Author
Access to health care is provided for asylum seekers as part of the reception conditions.[1] It covers essential medical services and corresponds to the 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 the Asylum Decree, 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.’[3]
In practice, there are no guidelines for identifying vulnerable asylum seekers as well as a lack of specialised medical services. Furthermore, only a few experts speak foreign languages and even fewer have experience in dealing with torture or trauma survivors. The Cordelia Foundation, a Budapest based NGO, is the only organisation with the necessary expertise and experience and that is specialised in providing psychological assistance to torture survivors and traumatised asylum seekers. Their capacity is constrained and every year the question arises whether it will continue to provide these much-needed services, as its activities are funded on a project-by-project basis and not under the framework of a regular service provider contracted by the NDGAP. The therapeutic activities of the Foundation include verbal and non-verbal, individual, family and group therapies, and psychological and social counselling.
In 2021, the psychologists and psychiatrists of Cordelia visited Balassagyarmat, Vámosszabadi and Fót on a weekly-fortnightly basis unless the reception facilities were under lockdown due to the COVID-19 pandemic.[4] In 2022, the Cordelia foundation continued visiting Fót facility. In 2023, the Cordelia foundation did not visit Fót, neither Balassagyarmat nor Vámosszabadi.
In 2021, four psychiatrists, two psychologists and two intercultural mediators provided psycho-social assistance to a total of 179 people in the reception centres, asylum detention and Budapest. In 2022, 14 Cordelia therapists treated 253 patients in Budapest, out of those 189 were refugees from Ukraine. In 2023, 15 Cordelia therapists treated 198 patients in Budapest and 85% were refugees from Ukraine.
The psychologist of the Menedék Association also visited Fót and Vámosszabadi regularly in 2020. In 2021 only for the first half of the year was a psychologist present (online) from the organisation in Fót.
According to the NDGAP,[5] child asylum seekers have regular access to a paediatrician in Vámosszabadi, and since 15 June 2020, there is one general practitioner available for adults. Depending on the number of residents, medical services were provided twice or once a week or as needed.[6] In 2022 and 2023, however, there were no asylum seekers in Vámosszabadi.
In Balassagyarmat asylum seekers are provided with specialised and general medical care by the local health care services in town.[7]
Concerning unaccompanied or separated asylum-seeking children, access to health care services is seriously delayed due to the Embassy procedure. Even though the submission of the statement of intent at the Hungarian Embassies in Kyiv or Belgrade can be realised by the legal guardian of the UaSC, children are often not registered as asylum seekers for months. And, although the Health Insurance Act provides for the health care of children temporarily placed in Fót, health service providers are unaware of the applicable type of billing, due to a legislation gap in the executive decree.[8] Thus, health care is provided only on the condition that the childcare facility reimburses the costs.[9] There are many children who have serious health problems, have had an accident (e.g. fell from the Serbian-Hungarian border fence) or were subject to police ill-treatment. These children initially received emergency health care. However, their access to subsequent necessary health treatments is hindered by the fact that Fót is reluctant to reimburse the costs. The same issues were reported by the Menedék Association for 2022 and 2023. In addition, Ukrainian children were placed in Fót, and in their case, the slow appointment of a guardian caused a problem.
The Asylum Decree states that asylum seekers residing in private accommodation are eligible for health care services at the general physician operated by the competent local government and determined by the residency address of the applicant.[10] In practice, these asylum seekers struggle with accessing medical services as physicians systematically refuse the registration and treatment of asylum seekers on the ground that they lack a health insurance card. According to oral information provided by the former IAO in 2016, asylum seekers can be registered with the number of their humanitarian residency card and have to be treated in accordance with the law, although not all health centres are aware of this information. The Menedék Association and the legal officers of the HHC often provide asylum seekers with the necessary written explanation (written in Hungarian) that the patients can take with themselves to the check-ups, thus avoiding any misunderstanding and complications. Eventually, the social workers of the Menedék Association even give a call to the doctor and explain the legal eligibility of the asylum-seeker over the phone. This solution proves successful. The same problem persisted in 2023 as well, as some doctors believing that they can only treat free of charge people who have Hungarian social security number (TAJ).
[1] Section 26 Asylum Act.
[2] A detailed list is provided under Section 26 Asylum Decree.
[3] Section 34 Asylum Decree.
[4] For further information about reception conditions during the covid19 pandemic, see 2020 and 2021 updates to this report, available at: https://bit.ly/41vZs9h.
[5] Information provided by the NDGAP on 2 March 2021 and on 7 February 2022.
[6] Information provided by the NDGAP on 7 February 2022.
[7] Information provided by the NDGAP on 19 February 2023.
[8] Section 22(1)(m) of the Act CXXII all 2019 on Health Insurance.
[9] Note that emergency health care is ensured in all cases.
[10] Section 27(2) Asylum Decree.