Direct Request (CEACR) - adopted 2022, published 111st ILC session (2023)

In order to provide a comprehensive view of the issues relating to the application of ratified Conventions on social security, the Committee considers it appropriate to examine Conventions Nos 121 (employment injury benefits), 128 (invalidity, old-age, and survivors’ benefits), 130 (medical care and sickness benefits), and 168 (employment promotion and protection against unemployment) together.

The Committee notes the observations of the Central Organization of Finnish Trade Unions (SAK), the Finnish Confederation of Professionals (STTK), and the Confederation of Unions for Professional and Managerial Staff in Finland (AKAVA), communicated with the Government’s reports on the above-mentioned Conventions.

Article 7(1) of Convention No. 121. Definition of industrial accident. The Committee takes note of the Government’s indication that the Occupational Accidents, Injuries and Diseases Act adopted in 2015 (Act No. 459/2015) has not changed the principle of causality between a disease and a work-related injury necessary for entitlement to employment injury benefits. The Government further indicates that the compensation praxis in cases of employment injuries has been unified to avoid any inconsistency in the application of the national legislation that existed before the adoption of Act No. 459/2015.

Article 8of Convention No. 121. Occupational diseases. (i)Procedure for the recognition of the occupational origin of diseases. The Committee takes note of the Government’s indication that the recognition of the occupational origin of diseases which are not on the national list of occupational diseases may require an additional examination by the Finnish Institute of Occupational Health. The Government further indicates that insurance companies bear all necessary medical expenses in this respect. The average duration of an additional examination is about 6-8 months. According to the statistical data for 2020, the occupational origin of diseases was recognized in 934 out of 2520 cases. The Committee takes due note of this information.

(ii) Diseases caused by occupational exposure to moisture and asbestos. The Committee notes the observations of the SAK, the AKAVA and the STTK pointing out the lack of income protection for workers suffering from symptoms caused by moisture damage in the workplace since many of these workers fail to qualify for social security benefits. The SAK, the AKAVA and the STTK indicate in this respect that the national legislation should be more precise regarding the obligations of insurance companies to provide compensation due to diseases caused by moisture damage. The SAK, the AKAVA and the STTK also indicate that insufficient measures have been taken to ensure screening, monitoring and appropriate treatment of workers exposed to asbestos at the workplace. The Committee requests the Government to provide information on the measures taken to ensure the provision of employment injury benefits due to diseases caused by occupational exposure to moisture damage. With respect to the measures to be taken for the prevention and protection of workers against health hazards due to occupational exposure to asbestos, the Committee refers to its detailed comments under the Asbestos Convention, 1986 (No. 162).

Article 15(3) of Convention No. 128, in conjunction with Articles 17 and 18.Early retirement for workers in arduous and unhealthy occupations. The Committee notes that according to section 11 of the Employees Pensions Act (Act No. 395/2006), the retirement age for persons born between 1962 and 1964 has increased to 65 years old. The retirement age for persons born in 1965 and thereafter will be linked to life expectancy. The Committee further notes that according to sections 15 and 16 of Act No. 395/2006, a partial early retirement pension can be provided to persons born in 1964 at the age of 62 and to persons born in 1965 and thereafter at the age adjusted to life expectancy. In addition, as per section 53a of Act No. 395/2006, persons are entitled to a career pension at the age of 63 if they have been in hazardous work for at least 38 years and if their working capacity has been impaired because of an illness or disability.

The Committee recalls that according to Article 15(3) of the Convention, if the pensionable age is 65 years or higher, the age shall be lowered, under prescribed conditions, in respect of persons who have been engaged in occupations that are deemed by national legislation, for the purpose of old-age benefit, to be arduous or unhealthy. The Committee further recalls that the purpose of this provision is intended to ensure additional protection, through a more favourable system, to persons employed on arduous or unhealthy work, by allowing them to draw an anticipated old-age pension, of which the rate and qualifying period must conform to Articles 17 (old-age pension’s rate) and 18 (minimum qualifying period) of the Convention. In this respect, the Committee observes that the qualifying period of 38 years for the entitlement to the career pension under section 53a of Act No. 395/2006 exceeds a 30-year period of contributions or employment, which is the standard qualifying period for the entitlement to an old-age pension at the minimum level required by the Convention (Article 18). The Committee further observes that a partial early retirement pension is subject to a certain reduction which may result in the amount lower than old-age pension’s rate of 45 per cent of the reference wage required, according to Articles 17 and 26 of the Convention. The Committee therefore requests the Government to indicate other possibilities for workers in arduous and unhealthy occupations to draw a pension which meets the requirements of Articles 17 and 18 of the Convention at an age lower than 65.

Article 35(1) of Convention No. 128. General responsibility of a State for the due provision of invalidity, old-age, and survivors’ benefits. The Committee notes the observations of the SAK, the AKAVA and the STTK raising concerns about the sustainability of the pension system financed through employers’ and employees’ contributions. In particular, the SAK, the AKAVA and the STTK indicate the increased use of various contractual arrangements instead of labour contracts while the individuals concerned may be de facto in subordinate and dependent relationships with their employers. The SAK, the AKAVA and the STTK further point out that employers do not have to pay social security contributions for persons not employed under labour contracts which may affect not only the financial sustainability of the pension system but also result in lower pension levels.

In this respect, the Committee notes the Government’s indication regarding the proposal of a working group of the Ministry of Social Affairs and Health to amend the Self-Employed Persons’ Pensions Act with a view to improve pension security of the self-employed. The Committee welcomes this development and requests the Government to keep it informed on the outcome of this process.The Committee also requests the Government to continue to provide information on the measures taken or envisaged to ensure the sustainability of the pension system, in application of Article 35(1) of the Convention,

Article 13(c) of Convention No. 130, in conjunction with Article 17. Cost-sharing for pharmaceutical supplies. Further to its previous request on the reimbursement of costs for pharmaceutical supplies, the Committee notes the Government’s indication that the changes in the reimbursement rules made in 2016 aimed to ensure access to pharmaceuticals for persons who heavily depend on them and persons with low income. In this respect, for example, the basic reimbursement of costs for pharmaceuticals increased from 35 to 40 per cent. In addition, there was a decrease in the annual ceiling and only after reaching this ceiling of €579.7 is a fixed co-payment of £2.5 per each medicine required. The Committee also notes the Government’s indication that the Ministry of Social Affairs and Health has launched a comprehensive reform of pharmacotherapy, which will also involve reviewing the medicine reimbursement rules.

The Committee notes from the 2021 publication of the World Health Organization “Can people afford to pay for health care? New evidence on financial protection in Finland” that medicines account for the largest share of “catastrophic spending”, particularly in the poorer quintiles, and that people with chronic conditions are more sensitive to co-payments. Furthermore, not all people in vulnerable situations have effective access in practice to social assistance benefits provided to cover out-of-pocket payments for outpatient prescribed medicines. The Committee recalls that according to Article 17 of the Convention, cost-sharing for medical care benefits, including the necessary pharmaceutical supplies, shall be so designed as to avoid hardship and not to prejudice the effectiveness of medical and social protection. The Committee therefore requests the Government to provide information on the measures taken or envisaged to ensure effective access topharmaceutical supplies for persons protected, particularly those with low income and those who suffer from diseases recognized as entailing prolonged care, without financial hardship. In this respect, the Committee encourages the Government to take advantage of the pharmacotherapy reform to ensure that the medicine reimbursement rules are so designed as to avoid hardship and not to prejudice the effectiveness of medical and social protection, in line with Article 17 of the Convention.

Article 30(1)of Convention No. 130. General responsibility of a State for the due provision of medical care benefits. The Committee notes the Government’s indication that according to the Health Care Act, medical treatment in non-urgent cases shall be provided within a reasonable time not exceeding three months for primary medical care and six months for specialized medical care, including oral health care, since the assessment of patients’ needs. The Government further indicates that in 2021, there were no cases in which waiting times went beyond a maximum of three months and approximately 60 per cent of patients received primary medical care within one week since the assessment of patients’ needs. Only 6.8 per cent of patients were waiting for treatment longer than the statutory six-month maximum period for specialized medical care at the end of December 2021.

Furthermore, the Committee notes with interest that the Ministry of Social Affairs and Health submitted a draft law amending the Health Care Act to the Parliament on 12 May 2022 which ensures the provision of medical care within seven days from the assessment of patients’ needs for outpatient medical care and within three months for oral health care. The Government also indicates the allocation of more than €200 million to regional development projects seeking to improve access to medical care. The Committee requests the Government to continue providing information on the measures taken to ensure the due provision of medical care benefits to persons protected, in line with Article 30(1) of the Convention.

Articles 7 and 8 of Convention No. 168. Promotion of productive employment. With respect to the measures taken or envisaged topromote full, productive and freely chosen employment, including among disadvantaged persons, the Committee refers to its detailed comments under the Employment Policy Convention, 1964 (No. 122).

Article 21of Convention No. 168. Suitable employment. The Committee notes the Government’s indication that a jobseeker’s employment plan is elaborated after a jobseeker’s initial interview with the Employment and Economic Development Office (TE office). The jobseeker’s employment plan takes into account the jobseeker’s competence and professional skills, work ability, duration of unemployment as well as labour market situation. The Government also indicates that a jobseeker shall usually apply for four jobs each month in line with his/her employment plan to continue receiving unemployment benefits. The Committee also takes note of the Government’s indication that a jobseeker is bound to accept a job offer if the job search has lasted for more than six months since the initial interview.

Observation (CEACR) - adopted 2022, published 111st ILC session (2023)

Article 25, in conjunction with Article 21 of the Convention. Duration of payment of survivors’ benefits. The Committee notes from the Government’s report that, pursuant to the 2022 reform of the survivors’ pension scheme, the duration of the surviving spouse’s pension is limited to a period of ten years, or until the youngest child reaches the age of 18. The Committee recalls that Article 25 of the Convention requires survivors’ benefits be granted throughout the contingency, which is the loss of support suffered by the spouse or child as the result of the death of the breadwinner, as per Article 21(1). While the entitlement of spouses to survivors’ benefits may be conditional upon them being incapable of self-support, the Convention does not allow such entitlement to be based on other conditions such as caring for a dependent or to be limited in time, without this limitation being justified by a change in their own circumstances. The Committee therefore requests the Government to take the necessary measures to ensure that survivors’ benefits are paid throughout the contingency, in line with Article 25 of the Convention.

The Committee is raising other matters in a request addressed directly to the Government.

Replies received to the issues raised in a direct request which do not give rise to further comments (CEACR) - adopted 2019, published 109th ILC session (2021)

The Committee notes the information provided by the Government, which answers the points raised in its previous direct request and has no further matters to raise in this regard.

Direct Request (CEACR) - adopted 2019, published 109th ILC session (2021)

In order to provide a comprehensive view of the issues relating to the application of ratified Conventions on social security, the Committee considers it appropriate to examine Conventions Nos 121 (employment injury benefits), 130 (medical care and sickness benefits), and 168 (employment promotion and protection against unemployment) together.

The Committee notes the observations of the Central Organisation of Finnish Trade Unions (SAK), the Finnish Confederation of Professionals (STTK), and the Confederation of Unions for Professional and Managerial Staff in Finland (AKAVA), communicated with the Government’s reports on the above-mentioned Conventions.

