Europe’s excluded are falling through the cracks of healthcare

Whether it is an elderly German man who lost his job or a young boy that reached Europe fleeing war at home, Europe’s excluded are falling through the cracks of healthcare systems, writes Médecins du Monde.

Dr Françoise Sivignon is President of Médecins du Monde.

Your marriage dissolves and you lose your job. You have financial troubles because your benefits aren’t enough to care for you and your child. So you forego the prescriptions you need to care for your high blood pressure—how could you afford it without insurance, anyway?—and hope your circumstances change before anything life-threatening happens.

This is the story of Klaus, a 60-year old German national who sought help in one of our clinics last year, one of over 43,000 people we saw in the past year in 14 countries.

Our experience shows us that unmet medical needs and high levels of suffering is a reality for far too many in Europe who are living below the poverty line or fleeing conflict, violence or discrimination.

However, healthcare should not be made available only to those who have a certain level of income or live within certain borders. Despite  being a cornerstone of the EU Charter of Fundamental Rights, of the patients seen by Médecins du Monde in 2016, 3 in 5 did not have access to even the most basic healthcare coverage.

A number set to increase further as European countries backslide on commitments to universal health coverage in the face of austerity and implement restrictive measures to limit migrants access to healthcare.

Administrative complexity, lack of knowledge of the local language and bureaucratic procedures, as well as fear of arrest – a particular concern of migrants in countries such as the UK and Germany, where health systems have turned into tools for immigration enforcement – were also cited as barriers to accessing healthcare. As a result, Europe’s excluded are falling through the cracks of healthcare systems.

Regardless of a person’s immigration or economic status, healthcare is a universal human right for all. European healthcare is entering a critical phase, and now is the time to commit to strengthening health systems to ensure everyone has access to care across the EU.

As the European Commission develops projects to strengthen cooperation on prevention, research, data-sharing and cross-border project financing, they too should consider how to encourage cooperation and research into public health, health inequalities and healthcare systems to enable European-wide solutions, informed by evidence, to assist in making policies that protect the most marginalized from falling through the cracks.

As WHO Director General DR Tedros Ghebreyesus has said, ‘health coverage is a political choice [and] it is the responsibility of every country and national government to pursue it.’ Access to healthcare is a key pillar of the UN International Covenant on Economic, Social and Cultural Rights and of the UN Sustainable Development Goals – to which European countries are signatories.

It is imperative to start living up to these commitments, and the first step in that direction is for policy-makers to understand the scale of the deficiencies of and inequalities within European healthcare systems.

It is each government’s responsibility to uphold these commitments. Europe’s health ministers should work towards a more progressive and equitable approach to public health, including infectious disease prevention, access to primary, antenatal and post-natal care, public mental health services and health promotion.

To this end, 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, to ensure everyone, including the most vulnerable, has access to healthcare within Europe’s borders.

It was in our clinics that Klaus received treatment for his condition. Nevertheless, he was failed by his country’s healthcare system, which was unequipped to provide him with the care he needed.

While anyone can hit a road bump in life, it is up to our governments to ensure that adversities do not translate into life threatening health conditions. Whether it is an elderly German man who lost his job or a young boy that reached Europe fleeing war at home, we must strive for quality healthcare to no longer be a privilege for the few, but a right for all.