We need a shift in the power dynamic.

• Written by: Kimberley Somerside — Voluntary Health Scotland — Policy and Engagement Officer
• Published: 22nd May 2023

The right to health can only be realised if we reach those missing from our services.

This latest research by the ALLIANCE perfectly sets the scene for policymakers as we eagerly await the Scottish Government’s human rights incorporation bill.

I’ve heard some people express concern that a lot of hopes are hanging on this much anticipated legislation. It is potentially an opportunity to enshrine a human rights-based approach in our policy making. It could provide the tools we need to address the power imbalances in our system which drive health inequalities. Mostly though, it is an opportunity to advance the right to health, which we can’t afford to miss.

‘The Opportunity is Now’ acknowledges that a human rights-based approach requires an analysis of the inequalities that exist between duty bearers and rights holders, while focusing on those who are most marginalised.

We have seen two substantial reviews of health inequalities in Scotland published in the last year and the findings were no surprise to anyone. It is abundantly clear that the fortunes of those living in our most deprived communities are becoming detached from the rest of society. We know services are not reaching those most in need, inequalities are deepening, the most marginalised are being failed, and we need a radical shift in approach.

During the COVID-19 vaccine rollout, Voluntary Health Scotland made the case for taking the vaccine to those we knew could be missed by the programme. We saw some incredible examples of innovation and partnership working between the third sector and health services to ensure no one missed their opportunity for vaccination. In some cases, vaccine teams visited homeless accommodations and recovery cafes. This was a great example of inclusion health in practice, taking public health interventions to those often excluded from services, something we should be seeing much more of.

We need to be thinking about who is being served by our services and policy interventions and always question who is missing from the table. There are significant barriers to access for particular groups which need addressed.

This report is timely as we discuss how the health service needs to reform to break the perpetual cycle of NHS crises. The ‘Opportunity is Now’ recognises that crisis costs more than prevention in the long run. We should be taking an inclusion health approach and shifting from reactive to preventative interventions to reach those who need us most.

There’s already a strong case being made for a ‘maximalist approach’ to incorporation which empowers rights holders through primary legislation. We need this legislation to be accountable if it is to avoid being yet another victim of the implementation gap. Most importantly, we need the right to health to be tangible for those facing the biggest barriers to good health. This is not the only opportunity to imbed a human rights-based approach in our policy design, the National Outcomes review and the National Care Service are also important opportunities for us to seize. That said, it is incumbent on us as a sector to use this legislation to actively reach the people missing from our services and empower them to access their rights. We’ve got the evidence, now all we need are the tools.

Kimberley Somerside, Policy and Engagement Lead at Voluntary Health Scotland

Kimberley.somerside@vhscotland.org.uk

Read ‘The Opportunity is Now‘ report in full.

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