Presentation by Cezary Wlodarczyk, Council of Europe at a FEANTSA conference on "The Right to Health is a Human Right: Ensuring Access to Health for People who are Homeless", 2006

1. Council of Europe:
the right to health ,
particularly in relation to vulnerable groups
W. Cezary Wlodarczyk
Wroclaw, 13 October 2006

2. CoE: mission
 Vienna Summit (1993): the guardian of democratic security -
founded on human rights, democracy and the rule of law;
 Strasbourg Summit (1997): democracy and human rights, social
cohesion, the security of citizens and democratic values and
cultural diversity
 Summit Warsaw (2005): promoting the common fundamental
values of human rights, the rule of law and democracy;
strengthening the security of European citizens, fostering co-
operation with other organisations.


3. CoE mechanisms
 Fundamentals: European Convention on Human Rights
(guarantees civil and political human rights), European Social
Charter (guarantees social and economic human rights);
 Supervision: European Committee of Social Rights
determines whether or not national law and practice in the States
Parties are in conformity with the Charter;
 monitoring procedure: based on national reports (as a result
of the monitoring system, states make changes to their legislation
and/or practice in order to bring the situation into line with the
Charter);

4. SOURCES
 EUROPEAN SOCIAL CHARTER,
 EUROPEAN SOCIAL CHARTER (REVISED)
 DIGEST OF THE CASE LAW OF THE ECSR,
EUROPEAN SOCIAL CHARTER, March 2005,
 THE HUMAN DIGNITY AND SOCIAL
EXCLUSION PROJECT (HDSE Project): two
thematic reports: homelessness, health;

5. Perception of health
 Problems of health always integrated to broader
context of peoples’ social position;
 Concepts related to values: human dignity, social
integration;
 Social determinants of health: material status,
education, occupation, income, family status, gender,
social support, participation in social life;
 Health should be protected, but broad set of health
determinants must be considered;
 Concept of health determinants evolved;

6. Right to health and health care
 Health is an universal right;
 In many countries a lot health services is
principally available to all entitled (insured, own
citizens or citizens of specified countries);
 Usually, it is easier to get to preventive services;
 Those suffering due to specified diseases can
have additional entitlement;
 Underprivileged may have additional rights;

7. Homeless people
 themajority of those who become
roofless and end up on the street or in an
emergency shelter for homeless people
are poor, have no stable work, have
weak health and can no longer rely on
family and friends for help.

8. Direct health risks for homeless
 Exposure for physical, biological,
chemical, social, emotional risks resulted
from lack of dwellings or poor housing
conditions – leading to ill-health;

9. Social risks for homeless people
 A number of social rights have traditionally been
associated with a permanent abode or proof of
residence. Access to welfare benefits, basic health
care, personal documents, political participation,
operates on a territorial basis and citizens need to have
an address in order to claim their rights.
 Homeless people who cannot give proof of residence
may be denied all other basic human, social and
political rights.

10. First version
 EUROPEAN SOCIAL CHARTER, Turin,
18.X.1961, Entry into force: Conditions: 5 Ratifications.
Date: 26/2/1965;
 Right to health;
 Rights to social support (no direct reference to
housing;

11. Article 11 – The right to protection of
health
 Witha view to ensuring the effective exercise
of the right to protection of health, the
Contracting Parties under­take, either directly
or in co‑operation with public or private
organisations, to take appropriate measures
designed inter alia:

12. Article 11
 to remove as far as possible the causes of
ill‑health;
 to provide advisory and educational facilities
for the promotion of health and the
encouragement of individual responsibility in
matters of health;
 to prevent as far as possible epidemic, endemic
and other diseases.

