Demande directe (CEACR) - adoptée 2019, publiée 109ème session CIT (2021)

Finlande

Convention (n° 121) sur les prestations en cas d'accidents du travail et de maladies professionnelles, 1964 [tableau I modifié en 1980] (Ratification: 1968)
Convention (n° 130) concernant les soins médicaux et les indemnités de maladie, 1969 (Ratification: 1974)
Convention (n° 168) sur la promotion de l'emploi et la protection contre le chômage, 1988 (Ratification: 1990)

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.