Conclusion on right to protection of health

January 2014

European Social Charter (revised)

European Committee of Social Rights Conclusions 2013 (UKRAINE) Articles 3, 11, 14, 23 and 30 of the Revised Charter

This text may be subject to editorial revision.

The function of the European Committee of Social Rights is to rule on the conformity of the situation in States with the European Social Charter. In respect of national reports, it adopts conclusions; in respect of collective complaints, it adopts decisions.

Information on the Charter and the Committee as well as statements of interpretation and general questions formulated by the Committee appear in the General Introduction to the Conclusions.1 The European Social Charter (revised) was ratified by Ukraine on 21 December 2006. The time limit for submitting the 5th report on the application of this treaty to the Council of Europe was 31 October 2012 and Ukraine submitted it on 7 January 2013. On 3 April 2013, a letter was addressed to the Government requesting supplementary information regarding Article 23. The Government submitted its reply on 28 June 2013. Comments on the report from All-Ukrainian Council for Patients’ Rights and Safety were registered on 4 March 2013 and comments from Insight, Transgender and ILGA Europe were registered on 19 April 2013.

This report concerned the accepted provisions of the following articles belonging to the thematic group "Health, social security and social protection": •

the right to safe and healthy working conditions (Article 3),

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the right to protection of health (Article 11),

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the right to social security (Article 12),

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the right to social and medical assistance(Article 13),

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the right to benefit from social welfare services (Article 14),

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the right of elderly persons to social protection (Article 23),

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the right to protection against poverty and social exclusion (Article 30).

Ukraine has accepted the Articles from this group with the exception of Articles 12 and 13.

The reference period was 1 January 2008 to 31 December 2011.

The present chapter on Ukraine concerns 11 situations and contains: – 2 conclusions of conformity: Articles 3§1 and 14§2.

– 8 conclusions of non-conformity: Articles 3§§2 to 4, 11§1, 11§2, 14§1, 23 and 30.

In respect of 1 situation concerning Article 11§3, the Committee needs further information in order to assess the situation. The Committee consequently asks the Government to comply with its obligation to provide this information in its next report on the article in question.

The next report from Ukraine deals with the accepted provisions of the following articles belonging to the thematic group "Labour rights": •

the right to just conditions of work (Article 2),

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the right to a fair remuneration (Article 4),

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the right to organise (Article 5),

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the right to bargain collectively (Article 6),

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the right to information and consultation (Article 21), 3

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the right to take part in the determination and improvement of the working conditions and working environment (Article 22),

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the right to dignity at work (Article 26),

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the right of workers’ representatives to protection in the undertaking and facilities to be accorded to them (Article 28),

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the right to information and consultation in collective redundancy procedures (Article 29).

The deadline for the report was 31 October 2013. ________________________ 1 The conclusions as well as state reports can be consulted on the Council of Europe's Internet site (www.coe.int/socialcharter).

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Article 3 - Right to safe and healthy working conditions Paragraph 1 - Safety and health regulations The Committee takes note of the information contained in the report submitted by Ukraine.

General objective of the policy The Committee previously examined (Conclusions 2009) the general objective of the national policy on occupational health and safety and concluded that the situation was in conformity with Article 3§1 of the Charter on this point. It asked for more details in the next report on the sectoral programmes implemented by the ministries and other central executive authorities.

The report states that, by Presidential Decree No. 408/2011 of 6 April 2011 on Regulations governing the State Service of Mining Supervision and Industrial Safety (Derzhhirpromnahlyad), the latter has taken over the role of the State Committee responsible for industrial safety, occupational safety and mining supervision. A central government agency operating under the Ministry of Emergencies, the Derzhhirpromnahlyad is responsible for industrial and occupational safety and exercises supervision over compliance with the relevant legislation. ILO Convention No. 155 on Occupational Safety and Health (1981) was ratified on 4 January 2012.

The report states that Act No. 2694-XII of 14 October 1992 on safety at work calls for a national policy on occupational safety based on activities and measures, and that occupational safety is part of the reform programme “Prosperous Society, Competitive Economy, Efficient State” for 2010-2014. For the purposes of the development strategy “Reforming the Occupational Safety Provision System in Ukraine”, launched by the President on 17 November 2010, the Derzhhirpromnahlyad has devised ways of radically improving occupational and industrial safety through various activities and measures over the next ten years. The report further indicates that, together with the Fund for Social Insurance against Occupational Accidents and Diseases and the social partners, the Derzhhirpromnahlyad also helped draw up the Nationwide Target Programme for the Improvement of Occupational Safety, Occupational Health and the Working Environment for 2012-2016, adopted by Cabinet of Ministers Resolution No. 889 of 31 August 2011. This Programme aims to create a modern working environment, minimise occupational hazards and accidents, industrial incidents and occupational diseases.

In reply to the Committee’s request, the report indicates that under section 4 of Act No. 2694XII, the national policy on occupational safety addresses specific problems through long-term national, regional and sectoral programmes. The sectoral programmes, which are developed by the ministries and central executive authorities under section 33 of Act No. 2694-XII, seek to improve working conditions in companies through the achievement of organisational, logistical and knowledge-based objectives. These objectives are developed on the basis of proposals from central, regional and local authorities, social partners, research institutes and undertakings; of occupational safety problems identified in specific sectors; and of scientific and technological progress. The sectoral programmes include prevention activities such as measures to eliminate risk factors; workplace assessments; implementation of safe production methods and technologies; development of information technology programmes on occupational safety and automated systems for analysis and forecasting on production methods; comparative study of other countries’ experiences, etc. During the reference period, six sectoral programmes were in operation in Ukraine, under the direction of various ministries.

