2017-07-24 HIA submission to LegCo’s Subcom on Children’s Rights on Rights of refugee children (public hearing)

The Legislative Council Subcommittee on Children’s Rights

24 July 2017 Meeting on

“Rights of refugee children”

 

Submission from Health In Action

 

  1. Health is a fundamental human right and it is enshrined in the Convention on the Rights of the Child: “States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services” (article 24.1).

 

  1. In Hong Kong, refugee* children are entitled to access basic healthcare services at public hospitals and clinics (managed by the Hospital Authority (HA) and the Department of Health (DH)), for which the charges can be waived by applying for a medical waiver through Medical Social Workers (at the HA) or Social Workers at Integrated Family Service Centres (IFSC) (at the Social Welfare Department (SWD)). Yet, frontline experience has shown that refugee children face multiple barriers in accessing medical services and in exercising their right to health. Some major problems and suggestions are summarized below.

 

  1. Lack of support towards refugee children for attending regular medical appointments
  • There are refugee children who have to attend medical appointments regularly, yet neither these children nor their refugee parents are given additional transport allowance from International Social Service Hong Kong Branch (ISS-HK) to support their journeys to hospitals and clinics.
  • Suggestion: Provide additional transport allowance through ISS to refugee children and their parents who have regular medical follow up appointments at public hospitals and clinics.
  • In addition, every time a refugee child has to attend a medical appointment, his or her family has to apply for a separate medical waiver for each appointment before seeing the doctor, which presents additional difficulty for refugee children who have to attend school.
  • Suggestion: Issue renewable half-year medical waivers (instead of the currently one-off medical waivers) to refugee children for accessing healthcare services at the HA and DH.

 

  1. Unmet needs of dental and eye care for refugee children
  • Since refugees are prohibited from taking any employment in Hong Kong, they rely completely on Government provision to survive. Yet, if refugee children have special medical needs (e.g. require eye glasses), there is currently no support from the Government. By comparison, local families under the Comprehensive Social Security Assistance (CSSA) scheme receive special grants if their children have special medical needs, called “medical and rehabilitation grants”. (As a crude reference, a three-person local family (adult mother and two children aged 14 and 12 respectively) will be given around $11,301 per month under CSSA and a three-person refugee family (same household make-up) will be given around $8,100 per month under ISS assistance [1].)
  • Although refugee school children receive eye check up every year through the Student Health Service (managed by the DH), there is no subsequent support for refugee children to obtain eye glasses should it be required.
  • Free dental care is currently provided to school children up till primary six. Yet, children in secondary school have no access to dental care (apart from extraction) and some of these children have suffered from dental pain so severe that they are unable to attend school. Public dental clinics (managed by the DH) only provide emergency dental service (limited to pain relief and extraction of one tooth only) and limited quota are given on a first-come-first-served basis.
  • Suggestion: Provide special grants to refugee children to cover costs of dental treatment (for children above primary six) and eye glasses, by taking reference to the CSSA’s “medical and rehabilitation grants” (i.e. for dental treatment: actual expenses or the ceiling amount of the dental treatment item set by the SWD; for eye glasses: up to a maximum of $500 (or more in exceptional cases) [2]).

 

  1. Misunderstanding and insensitivity of public hospital and clinic staff
  • Public hospital and clinic staff are often not aware of the rights and entitlements of refugee children in accessing healthcare services in Hong Kong, hence refugee children are sometimes turned away at hospitals and clinics when the staff asked the parents to pay but the parents are unable to, alternatively refugee children are asked by staff to attend private medical services instead of using public services.
  • Suggestion: Strengthen training to frontline staff of public hospitals and clinics (HA and DH) about the policies and procedures of medical service provision to refugee children and families.
  • Parents of refugee children have expressed that their children who were born in their home countries suffered from discrimination by public hospital staff, as compared to their children who were born in Hong Kong. Moreover, some refugee pregnant ladies have expressed experiencing discrimination and ignorance from public hospital staff regarding their cultural and religious practices.
  • Suggestion: Enhance cultural competence of frontline staff of public hospitals and clinics (HA and DH) towards refugee children and families, such as awareness of dietary restrictions and female genital mutilation (FGM).

 

Reference:
1. Calculation method for a three-person family (adult mother and two children aged 14 and 12 respectively):

  CSSA ISS assistance
Standard rate (including for food and transport) 1 single parent and 2 able-bodied children:
$2,375 + $2,165×2 = $6,705
Food:
$1,200×3 = $3,600
Transport:
$200×3 = $600
Total (food and transport) =
$3,600 + $600 = $4,200
Single parent supplement $340 Nil
Rent $3,200 1 adult and 2 children:
$1,500 + $750×2 = $3,000
Utilities $36 (water and sewage charges) $300×3 = $900 (water and electricity charges)
Meal allowance for the students $570 Covered under Student Financial Assistance (SFA)
Travelling expenses to and from school $450 Covered under Student Financial Assistance (SFA)
Grand Total $11,301 $8,100
Taken from SWD: A guide to comprehensive social security assistance (internet version) http://www.swd.gov.hk/doc/social-sec1/CSSAG0217(eng).pdf  [accessed 12 July 2017] ISS: Provision of Assistance for Non-Refoulement Claimants
http://www.isshk.org/en-us/services/index/NRC [accessed 12 July 2017]
  1. Social Welfare Department (Feb 2017). A guide to comprehensive social security assistance (internet version) http://www.swd.gov.hk/doc/social-sec1/CSSAG0217(eng).pdf [accessed 11 July 2017].

* In this submission, “refugees” refers to non-refoulement claimants in Hong Kong.

12 July 2017

 

http://www.legco.gov.hk/yr16-17/english/hc/sub_com/hs101/papers/hs10120170724cb4-1432-2-e.pdf