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

Toebes, April 2007 Health and Human Rights :  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 from Research on ‘Right to Health’ Advising on the privatisation of the Dutch health care system

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

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

Toebes, April 2007 Terminology Privatisation? Commercialisation?

Toebes, April 2007 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 IFI’s and TNC’s

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

Toebes, April 2007 Trends health insurance health care provision multinational expansion

Toebes, April 2007 BMA ‘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 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: ‘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 perspective? ‘Human rights impact assessment’

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

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

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

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

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

Toebes, April 2007 Obligation to protect Regulate Monitor Provide redress

Toebes, April 2007 Accountability Right to an effective remedy

Toebes, April 2007 Protection of privacy Data protection

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