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Toebes, April 2007 Taking a human rights approach to health care commercialisation Dr Brigit Toebes, The University of Aberdeen School of Law b.toebes@abdn.ac.uk
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Toebes, April 2007 Health and Human Rights http://www.abdn.ac.uk/law/hhr.shtmlhttp://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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Toebes, April 2007 Where do I come from Research on ‘Right to Health’ Advising on the privatisation of the Dutch health care system
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Toebes, April 2007 Health care commercialisation Human rights law: neutral yet: serious human rights consequences
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Toebes, April 2007 This presentation Terminology Rationale and causes Trends Public health perspective Human Rights perspective A ‘human rights impact assessment’
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Toebes, April 2007 Terminology Privatisation? Commercialisation?
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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
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Toebes, April 2007 The promise: Enhance the consumer’s range of choice
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Toebes, April 2007 Trends health insurance health care provision multinational expansion
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Toebes, April 2007 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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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.
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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’
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Toebes, April 2007 The human rights perspective? ‘Human rights impact assessment’
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Toebes, April 2007 Relevant human rights Rights to information and political participation Right to health Right to a remedy Right to privacy
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Toebes, April 2007 Information and political participation Information and consultation of the public
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Toebes, April 2007 Right to health AAAQ Minimum core ‘obligation to protect’
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Toebes, April 2007 AAAQ Availability Accessibility Non-discrimination Physical accessibility Affordability Information accessibility Acceptability Quality
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Toebes, April 2007 Minimum core obligations Programme of Action ICPD Primary Health Care WHO Millennium Development Goals
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Toebes, April 2007 Obligation to protect Regulate Monitor Provide redress
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Toebes, April 2007 Accountability Right to an effective remedy
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Toebes, April 2007 Protection of privacy Data protection
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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?
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Toebes, April 2007 The international community WHO; International Health Authority?; General Comment.
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