The report states that in the most injury-prone sectors, the Cabinet of Ministers may adopt individual measures such as the Energy and Coal Industry Ministry’s Programme for Improving Occupational Safety in Coal Producing and Mine Building Enterprises for 2006-2010, adopted 5

by Cabinet of Ministers Resolution No. 374 of 29 March 2006 and amended by Cabinet of Ministers Resolution No. 521 of 18 May 2011. This programme envisages a range of initiatives in organisational matters; coal bed degasification; reconstructing mine ventilation systems; preventing gas and dust contamination; improving safety equipment and devices, etc. The report states that 29 sites have been fitted with systems for telecommunication monitoring and automated control of the mining process.

The Committee takes note of the information. It notes that there is a legislative framework which allows a comprehensive approach to occupational health and safety. It also notes that the report describes a considerable number of initiatives for developing an occupational health and safety policy which had not reached the implementation stage in the period under review. It asks that the next report provide examples of how these initiatives have helped to create a culture of prevention in respect of occupational health and safety in practice. It also wishes to know whether these policies are regularly reviewed in the light of changing risks.

Organisation of occupational risk prevention The Committee previously examined (Conclusions 2009) the organisation of occupational risk prevention and concluded that the legislation and regulations provide for prevention in public authorities’ activities at national and regional level, and also at company level. It asked for more information on the preventive role of the Derzhhirpromnahlyad and on the functioning and action of the Council for policy-making in expert examination of industrial and occupational safety.

The report states that Cabinet of Ministers Resolution No. 994 of 27 June 2003 indicates the measures and capital expenditure required in the field of occupational health and safety. Derzhhirpromnahlyad Order No. 35 of 22 February 2008 sets out recommendations for the design, implementation and improvement of occupational safety management systems, which according to the report more than 60% of companies in Ukraine use. The aim is to extend them to all companies, irrespective of the sector, number of staff and ownership pattern. The report states that in 2010, the Ministry for Energy and Coal Industry introduced a system of production and labour protection management in the coal industry. This establishes a unified procedure for mining enterprises, which aims to ensure that mining is carried out safely in accordance with the requirements of the legislation on mining. The procedure includes occupational safety regulations; job descriptions; labour protection services; regular meetings of standing committees on occupational safety; plans to improve working conditions; and disciplinary and administrative penalties.

In reply to the Committee’s request, the report states that the Derzhhirpromnahlyad exercises supervision pursuant to the Act No. 877-V of 5 April 2007 on the basic principles of state oversight in the field of economic activity. Occupational accidents are investigated by an ad hoc commission set up by the employer, and by the Derzhhirpromnahlyad as special investigations in the case of fatal, serious or group accidents. On completion of the investigation, the employer is required to take measures on the commission’s recommendations within five days, which are appended to the report. The employer must also inform the Derzhhirpromnahlyad about the implementation of the measures within a prescribed period.

Under Act No. 2694-XII the Derzhhirpromnahlyad may take administrative action against any workers who have committed breaches of the law; notify the unsuitability of some posts to the employer; and submit findings to prosecution authorities for the purpose of instituting criminal proceedings. The report indicates that all findings of special investigations are submitted to the prosecution authorities.

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In reply to the Committee’s request, the report also states that the Council for Policy-Making in Expert Examination of Industrial and Occupational Safety operated from 2008 to 2010. Its task was to advise the Derzhhirpromnahlyad on improvements to the system of expert examination and certification, impartiality of the work, and representation of the interests of the various stakeholders (undertakings, institutions, universities, trade unions, media). It proposed measures to ensure that expert examinations were carried out in a transparent and impartial manner, devised testing methods and prepared draft regulatory instruments.

The Committee takes note of this information. It notes that, while it describes certain measures aimed at organising occupational risk prevention, the report provides no information on how these measures are implemented in sectors other than mining. It therefore asks that the next report provide information on the assessment of work-related hazards and the adoption of preventive measures geared to the nature of hazards, and on information and training measures for workers. It also requests information on the part played by the Derzhhirpromnahlyad in developing a health and safety culture among employers and workers, and on the requirement for the labour inspectorate to share (practical instruction, prevention measures, advice) knowledge of occupational risks and prevention gained through inspection activities.

Improvement of occupational safety and health The Committee previously examined (Conclusions 2009) improvements in occupational safety and health.

The report states that the Derzhhirpromnahlyad is in charge of scientific research and methodological support in the field of occupational safety via the National Research Institute for Industrial and Occupational Safety; that it introduces procedures for training and testing the knowledge of workers and employer’s representatives; and that supervises the activities of the Fund for Social Insurance against Occupational Accidents and Diseases. It is advised in this task by the Scientific and Technical Council, which deals with issues relating to scientific and technological progress in this area; safe working methods; and training for employers and workers. It also relies on an integrated system of scientific and technical support for supervision, made up of the 25 Expert Technical Centres (ETCs) which maintain a database on high risk exposure in companies all over the country, and which carry out ad hoc tasks; provide legal opinions on draft regulatory instruments; conduct expert reviews and inspections of machinery; and provide training in occupational safety. The Derzhhirpromnahlyad also runs the National Research Institute for Industrial and Occupational Safety which carries out scientific tests at the request of companies and government bodies; conducts research in the field of technical regulation, standardisation and certification; publishes scientific literature; analyses occupational accidents; makes improvements to methods of state supervision; and deals with science and technology policy.

The report states that compulsory training for public officials in charge of occupational safety in the various sectors and regions, company managers, heads of universities, employees responsible for the organisation of production and workers employed in hazardous jobs is provided in the Chief Training and Methodological Centres (CTMCs) and the ETCs. The report explains that, when carrying out inspection visits, the Derzhhirpromnahlyad checks to ensure that anyone required to undergo training is in possession of the necessary certificates.

