Documenting Undocumented People's Health: an ISS-EUR Collaboration

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Funded by the Rotterdam Global Health Initiative

'Seeking health below the radar: Undocumented People's access to healthcare in two Dutch cities'.

Published in Social Science and Medicine, this article reports on a collaborative PEER (Participatory Ethnographic Evaluation and Research) study on the health situation of undocumented (irregular) migrants in two Dutch cities - The Hague and Rotterdam. 

In light of a recent report (in Dutch) by Dokters van de Wereld (Doctors of the World), the Dutch MSF, on the Right to Health Care of undocumented people, Dr Helen Hintjens, Dr Karin Astrid Siegmann and Professor Richard Staring have published their findings on the health situation of undocumented migrants in the Netherlands.

Since 2009, under Article 122a of the Dutch Health Insurance Act, healthcare providers can claim 80 per cent reimbursement for any medical costs incurred through medical treatment of ‘uninsurable’ (i.e. undocumented or irregular) patients.

Lower uptake of healthcare by undocumented patients in the Netherlands than elsewhere in Europe.

The formal, legal health rights of undocumented people in the Netherlands are relatively good by EU standards. Yet take-up of healthcare is lower than in some other countries (such as Belgium) with less generous legal provisions.

A significant proportion of undocumented people fail to access the 'medically necessary' healthcare they have a right to under Dutch law, according to an estimate in 2012 by Dutch Médecins du Monde. A 2013 Ombudsman Report on Asylum Seekers and Failed Asylum Seekers' access to healthcare, found that undocumented people avoided presenting themselves to medical care providers when ill, and tended to do so only in an emergency (De Nationale Ombudsman, 2013).

This study addressed these puzzling problems by trying to determine the main reasons so many undocumented people do not seek health services they are entitled to in law.

Funded by a grant from the Rotterdam Global Health Initiative (RGHI), this article for the first time reports on the main findings of the research and is now available online (see below). The final published version will appear in Social Science and Medicine in April 2020 (current issue). The online version is available to download for free, for a limited period only (see link below).

About the research

The research team consisted of Dr Helen Hintjens and Dr Karin Astrid Siegmann, both of ISS, and Professor Richard Staring, a criminologist and anthropologist in the Erasmus School of Law.

Karin Astrid Siegmann - 2022 Richard Staring

The interviews, around 50, were conducted by PEER-trained researchers, most of whom were, or had been, in an irregular situation in the Netherlands. The authors would like to thank RGHI, Rotterdam Ongeducumenteerden Steunpunt (ROS) in Rotterdam, and Joanne Hemmings of Options, London for making this study possible. The authors reserve a special 'thank you' for the PEER researcher teams in Rotterdam and The Hague, without whom they could not even have conceived of doing this study. 

They welcome critical feedback on the article.

Assistant professor
Dr Helen Hintjens
Assistant professor
More information

'Seeking health below the radar: Undocumented People's access to healthcare in two Dutch cities' - available until the end of March 2020.

Thereafter the final version of the article will be available through the journal website.

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