Health care

Poland

Country Report: Health care Last updated: 30/11/20

Author

Independent

Access to health care for asylum seekers is guaranteed in the law under the same conditions as for Polish nationals who have health insurance.[1] Health care for asylum seekers is publicly funded.

Basic health care is organised in medical offices within each of the reception centres. The Office for Foreigners informed that until 15 June 2019 the medical doctor in the centres had 10 duty hours per 120 asylum seekers, while the nurse had 20 hours for the same amount of possible patients. Both had 3 hours a week extra for every additional 50 asylum seekers. Since 16 June 2019, the medical doctor in the centres has 6 duty hours per 120 asylum seekers, with 3 hours a week extra for every additional 50 asylum seekers, at least three times a week. Additionally, in every centre the duty hours of a pediatrician should be organized at least for 4 hours a week per 50 children, with extra 2 hours of duty for every additional 20 children. The duty hours of nurses have not changed.[2]

There is a medical centre at the Office for Foreigners as well, however in 2019 the Supreme Audit Office concluded that it had not been managed properly (in particular it was open one hour a day shorter that it was agreed with the Office for Foreigners).[3]

Heath care for asylum seekers includes treatment for persons suffering from mental health problems. Currently, psychologists work in all the centres for at least 4 hours a week for every 120 asylum seekers. This is extended to 1 hour for every additional 50 asylum seekers.[4] Their help is limited to basic consultations, however.[5] Asylum seekers can also be directed to a psychiatrist or a psychiatric hospital. According to some experts and many NGOs, specialised treatment for victims of torture or traumatised asylum seekers is not available in practice.[6] NGOs still point at the lack of proper treatment of persons with PTSD. The available psychological assistance is considered an intervention, not a regular therapy.[7] There is a shortage of psychologists prepared to work with vulnerable and traumatized asylum seekers.[8] Moreover, there are only three specialised NGOs that provide psychological consultations and treatment to asylum seekers.[9] In 2019, some form of psychological support was provided by NGOs only in three reception centres.[10]

The medical assistance is provided since July 2015 by the private contractor Petra Medica,[11] with whom the Office for Foreigners has signed an agreement to coordinate medical care for asylum seekers. The Office for Foreigners monitors the application of this agreement. The quality of medical assistance provided under this agreement has triggered wide criticism. In particular, some asylum seekers are refused access to more costly treatments. It happens that only after NGOs’ interventions and months of fighting for the access to a proper medical treatment, asylum seekers were able to receive it.[12] The access to a treatment is particularly difficult for HIV-positive asylum seekers. In 2019, the SIP described its battle to provide the continuation of the treatment for the asylum-seeking women that was HIV-positive and had a Hodgkin lymphoma. The women started the treatment in Germany and afterwards was sent back to Poland under the Dublin III Regulation. In Poland, she faced multiple refusals of the treatment and administrative obstacles to receiving medical assistance from proper doctors and medical facilities. She was not referred to infectious diseases, cardiological nor psychiatric clinics even though the medical documentation from Germany found it was necessary. She was repeatedly misinformed that she is not entitled to the HIV-treatment in Poland. Even though she was in bad health condition, the staff of the centre in Dębak refused calling for the ambulance explaining (falsely) that she was not entitled to it. Moreover, one of the Polish doctors said to her that Poland does not need sick people. Finally, the foreigner received proper treatment in Poland. Thanks to the German doctor who sent her additional medication, she was left without it ‘only’ for two weeks. The SIP points out that it was not an exceptional situation.[13]

One of the biggest obstacles in accessing health care that asylum seekers face is the lack of intercultural competence and knowledge of foreign languages amongst doctors and nurses.[14] Petra Medica that is responsible for the provision of medical assistance to asylum seekers is also obliged to ensure interpretation during the medical and psychological consultations, if it is needed.[15] According to the governmental information, such interpretation is available in Russian, Ukrainian, English, Georgian, Persian, Arabic, Chechen, Uzbek. Doctors working in the centres are expected to know Russian.[16] However, since 2016 NGOs have been expressing concerns in regard to availability and quality of the interpretation provided to asylum seekers in connection with medical consultations[17].

