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Report on obstacles to access to Social Protection in Europe report II (rev) Peter Melvyn - European Centre for Social Welfare Policy and Research I. Communication and information
Minorities (immigrants, refugees, asylum seekers, ethnic etc. groups)
III. Organisation and management problems (co-ordination between service providers)
References
l. This text represents a restructured version of the first report on “Obstacles to access to social protection” which had been presented to and discussed by Group CS-PS at its Third Meeting, Moscow, 22-24 May 2000. Further to its discussion, the Group recommended that in order to limit the scope of work the report to be restructured around four main topics: I. Communication and information policy concerning social benefits, II. Specific obstacles of vulnerable groups concerning access to social protection, III. Organisational and/or management problems (co-ordination between service providers), and IV. Partnership with organisations representing society at large (non-governmental organisations etc.) in the improvement of social protection. The restructured version is not intended to replace the first report but is focusing on the aforementioned four topics. Although replies to the questionnaire that are relevant to these topics are taken up again, this version contains much information from other sources which are listed under “references”. This additional information should give more substance to the topics, in particular to IV. which the first report did not cover. Further, not all “vulnerable groups” enumerated below could be treated as a thorough study of this topic would require further research. Therefore a small selection had to be made. It should also be recalled that the manifold problems of these population groups are such that an overview such as this can barely touch the surface. In the restructured report due account has been taken of observations made by government authorities as well as NGOs wherever they could be accommodated in the new structure. I. Communication and information 2. In the “Reports to the 6th European Congress for Labour Law and Social Security” (Warsaw, 1999) it is pointed out that “in so far as social benefits and services are directed at persons who are at a social disadvantage, the effects of this can also make themselves felt in that the individuals concerned are not fully informed of their rights...The legal system assumes that the citizen knows his rights...” Yet, as many of the replies to the questionnaire show, this is, for a variety of reasons, not always the case. 3. Thus all replies are unanimous in acknowledging the difficulties of the public to understand fully the legal texts pertaining to social protection. A few replies also confirm the complexity of the procedures while quite a number admit to the difficulties of understanding and interpretation not only by the beneficiaries but also by the service providers. In most cases efforts are mentioned to provide more transparent and simplified versions of the legal texts. There is unanimity that the benefits should be easy to claim and easy to administer. Both claimants and providing agents should find them easy to understand. Most government services and NGOs see one of their main functions in counselling and assisting clients with application procedures since many of the latter seem not able to cope by themselves. Several NGOs complain that frequent amendments, temporary rulings or different versions of the same ruling, – all of which being valid, – cause considerable confusion and may lead to delays in the application procedure. Thus, according to an NGO source from Ireland, most rules of the social welfare system as well as the claims forms are so complicated to understand that they alienate many potential claimants and thereby constitute a major stumbling block to social protection. 4. Lack of understandable information as well as the complexity of procedures may lead to abandoning the application process. This is given as one of the main reasons for the low level take up in social assistance (NGO source, Ireland). A similar point made by a Finnish NGO is that there is an estimated number of 100,000 households which could be found entitled to social assistance, yet they do not apply for this benefit. Again, one of the reasons given is the complicated application procedure which, particularly if the benefits are likely to be very small, may not be worth the effort. 5. There is unanimity among the responding countries that lack of information can lead to loss or to delays in benefits or other services. Information, as pointed out by the government source of Liechtenstein, is the starting point of each and every support and benefit measure. Yet, as it is mentioned in another reply, it is difficult to establish whether the information was not provided, application procedures not clear or whether users are simply not aware of this information. 6. Another consequence of lack of information, particularly in the administration of financial assistance, seems, as already mentioned, due to the claimants’ level of awareness or knowledge regarding their entitlements. Although most countries point to their efforts in the dissemination of information through various means, there still appear to be individuals or groups of people who are not being reached. One of the consequences of lack of information, as shown by an Irish NGO, is the low take up rate for certain benefits. Thus a study showed that over four fifths of respondents reported needs for which they did not lodge claims. This was partly explained by the fear that if a claim is made for one benefit, entitlement to another may be refused. 7. The problem of low take up is also confirmed by an NGO source from the United Kingdom which quotes from the considerable amount of research that has been done on this problem. The studies mention a range of factors, – the structure of different benefit schemes, the administration of benefits or those relating to the individual’s awareness, beliefs and perception of the benefit system. Lack of basic knowledge of benefits and the different rules or uncertainty whether a particular benefit would apply to the claimant’s circumstances are among the reasons. Another Irish NGO makes the comment that “lack of information is lack of power”. According to this organisation’s experience, most of its clients prefer to be given the information they need or advice where it may be obtained than have their benefits secured on their behalf. Further, people express a great deal of resentment and anger upon discovering that there is information on benefits and services to which they would have been entitled but which they forfeited due to lack of information, tending to assume that it had been withheld deliberately. In short, information that is accurate, up-to-date and accessible to all is crucial in promoting self-empowerment. 8. In section V.5.1 the questionnaire requests a reply as to whether the information disseminated regarding entitlement to benefits and existing procedures for their provision are adequate from two standpoints: a) qualitatively, and b) adaptation of the information to different target groups. On this question, the replies given by government services and NGOs are farthest apart. In most of the replies (from 15 countries), items (a) and (b) are not clearly kept separate. All government services but one appear to be satisfied with the adequacy and quality of the information which they supply to the public concerning entitlement and procedures for making claims. However, a few do admit the existence of problems reaching certain ethnic or linguistic minorities. On the other hand, most NGOs tend to be highly critical of the information disseminated by official sources. Their criticism focuses by and large on the following points: (1) general inadequacy: inaccuracies or mistakes in the information material, failure to keep information up-to-date, (2) excess of information on some services, e.g. pension schemes, dearth of information on others, e.g. means-tested benefits, (3) lack of adaptation to levels of education or language groups, to migrants, to people with visual disabilities (use of Braille), (4) fragmentation of information due to the organisation of social protection at different levels (e.g. federal/provincial/local), and (5) no outreach to disadvantaged groups. 