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Taking a human rights approach to health care commercialisation

Taking a human rights approach to health care commercialisation. Dr Brigit Toebes, The University of Aberdeen School of Law b.toebes@abdn.ac.uk. Health and Human Rights. http://www.abdn.ac.uk/law/hhr.shtml : Honours course ‘Health and Human Rights’

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Taking a human rights approach to health care commercialisation

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  1. Taking a human rights approach to health care commercialisation Dr Brigit Toebes, The University of Aberdeen School of Law b.toebes@abdn.ac.uk Toebes, April 2007

  2. 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 Toebes, April 2007

  3. Where do I come from • Research on ‘Right to Health’ • Advising on the privatisation of the Dutch health care system Toebes, April 2007

  4. Health care commercialisation Human rights law: • neutral • yet: serious human rights consequences Toebes, April 2007

  5. This presentation • Terminology • Rationale and causes • Trends • Public health perspective • Human Rights perspective • A ‘human rights impact assessment’ Toebes, April 2007

  6. Terminology • Privatisation? • Commercialisation? Toebes, April 2007

  7. 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 Rationale: curb public spending Toebes, April 2007

  8. The promise: Enhance the consumer’s range of choice Toebes, April 2007

  9. Trends • health insurance • health care provision • multinational expansion Toebes, April 2007

  10. 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.’ Toebes, April 2007

  11. 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. Toebes, April 2007

  12. 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

  13. The human rights perspective? ‘Human rights impact assessment’ Toebes, April 2007

  14. Relevant human rights • Rights to information and political participation • Right to health • Right to a remedy • Right to privacy Toebes, April 2007

  15. Information and political participation Information and consultation of the public Toebes, April 2007

  16. Right to health • AAAQ • Minimum core • ‘obligation to protect’ Toebes, April 2007

  17. AAAQ • Availability • Accessibility Non-discrimination Physical accessibility Affordability Information accessibility • Acceptability • Quality Toebes, April 2007

  18. Minimum core obligations • Programme of Action ICPD • Primary Health Care WHO • Millennium Development Goals Toebes, April 2007

  19. Obligation to protect • Regulate • Monitor • Provide redress Toebes, April 2007

  20. Accountability Right to an effective remedy Toebes, April 2007

  21. Protection of privacy Data protection Toebes, April 2007

  22. 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? Toebes, April 2007

  23. The international community • WHO; • International Health Authority?; • General Comment. Toebes, April 2007

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