Article 7(1) of Convention No. 121. Definition of industrial accident. Reform of national legislation on employment injuries. Referring to its previous comments on the reform of accident insurance and occupational diseases, the Committee takes note of the Occupational Accidents, Injuries and Diseases Act (459/2015), which entered into force on 1 January 2016. The Committee notes the indications provided by the Government in its report that the new Act does not significantly change the content of the system of employment injury insurance, nor the types and amounts of benefits. The Committee also notes the observations of the SAK, STTK and AKAVA that insurance companies no longer pay compensation in respect of incapacity for work due to complications arising from the medical treatment of an employment injury due to the new interpretation of the principle of causality which is being applied to such cases. The Committee requests the Government to provide information in this respect.

Article 8. Occupational diseases. The Committee notes the information provided by the Government in reply to its previous request to provide information regarding the new list of occupational diseases and, notably, the adoption of the Occupational Accidents, Injuries and Diseases Act (459/2015) and the Occupational Diseases Decree (769/2015). The Committee also notes the Government’s explanations that, in accordance with Article 8(c) of the Convention, Finland follows a mixed approach for the identification and definition of occupational diseases, which includes both a list of occupational diseases and a general definition of occupational disease set out in the legislation. With respect to the procedure for the recognition of the occupational origin of diseases that are not included in the list, the Government indicates that such a procedure requires “a higher level of proof in individual cases of the causal link between exposure and illness, because the illness is not generally recognised as being a typical occupational disease”. The Committee requests the Government to indicate the average duration of such a procedure, the allocation of the burden of proof, the number of requests submitted and the number of cases of occupational diseases recognized under this mechanism, particularly with regard to the substances covered by Article 8 and Schedule I of Convention No. 121.

Article 13(c) of Convention No. 130, in conjunction with Article 17. Cost-sharing – pharmaceutical supplies. The Committee notes the Government’s indication that the expenditure allocated to the reimbursement of insured persons for the costs of pharmaceutical supplies has grown in recent years, and that means for curbing this growth had to be sought. In this regard, the Committee notes the Government’s indication of the introduction in 2016 of an initial co-payment of €50 per calendar year for pharmaceutical reimbursements for all persons aged 18 or over and an increase of the co-payment for each reimbursed pharmaceutical from €1.50 to €4.50. The Committee also notes that the maximum total co-payment per year for reimbursed pharmaceuticals (annual cap) decreased from €700.92 to €610.37. The Committee further notes that, according to SAK, STTK and AKAVA, the increase in co-payments for medicines forces many low-income persons to “compromise on the purchase of medicines and abandon treatment because they are not able to afford it”. The Committee requests the Government to indicate the measures taken to ensure that the participation of protected persons in the costs of pharmaceutical supplies does not entail financial hardship nor prejudice the effectiveness of medical and social protection.

Article 30(1). General responsibility of a Member for the due provision of the benefits. The Committee notes the indication provided by the SAK, STTK and AKAVA on the introduction of a National Health Care Guarantee which includes the establishment of a maximum time limit for the provision of medical treatment, within the framework of the Act on Specialized Health Care of 2005. The Committee also notes the indication of SAK, STTK and AKAVA that, although the introduction of the National Health Care Guarantee has reduced the period before persons in need of healthcare receive treatment, there are still cases in which the prescribed deadlines are not met. The Committee requests the Government to provide information on progress made in the implementation of the National Health Care Guarantee with a view to ensuring the due provision of medical care benefits to protected persons, in line with Article 30(1) of the Convention.

Articles 7 and 8 of Convention No. 168. Promotion of productive employment. The Committee takes due note of the information provided by the Government on Finland’s employment policy, in reply to its previous comments. The Committee also notes the indications provided by SAK, STTK and AKAVA that measures to promote employment, particularly with respect to providing employment opportunities and vocational education and training programmes, are still needed. In this regard, the Committee refers to its detailed comments under the Employment Policy Convention, 1964 (No. 122).

Article 21. Suitable employment. The Committee notes the Government’s indications that the active labour market policies in place in Finland put an increased emphasis on the responsibility of unemployed persons to seek work actively and to accept jobs offers, as a prerequisite for receiving unemployment benefits. The Government indicates more specifically that jobseekers are obliged to accept employment from outside their travel-to-work area if the daily commute by public transport, car or bicycle does not exceed an average of three hours. The Government further indicates that jobseekers no longer have a valid reason for refusing to accept a full-time job where the total wages together with any adjusted unemployment benefit, with deductions of commuting costs and other costs incurred through accepting the job, are less than the unemployment benefit that they would be entitled to otherwise. In this regard, SAK, STTK and AKAVA point out that the tightening of the eligibility requirements for entitlement to unemployment benefits, the extension of the sanction system and the obligation for unemployed persons to participate in all services offered to them, even if such services were not agreed upon in the employment plan, raise issues of compatibility with the Convention. The Committee requests the Government to explain how the criteria specified in Article 21(2) of the Convention, namely the age of unemployed persons, their length of service in their former occupation, their acquired experience, the length of their period of unemployment, the labour market situation, and their personal and family situation, are taken into account by the administrative authorities in assessing the suitability of the employment or service offered.

Replies received to the issues raised in a direct request which do not give rise to further comments (CEACR) - adopted 2012, published 102nd ILC session (2013)

The Committee notes the information provided by the Government, which answers the points raised in its previous direct request and has no further matters to raise in this regard.

Direct Request (CEACR) - adopted 2012, published 102nd ILC session (2013)

Reform of national legislation on employment injuries. With reference to the issues raised previously by the Central Organization of Finnish Trade Unions (SAK) and by the Confederation of Unions for Academic Professionals in Finland (AKAVA), the Government indicates that a reform process of the legislation on accident insurance and occupational diseases is currently being prepared by the Ministry of Social Affairs and Health together with key central labour market organizations and other stakeholders. The goal of the reform is to update the national legislation to correspond to the altered conditions of working life and new objectives. The reform will also address issues brought up by central labour market organizations concerning, for example, the level of benefits and the improvement of the protection of workers suffering from symptoms caused by moisture damage in the workplace. For their part the SAK, the AKAVA and the Finnish Confederation of Salaried Employees (STTK) stress that, while there have been attempts to solve the problem as part of the reform process, progress has so far been slow. Victims of moisture damage are often left without social security coverage following expiry of their sick leave compensation, since their symptoms are not regarded as sufficient for an occupational disease diagnosis. These problems could be solved rapidly by ensuring prompt examination of persons concerned and uniformity between insurance companies’ compensation practices. The Committee takes note of this information and hopes that the Government together with the social partners will reform the national legislation on employment injuries in the best interest of protected persons and in accordance with the provisions of the Convention.

Article 8 of the Convention. Occupational diseases. With reference to previous comments, the Government indicates that, since the current list of occupational diseases contained in Decree 1347/1988 (ammattitautiasetus) is not a closed list, a disease not mentioned in the list can nonetheless be compensated as an occupational disease on the basis of a general provision of the Act on occupational diseases (1343/1988) (ammattitautilaki) if a likely causal relationship can be proven to exist between the disease and the work considering the worker’s degree of exposure. The Government also indicates that, given that the legislation on accident insurance and occupational diseases is currently being reviewed, the list of occupational diseases will be updated in view of European Commission Recommendation 2003/670/EC of 19 September 2003 concerning the European schedule of occupational diseases. Taking note of this information, the Committee asks the Government to indicate progress achieved in the reform process with respect to the list of occupational diseases, indicating how the new list, if adopted, gives effect to Article 8 of the Convention. Please also provide information regarding the implementation of the procedure for the recognition of the occupational origin of diseases which are not included in the national list.

Direct Request (CEACR) - adopted 2012, published 102nd ILC session (2013)

Article 13 of the Convention (read in conjunction with Article 32). Introduction of active labour market policies for beneficiaries of disability pensions. The Committee notes that, in 2009, a workbank pilot was established aiming at finding employment for persons at a potential disadvantage in the labour market, such as partially disabled persons and the long-term unemployed. Workers have an employment relationship with the workbank, which then hires the workers out to enterprises and communities. The periods during which workers are not occupied are used for education and training purposes. The Committee also notes the concomitant adoption of a provisional Act promoting the return to work from disability pension (738/2009), in force from 2010 to 2013 at which stage the impact of the provisional act will be assessed. The Government indicates that the provisional Act makes it easier to suspend the disability pension and raised the maximum limit of earnings permitted during the payment of disability pension, offering better opportunities for low-income retirees only living on a pension to engage in and try gainful employment. Thus, a beneficiary of full disability pension may perceive an income up to 40 per cent (subject to a maximum of €714 per month) of his/her previous earnings without losing full pension rights. The Committee takes due note of this information and would be grateful if the Government would provide information in its next report on the results of the assessment of these measures indicating the extent to which they contributed to improve suitable employment opportunities for disabled persons as envisaged by the above provisions of the Convention.

Direct Request (CEACR) - adopted 2011, published 101st ILC session (2012)

Article 8 of the Convention. With reference to its previous direct request, the Committee notes that hard-metal pneumoconiosis is listed as a typical occupational disease caused by cobalt and its compounds in section 3(6) of Decree No. 1387 on occupational diseases of 29 December 1988, as amended. With respect to occupational diseases in item No. 27 of the list in Schedule I of the Convention, the Government states that dry distillation products of wood and coal and distillation residues of crude oil, as well as diseases caused by them, such as cancer of the skin were included in Decree No. 639 and Decision No. 640 of 1967 previously in force, and that new legislation is being drafted to incorporate these diseases again in Finnish legislation. The Committee requests the Government to submit new legislation once it is adopted.

Observations by the Central Organization of Union of Finnish Trade Unions (SAK). The Committee recalls that the Government’s report of 2007 contained the statement of SAK that the Employment Accidents Insurance Act did not respond anymore to the changed requirements of working life and that compensation for occupational accidents was problematic, in particular for upper limb injuries. SAK also referred to the incoherence in the determination of the annual income to establish the level of compensation which puts employees in unequal positions. Daily sickness benefits in case of a temporary incapacity, compensated at a rate of 100 per cent, were reduced by 15 per cent when converted into an accident pension, and were not taken into account for the calculation of the old-age pension. In the direct request of 2008 the Committee invited the Government to reply to SAK’s observations. The Government replied in 2009 that tripartite negotiations have been conducted on the grounds for compensation for certain strain injuries of the upper limbs and that the drafting of necessary amendments was under way; in other respects a reply to the observations will be provided in the context of the next periodic report.

Observations by the Confederation of Unions for Academic Professionals in Finland (AKAVA). In its comments included in the Government report of 2009, AKAVA expressed its concern about the situation of employees who contracted the skin diseases mentioned in item 26 of Schedule I of the Convention due to exposure to biological agents from water damage in buildings. These employees might find themselves without an income after the expiration of the maximum period of sickness benefits because the Social Insurance Institution does not consider them incapable to work or entitled to benefits. Compensation through statutory accident insurance might be a problem with respect to establishing the burden of proof of the cause of the disease. AKAVA indicated that compensation practices of insurance companies responsible for the implementation of the statutory accident insurance are incoherent and poorly managed. Employees might be without any source of income when they are unable to return to work and the employer refuses to employ them at other premises. The Committee recalls that AKAVA already highlighted the question of the establishment of the burden of proof in the report of 1999 with respect to broncho-pulmonary diseases caused by impurities in indoor air, to which no reply from the Government was received.

The Committee considers that the observations of SAK and AKAVA raise substantial problems regarding the application of the Convention in law and practice, which require much more focused attention from the Government. The Committee requests that in future the Government will reply to the observations of the workers’ organizations in a thorough and detailed manner, so that the ILO supervisory bodies may fully benefit from the practical knowledge and wisdom of the social partners. The Committee expects that the Government’s next report due in 2012 will contain full explanations on all the questions concerning the application of the Convention in Finland raised by the national trade union organizations since 1999.

