Heilsa og notendastýrð þjónusta

1. Heilsa og notendastýrð þjónusta Hugleiðingar á ráðstefnu um notendastýrða þjónustu, Grand Hótel 27. september 2008 Héðinn Unnsteinsson, stefnumótunarsérfræðingur Heilbrigðisráðuneytinu

3. Heilsa • Hvað er heilsa? • Ef heilsa er andstæðan við sjúkdóm • Er þá “disease” andstæðan við “ease” ? • Eða eru heilsa og sjúkdómar samtvinnuð tilvistarfyrirbrygði? • Og ef svo er ber þá ekki að vinna með ’heildina’ ?

4. Ease vs. Dis-ease • WHO (1948): “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. • Does complete well-being = health? • What is illness then? And where do we draw the line between or are we a constant mixture of both health and illness or more specifically: a dynamic mixture of ease and dis-ease?

5. The Alma Ata declaration 1978 I The Conference strongly reaffirms that health, which is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, is a fundamental human right and that the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the healthsector.

6. The Ottawa Charter for Health Promotion, 1986 Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy lifestyles to well-being.

9. Notendastýrð þjónusta => sjálfstæð tilvera (indipendant living) • Independent Living, as seen by its advocates, is a philosophy, a way of looking at disability and society, and a worldwide movement of people with disabilities who proclaim to work for self-determination, self-respect and equal opportunities. • The social model looks beyond a person’s impairment at all the relevant factors that affect their ability to be a full and equal participant in society.

10. Samningur SÞ um réttindi fólks með fötlun (The UN Convention on the Rights of Persons with Disabilities) Markmiðið með samningi þessum er að stuðla að því að fatlaðir njóti allra mannréttinda og mannfrelsis til fulls og jafns við aðra, jafnframt því að vernda og tryggja slík réttindi og frelsi, og að auka virðingu fyrir mannlegri reisn þeirra.

11. Tími • En hversu lengi þarf alþjóðasamfélagið /Ríki/Sveitarfélög að semja sérsamninga til handa þeim sem greindir eru útfrá takmörkunum sínum en ekki getu? • Hvers vegna duga samréttindi ekki? • Við gerð þessa samnings tóku fatlaðir og fulltrúar þeirra (allir 3 megin flokkar) þátt á jafnréttis grunni við opinbera fulltrúa og starfsmenn SÞ (lárétt vinnulag, “open method of coordination”)

13. VAL D