Shirley Cramer CBE, Chief Executive of RSPH, reflects on the positives offered by a human rights-based approach to public health.
In the midst of the cut and thrust of debate around Brexit, it is noticeable how demonised the concept of human rights has become in certain quarters. Seen by many leavers’ as the reason that terrorists and miscreant migrants are still here in the UK, the Human Rights Act has been characterised as supporting ‘enemies of democracy’ and subverting the ‘british way of life’.
Parts of both Westminster and the media have opined on this subject to the detriment of a more positive societal discussion on human rights. Perhaps this is why, here in England, we have not taken a rights-based approach to the public’s health.
In autumn last year, we held the third UK Public Health Network Summit in a sunny and blustery Edinburgh, with individuals representing all four nations of the UK, including government agencies and civil society. We heard from experts in law, health, local authorities and charities in Scotland about a very different approach to the public’s health.
As Professor Paul Hunt reminded us, the Universal Declaration of Human Rights is set out in numerous legally binding international treaties and is enshrined in national constitutions. Public health and human rights are closely aligned and we need to make better arguments for the ‘right to health’.
Scotland has created a national action plan which enables public bodies to integrate human rights into all their work, it is a binding force for issues such as housing, employment, education and health. The argument is clear that a right to health is related to all other rights and if you upset one area (i.e. you have inadequate housing, poor employment) then your health is in serious jeopardy. An emphasis on the wider determinants of health supports a rights-based approach, but we have too often prioritised economic arguments over the right to health.
Taking a rights-based approach means putting people at the centre of a process that sees them as assets and aims to restore self-esteem and dignity. There are certain aims across the system in Scotland that services should be: available, accessible, acceptable and equal and an understanding that people need to understand their rights, to have higher expectations and that rights should be championed both from the grassroots and at Board level.
What struck many of us during the presentations in Edinburgh was the high level of consensus and commitment across government agencies, civil society and politicians, to a rights-based approach to health. The conversation was how best to implement the ‘rights’, not whether they existed. In the various strategies and action plans, they were seeking policy opportunities where a rights-based approach could be taken.
As we begin 2018 with all the evidence and articles about increasing health inequalities, perhaps we should incorporate a new approach into our thinking and embed a human rights culture into our practices to support the public’s health.
Perhaps a rights-based approach would gain more traction with the public and provide a new narrative to tackle the social determinants of health? We need to have new solutions and persuasive arguments and the new year is a good place to start.