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Part IV (Unemployment benefit) of the Convention. The Committee notes the detailed information on Part IV in the Government’s report and asks it to reply to the following questions:

(a)       Article 23. Under the general scheme, in order to be eligible for unemployment allowances, a full-time worker must complete a certain qualifying period, the length of which depends on the worker’s age. If he is between 36 and 50 years of age, he must provide evidence of 468 days worked during the 27 months preceding the benefit application; if he is aged 50 or over, the qualifying period increases to 624 days worked during the previous 36 months. The Committee observes that the length of the qualifying period for these categories of workers is much longer than in the other Contracting Parties. It also observes that the said qualifying period can include several different periods which are computed as days worked or included in the reference period, which makes the rules for calculating the qualifying period very complex. The Committee reminds the Government that section 23 of the Convention states that the duration of the qualifying period may not be longer than what is needed to preclude abuse, both on the part of potential beneficiaries of the unemployment allowance and on the part of the institutions and services which administer it. It therefore asks the Government to explain in its next report the reasons why it has introduced such qualifying periods for the unemployment allowance.

(b)      Article 69(d). According to the report, unemployment allowances are suspended for between one and 13 weeks when the unemployed person has made an inaccurate, incomplete or belated declaration or has omitted to make a required declaration and has received or can receive allowances unduly as a result. Fraudulent intention is not required for a suspension to be applied; the mere fact of the irregularity being established is sufficient. The Committee draws the Government’s attention to the fact that, in the cases in question, the abovementioned provision of the Convention authorizes the suspension of the benefit only if the person concerned has attempted to obtain it fraudulently.

(c)       Article 69(f). The report indicates that if the worker is responsible for his dismissal, he may receive a caution or his benefit may be suspended for a minimum of four weeks and a maximum of 26 weeks. He is deemed liable for his dismissal if he is personally guilty of misconduct which gave rise to it. The Committee is bound to reiterate in this respect that the Convention authorizes the imposition of penalties only where the misconduct was wilful. The same rule also applies in cases where the unemployed person is penalized when support or rehabilitation measures are discontinued or fail owing to misconduct on his part.

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Part IV (Unemployment benefit) of the Convention. The Committee notes that the report contains no information on this part of the Convention. It therefore hopes that in its next report the Government will not fail to provide detailed information on trends in this branch during the period from 2001 to 2007 and the calculations of rates of unemployment benefit, taking into account the comments below.

Part XI (Standards to be complied with by periodical payments). The Committee notes that the reference wage of the standard beneficiary used in calculating the replacement rates of the various benefits varies from one branch of social security to another. For Parts III, VIII, and IX of the Convention, the reference wage is that of a skilled worker in the construction industry (102.752 euros per eight-hour working day at 1 October 2005). For Parts V and X, it is the annual agreed wage of 26,709.66 euros (in 2004) payable to a skilled worker chosen, according to the report, in accordance with the provisions of Article 65(6)(b) of the Convention. For Part VI, it is the basic wage of a “fully skilled mechanical engineer in small-scale industry” chosen in accordance with Article 65(6)(a) of the Convention which at July 2005 amounted to 18,611.19 euros per year or 51.36 euros per calendar day, which equals exactly half the daily reference wage of the skilled worker in the construction industry chosen for Parts III, VIII and IX. Lastly, for Part VII (family benefit), the standard annual wage of an unskilled labourer determined in accordance with Article 66 of the Convention, amounted to 22,927.68 euros in 2002, which is far higher than the reference wage of a skilled worker as determined in Part VI of the Convention. In view of the inconsistency of these figures, the Committee requests the Government to recalculate the replacement rate of these benefits on the basis of the monthly wage of a standard beneficiary for the same reference period, giving the reasons and methodology of the Government’s choice for each branch. Please also include in the calculations the amounts corresponding to family allowances.

[The Government is asked to reply in detail to the present comments in 2007.]

