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Resolution 2139 (2016)
Ensuring access to health care for all children in Europe
1. European health care systems show
significant deficiencies in the provision of health care to children, even
though they remain among the most accessible globally. As a result
of the most recent economic crisis and subsequent austerity programmes,
access to health care has become more and more difficult, particularly for
children already living in insecure conditions or belonging to vulnerable
groups, but all countries – poorer and richer ones alike – face
their own specific challenges with regard to health care provided
to children.
2. The Parliamentary Assembly is concerned about the inequalities
across Europe and within European countries concerning the right
of children to the “highest attainable standard of health” as defined
by the World Health Organization (WHO), both in terms of availability
and accessibility of health care services and health levels. Quality
health care services for children should not only be made available,
but should also be effectively accessible to all children in a given
country, whatever their socio-economic, ethnic or migrant background,
geographical location, state of health or legal status in the country.
3. The Assembly calls on member States to comply with the relevant
international and European standards, including the United Nations
Convention on the Rights of the Child, the European Social Charter (revised;
ETS No. 163) and the Convention on Human Rights and Biomedicine
(ETS No. 164). Governments should promote child-friendly health
care systems according to the relevant Council of Europe guidelines,
and make them a priority of public health policies. The importance
of the health of children and adolescents, and a path forward, are
also outlined by WHO in its document “Investing in children: European
child and adolescent health strategy 2015-2020” – an essential reference
in this field.
4. While the most urgent task is that of restoring adequate services
in countries where health systems have suffered from the economic
crisis and austerity programmes, a further challenge consists in
ensuring healthy living conditions and providing health care services
to children and families living in precarious situations due to
unemployment, poverty, war or migration, for example. Child-friendly
health care systems also require appropriate prevention programmes,
according to Assembly Recommendation
1959 (2011) on preventive health care policies in the
Council of Europe member States.
5. Against this background, the Assembly calls on the member
States of the Council of Europe to:
5.1. ensure adequate funding to develop health care systems
of the highest standard possible to be available to all children
in an equitable manner across every country, which are comprehensive (including
prevention, diagnosis, treatment, rehabilitation and palliative
care), address health emergencies and chronic diseases affecting
physical and mental health, ensure the provision of medicines to
all children, and put an emphasis on prevention from an early age,
including antenatal health care;
5.2. improve data collection in the health field with a view
to measuring current disparities in children’s access to health
care and assessing the effectiveness of health policies, disaggregated
by age group (smaller children and adolescents) and covering both
physical and mental health issues;
5.3. address the fundamental social determinants of health,
such as poverty, income inequalities and education levels, but also
environmental determinants, with a view to improving health and
access to health care services;
5.4. develop health literacy through specific programmes, dispensed
via educational systems or targeted at specific categories of the
population, including disseminating basic knowledge of symptoms requiring
medical attention and of healthy ways of living, as well as information
about the functioning of health systems;
5.5. promote a new approach to informing children about and
consulting them on health decisions concerning them, and let children
participate in the planning, design and delivery of health care
where appropriate, thus responding to the highest standards of child
participation;
5.6. provide specific support to the most vulnerable groups
of children, including putting in place targeted programmes to respond
to their specific needs, and through the following measures:
5.6.1. setting up regular screening programmes for all children
in schools, including for children living in poverty or in families
with low levels of health literacy, in line with WHO standards in
this field;
5.6.2. devising programmes to improve the presence of and access
to health workers in remote rural areas through training, regulation
and (where appropriate) financial incentives, as well as to help
children and families access their nearest health care centres;
5.6.3. improving access for children with disabilities to quality,
affordable health care services by reviewing legislation and policies,
increasing targeted budgets and improving service delivery;
5.6.4. in the light of the current refugee crisis, taking immediate
action to guarantee access for children “on the move” (migrants
and refugees) to quality health care, independently of their legal status
and without discrimination based on gender, age, religion, nationality
or race;
5.6.5. in the same context, dedicating special attention and
resources to children affected by armed conflicts, either by physical
injuries requiring aftercare or by traumatising incidents that have
led to a significant increase in mental health problems among these
children;
5.6.6. taking action to guarantee access to quality health care
for children of ethnic minorities, such as Roma and Traveller children,
including through specific outreach programmes designed to overcome
reluctance to turn to public health services;
5.6.7. providing specific training programmes for health care
professionals to help them address culturally sensitive matters,
such as sexual and reproductive health, and deal with traumatised
children;
5.7. co-operate to provide support in delivering access to
health care for all children to countries with the greatest need
and the least resources.
6. Improved accessibility to health care systems should also
include complaint mechanisms for patients encountering failures
in the system or unequal treatment, inspection bodies in charge
of supervising health facilities and quality management systems
to improve services wherever needed.