ERRC Action to Challenge Exclusion of Roma from Health Care in Bulgaria

22 October 2007

Collective Complaint against Bulgaria under the Revised European Social Charter Claims Violation of the State's Obligation to Protect Health

Strasbourg/Budapest

The European Roma Rights Centre today brought a collective complaint under the Revised European Social Charter (RESC) against Bulgaria for persistent and systematic violations of the right to protection of health and to social and medical assistance with respect to Bulgarian Roma as guaranteed under Articles 11 and 13 of the Charter and related international standards.

Under the RESC, the Bulgarian government is obliged to ensure the protection of health by removing as far as possible the causes of ill-health; by providing advisory and educa¬tional facilities for the promotion of health; and by encouraging individ¬ual responsibility in matters of health (Article 11 (1,2,3,)). Furthermore, the government is obliged to ensure the right to social and medical assistance by guaranteeing that any person who is with¬out adequate resources and who is unable to secure such resources either by his own efforts or from other sourc¬es, in particular benefits under a social security scheme, be granted adequate assis¬tance, and, in case of sickness, the care he needs (Article 13 (1)).

The ERRC collective complaint alleges that these commitments are not upheld with respect to Roma in Bulgaria, because the Bulgarian government has failed to eliminate the disparate impact of health insurance legislation on Roma and other vulnerable groups in society and tolerates policies and practices which undermine the protection of health of members of the Romani communities in Bulgaria. In particular:

• Bulgarian legislation does not guarantee health insurance coverage for the most vulnerable individuals, especially long-term unemployed people, a disproportionate number of whom are Romani;
• The government has not undertaken effective measures to address the disparities in health between Roma and non-Roma as well as mitigate the adverse effect of socio-economic determinants such as poverty, poor housing and sanitary conditions, and low educational levels on the health of Roma and their access to health care;

Systematic discriminatory practices such as segregation of Romani women in maternity wards, denial of emergency aid services to Roma, and denial of other types of medical care are not addressed by the government.

The ERRC alleges that, taken together with their large scale character, these issues give rise to systemic violations of the rights ensured in Articles 11 and 13, read together and/or independently of the Revised Charter's Article E non-discrimination guarantees.

The present collective complaint reveals high levels of exclusion of Roma from health care, gross disparities in health between Roma and non-Roma, and higher vulnerability of Roma to tuberculosis and other infectious diseases. These conditions prevail in many Romani communities throughout Europe. Taking note of the World Health Organisation European Ministerial Forum "All Against Tuberculosis" which is held today in Berlin, the ERRC urges European Health Ministers to:

• ensure that TB screening and treatment programmes reach the most excluded segments of the Romani communities;
• ensure that accurate and consistent data about TB incidence and adherence to treatment in Romani communities is available;
• provide adequate support for the active engagement of Roma grassroots organizations in the design and implementation of TB prevention and treatment programmes;
• amend legislation to eliminate adverse impact on the access of socially vulnerable individuals to health care services;
• design comprehensive public health programmes to eliminate the disparities in health between Roma and non-Roma. Such programmes should be developed across all sectors and address the impact of housing, education, social services and other factors on health and access to health care;
• establish special mechanisms for monitoring and assessment of health care services to deal specifically with discrimination in the health care system.

The full text of the Collective Complaint is available at:  View it (Acrobat pdf format)!.

For further information on the ERRC collective complaint, please contact ERRC Research and Policy Coordinator Savelina Danova/Russinova: savelina.danova@errc.org.

For further information regarding access of Roma to health care in European countries, see ERRC repot “Ambulance Not on the Way: The Disgrace of Health Care for Roma in Europe”, available on the internet at: http://www.errc.org/uploads/upload_en/file/01/E6/m000001E6.pdf.