Thirty-Ninth Amendment of the Constitution (Right to Health) Bill 2019: First Stage


Go gceadófar go dtabharfar isteach Bille dá ngairtear Acht chun an Bunreacht a leasú.

I move:

That leave be granted to introduce a Bill entitled an Act to amend the Constitution.

The Bill will be entitled the Thirty-Ninth Amendment of the Constitution (Right to Health) Act 2019 and insert into Article 43.4 of the Constitution the following statements: the State recognises the equal right of every citizen to the highest attainable standard of health protection and shall endeavour to achieve the progressive realisation of this right; the State shall endeavour, within its available resources, to guarantee affordable access to medical products, services and facilities appropriate to defend the health of the individual; and the health of the public being, however, both individual and collective, the State shall give due regard to any health interests that serve the needs of the common good.

The purpose of the Bill is to give constitutional status to every citizen's right to health. It will place an obligation on the State to realise progressively this right within its available resources and give a balance of rights between the individual and population health needs. Health is an internationally recognised human right. The EU Charter of Fundamental Rights states, "Everyone has the right of access to preventive health care and the right to benefit from medical treatment under the conditions established by national laws and practices." The UN's International Covenant on Economic, Social, and Cultural Rights states in Article 12: "The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health."

These treaties, to which Ireland is a signatory, affirm that good health is a prerequisite for public activity and private freedoms. With the advancement of medical knowledge, the exclusivity of private health systems and a continued exposure to global health issues, it cannot be said today that a citizen's health is beyond the realm of the State. That is why the Bill will initiate the constitutional amendment process. It will affirm the right to health as one of modern Ireland's foundational political and social values by enshrining it in our fundamental law, the Constitution.

Without a constitutional foundation, the Government may simply sit on its promises and look only to the short term. We have seen the results of this approach, such as long hospital wait times, a lack of bed capacity, vacant consultant posts, a creeping rate of legislation and many other issues that have led to unreasonable unmet need.

Ever since the initial publication of the Sláintecare report in 2017, the Department of Health has been committed to achieving a universal single tier health and social care system where everyone has equal access to services based on need and not the ability to pay. Despite the commendable intentions of the Government, there is no assurance in this regard other than the Government's promise that long-term objectives will be met.

This Bill would, therefore, crystallise the right to health within the Constitution so as to protect individuals and generate new legislative initiatives. It has worked in jurisdictions such as India and South Africa, which have used the constitutional right to health to pave the way for health reform and make new laws. This amendment to our fundamental law will better reflect modern Ireland's primary concerns and the Constitution would hold the State accountable to its democratic mandate to provide equitable and quality health services.

In addition, the amendment is intended to be fully cognisable by the courts, in the hope that individuals and interest groups can bring unacceptable public health issues to the attention of the courts. Litigation is circumscribed within reason by the deliberate language of the amendment, which states: "The State shall endeavour to achieve the progressive realisation of this right [and] the State shall endeavour, within its available resources, to guarantee affordable access".

Progressive realisation acknowledges the practical limitations to fulfilling a universal right to health, but it also ensures a process of continual advancement in the creation and implementation of public health measures without retrogression. Public health protection must be within available resources, a phrase which expects the State to consider health among its top budgetary priorities. At the moment, for instance, it has been noted that the 2020 budgetary allocations for Sláintecare have not met the estimates it is understood are necessary for Sláintecare to meet its long-term goals.

In essence, a constitutional right to health makes certain that initiatives like Sláintecare are backed by a constitutional mandate, with no excuse for delay or negligence. The right to health belongs among our most highly cherished fundamental and personal rights, and I believe the public deserves a chance to affirm the primacy of this right by referendum. I commend the Bill to the House.

I thank Deputy Harty. Is the Bill opposed?

Cuireadh agus aontaíodh an cheist.
Question put and agreed to.

Since this is a Private Members' Bill, Second Stage must, under Standing Orders, be taken in Private Members' time.

Tairgim: "Go dtógfar an Bille in am Comhaltaí Príobháideacha."

I move: "That the Bill be taken in Private Members' time."

Cuireadh agus aontaíodh an cheist.
Question put and agreed to.