Free Treatment for All Works
posted: 13/01/2011
A French government enquiry shows that free healthcare for all migrants, even those without official papers, works well. By contrast, in England, some migrants with HIV have no right to free HIV treatment and can be charged thousands of pounds.
The Department of Health in London has repeatedly claimed (without evidence) that migrants with HIV abuse the NHS. Treatment of HIV is the only sexually transmitted infection in England which anyone has to pay for.
In France, right-wing politicians make similar claims to our own Department of Health, that fraud and abuse infects their system of free healthcare for undocumented migrants.
This French enquiry disproved this and says that adding any new restrictions (like charges) will be harmful. Restrictions would discourage people from testing and treatment at the best time, resulting in worsened health for individuals and the spread of infectious diseases.
The English Department of Health could learn useful lessons from this French enquiry.
HIV organisations condemn ‘scandalous concealment’
HIV non-governmental organisations AIDES, ARCAT, ActUp Paris, Sida Info Service and Solidarité Sida, are among those condemning the "scandalous concealment" of the French enquiry report from trhe French National Assembly and call for the new charge of €30 to be suspended.
The French model
France has an unusual system, with easy rules. The person simply has to show that
- he or she is living in France
- has lived in the country for at least three months, and
- is poor (monthly income below €634, about £530).
Then the person (and his or her family members) gets a wide range of free healthcare for one year, after which time he or she must re-apply.
While the French right wing has attacked this system for years, HIV and health non-governmental organisations point out that healthcare is a fundamental and universal right, that the people forced by circumstances to use this system are among the poorest and most socially excluded. They argue that any restrictions undermine HIV testing, boost late diagnosis, worsening individual’s health and the public health.
The real problem : migrants avoiding healthcare
The government asked two official bodies (of auditors and of social care inspectors) to see how well the system works. The French government seems to have disliked the message from the enquiry, and suppressed the reports until New Year’s Eve, after the National Assembly had already debated reforms and added a new charge.
The auditors found almost no evidence of fraud or abuse. They said that the real problem is that many migrant people avoid healthcare to save money. Most of the people with a right to free healthcare have not joined the scheme. Most only apply when their health gets very poor and when they need urgent treatment.
Reforms and charges
The auditors looked into possible reforms to the French system, including making an annual charge of €30. They found this charge would only raise €6 million, about 1% of the annual cost of €500 million, but would deter even more people from seeking healthcare, be costly to administer, and increase total health costs even more (people will put off getting simple early treatment and then need expensive hospital care later). The charge would worsen public health - tuberculosis and other infectious diseases are common among people entitled to the help; these infections will spread.
The social inspectors report decided charges are a mistake for the people, administratively complex, and risk harming public health.
Hiding this report meant the National Assembly was kept in the dark and voted for the charges, which will begin in April. HIV protests continue.
UK healthcare and migrants rights information
Information about access to healthcare for migrants in the UK is in NAM’s Social and Legal Issues for People with HIV.
Source, with reference
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