To this day, many people are denied access to essential health services simply because they do not have the right paperwork to be in the country they live in. States, however, have a general duty under international human rights law to ensure the right to health. This also requires states to address living conditions and other factors that affect health. All of this should be done without any discrimination based on nationality or residence status. But in reality, that’s not always the case.
Even in countries where health services are available as a matter of law, there remain many administrative and other practical barriers that can prevent people who are undocumented from receiving the care they are entitled to. They may fear or actually risk being denounced to the immigration authorities or receiving large bills they cannot pay as a result of accessing services. They may also be incorrectly denied care and turned away because of complicated and inconsistently applied rules. Sometimes, administrative personnel in hospitals is not even aware that undocumented people have a right to access health care services. As a result, people who are undocumented often do not use even the health services they are entitled to. When they do access health services, it is often late, in emergencies.
Linking access to health care to residence status above all hurts individuals, families and communities. People unable to access the health system are deprived of comprehensive information about prevention and promotion and therefore cannot properly manage health-related risks. Health care providers are also often the first points of contact for people who have experienced violence. They provide an essential connection with other key services and supports, such as access to justice.
Linking health care and residence status also puts health providers in the position of compromising their medical ethics.
Shutting people who need care out of the health system can have disparate effects on children, who may be unable to go to school without vaccinations; on women, who cannot benefit from gynaecological screenings without access to primary health care; and others, like people with disabilities or chronic conditions, whose condition can worsen irreversibly without early and appropriate attention. This means that treatable, even preventable, conditions are unaddressed until it may be too late, which is costly for the individual as well as for the health system.
For legal, medical, financial, ethical and practical reasons, providing health care services to all residents, regardless of status, is beneficial, practical and necessary.
PICUM believes that every person should feel safe to seek medical care, regardless of their residence status.
We want health care services to be clearly detached from immigration control. This means prohibiting immigration enforcement actions near health care facilities and the sharing of personal data between the health system and immigration authorities.
We also want health services to be provided based on people’s needs, not their residence status, and removal of administrative barriers that hinder access to services.
We advocate for the reform of laws and policies that link health care services to immigration enforcement, and that limit access to health services based on a person’s residence status, so that adequate care can be provided based on need.
We do so by gathering and presenting evidence of approaches of governments and non-governmental partners at the local, regional and national levels to improve access to health care for people, regardless of residence status. We call attention to the rights – to health, to life, to privacy – that are promoted through inclusive health systems, and governments’ obligations to uphold them.
We work with national organisations that are members of our network to realise the right to health in their national contexts. And with international organisations like the World Health Organization, the International Organization for Migration and UNAIDS to develop and promote health standards that address the situation of undocumented people.
We participate in the Nobody Left Outside coalition to elevate issues affecting people who are among the most marginalised in our society, and to advance a shared set of goals addressing the systematic ways that our health systems fail those with the greatest need.
Contact: Dastan Salehi (firstname.lastname@example.org)