Theme 2: Health
Under the theme of Health the report provides an overview of what appear to be some human rights gaps and good practices in the following areas
Integrating a human rights based approach in health, law and policy making
The opportunities to advance human rights in health care through the Patients’ Rights Act and Charter as well as the development of Health Inequalities Impact Assessment processes are identified in the report, as are steps to increase participation in decision making in health contexts. The report also considers the extent to which accountability mechanisms fulfil the requirements of a human rights based approach and opportunities arising from the pursuit of No Fault Compensation.
Health care services need to be both well resourced and competent, we often struggle to attract staff to the islands … it’s not uncommon to have clients kept in hospital or respite because of the lack of resources in the community.
Karen, 3rd sector advocacy worker
Healthcare quality
The report considers opportunities for the further integration of human rights in healthcare delivery connected with the Healthcare Quality Strategy. Despite a general satisfaction with the quality of care received some research suggests concerns related to, amongst other things: unintentional harm; contracting infections such as MRSA; and concerns related to delayed discharge.
Health promotion
Addressing underlying determinants of health is a core component of the right to the highest attainable standard of health. The report cites research demonstrating that lifestyle choices remain a significant health challenge in Scotland including in relation to smoking, diet and alcohol consumption. Research also indicates that health outcomes are also related more "fundamental" factors such as deprivation and poverty, an ageing population and a complex geography with large and sometimes sparsely populated rural areas. The impact of increased pressure on public funds in a time of recession was also identified in some sources.
Non-discrimination within health care
The right to health includes an obligation to ensure that health facilities, goods and services are accessible to all without discrimination. In this context there are four dimensions to consider: non-discrimination (in law and fact), physical accessibility (including in rural areas and for disabled people), economic accessibility and information accessibility. The research identifies issues faced by groups such as minority ethnic and religious communities, as well as people with disabilities and LGBT people, and the research also indicates particular challenges in accessing health services faced by those living in rural areas.
Mental health care and treatment
The care and treatment of patients in and outside of mental health institutions engages a range of human rights including the right to life, the right to liberty, the right to freedom from torture, inhuman or degrading treatment or punishment, and the right to respect for private and family life. The report considers responses to mental health stigma, access to mental health care, quality of mental health care of treatment (including restraint, seclusion and reports of individuals being forced to take certain medications) and specific concerns for those patients receiving dementia care.