As the European Union approaches the pivotal 2024 elections and a new parliamentary mandate, it is imperative that legislative priorities place access to healthcare and the reduction of health inequalities at the forefront of the political agenda. To ensure sustainable and inclusive healthcare systems across the EU, it is crucial to prioritise marginalised groups, including people experiencing homelessness, LGBTI people, people who use drugs, prisoners, sex workers, ethnic minorities, and undocumented migrants, and confront the existing disparities that undermine equitable healthcare.

The Nobody Left Outside (NLO) initiative recommends the following:
  1. Ensuring Universal Health Coverage: Enact policies and legislations that guarantee equal access to quality healthcare services for all individuals, irrespective of their socioeconomic background, ethnicity, gender, age, sexual orientation, occupation, migration status or other factors. This should include ensuring that accessing health services, and other vital services and supports, does not have immigration consequences for people with irregular or insecure residence status through the creation of “firewalls”.
  2. Intersectional Approach: Recognise the intersecting identities and challenges faced by individuals within these groups when accessing healthcare services and develop an EU Action Plan on Access to healthcare for Marginalised communities.
  3. Integrating Health Perspective into All Policies: Approach policy development in all areas, including migration policy, with a focus on assessing and understanding their potential health impacts on marginalised communities.
  4. Removing financial Barriers: Ensure that healthcare services are affordable and accessible to marginalised groups by reducing financial and administrative (such as requirement to have an address) barriers.
  5. Elimination of Discrimination and Stigma: Combat discrimination within healthcare services towards marginalised groups, as these violate fundamental rights and lead to reduced access, inadequate care, or avoidance of healthcare services due to fear of mistreatment or stigmatisation.
  6. Enhancing Primary Healthcare: Invest in robust primary healthcare systems that serve as the first point of contact for individuals, especially those from marginalised communities, and prioritise preventive care, early intervention, and health promotion for these groups.
  7. Promoting Health Literacy: Promote initiatives that enhance health literacy among marginalised communities, empowering them to make informed decisions about their health. Provide access to reliable health information, health education programs, and multilingual resources to bridge language barriers.
  8. Data Collection and Monitoring: Establish robust systems for data collection, analysis, and monitoring of health inequalities, with a particular focus on marginalised groups, to inform evidence-based policies and interventions that effectively reduce disparities.
  9. Best Practice Sharing: Foster collaboration and knowledge sharing among the EU Member States to develop innovative approaches and share best practices in reducing health inequalities and improving healthcare access for marginalised communities.
  10. Active Inclusion of Marginalised Communities in Policymaking: Establish a comprehensive framework for the active inclusion and participation of marginalised communities in the development of public health policies and services. This should involve continuous and structured engagement mechanisms, collaboration with community-led organisations, and inclusive decision-making processes that prioritise the specific needs and expertise of these communities.