Alongside these training efforts, a university-level degree in occupational safety has been introduced, and immediate measures adopted, by Joint Ordinance of the Ministry of Education and Science, Youth and Sport and the Ministry of Emergencies No. 969/922/216 of 21 October 2010 on the organisation and improvement of training in occupational safety, the safety of vital 7

activities and civil defence, to incorporate the basics of occupational safety in degree courses in all disciplines and all universities.

The Committee takes note of this information. It observes that there is a system which is designed to improve occupational health and safety through research, development and training. It asks that the next report provide information on the resources allocated to the institutions and bodies mentioned and on the materials (recommendations, guides, good practice, advice) aimed at undertakings in the private sector.

Consultation with employers’ and workers’ organisations The Committee previously examined (Conclusions 2009) the consultation with employers’ and workers’ organisations under Article 3§2 the Charter. It deferred its conclusion pending receipt of updated information on the scope and content of the General Agreement on Occupational Safety and Workers’ Protection (General Agreement).

In reply to the Committee’s request, the report states that the General Agreement was concluded on 15 April 2008 pursuant to Act No. 3356-XII of 1st July 1993 on collective agreements between, on the one hand, the Cabinet of Ministers and employers’ organisations and, on the other hand, workers’ organisations. It provides for social dialogue in the field of occupational health and safety and promotes the inclusion in regional, sectoral and companywide agreements to eliminate harmful and dangerous factors. It was renewed on 9 November 2010 via the Agreement regulating the basic principles and rules governing the implementation of socio-economic policy and labour relations for 2010-2012, which provides for occupational safety training for students and trainees from higher educational institutions; the establishment of labour protection services in national and local authorities; the introduction of statistical reporting on occupational safety issues; and revision and updating of the rules governing the provision of personal protection equipment. The Cabinet of Ministers adopted an action plan to implement this Agreement by Ordinance No. 261-p of 20 March 2011.

The report indicates that the existence of the National Tripartite Social and Economic Council (National Council), established by Presidential Decree No. 1871 of 29 December 2005 on the development of social dialogue, was confirmed by Presidential Decree No. 347 of 2 April 2011.

Under Act No. 2862-VI of 23 December 2010 on social dialogue, which sets out the procedure for social dialogue, the National Council is called upon to improve the protection and the monitoring of occupational health and safety.

The report further explains that representatives of the social partners are represented at board meetings of the Derzhhirpromnahlyad and its regional branches, as well as meetings of the commissions responsible for investigating occupational accidents and diseases. At regional and local level, the Derzhhirpromnahlyad works with the social partners through sectoral or regional agreements, such as those concluded on 24 June 2009 and 28 April 2011 with the Federation of Trade Unions of Ukraine.

The Committee takes note of this information. It notes that there is a system for consulting social partners at public authority level. It also notes that the General Agreement was not truly tripartite as it allied the Cabinet of Ministers and employers’ organisations. It asks that the next report provide information on consultation with the competent occupational health and safety bodies within enterprises, in particular enterprises where there are no workers’ representatives.

Conclusion

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Pending receipt of the information requested, the Committee concludes that the situation in Ukraine is in conformity with Article 3ยง1 of the Charter.

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Article 3 - Right to safe and healthy working conditions Paragraph 2 - Safety and health regulations The Committee takes note of the information contained in the report submitted by Ukraine.

Risks covered by the regulations The Committee previously examined (Conclusions 2009) the extent of the risks specifically covered by the legislation and regulations on health and safety at work. It deferred its conclusion pending receipt of information requested on whether the regulations on safety at work cover the majority of workers and on whether they were to be extended to all sectors of the economy; on the levels of prevention and protection granted by Act No. 2694-XII of 14 October 1992 on safety at work; and on the National programme for adjusting Ukrainian legislation to EU law (National Programme) in matters related to safety at work.

The report states that the State service of mining supervision and industrial safety (Derzhhirpromnahliad) undertook to review the legislative and regulatory acts developed in the USSR by Order No. 225 of 1st November 2010 to approve the Action plan for stock-taking and systematisation of USSR laws applied in accordance with Resolution of the Verkhovna Rada No. 1545 of 12 September 1991 on the procedure of temporary validity of some USSR laws in the territory of Ukraine. Derzhhirpromnahliad Order No. 62 of 22 March 2010 on coal mine safety rules establishes new regulations for the safe conduct of mining work and the safe use of equipment, ventilation and emergency protection. These regulations apply to coal mines and to external undertakings or institutions performing works in these mines.

In reply to the Committee’s request, the report states that, in accordance with Derzhhirpromnahliad Order No. 151 of 8 June 2004 on the Regulation on the State register of regulatory acts on safety at work, the current body of regulations is listed with the State register of regulatory acts on safety at work, and applies to all undertakings in several sectors of the economy. It also indicates that in accordance with Act No. 1629-IV of 18 March 2004 on the National Programme, and with the Partnership and Co-operation Agreement of 14 June 1994 (PCA), regulations are harmonised with the Community acquis. During the reference period, Ministry of Emergencies Order No. 459 of 19 July 2006 incorporated Council Directive 92/104/EEC of 3 December 1992 on the minimum requirements for improving the safety and health protection of workers in surface and underground mineral-extracting industries; Ministry of Emergencies Order No. 627 of 22 March 2012 on requirements for the protection of workers from harmful exposure to chemical agents implemented Council Directive 98/24/EC of 7 April 1998 on the protection of the health and safety of workers from the risks related to chemical agents at work, Commission Directive 91/322/EEC of 29 May 1991 establishing indicative limit values, Commission Directive 2000/39/EC of 8 June 2000 establishing a first list of indicative occupational exposure limit values, and Commission Directive 2006/15/EC of 7 February 2006 establishing a second list of indicative occupational exposure limit values.