Direct Request (CEACR) - adopted 2008, published 98th ILC session (2009)

The Committee notes the Government’s report for the period from
1 June 1999 to 31 May 2007, which also contains its reply to the direct request of 1999 and an observation made by the Central Organization of Finnish Trade Unions (SAK). The Committee notes the statistical information concerning adjustment of benefits requested under Article 21 of the Convention and provided by the Government in its report on Convention No. 128.

With regard to the application of the Articles of the Convention, the Government states that it has “nothing new to report”. The Committee would like to point out that, even if no legislative changes have occurred in the reporting period, under the report form on the Convention, the Government is requested to supply once every five years updated statistical information on the scope of personal coverage of the Convention, the amounts of the benefits paid for different contingencies and their replacement level in relation to the reference wage of a standard beneficiary. In order to confirm that the quantitative requirements of the Convention are being complied with, the Government is requested to furnish such detailed statistical data for examination by the Committee at its next session in November–December 2009.

Article 8 of the Convention. For many years, the Committee has been pointing out that the list of occupational diseases contained in Decree No. 1347 of 1988 does not mention the following diseases which appear in the list (amended in 1980) included in Schedule 1 to the Convention: (a) broncho-pulmonary diseases caused by hard metal dust (item No. 2); (b) primary epithiliomatous cancer of the skin caused by tar, pitch, bitumen, mineral oil, anthracene, or the compounds, products or residues of these substances (item No. 27). Consequently, it has asked the Government to take measures to ensure that workers exposed to the risk concerned and afflicted with the abovementioned diseases could fully benefit from the presumption of their occupational origin established by the Convention, and to consider the possibility of including these diseases into the list contained in Decree No. 1347.

In reply, the Government states that lung diseases caused by hard metal dust are included in Decree No. 1347. The Committee asks the Government to confirm this statement by supplying a consolidated copy of the Decree including all the amendments made and indicating the relevant provision. As regards primary epithiliomatous cancer of the skin caused by tar, pitch, bitumen, mineral oil, anthracene, or the compounds, products or residues of these substances, the Committee regrets to note that no specific measure has been taken during the reporting period to recognize the occupational origin of such disease. The report states however that the Ministry of Social Affairs and Health has established a working group to reform the current Act on Occupational Diseases (1343/1988), which will consider the Committee’s recommendations in this respect. The Committee hopes that the Government in the near future will take measures to expressly recognize occupational origin of the disease mentioned in item No. 27 of the list given in Schedule I to the Convention, so as to dispense the afflicted workers of the burden of proof.

Finally, the Committee hopes that the Government will reply to the observation made by the Central Organization of Finnish Trade Unions (SAK) in its next report.

[The Government is asked to reply in detail to the present comments in 2009.]

Direct Request (CEACR) - adopted 2008, published 98th ILC session (2009)

Articles 13, 17 and 30 of the Convention. With reference to its observation, the Committee notes the observations attached to the Government’s report for the period ending 31 May 2007, in which the Central Organization of Finnish Trade Unions (SAK), The Finnish Confederation of Salaried Employees (STTK) and the Confederation of Unions for Academic Professionals (AKAVA) state that the resources of municipalities for preventive and basic health care are inadequate, the public health service suffers from a shortage of doctors and nursing staff, access to health care is unequal and there are substantial differences in the health status of different socio-economic groups. The unions indicate that sickness insurance compensation for private health care has not been raised since 1989 and covers only about 30 per cent of the cost of care. They consider that endemic diseases, obesity, substance abuse, mental health, etc., require an extensive social welfare policy programme and better evaluation of health impacts.

The Government states that in the last decade there were significant changes in the funding of health-care services. In 1996, households accounted for 21.5 per cent of total health care expenditure, while the part of the central Government was 24.3 per cent, local authorities – 36.8 per cent, and Social Insurance Institution (sickness insurance) – 13.6 per cent. By 2007, the share of the central Government has dropped to less than 20 per cent, while the share of local governments has increased to 43 per cent. The share of fees charged directly to beneficiaries stayed at the level of 20 per cent. The charges payable by beneficiaries are laid down in the Act and Decree on Social Welfare and Health-care Charges. The Act on the status and rights of patients requires health care to be of good quality and empowers an appellate authority to take remedial measures, if necessary. Municipal health centres provide primary health care. Municipalities are also responsible for arranging specialized hospital care and ensuring that the level and quality of services meet their residents’ needs. They may arrange services independently or buy them from a service provider. The role of private service providers has increased and accounts for some 25 per cent of health spending. Part of the cost of health care given by private providers is compensated by sickness insurance: 60 per cent of doctors’ fees and 75 per cent of medical examination and treatment at rates approved by the Sickness Insurance Institution (SII). The approved rates for medical services in the private sector are fixed by the Government. For amounts paid in excess of these rates no compensation is provided by the SII. In 2006, the average compensation of doctors’ fees attained only 27.5 per cent (39.1 per cent in 1997) and of the cost of medical examination and treatment – 31.75 per cent (42.8 per cent in 1997). Although the real level of compensation has dropped below the 30 per cent level, according to the Government, this has not led to a fall in the demand for private health-care services or made it more difficult for lower-income classes to have access to them. The report further indicates that, as from 1 January 2005, an examination or treatment prescribed by a physician is compensated for a maximum of 15 times during a year (previously 15 times in three months). From 1 January 2006 medicines are compensated at a fixed percentage of the price, the basic compensation covering 42 per cent of the price of an approved medicine. From 1 January 2006 the funding of sickness insurance was revised. Sickness insurance was divided into earnings security insurance funded by the employers and the employees and medical care insurance funded by the insured and the state.

The Committee also notes that, in 2001, the Government adopted a public programme “Health 2015”. In 2002–07, two national development projects were implemented: the “National Health Care Project” and the “Development Project for Social Services”. In 2005, the nationwide immunization programme was revised. The Commission for Local Authority Employers (KT) points out that the number of health personnel, particularly of nurses, has increased faster than in any other area of administration in the municipal sector. The Committee observes that the measures highlighted in the Government’s report show that the Government assumes its responsibilities for the sound administration of health institutions and for the provision of the medical benefits (Article 30 of the Convention). With regard to the question of the effectiveness and sufficiency of these measures raised by the workers’ organizations, the Committee draws attention to Recommendation No. 1626 (2003) of the Parliamentary Assembly of the Council of Europe on the reform of health-care systems in Europe, which states that “the main criterion for judging the success of health systems reforms should be effective access to health care for all without discrimination, which is a basic human right. This also has the consequence of improving the general standard of health and welfare of the entire population.” On its part, the Convention also emphasizes that medical benefits should not be limited to curative medical care but aim at actually improving the health of the protected persons (Articles 8 and 9). Reforms of health care must be implemented in such a manner as to take into account the economic situation and avoid hardship to persons of small means (Article 17). Bearing this in mind, the Committee would like the Government to state the main indicators used to monitor the general standard of health and welfare of the population in Finland and trends in this standard in the last few years, paying particular attention to the situation of the low-income categories of the population. The Committee would also appreciate information on the measures taken or envisaged to ensure the financial sustainability of the sickness insurance system in the long term.

Article 27. The Committee recalls that the burial grant paid under the National Pension Act was abolished in 1996, but can be applied for under section 16 of the Accident Insurance Act. In 2007, the amount of the burial grant was 4,040 euros. The report also indicates that nearly all persons covered by compulsory insurance under this Act fall within the scope of the employees’ group life insurance, which the employer may be obliged to set up under the generally binding collective agreements. The Committee would like to point out that compensation paid by the group life insurance for the death of an employee could not be regarded as a funeral benefit in the sense of Article 27 of the Convention. The Committee would, therefore, like the Government to explain in its next report the extent of the personal coverage of the Accident Insurance Act and to show that the survivors of all persons protected in Finland in application of Article 19 of the Convention who were in receipt of, or qualified for, the sickness benefit shall be entitled to a funeral benefit guaranteed by Article 27. Please explain whether the current amount of the burial grant is sufficient to cover the real expenses of the funeral.

Observation (CEACR) - adopted 2008, published 98th ILC session (2009)

The Committee notes with satisfaction, from the Government’s reply to the Committee’s comments of 2001 concerning the application of Article 12 of the Convention, in conjunction with Article 32(e), that the provision allowing suspension or reduction of the disability pension in cases where the beneficiary caused their invalidity through gross negligence has been removed from the new pension legislation which entered into force in 2007.

The Committee would also like the Government to comment at its earliest convenience on the issues raised in the observations on the Government’s report made by the Central Organization of Finnish Trade Unions (SAK), the Finnish Confederation of Professionals (STTK) and the Confederation of Unions for Professionals and Managerial Staff in Finland (AKAVA).

Observation (CEACR) - adopted 2008, published 98th ILC session (2009)

With reference to its previous observation where it asked the Government to adopt legislation so as to extend coverage for dental care to the whole of the adult population, the Committee notes with satisfaction from the Government’s report that, since 1 December 2002, the entire population is covered by dental care under sickness insurance.

The Committee recalls that since the middle of 1990s the workers organizations of Finland – the Central Organization of Finnish Trade Unions (SAK), the Finnish Confederation of Professionals (STTK) and the Confederation of Unions for Professionals and Managerial Staff in Finland (AKAVA) – have been expressing their concern, in the light of Articles 13, 17 and 30 of the Convention, regarding the insufficient funding and staffing of the public health system, the lowering of the quality of the municipal health services, the reduction of the preventive health care and the consequent transfer of medical care to the more expensive private sector providers, accompanied by the reduction of the level of compensation and the increase of the patient’s own share in the cost of the necessary medical care. In their new observations attached to the Government’s latest report for the period ending 31 May 2007, these organizations maintain that: the resources of municipalities for preventive and basic health care are inadequate, the public health service suffers from a shortage of doctors and nursing staff, access to health care is unequal and there are substantial differences in the health conditions of different socio-economic groups. The Committee deals with the issues raised by the workers’ organizations in a request addressed directly to the Government.

Direct Request (CEACR) - adopted 2001, published 90th ILC session (2002)

Part II (Invalidity Benefit), Article 12 of the Convention, in conjunction with Article 32(e). In reply to the Committee’s previous comments, the Government indicates that no motion has been made to remove the provisions contained in the employment pensions Acts for the public sector (VEL, KVTEL) and the Employees’ Pension Act (TEL) according to which disability pension may be suspended or reduced if the beneficiary has caused his invalidity through gross negligence.

The Committee notes this information. It recalls that a similar provision in the National Pensions Act (KEL) has been repealed already in 1983. Taking into account that the said provision of the employment pensions Acts are only very rarely used, the Committee hopes that the Government would not have any difficulty in repealing it when the legislation is next revised, so as to give full effect to Article 32(e) of the Convention which allows for suspension of benefit only where the contingency has been wilfully caused by the serious misconduct of the person concerned.

Observation (CEACR) - adopted 2001, published 90th ILC session (2002)

The Committee notes the observations presented by the Central Organization of Finnish Trade Unions (SAK) and the Confederation of Unions of Academic Professionals (AKAVA). As these organizations express concern over the impact of changes adopted to the pensions scheme, in particular the disability pensions, the Committee would be grateful if the Government would continue to supply in its next report detailed information on the incidence of such changes on the application of the corresponding provisions of the Convention, as well as the statistical information required by the report form under Article 26 of the Convention.

