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

1. Part II (Medical care), Article 10, and Part III (Sickness benefit), Article 19 (in relation with Article 5), of the Convention. With reference to its previous comments, the Committee notes with interest from the Government's report that the coverage of the general social security scheme has been extended to the public sector employees, as regards medical care and cash benefit for temporary incapacity, by Decree No. 3325 of 13 January 1994, and that basic principles permitting the affiliation of artisans and artists to this scheme were laid down by Decree No. 2558 of 1992. The Government adds that studies have been carried out with a view to extending its coverage further to some other categories of workers and geographical regions of the country. The Committee also observes that in 1995 according to the available statistics (supplied by the Government in its report under Convention No. 102 as well as in the Venezuelan Statistical Yearbook of 1994), the general insurance scheme covered only about 55 per cent of the total number of employees in the country. Taking account of the previous comments made by the Venezuelan Federation of Chambers and Associations of Commerce and Production (FEDECAMARAS) highlighting the difficulties in this process, the Committee hopes that the Government will continue its endeavours to progressively extend the social security scheme to the whole of the country, so as to attain in particular the level of coverage set out by the above-mentioned provisions of the Convention. It also hopes that the next report of the Government will contain detailed information in this respect, including up-to-date statistics required in the report form on the Convention adopted by the Governing Body, both for the private and the public sectors.

2. Part II (Medical care), Article 13. For a number of years the Committee has been asking the Government to indicate what specific provisions in laws, regulations or administrative rules guarantee the provision of the types of the medical care required by Article 13 of the Convention and, in particular, to supply the text of the internal rules to be issued by the Board of Governors of the IVSS in pursuance of section 119 of the General Regulations of the Social Insurance Act, that the IVSS will provide medical benefits in the form and conditions set forth by the Board. In reply, the Government refers to the information supplied in its report under Convention No. 102 and, in particular, to the regulations of hospitals of the IVSS, a copy of which was supplied in the annex to its report on Convention No. 102. The Committee observes that while these regulations contain detailed provisions concerning the internal organization of the medical services in hospitals, they do not specify, as neither do the Social Insurance Act and its General Regulations, the types of medical care ensured to the protected persons. In this situation and taking into account that, according to the Government's report on Convention No. 102, the IVSS is currently undergoing restructuring, the Committee would urge the Government to take the necessary measures with a view to expressly specifying in the legislation the types of medical care provided by the IVSS to the insured persons, which should include at least those mentioned in Article 13 of the Convention.

3. Article 16, paragraph 1. The Government states that the Committee's comments concerning the need to bring the content of section 127 of the General Regulations of the Social Insurance Act in line with the established practice of the IVSS to provide medical assistance throughout the contingency, have been noted. The Committee therefore hopes that in its next report the Government would not fail to indicate measures taken to this end and in the meantime to supply the text of any decisions, circulars or other administrative regulations of the IVSS establishing the said practice.

4. Article 16, paragraphs 2 and 3. In its previous comments the Committee had asked the Government to supply the text of any decisions, circulars or other administrative regulations of the IVSS establishing the practice to continue to provide medical care where a beneficiary ceases to belong to one of the categories of persons protected when the sickness started while he or she still belonged to the said category. In its reply, the Government states that this practice is not yet reflected in the social security legislation. In this situation the Committee again asks the Government to take the necessary measures to ensure that full effect is given to these provisions of the Convention in the legislation as well.

5. Part III (Sickness benefits), Article 22 (in conjunction with Article 1(h)). In its previous comments the Committee had requested the Government to supply statistical information called for under Titles I and II of the report form under this Article of the Convention, in order to enable it to ascertain whether the amount of the sickness benefit attains the percentage prescribed by the Convention (60 per cent) for a standard beneficiary (a man with a wife and two children) whose wage is equal to that of a skilled manual male employee, in accordance with paragraph 3 of Article 22. In reply, the Government refers to the statistics of the IVSS attached to its report. As these statistics have not reached the Office, the Committee once again asks the Government to provide the statistical information requested in its next report.

6. Part IV (Common provisions), Article 28, paragraph 2. With reference to its previous comments concerning section 144 of the General Regulations of the Social Insurance Act providing for the withdrawal or reduction of cash benefits for temporary incapacity, the Committee hopes that, when this legislation is next revised, the Government will not fail to ensure that in the appropriate cases part of the suspended benefit shall be paid to the dependants of the person concerned, as required by this Article of the Convention.