Mechanisms of Accountability for the Realization of the Right to Health in China

Qiu, Shengnan; Macnaughton, Gillian

Political accountability means that the government is required to ensure participatory processes for the adoption of health policies and strategies. The right to health requires the government to set up an appropriate health system and remedy market failures through both regulation and resource allocation. A central concern of the right to health is participation in the development of laws, policies, and practices to realize the right to health. This concept of political accountability has its roots in Western democratic political systems, where it is understood that political accountability requires mass participation by individuals. 43 Whether meaningful political accountability can be achieved with a single party government like that in China is, as Alston states, "[t]he most difficult and complex challenge." 44 Generally speaking, political accountability demands a democratic political framework carried out through mechanisms such as free and fair elections and the workings of parliaments; thereby, the party in power may be removed if it fails to satisfy the public. 45 By contrast, however, in China there is only one party governing the country. Nevertheless, political accountability in the broader Western sense is not entirely absent. In theory, the National People's Congress provides a mechanism similar to a parliament by which political power is monitored. According to the Constitution, the National People's Congress plays the legislative role, and the State Council, which practices executive and administrative power, is authorized and supervised by the National People's Congress. 46 The State Council is directly accountable to the National People's Congress for all its decisions and actions. In relation to the right to health, three forms of political accountability are reflected in the Chinese political system. These include accountability of the National People's Congress, which concerns supervision of political power in the process of decision making; accountability of the State Council, which concerns the use of available resources and the equal allocation of resources for the right to health; and accountability within the Communist Party, which has a unique form with particular Chinese characteristics.