9. Several examples from national contexts illustrate such obstacles in communication, some of which show the relationship between the complexity of a given benefit system and the difficulty to communicate it effectively. Thus, a United Kingdom government source identifies three sets of barriers: (a) the complexity inherent in any social security and benefit system, (b) lengthy and often complicated forms and the need for clients to contact more than one agency or office, and (c) the lack of privacy in many local offices. A Belgian NGO remarks that apart from being frequently incomplete and incorrect, the information supplied is primarily addressed to a public which is already familiar with the functioning of benefit systems. Irish NGOs comment on a number of similar as well as on other problems. They recognise that the government departments that administer a broad system of social protection produce and make available a variety of information on entitlements to social services. However in their words, the range of the benefits and services that compose the system is quite bewildering. In addition, the language and the style of much of the published information material can only be understood by policy makers and staff responsible for the administration of the services. Information is often couched in legalistic and bureaucratic terms. If this makes access difficult for many ordinary people, persons with literacy and numeracy problems and members of certain minorities face a great obstacle. Further, generally speaking, people living in poor neighbourhoods are much less likely to have access to information. 10. A government source from Estonia reports that there is still insufficient guidance to ensure that legislation on rights and benefits is clearly understood in terms of enforcement A major problem seems to arise, as averred by this source, in connection with the Language Act, according to which the country’s only official language is Estonian. Yet, a large proportion of the population of Estonia is of Russian origin; many do not understand or are not fluent in the national language. It may therefore happen that information on social benefits does not reach this segment of the population. However, considerable efforts are reported to have been made to support and extend the teaching of Estonian. After facilitating the acquisition of Estonian citizenship for elderly and disabled persons, the language examination has been simplified for all applicants. It is evident that information material cannot be made available in all the languages of immigrant minorities which in some countries would be one dozen or more. Nevertheless, information on services is often available in the main languages. Where necessary, as reported by several countries, assistance with applications is provided. 11. The countries reporting on information technologies as a tool in the dissemination of information and in the administration of programmes, report a great improvement in their benefit and service delivery. Over the past decades, the various applications of information technologies have gradually entered government and private social protection services. The possibilities that these technologies have to offer require new forms of organisation in social welfare. For example, a Swedish government source points to the fact that it has become possible to obtain information about people who may be entitled to benefits but do not use their rights. Yet the issue of general access, confidentiality and ethics in the use of these new forms of technology needs still to be raised. In the replies, administrations that are not yet equipped with electronic information services or only partly, point to the considerable investments involved. On the other hand, the internet is well on its way to becoming a mass medium that social protection services in a number of countries have begun to use. It is gaining importance in the work done, for example, by self-help groups and organisations. (In this connection attention is drawn to the report of the “International Conference on Information Technology: new service opportunities for social security schemes”, Montreal, Quebec, Canada, 27-30 September 1999, organised by ISSA (International Social Security Association, Geneva). II. Specific obstacles of vulnerable population groups 12. There is a variety of terms referring to vulnerable population groups such as disadvantaged, underprivileged, marginal, groups at risk to fall below the poverty line or to groups or individuals who are socially excluded or threatened with exclusion. The term ‘social exclusion’ is occasionally used interchangeably with ‘poverty’. Yet they are not synonymous. While poverty means “non-access to goods and services due to unequal material resources, social exclusion refers to unequal participation in social life or being denied a place in the consumer society, often linked to the social role of employment and work” (Dror, D. and Jacquier, C., quoting Duffy, K., 1999). In the latter case one may speak of ‘poverty-related exclusion’ inasmuch as changes in the labour market have affected – and are still affecting -large numbers of individuals in many countries who found themselves in unemployment or low-paid jobs or in receipt of social assistance or with minimal pensions and, as a consequence, in poverty. 13. A number of countries such as Denmark, France, the United Kingdom have developed programmes to combat social exclusion, with the aim to cover both the poverty-related as well as the socially excluded. The individuals and groups in these categories – which cannot be neatly kept apart – consist of a wide spectrum of people with largely overlapping problems such as the long-term unemployed, the ‘working poor’, long-term recipients of social assistance, the homeless, people with physical or mental disabilities and very low income, old people with minimum pensions, drug addicts and AIDS patients, offenders, lone parent- as well as large families, vulnerable youth, refugees, -resident or illegal -, certain ethnic minorities such as Roma, communities of immigrant workers from non-EU countries, people living in isolated rural areas or in economically deprived regions. Attention is drawn to the fact that the questionnaire did not mention ‘vulnerable groups’ as such. Apparently they were to be covered under the term ‘minority groups who remain excluded from certain benefits or services or for whom access to certain benefits or services is made difficult’ (VI.6.1). Since the question is not explicit as to the definition of a minority group, a selection had to be made among groups appearing in the replies that coincide with those enumerated above. Minorities (immigrants, refugees, asylum seekers, ethnic etc. groups) 14. At the outset it may be useful to recall that the European Committee on Social Rights, with reference to the European Charter, Article 13 (the right to social and medical assistance), identified a number of groups who are likely to be in need of social services, inter alia, “minorities (migrants, gypsies, refugees etc.)”, adding that “this list is not exhaustive as the right to social services must be open to all individuals in the community”. Further, account may be taken of the country reports of the European Commission against Racism and Intolerance (ECRI), which periodically examine the situation of non-nationals and minorities with regard to discrimination. 