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

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

The Committee notes the observations of the employees’ representatives on the National ILO Council, communicated with the Government’s report.

Article 6(2) of the Convention. Participation of insured persons in the management of sickness insurance institutions. In its previous comments, the Committee noted that over the previous reporting period, several changes had taken place with respect to the involvement of insured persons in the oversight of the management and operation of healthcare providers. It also invited the Government to provide further details regarding the manner in which the national law and practice ensured compliance with Article 6 of the Convention, indicating in particular how the participation of insured persons in the management of health insurance institutions, including through trade union organizations representing the interests of insured employees, was guaranteed and how it operated in practice. The Committee notes the Government’s reply in its report indicating that the participation of insured persons in the work of regional healthcare councils is ensured by the representation of patients’ organizations in these councils. Regional healthcare councils are composed of the representative of the municipality of the given region, the representative of the competent health insurance body, one representative of the non-publicly funded healthcare service providers operating in the region and participating in basic healthcare services, one representative of each professional chamber operating in the area of healthcare, respectively, and one joint representative of the patients’ organizations operating in the region. The Government further indicates that the Ministry of Health liaises with the National Patient Forum, an advisory body composed of civil organizations representing patients suffering from the same disease, which also contributes to the representation of insured persons in decision-making processes. The Committee takes due note of this information. The Committee also notes the comments put forward by the employees’ representatives on the National ILO Council, which, as in the past, raise concerns as to the lack of harmonization of the law with Article 6 of the Convention concerning, notably, the participation of insured persons in the management of sickness insurance. They also consider that patients’ organizations are not sufficiently represented in regional health councils, which account for only one representative of patients’ organizations. Based on the above, the Committee is bound to note once again that, while representatives of insured persons are involved in a consultative capacity in the policymaking and supervision of health protection issues, additional clarification is needed on the manner in which their participation in the management of health insurance institutions is ensured, as required by Article 6(2) of the Convention. The Committee thus requests the Government to indicate how, since the restructuring of the health insurance system, the participation of insured persons in the management of health insurance institutions is guaranteed by law and how it is given effect in practice.

The Committee has been informed that, based on the recommendations of the Standards Review Mechanism (SRM) tripartite working group, the Governing Body has decided that member States for which the Sickness Insurance (Industry) Convention, 1927 (No. 24) is in force should be encouraged to ratify the more recent Medical Care and Sickness Benefits Convention, 1969 (No. 130), or the Social Security (Minimum Standards) Convention, 1952 (No. 102), accepting Parts II and III (see GB.328/LILS/2/1). Conventions Nos 130 and 102 reflect the more modern approach to medical care and sickness benefits. The Committee therefore encourages the Government to follow up the Governing Body’s decision at its 328th Session (October–November 2016), approving the recommendations of the SRM tripartite working group and to consider ratifying Conventions Nos 130 or 102 (Parts II and III) as the most up-to-date instruments in these subject areas.