The Right to Health pp 373-401 | Cite as
The Challenges to Realising the Right to Health in Ireland
Abstract
Political will is vital to realising the right to the highest attainable standard of health found in Article 12 of the International Covenant on Economic, Social and Cultural Rights and its related General Comment No 14 (General Comment No 14, para 12 (www.unhchr.ch/tbs/doc.nsf/(symbol)/E.C.12.2000.4.En)). Domestic stakeholders influence the political will to the realisation of this right. This chapter analyses the challenges in realising the right to health in Ireland where stakeholders wielded significant power. It reveals that there is no enforceable legal right to health in Ireland and that there is significant political discretion in realising the availability, accessibility, acceptability and quality objectives of General Comment No 14. The Catholic Church and medical profession have exercised a dominant influence over Irish health policy for decades. A consequence of this influence was that the Irish health system developed a unique mix of public and private health care which continues to hamper the realisation of the availability and accessibility objectives of General Comment No 14. The chapter discovers that there is a significant challenge in achieving the acceptability objective in Ireland with religious homogeneity. It discusses the role of the Catholic Church in access to health care with a focus on family planning. Finally, the chapter discusses Ireland’s progress in achieving the quality objective of General Comment No 14 because all stakeholders desired improvements in the quality of healthcare delivery.
Keywords
General Medical Service Health Service Executive Voluntary Health Insurance General Practitioner Care Public PatientReferences
Literature
- Adshead M, Millar M (2003) Ireland as Catholic corporatist state: a historical institutional analysis of healthcare in Ireland. Limerick Papers in Politics and Public Administration, pp 1–19. http://ulir.ul.ie/bitstream/handle/10344/477/MA_Ireland.pdf?sequence=2
- Backman G, Acurio Páez D, Hunt P, Armijos Pineda M, Farcasanu D, Frisancho A, Khosla R, Jaramillo-Strouss C, Mekuria Fikre B, Motlagh M, Pevalin D, Rumble C, Tarco D, Vladescu C (2008) Health systems and the right to health: an assessment of 194 countries. Lancet 372:2047–2085CrossRefGoogle Scholar
- Barrington R (2003) Catholic influence on the health services 1830–2000. In: Mackay JP, McDonagh E (eds) Religion and politics in Ireland at the turn of the millennium. Columba Press, Dublin, pp 152–165Google Scholar
- Barry J, Allwright S, Darker C, O’Dowd T, Thomas D (2010) Primary medical care in Irish prisons. BMC Health Serv Res 10:74. http://www.biomedcentral.com/1472-6963/10/74
- Bhagwati PN (1985) Judicial activism and public interest litigation. Columbia J Transnatl Law 23:561–578Google Scholar
- Cassels J (1989) Judicial activism and public interest litigation in India: attempting the impossible? Am J Comp Law 37:495–519CrossRefGoogle Scholar
- CESCR (1999) Committee on Economic, Social and Cultural Rights 1999, Concluding observations E/C.12/1/Add.35 14th May 1999Google Scholar
- CESCR (2002) Committee on Economic, Social and Cultural Rights 2002, Concluding observations E/C.12/1/Add.77 5th June 2002Google Scholar
- Colombo F, Tapay N (2004) Private health insurance in OECD countries: The benefits and costs for individuals and health systems. OECD working papers no 15. www.oecd.org/els/healthpoliciesanddata/33698043.pdf
- Considine M, Dukelow F (2009) Irish social policy: a critical introduction. Gill and Macmillan, DublinGoogle Scholar
- Constitution Review Group (1996) Report of the Constitution Review Group. Stationary Office, Dublin 1996Google Scholar
- General Comment No 14: The right to the highest attainable standard of health (Art 12 of the covenant) (E/C.12/2000/4)Google Scholar
- Government of Ireland (1997) Report of the tribunal of inquiry into the blood transfusion service board, Pn 3695Google Scholar
- Gwynn Morgan D (2002) A judgment too far? judicial activism and the constitution. Cork University Press, CorkGoogle Scholar
- Hardiman A (2004) The role of the supreme court in our democracy. In: Mulholland J (ed) Political choice and democratic freedom in Ireland. Lead Irish Thinkers 40:32–44Google Scholar
- Hogan G (2001) Directive principles, socio-economic rights and the constitution. Irish Jurist 36:174–198Google Scholar
- HSE (2013) Investigation of Incident 50278 from time of patient’s self-referral to hospital on the 21st October to the patient’s death on the 28th October 2012Google Scholar
- Irish Times (2001a) Woman applies to court over hospital’s deferral of cancer treatment, Irish Times, p 326, June 2001Google Scholar
- Irish Times (2001b) Cancer patient assured of private bed after taking hospital to court, Irish Times, p 4, 28 June 2001Google Scholar
- Kinney E, Clark B (2004) Provisions for health and health care in the constitutions of the countries of the world. Cornell Int Law J 37:285–355Google Scholar
- Palmer A, Fernandes K, Ford N, Guyatt G, Joffres M, Lima V, Mills E, Montaner J, Phung C, Tomkinson J, Zeng L (2009) Does ratification of human-rights treaties have effects on population health? Lancet 373:1987–1992CrossRefGoogle Scholar
- Regulation of Information (Services outside the state for termination of pregnancies) Act 1995Google Scholar
- Rossa Phelan D (1994) The concept of social rights. Dublin Univ Law J 16:105–146Google Scholar
