182. This opinion is contested by the Office for Foreigners, claiming that psychological diagnosis and diagnosis of PTSD are provided to asylum seekers, available at: http://bit.ly/1T80U8n.
- 10. NGO (LIA) representative, interview from October 2016.
- 11. Ibid, 174-176.
- 12. Letter from the Head of the Office for Foreigners from 27 August 2015 no BSZ-0811/1429/15/RW, confirmed by the Office for Foreigners’ letter to HFHR from 1 February 2017 no BSZ.WAiSM.0361.7.2017/TB.
- 13. Centrum Pomocy Prawnej im. H. Nieć, Situation of Dublin Returnees in Poland. HNLAC Information Note – July 2016, p. 8, available at http://bit.ly/2lkV08v.
- 14. Letter from HFHR to the Head of the Office for Foreigners from 13 September 2016 no. 1765/2016/BD.
- 15. N. Klorek, op. cit., 93-94.
- 16. H. Grzymała-Moszczyńska, Uchodźcy jako wyzwanie dla polskiego systemu opieki zdrowotnej (Refugees as a challenge for the Polish health care system), in A. Chrzanowska, W. Klaus, Poza systemem. Dostęp do ochrony zdrowia nieudokumentowanych migrantów i cudzoziemców ubiegających się o ochronę międzynarodową w Polsce, 2011, 143.
- 17. The Office for Foreigners’ letter to HFHR from 1 February 2017 no BSZ.WAiSM.0361.7.2017/TB.
- 18. Articles 76(1) and 70(1) Law on Protection.