Direct Request (CEACR) - adopted 2006, published 96th ILC session (2007)

The Committee notes the detailed report of the Government and would like it to supply additional information and explanations on the following points.

1. Part II (Medical care), Article 10, paragraph 2, of the Convention. The report states that, in case of out-patient treatment, a worker insured under Laws Nos. 506 and 2925 has to pay 20 per cent of the cost of the prescribed medicines in respect of himself and 10 per cent in respect of his dependants, as well as 20 per cent of the cost of medical tools and prosthetic appliances, subject to a ceiling which may not exceed the current minimum wage (531 YTL in 2006). Comparable cost-sharing requirements in respect of civil servants insured under Law No. 5434 are much less demanding: the beneficiary pays only 10 per cent of the cost of prosthetic appliances, medical tools and medicines, subject to a ceiling which may not exceed the minimum pension paid by the pension fund covering civil servants (591.47 YTL in 2006). Moreover, the fund pays full cost of medicines in case of outpatient or home treatment of persons requiring long-term treatment for illnesses determined by the Ministry of Health (tuberculosis, cancer, chronic kidney disease, settled insanity, transplantation, etc.). In the light of this comparison, the Committee would like the Government to show that the rules and levels of cost-sharing established for the salaried workers are so designed as to avoid hardship, as well as to indicate whether similar provisions of reducing the burden of cost-sharing as are foreseen for the civil servants exist also for the salaried workers.

2. Part III (Sickness benefit). Article 16, paragraph 1 (in conjunction with Article 68). The report states that daily cash benefits in case of sickness is paid at the rate of one-half for inpatients undergoing treatment in medical establishments and of two-thirds for outpatients. The Committee would like the Government to explain the reason for reducing the rates of sickness benefit in these cases, taking into account that Article 69(b) of the Convention authorizes reduction of benefit to the extent prescribed only as long as the person concerned is maintained at public expense or at the expense of a social security institution or service.

3. Part VIII (Maternity benefit). Article 52. The report states that the daily temporary incapacity allowance is paid for the total period of eight weeks before and after confinement. The Committee would like the Government to explain how effect is given to Article 52 of the Convention, which provides for a minimum duration of the benefit payment of 12 weeks.

4. Reform of the social security system. By Law No. 5502, effective since 22 May 2006, social security agencies were unified into a single Social Security Institution, financially and administratively autonomous public body supervised by the Ministry of Labour and Social Security. The Law regulates in a systemic manner the powers, competencies, functions and organization of the new Social Security Institution. Law No. 5510, effective on 1 January 2007, established common norms and standards for programmes under the social insurance and the general health insurance and formed a universal health insurance. The Law determines the scope of personal coverage under social insurance programmes and the universal health insurance, benefits to be provided, conditions of eligibility, methods of financing, principles and procedures of their operation. The Committee notes these developments with interest and would like the Government to explain their impact on the application of the corresponding parts of the Convention in its next report.