According to the National Profile on Occupational Safety and Health (pp. 19-20) (National Profile),1 Council Directive 89/656/EEC of 30 November 1989 on the minimum health and safety requirements for the use by workers of personal protective equipment at the workplace and Council Directive 92/91/EEC of 3 November 1992 concerning the minimum requirements for improving the safety and health protection of workers in the mineral-extracting industries through drilling were also incorporated into national law. ILO Convention No. 184 on Safety and Health in Agriculture (2001) was ratified on 1st December 2009; ILO Conventions No. 176 on Safety and Health in Mines (1995) and No. 174 on the Prevention of Major Industrial Accidents (1993) were on 15 June 2011. According to the Decent Work Country Profile (pp. 46-48),2 10

legislation and regulations are focused on technical details, lack a modern approach to promoting prevention of injuries and disease, and do not require risk assessment in all workplaces.

The Committee takes note of this information. It notes that efforts have been undertaken to incorporate international standards of exposure to occupational risks into specific legislation and regulations. It nevertheless notes that, during the reference period, only few relevant ILO Conventions were in force, and much of the Community acquis, stemming from Directive 89/686/EEC of 21 December 1989 on the approximation of laws of the Member States relating to personal protective equipment, as amended by Council Directive 96/58/EC of the European Parliament and the Council of 3 September 1996; Directive 97/23/EC of the European Parliament and of the Council of 29 May 1997 on the approximation of laws of the Member States concerning pressure equipment; Directive 2002/44/EC of the European Parliament and of the Council of 25 June 2002 on the minimum health and safety requirements regarding the exposure of workers to the risks arising from physical agents (vibration); Directive 2003/10/EC of the European Parliament and of the Council of 6 February 2003 on the minimum health and safety requirements regarding the exposure of workers to the risks arising from physical agents (noise); Directive 2009/104/EC of the European Parliament and of the Council of 16 September 2009 concerning the minimum safety and health requirements for the use of work equipment by workers at work, was not reflected in the current national law. The Committee therefore considers that the legislation and regulations in force do not meet the general obligation under Article 3ยง2 of the Charter, which requires that most of the risks listed in the general introduction to Conclusions XIV-2 be specifically covered, in line with the level set by international reference standards.

Levels of prevention and protection The Committee examines the levels of prevention and protection provided for by the legislation and the regulations in relation to certain risks.

Establishment, alteration and upkeep of workplaces The Committee previously examined the prevention and protection levels in relation to the establishment, alteration and upkeep of workplaces (Conclusions 2009).

The report states that production buildings, machines, equipment and manufacturing processes must meet requirements set by Act No. 2694-XII. The conduct of highly hazardous works and the operation of highly hazardous machines, mechanisms and equipment require authorisation by the Derzhhirpromnahliad in accordance with Cabinet of Ministers Resolution No. 1107 of 26 October 2011 on the Procedure to issue authorisations for conduct of highly hazardous works and operation of highly hazardous machines, mechanisms and equipment. The National Profile (pp. 6-14) lists many more regulations, such as Cabinet of Ministers Resolution No. 442 of 1 August 1992 on the Procedure for the certification of working conditions at the workplace; Ministry of Health Order No. 528 of 27 December 2001 on Hygienic classification of work types based on harmful and hazardous occupational factors and work stress; Derzhhirpromnahliad Order No. 208 of 27 September 2004 on technical regulations on conformity certification of personal protective equipment.

The report indicates that Cabinet of Ministers Resolution No. 898 of 8 October 2008 on the Technical regulation to certify equipment and protective systems for use in potentially explosive atmospheres takes account of Directive 94/9/EC of the European Parliament and the Council of 23 March 1994 on equipment and protective systems intended for use in potentially explosive 11

atmospheres; Cabinet of Ministers Resolution No. 1262 of 25 November 2009 on the Technical regulation on occupational safety and health signs takes account of Council Directive 92/58/EEC of 24 June 1992 on the minimum requirements for the provision of safety and health signs at work; Minister of Emergencies Order No. 67 of 25 January 2012 on the General requirements for employers to secure occupational safety implements Council Directive 89/654/EEC of 30 November 1989 concerning the minimum safety and health requirements for the workplace and of Directive 2009/104/EC of the European Parliament and of the Council of 16 September 2009 concerning the minimum safety and health requirements for the use of work equipment by workers at work. According to the National Profile (p. 19), Council Directive 90/270/EEC of 29 May 1990 on the minimum safety and health requirements for work with display screen equipment was incorporated, and Council Directive 90/269/EEC of 29 May 1990 on minimal safety and health requirements for the manual handling of loads where there is a risk particularly of back injury to workers was partially so.

The Committee takes note of this information. It asks for comprehensive information on any regulatory acts to implement the provisions of Act No. 2694-XII quoted in the report. It also asks whether employers are under the duty to assess exposure to occupational risks beyond highly hazardous works and highly hazardous machines, mechanisms and equipment.

Protection against hazardous substances and agents The Committee previously examined (Conclusions 2009) the levels of prevention and protection in relation to asbestos and ionising radiation. It deferred its conclusion pending receipt of information on the implementation of international standards relating to asbestos and to ionising radiation.

