Toebes, April 2007 Taking a human rights approach to health care commercialisation Dr Brigit Toebes, The University of Aberdeen School of Law [email protected].

Toebes, April 2007

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

[email protected]

Toebes, April 2007

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

Toebes, April 2007

Where do I come fromWhere do I come from

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

health care system

Toebes, April 2007

Health care commercialisationHealth care commercialisation

Human rights law: neutralyet: serious human rights consequences

Toebes, April 2007

This presentationThis presentation

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

Toebes, April 2007

TerminologyTerminology

Privatisation?Commercialisation?

Toebes, April 2007

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

Toebes, April 2007

The promise:The promise:

Enhance the consumer’s range of choice

Toebes, April 2007

TrendsTrends

health insurance health care provisionmultinational expansion

Toebes, April 2007

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.’

Toebes, April 2007

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.

Toebes, April 2007

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’

Toebes, April 2007

The human rights The human rights perspective?perspective?

‘Human rights impact assessment’

Toebes, April 2007

Relevant human rightsRelevant human rights

Rights to information and political participation

Right to healthRight to a remedyRight to privacy

Toebes, April 2007

Information and political Information and political participationparticipation

Information and consultation

of the public

Toebes, April 2007

Right to healthRight to health

AAAQMinimum core‘obligation to protect’

Toebes, April 2007

AAAQAAAQ

AvailabilityAccessibilityNon-discrimination

Physical accessibility

Affordability

Information accessibility

AcceptabilityQuality

Toebes, April 2007

Minimum core obligationsMinimum core obligations

Programme of Action ICPDPrimary Health Care WHOMillennium Development Goals

Toebes, April 2007

Obligation to protectObligation to protect

RegulateMonitorProvide redress

Toebes, April 2007

AccountabilityAccountability

Right to an effective remedy

Toebes, April 2007

Protection of privacyProtection of privacy

Data protection

Toebes, April 2007

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?

Toebes, April 2007

The international communityThe international community

WHO;International Health Authority?;General Comment.