State of the World's Minorities and Indigenous Peoples 2013 - Germany

Germany's minorities face difficulties accessing health care. Turks in the country tend to visit hospitals because of their mistrust of general practitioners (GPs), according to the German newspaper Die Welt. A 2012 analysis by the MdM showed that 68 per cent of the patients visiting their centre in Munich only had access to emergency care in hospitals, and only 8 per cent were covered by health insurance or by the health insurance system of their country of origin. Greater use of hospital for treatment by minorities is not only more expensive, it also often means a delay in treatment and increases the likelihood of surgery being needed.

Language barriers are one of the main issues when trying to obtain health care for minority groups. Even those whose command of German is excellent tend to be less informed during hospital visits than the majority population. Translators are not only relevant for minority members who do not speak sufficient German or who require psychotherapy, they are also needed for an ageing population in which minority members whose first language was not German may lose their language skills due to dementia or Alzheimer's disease. Access to primary care and preventative medicine is also problematic. Although Germany has a culture of regular health check-ups and health monitoring, minorities often only see doctors when they are already sick or feel at risk of illness, which means they often miss out on preventative medicine and health check-ups for children. The MdM study noted that, whereas in other European cities, lack of knowledge about patients' rights was the key barrier to accessing health care, this was hardly an issue at their treatment centre in Munich since the vast majority of visitors, lacking permanent residency, hardly had any rights at all.

Minority children whose parents both come from a migrant background are also more likely to be overweight and have bad teeth than majority children, which is partly due to lack of preventative medicine and dental hygiene. Integration and social status play a role as well: the more well-integrated (assessed on the basis of language proficiency and resulting improved social status and employment situation) and more wealthy minority families are, the less likely they are to suffer from hepatitis, tuberculosis and other poverty-related illnesses, and the more likely they are to report allergies.

Inclusion and full participation in Germany's social and economic life is a constant and unresolved issue for minority groups. Under-representation of minorities in the public sector is a fact, which Chancellor Angela Merkel has said she wants to change, after leading a national integration summit in Berlin in January. The German government confirmed that it wanted to visibly increase the number of immigrants working in the public sector, which, according to national integration commissioner Maria Böhmer, served as a model for the rest of the labour market. Whether the government does a better job of ensuring the public sector reflects the demographics of the country remains to be seen. According to a study by the Organisation for Economic Co-operation and Development (OECD), Germany takes a 'sad last place' compared to the 34 other member states of the OECD when it comes to the number of descendants of migrants working in the public sector.

A ruling on circumcision that was handed down by a court in Cologne in June sparked an outcry among Muslim and Jewish communities and led to joint protests in the country. The judge ruled that the circumcision of a young boy on religious grounds amounted to grievous bodily harm and contravene the right to choose religion freely in later life, and was therefore illegal. The case arose when the circumcision of a Muslim boy had gone wrong and the boy was admitted to hospital. 'We consider this to be an affront [to] our basic religious and human rights,' stated the unusual joint statement, signed by leaders of the Rabbinical Centre of Europe, the European Jewish Parliament, the European Jewish Association, Germany's Turkish-Islamic Union for Religious Affairs and the Islamic Centre Brussels.

In September the state government in Berlin announced that circumcision was legal there, as long as it was properly carried out. The federal government also responded by stating that it wants to legalize the procedure explicitly and proposed a new law. According to the draft law, circumcision is legal in Germany. In the first six months of a boy's life, it can be performed by a member of the boy's religion who has received the necessary training or a doctor. After that age, it can only be performed by a doctor. The German parliament approved the bill in December.