Asylum seekers without adequate resources are entitled to free medical care in public medical institutions covering at a minimum, emergency health care and essential treatment of illnesses and serious mental disorders. Welfare beneficiaries and residents in the reception centre are explicitly eligible for free medical care and in that respect they have access to free health care. The level of resources needed to receive free medical care in the case of asylum seekers not receiving welfare assistance is not specified.
Free access to health care is granted upon the presentation of a “Type A” Hospital Card, issued by the Ministry of Health. This document is provided to all residents of the Kofinou Reception Centre, while for persons residing in the community, a welfare dependency report indicating lack of resources is required by the Ministry of Health. This dependency report must be submitted by the individual applying for the hospital card. Evidence suggests that a lack of information and coordination between Welfare Services and the Ministry of Health has deprived persons from securing free health care as they are not aware of such a right. Asylum seekers are no longer able to apply for the Hospital Card at local hospitals and are required to commute to the Ministry of Health in Nicosia in order to obtain it.
As of the 1 June 2019, a National Health System (GESY) is in effect for the first time in Cyprus, introducing major differences in the provision of health care services. The new system introduces the concept of a personal GP in the community as a focal point for referrals to all specialised doctors. A network of private practitioners, pharmacies and diagnostic centres has been set-up in order for health services to be provided, and in June 2020 a number of private hospitals are also expected to join the new health system for purposes of in-hospital treatment. For the most part of the population (Cypriots and EU citizens) in Cyprus, health services are now provided almost exclusively under the new health system.
Asylum seekers, along with other segments of the migrant population, are not included in the provisions of GESY. Their access to health services continues under the provisions of the previous system, which basically entails treatment by public, in-patient and out-patient departments of the public hospitals. The transition to the new health system impacted access of asylum seekers to those services, as, until the 18 December 2019 when a relevant decision by the Council of Ministers was issued, there were no official decisions on the exact procedures regarding asylum seekers’ access to health services.
The transition to the new system created vast confusion among medical and hospital staff in regard to asylum seekers’ rights to health care. In various instances across Cyprus, and as it was reported to the Cyprus Refugee Council and other NGOs, persons were denied access to treatment in the hospital and were asked to register with GESY instead. Scheduled appointments with doctors who, in the meantime, had joined GESY were cancelled, access to particular medicine was also restricted. Although the situation at present is better, further monitoring is required.
The transition to the new health system is particularly relevant after the measures for tackling Covid-19 were taken. According to such measures, the public is expected to consult personal GPs before visiting the hospitals. As asylum seekers are not covered by GESY, they do not have access to personal GPs, which has created a serious shortcoming in accessing appropriate health care services. In addition, language barriers also prohibit asylum seekers from receiving health related information about Covid-19 through the hotline which was set-up for this purpose (1420). NGOs and volunteers in the community are trying to facilitate access to information for asylum seekers in respect of Covid-19, but this is far below the current needs of the population.
Further obstacles in accessing health services include the fact that many asylum seekers do not receive welfare assistance, which creates difficulties in securing a hospital card. In practice, however, the vast majority of asylum seekers do receive a hospital card, which grants them access to public health institutions with some charges, which applied to nationals from 2013 and since the introduction of GESY. More specifically, applicants are required to pay €3-6 in order to visit a doctor and an additional €0.50 for each medicine / test prescribed, with a maximum charge of €10. Emergency care remains free for holders of medical cards, otherwise it costs €10.
Asylum seekers who need to receive essential treatment which is not available in the RoC are not included in the relevant scheme introduced by the Ministry of Health transposing the Directive on patients’ rights in cross-border healthcare. In practice, however, the Ministry has covered the costs, upon approval of the Minister of Health, for several cases of child asylum seekers to receive medical treatment outside the country.
In a number of cases, asylum seekers reported to Cyprus Refugee Council that they faced racist behaviour from medical staff, often in relation to their poor Greek language skills and the reluctance of the latter to communicate in English.
Specialised health care
Asylum seekers without adequate resources who have special reception needs are also entitled to free of charge necessary medical or other care, including appropriate psychiatric services. The Refugee Law incorporates the provision of the recast Reception Conditions Directive in relation to the identification and addressing of special reception needs, including victims of torture. However, in practice, due to the recent amendment as well as a lack of specific guidelines or procedures, the provisions are not implemented yet. There are no specialised facilities or services, except for the ones available to the general population within the public health care system. Currently, there is only one NGO, the Cyprus Refugee Council, offering specialised social and psychological support to victims of torture, operating through the funds of United Nations Voluntary Fund for the Victims of Torture (UNVFVT) and the EU.
Article 9ΙΓ(1)(a) Refugee Law.
Ombudsman, Report on access of an asylum seeker to the social welfare system and medical services, 1553/2013, December 2016.
 Article 9ΙΓ(1)(b) Refugee Law.