Direct Request (CEACR) - adopted 1999, published 88th ILC session (2000)

With reference to its previous comments, the Committee notes the information supplied by the Government in its report, as well as the statements made in this connection by the Confederation of Finnish Industry and Employers (TT), the Employers' Confederation of Service Industries in Finland, the Central Organization of Finnish Trade Unions (SAK) and the Confederation of Unions for Academic Professionals (AKAVA).

Article 8 of the Convention. In its previous comments, the Committee noted that the list of occupational diseases contained in Decree No. 1347 of 1988 does not mention the following diseases which appear in the list (amended in 1980) included in Schedule I to the Convention: (a) broncho-pulmonary diseases caused by hard-metal dust (item No. 2); (b) primary epithiliomatous cancer of the skin caused by tar, pitch, bitumen, mineral oil, anthracene, or the compounds, products or residues of these substances (item No. 27). Consequently, it has asked the Government to indicate how in practice the workers afflicted with the above diseases can benefit from the presumption of their occupational origin when they are engaged in work involving exposure to the risks concerned, and on whom rests the burden of proof.

In reply, the Government indicates that for a disease to be diagnosed as occupational, a two-step causality relationship must be established. First of all, the causality must be generally acknowledged, i.e. there must be evidence based on scientific research that exposure to the agent in question may cause the disease concerned. This requirement is considered to have been met if such a connection is mentioned in the list of Decree No. 1347. Secondly, it must be shown that the disease examined in each individual case is likely to have been caused primarily by such exposure. Sufficient on-the-job exposure of an employee with a diagnosed disease is an adequate basis for compensation in the case of diseases referred to in the said list. Otherwise, a normal medical explanation of the sufficiency of the exposure as the primary cause of the disease is required, taking into account the employee's individual circumstances and lifestyle. The Government does not indicate on whom rests the burden of proof in this two-step procedure of establishing the causality relationship proving the occupational origin of the disease, particularly as regards the diseases not mentioned in the list of Decree No. 1347.

The Committee understands from this information that while the proof of the occupational origin of the diseases mentioned in the list of Decree No. 1347 in the second stage of this procedure is greatly facilitated by the general presumption of the existence of the causality relationship between exposure to the agent concerned and the related disease in the first stage, this would not be the case for diseases which do not figure on this list and for which proof should be established on a case-by-case basis after an appropriate scientific and medical inquiry. With respect to the first stage inquiries, the Confederation of Unions for Academic Professionals (AKAVA) highlights the problem of the establishment of causality specifically as regards broncho-pulmonary diseases caused by impurities in indoor air, while with respect to the second stage medical explanation, the Central Organization of Finnish Trade Unions (SAK) expresses its concern over conflict situations between the attending physician and the insurance company's expert physician arising from differences of opinion concerning the work-related nature of an occupational disease. In the light of these comments, the Committee wishes to draw the Government's attention to the fact that the inclusion of the occupational diseases mentioned in items Nos. 2 and 27 into the list given in Schedule I to the Convention, resulted from the irrefutable body of international evidence establishing the causality link between the exposure to the agent and the disease in question under prescribed conditions and, consequently, an automatic presumption of their occupational origin dispensing the afflicted workers of the burden of proof. It therefore asks the Government to indicate the measures taken or contemplated to ensure that the workers exposed to the risk concerned and afflicted with the abovementioned diseases could fully benefit from the presumption of their occupational origin established by the Convention. In this respect the Committee further notes from the comments made by the Confederation of Finnish Industry and Employers (TT) and the Employers' Confederation of Service Industries in Finland that preparatory work is being carried out to revise the list of occupational diseases on the basis of current knowledge. The Committee hopes that in this process consideration will be given to the possibility of completing the list of occupational diseases of Decree No. 1347 of 1988 by the diseases mentioned in items Nos. 2 and 27 of the list given in Schedule I to the Convention. The Government is asked to indicate any progress made in this respect in its next report.

Article 21. With reference to its previous comments, the Committee notes the statistics for the period 1993-99 concerning changes of the working age index and the retirement age index used for adjusting employment injuries and survivors' pensions payable under the Accident Insurance Act to rising pay and price levels. The Committee points out that, in the absence of the concomitant data for the same period on the evolution of the cost of living and the general level of earnings, it is impossible for the Committee to assess the situation fully. It therefore once again expresses the hope that the Government will be able to supply in its next report all the statistical information requested under this Article in the report form adopted by the Governing Body.

Direct Request (CEACR) - adopted 1999, published 88th ILC session (2000)

The Committee takes note of the information provided by the Government in its report and, in particular, that concerning the application of Articles 3, 10, paragraph 1, and 11, paragraphs 1 and 2, of the Convention, which were the subject of its previous comments. It also notes the comments, included in the report, made by the Central Organization of Finnish Trade Unions (SAK) and the Finnish Confederation of Salaried Employees (STTK).

Articles 7, 8 and 9 of the Convention (Promotion of employment). In its comments the SAK indicates that unemployment security has been reformed at the beginning of 1997, with a number of qualifying conditions for receiving unemployment benefit being tightened. As a result, the relative number of unemployed persons outside the actual unemployment security system has been on the rise and about half of all unemployed are already on labour market support. The impact of the reform should therefore be closely monitored so that it does not cause exclusion in any group. In this respect the SAK welcomes the fact that measures of assistance to long-term unemployed people on labour market support (for example, guidance into unpaid trainee work and employment using combination subsidy) have begun to be differentiated from the measures offered to other unemployed. However, it considers that particular attention should be paid to the situation of ageing long-term unemployed, who find it difficult to get work despite the increase in employment due to favourable economic trends.

The STTK concentrates its comments on the public labour market policy reform which took effect at the beginning of 1998, drawing attention to the fact that new employment opportunities should not be created at the expense of reducing expenditure on and the level of unemployment security. Undermining the livelihood of unemployed people has not been shown to create new jobs or to noticeably reduce the need for public income transfers. The STTK stresses that unemployed people who are in fact no longer available to the labour market should be provided with additional arrangements to meet their needs and emphasizes in this respect the importance of strengthening cooperation between the labour administration, the Ministry of Social Affairs and Health, local social services and health care services, and pension authorities.

The Government indicates in its report that the labour market policy reform of 1998 contains effective measures designed for people who have been unemployed for a particularly long time and have received their unemployment benefit for 500 days, and cites, in particular, the provision of "combination subsidy". Employment appropriations also focus on young people under 25 who are registered with an employment office, and the long-term unemployed who have been seeking work for more than 12 months, and cover such measures as subsidized employment, trainee work, adult labour market training, rehabilitation and training. As a new special group, the Government mentions ageing jobseekers whose employment on the open market has been promoted through, for instance, the National Programme on Ageing Workers and the National Workplace Development Programme.

The Committee notes this information as well as the statistics contained in the report on the number of employed, the number of recipients of unemployment benefits and the amount of expenditure on unemployment security for 1994-97. It notes, in particular, that while the number of employed people in all sectors has increased by 116,000, the number of recipients of unemployment benefits for the same period has decreased by 347,803. This substantial decrease has been accompanied by the 27 per cent reduction in expenditure on earnings-related unemployment benefit and by the over five times reduction in expenditure on basic benefit. At the same time the expenditure on labour market support has increased four times, proving that a number of people who had been previously receiving earnings-related or basic unemployment benefits have passed on to labour market support. According to the statistics, the total amount of labour market support in 1997 amounted to over 41 per cent of the combined expenses on earnings-related and basic unemployment benefits, while the SAK considers that about half of all unemployed are already on labour market support, partly because of long-term unemployment and partly because they are unable to fulfil more strict qualifying conditions for receiving the daily unemployment allowance. The Committee would like the Government to provide updated statistics in its next report, indicating in particular the total number of unemployed people receiving labour market support, as well as the number of those who have moved on to labour market support having used the full 500 days' duration of their daily unemployment benefits. It would further like the Government to detail, with appropriate statistics, the measures taken or contemplated with a view to preventing marginalization of unemployed and in favour of long-term and very long-term unemployed, including older jobseekers. In the light of the comments made in this connection by the trade union organizations, the Committee would like to stress that the use of social security, including its financial resources, as a means to promote employment, foreseen in Article 7 of the Convention, should be made in such a manner as to maintain in any circumstances the level of unemployment benefit at least at the minimum level prescribed in Article 15(1) of the Convention. Furthermore, the Committee would be glad if, as suggested by the STTK, the Government would consider in its next report the need to strengthen cooperation in providing additional assistance to the most disadvantaged categories of unemployed persons between the labour administration, the Ministry of Social Affairs and Health, local social services and health care services, and pension authorities. Finally, the Committee draws the Government's attention to its 1998 comments under the Employment Policy Convention, 1964 (No. 122).

Articles 15, paragraph 1(b), and 16. According to STTK, recent reforms have resulted in a situation where the standard of unemployment security, including earnings-related benefits, is already below the general income support for many unemployed people. In this respect, the Government indicates in its report that income support payable under the Act on Income Support No. 1412/97 is part of the social security system and is regarded as a last-resort type of financial support to be used purely to safeguard a person's livelihood in conditions of human dignity. The tax-free full basic amount of income support for a single person constituted FIM2,021 a month in the first category of municipalities and FIM1,934 a month in the second category of municipalities. At the same time, basic daily unemployment allowance amounted to FIM2,129 per month after tax and the minimum wage under the collective agreements currently in force attained FIM3,900-4,000 a month after tax at average rates. According to the Government, basic daily allowance can thus be considered to cover 50 per cent of the standard required under Article 15, paragraph 1(b), of the Convention. As regards the labour market support, its full amount is the same as the basic daily unemployment allowance. It is means-tested for unemployed persons who do not fulfil the previous employment requirement for the daily unemployment allowance, as well as for those who have received labour market support for 180 days after the maximum 500 days' period of receiving the daily allowance. As regards earnings-related daily unemployment allowance, it consists of the basic part equal to the full basic daily allowance plus an earnings-related part constituting 42 per cent of the difference between the daily wage and the basic part. In 1998, earnings-related daily allowance was about 58 per cent of the wage with average income levels.

The Committee notes this information and, in particular, the Government's statement that, in application of Article 15, paragraph 1(b), of the Convention, the level of the basic unemployment benefit covers 50 per cent of the statutory minimum wage. It recalls that this provision of the Convention links calculation of the level of unemployment benefit which is not based on contributions or previous earnings, also to the level attaining 50 per cent of the wage of an ordinary labourer, or to a level which provides the minimum essential for basic living expenses, whichever is the highest. The Committee notes in this respect that, according to the data provided by the Government, the amount of the basic daily unemployment allowance is only slightly higher than the amount of the income support which provides the minimum essential for basic living expenses. In order to be able to monitor the situation, the Committee asks the Government to continue to supply detailed updated statistical information on the amounts of the basic daily unemployment allowance, income support, minimum wage and the wage of an ordinary labourer, before and after tax.

Article 18, paragraph 1. The Government indicates that by virtue of the legislative amendments which came into force at the beginning of 1997, payment of daily unemployment allowance begin when a person has been an unemployed jobseeker registered with an employment office for seven working days during a maximum of eight consecutive weeks. This waiting period is counted once for the maximum payment period of 500 days. It further specifies that, for the purpose of the payment of the daily allowance, each calendar week may not comprise more than five payment days.

The SAK points out in this respect that, since daily unemployment allowance can be paid for a maximum of five days a week, this means that a person who becomes unemployed cannot, because of this waiting period, receive the allowance for the first nine to 11 calendar days he is unemployed. Moreover, the monitoring period during which the waiting days must be accumulated was not extended beyond eight calendar weeks. These changes cause losses, especially for people in part-time employment. However, the holiday remuneration at the end of an employment relationship was made payable in parts over the waiting period for the daily unemployment allowance.