Another challenge is the fact that some clinics and hospitals providing medical assistance to asylum seekers are located far away from the reception centres, so an asylum seeker cannot be assisted by the closest medical facility, except for emergency situations. The Office for Foreigners noticed that for those asylum seekers living outside the reception centres health care is provided in voivodeship cities in Poland and that coordination of visits is conducted by the helpline of the contractor, where the asylum seeker can learn about the time of the visit and ways to get the prescription.[18]

If an asylum seeker is deprived of material reception conditions or they are limited, they are still entitled to health care.[19]

In 2019, the Office for Foreigners registered 13 complaints, all of them concerned medical assistance.[20]


[1]  Article 73(1) Law on Protection.

[2] Information provided by the Office for Foreigners, 22 January 2020.

[3] Supreme Audit Office, Przygotowanie administracji publicznej do obsługi cudzoziemców. Informacja o wynikach kontroli (2019), available (in Polish) at: https://bit.ly/2OIlqln, 43.

[4]Information provided by the Office for Foreigners, 22 January 2020.

[5]  See Pachocka, M. and Sobczak-Szelc K., ‘Refugee Protection Poland – Country Report’, Multilevel Governance of Mass Migration in Europe and Beyond Project (Horizon2020), January 2020, available at: https://bit.ly/2U1A9uL, 70. The Office for Foreigners claims that those psychologists’ assistance concentrates on psychological support and counselling and also on diagnosis of mental disorders, including PTSD.

[6] See e.g. M. Szczepanik, Right to healthcare and access to medical services for asylum seekers and beneficiaries of international protection in Poland, May 2017, available at: http://bit.ly/2CxXokd.

[7] Information provided by the Association for Legal Intervention, October 2016.

[8] Pachocka, M. and Sobczak-Szelc K., ‘Refugee Protection Poland – Country Report’, Multilevel Governance of Mass Migration in Europe and Beyond Project (Horizon2020), January 2020, available at: https://bit.ly/2U1A9uL, 71.

[9]  M. Szczepanik, Right to healthcare and access to medical services for asylum seekers and beneficiaries of international protection in Poland, May 2017, available at: http://bit.ly/2CxXokd.

[10]  Information provided by the Office for Foreigners, 22 January 2020.

[11] Information from the Office for Foreigners website: http://bit.ly/1XqYMIQ; Office for Foreigners, Guidebook Department of Social Assistance (2019), available at: https://bit.ly/39ljreM, 6.

[12] Such problems were notified by SIP on 8 January 2020 in regard to the HCV. In 2019, in one case, it took more than half of the year from the diagnosis and determination of the proper treatment to the factual provision of the treatment due to the administrative obstacles.

[13] O. Hilik, ‘Leczenie osób zarażonym wirusem HIV w postępowaniu w przedmiocie udzielenia ochrony międzynarodowej’ in Stowarzyszenie Interwencji Prawnej (SIP), SIP w działaniu. Prawa cudzoziemców w Polsce w 2018 r. (2019), available (in Polish) at: https://bit.ly/2viZkz5, 46-48.

[14]  M. 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 (Instutut Spraw Publicznych 2019), 43.

[15] Information provided by the Office for Foreigners, 1 February 2017.

[16] Ministerstwo Pracy, Rodziny i Polityki Społecznej, Informacja o sytuacji osób starszych w Polsce za 2018 r. (2019), 146.

[17] Centrum Pomocy Prawnej im. H. Nieć, Situation of Dublin Returnees in Poland. HNLAC Information Note – July 2016, available at: http://bit.ly/2lkV08v, 8; HFHR, Letter to the Head of the Office for Foreigners, 1765/2016/BD, 13 September 2016. Information confirmed by SIP, 8 January 2020.

[18]Information provided by the Office for Foreigners, 1 February 2017.

[19]  Articles 76(1) and 70(1) Law on Protection.

[20] Information provided by the Office for Foreigners, 22 January 2020.

 

Table of contents

  • Statistics
  • Overview of the legal framework
  • Overview of the main changes since the previous report update
  • Asylum Procedure
  • Reception Conditions
  • Detention of Asylum Seekers
  • Content of International Protection
  • ANNEX I – Transposition of the CEAS in national legislation