Precarious work = precarious health rights? D-number migrants in Norway

Temporary migrants in Norway face barriers to accessing healthcare and are at risk of suffering and destitution. EEA citizens in precarious employment can get stuck in a temporary status for years.

Background: In 2021 ca 70 000 EEA citizens working in Norway were registered with a D-nummer, designating them as temporary migrants in the country. Currently almost no research exists about access to public healthcare for this large group of migrants. In this paper we explore how being registered with a D-nummer affects EEA citizens access to public healthcare and paid sick leave in Norway.

Methods: The paper is the result of a cooperation between a researcher and an NGO community worker who has worked for many years supporting EEA citizens to gain access to public healthcare and paid sick leave. The paper relies on qualitative analysis of data gathered during advice meetings between the community worker and 12 EEA citizens registered with a D-nummer in Norway, including meeting notes, EEA citizens patient journals and their correspondence with NAV, Skattetaten and other authorities.

Results: EEA citizens registered with a D-nummer face a variety of barriers to accessing public healthcare services and paid sick leave including lack of access to a home doctor, difficulties of obtaining sick leaves and inability to login to user accounts of public administration websites such as NAV and Helsenorge, which can make it impossible to access a sick note, prescriptions and to apply for sick pay. As a result, some migrants suffer from untreated health conditions and fall into homelessness and destitution due to lack of financial assistance during their sickness. EEA citizens working in industries such as construction, cleaning and hospitality may be unable to become residents of Norway because they must secure a contract of six months future uninterrupted employment to get registered with a birth number, which can be extremely difficult in these industries. The result is that some EEA citizens live for many years registered with a D-nummer in Norway.

Conclusions: Our findings suggest there is large group of migrants working in Norway that are at risk of exclusion from healthcare and sick pay and as a result at risk of extreme suffering, homelessness, and destitution. Furthermore, our findings show that EEA citizens registered with the D-nummer can get trapped in a temporary status and that precarious working conditions can lead to precarious health rights in Norway. This represents a form of discrimination based on type of employment, contradicting the fundamental norm of universality in the Norwegian healthcare system. In order to prevent suffering the barriers to accessing healthcare for temporary migrants who work in Norway must be removed and the criteria for the allocation of the birth number must be adjusted so that EEA citizens who live and work in Norway for more than six months can register as residents regardless of the type of their employment.