1. Panel 2: Breaking the social and spatial isolation of people with a migrant background: EU/Brussels initiative
23 NOVEMBRE 2015

2. Brussels-Capital: elements of context
Population: 1.19 Million
Area:  km²
Seat of federal institutions
Transit point for migrants
Brussels-Capital Region Government: Managing Authority of the ERDF Operationnal Programme for Brussels-Capital Region (95 Millions EUR ERDF)

3. ERDF/migrants issue: invitation for proposals
Oct. 2015: Letter from the Commissionner Corina Crețu Answer from the Brussels-Capital Minister- President Rudi Vervoort to reallocate a part of the ERDF amount (+nat. counterpart) to a new migrants project Feb. 2016: Invitation from COM to the MA to modify the ERDF OP to support such a project (new budget, Spec. Obj., described actions, indicators…) May 2016: New OP adopted by the Monitoring Committee Dec. 2016: Official selection of the Healthcare access project coordinated by Médecins du Monde

5. Access to healthcare Around 5-10% in Brussels
CPAS OCMW
Undocumented migrant
Refugee
Fedasil
European
CPAS+insurance
« Visa »
nothing
No health insurance
prisoner
SPF-POD Justice
Access to Healthcare is blocked by one or more barriers

6. The Healthcare access project
Budget: 7,440,000 EUR
Supporting operating costs and investment costs through:
A: Outreach team to orient patients to primary healthcare centres (medical, psychological, social assistance)
B: creation of 2 integrated Social-Health centers (1 multi-certified and 1 De novo)

7. The Healthcare access project

8. Part A: Outreach team – access to healthcare
In theory: the migrants have the right to “urgent medical help”
In reality: this outreach team is often their only mean of access to health care

9. Part A: Outreach team – access to healthcare
The team is composed of local GP, psychologist, social worker and street worker. The grant allows the team to works for free and to deliver medication.
Beyond, they collect useful information to identify specific health problems and to improve the quality of answer for this specific audience.

10. Part A: Outreach team – access to healthcare

11. Difficulties and challenges
Destination: England…, transit in Belgium!
Trust issues
Migrants in survival mode (health not a priority): wait until emergency
Unaccompanied children: How to convince them to seek legal assistance to reach their goals?
Police control, more repression of irregular migration  anxiety-provoking climate

12. Part B: Creation of 2 Integrated Social-Health Centers
Objective: to reinforce Primary Healthcare system in Brussels, with 2 new centers in the 2 neighborhoods. The center will clearly welcome the migrants (whatever their administrative status) but will be open to everyone
CSSI Multi agreement “Brunfaut” (Molenbeek):
Temporary “Maison médicale” (2017)
Relocation in a new center (2019)
CSSI De Novo “Goujons” (Anderlecht):
Opening (2020)

13. A project realized in consultation
In amount (definition, strategy, ERDF OP) between Regional and European authorities
With partners and field operators (from health sector)
With the local authorities (authorisations, coherent project development …) and regional development partners.

14. From the European point of vieuw
Good opportunity to allocate EU money at regional/local level to answer to an important challenge
Particular follow-up about the project development (and results)

15. From the regional point of view
Opportunity of a constructive dialogue with an NGO about a territorial challenge
Opportunity to stimulate synergies beween the healthcare sectors (despite their classical differences in terms of profiles, needs or interrest)
Operational collaboration/support to th real estate develoment (with consultation of local authorities and inhabitants, for a broader project)

16. From the local/municipal point of view
Opportunity to integrate et develop sociomedical services (healthcare offer)
Information from authorities to the NGO
Consultation inhabitants/NGP/municipality

17. Thanks for your attention Quentin Richard First Officer/Deputy director ERDF Unit