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

Qiu, Shengnan; Macnaughton, Gillian

Despite China's ratification of the ICESCR, the right to health is not directly justiciable in Chinese courts. Nonetheless, it is partially justiciable through other health-related rights that are directly justiciable. Political accountability in China has traditionally been performed through the National People's Congress, through the reporting of the State Council, and through supervision mechanisms within the Communist Party. Although there is an identifiable framework of political accountability, lack of public participation has rendered it a very weak mechanism by which to hold the government to account. It has therefore recently come to be practiced in combination with a new process of public censure through the media. Additionally, in recent years, the government has started to explore other means of public participation, such as a 2008 pilot of an online feedback system that invited individuals to comment on ongoing health care reforms. 81 By contrast, administrative accountability can be used to monitor and supervise officials who perform delegated duties. This process can be achieved by government action or through administration litigation. Nonetheless, administrative accountability has often resulted from the publicity of some scandal rather through a systematic procedure. In response to the failures of administrative supervision and litigation, in 2017 the Chinese government began piloting "powerful" supervisory commissions in Beijing, Shanxi, and Zhejiang. 82 Further, although there are statutes and regulations on medical professional standards, there is no distinct professional accountability mechanism. People must rely on administrative or judicial mechanisms in cases of professional incompetency. Because of information asymmetry and the lack of oversight through professional medical associations, it is difficult, however, to hold health care providers accountable through these mechanisms. In short, professional accountability, like political accountability, does not function independently but works together with other forms of accountability.