Right to health: between universality and exclusion
In the context of the Spanish economic crisis, one of the main obstacles for the integration of foreign nationals has been the limitation of its economic and social rights, including the right to healthcare. The scope and impact of these restrictions will be scrutinised on Tuesday 21 April during the seminar on "Right to health: between universality and exclusion", with Carlos Lema, professor of Legal Philosophy at Carlos III University in Madrid, and Rafael Sotoca, president of Doctors of the World in the Valencian Community.
Professor Angeles Solanes, in charge of the right to health in the scientific committee of Spain's II Human Rights Action Plan, will moderate this free activity at 10:30am, in the Auditorium of the Social Science Faculty. The seminar is part of the Seminar series on conflicts, multiculturalim and public policies: case studies.
Carlos Lema has published a number of monographs on social rights, heath and bioethics, such asApogeo y crisis de la ciudadanía de la salud (Dykinson, 2012), Salud, Justicia, Derecho. El derecho a la salud como derecho social (Dykinson, 2009); Antes de Beatriz. Cuestiones de legitimidad y regulación jurídica en la selección de sexo, (Comares, 2003) and Reproducción, Poder y Derecho. Ensayo filosófico-jurídico sobre las técnicas de reproducción asistida (Trotta, 1999). His intervention will highlight that the right to health is recognised in the 1978 Spanish Constitution, although not with the wording and guarantees that would have brought it in line with international human rights law. This right has been developed legal, institutional and organisationally, leading to the creation of a near-universal and egalitarian National Heath System, a high-quality public service whose management largely devolved to Autonomous Communities. Its perceived deficiencies are attributable to chronic underfunding in relation to similar advanced countries, caused by the social deficit inherited from the dictatorship and that manifests itself through health inequality in particular. Adding to these problems, the recent privatisations and spending cuts are undermining the principles of universality and equality, weakening the right to health itself. The erosion of universality caused by Royal Decree-Law 16/2012 tends to dissolve its meaning as a right, contradicting the historical meaning of a Public Health Service. This entails an illegitimate breach of the principles of universality and equality that prefigures a paradigmatic shift away from post-constitutional developments, with grave repercussions on this right.
Rafael Sotoca currently works as a doctor in charge of chronic diseases in Manises Department of Health. He has previously worked as an adviser on health information in the Health Ministry and as director of information system design in the Valencian government. He has also been a mission leader and medical coordinator for Doctors Without Borders in Argentina, Colombia and Albania. Coinciding with the third anniversary of Royal Decree-Law 16/2012 of health exclusion, he will underline that thousands of persons have lost or had problems accessing the healthcare services they finance and are entitled to. The misguided legislative provision, which entails a radical turnaround in the historical universalisation of the Spanish health system, has been applied without the necessary political debate, without any economic report and without the agreement of Autonomous Communities. At the same time, it has stirred a lively reaction in civil society, led by the most engaged groups in the health area. As professor Ildefonso Hernández stated in the summer of 2012, "we are still in the state of shock". The organised opposition progressively took shape, generating highly effective political networks. In the Valencian Community, Doctors of the World, the Valencian Society of family doctors and Caritas founded ODUSALUD, the Observatory of the Universal Right to Health, that has become one of the citizen networks of reference for the recovery of the right's universality. At the moment, ODUSALUD has published nine reports and denounced more than 1000 documented cases of infraction to the right to health in the Community, including dozens of minors. However, perhaps the most surpring fact about the Observatory has been its capacity gain the adhesion of 78 civil society groups in the Community, from NGOs to professional organisations, neighbourhood associations and patient groups. This shows that organised civil society is able to modify the political agenda and, therefore, set itself objectives of social change.