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), 128 (invalidity, old-age, and survivors’ benefits), 130 (medical care and sickness benefits), and 168 (employment promotion and protection against unemployment) together.

The Committee notes the observations of the Central Organization 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. The Committee takes note of the Government’s indication that the Occupational Accidents, Injuries and Diseases Act adopted in 2015 (Act No. 459/2015) has not changed the principle of causality between a disease and a work-related injury necessary for entitlement to employment injury benefits. The Government further indicates that the compensation praxis in cases of employment injuries has been unified to avoid any inconsistency in the application of the national legislation that existed before the adoption of Act No. 459/2015.

Article 8of Convention No. 121. Occupational diseases. (i)Procedure for the recognition of the occupational origin of diseases. The Committee takes note of the Government’s indication that the recognition of the occupational origin of diseases which are not on the national list of occupational diseases may require an additional examination by the Finnish Institute of Occupational Health. The Government further indicates that insurance companies bear all necessary medical expenses in this respect. The average duration of an additional examination is about 6-8 months. According to the statistical data for 2020, the occupational origin of diseases was recognized in 934 out of 2520 cases. The Committee takes due note of this information.

(ii) Diseases caused by occupational exposure to moisture and asbestos. The Committee notes the observations of the SAK, the AKAVA and the STTK pointing out the lack of income protection for workers suffering from symptoms caused by moisture damage in the workplace since many of these workers fail to qualify for social security benefits. The SAK, the AKAVA and the STTK indicate in this respect that the national legislation should be more precise regarding the obligations of insurance companies to provide compensation due to diseases caused by moisture damage. The SAK, the AKAVA and the STTK also indicate that insufficient measures have been taken to ensure screening, monitoring and appropriate treatment of workers exposed to asbestos at the workplace. The Committee requests the Government to provide information on the measures taken to ensure the provision of employment injury benefits due to diseases caused by occupational exposure to moisture damage. With respect to the measures to be taken for the prevention and protection of workers against health hazards due to occupational exposure to asbestos, the Committee refers to its detailed comments under the Asbestos Convention, 1986 (No. 162).

Article 15(3) of Convention No. 128, in conjunction with Articles 17 and 18.Early retirement for workers in arduous and unhealthy occupations. The Committee notes that according to section 11 of the Employees Pensions Act (Act No. 395/2006), the retirement age for persons born between 1962 and 1964 has increased to 65 years old. The retirement age for persons born in 1965 and thereafter will be linked to life expectancy. The Committee further notes that according to sections 15 and 16 of Act No. 395/2006, a partial early retirement pension can be provided to persons born in 1964 at the age of 62 and to persons born in 1965 and thereafter at the age adjusted to life expectancy. In addition, as per section 53a of Act No. 395/2006, persons are entitled to a career pension at the age of 63 if they have been in hazardous work for at least 38 years and if their working capacity has been impaired because of an illness or disability.

The Committee recalls that according to Article 15(3) of the Convention, if the pensionable age is 65 years or higher, the age shall be lowered, under prescribed conditions, in respect of persons who have been engaged in occupations that are deemed by national legislation, for the purpose of old-age benefit, to be arduous or unhealthy. The Committee further recalls that the purpose of this provision is intended to ensure additional protection, through a more favourable system, to persons employed on arduous or unhealthy work, by allowing them to draw an anticipated old-age pension, of which the rate and qualifying period must conform to Articles 17 (old-age pension’s rate) and 18 (minimum qualifying period) of the Convention. In this respect, the Committee observes that the qualifying period of 38 years for the entitlement to the career pension under section 53a of Act No. 395/2006 exceeds a 30-year period of contributions or employment, which is the standard qualifying period for the entitlement to an old-age pension at the minimum level required by the Convention (Article 18). The Committee further observes that a partial early retirement pension is subject to a certain reduction which may result in the amount lower than old-age pension’s rate of 45 per cent of the reference wage required, according to Articles 17 and 26 of the Convention. The Committee therefore requests the Government to indicate other possibilities for workers in arduous and unhealthy occupations to draw a pension which meets the requirements of Articles 17 and 18 of the Convention at an age lower than 65.

Article 35(1) of Convention No. 128. General responsibility of a State for the due provision of invalidity, old-age, and survivors’ benefits. The Committee notes the observations of the SAK, the AKAVA and the STTK raising concerns about the sustainability of the pension system financed through employers’ and employees’ contributions. In particular, the SAK, the AKAVA and the STTK indicate the increased use of various contractual arrangements instead of labour contracts while the individuals concerned may be de facto in subordinate and dependent relationships with their employers. The SAK, the AKAVA and the STTK further point out that employers do not have to pay social security contributions for persons not employed under labour contracts which may affect not only the financial sustainability of the pension system but also result in lower pension levels.