15. The replies to the questionnaire frequently mention individuals and families without residence permits. While in some countries such persons or families are not entitled to any benefits or services, e.g. according to government sources in the Czech Republic and Estonia (where in exceptional cases benefits may be granted at the discretion of municipalities), in others they may be eligible for certain benefits only after a determined period of residence, e.g. in Belgium for family allowances (government source) and for unspecified types of benefits in Latvia (government source). As the exclusion from benefits and services pertains only to those that are state-funded, there seem to be no barriers to assistance from voluntary organisations. Many countries use their immigration and social welfare laws to exclude immigrants and asylum seekers from social benefits and services. Thus in the United Kingdom access to welfare is being tied even more closely to immigration and residence status, thereby making it more difficult for immigrants and asylum seekers to receive financial or housing assistance from the state (Lister, R., 1998). Likewise in Austria where, according to the law, asylum seekers have no legal right to health care, two thirds of them are taken charge of by NGOs or church institutions. Provision of public health care is discretionary, apparently under certain conditions, the lack of transparency of which is being strongly criticized by UNHCR and NGOs. 16. With regard to immigrants and refugees, according to several replies this group is excluded from certain benefits or services, without further specification. Examples are Spain (government source) where persons without fixed address and homeless people are excluded, Denmark (NGO source) which grants smaller benefits to immigrants than to nationals, while in Finland immigrants who have arrived in the country at an advanced age are not entitled to old age pensions but may receive social assistance (government source). In Ireland where there has been an increasing number of refugees and asylum seekers during the last years, an NGO source spots prejudice and racism on the part of some service deliverers which renders access to benefits and services difficult for the claimants. A similar report comes from France (NGO source) where cases of blocking of services on the part of certain municipal officials have been noticed, particularly with regard to medical care. A Swiss NGO source detects that the legitimacy of claims regarding work accidents and invalidity insurance is more frequently called into question by service providers when foreign nationals are involved. Yet, according to this source, foreign manual workers are often at a higher accident risk than nationals because of the kind of work for which they are often hired. 17. As far as non-European migrant workers are concerned, neither the European Social Charter (Turin, 1961), nor its additional protocols (1988 and l991), nor its revised version (1996), nor the European Agreement (1977) of the Council of Europe regarding the legal status of migrant workers, are of relevance to this group. Thus e.g. workers from the Maghreb are not assured of equitable social protection and consequently they do not enjoy certain benefits linked to their contributions such as unemployment or health care if they return temporarily (e.g. for vacation) to their country of origin or if the members of their families reside there (e.g. special allowances for childbirth or for dependent spouse). In addition, Council Regulation No.1408/71 (European Communities) of 14 June 1971, respecting the application of social security schemes to wage earners and their families does not extend to Maghreb migrant workers and their families (Boudahrein, A., 2000). (See Addendum). 18. Replies from three countries in particular, Ireland, Romania and Slovakia, report on the difficulties of their indigenous minority groups such as the Travellers and the Roma, with regard to access to benefits and services. Both groups have in common that they are traditionally nomadic, though quite a number have become sedentary and are settled in housing or in caravans. Some live on the side of roads without any access to services. Both groups – the Roma in some of the countries of central and eastern Europe where they are particularly numerous – are exposed to all-pervasive racism and long-standing prejudices on the part of many in the societies within which they live. This situation leads to their marginalisation and exclusion from most of the institutions and structures of society which they experience at both the individual and the institutional level. Thus in Ireland (NGO source), Travellers who are settled have to sign for social welfare services at separate times, they have to use separate, segregated social work service and children are often attending separate classes in school. 19. In central and eastern Europe where there has always been a relatively large Roma population most live under poverty-stricken conditions. In Romania (government source) large segments of the Roma live in dire poverty due to an extremely high rate of unemployment, especially since 1989. According to the same source, the Roma minority is characterised by a very high school absentee and illiteracy rate and consequently low levels of education and training. These factors contribute to a tendency to engage in illegal and even criminal activities. It is further pointed out that the main problem lies with the values, norms, attitudes and behaviour that are specific to this ethnic group which renders their integration very difficult. The high birth rate of the Roma that is partly due to a very limited access to family planning services is an additional factor in poverty generation. 20. As in Romania, Slovak Roma groups are characterised by high unemployment and low social status, mainly those living in Roma settlements, often in decrepit housing. The new socio-economic situation after 1989 had a most severe impact on the weakest groups of society such as the Roma, inasmuch as their problems that existed before have multiplied. In addition, responsibility for government policy on the Roma changed a number of times. Thus co-ordination of government activities for the Roma has recently been transferred from the Ministry of Labour and Social Affairs to the Slovak Government Office. According to a recent report (government source), special efforts are being undertaken by this Office together with NGOs to improve the situation of the Roma community, in particular in the fields of employment, training and employment. However, in view of the growing hatred and discrimination – often accompanied by aggression and violence – against the Roma in countries where they form a sizeable minority (up to 10 per cent of the population, – altogether 8-10 million spread over most European countries), the United Nations as well as the OSCE are giving increasing attention to this problem by, as a first step, recommending member States to introduce anti-discriminatory legislation. 