In reply to the Committee’s request, the report states that amphibole asbestos is forbidden, that the State sanitary and epidemiological service (Derzhsanepidsluzhba) files chrysotile asbestos with the State register of hazardous factors, and that asbestos-using undertakings are supervised in accordance with the Sanitary rules for work with asbestos and ILO Convention No. 162. All workers exposed to asbestos or asbestos-containing materials undergo preliminary and annual medical examinations under Ministry of Health Order No. 246 of 21 May 2007 on the Procedure for medical examination of certain worker categories. Workplaces where asbestos and asbestos-containing materials are used are subject to assessments. A study by the Institute of Labour Medicine on the impact of working conditions in asbestos cement production confirmed that the chrysotile asbestos fibre content at most workplaces complied with international standards and found no case of occupational disease. New regulations were drafted to take ILO Convention No. 162, ILO Recommendation No. 172 concerning safety in the use of asbestos (1986) and the ILO Code of Practice on Safety in the use of asbestos (1984) into account. Some 4 000 workers are exposed to chrysotile asbestos in production, and 50 000 in services to production such as construction.

ILO Convention No. 139 on occupational cancer (1974) was ratified on 17 June 2010. The National Profile (p. 48) ranks exposure to asbestos as a moderate problem, and reports (p. 19) that there is consensus among public authorities and social partners that ILO Convention No. 162 should be ratified in the near future.

The Committee takes note of this information. It notes that, during the reference period, the draft regulations on the protection of the health of workers exposed to asbestos and asbestoscontaining materials were not yet in force. It therefore considers that levels of prevention and protection against asbestos are not in line with the benchmark international standards. It requests that the next report indicate whether ILO Convention No. 162 was ratified and draws 12

the Government’s attention to Recommendation 1369 (1998) of the Parliamentary Assembly on dangers of asbestos for workers and the environment,3 which calls for the elimination of asbestos where current technological knowledge permits.

In reply to the Committee’s request, the report states that Chief State Health Officer Resolution No. 62 of 1 December 1997 to approve the Radiation safety standards (NRBU-97) regulates the safe operation of sources of ionising radiation and exposure levels for the society at large. They are in line with ILO Convention No. 115 on Radiation Protection (1960) and ILO Recommendation No. 114 on the Protection of workers against ionising radiations (1960).

Ministry of Health Order No. 54 of 2 February 2005 to approve Principal sanitary regulations for the provision of radiation safety (OSPU-2005) establishes standards of protection against ionising radiation at work. Occupational accidents which occur at nuclear plants are investigated in accordance with Cabinet of Ministers Resolution No. 1232 on some matters concerning investigation and recording of occupational accidents, occupational diseases and industrial accidents. According to the State Nuclear Regulatory Committee (Derzhatomrehuliuvannia), workplace assessments conducted in accordance with Act No. 2694-XII have confirmed that its employees are exposed to harmful working conditions and are entitled to preferential pension coverage, additional paid leave, reduced working hours, and personal protective equipment.

The National Profile (p. 48) ranks exposure to ionising radiation as a moderate problem.

The Committee takes note of this information. It asks for information in the next report on whether the NRBU-97 and the OSPU-2005 incorporate either ICRP Recommendation (1990) or Council Directive 96/29/EURATOM of 13 May 1996 laying down basic safety standards for the protection of the health of workers and the general public against the dangers arising from ionising radiation. It also asks for information on whether obligations have been undertaken under the National Programme or the PCA to incorporate Council Directive 97/43/EURATOM of 30 June 1997 on health protection of individuals against the dangers of ionising radiation in relation to medical exposure, and Council Directive 2003/122/EURATOM of 22 December 2003 on the control of high-activity sealed radioactive sources and orphan sources.

Personal scope of the regulations The Committee examines the personal scope of legislation and regulations with regard to workers in insecure employment.

Temporary workers The Committee previously examined (Conclusions 2009) the protection of agency or temporary workers or employees on fixed-term contracts under occupational health and safety legislation and regulations. It deferred its conclusion pending receipt of information on how medical surveillance and representation at work is made available for these types of workers.

In reply to the Committee’s request, the report states that in accordance with Act No. 2694-XII, preliminary and periodic health examination, which under Ministry of Health Order No. 246 is compulsory for workers employed in heavy works, works with harmful or hazardous working conditions or works requiring professional selection, includes temporary workers. The National Profile (p. 20) reports that Council Directive 91/383/EEC of 25 June 1991 supplementing the measures to encourage improvements in the safety and health at work of workers in fixedduration employment or in temporary employment, should be reflected in national legislation in the near future.

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The Committee takes note of this information. It notes that non-permanent and temporary workers employed in heavy works, works with harmful or hazardous working conditions or works requiring professional selection have access to medical surveillance. The report contains no information on the representation of these workers at work. Recalling that all workers, all workplaces and all sectors of the economy must be covered by health and safety regulations,4 the Committee asks for information on whether agency or temporary workers or employees on fixed-term contracts in other sectors of the economy involving exposure to high risks than mining, or at any workplaces, have access to medical surveillance and are represented at work.

It also asks for information and concrete examples of how these types of workers receive training and information in occupational health and safety matters.

Other types of workers The Committee previously examined (Conclusions 2009) the coverage of self-employed, home and domestic workers by occupational health and safety legislation and regulations. It deferred its conclusion pending confirmation that these types of workers are covered as well.

In reply to the Committee’s request for information, the report states that occupational health and safety legislation and regulations apply to all legal and natural persons using agency workers, as well as to all types of workers including self-employed ones.

The Committee takes note of this information. It asks that the next report indicate how information and training on occupational health and safety, and medical surveillance is made available to self-employed, home and domestic workers in practice. It also asks for information on existing arrangements for the representation of these types of workers at work.

