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Taking a human rights Taking a human rights approach to health care approach to health care

commercialisationcommercialisation

Dr Brigit Toebes,

The University of Aberdeen

School of Law

b.toebes@abdn.ac.uk

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Health and Human RightsHealth and Human Rights

http://www.abdn.ac.uk/law/hhr.shtml : Honours course ‘Health and Human Rights’ ‘Monitoring the Right to Health: a Multi-

country study’ Research on health care commercialisation PhD Research Dabney Evans on Race and

Health

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Where do I come fromWhere do I come from

Research on ‘Right to Health’Advising on the privatisation of the Dutch

health care system

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Health care commercialisationHealth care commercialisation

Human rights law: neutralyet: serious human rights consequences

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This presentationThis presentation

TerminologyRationale and causes TrendsPublic health perspectiveHuman Rights perspectiveA ‘human rights impact assessment’

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TerminologyTerminology

Privatisation?Commercialisation?

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Rationale: Rationale: curb public spendingcurb public spending

Developed countries Inefficiency Ageing of the

population Improvements of

medical techniques Rising expectations Over-consumption?

Developing countries Inefficiency General poverty on the

part of the government Pressure from IFI’s

and TNC’s

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The promise:The promise:

Enhance the consumer’s range of choice

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TrendsTrends

health insurance health care provisionmultinational expansion

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BMA - 2006BMA - 2006

‘There should be no further involvement of the commercial private sector in providing

NHS care. The BMA will campaign to restore an integrated publicly provided

health service in England.’

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The public health perspectiveThe public health perspective

Mackintosh and Koivusalo:More of GDP spent by government or

social insurance funds on health care: better care at birth;

Higher primary care commercialisation: greater exclusion of children from treatment when ill.

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Their conclusion:Their conclusion:

‘Health systems are part of the public policy sphere’

‘Policies towards commercialization within health systems should and can be within national and local democratic control’

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The human rights The human rights perspective?perspective?

‘Human rights impact assessment’

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Relevant human rightsRelevant human rights

Rights to information and political participation

Right to healthRight to a remedyRight to privacy

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Information and political Information and political participationparticipation

Information and consultation

of the public

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Right to healthRight to health

AAAQMinimum core‘obligation to protect’

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AAAQAAAQ

AvailabilityAccessibilityNon-discrimination

Physical accessibility

Affordability

Information accessibility

AcceptabilityQuality

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Minimum core obligationsMinimum core obligations

Programme of Action ICPDPrimary Health Care WHOMillennium Development Goals

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Obligation to protectObligation to protect

RegulateMonitorProvide redress

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AccountabilityAccountability

Right to an effective remedy

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Protection of privacyProtection of privacy

Data protection

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The human rights impact The human rights impact assessmentassessment

Public informed and consulted?Effects on the adequacy of the services?Regulatory mechanisms in place?Means of redress?Medical data protected?

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The international communityThe international community

WHO;International Health Authority?;General Comment.