“The whole situation is difficult enough for us to neither have medical assistance“says María, who emigrated from Venezuela in search of a better life. She has lived in Spain for five years and, when she arrived, she did not expect that access to healthcare would be a problem linked to the search for work, the irregular administrative situation or the transfer of his minor son. “A month ago he fell: a sprain and a blow to the hip. And they don’t serve me! I have to go to the hospital for medical assistance. Then they give me a bill from the public hospital for treating me, “she laments.
She is one of the victims of “regulatory chaos” and the “flagrant breach” of the law by the autonomous communities, which I Yes Universal Health has denounced this Tuesday. The Canary Islands, the Community of Madrid and Melilla stand out due to the obstacles to healthcare migrants in an irregular situation, while Catalonia and Asturias offer more facilities, according to his research, which also shows how the legislative reforms of the PP and PSOE in 2012 y 2018 they have curtailed this right in Spain.
“Worry due to regulatory heterogeneity and legal uncertainty has led us to produce this report”, justified the health worker Nacho Revuelta, spokesman for Yo Sí Universal Health, in a meeting with journalists to explain “the complexity that the map of health exclusion in our country has taken on”.
“��@YoSisanidaduniv denounces the setback of our country in health care for people in an irregular situation
▪️The problems due to the lack of registration and the rejection of other alternatives to the register stand outhttps://t.co/LoUJXEt2OV pic.twitter.com/Pnj4835Lcu“
— Radio 5 (@radio5_rne) November 29, 2022
Months of waiting and healthcare payment
The consequences of the labyrinth are months and months of waiting to get the health card or a similar document that entitles you to assistance. Thus, for people in an irregular situation, Going to the emergency room becomes the only possible access route to healthcare.
But even then, the problems remain. According to the platform, up to 15 autonomous communities bill patients systematically or at least that possibility exists, as happened to María in the Community of Madrid. The situation is repeated in the rest of the autonomies, except in Catalonia and Asturias. For its part, the Basque Country issues a “billing notice”, with the “dissuasive effect” that this entails, while Ceuta has not been able to be evaluated due to lack of data.
“Hay many barriers that make getting the document take longer or, in some communities, that it is very difficult to obtain it (…) And it must be renewed every year, two years, which means a loss of access, appointments, follow-up, etc.”, explained the spokesperson Raquel González, who denounces that minors and pregnant women are also being subjected to these practices “whose frequency is increasing.”
Big differences between communities
Most of the migrants in Spain enter as tourists, so in 14 autonomous communities they are excluded from healthcare during the first three months. This is established, even when they express their intention to stay longer when registering in a municipality (with their corresponding obstacles).
For these cases, the Ministry of Health issued a series of recommendations that urged the autonomous communities to facilitate access through a social work report, something that only five autonomous governments have carried out with deficiencies, according to Yo Sí Sanidad Universal . They are Aragon, the Valencian Community, Asturias, Extremadura and Navarra. On the contrary, in Catalonia, the Balearic Islands, Castilla La-Mancha and Andalusia people in an irregular situation they can opt for direct public coverage during the first three months.
Minors and pregnant women without health care
The platform for universal health has placed special emphasis on denying assistance to minors and pregnant women in an irregular situation. “Many autonomous communities are directly breaking the law”Revuelta has affirmed, recalling that the articles related to vulnerable people belong to the previous royal decree, of 2012, but “they are not repealed”.
For the spokespersons of the organization, the drafting of the 2018 law has exacerbated the main problems. First, because it does not mention the international agreements signed by Spain on the right to care for the most vulnerable. Second, because it stops emphasizing that emergency care must be universal. “What the Ministry said at the time is that ‘it is not necessary because everyone will be attended to’. But the reality is that it is not even remotely like that,” Revuelta has settled.
Likewise, up to 14 autonomous communities exclude regrouped ascendants from free health care and in 11 territories the document certifying care is not a health card, but a piece of paper.
For all these reasons, the organization speaks of a “vicious circle of exclusion”, to which is added the lack of transparency and information, also among the health workers themselves and administrative staff. “When a person goes to request access and is denied, it is always done verbally, which makes claims more complicated and encourages the administration to more easily evade its responsibility,” González pointed out.
“We have not found another law that is this chaotic and fragmented by the communities,” added Revuelta, comparing it with the legal system of education or justice for migrants in an irregular situation.
With an eye on the future law
All in all, Yo Sí Universal Health is now focusing its pressure on the draft for the new law that regulates the “equity, universality and cohesion” of the National Health System. In his opinion, the text presented keeps major bugssuch as that the procedures remain in the hands of the communities and the exceptions for pregnant women, minors and urgent care are not highlighted.
“We demand that the Government shield universality in a simple and clear law, without distinctions by administrative situation, as well as promote a regulatory development that guarantees homogeneity in access to the health system for all people throughout the Spanish territory”, they concluded.