Consultation with employers’ and workers’ organisations The Committee previously examined (Conclusions 2009) the consultation with employers’ and workers’ organisations under Article 3§2 the Charter. It deferred its conclusion pending receipt of updated information on the scope and content of the General Agreement on Occupational Safety and Workers’ Protection (General Agreement).

In reply to the Committee’s request, the report states that the General Agreement was concluded on 15 April 2008 pursuant to Act No. 3356-XII of 1st July 1993 on collective agreements between, on the one hand, the Cabinet of Ministers and employers’ organisations and, on the other hand, workers’ organisations. It provides for social dialogue in the field of occupational health and safety and promotes the inclusion in regional, sectoral and companywide agreements to eliminate harmful factors. It was renewed on 9 November 2010 by the Agreement regulating the basic principles and rules governing the implementation of socioeconomic policy and labour relations for 2010-2012, which provides in particular for the establishment of labour protection services in national and local authorities; the introduction of statistical reporting on occupational safety issues; and revision and updating of the rules governing the provision of personal protection equipment. The Cabinet of Ministers adopted an action plan to implement this Agreement by Ordinance No. 261-p of 20 March 2011.

The report indicates that the National Tripartite Social and Economic Council (National Council), established by Presidential Decree No. 1871 of 29 December 2005 on the development of social dialogue, was confirmed by Presidential Decree No. 347 of 2 April 2011. Under Act No. 2862-VI of 23 December 2010 on social dialogue, which sets out the procedure for social dialogue, the National Council is called upon to improve the protection and the monitoring of occupational health and safety.

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The report further explains that social partners are represented at board meetings of the Derzhhirpromnahlyad and its regional branches, as well as at meetings of the commissions responsible for investigating occupational accidents and diseases. At regional and local level, the Derzhhirpromnahlyad works with the social partners through sectoral or regional agreements, such as those concluded on 24 June 2009 and 28 April 2011 with the Federation of Trade Unions of Ukraine.

The Committee takes note of this information. It notes that there is a system for consulting social partners at public authority level. It also notes that the General Agreement was not truly tripartite as it allied the Cabinet of Ministers and employers’ organisations. It asks that the next report provide information on consultation with the competent occupational health and safety bodies within enterprises, in particular enterprises where there are no workers’ representatives.

Conclusion The Committee concludes that the situation in Ukraine is not in conformity with Article 3§2 of the Charter on the grounds that: •

the coverage of occupational hazards by specific occupational health and safety legislation and regulations is insufficient;

•

the level of protection against asbestos-related occupational hazards is insufficient.

________________________ 1 International Labour Organization, National Profile Occupational Safety and Health in Ukraine, Kyiv: ILO 2010, available at http://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/--safework/documents/policy/wcms_187970.pdf 2 International Labour Office, Decent Work Country Profile, Ukraine, Geneva : ILO 2011, available at http://www.ilo.org/wcmsp5/groups/public/---dgreports/--integration/documents/publication/wcms_167363.pdf 3 http://assembly.coe.int/Main.asp?link=/Documents/AdoptedText/ta98/EREC1369.htm 4 Conclusions II, Statement of Interpretation on Article 3§1, p. 12.

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Article 3 - Right to safe and healthy working conditions Paragraph 3 - Enforcement of safety and health regulations The Committee takes note of the information contained in the report submitted by Ukraine.

Occupational accidents and diseases The Committee previously examined (Conclusions 2009) the level of occupational accidents and diseases. It deferred its conclusion pending receipt of statistics on occupational diseases.

The report indicates that the number of occupational accidents has been decreasing overall during the reference period (from 16 211 in 2008 to 11 698 in 2010), as has the rate of incidence for such accidents (from 101.79 in 2008 to 81.59 in 2010). These figures, which reflect a persistent downward trend compared to the previous reference period, are excessively low in comparison with the average rate of incidence for other States Parties, as illustrated by EUROSTAT data for the EU-27 (from 2 269.42 in 2008 to 1 582.71 in 2010),1 which could indicate the occurrence of under-reporting in practice. The number of fatal accidents has been decreasing too (from 1 013 in 2008 to 644 in 2010), as has the rate of incidence for such accidents (from 6.36 in 2008 to 4.49 in 2010). These figures, which reflect a steady downward trend compared to the previous reference period, are still considerably higher than the average rates of incidence for other States Parties, as illustrated by EUROSTAT data for the EU-27 (from 2.36 in 2008 to 1.87 in 2010). According to the report, the increase in fatal accidents by 6% in 2011 should be related to the 20% growth of GDP in the same year.

According to ILOSTAT data,2 15 564 occupational accidents were reported in 2009 (reported injuries) and 11 654 in 2010 (workers in undertakings of all sizes of all institutional sectors and all economic activities). The corresponding incidence rates (per 100 000 workers in the aforementioned reference groups) were 112.6 in 2008 and 112.2 in 2010. 927 fatal accidents were reported in 2008 (deaths from reported injuries occurring within four months) and 580 in 2010 (deaths from reported injuries). The corresponding incidence rate (per 100 000 workers in the aforementioned reference groups) was 8.0 in 2008 and 5.6 in 2010. These figures, which confirm a downward with the previous reference period, are also much higher than the average recorded in other States Parties, as illustrated by EUROSTAT data for the EU-27.

According to the Decent Work Country Profile (pp. 43-48),3 non-fatal injury rates have been decreasing steadily, which could reflect a shift from employment in sectors of the economy which involve high risk to services. At the same time, the severity of injuries increased recently, which could be explained by notoriously dangerous working conditions in coal mining and by less serious injuries not being reported.

