Some policy issues on migrant health
This chapter pulls together some of the implications for health planning posed by the ﬁndings reported on in the earlier chapters. Migration – particularly within-country temporary or circular migration, and internationally, labour migration and unrecorded and ‘illegal’ migration – has always posed particular problems for economic and social planning. The same is true for health planning. Because of their temporary or ‘illegal’ status, labour migrants are placed in a lower priority situation in relation to services provided by the (often unwilling) ‘host’ government. This raises both ethical and political issues. On the former, it seems that many governments have avoided ratifying the 1990 UN Convention on the Protection of Migrant Workers and Members of their Families, thus avoiding the responsibility of providing certain services for labour migrants. On the latter, governments are usually under pressure from their electorate, or from whatever avenues of public expression of opinion exist, to give priority to their own citizens in the provision of services. Yet even if we accept this narrow view of the responsibilities of national governments, the health problems of migrants (documented or undocumented), if left unattended, or not fully dealt with by the existing health services, can also pose serious threats to the health of the host population. In China, for example, the SARS epidemic showed the government how vulnerable it was to the possibility of spread of the disease by the ‘ﬂoating population’, which was largely out of the reach of the urban health services.