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  • Rory O'Keeffe

A Note on AMKA and access to healthcare for refugees and asylum seekers in Greece


On 12 July this year, Greece’s new Labour and Social Affairs Minister Nikos Vroutsis cancelled a memo which had been designed to inform Municipalities and others across Greece about who was entitled to receive an AMKA number, and how they could do so.

Yesterday, 1 October 2019, the Greek government issued a new circular on the same issue.

We will go into a small amount of detail on the issue below, but in summary, the two most important points are that of the groups listed on this new circular, the one most relevant to us is: Beneficiaries of International Protection and their family members, who can gain an AMKA from either a KEP (Citizen’s Service Centre) or EFKA (social security office) on presentation of ‘a Residence permit for the Beneficiary of International Protection and for the children of Birth Registration Act, if they were born in Greece (newborns born in Greece are covered by the foster parent's residence permit until they apply for a residence permit as well)’.

This means that anybody who has had their refugee status or any other form of international protection confirmed – anyone, in short, who has their Full Registration – can get an AMKA.

The new circular deals only with people who are applying or wish to apply for an AMKA, which also means that despite earlier (and understandable) concerns from people throughout the sector, and the men and women we work with and for, there is no proposal in place that anyone with an AMKA number would have it taken from them.

This does not mean that no such move will be made in future, but it has not been and there is as yet no indication that the government will make it.

The second part of the – rather long – circular which is relevant to us is on page ten, where the government states:

‘Σημειώνεται πως για τις περιπτώσεις:

α) αιτούντων διεθνή προστασία ή άσυλο και τα μέλη οικογενείας τους, β) τους ανήλικους ασυνόδευτους αλλοδαπούς με δελτίο αιτούντος διεθνή προστασία και γ) πολίτες τρίτων χωρών και τα μέλη οικογενείας τους αιτούντες διεθνή προστασία με ένα όνομα (π.χ. Ινδοί), θα ακολουθήσει επόμενη εγκύκλιος, των συναρμόδιων Υπουργείων.’

That is:

‘Note that for cases: (a) applicants for international protection or asylum and their family members; (b) unaccompanied minor aliens with a request for international protection; and (c) third-country nationals and their family members seeking international protection under a name (eg. Indians); follow the next circular of the relevant Ministries.’

This means that as yet, there is no new guidance on the process under which asylum seekers – those with pre-registered status – should apply for an AMKA. This means that the law still applies as it always has, and those people can still apply.

We are very well aware that since Vroutsis’ dismissal of the earlier circular (itself issued by the Syriza/ANEL coalition government on 20 June 2019, and based – as all such circulars have been – on a law passed in 2009 by Nea Dimokratia) certain municipalities have refused to issue AMKA numbers to refugees and asylum seekers.

This refusal is illegal and should be met with an immediate challenge from any legal practitioner who is available to issue such a challenge.

There is absolutely no justification, under Greek law, for refusing an AMKA to a refugee or asylum seeker.

It is very likely that such a justification will be made but it has not been and until it is, it is illegal for refugees and asylum seekers to be refused access to the Greek healthcare system, education system and labour market which comes with the AMKA.

In purely health terms, we must note that even if a person who is a refugee or is seeking asylum is refused an AMKA, and while a challenge against that is made, every refugee and person seeking asylum is entitled to use any and all available public healthcare services available in Greece, including receipt of medicines for physical and mental illnesses, diseases or other matters detrimental to health, under emergency guidance issued in May 2016.

It is illegal for anyone to attempt to prevent a refugee or person seeking asylum from accessing public healthcare in Greece.

That effectively covers every point of importance on this issue to date (2 October 2019).

However, in the interests of greater detail and clarity, the 20 June 2019 circular, which had been issued to everyone in the Greek Parliament, was dismissed by Vroutsis, who said that: ‘Greece is not an unfenced yard’ – an indication that this dismissal was targeted at refugees and asylum seekers, despite yesterday’s 34-page document which mentions them once, to say they will be addressed in ‘the next circular’.

Vroutsis also stated that the contents of the 20 June circular were: ‘easy to disprove’, despite it being directly taken from the 1 April 2009 law 7791/245/Φ80321/09 – passed by Nea Dimokratia – explaining the rights of foreign nationals to an AMKA.

The new circular lists four groups of people: Greek nationals residing in Greece; Expatriates residing permanently in Greece; European citizens living and working in Greece (as well as their family members) and beneficiaries of international protection and their family members, as ‘eligible for AMKA’.

It lists five groups – Greek people who do not live in Greece; European citizens temporarily resident in Greece (for less than three months, and who will not work in Greece); minors born to EU nationals in Greece but whose parents do not live in Greece; minors of third-country nationals born in Greece to ‘irregularly resident’ parents; and citizens of third countries who hold residency permits which do not entitle them to work – who are not entitled to AMKA.

A further list, which contains six further non-Greek groups (third-country nationals with a residence permit for work of application certificate for such; third-country nationals of a named country – eg India – with a residence permit and their family members; family members of third-country citizen status reunited with family in Greece; third-country nationals with a residence permit to study; those who hold visas entitling them to work in Greece; irregular rural workers; third-country citizens without residency permits but who have founded companies in Greece) may receive an AMKA but only through application at EFKA offices.

Once again, within this circular there is absolutely no update on the status of men, women and children seeking asylum. It is illegal to deny them the right to an AMKA, as the law stands today. It is also illegal to deny them access to the Greek public health service, even during the period in which they do not have an AMKA.

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