- Toth F (2013) The choice of healthcare models: how much does politics matter. Int Polit Sci Rev 34:159–172CrossRefGoogle Scholar
- Wren M (2003) Unhealthy state: anatomy of a sick society. New Island Books, Dublin, IrelandGoogle Scholar
Documents
- Central Statistics Office (2012) Profile 7 religion, ethnicity and Irish travellersGoogle Scholar
- Competition Authority (2010) Competition in professional services: general medical practitionersGoogle Scholar
- Constitution of Ireland 1937Google Scholar
- Criminal Law Amendment Act 1935Google Scholar
- Criminal Law Amendment Bill 1971Google Scholar
- Criminal Law Amendment Bill 1972Google Scholar
- Dentists Act 1985Google Scholar
- Department of Health (1947) Outline of proposals for the improvement of the health serviceGoogle Scholar
- Department of Health (1987) Health the wider dimensionsGoogle Scholar
- Department of Health (1994) Shaping a healthier future—a strategy for effective health care in the 1990sGoogle Scholar
- Department of Health and Children (2001) Quality and fairness: a health system for you health strategyGoogle Scholar
- Department of Health and Children (2013) The path to universal healthcareGoogle Scholar
- European Convention for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment 1987Google Scholar
- European Convention for the Protection of Human Rights and Fundamental Freedoms 1950Google Scholar
- European Social Charter 1961Google Scholar
- Family Planning Bill 1973Google Scholar
- Health and Social Care Professionals Act 2005Google Scholar
- Health (Family Planning) Act 1979Google Scholar
- Health (Family Planning) (Amendment) Act 1992Google Scholar
- Health (Family Planning) (Amendment) Act 1993Google Scholar
- Health (Pricing and Supply of Medical Goods) Act 2013Google Scholar
- Health (Provision of General Practitioner Services) Act 2012Google Scholar
- International Covenant on Civil and Political Rights 1966Google Scholar
- International Covenant on Economic, Social and Cultural Rights 1966Google Scholar
- International Convention on the Elimination of All Forms of Racial Discrimination 1966Google Scholar
- Medical Practitioners Act 1978Google Scholar
- Medical Practitioners Act 2007Google Scholar
- Nurses Act 1985Google Scholar
- Nursing and Midwives Act 2011Google Scholar
- Offences against the Person Act 1861Google Scholar
- Protection of Life During Pregnancy Act 2013Google Scholar
- United Nations Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment 1984Google Scholar
- United Nations Convention on the Elimination of All Forms of Discrimination against Women 1979Google Scholar
- United Nations Convention on the Rights of the Child 1989Google Scholar
- United Nations Convention on the Rights of Persons with Disabilities 2006Google Scholar
Cases
- A and B v. Eastern Health Board (1998) 1 IR 464Google Scholar
- A, B and C v. Ireland (Application no 25579/051), 6th December 2010Google Scholar
- Application of Woods (1970) IR 154Google Scholar
- Attorney General (SPUC) v. Open Door Counselling Ltd (1988) IR 593Google Scholar
- Attorney General v. X (1992) 1 IR 1Google Scholar
- Brennan v. An Bord Altranais, unreported, High Court, Dunne J, 20th May 2010Google Scholar
- Bupa Ireland Ltd v. Health Insurance Authority, unreported, Supreme Court, 16th July 2008Google Scholar
- CK v. Northern Area Health Authority (2002) 2 IR 545Google Scholar
- D (A Minor) v. District Judge Brennan and Health Services Executive, unreported, High Court, McKechnie J, 9th May 2007Google Scholar
- Dunne v. National Maternity Hospital (1989) IR 91Google Scholar
- E v. E (1982) ILRM 497Google Scholar
- Eastern Health Board v. An Bord Uchtála (1994) 3 IR 207Google Scholar
- FN v. Minister for Education (1995) 1 IR 409Google Scholar
- In Re A Ward of Court (withholding medical treatment) (No 2) (1996) 2 IR 79Google Scholar
- In Re Health (Amendment) (No 2) Bill 2004 (2005) 1 IR 105Google Scholar
- In Re Ó Laighléis (1960) IR 93Google Scholar
- Jazvinský v. Slovakia (Application nos 33088/96, 52236/99, 52451/99, 52453/99, 52455/99, 52457/99 and 52459/99), 7th September 2000Google Scholar
- Kavanagh v. Ireland (1996) 1 IR 321Google Scholar
- Kennedy v. Ireland (1987) IR 587Google Scholar
- Kudła v. Poland (Application no 30210/96), 26th October 2000Google Scholar
- McDonagh v. Frawley (1978) IR 131Google Scholar
- McGee v. Attorney General (1974) IR 284Google Scholar
- McMenamin v. Governor of Wheatfield Prison, unreported, High Court, Hanna J, 29th June 2012Google Scholar
- Nitecki v. Poland (Application no 65653/01), 21st March 2002Google Scholar
- O’Laoire v. Medical Council, unreported, High Court, Keane J, 27th January 1995Google Scholar
- O’Reilly v. Governor of Wheatfield Prison, unreported, High Court, Hanna J, 22nd June 2007Google Scholar
- O’Reilly and Others v Limerick Corporation (1989) ILRM 181Google Scholar
- Open Door and Dublin Well Woman v. Ireland (Application nos 14234/88; 14235/88), 29th October 1992Google Scholar
- Prendiville v. Medical Council (2008) 3 IR 122Google Scholar
- Roe v. Wade 410 US 113 (1973)Google Scholar
- Ryan v Attorney General (1965) IR 294Google Scholar
- TD v. Minister for Education (2001) 4 IR 259Google Scholar
- The State (C) v. Frawley (1976) IR 365Google Scholar
- The State (Richardson) v. Governor of Mountjoy Prison (1980) ILRM 82Google Scholar
- Tysi ą c v. Poland, (Application no 5410/03), 20th March 2007Google Scholar