This Quebec autumn is one of all dangers for human rights: housing crisis, homelessness, inflation, food insecurity and disruption of education services follow forest fires and floods. Meanwhile, in terms of health, we are rapidly increasing recourse to the private sector which comes to the rescue of the public, siphoning off the latter’s resources under the pretext of greater efficiency.
It is in this context that the “Health Plan” and Bill 15 relating to the institutional reform that accompanies it are being deployed. Many voices have been heard to denounce the lack of attention these initiatives pay to the social determinants that have an impact on the health of the population. Is it any wonder that households that are poorly housed, poorly educated, poorly served by work and poorly fed… fall ill?
However, acting upstream of the state of illness seems beyond the imagination and ambition of a government which defines its role as limited to the management of increasing crises. The case of health is obvious: focus on access to health care at any price, and nothing or very little for public health and social services. Crisis management serves a government that likes to impose its solutions – and an ideology of privatization – in the name of urgency.
The many risks that people face clearly constitute a human rights issue, and the right to health crystallizes this issue because the violation of other rights, linked to current crises, undermines health. This statement implies obligations for the State.
First, we must give the population control over determining their needs before they are confronted with the disease. Democratizing health means recognizing the decisive importance of public health and population health strategies. This will not be the mandate of the new Santé Québec agency, which will camouflage public health in a Kafkaesque organization chart.
Second, the health and social services system must distribute its efforts between upstream and downstream health problems. What is the point of quickly diagnosing diabetes, asthma or anxiety if the only available solution is to prescribe medication? It does not eradicate housing mold or poverty, and does not address the exorbitant cost of the food basket or low levels of health literacy.
Third, recognition of the right to health postulates recognition of other fundamental rights and requires the implementation of a set of social policies to ensure their realization. In response to the numerous crises affecting populations, the human rights reference framework is not an abstraction. Rather, it is a methodology of human dignity.
It requires carrying out an analysis of the impacts of public policies on human rights which includes procedural and substantive requirements. On a procedural level, the effective participation of populations in determining health and social services and in their organization must be guaranteed. On a substantive level, it is important to evaluate, among other things, whether the privatization of health care has an impact on the constant improvement of the living conditions of populations. Obviously, the obsession with managing waiting lists reduces the right to health to a minimum.
In light of these demands, managing Quebec “one crisis at a time” by relying on the laws of the market represents in itself a violation of fundamental rights. And the state of crisis does not exempt Quebec any more than other societies from the demand for their respect.
The social and economic dimension of the right to health is inseparable from the exercise of other rights, including the right to housing, education, work, food and a healthy environment. Investing in population health is a matter of human dignity and security; It is urgent that the Quebec government carry out a profound transformation of its vision and assume its responsibilities in terms of human rights.
Because, this fall more than ever, the right to health is eluding us!