From 12 November 2007 to 12 May 2008, the Slovak Republic was for the first time the Presidency of the Committee of Ministers of the Council of Europe. On 22 and 23 November 2007, the 8th Conference of Health Ministers of the Member States of the Council of Europe was organised under the auspices of the Prime Minister of the Slovak Republic.
The 8th conference was attended by the leaders of the Council of Europe, the Parliamentary Assembly, the representative of the European Commission, the World Health Organisation, the International Organisation for Migration, the OECD, the observer countries and a number of recognised experts.
At the end of the conference, participants adopted the Bratislava Declaration on Health, Human Rights and Migration.
Eighth Conference of European Health Ministers
People on the move:
Human rights and health system challenges
Bratislava Declaration
on health, human rights and migration
Bratislava
22. 23 November 2007
PREAMBLE
We, Ministers of Health of the Forty-Seven Member States of the Council of Europe, gathered from 22 to 23 November in Bratislava at the invitation of the Slovak Government at the Eighth Conference of European Health Ministers, organised by the Council of Europe, as guardians of the health of our peoples, note that:
The movement of people within and into Europe is a growing phenomenon which poses challenges for health services and human rights;
People on the move never fall into one category; they may be immigrants, internally displaced persons, internal migrants, refugees, returnees, victims of trafficking in human beings, asylum seekers, irregular migrants and working migrants, including health professionals;
The factors contributing to the steady increase in migration, such as poverty, war, climate change and the lack of access to essential services, inevitably raise questions about social integration and people's health on the move;
We believe that we must work together to ensure that migration within and into Europe does not adversely affect the health of migrant or host country populations in any way;
We believe that human health on the move must be taken care of on both sides of the migration process, for example by strengthening healthcare systems in sending countries and providing development assistance;
We also believe that if all Member States coordinate their activities, update and share scientific data and information, it will be possible to find rapid joint responses to emerging threats to public health.
FROM THIS GROUNDS MY MINISTERS, WE KNOW THAT:
Given that health concerns all people on the move, regardless of age, gender and cultural differences, governments should take into account the cultural (and religious), social and economic diversity of these people when designing health policies;
The migration process is also a stressful event under the best possible conditions and thus increases the risk of migrant suffering from illness; internally displaced persons are at even greater risk of mental or other illnesses due to their long-term despair and lack of satisfactory health care services;
Socio-economic, cultural and language barriers may place obstacles on the move for people looking for health services as well as for providers of these services; these barriers may exacerbate the lack of awareness or ignorance of available services;
Women, children and the elderly need special protection; they represent a large proportion of all people on the move, have specific health needs and are often at risk of economic, gender and sexual exploitation and violence;
The growing mobility of healthcare workers, including mobility within the forty-seven Member States of the Council of Europe, favours some countries and deprives others of professionally trained and highly needed professionals.
NOTE THAT:
for States Parties to the following documents:
- European Social Charter (Revised) (ETS 163) ensure, where applicable, the protection of health (Article 11), the right to social and medical assistance (Article 13) and the protection of migrant workers (Article 19) and the elderly (Article 23);
- Article 3 Convention on Human Rights and Biomedicine (ETS 164) concerns the need to take measures to provide fair access to healthcare of adequate quality;
- the European Convention on the Status of Migrant Workers (ETS 093); Article 19, provides that: "Each Contracting Party undertakes to provide social and medical assistance on its territory to migrant workers and their family members legally residing in its territory on the same basis as nationals', in accordance with commitments made under other international agreements and in particular the 1953 European Convention on Social and Medical Assistance;
Some of the recommendations of the European Committee for the Prevention of Torture relate in particular to the health and living conditions of foreign nationals who are deprived of liberty;
The objective of several recommendations The Committee of Ministers is to provide comprehensive protection, in particular the Rec recommendation (2006)18 on health services in a multicultural society, the Rec recommendation (2006)10 to improve access to healthcare for Roma and Travellers in Europe and the Rec recommendation (2006)11 on cross-border mobility of healthcare professionals and its implications for the functioning of health systems.
RECOGNIZING THAT:
Well-managed health measures for migrants, including public health, promote living conditions for all and facilitate the integration and participation of migrants in host countries by supporting and understanding, thereby contributing to social cohesion and enhanced development;
Greater involvement of women in promoting and protecting the health of migrant women enables better understanding and integration of migrant women in host country health systems, taking into account their specific role in the next generation of education;
In the field of health, no exceptions to the principles and standards enshrined in international migration law should apply;
Member States shall ensure that irregular migrants have access to healthcare services in accordance with applicable international treaties and national laws and policies.
