Observación (CEACR) - Adopción: 2001, Publicación: 90ª reunión CIT (2002)

Convenio sobre el seguro de enfermedad (industria), 1927 (núm. 24) - Perú (Ratificación : 1945)

With reference to its previous comments, the Committee notes the information supplied by the Government in its report. In particular, it notes the information on the application of Article 7, paragraph 2, of the Convention.

Article 2 of the Convention. In its previous comments, the Committee asked the Government to indicate whether in practice all the workers covered by the Convention and, in particular, apprentices, are affiliated to the social security scheme provided in Act No. 26790 of 1997. It also requested information on the geographical coverage of the new health-care system, with an indication of the regions which are not yet covered. In its report, the Government indicates that all employed workers, including apprentices, are covered by the Act in question and by Legislative Decree No. 20151. The Government also indicates that this new health insurance scheme is nationwide in scope but it does not supply statistics on either the real cover or the geographical cover of the new health scheme. The Committee observes however that, according to the report of the Peruvian Social Security Institute (IPSS) for 1999, the population insured numbers 6,574,534 persons, of whom 47.9 per cent are in Lima and Callao and the remaining 52.1 per cent from towns in the interior of the country. With regard to geographical cover, the Government indicates in its report on the Social Security (Minimum Standards) Convention, 1952 (No. 102), that the EPS (health-care providers) have regional scope and that there is no regulatory limitation or restriction on any region in the country; hence, 20 departments in the country are beneficiaries under this system; geographical cover of the new health scheme ESSALUD comprises care centres consisting of 112 hospitals, 42 medical centres, 193 health stations and 31 outpatient clinics. The Committee notes this information. It asks the Government to provide in its next report an example of the latest IPSS report, as well as the monthly reports of affiliation to the EPS. It also asks it to supply disaggregated statistical information on the number of persons who belong to the workforce in Peru and of persons who are insured and covered either by ESSALUD or by the EPS. In regard to geographical cover, the Committee requests that the Government specify the regions which are not yet covered, the zones where establishments providing care are located, along with information on the insured persons and beneficiaries given treatment in these establishments.

Article 6, paragraph 1. In its previous comments, the Committee asked the Government to indicate the manner in which it gave effect to this provision of the Convention under which health-care insurance must be administered by self governing institutions, under the administrative and financial supervision of the public authorities and shall not be carried out with a view to profit. Institutions funded by private initiative must be recognized by the public authorities. The Government’s report refers, inter alia, to section 13 of the regulations of Act No. 26790 (DS No. 009 97 SA) under which the sole purpose of the health-care providers is to provide health-care services with their own or with third parties’ infrastructure. The Committee notes this information. It requests that the Government supply copies of the decisions authorizing operation by which the EPS obtain recognition, of EPS superintendence reports and examples of agreements concluded with EPS.

Article 6, paragraph 2. In reply to previous comments of the Committee regarding participation of insured persons in the management of the health care scheme, in particular as regards the EPS and health-care services provided by the employer, the Government indicates that insured persons participate in the management of the health scheme through representation of the most representative organizations of the group of the workers in the public, private and pensioners’ labour system. The Committee notes this information. It observes, however, that the legislative provisions which the Government cites, under which participation of insured persons is provided, relate to the Social Security Health System (ESSALUD). Finally, it requests that the Government indicate the legislative provisions under which participation of insured persons in EPS and in health services provided by employers is envisaged.

[The Government is asked to report in detail in 2002.]