21. There is ample evidence from most countries that many disabled people experience economic hardships, social barriers and disadvantages, in particular in education and employment as well as due to their dependence on social benefits. Difficulty of accessibility to services for disabled persons is acknowledged in the replies to the questionnaire by many countries, though not all have reacted to what is a visible and widely recognised problem. The particular difficulties for disabled people range from problems with the use of public transport to access to office buildings that are not appropriately equipped to receive people with impaired mobility. Some countries have set up home visiting services to assist with information and claims. Two countries (Portugal and the United Kingdom, national government sources) report on legislative provisions to guarantee accessibility for disabled persons. Thus in Portugal, the law applies to buildings under construction and adaptation to existing ones. In this connection, a Norwegian NGO draws attention to the problem of the lack of European standards for accessibility of disabled persons to built environment (hotels, public buildings etc,) and of the means for their enforcement. The United Kingdom’s Disability Discrimination Act (1995) acknowledges the right of disabled person to employment opportunities and to access to service on the same basis as able-bodied people. The Act further provides for the removal or the alteration of physical features which constitute barriers to employment or to the use of social services. On the other hand, in the United Kingdom claims procedures for disability have been considerably tightened on account of the new Disability Integrity Procedure and as part of the general trend toward “better targeting” in order to provide for “genuine need”. This procedure makes people who had been granted benefits for life complete a 33-page questionnaire or give answers to administrative interviewers with the aim of re-examining eligibility for assistance (Jordan, B., 1998). Finally, several countries refer to problems of accessibility not only for the old or disabled, but also for mothers with small children who often have to stand in line for long hours and for whom no facilities for child minding are available in public buildings. 22. Over the past twenty years or so, many European cities have experienced an increasing residential polarisation between wealthier and poorer neighbourhoods inasmuch as the first have benefited from rising living standards while the poorer ones have tended to become more dilapidated, more prone to crime and more cut off from the labour market, developing into so-called “vulnerable zones”. Though there are often no clear dividing lines between the two areas but pockets of deprivation where problems of unemployment, poverty and poor health are acute. Ethnic minorities are generally more likely to settle in poor areas, be without work, have low income, poor housing and poor health. Major economic and social changes have played a large part in this development such as the decline of traditional industries, the lack of unskilled jobs, trapping people in unemployment, in low-paid work, in insecurity of earnings, in long-term receipt of social assistance and hence in poverty. Thus poverty and the ensuing social segregation has in the course of the 1990s again become a visible and identifiable problem. Homelessness, poverty of children and of lone, almost exclusively female, parents, of labour market outsiders are becoming a matter of public concern. 23. Homelessness is apparent on a more or less large scale in a number of the larger European cities. According to 1993 figures, the number of homeless in European Union countries was estimated at about 3 million. Their number is likely to have grown since. This number comprises so-called “rough sleepers”, that is those who sleep outside or in underground or makeshift shelters, dormitories, condemned housing etc. Prolonged homelessness has serious effects on health, life expectancy, employment opportunities, leading inevitably to marginalisation and social exclusion. The persistence of this problem is thought to be largely due to the increase in poverty since the 1970s/1980s and linked to changes in economic and social conditions such as the rise of unemployment, increasing shortage of social housing as well as lesser entitlement to such housing, changes in the mental health care and benefit systems. These factors vary of course from country to country. 24. In the national legislation on housing of several countries responsibility for the homeless is delegated to local authorities (Denmark, France, Italy, United Kingdom), thus considering homelessness as housing problem rather than a form of social exclusion, “characterised chiefly by the inability of a section of the socially excluded to get access to welfare services and social housing” (Pleace, N., 1998). Research in the United Kingdom has shown the extent of prejudice and of hostility towards homeless people even by those services which are designed for them to use. Thus they are sometimes refused assistance based on rules with regard to “worthiness”, requirements of proof of homelessness, proof of the presence of children or of debilitating vulnerability, access to other state social benefits and to national health service (Ibid.). Yet in the beginning 1990s, homelessness in the United Kingdom was so severe, with such visible consequences for people’s mental health on the street – as a result of cutting expenditure on mental health services – that the government introduced a number of initiatives such as Homeless Mentally Ill Initiative and the Rough Sleepers Initiative in addition to a grants programme under the 1996 Housing Act. Research further points to homelessness and rough sleeping as one of the many manifestations of social exclusion, “occurring in a context within which little or no assistance is given to those who experience it... (that is) people who are unable to function in the formal economy and who are ineligible for assistance from the state” (Ibid). Vulnerable population groups in transition economies 25. It should be noted that the terms “social exclusion” or “marginalisation” are still relatively new to the social policy vocabulary in most central and eastern European countries which does not mean that the problem does not exist. Social insurance in these countries was and still is geared to people who are or were in employment. However, there are groups of people and particular needs that are not catered for in social insurance or state support schemes. For those there is social assistance which is very much a residual scheme, or a last safety net (Castle-Kanerova, M., 1997). Although in the transition economies the individuals and groups most at risk are fairly similar to those in Western countries, their situation is more difficult due to the large gaps in the social safety net. 26. This is due to two major factors. One, the heavy financial burden that the social protection system imposes on the economy and the state budget, severely aggravated by the fiscal difficulties engendered by market-oriented reforms and two, resulting from this situation, the hardships suffered by large parts of the population, since social policies tend to lag far behind economic reforms and sometimes considered to be a burden. A number of countries have therefore chosen to take a “targeted” approach, that is the attempt to allocate resources foremost to the neediest and most vulnerable parts of the population, - in other words a highly selective safety net. The kind, the extent and the level of social protection varies between these countries, depending on their financial means, and the administrative and human resources available, that is the actors willing and capable to take on the tasks necessary for the functioning of services. Besides, a much higher proportion of the population is still dependent on agriculture which has important implications for social policy developments. Although all the transition countries have established a set of minimum state guarantees for social protection, their implantation often meets with problems, e.g. irregular payments of benefits due to lack of state funds (government source, Russia) or understaffing, – in turn related to low wages in state social services, – and as a result long