1. Questionnaire on Human Rights in relation to health inspection Tallin May 2010 Olav Molven Norwegian Board of Health Supervision

2. What I’m going to talk about Human rights and health ICSECR article 12 Other conventions and provisions on health The presented questionnaire and health Violations of the right to health Supervising on basis of human rights

3. What are human rights? Focus on dignity of human beeing Guaranteed by international standards Are legally protected Protect individuals and groups Oblige states and state actors Cannot be waived or taken away Are interdepended and interrelated Are universal

4. The link between health and human rights Violations or lack of attention to human rights can have serious health consequences Health policies and programmes can promote or violate human rights in the ways they are designed or implemented Vulnerability and the impact of ill health can be reduced by taking steps to respect, protect and fulfill human rights

5. How are human rights enshirred in international law? IHR treaties –are binding on governments that ratify them IHR declarations –are non-binding IHR programmes of action –are non-binding

6. The implementing in Norwegian Law Section 2 The following conventions shall have the force of Norwegian law …: … The International Covenant of 16 December 1966 on Economic, Social and Cultural Rights, Section 3 The provisions of the conventions and protocols mentioned in section 2 shall take precedence over any other legislative provisions that conflict with them.

7. The international human rights instruments that set out govern- mental commitments on health UN treaties (and General Comments) –ICCPR –ICESCR –CRC –CEDAW –CRPD –CACIDTP –CERD Declarations and programs European treaties

8. Ingredients in a rights-based approach to health (substantive elements) Human dignity Vulnerable groups Accessible health systems Gender perspective Best interest of the child The view of the child

9. Ingredients in a rights-based approach to health, substantive elements (cont) Equality Education Information Identifying benchmarks and indicators Concrete government obligations Optimal balance between good public health outcomes and the protection of human rights

10. ICESCR article 12 ”The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.”

11. What is meant by ”The right to health”? Policies and action plans must affect –Underlying determinants/basic elements Water, food, sanitation, healthy environmental conditions, health related education –Health care Prevention and health protection Health care

12. What is meant by ”The right to health” (cont.)? Four criteria by which to evaluate the right to health* –Availability –Accessibility –Acceptability –Quality * General comment 14

13. ICESCR article 12 (cont.) The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right shall include those necessary for: a.the provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child; b.the improvement of all aspects of environmental and industrial hygiene; c.the prevention, treatment and control of epidemic, endemic, occupational and other diseases; d.the creation of conditions which would assure to all medical service and medical attention in the event of sickness.

14. The questionnaire The history ”Basic rights” –Contains rights both with direct and indirect linkages to health ”Prevention and health protection” –Contains specific rights with indirect linkages to health ”Health care/health services” –Contains specific rights with direct linkages to health

15. Violation of the right to health (1) Violations –in general (Gen. Com. § 47-48? –of the obligation to respect § 50 –of the obligation to protect § 51 –Of the obligation to fulfil § 52

16. Violation of the right to health (2) Violations through acts of commission include the formal repeal or suspension of legislation necessary for the continued enjoyment of the right to health or the adoption of legislation or policies which are manifestly incompatible with pre- existing domestic or international legal obligations in relation to the right to health.

17. Violation of the right to health (3) – Ex. from Norway? Reorganising hospitals in Oslo – health personnel reduced with 3000 (10-15 %) The standard of sound professional practice in mental health care is often not met The quantity and quality of supervising nursing homes by doctors are not good, have not improved, rather worsened