GLOBAL C R I S I S

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GLOBALC R I S I S !!!!!
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As a GLOBAL excuse to neglect social issues
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Morality, Money, Menschenrecht and Medicine
the Council of Europe approach to health
governance

• Piotr Mierzewski
• Head
• Health Division
• DG III Social Cohesion
• Council of Europe
• Strasbourg

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Council of Europe ? European Union

47 member states 4 countries with observer
status
27 member states 2 candidate countries
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COUNCIL OF EUROPE

• Founded
• in 1949
• 47 member states
• 800 mln Europeans
• Seat
• Strasbourg, France

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MEMENTO...

• MONEY makes the WORLD go round...
• But
• WHO decides in which direction?
• Human rights principles
• Rule of law
• Working democracy
• Social cohesion idea

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HUMAN RIGHTSPALACE

but human rights are realised at homes and
hospitals
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LEGAL TOOLS

• European Conventions and Agreements
• Binding on the States that ratify them
• Recommendations
• Policy statements proposing a common
• course of action to be followed
• Obliging, but not obligatory

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COE respects HR ECHR, Oviedo Convention,EC
for the Prevention of TortureCOE protects HR
ECHR European Court of HREuropean Social
CharterCOE fulfils HR ECHR European Court
of HR, Commissioner for Human Rights
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Article 30 of the Council of the Revised European
Social Charter says that everyone has the right
to protection against poverty and social
exclusion.So what?....
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To write a right is not enough!
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Building bridges....

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Pillars

• Principles
• Policy
• Politics
• Practice

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FOUR Ps

• Principles - COE
• Policy - WHO
• Politics - EU
• Practice - COUNTRIES

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A I D S

• Acquired
• Immuno
• Deficiency
• Syndrome

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A I D S

• Acquired
• Ideals
• Deficiency
• Syndrome

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BIOETHICS CONVENTION

• Article_2 - Primacy of the human being
• The interests and welfare of the human being
  shall prevail over the sole interest of society
  or science.
• Article_3 - Equitable access to health care
• Parties, taking into account health needs and
  available resources, shall take appropriate
  measures with a view to providing, within their
  jurisdiction, equitable access to health care of
  appropriate quality.
• Article_4 - Professional standards
• Any intervention in the health field, including
  research, must be carried out in accordance with
  relevant professional obligations and standards.

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BIOETHICS CONVENTION

• Article 28 - Public debate
• Parties to this Convention shall see to it that
  the fundamental questions raised by the
  developments of biology and medicine are the
  subject of appropriate public discussion in the
  light, in particular, of relevant medical,
  social, economic, ethical and legal implications,
  and that their possible application is made the
  subject of appropriate consultation

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Do not let social solidarity to vanish.
Social solidarity was a first, paradoxical
victim of the victory of the Solidarity
movement.
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Social cohesion as a prerequisite of  Human
Rights Health   Equity in access
to social rights gtgt minimum   Impact of other
policies on health inequity and social
cohesion health and social audit of other
policies
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POVERTYis PRISON
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• NO POOR HEALTH FOR POOR PEOPLE

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A I D S

• Acquired
• Instruments
• Deficiency
• Syndrome

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Recommendation
Appendix
Explanatory Memorandum Working glossary
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Paving a way
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A I D S

• Acquired
• Involvement
• Deficiency
• Syndrome

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(No Transcript)
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Recommendations

• Rec(2000)5 on the development of structures for
  citizen and patient participation in the
  decision-making process affecting health care
• Patient as a real health minister

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Democracy depends on the power to votebut most
people, most of the time are healthy
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Citizens need voice, consumers are satisfied
with a choice.
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Symphonic orchestra or jazz combo?
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Fortress Europe ? Club Europe ?
Forum Europe ? Agora Europe !
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Forum is a meeting place of invited
participantsgood for negotiationsAgora is an
open space for all good for an intercultural
dialogue
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A I D S

• Acquired
• International
• Deficiency of
• Strategy

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The current worldwide economic crisis has
highlighted the crucial role of good governance,
and the dangers of its absence. The social
cohesion and health field are likely to be among
the most affected.
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The Council of Europe health strategy is a
collection ofguiding principles, binding
legal instruments, political declarations,
policy recommendations and a lot of sermons.
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Economic deficit is no excuse for ethical
deficit.
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MEDICINEMenschenrechteMORALITY MONEY
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MEMENTO...

• MONEY makes the WORLD go round...
• But
• WHO decides in which direction?
• Human rights principles
• Rule of law
• Working democracy
• Social cohesion idea

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The context- the Group of States
against Corruption (GRECO)- RESOLUTION (97) 24
ON THE TWENTY GUIDING PRINCIPLES FOR THE FIGHT
AGAINST CORRUPTION - Good governance a key
factor for the sustainable economic development
of regions, the Congress of Local and Regional
Authorities- Recommendation CM/Rec(2007)7 on
good administration- Recommendation No.
R (2000) 10 on codes of conduct for public
officials
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The Warsaw Summit Declaration of the Ministers,
on which this recommendation is based, states
We are convinced that effective democracy and
good governance at all levels are essential for
preventing conflicts, promoting stability,
facilitating economic and social progress, and
hence for creating sustainable communities where
people want to live and work, now and in the
future.
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Don Doctore,Sancho PatientandDollarea
Piotr Mierzewski
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The project Good governance for equity in health
care is a direct link to the recommendation of
the High-level Task Force on Social Cohesion in
the 21st Century Spearhead the development of
a value-based governance framework for our time
in health care that is oriented to
accountability, transparency, sustainability and
patients rights, avoiding corruption and
conflicts of interest and invoking the shared
responsibility of all stakeholders in society.
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The project is compatible with and supplementary
to the proposals of the WHO Tallinn Charter
(2008).
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Individual ethics should be complemented by
the ethics of common (collective) good..
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EfficiencyQualityEquityNew universalismSolid
arityPluralismCitizenshipSocial
responsibilityIndividual and family
autonomyEquality of opportunitySocial Inclusion
Purposes Operational principle Guiding
principles Social values
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FOUR Ps revisited

• Principles Hippocrates
• Policy Ministeres
• Politics Democrates
• Practice Hypocrysis

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VALUE FOR MONEY ECONOMIC IMPERATIVE MONEY
FOR VALUEETHICAL IMPERATIVE
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AN ADDED VALUEof the Council of Europe IN
ADDING VALUES !
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TIME HORIZONS

• POLICY next generation
• POLITICS next elections
• PHYSICIANS next fee
• PATIENTS next disease
• ______________________________
• REFORMS yesterday

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Thank You for your attention
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(No Transcript)
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Council of Europe DefinitionSocial cohesion is
the capacity of a society to ensure the
well-being of all its members, minimising
disparities and avoiding marginalisation. The
Task Force emphasises in addition Societys
capacity to manage differences and divisions and
ensure the means of achieving welfare for all
members. Principles Equal access to rights and
resources, with attention also to vulnerable
groups, and dignity/recognition for individuals,
as expressed through human rights Sharing of
responsibilities An activating approach
(participation and reconciliation) Managing the
balance across interests, generations and domains
of action
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Governance refers to the process of excercising
power by bodies that govern. Governance is a
standard term in political science and
administrative research vocabulary. Stewardship
came into fore in 2000 through the WHR of the
WHO, and has since been used in various WHO
documents. According to the WHR 2000, stewardship
is defined (p.119, following Saltman et al. 2000)
as a function of a government responsible for
the welfare of the population, and concerned
about the trust and legitimacy with which its
activities are viewed by the citizenry.
Governance relates to the process of governing
stewardship more to a certain approach to
governance.