This year the theme of World Health Day was ‘My health, my right’. The emphasis on rights instead of aspiration is fuelled by the news that less than 2 per cent of the nations that acknowledge health to be a right support it by providing details of how they will finance it. This suggests that if people want the support of good health to be a priority of their governments, they will need to agitate for it.
To insist that health is a right, too, calls on us to ask who among our citizens have access to programs that care for illness and to those that prevent it. All too often, access to hospitals, to necessary medicines, and to other health care depends on one’s capacity to pay. Medical care is seen as a private transaction and not as a public right. In practice, too, access to health care depends largely on whether we live in the first world or the third world. The price of medical equipment, of medicines, and the remuneration of medical staff ensure that for the majority of the world’s population good health is not theirs by right but by good fortune.
Seen against this background, the claim that health is a right emphasises that it is not a privilege, and that we cannot be content with inequity in people’s access to care or to living conditions that promote good health. We must press for health to be seen as a right shared equally by all people throughout the world. And addressing that need in Australia must begin by strengthening our public health system.
To focus narrowly on health as a right, however, is to neglect equally important aspects. Health is also a gift. It is a gift in the obvious sense that enjoying and keeping it cannot be guaranteed by our own efforts or by good medical care. We can all be involved in accidents, fall ill with an incurable disease, or have a congenital condition. Good health is not an achievement to take credit for. It is something to be grateful for, a sign of good fortune as well as of good living.
Health is also a gift in the less obvious sense that the good effects of health care depend largely on the spirit in which it is provided. Those who care for others are most effective when they see their service as a gift to those for whom they care and as a gift for themselves. That circularity of gift received and gift given is central to the therapeutic power of health care.
When we consider large modern hospitals with their pressures of staff shortages, financial stringency, rapid turnover of patients and multiple protocols to be observed, this view of health care may seem to be romantic. Particularly when media attention focuses more the mistakes made or dissatisfaction expressed about hospitals. When you arrive at Casualty you fear you have fallen into a huge and impersonal machine.
In contrast, my recent experience at the large Royal Melbourne Hospital for a relatively unimportant condition was to my surprise one both of receiving and discovering a gift. The receptionists in Casualty charged with taking details and presumably making a first assessment of urgency were welcoming, helpful and engaged with me as a person. That was true also of the nurses and doctors who explored my condition and made a first assessment. They took their time as if time belonged to the patient and not to themselves, explained what they were doing and what the next stage might be. In my case, where the symptoms were clear but not the diagnosis, that meant staying a few days in hospital in a public ward.
'Good health is not an achievement to take credit for. It is something to be grateful for, a sign of good fortune as well as of good living.'
Here I had the opportunity to interact regularly with a number of nurses, doctors and kitchen staff, as well as to notice the way in which they related with one another and with patients, some of whom clearly suffered from mental illness. I was impressed in particular that the unfailing respect and humanity with which they related to me and to other patients appeared to characterise their relations with one another. In my experience, there are relatively few organisations in which the values of respect, care and skill proclaimed in the mission statement have been owned personally and extended to all the relationships between members of staff and the people they serve, management and staff, staff with one another, and all with visitors. I am sure that the staff in this hospital, as any other organisation, would include some people ill-equipped for such an environment by temperament, lack of empathy, of motivation or skills. But I did not see them and imagined that they would stand out. In the hospital people seemed to see, and some spoke of, their commitment to their work as a calling or vocation and so as more than a job. A full description of their commitment to work in the hospital would need to include love as well as choice, duty or contract.
The same attention and care extended to the care after returning home, with provision of equipment helpful for living at home, regular visits from nurses, occupational therapists and physiotherapists, each showing the same respect, flexibility and expertise as their colleagues in the hospital.
Such care for one’s health is deeply encouraging. That other people should take our health seriously encourages us to cooperate in our recovery. It also encourages gratitude for living in a society where there is a tradition, admittedly under great pressure, to see good health as a common good and not as a private acquisition. That all this hospital care, visiting and monitoring should come free of charge and to be as available to someone who comes in off the street as to someone who books an appointment embodies respect for the human dignity of each human person, regardless of their wealth, mental state or virtue.
Respect for human dignity entails attending to all the relationships salient to others’ well-being and ensuring that they are built upon respect. These extend beyond keeping persons alive and sheltered to being adequately fed, clothed, clean, provided with medical care, and consulted about any treatment they receive. Care must also begin with and be supported by personal relationships with people who have time to care, are sufficiently empathetic and have sufficient knowledge of their condition and needs. Where such a mission statement is enacted in human relationships it makes for healing. It should characterise all medical care as in my experience it did at the Royal Melbourne Hospital.
That goes beyond seeing health as a right to recognising it as a gift. It includes the gift that skilled people are to those in need of their skills, the gift of respect shown by healers to those whom they heal, the gift of the whole community to those who are ill by resourcing by the medical system, and the gift of wealthy nations to provide care for those less wealthy and the gift of empathy and compassion.
Andrew Hamilton is consulting editor of Eureka Street, and writer at Jesuit Social Services.
Main image: (Getty Images)