The European Journal of Public Health
Volume 26, Issue 1, 1 February 2016
http://eurpub.oxfordjournals.org/content/26/1

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Viewpoints
Europe’s migration challenges: mounting an effective health system response
Govin Permanand, Allan Krasnik, Hans Kluge, Martin McKee
DOI: http://dx.doi.org/10.1093/eurpub/ckv249 3-4 First published online: 1 February 2016
Extract
Health systems are at the forefront of the response to the ongoing humanitarian crisis facing refugees and other migrants fleeing to Europe, both as a first point of contact for arrivals and later during their resettlement and beyond. (The term ‘migrant’ is used here with the understanding that there are numerous groups that fall within this categorization, but which are distinct in terms of their status, e.g. asylum-seeker, refugee, undocumented migrant, economic migrant, family-reunited migrant, etc., where a specific group is mentioned by name, it is in a context where this specificity is required.) Yet even if the scale of migration is new, at least in the post-war period, some European countries have considerable experience of sudden large-scale immigration, whether from Algeria to France in the 1960s, East African Asians coming to the United Kingdom in the 1970s, refugees from former Yugoslavia in the 1990s and, more recently, across the Mediterranean to Italy, Malta and Spain.

However, few lessons seem to have been learnt, and European health systems vary greatly in their ability to respond to this new challenge.1The situation is complicated further by differences in formal entitlement to health care,2 even though it is now clear that restricting access costs more money in the long run.3 The challenges facing undocumented migrants are particularly alarming, as many of those now moving either fall into this category already or will soon do so if their applications for asylum are rejected.

Even where migrants are entitled to care they may face many barriers. These include language barriers and inadequate information about their rights and how to claim them…

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Europe’s response to the refugee crisis: why relocation quotas will fail to achieve ‘fairness’ from a health perspective
Kayvan Bozorgmehr, Joachim Szecsenyi, Christian Stock, Oliver Razum
DOI: http://dx.doi.org/10.1093/eurpub/ckv246 5-6 First published online: 1 February 2016
Extract
EU refugee law is deficient—this has become obvious as thousands of refugees cross the Mediterranean and EU borders to reach a safe destination. Germany’s Chancellor Angela Merkel calls for a scheme of compulsory relocation of refugees to EU member states to achieve a ‘fair’ distribution1 based on ‘objective, quantifiable and verifiable criteria’ such as GDP, population size and unemployment rates.2 While we strongly believe that providing international protection to refugees is a collective duty of EU member states, we argue that the concept of their ‘fair’ (but factually enforced) relocation across the EU is flawed and may ultimately be detrimental from a public health perspective.

First, if fairness is defined as the product of a quota based on a contract between EU member states, the interests of non-contractors (here refugees) remain neglected—a dilemma inherent in contractarian concepts of fairness.3…