Serbia: discrimination and corruption, the flaws in the health system

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Publication of a report by the investigation mission on the right to health

The International Federation for Human Rights (FIDH) publishes a report on the exercise of the right to health in Serbia.

This report, which follows the FIDH investigation mission in Serbia, is being submitted to the United Nations Committee on Economic, Social and Cultural Rights which, on 2-3 May, will examine the report by Serbia-Montenegro on the application of the International Covenant on Economic, Social and Cultural Rights, article 12 of which guarantees the right to health.

Several groups appear to be particularly vulnerable to discrimination regarding their right to health in Serbia: displaced persons and refugees, the handicapped, the aged, women who are victims of marital abuse, abandoned children, persons suffering from post-conflict trauma, isolated country dwellers. Two categories suffer even greater discrimination: Roma and the displaced persons and refugees living in centres not registered by the High Commissioner for Refugees (HCR).

Discrimination is not rooted in blatantly discriminatory laws but is apparent however in the case of access to health-care, and access to the underlying determinants of helath (housing, food, healthy environment...). The mechanisms of discrimination are linked to adequate housing, to administrative obstacles (which arise in particular in the case of persons with no fixed address), to stigmatisation (from which the Roma suffer in all areas, including health), and also the lack of access to health-care for economic reasons for the poorest people. The actual costs of health-care no longer correspond to the health assurance rates of reimbursement and furthermore, the State budget scarcely covers the many non-contributors.

The mission notes that very few effective remedies as regards violations ofthe right to health are possible.

Generalised corruption leads to more discrimination against the poorest in their access to health-care, and tends to reduce the amount of contributions to health assurance and the funds allocated to State spending on health.

Efforts to reform the system clash with the political instability and the interests of those who benefit from a system of corruption. The system therefore remains unsuited to the needs of the population. The primary health-care sector is neglected although it is a priority, and there is a disproportionate number of specialist doctors in relation to general practitioners. In addition, the lack of clear distinction between the private and public sectors hinders the smooth running of the system.

The FIDH wellcomes the signature by Serbia-Montenegro, on 22 March, of the revised European Social Charter and calls the gouvernment to ratify this instrument as soon as possible, as well as the 1995 Protocol authorising collective complaints to the European Committee for Social Rights.

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