The Committee notes this information. It would like the Government to provide a copy of the legislative amendments in question and to explain, in the light of the above comments made by the SAK, the practical consequences of the introduction of the new waiting period of seven working days for the unemployed, taking into account that, according to Article 18(1) of the Convention, any such period shall not exceed seven days.

Article 20(b). In reply to the Committee's previous comments, the Government indicates that in cases where employment has been refused or terminated without an acceptable reason, the opinion on whether the preconditions for receiving unemployment security are met, is given by a labour commission, which consists of representatives of employers and employees, with a representative of the employment office as chairperson. Each case of refusing or terminating employment is solved individually, in accordance with the principles set down in Act No. 602 of 1984, which respects the protection of the livelihood of unemployed persons. The Government further indicates that, as of the beginning of 1997, the duration of the suspension of the unemployment benefit in case of self-inflicted unemployment has been extended. Thus a person who has resigned from his job without justifiable reason or who has himself caused the employment relationship to terminate is not entitled to daily allowance for three months. If a person has, through his own conduct, caused an employment contract not to be made, he is not entitled to daily allowance for six weeks.

The SAK states that it does not accept the extension of the penalty periods of suspension of benefit, as these periods were already long enough before the extension, and points to many problems involved in fixing these periods in terms of the legal protection of the unemployed. It is very problematic, for instance, to investigate a job interview situation or to prove that an employee's own conduct was reprehensible.

The Committee notes this information, as well as the fact that because of the extension of the duration of the suspension of the unemployment benefit in cases of self-inflicted unemployment, the question of determining the employee's own responsibility has acquired importance. It further notes that, while the decisions in such cases are taken by the tripartite labour commission, this in itself does not exclude difficulties in assessing the degree of an employee's own fault and problems in ensuring his legal protection. The Committee recalls that the guiding principle for such situations established by this provision of the Convention consists in determination by the competent authority that the person concerned had deliberately contributed to his or her own dismissal. It would therefore ask the Government to indicate how this principle is being applied in the decisions of the labour commissions and the appeal bodies, and to provide examples of the relevant administrative or judicial decisions.

Article 25. With reference to its previous comments, the Committee recalls that this provision of the Convention calls for the adjustment of the statutory social security schemes, including unemployment security, to the occupational circumstances of part-time workers, unless their hours of work or earnings can be considered, under prescribed conditions, as negligible. As the legislation in Finland excludes from the entitlement to daily unemployment benefits part-time workers who work less than 18 hours per week, the Committee asked the Government to explain the criteria used in setting the said 18 hours/week threshold, below which the work done by part-time workers is apparently considered as negligible.

In reply, the Government indicates that unemployment security is an insurance-type benefit based on a previous employment requirement which calls for the amount of work considered to provide a person with an adequate income, i.e. 18 hours a week. At the beginning of 1997, the previous employment requirement was extended from 26 weeks to 43 weeks during the preceding 24 months in a job where the weekly working time was at least 18 hours. The Government recalls that before 1 January 1994 basic daily allowance was paid to people in need of financial support even if the previous employment requirement was not met. Afterwards, unemployed persons who do not fulfil this requirement can be granted labour market support subject to needs assessment without a set maximum period. The Social Insurance Institution is also in charge of paying labour market support.

In its comments, the SAK considers that the reform of unemployment security undertaken in 1997 has had a number of negative consequences particularly for people in part-time employment. Besides the extension of the previous employment requirement and of the waiting period, it finds that another feature introduced by the reform -- redefinition of the wages used as a basis for daily unemployment allowance after each new period of employment -- has caused problems specifically for people in part-time jobs and resulted in a downward spiral in the income of many of them.

The Committee notes from the Government's reply that the criteria used in setting the 18 hours/week threshold for coverage of part-time workers by unemployment security consisted in covering by social insurance only work which provided a person with an adequate income. It observes that, while in traditional spheres of employment gaining an adequate income would normally require working not less than 18 hours per week, in modern sectors of the economy with a high value-added potential it is now not rare to find part-time employment with less than 18 hours per week which would still permit to obtain an adequate living income. In Finland, however, under the present legislation such part-time employment would appear to be excluded from unemployment security. The Committee considers that the fact that the new forms of part-time employment which ensure an adequate income for work of less than 18 hours per week, do not carry with them the right to unemployment security is not in accordance with the priority objective of employment promotion and using social security as a means for achieving this objective, enunciated in Article 7 of the Convention. Such types of work gain a growing social importance and in no case could be considered as negligible in terms of Article 25(1) of the Convention. The Committee recalls however that, being particularly flexible, this Article permits to take into account for the determination of the non-negligible part-time work not only the hours of work, but also the earnings which are obtained from this work. It also recalls that the previous employment condition, under section 16 of Act No. 602 of 1984, which respects the protection of the livelihood of unemployed persons, also requires having a wage paid in accordance with the collective agreement or at the customary level, and that in branches of employment where the arrangements made for the hours of work depart from the normal, an exception to the requirement relating to the weekly hours of work may be made, subject to such conditions as may be prescribed by ordinance, if the person concerned can be regarded, on the basis of his earned income, as deriving his livelihood from such work. The Committee therefore asks the Government to indicate how these provisions are being applied in practice and whether any minimum amount of earned income from part-time employment has been established for the purpose of coverage by the unemployment security. If not, the Government might wish to consider the possibility of introducing an earnings criteria, on par with the 18 hours/week threshold, as an alternative means of satisfying the previous employment requirement for the entitlement to the daily unemployment benefit.

As to the actual situation of part-time workers, the Committee notes, from the Government's report and the comments made by the SAK, that modifications of unemployment security introduced in the reporting period with respect to the previous employment requirement have resulted in the exclusion of part-time workers working less than 18 hours per week, in addition to the earnings-related allowance, from the basic daily unemployment allowance as well, thus leaving labour market support the only kind of assistance on which they can still count in case of unemployment, subject to needs assessment. As regards the situation of part-time workers who, in principle, work more than 18 hours per week, it further notes that, according to the SAK, the extension of the previous employment requirement for the entitlement to daily unemployment benefit from 26 to 43 weeks has made it more difficult for them to get included in the unemployment security system and, to some extent, to renew their right to unemployment security. In this situation, the Committee asks the Government to provide in its next report detailed information on the conditions attached to granting labour market support in case of part-time workers who are not able to fulfil the previous employment requirement. Finally, taking into account that the application of Article 25 of the Convention requires governments to constantly keep in mind, particularly when reforming their social security schemes, the occupational circumstances of part-time workers, the Committee would like the Government to indicate in its next report the legislative and administrative measures taken or contemplated, including any statistical studies and reviews, to adjust the national unemployment security scheme to the specific needs of growing part-time employment.

Observation (CEACR) - adopted 1999, published 88th ILC session (2000)

1. The Committee notes the information provided by the Government in its report for the period 1994-98 together with the new comments made by the Central Organization of Finish Trade Unions (SAK) and the Confederation of Unions for Academic Professionals (AKAVA). It recalls that in its previous observation dealing with the Government's report for the period 1991-94 and the comments of the same organizations, concern was expressed, in the light of Articles 13, 17 and 30 of the Convention, over the fact that continuous cuts in government health spending led to the weakening of the public medical services, the significant transfer of medical care to the more expensive private sector providers, accompanied by the general reduction of the level of compensation and the consequent increase of the patient's own share in the cost of the necessary medical care. The Government was asked in particular to reconsider these questions, reinforce public health care facilities and ensure that the level of compensation for medical care prescribed in the legislation is applied in practice.

In their new comments, both trade union organizations point out that the problems relating to the availability, coverage and compensation of health care services mentioned in their comments of 1994, remain largely the same and that the overall situation has not improved. The AKAVA states that cost-cutting in the public health system has led to the reduction of the preventive and basic health care services and staff, with the remaining staff showing signs of burn-out. One result of such measures has been an increase in spending on specialized medical care and impractical placements of patients. The SAK adds that, as a result of the public management reform, local authorities' financial situation and growing autonomy, public health care staff resources are not gauged to meet the need, and waiting lists for various public health services, such as operations, have got longer. Supervision and monitoring of municipal health services, which are the responsibility of the local state offices, have deteriorated and are often not performed in practice because of lack of competence or the data needed to carry it out. On the other hand, the cost of private physicians' services puts them beyond the reach of many. Concerning the level of compensation of medicines, the SAK states that, because of the way medicinal products are priced, the deductible part payable by low-income people is becoming unreasonable. According to the AKAVA, the proportion of medicine costs paid by patients has risen greatly in the last five years and now accounts for over half of the total. This, in turn, has reduced the chance that people get all the treatment they really need. Finally, the SAK stresses that social decisions on health care systems and compensation should be taken with a long-term perspective in view.

With regard to public health care facilities, the Government points in the report to an increase in the number of visits to public services, part of which could be attributed to a real increase in visits, while another part is due mostly to the fact that, as a result of the state subsidy reform of 1993, hospitals obtain their revenues now primarily on the basis of patients treated and have therefore introduced more exact registers of visits by type of treatment. In reality, the structural changes in the public health care system in the reporting period have resulted in the decrease in institutional care and the increase in outpatient (open care) specialist medical care. An estimated 50 per cent of the population are currently covered by the "personal physician system", which has reduced waiting periods in the public sector so that it is now usually possible to get treatment within a few days. Waiting lists for operations at public hospitals have shortened, though for certain treatments the trend was the reverse. In Finland, organization of such types of health services as medical care, dental care, school health care and occupational health care falls under the responsibility of the local authorities, which are free to fix the amount of charges taken for each service. In practice, while the actual charges taken by different local authorities may vary greatly, most local authorities charge the maximum allowed by the Decree on social welfare and health care charges. If the charges perceived cause certain categories of low-income people unreasonable financial hardship, the local authority can decide to reduce the charge or to grant income support to cover the cost of medical care.

Generally, according to the report, households accounted for 21.5 per cent of total health care expenditure in 1996, while the public funding was distributed as follows: central government 24.3 per cent, local authorities 36.8 per cent and Social Insurance Institution (sickness insurance) 13.6 per cent. The Government further indicates that, with the improving economic situation, use of private health services has increased. The level of compensation for these services is prescribed by the Sickness Insurance Act as follows: for physicians' fees it is 60 per cent of the rates approved by the Social Insurance Institution (any part of the fee above the approved rate is not compensated); for medical examinations and treatment ordered by physicians it is 75 per cent of the part of the approved fees per medical order after deducting FIM70 per treatment constituting the patient's "own risk"; for medicines prescribed by physicians the basic compensation is 50 per cent per purchase over and above the deductible sum of FIM50. The detailed statistics supplied by the Government for the period 1994-97 show, however, that in practice the average level of compensation, having slightly increased, is still far below the prescribed rates of compensation for the abovementioned types of health services, attaining respectively only 39.1 per cent of physicians' fees, 42.8 per cent of the cost of medical examinations and treatment, and 39.7 per cent of the cost of medicines. Since the beginning of 1996, in principle 75 per cent (previously 90 per cent) of dental check-up and treatment costs and 60 per cent of other costs at approved rates have to be covered in the case of those born in and after 1956. In practice though, it amounted to only 49 per cent in 1997, down from 55.6 per cent in 1994. While referring to legislative measures taken at the end of 1997 to restrain rising costs of medicines, the Government states also that, from January 1999, basic compensation paid is to be limited and subjected to specific clarification in case of certain diseases and expensive medicines. Finally, the maximum amount of compensation in excess of which medicine costs are compensated in full has been raised to FIM3,240.43 in 1998.