processing times for claims (government source, Czech Republic) 27. In economies of transition previously fairly secure groups are seeking social protection because they bear a disproportionate share of the costs of transformation. Even employment does not necessarily mean that people earn enough to meet their needs. They therefore seek parallel economic activities, – a second or more jobs – frequently in the unofficial economy. Thus in Russia, the collapse of the previous economic and social system, the ensuing restructuring of the economy, the effects of price liberalisation, high inflation, subsidy withdrawals etc. have been accompanied by a massive rise in the extent and depth of poverty. According to the All Russian Standard of Living Centre the poverty rate estimated in 1995 was reported to be at 40 per cent (60 million people) of the total population. Thus the poor are the most vulnerable group in a society, though not only in Russia, because they are the most exposed to a whole range of risks. At the same time they have the least access to appropriate services because benefits are not – or with great delay – paid to those who are entitled to receive them. 28. A striking feature in the composition of the poor in Russia, i.e. people with below minimum subsistence income, is the number of “working poor” (Osadchaya, G. et al., 1997). Thus according to a recent Russian Longitudinal Survey, 66 per cent of the poor are actually working, most of them are families with children. Among families with three or more children the relative incidence of poverty is much higher – which is also the case in other countries – as well as among the very elderly, mainly widows. Not only are the latter’s pensions inadequate to begin with but they have been – and still are – eroded by inflation (36,5 per cent in 1999). Some of the main reasons for poverty are, as already indicated, the long delays and non-payment of wages, pensions and benefits affecting wage earners and recipients of benefits alike. A main problem for the social protection system is the repayment of debts on wages. Lump sum repayment of debts proves to be impossible due to lack of funds by the enterprises (about 18 milliards of roubles in 1999) (TACIS ACE Survey). Little information is reported to be available on the functioning of the social assistance system which is provided locally and mostly in kind rather than in cash or on the number of persons receiving it (Osadchaya, op.cit.). 29. As to the questionnaire’s reference to “physical obstacles (geographic)”, a number of countries considered access of people in rural areas to protection services as a problem, often regardless of their countries’ geographic location in Europe and of the size of their territories. Climatic conditions such as long and severe winters aggravate the problem in northern and easternmost Europe. However, in many countries exist dense networks of service points that facilitate access. In others such as Norway or Iceland, with large sparsely populated areas contacts maintained by telephone, fax and e-mail are quite common. In replies from a few smaller countries where distances are relatively short (government source Estonia, NGO Ireland), mention is made of inadequate conditions of public transport such as the infrequency and limited schedules of local trains and buses as well as their cost, - too high for low-income persons. In the largest European country, the Russian Federation, according to a government source, people in remote settlements cannot be provided with certain services all year round. There are also indications of withdrawal of state social protection services from certain regions, mainly on the periphery of the Russian Federation such as in parts of Siberia where gold and tungsten mining or whole industries have been abandoned or from settlements in the Polar Regions. III. Organisation and management problems (co-ordination between service providers) 30. Social protection is generally implemented at different levels of government, national, regional and local. It is widely assumed that a decentralised system allows for more flexibility and greater capacity to adapt to regional and local needs. Although the forms of decentralisation may differ, ideally the responsibilities are clearly assigned to the different levels and not fragmented. Social protection systems are usually built around several major trunks such as pensions, health, family support, disability, social assistance etc. under autonomous management with its proper rules and regulations regarding entitlements and implementation. Any blocks and barriers in communication and in the co-ordination of benefits and services between the trunks are however in many instances creating problems, ultimately to the detriment of the user population. A number of examples that illustrate the variety of problems that may arise are being provided by the replies to the questionnaire as well as by other sources. 31. Most respondents tend to see major general obstacles in what the question refers to as “lack of clarity in the definition and distribution of powers, responsibilities and obligations”. In broad terms, several countries face similar issues in the organisation of health care. As one country with a highly developed health care system reports, the different services are not sufficiently integrated and do not always co-operate, one result being unnecessarily long hospital stays of patients. Further, the co-operation of the different professions in the health field is not sufficiently close in order to ensure optimal care. Thus too many diagnostic steps as well as medical procedures are being undertaken which may not always be medically justified. Another country with similar high standards in health care regrets the fragmentation of responsibilities in this field which in this case is divided between the central (or federal) health administration and regional/provincial and local health care organisations. This lack of co-ordination as well as the lack of networking is said to have a negative effect on the quality of care (Germany and Austria, government health care services). An OECD report (1998) on Finland’s health care system – which is doing well according to most health indicators – points nevertheless to problems arising from large regional differences in per capita expenditure and in treatment practices, poor municipal control over service providers, overlapping services and parallel systems of funding. 32. In the field of social protection, some countries which operate in so-called “difficult socio-economic systems” due to their transition to a market-oriented economic and social system during the last decade, the social protection system is considered as still being in flux and not yet fully structured. In the areas of social assistance and social services in particular, frictions arise due to lack of clearly defined lines in the distribution of powers and responsibilities mainly at district and local levels. In several of these countries a devolution process has been initiated, though without guarantees of funding local authorities which are expected to provide the services for which they are responsible. According to Russian government sources, deficiencies exist in the management of the system with regard to sharing responsibility between federal, regional and local authorities. This is apparently due, at least in part, to the lack of clear demarcation lines of responsibility, with the result that one layer of government can hold another accountable or can apportion responsibility to another for the delivery of services. 