Author
The initial medical examination of asylum seekers after their initial admission to a reception centre (EAST or VQ) is usually conducted within 24 hours. A general examination is conducted through a physical examination including vital signs, skin lesion, injuries, including Tuberculosis (TBC) X-ray and questions on their state of health by means of a standardised medical history. If, within the scope of the medical examination, circumstances indicate that further investigations are required, asylum seekers are transferred to specialist doctors or a hospital.[1] After the asylum seeker has submitted the asylum application, they must undergo a mandatory medical examination, including a tuberculosis examination. The Ministry of the Interior has commissioned the BBU GmbH to carry out the medical examination, which is part of the admission procedure. The company has contracts with general practitioners and nurses to provide health care in the federal reception centres.
Every asylum seeker who receives Basic Care has health insurance. Treatment that is not covered by health insurance may be paid, upon request, by the federal provinces’ departments for Basic Care or the Ministry of Interior. If Basic Care is withdrawn, asylum seekers are still entitled to emergency care and essential treatment.[2]
In practice, this provision is not always easy to apply, however. If an asylum seeker has lost basic care due to violent behaviour or absence from the EAST for more than three days, they will not receive medical assistance, because it is assumed that they have had the opportunity to visit the medical station in the EAST. However, as those asylum seekers are no longer registered in the EAST, they will not be allowed to enter and receive medical treatment there. Without health insurance or access to the medical station of the EAST, asylum seekers may face severe difficulties in receiving necessary medical treatment. Some of them come to the NGO-run health project AMBER MED with doctors providing treatment on a voluntary basis.[3]
In some federal provinces such as Vienna, asylum seekers receive an insurance card in the same way as other insured persons and can thus access health care with their insurance contracts without complications. In all other provinces, asylum seekers do not receive an ecard, instead of the ecard they receive a replacement document (c-card Ersatzbeleg), except Tyrol where people in basic care have their insurance number written on the back side of their white ID card, which is working well when going to a doctor’s office. Caritas Salzburg reports that it is also working without replacement document, and doctor’s appointments could also be made this way because of the plug-in card system, it is only necessary to tell the insurance number.[4]
Asylum seekers are obliged to submit medical findings and expert opinions, if those help to assess the presence of a mental disorder or other special needs (§ 2 Abs. 1 GVG-B).[5] (See Use of medical reports).
Since September 2018, hospitals have the obligation to inform the BFA of the upcoming release of a foreigner against whom a deportation procedure is pending. This is not mandatory but happens upon requests of the BFA. However, once such a request has been issued, hospitals are obliged to keep the BFA updated of relevant developments (e.g. if there a change in the release date for example). The police may further also be informed on the matter by the BFA upon explicit request.[6] In practice, there are no reports by hospitals that the police or BFA have issued such information requests.
Specialised treatment
In each federal province, one NGO part of the Network for Intercultural Psychotherapy and Extreme Trauma provides treatment to victims of torture and traumatised asylum seekers. This is partly covered by AMIF funding, partly by the Ministry of Interior and regional medical insurance. However, the capacity of these services is not sufficient. Victims often have to wait for more than 6 months in Vienna, Styria and Tyrol for psychotherapy, while in other federal states they wait approximately 3 months.[7]
The Basic Care system – and thus the health care provided – varies from one federal province to another and is regulated in many different laws on state level. In some federal provinces, asylum seekers will be provided care in regular special care facilities (see Special Reception Needs). “Increased care” for special needs must however be requested by the social worker. A prerequisite for receiving additional care is the submission of up-to-date specialist medical findings and assessments demonstrating a need for care, as well as social reports not older than 3 months. These requirements contribute to the asylum seeker’s obligation to cooperate throughout the procedure. Reports from NGOs are also taken into account when examining the additional need for care.[8]
[1] Ministry of Interior, Answer to parliamentary question 8774/J (XXV.GP), 17 May 2016, available in German at: http://bit.ly/2lq2GHj.
[2] Article 2(4) GVG-B.
[3] See the official website AmberMed available in German at: http://www.amber-med.at/.
[4] asylkoordination österreich, Nationwide NGO survey on basic services, Dec 21/Jan 22, unpublished.
[5] Article 15 (1)3 Asylum Law.
[6] § 46 (7) Aliens police Law 2005.
[7] Projekt NIPE asylkoordination österreich de, available in German.
[8] asylkoordination Österreich, ‘Kompetenznetzwerk Grundversorgung’, last modified 17 March 2024, available in German at: https://bit.ly/3xUv51G.