The Committee notes this information together with the statistical data on the volume of medical care provided by the public and the private sectors. It notes that no significant sign of the improvement of the public health services could be observed from this information and data, and that, moreover, the Government does not make any attempt in its report to contest the allegations made by the trade union organizations concerning progressive decline of the public health system in the country with the concurrent increase in the cost of the private medical services. The information and data provided in the report with regard to the actual level of compensation for private medical services show that it has not improved over the last years and remains far below the percentage prescribed in the legislation. With regard more particularly to the level of compensation of the cost of prescribed medicines, the Committee notes that, according to the trade union organizations, the part paid by the beneficiary of the cost of medicines is becoming unreasonable for the low-income categories of the population, reducing their chance for getting all the necessary treatment. In this respect, the Committee once again wishes to draw the Government's attention to the principle laid down in Article 17 of the Convention, according to which the rules concerning sharing by the beneficiary or his breadwinner in the cost of medical care should be so designed as to avoid hardship and not to prejudice the effectiveness of medical and social protection. In the light of this provision of the Convention and the abovementioned allegations of the trade union organizations, the Committee would like the Government to explain in detail in its next report, with the help of appropriate statistical information if possible, what measures are being taken or contemplated, including by the different local authorities to which the Government refers in its report, to alleviate hardship that might be caused to the low-income categories of the population by the inadequate level of actual compensation of private medical care and medicines.

The Committee further notes that the trade union organizations stress in their comments the fact that reduction in the quantity and quality of the preventive and basic health care services and staff due to financial cuts goes hand in hand with the non-fulfilment by the State and the local authorities of their supervisory functions in this area due to lack of competent staff and corresponding data. This situation leads to the growing ineffectiveness of the health care system as a whole, manifested in the impractical placement of patients, longer waiting lists, staff overstrain and the shift of burden from general to specialized medical care. It may be further aggravated by the fact that important decisions on health care systems and compensation are decentralized to the local authorities and taken, according to SAK, without a proper long-term perspective and more under short-term budgetary and electoral pressures. The Committee would like the Government to address these concerns in its next report in the light of any long-term policy concerning the development of the national health care and compensation system which may have been established. In this connection, it wishes to remind the Government of its general responsibility under Article 30 of the Convention, for the due provision of the medical benefits of the quantity and quality specified in Article 13, as well as for the proper administration and supervision of the institutions and services concerned. The fulfilment of both these responsibilities, which provide the best existing safeguards against ineffectiveness and decline of the social security schemes, calls for the adoption of special long-term planning measures, including periodic actuarial studies and calculations concerning financial equilibrium, taking into account all the resources allocated by the state and local authorities for these purposes. The Committee would be grateful if the Government's next report would contain detailed information, supported by corresponding studies and statistical data on the comparative development of the public and private health care services, on any such measures taken by the state and local authorities to discharge their general responsibilities under Article 30 of the Convention with respect to medical care. Please indicate also the number of inspections and supervisory visits in health services carried out by the responsible authorities and their outcomes.

2. Extending coverage of dental care to all adult population. The Government states that, following an amendment of the Sickness Insurance Act which took effect on 1 October 1997, those born before 1956 can claim compensation once every three years for dental check-ups and preventive care. This amendment is for a fixed period and is only effective until 31 December 1999. Because of problems with public finances, a decision on a planned amendment concerning payment of dental care compensation to the entire population without any age limits has been postponed until the end of 1999. The Committee once again hopes that the Government will be able to adopt the said amendment in the near future, so as to extend coverage for dental care to the whole of the adult population, and will not fail to indicate the progress made in this respect in its next report.

3. Articles 18 and 26, paragraph 3, of the Convention. The Government indicates in its report that the grounds for granting the daily sickness allowance were changed at the beginning of 1996. The minimum amount of the daily allowance was abolished and the allowance is no longer paid at all if earnings are lower than the statutory limit (FIM5,170 in 1998). However, it can be paid to those who have no, or only a small, income on a discretionary basis, if the disability caused by the illness lasts over 60 calendar days without interruption. The 60-day waiting period is not applied in the case of discretionary rehabilitation allowance.

The Committee notes this information and would like the Government to provide a copy of the legislative provisions in question. It also notes that the above statutory limit of earnings, below which no daily sickness allowance is payable, appears to be rather high compared to the average monthly pay of an industrial employee which, according to the report, amounted to FIM9,952 in the last quarter of 1996, and might result in substantial numbers of low-paid or partially employed persons being refused this allowance. The Committee would like to recall in this respect that, according to Article 18 of the Convention, sickness benefit shall be paid to all persons protected covered by Article 19 in case of their incapacity for work resulting from sickness and involving suspension of earnings, as defined by national legislation. With respect to the 60-day waiting period before the daily allowance could be paid on a discretionary basis, it also recalls that Article 26, paragraph 3, of the Convention stipulates that, where the national legislation provides that sickness benefit is not payable for the initial period of suspension of earnings, such period shall not exceed three days. The Committee would therefore ask the Government to indicate in its next report how the protection guaranteed by these provisions of the Convention is ensured in respect of persons protected whose wages are below the said statutory limit.

4. Article 27. The Committee notes that, according to the report, the burial grant paid under the National Pension Act was abolished in 1996. However, it can now be applied for under the Accident Insurance Act; in other cases, the local authority can grant income support for burial costs. The Committee would like the Government to indicate the relevant provisions of the Accident Insurance Act and to explain whether they are sufficient to guarantee payment of a funeral benefit in all cases covered by this Article of the Convention.

Direct Request (CEACR) - adopted 1997, published 86th ILC session (1998)

Article 8 of the Convention. In reply to the Committee's previous comments, the Government confirms that the list of the physical, chemical or biological agents present in work and the typical pathological manifestations likely to be caused by the agent in question, contained in section 3 of Decree No. 1347 of 1988, is not exhaustive; even if a factor or disease is not mentioned in the list, a disease can be compensated for as an occupational disease if it is probably and primarily caused by subjection to a physical, chemical or biological factor at work. According to the Government, this procedure will be applied to the following diseases, which are not mentioned in Decree No. 1347 despite the fact that they figure in the list of occupational diseases (amended in 1980) in Schedule 1 to the Convention: (a) broncho-pulmonary diseases caused by hard-metal dust (item No. 2); and (b) primary epitheliomatous cancer of the skin caused by tar, pitch, bitumen, mineral oil, anthracene, or the compounds, products or residues of these substances (item No. 27). The Committee notes this information with interest. It would like the Government to indicate how in practice the workers afflicted with the above diseases can benefit from the presumption of their occupational origin when they are engaged in work involving exposure to the risks concerned, and on whom rests the burden of proof.

The Committee has also taken note of the observations presented by the Central Organization of Finnish Trade Unions (SAK).

Article 21 of the Convention. The Committee takes note of some statistical data covering the implementation of this Article of the Convention which calls for the adjustment of long-term benefits due in case of employment injury. In order to fully assess the situation the Committee would like the Government to supply in its next report all the statistical data requested under Article 21 (questions B, C and D) by the report form adopted by the Governing Body.

Direct Request (CEACR) - adopted 1997, published 86th ILC session (1998)

Part II (Invalidity Benefit), Article 12 of the Convention, in conjunction with Article 32(e). In reply to the Committee's previous comments, the Government indicates that the employment pensions acts for the public sector (VEL, KVTEL) and the Employees' Pension Act (TEL) still contain a provision according to which disability pension may be suspended or reduced if the beneficiary has caused his invalidity through gross negligence; in practice, however, this provision is applied extremely rarely. There is no comparable provision in the Seamen's Pensions Act (MEL). The Government adds that, so far, no motion has been made to remove this provision from the employment pensions acts.

The Committee notes this information. It recalls that similar provision of the National Pensions Act (KEL) has been repealed already in 1983. Taking into account that the said provision of the employment pensions acts has fallen into disuse (according to the Government, the last case dates back to 1985), the Committee hopes that the Government would not have any difficulty in repealing it when the legislation is next revised, so as to give full effect to Article 32(e) of the Convention which allows for suspension of benefit where the contingency has been wilfully caused by the serious misconduct of the person concerned.

Observation (CEACR) - adopted 1997, published 86th ILC session (1998)

1. In its previous comments, the Committee expressed the hope that the ongoing reform of the pensions scheme will enable workers engaged in occupations that are arduous or unhealthy to receive old-age benefit before the age of 65 years, in accordance with Article 15, paragraph 3, of the Convention, despite the fact that public sector workers in such jobs are no longer entitled to old-age pension before 65 years of age. The Committee notes with interest, from the Government's reply, that flexible retirement before 65 years of age is now possible for public sector employees on the same terms as for private sector employees; thus, public sector employees in arduous or unhealthy occupations have the opportunity to take an early old-age pension at age 60 and to apply for a part-time or an individual early pension at age 58. An employee qualifies for individual early pension, which is equal in size to the disability pension, if he has a long history of work and if his capacity for doing his work has decreased taking into account the strain and wear of the job and the working conditions.

2. The Committee has also noted the observations presented by the Confederation of Unions of Academic Professionals (AKAVA) and the Central Organization of Finnish Trade Unions (SAK). As these organizations express concern over the impact of the changes adopted to the employment pensions scheme, in particular on the level of the benefits, the Committee would ask the Government to supply in its next report detailed information on the incidence of such changes on the application of the corresponding provisions of the Convention, as well as the statistical information required by the report form under Article 26 of the Convention.

Direct Request (CEACR) - adopted 1996, published 85th ILC session (1997)

With reference to its previous comments, the Committee took note of the information provided by the Government in its report and, in particular, that concerning the application of Articles 24 and 27, paragraph 1, of the Convention. It has also noted the comments, included in the report, made by the Confederation of Finnish Industry and Employers (TT), the Employers' Confederation of Service Industries (LTK), the Central Organization of Finnish Trade Unions (SAK) and the Confederation of Unions for Academic Professionals in Finland (AKAVA).

Article 3 of the Convention. In its comments the SAK draws attention to the inadequacies in tripartite collaboration. According to this organization, such inadequacies result from the fact that the legislation has been amended with undue haste and that the Government has continued to present draft legislation to curb spending, holding discussions with organizations only after the matter has already been decided. The SAK considers that such behaviour, which has twice brought the country almost to a general strike in defence of unemployment security, contravenes Article 3 of the Convention. The Committee recalls that the SAK's previous comments supplied by the Government with its report of 1992, already referred to the difficulties encountered in the application of Article 3 of the Convention, pointing out, in particular, that, while negotiations have been held and decisions have been taken jointly in matters concerning unemployment security, the procedure applied in the preparation of the new employment security legislation has not observed the modes normally used in applying the tripartite principle. At the same time the Local Authority Employers' Commission (KT) also complained at the fact that, while local authority employers were financing unemployment security, the KT was not represented in the tripartite unemployment bodies and had not been consulted in any policy decisions.

The Committee notes, with respect to all of the above comments, that the Government's report does not contain any reply to the criticisms expressed. In this situation, the Committee is bound to recall that Article 3 requires the Government to implement the provisions of the Convention in consultation and cooperation with the organizations of employers and workers. It therefore hopes that, in its next report, the Government will not fail to explain in the light of the comments made by the above-mentioned organizations, how such consultation and cooperation take place in practice, in particular with respect to the elaboration of draft legislation pertaining to the application of the Convention. The Committee also draws the Government's attention to its latest comments made under Article 3 of the Employment Policy Convention, 1964 (No. 122).