13. Health
 State of health of the population:
 the state of public health, life expectancy, principal causes of death;
 the infant and maternal mortality rates as close to zero as possible.
 Access to health care:
 health care should be funded collectively;
 the costs involved should not be too onerous on individuals;
 access to health care should be provided without undue delay (waiting
lists);
 health personnel and equipment should be sufficient;

14. Protection and promotion of health
 Encouragement of individual responsibility;
 Consultation and screening;
 Rights to medical care – not emphasized;

15. Areas of interventions
 Healthy environment: air pollution, nuclear
risks, risks relating to asbestos, food safety;
 Tobacco, alcohol and psychotropic
substances;
 Immunisation and epidemiological monitoring;
 Accidents;

16. Additional provisions
 Article 12 – The right to social security;
 Article 13 – The right to social and medical
assistance;
 Article 14 – The right to benefit from social
welfare services;

17. Articles 12 & 13
 Social security, universal, occupational
schemes, special schemes (sickness,
incapacity for work, maternity, family charges,
unemployment, old age, death, widowhood,
occupational accidents and diseases);
 Social assistance, benefits granted essentially
on the basis of individual need . Is granted
where there is no social security benefit
ensuring that the person concerned has
adequate resources.

18. Social assistance
 Social assistance covers cash benefits and
benefits in kind payable primarily on the basis
of need (social allowances, social pensions,
minimum integration income, etc).
 Medical assistance covers access to free or
subsidised health care, or payments enabling
people to afford the care they require.

19. Social assistance
 The right to social assistance must be
maintained for as long as the state of need
persists;
 Conditions concerning length of residence or
ordinary residence are contrary to this
provision (foreigners likely affected);
 Foreigners with their residence or work permits
valid may not be expelled solely because they
are in need;

20. The vulnerable groups
 Social welfare services for everybody lacking
capabilities to cope, in particular the vulnerable
groups and individuals who have a social
problem;
 Children, the family, the elderly, people with
disabilities, young people with problems, young
offenders, refugees, the homeless, alcohol and
drug abusers, victims of domestic violence and
former prisoners;

21. New version
 EUROPEAN SOCIAL CHARTER (REVISED)
Strasbourg, 3.V.1996, Entry into force: Conditions: 3
Ratifications, Date: 1/7/1999;
 Right to housing;
 Protection against poverty and social exclusion;

22. Article 31 – The right to housing
 With a view to ensuring the effective exercise of the
right to housing, the Parties undertake to take
measures designed:
 to promote access to housing of an adequate standard;
 to prevent and reduce homelessness with a view to its
gradual elimination;
 to make the price of housing accessible to those
without adequate resources.

23. Adequate housing
 must be defined in law;
 structurally secure;
 safe from a sanitary and health point of view;
 not overcrowded;
 with secure tenure supported by the law;

24. Equal treatment
 Equal treatment with respect to housing must
be guaranteed, in particular, to the different
groups of vulnerable persons, particularly low-
income persons, the unemployed, single
parent households, young persons, persons
with disabilities including those with mental
health problems;

25. Obligations of the state
 States must gradually reduce homelessness,
towards its elimination;
 States must also take action to prevent
categories of vulnerable people from becoming
homeless. To this purpose they must
implement a housing policy for all
disadvantaged groups of people to ensure
access to social housing;
 Forced eviction must be strictly regulated;

26. Article 30 – The right to protection against
poverty and social exclusion
 With a view to ensuring the effective exercise of the right to
protection against poverty and social exclusion, the Parties
undertake:
 to take measures within the framework of an overall and co­
ordinated approach to promote the effective access of persons
who live or risk living in a situation of social exclusion or poverty,
as well as their families, to, in particular, employment, housing,
training, education, culture and social and medical assistance;
 to review these measures with a view to their adaptation if
necessary.

27. Article 30
 ...living
in a situation of poverty and social
exclusion violates the dignity of human
beings...
 access to social rights, in particular
employment, housing, training, education,
culture and social and medical assistance.

28. CONCLUSION
 A guarantee to all nationals and foreigners legally
resident and/or working that the right to protection of
health, set out in the Charter, applies regardless of
race, sex, age, colour, language, religion, opinions,
national origin, social background, state of health
(persons with disabilities), scope of family
responsibilities or association with a national minority.
 It covers the right to social integration and participation
in the life of the community.