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Europe’s excluded ‘falling through the cracks’ in health systems – report

By 9 November 2017February 9th, 2020No Comments
  • Survey of 43,000+ people shows high levels of suffering, unmet medical needs
  • Almost a quarter were children
  • 3% were under 5 years old
  • High number of Syrian people cannot access healthcare services
  • Brexit negotiations: Report calls on EU institutions to prioritise healthcare coverage both for EU citizens living in the UK and UK citizens living in the EU
  • Observatory Report says austerity is putting public health at risk, urges Europe to recommit to universal health coverage

Dublin – Healthcare systems across Europe are failing the continent’s most marginalised people, humanitarian group Médecins du Monde warned in a new report today.

The report draws on data and interviews gathered from 43,286 people who attended clinics and programmes run by Médecins du Monde and partner NGOs in 14 countries in 2016.  These included national citizens in their own countries, as well as EU/EEA migrants, and migrants from outside of EU/EEA, many of whom had fled violence, conflict or discrimination in countries such as Syria and Afghanistan. Almost a quarter of those seen by the charity were children under 18.

The report includes data and testimonies collected by the Migrant Rights Centre Ireland, which operates a free advice, information and support service in Dublin city centre.

As well as physical problems, many people surveyed were suffering psychological trauma. Of those who responded, over half talked about violence in their consultation[1] and more than 60 per cent of those who reported having children under 18 were separated from some or all of their children[2].

“This report details a healthcare crisis across Europe,” said Edel McGinley, Director of the Migrant Rights Centre Ireland. “In Ireland, we see adults and children who are undocumented and unable to access essential care, women who are pregnant and afraid to go to the hospital because they are undocumented, even people with cancer who have paid taxes in Ireland for years but can’t access treatment here because they don’t have the right papers.”

The report documents European countries’ backsliding on commitments to universal health coverage in the face of austerity. It details backward legal steps in Ireland, France, Germany, and the United Kingdom. It said restrictive measures limiting access to healthcare for migrants had been detrimental to people in situations of vulnerability – and criticised countries such as the UK that have used healthcare as a tool of immigration enforcement.

“Everyone deserves healthcare.” said Ms McGinley. “People aren’t coming to Europe to access healthcare, but excluding them from services is cruel. Adults and children are falling through cracks in Europe’s healthcare systems; we can and must do better.”

The report calls for a more progressive, equitable approach to public health, including access to primary, antenatal and postnatal care, mental health services and health promotion.

It says governments should take steps to end administrative barriers and discrimination within healthcare services and to raise awareness of rights and entitlements amongst patients and healthcare workers, for example information campaigns and training frontline health staff on how to manage people in precarious situations.


Aoife Murphy 083 888 9185 / 01 524 1454

About the Report

The Observatory Report (click for full report and executive summary) is a snapshot of those who are falling through the cracks in European healthcare systems, based on data and interviews gathered in 2016 from 43,286 people in 13 countries across Europe who attended clinics and programmes run by Médecins du Monde, and partner NGOs. The report is produced in partnership with University College of London’s Institute of Global Health. Data on the health status of excluded groups is notoriously difficult to collect so the report, an annual piece of research, aims to further understanding of health inequalities and inform advocacy towards more equitable healthcare systems in Europe.

About The European Network to reduce vulnerabilities in health

The European Network to reduce vulnerabilities in health, hosted by Médecins du Monde, brings together MdM programmes, partner NGOs and academics from 17 EU member States and 2 EFTA/EEA countries. The Network common goal is to contribute to decreased EU-wide health inequalities and to more responsive health systems that are better equipped to deal with vulnerability factors that increase health inequalities.

About Migrant Rights Centre Ireland (MRCI)

MRCI operates a free and confidential advice, information and support service in Dublin city centre. Some 2,000 people from over 100 countries come to the service every year. Since 2015, MRCI caseworkers have been working with Médicins du Monde to survey service users about access to healthcare in Ireland.

About Médecins du Monde

Médecins du Monde is an independent humanitarian movement working at home and abroad to empower excluded people to access healthcare. Through over 350 programmes in 80 countries run by more than 3,000 volunteers, MdM provides medical care, strengthens health systems and addresses underlying barriers to healthcare.

Case studies

Testimonies from patients interviewed from the report can be found here

[1] 51.8% (9,667/18,650).

[2] 61.7% (1,496/2,425)