Direct Request (CEACR) - adopted 2013, published 103rd ILC session (2014)

Sickness Insurance (Industry) Convention, 1927 (No. 24) - Hungary (Ratification: 1928)

Article 6 of the Convention. Management of sickness insurance institutions. With reference to its previous observation, the Committee notes the Government’s statement that, during the reporting period, several changes have taken place with respect to the involvement of insured persons into controlling the management and operation of health-care providers. Overall, health services continue to be purchased by the National Health Insurance Fund from health-care providers operating within the social insurance scheme. From 2007 to 2010, the Health Insurance Supervisory Authority was responsible for overseeing the functioning of the health insurance system and was assisted by a supervisory council composed of seven members including representatives from employers’ and employees’ sides. During the period 2009–11, the National Health Council (NHC), a consultative, advisory and reviewing body, supported the Government’s decision-making with respect to health policy and implementation. The NHC included among its members national representative bodies of patients. Starting from 2012, health regions have been established together with regional health councils which cooperate in health policy-making and assume certain responsibilities for the monitoring of the health policy at the regional level. These councils are composed of, inter alia, a representative of patients’ organizations at local level. In parallel, the Government also refers to the National Patient Forum – an advisory body composed of civil organizations representing patients suffering from the same disease. Taking into account the above, the Government states that the insured persons participate in decision-making processes related to health insurance through their right to be consulted and in contact with the responsible minister.

Taking due note of this information, the Committee would like to recall that Article 6 of the Convention aims at, on the one hand, guaranteeing that health insurance is administered by self-governing institutions under the administrative and financial supervision of the State, and that, on the other hand, the insured persons participate in the management of these self-governing institutions. The Committee notes that while it appears from the above information that representatives of insured persons have been and continue to be involved in a consultative capacity at the level of policy-making and supervision of health protection issues, the report does not state clearly how the participation of representatives of insured persons in the management of health insurance institutions operates. The Committee recalls in this respect that the employees’ side within the National ILO Council had in the past raised continuous concerns over the fact that existing mechanisms fail to ensure their participation in the management of health insurance institutions. The Committee therefore invites the Government to provide further details regarding the manner in which the national law and practice ensure compliance with Article 6 of the Convention, indicating in particular how the participation of the insured persons, including through trade union organizations representing the interests of insured employees, in the management of sickness insurance institutions is guaranteed and how it operates in practice.