Taking a human rights approach to health care commercialisation

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Taking a human rights approach to health care
commercialisation

• Dr Brigit Toebes,
• The University of Aberdeen
• School of Law
• b.toebes_at_abdn.ac.uk

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Health 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 from

• Research on Right to Health
• Advising on the privatisation of the Dutch health
  care system

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Health care commercialisation

• Human rights law
• neutral
• yet serious human rights consequences

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This presentation

• Terminology
• Rationale and causes
• Trends
• Public health perspective
• Human Rights perspective
• A human rights impact assessment

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Terminology

• Privatisation?
• Commercialisation?

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Rationale curb 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 IFIs and TNCs

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The promise

• Enhance the consumers range of choice

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Trends

• health insurance
• health care provision
• multinational expansion

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BMA - 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 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

• 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 perspective?

• Human rights impact assessment

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Relevant human rights

• Rights to information and political participation
• Right to health
• Right to a remedy
• Right to privacy

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Information and political participation

• Information and consultation
• of the public

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Right to health

• AAAQ
• Minimum core
• obligation to protect

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AAAQ

• Availability
• Accessibility
• Non-discrimination
• Physical accessibility
• Affordability
• Information accessibility
• Acceptability
• Quality

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Minimum core obligations

• Programme of Action ICPD
• Primary Health Care WHO
• Millennium Development Goals

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Obligation to protect

• Regulate
• Monitor
• Provide redress

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Accountability

• Right to an effective remedy

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Protection of privacy

• Data protection

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The human rights impact assessment

• 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 community

• WHO
• International Health Authority?
• General Comment.