The PhD research examines the national implementation of the right to health with a particular focus on Greece. For this reason, the research builds upon two interconnected parts, Part I and Part II. Part I seeks to identify the primary standards deriving from the right to health on the basis of human rights law by employing evidence from various sources: The UN, Council of Europe and human rights doctrine. Part II is a case study examining the Greek context relating to the right to health whilst considering the particular challenges within Greece such as, economic austerity.
Over half a century since its first recognition in the preamble to the Constitution of the WHO (1946), the right to health has increasingly obtained a prominent position in human rights law. Nevertheless, worldwide many people face serious impediments when it comes to the enjoyment of their right to health, particularly those most in need for care and/or in most financial need. Thereto, we need to move from the conception of the right to health to its actual realization. Put simply, we need to move from theory to practice by evaluating the status of the right to health within national contexts in view of particular challenges, such as economic recession, embedded inequalities, health sector privatization, corruption etc. Such an approach will help us acquire a greater understanding of the content of the right to health in practice, closer to national realities and the daily lives of individuals. Meanwhile, this approach could actually contribute to the emerging dialogue on best-practices and shortcomings in relation to the operationalisation of the right to health framework among different countries worldwide.
Indeed, the discussion of the Greek experience reveals significant gaps-deficiencies in the implementation of the right to health in Greece, as well as opportunities in this area. Since 2010 Greece is experiencing a severe financial crisis and, as a result, a major economic restructuring, involving the introduction of austerity measures and a privatization agenda, with implications on several areas of public services, especially in the health sector. Nevertheless, such developments concerning the area of health in Greece coupled with a persistent health sector corruption raise issues of great concern related to health inequalities among the population. In fact, the research points out that in Greece commitments stemming from human rights and constitutional provisions fade when it comes to providing access to health care to some of the most vulnerable groups in society, primarily undocumented migrants and Roma children. Indeed, one finds profound health inequalities in Greece with these vulnerable population groups either denied access or receiving substandard care. In light of such alarming developments the research highlights that these do not reflect progression, but rather constitute a significant cause for retrogression in the enjoyment of the right to health (care) of every individual in Greece. Nonetheless, this situation touches upon the question why one should not anticipate on the defence that when a State is being confronted with a financial crisis, it cannot abide by its right to health obligations due to lack of funds. The research denotes that resource availability cannot be used as a defence when the realization process is failing, given that the realization of the right to health of every individual combined with the elimination of health inequalities can be achieved by a State through setting priorities and by taking reasonable and targeted measures, and if necessary by seeking support from the international community.
Overall, the position taken in the research is that the Greek State within the scope of its powers must actively intervene to ameliorate the current situation and redress the rising health inequalities (e.g. to set priorities within its health system and to allocate its limited resources to those most in need). To this end, no easy solutions are available that can be achieved at once and several reform measures are required beforehand. In fact, the adoption of a framework law could make the right to health operational within the national legal order by identifying tangible commitments to be progressively implemented by all responsible actors and by being employed by individuals or (vulnerable) population groups as a means for redress once their right to health is violated.
Questions for further discussion:
How can the private procurement of (public) services in the area of health be most effective in the enjoyment of the right to health by every individual?
How can the value of ESC rights shape national policies in view of States’ limited capacities, especially in times of (economic) crisis?
How can the role of civil society be advanced for realizing the right to health of every individual and especially those most in need for care?