Indicator history

Migrants who are employed have to be included in the mandatory health insurance schemes by law under equal footing with nationals. In cases when health insurance does not arise from employment, different regimes apply to different categories of foreign nationals. Foreign nationals with permanent residency, including refugees, are entitled to compulsory health insurance on equal footing with Slovenian nationals if they meet certain conditions. According to Article 7 of the Health Care and Health Insurance Act, persons with temporary residence or persons without any legal status have limited access to health care services, and have only the right to emergency health care, which includes maintaining vital functions and preventing the deterioration of an individual’s health condition. According to the International Protection Act, asylum seekers shall, in general, have access to emergency health care. In regard to women, this provision also includes contraceptives, abortion and medical care during pregnancy and at giving birth. The law further stipulates that vulnerable groups and exceptionally other applicants have the right to additional medical services if needed. The scope of additional medical services is approved and defined by a commission appointed by the Minister of the Interior (Minister za notranje zadeve). Since 2010, amendments to this law were adopted providing for an equal access with nationals to health care services for minor asylum applicants.

Findings of a research which was based on 22 semi-structured interviews with migrants showed that the migrants face various obstacles in health care, including language barriers and open or hidden discrimination, also based on the lack of knowledge of Slovenian language (Bofulin and Bešter).

Another research based on semi-structured interviews with migrant women showed that migrant women with no health insurance face obstacles when seeking health care assistance, and they may be subject to discrimination, also based on language (Pajnik).

Another research shows similar patterns. It is based on on-going ethnographic research which started in 2008 among ten the migrant workers from Bosnia in construction industry. It showed that they lacked knowledge of the health care system, that they did not take sickness leave for the fear of dismissal, that they faced various obstacles in access to health services and the employers in some cases failed to provide for the migrants' health insurance (Lipovec Čebron).

With regard to the situation of irregular migrants and their access to health services a 2010 PICUM report states that  the most vulnerable group of such migrants includes the persons with mental health issues. There were reports of suicide attempts of the rejected asylum seekers (who consequently became irregular migrants) in the detention centre and asylum seekers in the open facilities. In such cases, the relevant authorities out of fear of media attention, quickly transfer such individuals to the closed mental institutions. The undocumented migrants have only access to the free emergency care (mentioned above). The latter is interpreted very narrowly by the hospitals, and only children are granted more favourable treatment.

In Slovenia there is no comprehensive research on the situation of the Slovenian Roma in the field of healthcare. Available sources generally refer to Roma as a vulnerable group (due to low education level, long time unemployment pattern, and different lifestyle). In this context it was established that Roma face higher incidence of chronic disease and lower participation rates in the preventive programmes, as well as that there is a higher proportion of Roma persons with risk factors for the chronic non-communicable disease.

According to the Social Care Act, migrants with a permanent residence permit have the right to social assistance, child’s benefits as well as all other benefits from the social security under equal footing with nationals of Slovenia.

However, migrants who only have a temporary residence permit only have the right to child benefits. Irregular migrants do not have the right to social protection system.

Access to social assistance and benefits is available to all nationals, regardless of their minority status. However, there are cases of de-facto discrimination on the grounds of ethnicity. The decision of 30 September 2010 issued by the Social Inspectorate (based at the Ministry of Labour, Family and Social Affairs) concerns a Roma couple who inquired about a possibility to acquire municipal financial assistance at the Centre for Social Work. When they inquired about this possibility, the social worker at the Centre responded that this financial assistance is not for Roma. A volunteer of a local association verified by phone whether Roma may apply for this assistance and she also received a negative response: the social worker confirmed that Roma may not apply for this financial assistance.  The social inspectorate found that such treatment constitutes discrimination, as there is no provision in the law that would allow a denial of a certain right on the basis of race or ethnicity. Municipal assistance is available for all people who meet the conditions, regardless of their ethnicity. In the procedure it was establish that if the couple applied for this assistance it would have been granted to them, as they met all the conditions.

Sources:
Bofulin, M. and Bešter, R. (2010) ‘Enako zdravstvo za vse? Imigranti v slovenskem zdravstvenem sistemu’ (Equal health for all? Immigrants in Slovenian health system), in Medvešek, M. and Bešter, R. (eds.), Državljani tretjih držav ali trtjerazredni državljani?, Ljubljana, Inštitut za narodnostna vprašanja, pp. 270-311.

Lipovec Čebron, U. (2010) ‘Slepa pega evropskega zdravstva: analiza nekaterih vidikov zdravja migrantov’ (Blind spot of European healthcare: analysis of some of the aspects of health of migrantzs), in Medica, K. et al (eds.), Migranti v Sloveniji, Koper, Univerza na Primorskem, Znanstveno-raziskovalno središče Koper, Zgodovinsko društvo za južno Primorsko, Univezitetna založba Annales, pp. 57-81.

Pajnik, M. and Bajt, V. (2011) ‘“Third Country” Migrant Workers as “Third Class Non-Citizens” in Slovenia’ in: M. Pajnik and G. Campani (eds.) Precarious Migrant Labour Across Europe, Ljubljana: Mirovni inštitut, pp. 97-118.

PICUM – Platform for International Cooperation on Undocumented Migrants (2010) Undocumented migrants’ health needs and strategies to access health care in 17 EU countries: Country report Slovenia, Brussels, PICUM – Platform for International Cooperation on Undocumented Migrants.

Health promotion strategy and action plan for tackling health inequalities in the Pomurje region, Ministry of Health of the Republic of Slovenia, available at http://ec.europa.eu/health/ph_determinants/socio_economics/documents/slovenia_rd01_en.pdf.

Zakon o socialnem varstvu – uradno prečiščeno besedilo (Social Care Act – official consolidated text), Official Journal of the Republic of Slovenia, No. 3/2007.
Social Inspectorate, Ministry of Labour, Family and Social Affairs, decision no. 06185-148/2010 of 30 September 2010.