Retour Ageing and Health: a challenge to public health and social cohesion - a strong need for common action

Strasbourg , 

As delivered

 

Introduction: the dilemma of aging populations

Ladies and Gentlemen,

Dear Colleagues and Friends,

We are getting older.

You will hear it many times today; you have probably heard it many times before: across the world, human beings are living longer than ever. And here in Europe the demographic shift is particularly pronounced. In 2014 it is estimated that nearly one in five Western Europeans was 65 years old or older. By 2030, this will have risen to one in four.

What does this mean for our continent?

First, let me say that I do not accept the simplistic caricatures which sometimes present aging populations as nothing but burdensome to younger generations.

We, rightly, laud the medical and technological developments which will allow so many of us to live into old age. And there are many profound benefits for societies in which children can grow up knowing their grand-parents, and sometimes their great grand-parents and great aunts and uncles too: the family ties; the retention of heritage; the accumulation of knowledge and wisdom. We also must not forget that longer lives mean longer working lives and, in many places, later retirement: many Europeans will pay their taxes for longer than their parents did.

But it is, of course, true that ageing populations present challenges – not least in ensuring that all who grow old can do so with dignity and in good health.

There are significant costs attached, particularly in terms of pensions, healthcare and welfare. And in recent years the difficulty of meeting these costs has been exacerbated by the financial crisis, high unemployment and sluggish growth – which many Council of Europe member states continue to grapple with.

It is not this Organisation’s mandate to tell democratically-elected governments how to spend money or run their public finances. This is the prerogative of national authorities – and I would like to commend the many politicians, medical professionals and campaigners I have met in our member States who clearly care deeply about ensuring that, in these troubled times, older citizens continue to have access to decent care and do not bear an unacceptable burden for austerity programmes. We commend such efforts.

Our job, by contrast, is to help states successfully address the challenges created by ageing populations by drawing on their shared experiences and by taking a human rights based approach, shaped by our common standards. How to meeting growing care needs; how to provide opportunities for older people to remain engaged and active; preventing ageism in healthcare settings, and also abuse. Issues which appear across our nations.

Council of Europe standards: the Convention and the Charter

In recent years in particular, the Committee of Ministers, the Parliamentary Assembly, the European Court of Human Rights, the Commissioner and the European Committee of Social Rights have all addressed these questions in one way or another.

And while the European Convention on Human Rights does not make an explicit reference to age, the European Court of Human Rights has increasingly passed judgments in this area. Whether with regards to poor hospital conditions, deficient access to care or inappropriate treatment of older people, resulting, notably in violations of Article 2: the right to life, Article 8: respect for private life, and Article 3: on the prohibition of torture and inhuman and degrading treatment.

Importantly the Court has also made clear that, in certain settings, older people may require special safeguards. This has been an important development in international law.

On the face of it, Heinisch vs. Germany is a case about a whistleblower’s right to freedom of expression: it concerns the dismissal of a nursing home employee who had drawn attention to the abuse of elderly residents. But this case is also significant because, in its judgment, the Court explicitly underlines that, in certain circumstances, older people may be particularly vulnerable: unable to speak out against breaches of their rights themselves, and therefore requiring special protections.

The European Social Charter contains a specific, binding provision to protect the rights of the elderly – which is, again, ground-breaking from a legal perspective. Of course, many of its Articles are relevant to older people, but in particular Article 23 of the revised Charter – which, for the technical among you, is identical to Article 4 of the Additional Protocol of the original 1961 Charter – explicitly states that “every elderly person has the right to social protection”.

One of its primary objectives is to enable older people to remain “full members” of society, meaning that they must suffer no discrimination on account of their age.

This means that the 43 states who are party to either the original or the revised Charter are required to combat age discrimination, including in healthcare, in law.

They are required to provide adequate care to meet older people’s needs, including palliative care services.

They are obliged to take appropriate measures against elder abuse. And, with regard to older people living in care homes, the Social Charter insists on their right to privacy and personal dignity, as well as their right to complain about the treatment they receive.

These obligations are frequently underlined by the European Committee for Social Rights – which monitors states’ compliance with the Charter. The Committee has stressed the need, in numerous cases, to expand healthcare facilities and services for older people; to provide care which is affordable and, where necessary, to provide assistance in covering the costs; the Committee has also repeatedly emphasised the need for effective and independent inspection bodies. When such conclusions are drawn, we then work with national authorities to help put the right reforms in place.

Recommendation on the promotion of human rights of older persons

Over the years, we have also accumulated a number of recommendations for member states and, before finishing, there is one I would like to highlight – because I think it will be especially important for some of the people in this room. 

Two years ago our Committee of Ministers adopted its Recommendation on the promotion of human rights of older persons. It is true that, as a Recommendation, it is not legally binding. But it is significant that 47 European governments have now collectively adopted a comprehensive, dedicated set of principles for the enjoyment of all human rights by all older people, including in healthcare – from non-discrimination, to having a say in the decisions which affect them, to protection from violence, abuse and neglect, and the provision of social protection and care. It is a truly ambitious and far-reaching statement on the rights and dignity we expect older people in Europe to enjoy. And I believe its adoption tells us something encouraging about the growing political recognition of the importance of this agenda.

Yes, much work will need to be done to turn these principles into reality. But written into the recommendation is the requirement to return to these issues in 2019 in order to track progress and, potentially, agree next steps.

This follow up process will, I hope, be a chance for civil society and all relevant stakeholders to be heard. It will also certainly build on recent initiatives launched by the Parliamentary Assembly, which rapporteur Lord Foulkes will tell you more about shortly. It therefore presents an opportunity for all of us to keep pushing for reform.

You will know from your own work: we have to take every opportunity to keep this issue on the political agenda, including at international level. For that reason I am extremely grateful to the INGO conference, and notably the president of the Committee Democracy, Social Cohesion and Global Challenges, for organising this event. I want to thank the many organisations and individuals here for their efforts in this area – and for being part of a movement in Europe to rediscover that people are assets to develop, not liabilities to manage, at any age. 

With that, I wish the best for your discussions; I look forward to hearing the outcome; and I wish you a great stay in Strasbourg. Thank you.