In this respect, the Committee notes the Government’s indication regarding the proposal of a working group of the Ministry of Social Affairs and Health to amend the Self-Employed Persons’ Pensions Act with a view to improve pension security of the self-employed. The Committee welcomes this development and requests the Government to keep it informed on the outcome of this process.The Committee also requests the Government to continue to provide information on the measures taken or envisaged to ensure the sustainability of the pension system, in application of Article 35(1) of the Convention,

Article 13(c) of Convention No. 130, in conjunction with Article 17. Cost-sharing for pharmaceutical supplies. Further to its previous request on the reimbursement of costs for pharmaceutical supplies, the Committee notes the Government’s indication that the changes in the reimbursement rules made in 2016 aimed to ensure access to pharmaceuticals for persons who heavily depend on them and persons with low income. In this respect, for example, the basic reimbursement of costs for pharmaceuticals increased from 35 to 40 per cent. In addition, there was a decrease in the annual ceiling and only after reaching this ceiling of €579.7 is a fixed co-payment of £2.5 per each medicine required. The Committee also notes the Government’s indication that the Ministry of Social Affairs and Health has launched a comprehensive reform of pharmacotherapy, which will also involve reviewing the medicine reimbursement rules.

The Committee notes from the 2021 publication of the World Health Organization “Can people afford to pay for health care? New evidence on financial protection in Finland” that medicines account for the largest share of “catastrophic spending”, particularly in the poorer quintiles, and that people with chronic conditions are more sensitive to co-payments. Furthermore, not all people in vulnerable situations have effective access in practice to social assistance benefits provided to cover out-of-pocket payments for outpatient prescribed medicines. The Committee recalls that according to Article 17 of the Convention, cost-sharing for medical care benefits, including the necessary pharmaceutical supplies, shall be so designed as to avoid hardship and not to prejudice the effectiveness of medical and social protection. The Committee therefore requests the Government to provide information on the measures taken or envisaged to ensure effective access topharmaceutical supplies for persons protected, particularly those with low income and those who suffer from diseases recognized as entailing prolonged care, without financial hardship. In this respect, the Committee encourages the Government to take advantage of the pharmacotherapy reform to ensure that the medicine reimbursement rules are so designed as to avoid hardship and not to prejudice the effectiveness of medical and social protection, in line with Article 17 of the Convention.

Article 30(1)of Convention No. 130. General responsibility of a State for the due provision of medical care benefits. The Committee notes the Government’s indication that according to the Health Care Act, medical treatment in non-urgent cases shall be provided within a reasonable time not exceeding three months for primary medical care and six months for specialized medical care, including oral health care, since the assessment of patients’ needs. The Government further indicates that in 2021, there were no cases in which waiting times went beyond a maximum of three months and approximately 60 per cent of patients received primary medical care within one week since the assessment of patients’ needs. Only 6.8 per cent of patients were waiting for treatment longer than the statutory six-month maximum period for specialized medical care at the end of December 2021.

Furthermore, the Committee notes with interest that the Ministry of Social Affairs and Health submitted a draft law amending the Health Care Act to the Parliament on 12 May 2022 which ensures the provision of medical care within seven days from the assessment of patients’ needs for outpatient medical care and within three months for oral health care. The Government also indicates the allocation of more than €200 million to regional development projects seeking to improve access to medical care. The Committee requests the Government to continue providing information on the measures taken to ensure the due provision of medical care benefits to persons protected, in line with Article 30(1) of the Convention.

Articles 7 and 8 of Convention No. 168. Promotion of productive employment. With respect to the measures taken or envisaged topromote full, productive and freely chosen employment, including among disadvantaged persons, the Committee refers to its detailed comments under the Employment Policy Convention, 1964 (No. 122).

Article 21of Convention No. 168. Suitable employment. The Committee notes the Government’s indication that a jobseeker’s employment plan is elaborated after a jobseeker’s initial interview with the Employment and Economic Development Office (TE office). The jobseeker’s employment plan takes into account the jobseeker’s competence and professional skills, work ability, duration of unemployment as well as labour market situation. The Government also indicates that a jobseeker shall usually apply for four jobs each month in line with his/her employment plan to continue receiving unemployment benefits. The Committee also takes note of the Government’s indication that a jobseeker is bound to accept a job offer if the job search has lasted for more than six months since the initial interview.