In response to the challenges posed by mobility for human rights in health and health systems, we, the Health Ministers of the Member States of the Council of Europe,
WE'RE DECISIONED:
By working with other international organisations, including non-governmental organisations, to emphasise the ethical and human rights aspects of migration;
Consider by the parties to the European Social Charter (revised) the adoption of provisions on health and well-being in all Member States and, where appropriate, provisions on the protection of migrant workers in the spirit of Article 19 of the European Social Charter (revised);
Work to remove obstacles to access to adequate health protection for all people on the move, including irregular migrants in emergency care;
Work to overcome obstacles to access to health protection for people on the move by building capacity and raising awareness among healthcare providers, policy makers, health management planners and health educators as well as other professionals involved in the provision of health services;
Implement measures leading to public health management on international migration by developing and strengthening partnerships between governments and organisations at international, national and Community level, including voluntary associations;
Support public health research to strengthen national and international surveillance and information systems to strengthen and support evidence-based programmes to promote human health on the move;
Take steps to strengthen and integrate the health dimension into development and cooperation policy in line with the principle of health in all policies.
Support the participation of migrants in programming, health service provision and evaluation;
Pay attention to health measures, in accordance with International Health Regulations (2005), when migrants arrive from areas of high health risk to be better cared for and directed towards relevant services;
Train and train healthcare providers, policy-makers, health management planners and health educators to address the issue of healthcare linked to the mobility of the population and differences in health services in different geographical areas;
Consider the necessary steps to better adapt health services of age, gender and diversity, for example by providing easily accessible information in the relevant language or by providing intermediaries.
Address the particular susceptibility of people on the move to infectious diseases such as TB, HIV/AIDS and sexually transmitted diseases, to seek better convergence in approaches to policies and strategies for prevention, control and treatment;
Taking into account the needs of people on the move, taking into account chronic diseases, including mental health;
Support mechanisms in host countries to address specific health problems that may result from forced resettlement, such as providing advice and psychotherapeutic assistance and rehabilitation to victims of torture or trauma, including sexual and gender violence or other human rights violations;
take action to counteract practices that harm women and girls, such as female genital mutilation and early or forced marriages that can have serious health consequences;
Invite host countries to consider the call of the Parliamentary Assembly at Resolution 1509 (2006) to lift the order for health service providers and school authorities to notify the presence of irregular migrants to the authorities;
Invite host countries to provide access to healthcare to all persons who are entitled to international protection on the same basis as nationals, while ensuring that asylum seekers receive the necessary healthcare that includes rapid medical assistance, basic treatment of the disease and the necessary medical and other assistance to those who have special needs;
Support civic initiatives by migrant women for migrant women, especially where migrant women can convey social cohesion and tolerance;
Support access to health and health information for migrants, especially young people; health education should include information on reproductive and sexual health, gender equality, nutrition and accidents at work;
Strengthen the ethical approach by coordinating joint actions between countries of origin and host countries to manage the emigration of health professionals from countries that have invested in their training;
AND WITH THIS OBJECTION, WE RECOMMEND THAT
Member States which have not yet done so have considered signing and ratification:
- those Council of Europe documents covering health aspects and aiming to facilitate the integration of migrant workers, such as the European Social Charter (revised), the European Convention on the Status of Migrant Workers, the European Convention on Social and Medical Assistance and the European Convention on Social Security.
In addition, in order to achieve greater social cohesion in Europe and the continued implementation of the Warsaw Summit Action Plan and the Social Cohesion Strategy, we recommend that the Committee of Ministers of the Council of Europe:
1. strengthen the health dimension of the future Council of Europe action programmes in order to achieve greater social cohesion;
2. continue to support policies that incorporate an ethical, social and human rights dimension into health policies, taking into account the specific needs of vulnerable migrant groups;
3. strengthen the role of the Council of Europe as guardian of human rights and social cohesion by including elements of solidarity and intercultural dialogue in European health policies involving migrants, refugees and other "people on the move";
4. called on the European Health Committee (CSD) to take into account the ethical and human rights dimension of migration in its future work, including the International Code of Ethics on Health Care for People on the Move';
5. entrusted the European Health Committee (CSD) with drawing up a work programme on current health challenges for vulnerable groups, including migrants, refugees, asylum seekers, Roma and nomads.