health coverage, namely the time countries take to
implement it, the lack of legislation or the political
will. In the context of achieving the right to health,
cross-national analysis showed that key factors for
success were the ability to raise tax, the existence of
democratic systems and having a legal mandate. In
terms of funding, the tax system is the best way to
collect money.
Research has shown that to achieve universal health
coverage, in addition to increased tax collection,
there should be institutional and political support
and a shared national identity making society more
willing to invest in the collective good. Furthermore,
a more divided society was less likely to promote
universal health coverage.
A rights-based health system should include the
incorporation of human rights treaties, advocacy,
functioning courts and an independent judiciary
to ensure the implementation of laws, monitoring
of implementation and strategic litigation. Health
systems should be participative, with community
engagement essential to achieving this. A health
system should function with transparency, respect for
cultural differences and ensure equality in accessing
it. In addition, independent monitoring, accountability, shadow reports and strategic litigation are
necessary to ensure standards are maintained.
Prof McKee gave the example of the UK in which the
government has moved towards contracting out parts
of the health service to private companies. This can
have a negative effect on the state’s accountability to
maintaining an appropriate standard of service and
can also prevent NGOs that are unable to function
as competitively as large corporations from being
involved in providing these services where the state
seeks to avoid responsibility. Many of the challenges
faced when implementing the right to health could be
relevant to the implementation of the right to rehabilitation, particularly in the areas of funding and state
accountability.
In the open discussion following Prof McKee’s presentation, it was noted that NGOs are bridging the
gap by providing the majority of torture rehabilitation
services. However, NGOs will still be held accountable, particularly in terms of accessing funding, and
therefore it is important to measure and evaluate the
effectiveness of services provided.
Prof. Martin McKee from the London School of Hygiene & Tropical Medicine reflected on the accessing
of health systems and health financing in the context of the right to health.
6
International Rehabilitation Council for Torture Victims