According to the National Profile on Occupational Safety and Health (National Profile) (pp. 4647),4 reporting obligations and investigation of occupational accidents and diseases are regulated by Cabinet of Ministers Resolution No. 1112 of 25 August 2004 on the Procedure for investigating and keeping records of occupational accidents, diseases and emergencies.

Employers are required to report occupational accidents immediately to the board of directors of the Fund for Social Insurance against Occupational Accidents and Diseases and to the State Sanitary and Epidemiological Service (Derzhsanepidsluzhba). Fatal or collective accidents must also be reported to the Derzhhirpromnahliad, to the prosecution authorities, to local public administration, and to the trade unions.

In reply to the Committee’s request, the report states that the number of recorded cases of occupational disease have decreased steadily (from 6 794 in 2008 to 4 965 in 2010). The main causes of occupational disease are linked to equipment which is obsolete or not in compliance 16

with maximum allowed exposure limits for dust, noise and vibration; low mechanisation of labour-intensive operations; employers’ unwillingness to invest in safe working conditions; workers’ unwillingness to seek medical care in early stages of pathology; imperfect health care; and the underestimation of the actual number of cases of occupational disease. These findings are confirmed in the Decent Work Country Profile (pp. 43-46), which also reports large-scale violations of occupational health and safety regulations and problems in securing sanitary supervision for cancer-hazardous productions. Overall the incidence rate for cases of occupational disease per 10 000 workers is increasing (from 1.85 in 1998 to 4.8 in 2009) and, compared with other European countries, occupational morbidity statistics are very low even though working conditions are considerably worse in comparison.

The Committee takes note of this information. Given the disparity between figures provided in the report and published by ILOSTAT, it reiterates that States Party have a duty to provide precise information on developments in respect of occupational accidents and that, in assessing respect for the right enshrined in Article 3§3 of the Charter, the number and frequency of occupational accidents and their trends are a decisive factor.5 It asks that the next report explain the disparity between the number of fatal accidents indicated in the report (1 013 in 2008 and 644 in 2010) and that published by ILOSTAT (927 in 2008 and 580 in 2010).

The Committee, on the basis of data from either source, considers that measures to reduce the excessive rate of fatal accidents are inssufficient. In view to assess the efficiency of the reporting system for occupational accidents and cases of occupational disease, it requests that the next report provide detailed information on reporting obligations under Cabinet of Ministers Resolution No. 1112 and on any penalties applicable in case of failure to fulfil these obligations.

It also asks for information on steps taken to reduce the high level of fatal accidents and diseases and to counter potential under-reporting in practice.

Activities of the Labour Inspectorate The Committee previously examined (Conclusions 2009) the labour inspection activities conducted in particular by the Derzhhirpromnahliad. It deferred its conclusion pending receipt of information on the mandates of the State Nuclear Regulatory Committee (Derzhatomrehuliuvannia), the State Fire Safety Department and the Derzhsanepidsluzhba; on conditions under which prosecuting authorities may be involved; on conditions under which workers may be held liable for infringements of the occupational health and safety regulations; on whether labour inspections are conducted in all undertakings of the mining sector; on the types of labour inspections and the labour inspectors’ mission; on the proportion of workers covered by inspection visits; and on reasons for the high number of fines imposed on workers.

In reply to the Committee’s request, the report distinguishes the Derzhhirpromnahliad, the Derzhatomrehuliuvannia, the Fund for Social Insurance against Occupational Accidents and Diseases, the Derzhsanepidsluzhba and the State Inspectorate for Technological Safety (Derzhtekhnogenbezpeky), which in accordance with Presidential Decree No. 392/2011 of 6 April 2011 succeeded to the State Fire Safety Department.

Under Presidential Decree No. 403/2011 of 6 April 2011, the Derzhatomrehuliuvannia implements the policy on safe use of nuclear energy, regulates nuclear and radiation safety, and manages the protection of nuclear material and installations, the safe transportation of radioactive material and the information in emergency situations. In the field of occupational health and safety the Derzhatomrehuliuvannia implements a monitoring and recording system for individual radiation doses; conducts training on nuclear and radiation safety for workers and safety officials; monitors compliance with legislation and regulations on nuclear and radiation 17

safety; carries out inspections of nuclear installations and other sources of ionising radiation. In case of infringement of the law, the Derzhatomrehuliuvannia may apply coercive measures, hold liable or sanction any legal or natural persons; restrict, suspend or terminate operation of undertakings or institutions operating nuclear installations and other sources of ionising radiation; suspend staff from work related to the control of reactor units or to nuclear and radiation safety; file infringement reports with prosecution authorities. According to the report, recent workplace assessments conducted by the Derzhatomrehuliuvannia in accordance with Act No. 2694-XII of 14 October 1992 on safety at work found no breaches of occupational safety regulations or standards, and no excess of radiation doses limit among the 12 000 workers employed at nuclear power plants in the country.

The Derzhteknogenbezpeky implements the policy on fire and technological safety. In the field of occupational health and safety the Derzhteknogenbezpeky develops regulations on fire and technological safety; monitors compliance with fire and technological safety legislation and regulations; certifies the conformity of equipment and devices in production facilities using dangerous substances; supervises emergency plans in hazardous facilities; conducts training on accident situations and technological and natural emergencies; investigates technological emergencies. In cases of infringement of the law on fire and technological safety, the Derzhteknogenbezpeky may issue infringement reports, injunctions and orders to eliminate the infringements, and rule on the application of prevention measures.

