During the organised exchanges for City Rights United access to health care kept coming back as main pressing issues in various countries in Europe.

Even though the precise bureaucratic systems have significant differences, the barriers experiences by the supporting organisations and the undocumented people themselves, are similar. Health care is one of those rights which seem to be difficult to access for irregular migrants in many different European countries.


Each Toolkit text is translated in Arabic, Spanish and French available through audio recording here below:

City Rights United decided to dive in to the topic and to unravel the precise barriers and collect some local solutions. We hosted a webinar with presentations of practices in Amsterdam, Stockholm and Naples to map the struggles and local solutions organisations have found.

After the series of webinars organized in 2020 and 2021, a group started to further look into the topic and have written down their findings. The group was under the lead of Juiliette Gagliardi.

You can download the complete booklet here (only in English), read the summary below or listen to the translation.

The work done by the healthcare access group consists of: Take awareness on the general importance of the Healthcare as a right which belongs to everyone.

There are various European and United Nations conventions and laws which all EU members have signed which take care of the right to health care. The members of the European Union have the obligation to provide the highest standard of accessible health care to everyone. In the booklet you can find the exact laws and covenants taking care of this right.

· We then outlined the main barriers to access healthcare services characterizing refugees and undocumented people:

1. Fear of being deported;

Despite being deported for accessing health care is strictly forbidden, the fear is great this will happen amongst undocumented people. This can be the consequences of not knowing their right but it is also the result of many years of policies aimed at criminalising migration. This has created a scepticism of approaching any governmental institutional, like hospitals.

In the German system there is also an Act which arranges that the Social Welfare Office has to transfer Data to the Foreigners’ Registration Office if they receive a request to cover the costs for medical services. The fear of being deported is not only in case of the access to health care but is a barrier in any sort of support given by the government.

2. Complexity in treating a patient with migratory background;

Basically, it is believed that the health status of migrants cannot be considered only from a strictly medical-healthcare point of view but subjective and objective factors in the life of migrants, and therefore of a socio-cultural, relational, economic and psychological, must be taken into consideration to assess their health status. It means in short that the migration process leaves it traces on the migrants and also has an influence on their health, this needs to be taken into considaration when treating a migrant.

3. Lack or misuse of language interpreters;

In Western countries, a growing number of migrants, with scarce or no knowledge of the language of the hosting countries, gives language interprets a fundamental role to guarantee access to services, in particular in the provision of healthcare services, where they are the key factor to respond to the need of a high quality communication. It is the fundamental element to establish a relationship of trust between physician and patient, making it easier for the patient to disclose symptoms and concerns. Physicians should be made aware of the importance of using professional interpreters, rather than untrained, to provide better care through an accurate communication and understanding of the cultural differences

4. Scarce financial availability;

Another barrier to access is related to the scarce financial availability of this fragile population, often living in precarious living conditions related to the impossibility to work legally and lack of financial state support from the State.

5. In some countries, denial to access to regular healthcare system by law.

Legal barriers refer to the existence of regulations that may complicate the possibilities of foreigners to access services, in relation to their legal status in the host country. To this hurdle, we must add also the bureaucratic-administrative barriers which refer to the complexity of the regulatory and administrative structure of health services, which can sometimes affect accessibility to services even by the native population, but which particularly affects immigrants, especially due to the lack of information on how health services work and on their rights, which is a first obstacle, especially for recently arrived persons.