Articles 7, 8 and 9 (Promotion of employment). The Government's reports on Conventions Nos. 168 and 122 contain additional comments made by the SAK and AKAVA. The SAK indicates in particular that, although finding a solution to the poor employment situation would require active labour market measures, the deletion from the Employment Act of the obligation to create work for the long-term unemployed as well as young persons has contributed to an increase in the number of long-term unemployed, with more and more people thus having to resort to welfare maintenance.

The Government confirms, in its reply, that the obligation established under the Employment Act of 1987, requiring the State and the municipalities to provide work for the long-term unemployed and for young persons under the age of 20, in case it is not possible to find them jobs through manpower services, has been abolished on the grounds that the cost of this work-creation requirement was found to be excessive. However, under the new Employment Services Act No. 1005/93, manpower services must activate labour policy and improve the functioning of the labour market with special emphasis on long-term and youth unemployment. In the meantime, the Ministry of Labour is using wage-related appropriations for employing the long-term and young unemployed with the aid of wage support in the event jobs have not been found through manpower services. Also, a special training and employment programme "An alternative to unemployment" has been drawn up for 1994-96 to alleviate unemployment among young people. Finally, the Act on labour market subsidies No. 1542/93 which came into force at the beginning of 1994, aims at providing the labour market subsidies to two special groups: those entering the job market for the first time and unemployed people who have exceeded the maximum period entitling them to the earnings-related unemployment allowance.

The Committee notes the comments made by the SAK and AKAVA as well as the Government's reply. In view of the fact that Finland has ratified Convention No. 122 (Employment Policy, 1964) and Convention No. 142 (Human Resources Development, 1975), the Committee hopes that the Government will continue to supply information in its reports on the application of these instruments. It also draws the Government's attention to its comments of 1995 (February-March session) and 1996 under Convention No. 122.

Article 10, paragraph 1. The Committee notes that the Government's report does not reply to its previous comments under this provision of the Convention. It notes, however, that, according to the observation made by the AKAVA, unemployment allowance paid during training to maintain professional skills depends on whether the training is regarded as labour market training, with the result that people's own active efforts to study at an educational institution bring payment of this allowance to an end. The Committee would therefore once again ask the Government to indicate whether the training provided under the Act on labour market training, No. 763 of 1990, corresponds in all cases to the one referred to in sections 4 and 9 of the Act respecting the protection of the livelihood of unemployed persons, No. 602 of 1984, and, if not, what other provisions of the legislation regulate such training and ensure in particular that persons referred for training receive allowances, of which the conditions and the amount correspond to the unemployment benefit under Act No. 602.

Article 11, paragraphs 1 and 2. With reference to its previous comments, the Committee notes from the Government's report that about 1,800,000 wage- earners, or 80 per cent of the total number of wage-earners in the country, are insured under earnings-related schemes. It recalls in this respect that, according to paragraph 1 of this Article of the Convention, the persons protected shall comprise not less than 85 per cent of all employees, including public employees and apprentices; the Government may, however, under paragraph 2 of this provision, exclude from protection public employees whose employment up to the normal retiring age is guaranteed by national laws and regulations. In order to be able to appraise whether the coverage under the earnings-related scheme attains the level prescribed by the Convention, the Committee would once again ask the Government to provide in its next report detailed statistical information, as required in the report form on the Convention adopted by the Governing Body, indicating in particular for the same time-period the number of employees protected under the earnings-related scheme, the total number of employees in Finland, including apprentices, and the number of public employees in guaranteed employment.

Article 15, paragraph 1(b), and Article 16. According to the report, the full basic daily unemployment allowance currently amounts to FIM116 a day. Please indicate, with reference to the necessary statistical data, whether this amount attains any one of the following reference levels mentioned in the Convention, as appropriate under the national conditions: (1) 50 per cent of the statutory minimum wage; or (2) 50 per cent of the wage of an ordinary labourer; or (3) a level which provides the minimum essential for basic living expenses.

Article 20(b). With reference to its previous comments concerning section 11 of Act No. 602 of 1984, the Committee notes that the amendments mentioned in the Government's report, effective from 1 September 1993, have not met the substance of its comments concerning suspension of the unemployment benefit in cases where the person concerned has himself been the cause of his employment relationship being terminated or has through his own behaviour been the cause of such a contract not being made. The Committee would therefore once again ask the Government to indicate whether in practice the application of this provision is limited, in accordance with the Convention, only to cases where it has been determined by the competent authority that the person concerned had deliberately contributed to his or her own dismissal, and to provide examples of the relevant judicial or administrative decisions.

Article 25. The Committee notes from the Government's reply that there are no statistics on the number of part-time workers who, by working less than 18 hours per week, are excluded from the entitlement to the earnings-related unemployment benefit. It recalls that this provision of the Convention calls for the adjustment of the statutory social security schemes, including unemployment security, to the occupational circumstances of part-time workers, unless their hours of work or earnings can be considered, under prescribed conditions, as negligible. The Committee therefore would be glad if the Government would explain in its next report the criteria used in setting the said 18 hours/week threshold, below which the work done by part-time workers is apparently considered as negligible.

Observation (CEACR) - adopted 1996, published 85th ILC session (1997)

With reference to its previous comments concerning the application of Article 17 of the Convention, the Committee notes the information provided by the Government in its report of 1991-94 together with the comments made by the Confederation of Unions for Academic Professionals (AKAVA) and the Central Organization of Finnish Trade Unions (SAK).

Both organizations point out that, as part of the Government's saving programme, compensation for medical treatment has been reduced and the share of the cost borne by the patient has grown, in particular for physicians' fees, out-patient and in-patient fees and medicines. At the same time, the right to deduct medical costs from the taxable income has been discontinued. The savings programme has particularly affected access to dental care, which has not been extended to unprotected segments of the population, despite the promises given. According to the AKAVA, central and local government cost cutting also threatens to reduce medical services in the public sector. The SAK considers that the scope and availability of medical care services, as defined in Article 13 of the Convention, is problematic because of scarcity and of the economic difficulties of those in need of such services.

In its report, the Government confirms that, as part of the Government saving programme, sickness insurance benefits have been cut, more costs have been shifted to patients, and as from 1992 medical costs are no longer tax deductible. As a result of the sharp decline in public resources, it has been considered justifiable to assign some health care responsibilities to the private sector. The new state subsidy scheme which took effect in 1993 has contributed to reinforcing the significance of the private sector, side by side with public services, by giving local authorities the chance of buying the services they offer from the private sector through competitive bidding. Over 27 per cent of all physicians' services in the community care sector compensated under the sickness insurance scheme were provided by private physicians. In principle, 60 per cent of physicians' fees are compensated, but in practice this compensation averaged about 36 per cent in 1993, as a result of the lower fee scale introduced by the Government. For medical examination and treatment ordered by physicians, the compensation is fixed at 75 per cent of the part exceeding the patient's "own risk" per medical order in accordance with the confirmed fees. However, the average compensation for these services amounted to only about 38 per cent in 1993. As regards dental care, about half of all expenditure on these services was spent in the private sector. The compensation percentage for dental treatment is 90 per cent and for other care 60 per cent of the confirmed fees. In practice though, it amounted to about 55 per cent on average in 1993. Generally, those born before 1956 are not entitled to compensation for costs incurred from dental care. This has been considered a real shortcoming and the Government has in fact been preparing to extend the coverage to the whole population. However, this has been postponed until the beginning of 1996 in order to curb government spending.

The Committee notes from the above information that, due to economic difficulties and the need to curb government expenses, the accessibility of medical care has been influenced in recent years, on the one side, by the continuous reduction of the level of compensation and the increase of the patient's own share in the cost of such care, and on the other side, by the significant shift in the provision of medical services from public to private sector to the extent that the above-mentioned occupational organizations have expressed concern with the "scarcity" of public medical services. At the same time, according to the figures given by the Government, compensation for care provided in the private sector by physicians and on their orders, as well as for dental care, attained in practice on average only 36, 38 and 55 per cent respectively of total cost, the rest of which has to be borne by the patient himself. In this situation, the Committee wishes once again to draw the Government's attention to the principle laid down in Article 17 of the Convention, according to which the rules concerning sharing by the beneficiary or his breadwinner in the cost of medical care should be so designed as to avoid hardship and not to prejudice the effectiveness of medical and social protection. It also draws the Government's attention to Article 30 according to which the State shall accept general responsibility for the provision of benefits due under the Convention and in particular for medical benefit provided for under Article 13. The Committee therefore hopes that in view of the situation the Government will reconsider its policy in light of Articles 13, 17 and 30 and reinforce public health care facilities, and will take the measures necessary to ensure that the level of compensation for medical care prescribed in the legislation actually is being applied in practice. In this respect, it asks the Government to continue to furnish in its next report the recent statistical data on the volume and proportion of medical care provided by each of the public and private sectors and on the average level of compensation by type of medical care provided by the private sector. Finally, as regards access to dental care, the Committee hopes that the Government will report on the progress made in extending coverage for dental care to the whole of the adult population, in accordance with its stated intentions.

Direct Request (CEACR) - adopted 1995, published 82nd ILC session (1995)

The Committee asks the Government to refer to its observation, and wishes to point out the following:

Part II (Invalidity Benefit), Article 12 of the Convention, in conjunction with Article 32(e). The Committee notes the Government's reply to its previous request concerning the application, in practice, of the provisions of the national legislation concerning pensions applicable to workers in the public sector and seafarers (VEL, KVTEL and MEL) and of the National Pensions Act (KEL) which provide that invalidity benefit may be refused or reduced, amongst other grounds, if the beneficiary has caused the invalidity through gross negligence.

The Government indicates in its reply that the above-mentioned provision of the National Pensions Act (KEL) was repealed in January 1983 and that the provisions of the other laws referred to in the Committee's request have not been applied except on one occasion in 1985 pursuant to the Local Government Employees Act (KVTEL).

The Committee notes this information with interest and hopes that in a future review of the national legislation the above-mentioned provisions of the legislation on pensions applicable to workers in the public sector and seafarers will also be brought fully into conformity with Article 32(e) of the Convention under which benefits may be suspended only when the contingency has been wilfully caused by the serious misconduct of the person concerned.

Observation (CEACR) - adopted 1995, published 82nd ILC session (1995)

The Committee notes the detailed information supplied by the Government in its last report and notes with interest the entry into force of the reform of the pensions scheme, which also covers public sector workers. The Committee notes in particular the existence of early and deferred old-age pensions and partial retirement pensions, for workers in both the public and private sectors, and the invalid's early allowance, established on an individual basis, for 16-64 year-old persons with decreased functional capacity who do not receive a disability pension. The Committee also notes the various amendments to the survivors' benefit scheme (PEL and TEL).

The Committee hopes that these reforms will enable workers engaged in occupations that are arduous or unhealthy to receive old-age benefit before the age of 65 years, in accordance with Article 15, paragraph 3, of the Convention, and in the conditions laid down by this instrument, despite the fact that public sector workers in such jobs are no longer entitled to old-age pension before 65 years of age and despite the amendments planned for raising gradually by the year 2002 the minimum age for entitlement to a pension for certain other categories of workers (for example seafarers).

The Committee has also noted the observations presented by the Finnish Employers' Confederation (STK), the Employers' Confederation of Service Industries (LTK), the Central Organization of Finnish Trade Unions (SAK) and the Confederation of Salaried Employees (TVK).

Direct Request (CEACR) - adopted 1994, published 81st ILC session (1994)

1. The Committee has examined the first report of the Government as well as the legislation supplied with it. It would be grateful if the next report would contain additional information on the following points:

Articles 7, 8 and 9 of the Convention (promotion of employment). Since Finland has ratified the Employment Policy Convention, 1964 (No. 122) and the Human Resources Development Convention, 1975 (No. 142), the Committee would draw the attention of the Government to its comments regarding these instruments.

