November 2014
EUROPEAN SOCIAL CHARTER
European Committee of Social Rights Conclusions XX-2
(GRECE)
Article 3 – Right to safe and healthy working conditions
Paragraph 1 – Safety and health regulations
The Committee takes note of the information contained in the report submitted by Greece.
Personal scope of the regulations
Other types of workers
Σελίδα 7: In its previous conclusions (Conclusions XIII-2, 2007 and XIX-2, 2009), the Committee did not consider self-employed workers were satisfactorily protected in Greece. In particular, the last conclusion was based on the consideration that, despite the improvements made in the reference period and given the high proportion of self-employed workers in Greece (according to 2007 Eurostat data, the highest in Europe with 21% of the total workforce – more than twice the EU average), the self-employed remained only partly covered by the above-mentioned regulations and on an exceptional basis, leaving a number of gaps in their protection (for example, shipyards, agriculture, hotels and restaurants). In this respect, the Committee recalled that that for the purposes of Article 3§1, all workers, including non-employees, must be covered by health and safety regulations as they are exposed to the same risks.
The report stresses that during the reference period, actions were implemented, concerning all workers, without exception, including self-employed persons. It recalls Act No. 3850/2010 (see above), which also concerns, as the other actions undertaken, the category of self-employed workers. More specifically, as far as workers on vessels are concerned, the reports indicates that Article 2§4 of the above-mentioned Act specifies the relevant provisions that apply to sea transport and that Act No. 4078/2012 ratified the ILO Maritime Labour Convention which contains provisions on the protection of seafarers’ health and safety and the prevention of accidents. As complementary information on this matter, the report refers to the developments concerning the information and training of the temporary workers on health and safety at work (see above).
Despite the improvements during the reference period, the Committee notes that self-employed workers continue to remain only partly covered by occupational health and safety regulations.
Conclusion
The Committee concludes that the situation in Greece is not in conformity with Article 3§1 of the Charter on the ground that the self-employed are not sufficiently covered by occupational safety and health regulations.
Article 3 – Right to safe and healthy working conditions
Paragraph 2 – Enforcement of safety and health regulations
The Committee takes note of the information contained in the report submitted by Greece.Occupational accidents and diseases
…As regards the difference between the data provided by Eurostat and SEPE, the report points out that on the basis of the legislation in force, the obligation of employers to report to SEPE accidents involving salaried workers, does not apply to self-employed persons, family enterprises, as well as work into quarries and mines, for which the competent agency is the Mines Inspectorate. The report also indicates that the data of Eurostat are based upon adjustment of the accidents reported to IKA concerning only persons insured with IKA from all sectors of economic activity, while the data of SEPE refer to insured persons of all dependent employment social security bodies, excluding the workers at quarries and mines. Based on this information, the Government is of the view that the comparison between the above-mentioned data is not reliable, because it does not concern comparable population groups.
Article 12 – Right to social security
Paragraph 1 – Existence of a social security system
The Committee takes note of the information contained in the report submitted by Greece.
Risks covered, financing of benefits and personal coverage
The Committee notes that Act 3655/2008 provided for the creation of new social security bodies through the merging of Funds or the integration of bodies and branches into already existing social security organisations. The main insurance bodies are the Social Insurance Institute (IKA-ETAM), Self-employed Workers’ Insurance Organisation, Agricultural Insurance Organisation, Unified Insurance for Self-Employed Persons and Unified Mass Media Personnel Insurance Fund. According to the report, there are supplementary insurance bodies and welfare bodies such as private sector welfare fund and public servants welfare fund. This administrative reform aimed at implementing the uniform management and operation rules, more substantial and effective monitoring and control, restraining of uncontrolled medical care expenditure and better and faster services for all citizens.
In its previous conclusion (Conclusions 2009) the Committee held that the personal coverage of social security risks was satisfactory and asked for updated information.