33. Yet these problems are not unique to former centrally controlled economy countries. Thus, according to a government source from Italy, rules in the complex social protection system are reported to be heterogeneous as they had been drawn up in different periods since 1945, yet are still in force and not easily definable. A major problem mentioned by the same source is the lack of balance between the expenditures for the pension system and those for social assistance which is allocated a relatively small part of the overall social budget, although it is a constitutional right. As there is still no national law governing social assistance, the various agencies providing health and social benefits are fragmented and have to relate to different competencies represented by the state, regional and local authorities. 34. Reports from one country in particular (source: several NGOs from Ireland) point to the lack of an integrated system of service delivery within the area of social protection, that is assistance being provided by a number of different administrative services. Thus failure to obtain a particular benefit is unlikely to lead to access to another. Services such as income maintenance, health, housing etc. have different requirements for means tests, yet the information that has to be provided with each claim is basically the same. The same sources point to the frequent unawareness of staff regarding other services, concluding that only voluntary information services have an overview of the protection and social welfare system in their country. An NGO source from Switzerland explains that every branch within the Swiss social security system functions within its own legislative framework. This makes for a great diversity in applications of the law, in benefits, in administrative and financial organisation with the result that access to benefits is rendered difficult because of the complexity of the system and the lack of co-ordination between its different components. The same source considers the rights and benefit systems as too fragmented and therefore lacking transparency. This is supposedly due to the organisation of the protection system and to its lack of in-built co-ordination and harmonisation of benefits and services. Furthermore, in Switzerland, certain areas such as maternity and family benefits, despite the fact that they are constitutionally regarded as areas of federal competence, are still managed by the cantons which means that there are 26 different legislative codes (Bonoli, G., 1997). 35. Other examples of high fragmentation of their social insurance/social protection systems are France and Greece. The French system consists of a set of compulsory basic ‘regimes’ such as health, pensions, family benefits etc. to which anyone who is working must be affiliated, complemented by a number of other ‘regimes’ designed to improve the level of coverage, especially in the areas of health and pensions, which are organised by economic sectors (agriculture, Trade and industry) as well as by economic status (managerial staff – workers/employees). Nearly 20 per cent of the population is thus insured by 120 special schemes that are administered by different funds at national, regional and local level. (Palier, B., 1997). Similarly in Greece social insurance, social assistance and health care are fragmented, consisting of 300 funds corresponding to a large number of professional or occupational groups, covering almost half of the population. The multitude of organisational and administrative structures result in substantial differences in the quantity and quality of coverage and funding. Yet the ultimate decision making power lies almost exclusively with the state (Papadopoulos, T., 1997). 36. Another example for the diversity of central-local relations is provided by the United Kingdom where the functional divisions within the welfare state are overlaid by divisions of responsibility according to spatial scale. These spatial divisions of labour are expressed by the allocation of responsibility for delivering – or ensuring the delivery – of many welfare services to various local authorities. Although the responsibilities are easy to identify, the problem is their relatively frequent change. While in Scotland and Wales district councils (local government) have responsibility for social services, England has five distinct types of local government with similar responsibilities. Alongside elected government there is an extensive array of unelected local agencies which have responsibilities for specific aspects of welfare provision (Cochrane, A., 1997). Even from this very simplified description of a highly complex system, it is apparent that “what are misleadingly called central-local relations are instead characterised by complex cross-cutting networks, which help to constitute the welfare state as a set of relationships rather than a unitary and undifferentiated entity” (Ibid.). IV. Partnership with non-governmental organisations in the improvement of access to social protection 37. From a survey such as this which is based on information from both government authorities and non-governmental voluntary organisations working in the field of social protection, arise inevitably questions on the relationship between the two sides. On the one hand, these relations have become more complex over the last decades with growing individualisation, the decline of traditional family structures and the increasing diversification of populations due to large-scale migration. On the other hand, communication and co-operation between public services and NGOs have steadily improved with the growing realisation that the state could – and should – not create and implement the whole range of social protection services. Because of the long tradition of voluntary engagement in Western Europe, its welfare states have always relied upon an active citizenry – the main feature of a civil society – and on the major role played by voluntary bodies. This role is being played mostly at a national and local level – though international NGOs have gained considerable importance – often intermediating between citizens and the state authorities. Although there are large differences between the kinds of NGOs regarding financial resources, power relations and political influence, they all play a role in putting forward the needs of specific groups in the population, eventually leading to new policies and legislation. There are also considerable differences in modes of organisation in the co-operation between volunteers and professionals and state and municipal welfare authorities. This diversity of the roles of state and non-governmental and voluntary groups is due to historic and cultural traditions of the different countries. 38. Generally speaking, NGOs occupy an area between the state and the market where social aims are being pursued and that is not – or not yet or no longer – adequately covered by either of the two. Thus for example increasing withdrawal of the central state leads to a growing role of the local authorities and of the voluntary sector as a service provider in the health and welfare fields. In addition, in securing, rendering and procuring social and care services, NGOs fulfil a variety of functions, – information, self-help, as advocate for individuals and groups, as pilots of new approaches to services, campaigners for social rights as well as constructive critics as the replies to the questionnaire show. As critics they may not always be appreciated by government services because they raise questions of clients’ rights and power, of exclusion and equality. They have been – and are increasingly – promoting the development of a consumer-oriented approach in the public services, involving consumers, that is clients and receivers of benefits and services more closely in the planning and the delivery of public welfare services. 