Article 10, paragraph 1. Under section 4 of the Act respecting the protection of the livelihood of unemployed persons No. 602 of 1984, the entitlement to unemployment benefit is conditional, among others, on the fact that the unemployed person has not been able to be referred to training, and the payment of benefit is further subjected, under section 9, to an obligation to take part in training. Please indicate whether the training referred to in the above provisions corresponds in all cases to the one provided under the Act on labour market training No. 763 of 1990 and, if not, what other provisions of the legislation regulate such training and ensure in particular that persons referred to training receive allowances, of which the conditions and the amount correspond to the unemployment benefit under Act No. 602 of 1984.

Article 11, paragraph 1. The Committee would like the Government to supply the statistical information required under this Article in the report form on the Convention adopted by the Governing Body, indicating the number of employees protected by the earnings-related benefit provisions as compared to the total number of employees. In this connection the Committee draws the Government's attention to the possibility of excluding from protection public employees whose employment up to normal retiring age is guaranteed by national laws or regulations, in accordance with paragraph 2 of this Article.

Article 15, paragraph 1(b), and Article 16. Please explain more fully the criteria used in determining the amount of the basic daily unemployment benefit provided under Act No. 602 of 1984, and indicate whether and how it attains the level required by the Convention.

Article 20(b). The Committee notes that under section 11 of the Act No. 602 the entitlement to unemployment benefit is suspended in the case of a person "whose behaviour has been such that a contract of employment is not concluded with him or who has himself been the reason for the termination of his employment relationship" until he has been at work or has been registered as a jobseeker for six weeks. Please indicate whether in practice the application of this provision is limited, in accordance with the Convention, only to cases where it has been determined by the competent authority that the person concerned had deliberately contributed to his or her own dismissal, and provide examples of the relevant judicial or administrative decisions.

Article 24. The Committee notes that, according to the report, receipt of the earnings-related daily unemployment allowance augments the person's pension right and the pension right of his dependants. Please indicate the relevant provisions of the national legislation.

Article 25. (a) The Committee notes, from the Government's report, that if the part-time worker's weekly working hours stand at least at 18, he can join an unemployment fund and become entitled to earnings-related unemployment benefit. It further notes that, under section 16 of Act No. 602 of 1984, his entitlement to earnings-related benefit is subject to the condition of completing a period of employment, that is, he has been engaged for at least 18 hours a week for 26 weeks in the course of the immediately preceding 24 months. The Committee would like the Government to indicate the number of part-time workers who, by working less than 18 hours per week, are thus excluded from the earnings-related benefit provisions, as well as their proportion to the total number of part-time workers.

(b) The Committee would like to point out that the adoption of the adjustment measures contemplated by this Article of the Convention is not restricted solely to the unemployment protection branch, but concerns all branches of statutory social security schemes which are based on occupational activity. It would therefore ask the Government to indicate in its next report how these schemes are adjusted to the occupational circumstances of part-time workers, for example, as is suggested in paragraph 22 of the Employment Promotion and Protection against Unemployment Recommendation, 1988 (No. 176).

Article 27, paragraph 1. Please indicate whether and under what legal provisions the claimant shall be informed in writing of the procedures available for complaint and appeal, as required by this Article of the Convention.

2. Finally, the Committee takes note of the comments on the application of this Convention made by the Central Organization of Finnish Trade Unions (SAK), the Finnish Employers' Confederation (STK), the Employers' Confederation of Service Industries (LTK) and the Local Authority Employers' Commission (KT), which the Government included in its report. The Committee would be grateful if the next report of the Government would contain any observations on the comments in question which it might consider useful.

Observation (CEACR) - adopted 1992, published 79th ILC session (1992)

Article 17 of the Convention. In its previous comments, the Committee noted the comments transmitted by the Central Organisation of Finnish Trade Unions (SAK) to the effect that, because the communities did not have enough capacity to provide basic municipal health care, insured persons had been forced to resort to private health services; some 30 per cent of the costs incurred were refunded. The Committee consequently pointed out that, under Article 17 of the Convention, the rules concerning sharing by the beneficiary or his breadwinner in the cost of medical care should be so designed as to avoid hardship and not to prejudice the effectiveness of medical and social protection.

In its reply, the Government states that medical care is the responsibility of the municipalities, particularly in the case of emergency treatment. It states that, if a patient also resorts for any reason to the care of a private physician, such care is reimbursed at 60 per cent of the rate approved by the Ministry of Social Affairs and Health, on the basis of the sickness insurance scheme. The same applies to examinations and treatment given at private hospitals or in special categories of municipal establishments.

The Committee has noted this information with interest. It would be grateful if the Government would indicate whether and, if so, for what reasons and under what conditions (for example owing to a possible inadequacy of the medical or hospital infrastructure at municipal level) insured persons may find it necessary in practice to resort to the services of private physicians or to undergo treatment in private hospital establishments. In this connection it asks the Government to supply statistics on the number of insured persons resorting to private medicine (whether for out-patient or in-patient care) in proportion to the total demand for care. Furthermore the Committee would also like the Government to indicate whether and how far the rates of reimbursement applied to consultations with private physicians and hospital care by the sickness insurance scheme correspond to the actual fees of physicians or hospitals.

Direct Request (CEACR) - adopted 1991, published 78th ILC session (1991)

Article 8 of the Convention

1. With reference to its previous comments, the Committee takes note of Act No. 1343 and Decree No. 1347 respecting occupational diseases which were adopted on 29 December 1988. In this connection, it notes that section 1 of Act No. 1343 defines "occupational disease" as "a disease which has probably been caused mainly by physical, chemical or biological agents in work which has been performed on the basis of a wage-earning or salaried relationship or in activity as an agricultural entrepreneur". In section 2 of the Act, a causal relationship between a disease within the meaning of section 1 and a physical, chemical or biological agent present in work shall be deemed to exist where an agent specified in the Decree has been present in the work to such an extent that it may be the principal cause of the disease. Section 3 of Decree No. 1347 gives a list of physical, chemical and biological agents and, for each agent, lists a number of typical pathological manifestations likely to be caused by the agent in question. The Committee understands that the list of pathological manifestations is not restrictive and that consequently, for the workers exposed to the agents mentioned in section 3 of Decree No. 1347 the occupational origin of the disease is presumed, whatever the pathological manifestation. The Committee asks the Government to confirm whether this is indeed the case. Please indicate also whether diseases other than those caused by the agents mentioned in section 3 of Decree No. 1347 of 1988 can be considered as occupational diseases within the meaning of section 1, subsection 1, of Ordinance No. 1343 of 1988.

2. Decree No. 1347 of 1988 does not mention the following diseases despite the fact that they appear in the list of occupational diseases (amended in 1980) in Schedule 1 to the Convention: (a) broncho-pulmonary diseases caused by hard-metal dust (item No. 2 in the list in the Convention); (b) primary epithiliomatous cancer of the skin caused by tar, pitch, bitumen, mineral oil, anthracene, or the compounds, products or residues of these substances (item No. 27). The Committee would be grateful if the Government would indicate how the workers afflicted with the above diseases can benefit from the presumption of their occupational origin when they are engaged in work involving exposure to the risks concerned.

Observation (CEACR) - adopted 1991, published 78th ILC session (1991)

Article 17 of the Convention. The Committee notes the information supplied by the Government in its report. It notes with interest the adoption of new regulations concerning the reimbursement of cost sharing for medicine and transport when the total of the cost sharing for the year reaches respectively FIM 2,833 for medicines and FIM 500 for transport.

The Committee also notes the comments transmitted by the Central Organisation of Finnish Trade Unions (SAK), which are contained in the report. In the opinion of the SAK, because the communities do not have enough capacity to provide basic municipal health care, people have been forced to resort to private health services; some 30 per cent of the costs incurred are refunded. The Committee would be grateful if the Government would supply detailed information on the impact of this situation on the implementation of the Convention, taking into account the requirements of Article 17, which provides that the rules concerning cost sharing by the beneficiary or his breadwinner in the cost of medical care shall be so designed as to avoid hardship and not to prejudice the effectiveness of medical and social protection. Please also state the rules that are in force respecting the reimbursement of the cost of medical care that is provided by private practitioners.

[The Government is asked to report in detail for the period ending 30 June 1991.]

Direct Request (CEACR) - adopted 1990, published 77th ILC session (1990)

The Committee takes note of the information supplied by the Government in its report as well as of the coming into force of the new Occupational Diseases Act No. 1343 of 1988. It also notes certain observations made by the Finnish Employers' Confederation (STK), the Employers' Confederation of Service Industries (LTK), the Commission for Local Authority Employers (KT), the Central Organisation of Finnish Trade Unions (SAK) and the Confederation of Salaried Employees (TVK), which have been communicated by the Government in its report.

In view of the time necessary for translating the new Occupational Diseases Act, the Committee is not in a position to consider this case at the present session. It decided to defer its examination to its session in March 1991.

Direct Request (CEACR) - adopted 1989, published 76th ILC session (1989)

1. The Committee wishes to refer to its observation and further requests the Government to provide clarification on the following point:

Part II (Invalidity benefit), Article 12 of the Convention (in conjunction with Article 32(f)). The Government indicates in its report that, under the Pensions Acts applicable to workers in the public sector and to seafarers (VEL, KVTEL and MEL Acts), invalidity benefits may be refused or reduced, inter alia, if the beneficiary has caused the invalidity through gross negligence. Such benefits may also be refused or reduced on those grounds under the National Pensions Act (KEL), but only until the beneficiary reaches the normal age of retirement, namely 65 years. The Committee requests the Government to provide in its next report a few examples illustrating the practical application of the relevant provisions of the above-mentioned legislation.

2. Furthermore, the Committee notes the Government's statement to the effect that a general reform of the survivors' pension scheme is being considered, but that the relevant Bill has not yet been introduced to Parliament. The Committee hopes that the Government will not fail to take account, in carrying out that reform, of the provisions of Part IV of the Convention and of the corresponding provisions of Parts V and VI.

Observation (CEACR) - adopted 1989, published 76th ILC session (1989)

Part III (Old-age benefit), Article 15, paragraph 3, of the Convention (in conjunction with Article 18). With reference to its earlier comments (concerning the lowering of the age of retirement below 65 years in respect of persons employed in arduous or unhealthy occupations), the Committee has examined the Government's detailed report and noted with satisfaction the introduction of a flexible retirement scheme for workers in the private sector, both salaried and self-employed (including agricultural workers and seafarers). It also notes that the introduction of a similar retirement scheme in the public sector is envisaged for July 1989, and that a bill on that subject has already been submitted to Parliament. The new scheme provides for an early retirement pension to be granted to persons over 55 years of age whose working capacity has been reduced due to ageing and the arduous nature of their work. The rate of such pensions is equivalent to that of a full invalidity pension, and they are granted until the age of 65 whereupon they are replaced by an old-age pension. The new scheme also provides for an early old age (from 58 years) or delayed pension and a part-time old-age pension intended to supplement the income of an elderly person working part time.

The Committee also notes with interest from the information provided in the report that in the public service, although the minimum age for entitlement to an old-age pension is generally 63 years, there are certain categories of arduous or unhealthy occupation in respect of which the minimum age is set at 55, 58 or 60 according to the nature of the occupation.

Furthermore, the Committee notes the comments made by the Finnish Employers' Federation, which considers that the introduction of the new flexible retirement scheme was a matter of necessity, despite the increase in contributions to the contributory pension scheme.