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ORIGINAL FRENCH ARTICLE: Portes closes pour les étrangers malades

by Émilie Rive

France’s Closed-Door Policy for Foreign Patients

Translated Wednesday 13 August 2008, by Gene Zbikowski

Human rights. The Observatory on the health rights of foreigners is giving a warning shout on the restrictive way that the law governing their stay in France is being applied.

Foreign patients have had the right to a one-year residence permit and to their private and family life ever since the May 11, 1998 law on foreign entry and residence and on the right to asylum came into effect. To benefit from this right, the foreign patient must be suffering from a serious pathology which cannot be treated in his/her home country, and the patient’s presence in France must not endanger public order. These legal provisions still exist, despite the denigration campaign launched in 2002 by the ministry of the interior against doctors that it accused of laxity, and despite the serious weakening of the law caused by its amendment in 2006. But just look at the way that this law is being applied!

“Pathological files”

Yesterday, the Observatory on the health rights of foreigners published its evaluation of the application of this law over the past ten years. (1) In fact, according to Caroline Izambert, who represented Act Up Paris, there has been “a serious deterioration in the provisions of the law because the prefectures (2) are not respecting the spirit of the law when they apply it.” A particularly insidious measure is the establishment of “country pathological files” which spell out the situation in each country with regard to access to care and medicine. The public health inspection doctors, who are responsible for recommending if a residence permit should be granted, are required to adhere strictly to these files. However the NGO Médecins du monde has found flagrant errors in the files on Egypt, Madagascar, Niger, Guinea, Benin ... Thus, the insulin which was supposedly available in Antananarivo, Madagascar, had been no longer usable already for over a year ...

The prohibitively high fees of doctors

The public health inspection doctors, Caroline Isambert adds, report that the prefectures put them under a great deal of pressure to give a negative recommendation. Some prefects decide not to follow their recommendations, whereas prefects are not supposed to have access to medical files, which are protected by medical confidentiality. Government employees in the prefectures have been seen opening medical files.” In addition, to obtain the medical certificate that they must present to the public health inspection doctor, foreign patients must see a doctor registered with the prefecture. Some city doctors charge prohibitive fees, “up to several hundred euros” while others have had their right to meet with such patients taken away by the prefect without any explanation being given, as was the case in Puy-de-Dôme.

Another serious problem concerns earning a living. Despite the right to work that is granted together with the residence permit, administrative delays can result in a patient having no financial resources for over a year.

A myth that is being spread to further political aims.

As to the residence permit for people accompanying patients, it is granted less and less. “We’ve had the case of a child suffering from a heart disease, fatal in the mid-term, whose father obtained a permit, but not his mother, because under the law only one parent is accepted,” Isambert said. “The government wants to convince the public that there is “therapeutic immigration” (3) but over 80% of the people who obtain a permit learn that they are ill after they arrive in France, and this is true for 94% of the AIDS cases. So we are really confronted with a myth, a false idea, that is being spread to further political aims.”

(1) The report in French is available at the Website of the Observatory: http//www.odse.eu.org

(2) In France, the prefect is the local representative of the central government.

(3) i.e. ailing foreigners immigrating to France to take advantage of the French health care system.

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