39. One of the main aspects of the consumer-oriented approach is the improvement of access to services, – the need to make services more readily available to consumers through 1) decentralisation of delivery to small-scale, locally based units, both within and outside the public sector, 2) by changing the style in which services are provided at the point of delivery and 3) by ensuring that the service that is provided is fully integrated. . Services provided in the context of neighbourhood, the family and other small nets at the “human” scale, are almost by definition more accessible. This is particularly important for people who are tied to their immediate environment because of limited mobility, lack of income or domestic commitments. Therefore the importance of decentralisation may be considered a main factor in any reform of public welfare services. 40. Attention to the role of voluntary organisations has also been drawn in a document submitted to the U.N. General Assembly at its 24th Special Session of 23 June 2000 (A/S-24/2/Add.2 (Part II) that calls upon member States to “promote the contribution that voluntarism can make to the creation of caring societies as an additional mechanism in the promotion of social integration....The Commission for Social Development is invited to consider the issue in 2001, the International Year of Volunteers....promote the involvement of volunteers in social development, inter alia, by encouraging Governments, taking into account the views of all actors, to develop comprehensive strategies and programmes, by raising public awareness about the value and opportunities of voluntarism and by facilitating an enabling environment for individuals and other actors of civil society to engage in, and the private sector to support the voluntary activities” (paragraphs 54 and 55). 41. A few examples from Council of Europe member States are chosen to illustrate the role of volunteering in the social field. In Finland most of the welfare services are provided by local authorities and financed from municipal taxes and state subsidies while 10 per cent of the costs are covered by fees paid by clients. As these services may fail to reach persons in real need, voluntary organisations are often considered “suitable for dealing with the leftover excluded population” (VIP, 1999). According to this source, statistics and research clearly show that new polarisation processes are going on in society, resulting in the exclusion of vulnerable people and groups. Thus the voluntary sector plays an important role considering there are over 100,000 registered voluntary organisations in Finland (pop. 5 million) and there are about 700,000 volunteers involved in different kinds of activities. These organisations account for almost 25 per cent of all the health and welfare services provided. 42. An example of a neighbourhood volunteer programme is the British “Home Start Programme”. It is run by neighbourhood volunteers experienced in the education of their own children, offering families support, friendship and practical help. Started in 1973, there are today 200 Home Start agencies with over 5,000 volunteers. Each agency has a paid co-ordinator responsible for the funding of the programme and the recruitment of volunteers. The programme is designed to help isolated parents or families with disabled children, newly arrived families, lone mothers etc. Similar programmes exist in Sweden for ambulant psychiatric patients and in the Netherlands (‘Optap’ – for the integration of young or immigrant families, newly settled in a neighbourhood) and in Germany (“Familien im Stadtteil”). In the Netherlands, according to one source, “the government’s policy in relation to migrants, poverty and educational inequality has mainly a ‘top-down’ character while organisations and groups of citizens, that is NGOs, try to tackle the problem from ‘bottom-up’ “ (Gabriels, R., 1999). Thus aid-schemes have been initiated by one NGO in form of non-profit savings and credit unions for the provision of loans to migrants. Migrant work by NGOs is also reported from Austria where volunteer groups assist migrants with integration through language courses, information and counselling. One of these projects won the UNHRC Refugee Award in 1996. 43. The Ministry of Social Affairs of Denmark has increasingly co-operated with funded voluntary agencies whose work, complementing professional approaches, has produced positive results, particularly among the least privileged groups. In this way voluntary work supplements public policies. It has been noted in Denmark that private individuals, civic and local community groups etc. frequently come up with novel solutions and ways of working together. Further, experience has shown that voluntary initiatives are often more flexible and may reach further and wider than public measures. This may be due to the approach adopted by the voluntary organisations which allows users and voluntary workers to meet on equal footing. In Denmark co-operation with voluntary organisations typically consists of the local authorities putting premises and other facilities at the former’s disposal; some are also granted financial support. In Italy where volunteering is regulated by legislation (Law No.266/1991), the voluntary sector has grown continuously since the middle 1990s and is co-operating with local authorities, providing social services within the context of the law. The sector offers services that complement the often inadequate social and health care by public providers (VIP, 1999). 44. In central and eastern European countries, non-governmental organisations had fallen into oblivion during the decades of totalitarian rule. After its downfall in 1989 however they were rediscovered and very quickly began to be active in different sectors. The change in the system gave an impetus to many citizens to become involved in the promotion of causes that in their opinion seemed important. Most of the new initiatives concerned – and continue to do so – the protection of the environment, social welfare and social policy as well as humanitarian aid. The number of NGOs has grown considerably in most of these countries, though, as one study points out, “most are, at best, tolerated by government and rarely seen as partners...(yet) increasingly supranational and international programmes, including UNHRC, EU Phare, TACIS etc. promote the work of partner NGOs as providers of social welfare services” (Deacon, B., 1997). 45. In Poland NGOs are reported to be “mushrooming as a sign of a new civic initiative, but lacking public support and control...The challenge lies in the devolution to decentralised levels (i.e. municipal) and to non-profit, private and voluntary organisations, particularly NGOs” (POMOST-selfhelp, 1998). In this country about 3,500 organisations are actively providing services, that is, provision of basic goods and services for the poor, elderly, lone or disabled persons etc. or act as interest organisations or advocacy groups. A number of problems, – not unknown to NGOs in EU-countries – have arisen in Poland and still remain to be regulated, to mention but a few: a clear division of responsibilities between central, regional and local authorities on the one hand and NGOs on the other hand; appropriate legal provisions regulating the co-operation between state institutions and NGOs; principles of financial support for NGOs by state organs (ibid.) 46. In the Czech Republic, the reorganisation of the social security system which took place in 1996 rests on three components: social insurance, state income support and social assistance and is demarcated in terms of finance and administration. While the first two are governed by the principle of solidarity as laid down in social legislation, social assistance is designed for people and needs that are not covered by the other two schemes and is supposed to prevent poverty and destitution through provision of cash benefits, of existential minima (food, clothing and shelter) and social services. The scheme is financed through government grants to local authorities. However, according to one source, “local authorities are neither prepared nor sufficiently organised to cope with potential demand ...in this situation it is the voluntary sector and charities that are heavily relied upon for local support and services” (Castle-Kanerova, M., op.cit.) 47. An increasing role of the voluntary sector is also reported from Hungary where in 1998 existed over 50,000 registered voluntary civil organisations, providing information, medical care, day care, home nursing etc. (Szeman, Z., 1999). The beneficiaries of their services are composed of 51 per cent youth, 44 per cent elderly, 31 per cent disabled, 30 per cent of people with health impairment, 28 per cent of families in difficulties, 25 per cent destitute people. Over half of the 3,000 local authorities have concluded agreements on co-operation with civil organisations. This situation arose when due to changes in the system in 1990, the central state began to withdraw from the economy and from social protection and welfare. 