The right to healthcare is a constitutional right, applicable to third-country nationals as well as to citizens.
Beneficiaries of international protection and members of their families are subject to the same rules as residents of Poland in accessing healthcare, based on public health insurance. Being “insured” usually is related to the age and economic activity of the person (e.g., those under 18 years old, lawfully employed or retired, or registered as an unemployed person). Beneficiaries of international protection and members of their families who have temporary residence permits are directly included on the list of persons authorised to access public healthcare services if they are not “insured”, provided that their income meets the criterion specified in the Law on Social Assistance. Beneficiaries of refugee status or subsidiary protection obtained in Poland covered by an IIP are “insured” under the programme (except when they are insured for another reason). [1]
Importantly, in Poland, all children under 18 years old are entitled to free health care, even if they are not insured and the cost of their treatment is covered by the State Treasury. Children under 19 years old who attend school, regardless of their migration status, are covered by preventive healthcare which includes medical and dental examinations, rehabilitation programmes, health awareness education and health emergency education provided by school or district nurses.[2]
The health insurance with the NFZ covers all guaranteed health care services specified in the lists of the Ministry of Health. They include both basic and specialist medical services, vaccinations, diagnostic testing (laboratory or other), rehabilitation, hospital care and medical rescue services, emergency ambulance services and medical transport. Notably, nursing care for elderly persons is not provided in Poland.[3]
Although these provisions were in place for years, there are still cases where they are put in question. In 2021, SIP reported a case of a woman granted subsidiary protection 10 years earlier, who was charged with the costs of perinatal care provided in the hospital when she was delivering her child. This action was taken based on a decision made by the President of the NFZ. The reasoning of the decision mentioned that at that time the woman had not had social insurance. As a result of a complaint submitted by the woman, assisted by the NGO lawyer, the authority annulled its own decision admitting that the woman had a right to cost-free perinatal care.[4]
The main issue concerning access to healthcare are linguistic and cultural barriers.[5] Access to interpretation in the health care system is not available at all.[6] Other challenges are similar to the challenges Polish nationals are facing as well: long waiting time to have an appointment with a specialist, costly private medical services and expensive medicines. The IP beneficiaries’ access to health care is jeopardised by difficulties in accessing legal forms of employment, which guarantee free health care.[7] Researchers reported on episodes of discrimination and unjust treatment of international protection beneficiaries while accessing medical services.[8]
One of the gaps in medical services is the specialized treatment for victims of torture or traumatized refugees. There is a clear lack of qualified psychologists and therapists specializing in treating trauma, in particular in an intercultural context.[9]
Some recurring issues in 2023 include – despite the abovementioned language and cultural barrier – differences in approach to medical procedures in the country of origin and in the host country.[10]
[1] K. Sobczak-Szelc, M. Pachocka, K. Pędziwiatr, J. Szałańska, M. Szulecka, From Reception to Integration of Asylum Seekers and Refugees in Poland, 2023, available at: http://bit.ly/3KiKMCy, 201.
[2] Article 27(1) and (3) Law on healthcare services financed from public funds.
[3] Alexander Wolffhardt, Carmine Conte, Thomas Huddleston, The European benchmark for refugee integration: A comparative analysis of the National Integration Evaluation Mechanism in 14 EU countries, 2019, available at: https://bit.ly/2SlshUh, 122.
[4] SIP, Opieka medyczna dla kobiet w okresie porodu i połogu oraz ich dzieci, 10 May 2021, https://bit.ly/3vuhsTH.
[5] K. Sobczak-Szelc, M. Pachocka, K. Pędziwiatr, J. Szałańska, M. Szulecka, From Reception to Integration of Asylum Seekers and Refugees in Poland, 2023, available at: http://bit.ly/3KiKMCy, 203.
[6] Alexander Wolffhardt, Carmine Conte, Thomas Huddleston, The European benchmark for refugee integration: A comparative analysis of the National Integration Evaluation Mechanism in 14 EU countries, 2019, available at: https://bit.ly/2SlshUh, 124.
[7] Maryla Koss-Goryszewska ‘Służba zdrowia’ in A. Górska, M. Koss-Goryszewska, J. Kucharczyk (eds), W stronę krajowego machanizmu ewaluacji integracji: Diagnoza sytuacji beneficjentów ochrony międzynarodowej w Polsce (Instytut Spraw Publicznych 2019), 43.
[8] K. Sobczak-Szelc, M. Pachocka, K. Pędziwiatr, J. Szałańska, M. Szulecka, From Reception to Integration of Asylum Seekers and Refugees in Poland, 2023, available at: http://bit.ly/3KiKMCy, 201.
[9] K. Sobczak-Szelc, M. Pachocka, K. Pędziwiatr, J. Szałańska, ‘Integration Policies, Practices and Responses. Poland – Country Report’, Multilevel Governance of Mass Migration in Europe and Beyond Project (#770564, Horizon2020), available at: http://bit.ly/3bfjTxL, 136.
[10] Programme of Integration of Immigrants in the Malopolska Region, ‘Open Malopolska’, Program integracji imigrantów w województwie małopolskim „Małopolska otwarta”, 24 October 2023, available (PL) at: https://bit.ly/3wnhZtB, 13.