Equitable access to healthcare for refugees and asylum seekers

Proposer:

Tham Hui Ying

Affiliations:

Asylum Access Malaysia

Policy Code:

2f3 Refugees and undocumented

Problem Statement / Issue:

A lack of legal status results in arrest and detention for immigration offences when accessing healthcare. A Ministry of Health Directive (Circular No 10/2001) states that government healthcare staff are to report undocumented persons seeking treatment. Within the Covid-19 response, refugees, and asylum seekers were also arrested and detained after testing and treatment. Although documented refugees and asylum seekers are given a 50% discount from the foreigners’ rate, the overall fees for foreigners were doubled in 2016 resulting in the cost of healthcare services being inaccessible. Refugees and asylum seekers also lack access to insurance coverage. Women face barriers to accessing pre- and post-natal care particularly in places of detention and due to fear of arrest and detention. Children face challenges in accessing immunization as non-Malaysian children are charged RM80 under the 2014 Fees Order. Children also miss primary age immunization as they do not have access to national schools.

Value(s) and Belief(s):

As part of commitments under SDG Goal No 3, Malaysia pledged to ensure inequities in access to healthcare for the most vulnerable are reduced and universal health coverage is achieved for all. Malaysia must uphold its international obligations and pledge to leave “no one behind” in the public health response.

Proposal of Solution and Call to Action:

1. Repeal MoH Circular No 10/2001, and any other subsequent Circular(s) with obligations on healthcare providers to identify and report undocumented patients seeking treatment to law enforcement authorities.
2. Introduce a firewall (a separation) between healthcare providers and immigration and security enforcement. Take necessary steps to ensure firewalls are respected.
3. Initiate a sustainable, and comprehensive health-financing scheme within the public health system for refugees and asylum-seekers with the aim to reduce the cost barrier, promote self-reliance, and improve universal health coverage.
4. Implement a public health response that is inclusive and regardless of legal status. Particularly within the Covid-19 response, ensure safe access to vaccinations, testing, and treatment for refugees and asylum seekers without reprisal.
5. In collaboration with civil society and refugee-led organizations, increase healthcare providers capacity to provide translation and interpretation services, and health education to increase health literacy, and enhance understanding of healthcare providers of the vulnerabilities, challenges, needs of refugees and asylum seekers.
6. Strengthen implementation of health policies and guidelines in all places of detention to ensure persons detained have adequate and prompt access to medical care when needed.
7. Amend the Fee Order to ensure that non-Malaysian children have access to free vaccinations.

Translation

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