48. Summing up it may be said that, according to a recent report of the European Commission on “The social situation in Europe 2000”, although “there is very little scientific evidence on volunteering and voluntary activity in the Member States, but what there is suggests that it is extensive and has been growing....A Survey of over 20,000 people across Europe found that one in four Europeans undertakes unpaid work for a variety of charitable causes and voluntary groups.” The concept of civil society citizens acting from their own volition for the common good is also making its way, as shown above, in the countries of central and eastern Europe. Boudahrein, A. “The insecure social protection of migrant workers from the Maghreb”, in International Social Security Review (Geneva), 2/2000, p.55
APPENDIX-QUESTIONNAIRE ON ACCESS TO SOCIAL PROTECTION The information to be collected by means of this questionnaire covers all existing social security and social assistance benefits as well as benefits provided by social services, whether at national, regional or local level. Could you briefly describe your scheme of social protection? (social security scheme, social assistance and social services). A-Obstacles I. General obstacles 1.1- In the performance of their task of social protection, do the people or institutions in charge of the management of benefits and social services encounter particular difficulties in providing these benefits or services? (for example due to: lack of resources, inadequate training of personnel, lack of clarity in the definition and distribution of powers, responsibilities and obligations). II. Structural obstacles 2.1- Concerning existing benefits and services, please describe: how effective are the administrative appeal procedures in place ? (provide statistics on the extent of refusal of benefits and services and the proportion of refusals giving rise to appeals). the relations between the different social services providers and decision-makers (are these relations good enough to ensure that the potential beneficiary is directed to the appropriate body in the case of error?) the consequences of a possible lack of information. the eventual interdependence between access to the different benefits or services. 2.2- Does failure to qualify for one of these benefits or services lead to a series of refusals and exclusion? III. Practical and administrative obstacles 3.1- Please describe the obstacles of a practical or administrative nature encountered by the beneficiaries of social benefits and/or social services, such as for example: Physical obstacles
Qualitative aspects of provision
Quantitative aspects of provision
IV. Psychological obstacles 4.1- Are there benefits or services which give the beneficiary a feeling of being socially stigmatised? If so, concerning which benefits? what are the consequences of such stigmatisation? (for example: self-censorship by beneficiaries: limitation or non-submission of claims for benefits or services; effect on health; social marginalisation of beneficiaries ( elderly people, people with handicaps, ethnic minority, etc… )) - Are there benefits or services which give rise to fear in certain beneficiaries, thus having the effect of limiting access to these benefits or services? (for example the hospital atmosphere, doctors, the bureaucratic machine); if so, describe the effects of limiting access to the benefits or services. - Do you know of any other psychological obstacles to access to social protection? (for example the psychological isolation of certain potential beneficiaries).
- Do you consider that the information disseminated concerning entitlement to benefits and existing procedures for its provision are adequate? from the qualitative standpoint
- Has the development of the use of new technologies caused problems for certain beneficiaries because of the way in which benefits are now granted or claims made? (for example computerisation of payment for health care, reimbursement to a bank account, etc.) VI. Socio-cultural obstacles - To your knowledge, are there any minority groups who remain excluded from certain benefits or services or for whom access to certain benefits or services is made difficult? - Does the low educational level of certain people or groups have an impact on their effective access to certain benefits or services? (for example are there special procedures for illiterate people or the socio-culturally disadvantaged?) VII.- Other types of obstacle Do you know of any other types of obstacle to access to benefits or social services that have not been mentioned above? If so, could you please describe them briefly? B- Examples of good practice and innovative measures With a view to the elimination of the obstacles enumerated in Part A of this questionnaire, do you know of any mechanisms that have been introduced at national, regional or local level and that can help promote effective access to benefits or social services? Several of the Council of Europe’s instruments in the field of social security and social assistance (notably the European Social Charter and the Revised Charter) are mentioned briefly in paragraph 17. Since it was established, the Council of Europe has studied the question of the rights of migrant workers and drawn up legal instruments aimed at facilitating their access to social protection. The Council of Europe’s instruments in the field of coordination are currently in force in several member states. The European Interim Agreements concerning social security systems and the European Convention on Social Security cover the nine traditional branches of social security. The European Interim Agreements have two objectives: to ensure equality of treatment on the territory of each Contracting Party between nationals of the Contracting Party and those of other Contracting Parties with regard to social security laws and regulations and to extend to all nationals of Contracting Parties the benefits of bilateral and multilateral social security conventions which are in force between two or more Contracting Parties linked by the Interim Agreements. The European Convention on Social Security incorporates the four fundamental principles of international social security law: equality of treatment, determination of the applicable legislation, retention of acquired rights and export of benefits. Under the European Convention on Social and Medical Assistance, each Contracting Party makes provisions in order to ensure that nationals of other Contracting Parties who are lawfully present within its territory and who are in need, receive social and medical assistance under the same conditions as its own nationals. |
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