To Lisbon yesterday, for a meeting with colleagues in the Portguese Ministry of Health and others from the International Organisation for Migration and the International Centre for Migration and Health.
Portugal will take over the rotating presidency of the European Union on the 1st of July. One of the main themes of its presidency will be migration and the Health Ministry is co-ordinating a report on migration and health. We, along with the IOM and the ICMH are helping to write the report that will provide the evidence base for any new policies.
The task is extremely challenging. Migration is an enormously controversial issue in Europe, with anti-immigrant parties doing surprisingly well in a number of countries. In the UK, for example, some newspapers wage an almost continuous campaign against “asylum seekers and refugees” whose numbers they inflate to absurd levels and whom they represent as coming to Britain to live on state benefits and to engage in crime. In many countries, migrants, especially those from Africa and the Middle East, have been subject to sustained discrimination and violence.
Ironically, many of those who complain most about migration have themselves relatives who migrated in the early years of the 20th century to Australia or North America, in search of a better life. However, what they almost certainly do not realise is the extent to which the current and future prosperity of Europe depends on substantial migration. European birth rates have fallen dramatically, to well below replacement rate. In the absence of migration, Europe would have a much smaller and older population, creating enormous difficulties in paying the pensions of today’s workers. What is more, without migration, there would be insufficient people to care for them in their old age as the health and social care workforces are heavily dependent on migrant workers.
However, it is not just the political problems. Even trying to define who is a migrant can be difficult. It is true that here are official definitions but there is considerable untidiness at the edges. For example, citizens of British overseas dependencies, such as those illegally displaced from the Chagos Islands to make room for the US air base in Diego Garcia, are considered migrants when they come to the UK. In contrast, citizens of Frances overseas Departments coming to metropolitan France are not. Those living in the Netherlands Antilles fall into the same category as those in British Overseas Territories for now but will be the same as their neighbours in Martinique or Guadeloupe when they are absorbed into the EU in 2008.
Then there is the complex set of laws on citizenship in Europe. Broadly, some countries base citizenship on where one is born while others base it on who one is descended from, although many countries have recently changed their laws, taking features of both.
Finally, there is the problem that many migrants are effectively invisible in national statistics. There is remarkably little information on their health status outside a few countries such as the UK and The Netherlands.
Still, if all goes well, we will have an authoritative report ready for the Portuguese presidency conference at the end of September. A lot of work ahead….