Author
The COA is responsible for the provision of health care in the reception centres. In principle, the health care provided to asylum seekers should be in line with the regular health care applied in the Netherlands. As any other person in the Netherlands, an asylum seeker can therefore visit a general practitioner, midwife or hospital. As of 1 January 2018, the Regeling Medische zorg Asielzoekers (RMA) Healthcare was the first point of reference for asylum seeker who had health issues.
As addressed above, issues connected to the lack of accessible health care services in emergency locations and crisis emergency locations emerged in 2022. On 3 August 2022, the Inspection of the Ministry of Health Care and Youth warned the Minister of Health Care and Youth and the Secretary of State of Justice and Security about the alarming situation with regard to access of health care in crisis emergency locations.[1] The Inspection saw that medical care for asylum seekers in crisis emergency locations is seriously suffering under the current crisis conditions. The care is sometimes limited to emergency care. That is less than the normal medical care to which everyone is entitled. It is also less than the medical care that asylum seekers’ centers and ‘ordinary’ emergency reception locations offer. In crisis emergency locations, care providers often cannot work according to the usual standards and guidelines, no matter how hard they try. This is due to the rapid grow of crisis emergency locations, to a lack of personnel and to the fact that many of the asylum seekers staying at these locations have not yet been registered – making it difficult to arrange the health insurance. There is a risk that healthcare will stagnate even more.
The relevant legal provision can be found in Article 9(1)(e) RVA. This provision is further elaborated in the Healthcare for Asylum Seekers Regulation (Regeling Zorg Asielzoekers). According to the latter, asylum seekers have access to basic health care. This includes inter alia, hospitalisation, consultations with a general practitioner, physiotherapy, dental care (only in extreme cases) and consultations with a psychologist. If necessary, an asylum seeker can be referred to a mental hospital for day treatment. There are several institutions specialised in the treatment of asylum seekers with psychological problems, such as Pharos.
When an asylum seeker stays in a reception facility but the RVA is not applicable, health care is arranged differently. Asylum seekers in the POL, the COL, as well as rejected asylum seekers in the VBL and adults in the GL only have access to emergency health care.[2] In medical emergency situations, there is always a right to healthcare, according to Article 10 of the Aliens Act. For this group, problems can arise if there is a medical problem that does not constitute an emergency. Care providers who do help irregular migrants who are unable to pay their own medical treatment can declare those costs at a special foundation, which then pays the costs.
Problems might also arise with respect to access to health care where the asylum seeker wants to use a health care provider whose costs are not covered by their insurance.
Asylum seekers, undocumented migrants and migrants in detention centres are explicitly included in the COVID-19 vaccination strategy.[3] Around half of the asylum seekers living in AZCs have received one or more vaccinations. Due to the influx and outflow, the vaccination rate varies. Furthermore, not all vaccinations are registered in medical files (e.g. vaccinations that were given abroad), which means that these residents are not included in the vaccination rate. On 29 November 2021, it was recorded that a total of 18,648 asylum seekers had received one or two vaccinations.[4] For 2022, these figures were not made available by the COA.
[1] Inspection Health Care and Youth, ‘Medische zorg in crisisnoodopvang asielzoekers onder enorme druk’, 3 August 2022, available in Dutch at: https://bit.ly/3Qp954k.
[2] Article 10(2) Aliens Act.
[3] See, point 2.3. Rijksinstituut voor Volksgezondheid en Milieu, COVID-19-vaccinatie Uitvoeringsrichtlijn, March 2021, available at: https://bit.ly/30wlHxw.
[4] Answers to questions of Member of Parliament by the Minister of Public Health, Welfare and Sports, 13 December 2021, available in Dutch at: https://bit.ly/33ndkbZ.