… The Committee takes note of the measures with a view to guaranteeing the insurance coverage of unemployed persons in respect of medical care benefits. It notes that unemployed and self-employed workers are covered in respect of sickness benefits in kind for two years by the social security organisation with which they were insured prior to the interruption of their employment. However, according to the report, due to the financial state of the country a great number of persons remain unemployed for longer than two years and therefore, they are not entitled to medical care benefits. The Committee notes in this regard however, that Act 3995/2011 provided by the possibility to extend the insurance coverage of the long-term unemployed persons for medical care benefits until 31/12/2011. The Committee wishes to be informed about further developments regarding this issue.
The Committee asks what is the total number of persons covered by healthcare out of the total population and in the meantime it reserves its position on this issue.
The Committee notes from the report that in 2011 the total of 1,2 million persons were insured by IKA-ETAM. As regards income-replacement benefits, the Committee asks that the next report provide information on the total number of persons insured under pension, unemployment, sickness and old-age branches out of the total active population. In the meantime, the Committee reserves its position as to the personal coverage of the social security risks.
Adequacy of the benefits
The Committee notes from Eurostat that 50% of the median equivalised income stood at €458 in 2011.
Sickness and maternity benefits
The Committee asks what is the minimum level of sickness and maternity benefits.
Conclusion
The Committee concludes that the situation in Greece is not in conformity with Article 12§1 of the Charter on the ground that the minimum level of unemployment benefit for beneficiaries without dependents is manifestly inadequate.
Και μια αναφορά με θέμα: Access to healthcare in times of crisis
Σελίδα 16: In Greece, the clientele of a charity in Athens, the ‘Social Mission Infirmary’ (see Chapter 4 section on ‘Drawing on less costly workers’) which treats uninsured persons, illustrates access problems for the groups mentioned above. Among its patients, 86% have lost insurance during 2010–2012. Almost half of its patients (48%) are self-employed people who lost insurance due to tax or insurance debts, and 8% are uninsured and pregnant.
In Greece, people who are unemployed for more than two years and their dependants are particularly at risk of losing insurance, since coverage is reduced after 24 months (see Chapter 4 section on ‘Increasing exemptions and coverage’).
Σελίδα 43: The ‘twilight zone’: In several countries, copayment exemptions and free insurance coverage are available for several vulnerable situations, such as being retired, unemployed and earning an income below a certain threshold. Nevertheless, the crisis has created additional groups of people who fall outside the criteria for those exemptions, such as people who are self-employed but have very little work due to the crisis, people who experienced income reductions but are just above the threshold that entitles them to exemptions, or people who lost their jobs just before retirement in countries where retirees qualify for entitlements but the unemployed do not.
Σελίδα 48: Within the existing measures in Greece up to June 2014, unemployed people are entitled to health insurance for up to two years of unemployment. Before the crisis (2006), the inactive and long-term unemployed were also covered if they lived on low benefits, via a so-called ‘Poverty Booklet’ giving them free access to treatment in public hospitals, to medical services and to
medicines. The crisis has resulted in many people falling between these measures. In September 2013, Greece launched a ‘Health Voucher’ programme, targeting both the long-term unemployed who had lost insurance coverage and also their dependants. The vouchers are valid for four months and cannot be renewed, but provide for up to three visits to a GP or diagnostic centre, and up to seven visits for pregnancy care. Hospital care is not covered. In November 2013, a measure was implemented that gave self-employed who were in debt to the insurance fund (often the case for people who had owned a small business but went bankrupt) access to health insurance benefits if they were complying with a debt settlement process. Since late June 2014, all uninsured persons are formally entitled to access to medicines and hospital care, subject to medical need. Non-emergency cases involving uninsured persons have to gain the approval of a committee in case hospital care is needed. Emergency cases, of insured and uninsured persons, are entitled to access to the emergency departments of public hospitals. Under these new rules, access to medicines for uninsured persons is covered by Greece’s National Organization for Health Care Services Provision (EOPYY). The cost of these new provisions for the uninsured is covered by a separate budget line of the Ministry of Finance.