Author
Access to health care for asylum seekers in the Czech Republic is guaranteed in law and practice, and it goes beyond emergency care. Asylum seekers are included in the Czech public health insurance system from the moment they make the application, meaning they are treated as insured persons under the Public Health Insurance Act and are entitled to health care on broadly the same terms as Czech nationals.[1] Therefore, because they are part of the public insurance system, asylum seekers can obtain both preventive and curative care, including general practitioner consultations, specialist care, hospital treatment, and necessary medical prescriptions.
The public health insurance system covers a wide range of services (outpatient, inpatient, emergency, preventive, etc.) subject to the general rules of the Czech system, and there is no formal legal restriction limiting asylum seekers only to emergency care.
In a detention centre, an applicant for international protection is entitled to the same level of health care as other detainees who have not applied for international protection.[2] This standard is lower than the standard of care afforded to applicants for international protection who are not detained. It includes emergency care for conditions that are immediately life-threatening, may lead to sudden death by exacerbating the disease progression, cause permanent disease progression without prompt provision of medical services, cause sudden suffering and pain, cause changes in the behaviour and actions of the person affected endangering them or those around them, or relate to pregnancy and childbirth, except for artificial termination of pregnancy at the request of the foreigner. Additionally, it includes healthcare care in connection with an ordered quarantine or in connection with other measures related to the protection of public health.[3]
In practice, asylum seekers have effective access to health care. There are no doctors in reception centres, so asylum seekers staying in reception centres can be accompanied to the doctor by social workers from the centre if needed. It does not happen that the applicant would have their reception conditions reduced or withdrawn (with the exception of the possibility to reduce the financial allowance).
The general Czech healthcare system includes mental health services (psychiatric and psychological care) that are available to insured persons, including asylum seekers. However, there is no separate legal provision that specifically guarantees specialised mental health care for torture survivors or traumatised asylum seekers beyond general access to mental healthcare services. In practice, access to psychological care is generally problematic in the Czech Republic. The demand for psychological care is rising and waiting periods can be quite long (weeks or months). For those applicants accommodated in residential centres, psychological help is available directly in the centre.[4] A psychologist is not always present at the facility. The RFA has contracts with selected psychologists who are available by appointment. Only few psychologists have contracts with the insurance companies that would allow people to seek psychological help on the expenses of the insurance company. Most of the time it is necessary to pay for psychological help (usually 1,000 – 1,500 CZK; approx. €40 – €60 an hour) which is not manageable for most asylum seekers.
Specialised trauma- or torture-specific treatment is not formally guaranteed by law and often depends on referrals and capacity within the system. In practice, specialised psychosocial support services are often run by NGOs working with refugees and migrants (e.g., AMIGA for mental health and psychosocial support, proFem for survivors of gender-based violence). These NGOs, however, are facing some budget cuts which make the availability of their services very limited.
[1] Section 7(1)(p) of the Act No. 48/1997 Coll., on Public Health Insurance and on Amendments and Supplements to Certain Related Acts
[2] Section 88(5) Asylum Act in conjunction with section 176 of the Immigration Act.
[3] Section 176(1) of the Immigration Act.
[4] Under section 42(2) of the Asylum Act psychological services shall be ensured for asylum seekers accommodated in asylum facilities.