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Part II (Medical care), Article 10, paragraph 2, of the Convention. In its previous comments, the Committee noted that, under the terms of the Royal Order of 21 September 1993 to modify the individual share in the cost of certain types of health care, the level of individual cost-sharing by beneficiaries for consultations, visits and opinions by general practitioners and specialists had been raised substantially.

In its report, the Government confirms that, in the case of visits and consultations by doctors, beneficiaries have to pay a share of the cost and that the average rate of the cost-sharing per beneficiary, for all categories of beneficiaries, calculated on the basis of the amounts actually paid in respect of cost-sharing by patients and registered by the INAMI for this type of care, amounted to 26.77 per cent in 1995. However, it states that the category of the most economically vulnerable beneficiaries (VIPOs) have to pay a share of 10 per cent of the cost of the benefit or a flat rate. It also refers to the social and fiscal "franchises", which permit the reimbursement to the insured person of the surplus of cost-sharing paid over a period of one year in excess of the limit established for the various categories of insured persons; these reimbursements represented an overall amount of around 2,400 million in 1995.

The Committee notes this information. It also notes that, according to the report, the rise in cost-sharing by insured persons resulted in 1995 in a transfer of around 7,500 million more to be covered by beneficiaries. In this context, the Committee recalls, in particular, that in the case of beneficiaries who do not fulfil the requirements set out in the legislation to benefit from either a preferential personal rate for the cost of medical care, or social and fiscal "franchise" measures, the rate of cost-sharing, according to the type of benefit, attains between 30 and 40 per cent of the level of the fees established for consultations, visits and opinions from general practitioners and specialists, which appears to be high. Furthermore, even in the case of beneficiaries who are entitled to a social or fiscal "franchise", the rate of their share of the cost of medical fees depends on the amount of the medical expenses incurred above the corresponding annual ceiling. In this situation, the Committee hopes that the Government will continue to supply detailed information on the measures that have been taken or are envisaged, in accordance with Article 10, paragraph 2, of the Convention, to ensure that the sharing by beneficiaries in the cost of medical care received in respect of a morbid condition is so designed as to avoid hardship.

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Part II (Medical care), Article 10, paragraph 2, of the Convention. The Committee notes with interest from the information supplied by the Government in its report on this Convention and on the application of the European Social Security Code and its Protocol, the adoption of the Royal Order of 3 November 1993 which introduces a social ceiling to cost-sharing; above a certain annual amount (15,000 francs of cost-sharing, if income is below 6,000,000 francs) households no longer share in the cost of care, which is provided free of charge for all the members of the household. This ceiling is adjusted on the basis of the income of the household and each household can benefit from it, with only medicaments being excluded from the ceiling. The Committee also notes the Royal Order of 21 September 1993 to modify the level of individual participation in the cost of certain health benefits, which includes in section 2(1) substantial increases in the levels of individual participation (with the exception of persons who benefit from supplementary insurance coverage) in the fees for certain benefits set out in the Annex to the Royal Order of 14 September 1984 enumerating health care benefits covered by compulsory health care and benefit insurance. It notes in particular, according to the information supplied by the Government, that the level of participation of beneficiaries is now set at 30 per cent (instead of the previous level of 20 per cent) of fees for consultations with general practitioners; 35 per cent (instead of 25 per cent) of fees for visits by general practitioners and paediatricians; and 40 per cent (instead of 25 per cent) of fees for consultations with specialists. However, the Committee notes that, in accordance with section 2(1) of the above Royal Order of 21 September 1993, the individual participation of beneficiaries in the fees of physicians relates to the medical acts covered by the code numbers set out in section 2(I)(A) of the Annex to the Royal Order of 14 September 1984.

The Committee requests the Government to supply detailed information on the impact of the new measures envisaged under the Royal Order of 21 September 1993 on the application of Article 10, paragraph 2, of the Convention, which provides that the participation of beneficiaries in the cost of medical care received in respect of a morbid condition shall not result in hardship.