Right to health
Everyone living in Ireland has a right to health and it is the responsibility of the Irish Government to protect and to deliver that right.
The right to health was recognised as a human rights as far back as 1948, when the Universal Declaration of Human Rights said: ‘Everyone has the right to a standard of living adequate for…health and well-being.'
In 1966, Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) made the right to health legally binding, when it said that every country signing the Covenant should recognise ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.’ Ireland ratified this Covenant in 1989.
States cannot protect against illness, but they need to be protecting the facilities, goods, services and conditions that are necessary to promote good health.
Rights are interdependent and indivisible and people do not experience one set of rights violations in isolation from other experiences. For example, access to other rights such as the right to adequate housing, education and work are vital for good health.
A key component of the right to health is that people are able to access healthcare without discrimination. This includes economic discrimination i.e. that healthcare is affordable.
The healthcare system in Ireland is extremely unequal:
- Significant numbers of people living in or at risk of poverty do not have a Medical Card.
- Private health insurance has risen every year since 2004.
- People who rely on the public system wait longer for care.
This is unacceptable. The poorer you are, the more likely you are to get sick. You are twice as likely to have a chronic illness if you are living in consistent poverty than if you are not (47 per cent compared with just 23 per cent of the general population).
There is no protection for the right to health in the Irish Constitution or legislation. The current legislation is falling short in ensuring people can access healthcare on an equal basis.
What needs to be done?
The Government must commit to a robust legal guarantee that no matter who you are or what you can afford you will have access to quality health care.
What do we mean by ‘a robust legal guarantee’?
A legal guarantee would mean that individuals could challenge government, and healthcare providers, when they were unable to access the healthcare they need.
The government’s planned health system reform includes a legislative basis for Universal Primary Care and for Universal Health Insurance. These pieces of legislation must ensure a legal guarantee of access to both primary and acute care services. They must rule out discrimination between patients based on what they earn or on what kind of health insurance they do or don’t have. We need to ensure that people relying on the public healthcare system are not offered an inferior package of healthcare services.
Under international law, all people have the right to appeal when their human rights are violated. Without access to redress human rights can mean very little. Sufficient solutions must also be provided for people who are denied access to healthcare services, or are discriminated against in how they access healthcare. The Office of the Ombudsman currently has jurisdiction over the Health Service Executive (HSE). When the HSE is abolished, provisions must be made for an appeals mechanism for the legal guarantee to healthcare.