Department of Public Health, University of Helsinki, Finland; Department of Health Security, National Institute for Health and Welfare, Finland; Doctoral Programme in Population Health, University of Helsinki, Finland.
Department of Health Security, National Institute for Health and Welfare, Finland; Doctoral Programme in Population Health, University of Helsinki, Finland.
Health Policy. 2019 Sep;123(9):825-832. doi: 10.1016/j.healthpol.2019.07.014. Epub 2019 Jul 20.
In 2015 Finland received an unprecedented number of asylum seekers, ten times more than in any previous year. This surge took place at a time the Finnish Government was busily undergoing a wide-range health and social care reform amid growing nationalist and populist sentiments. Our aim is to explore the governance of a parallel health system for asylum seekers with a right-to-health approach. We concentrated on three right to health features most related to the governance of asylum seeker health care, namely Formal recognition of the right to health, Standards and Coordination mechanisms. Through our qualitative review, we identified three major hurdles in the governance of the system for asylum seekers: 1) Ineffectual and reactive national level coordination and stewardship; 2) Inadequate legislative and supervisory frameworks leading to ineffective governance; 3) Discrepancies between constitutional rights to health, legal entitlements to services and guidance available. This first-time large-scale implementation of the policies exposed weaknesses in the legal framework and the parallel health system. We recommend the removal of the parallel system and the integration of asylum seekers' health services to the national public health care system.
2015 年，芬兰迎来了史无前例的大量寻求庇护者，是以往任何一年的十倍。在这一时期，芬兰政府正忙于进行广泛的医疗和社会保健改革，与此同时，民族主义和民粹主义情绪日益高涨。我们的目的是用健康权方法来探讨寻求庇护者平行卫生系统的治理。我们重点关注与寻求庇护者卫生保健治理最相关的三项健康权特征，即正式承认健康权、标准和协调机制。通过我们的定性审查，我们发现该系统治理面临三大障碍：1）国家层面协调和管理不力且反应迟缓；2）立法和监督框架不足，导致治理不力；3）宪法规定的健康权、法律规定的服务权利和现有指导之间存在差异。这些政策的首次大规模实施暴露了法律框架和平行卫生系统的弱点。我们建议取消平行系统，并将寻求庇护者的卫生服务纳入国家公共医疗保健系统。