Under Ministry of Health Order No. 54 of 2 February 2005 on Principal sanitary regulations for the provision of radiation safety, before certifying the operation of sources of ionising radiation, the Derzhsaniepidsluzhba checks every workstation for compliance with the State sanitary regulations and standards on hygienic requirements to arrangement and operation of X-ray rooms and to the conduct of X-ray procedures (DSanPiN 6.6.3-150-2007); the Principal sanitary rules for the provision of radiation safety (OSPU-2005); and the Radiation safety standards (NRBU-97). In that capacity, the Derzhsaniepidsluzhba took 851 administrative measures in 2011, of which 542 were decisions to suspend or terminate operation of undertakings or facilities; 26 submissions of findings to prosecution authorities; 93 suspensions of workers from work for failure to undergo periodic medical examination; and five decisions to limit a range of products. The Derzhsaniepidsluzhba carried out inspections at 467 undertakings or institutions employing 341 045 workers. In its general capacity, the Derzhsaniepidsluzhba imposed some 1 000 fines in 2011; issued 119 decisions to suspend or terminate the operation of undertakings or facilities and 7 192 individual suspensions of workers from work for failure to undergo periodic medical examination.

In reply to the Committee’s request, the report states that in exercising its labour inspection and occupational accident investigation powers under Act No. 2694-XII, the Derzhhirpromnahliad may notify employers on infringements of the law in matters of occupational safety; hold workers and employers liable under the Code on Administrative Offences for infringements of the law in matters of occupational safety, of the safe conduct of work, of storage, use and recording of explosives; and file material and findings with the prosecution authorities.

The report indicates that the recent increase in the number of infringements of the law in matters of occupational safety is caused in part by a lack of dissuasion. Under Cabinet of Ministers Resolution No. 1232 of 30 November 2011 on the Procedure for investigation and recording or occupational accidents, occupational diseases and industrial accidents, the Derzhhirpromnahliad investigates all fatal, serious or collective accidents (special occupational accidents), and files material and findings about such accidents and criminal elements found at labour inspections with the prosecution authorities. In reply to the Committee’s request, the report indicates that budget and staff allocation within 18

the Derzhhirpromnahliad depend on the quantity of supervised undertakings and their production output, and that labour inspectors operate by sector of the economy. According to the Decent Work Country Profile (pp. 47-48), the duplication of inspection powers to enforce occupational safety regulations precludes any coherence in state activities towards improving occupational health and safety. The National Profile (pp. 38-39) concurs and points at imperfect co-operation between authorities, lack of financial resources, and imperfect impartiality of state inspectors. The Decent Work Country Profile (p. 48) reports the Government’s intent to create an integrated inspection system.

The report provides no statistics on inspection activities. According to the National Profile (p.

29), the number of inspectors continued to increase over the reference period (from 1 725 in 2007 to 1 789 in 2009), and 75% of the labour force is covered by labour inspection services.

The coverage rate, based on the number of inspection visits per 1 000 workers and of the labour force published by ILOSTAT for 2009,6 was 10.36% in 2009. The Decent Work Country Profile (pp. 47-48) reports that labour inspectors lack transport facilities and equipment to carry out their duties, and only 5% of the workplaces covered by labour inspection services were inspected in 2008.

The Committee takes note of this information. It notes that labour inspection services are divided between several public authorities, who lack resources and co-operate only imperfectly.

It asks for information in the next report on the implementation of joint labour inspections under the Regulations on the interaction between the Derzhatomrehuliuvannia and the Derzhhirpromnahliad in matters of occupational health and safety in the use of nuclear energy (registered with the Ministry of Justice on 22 March 2010 under No. 234/17529). It also notes that the proportion of workers covered by inspection visits is too low.

The Committee concludes that the labour inspection system is inefficient. It asks for statistics in the next report, for each public authority, on the number of labour inspectors and on administrative measures (fines, suspensions or termination of activity, cases filed with public prosecution) taken. It also asks for statistics on sanctions applied following cases filed with the prosecution authorities. It then asks for information on the recently increased fines and penalties applicable under the Code of Administrative Offences and the Criminal Code for violations of Act No. 2694-XII.

19

Conclusion The Committee concludes that the situation in Ukraine is not in conformity with Article 3§3 of the Charter on the grounds that: •

measures taken to reduce the excessive number of fatal accidents are insufficient;

•

the labour inspection system is inefficient.

________________________ 1 http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hsw_mi03&lang=en 2 http://www.ilo.org/ilostat/faces/home/statisticaldata/data_by_country/countrydetails?country=UKR&_afrLoop=608507481707011#%40%3F_afrLoop%3D608507481707011%26count ry%3DUKR%26_adf.ctrl-state%3Dczxf4lahh_248 3 International Labour Office, Decent Work Country Profile: Ukraine, Geneva: ILO 2011, available at http://www.ilo.org/wcmsp5/groups/public/---dgreports/--integration/documents/publication/wcms_167363.pdf 4 International Labour Organization, National Profile Occupational Safety and Health in Ukraine, Kyiv: ILO 2010, available at http://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/--safework/documents/policy/wcms_187970.pdf 5 See for example, Conclusions 2009, Slovenia, p. 7.

6 http://www.ilo.org/ilostat/faces/home/statisticaldata/data_by_country/country-details/indicatordetails?country=UKR&subject=EAP&indicator=EAP_TEAP_SEX_AGE_NB&_afrLoop=963423522336224 #%40%3Findicator%3DEAP_TEAP_SEX_AGE_NB%26subject%3DEAP%26_afrLoop%3D96342352233 6224%26country%3DUKR%26_adf.ctrl-state%3Dczxf4lahh_1261

20

Article 3 - Right to safe and healthy working conditions Paragraph 4 - Occupational health services The Committee takes note of the information contained in the report submitted by Ukraine.

The Committee previously examined (Conclusions 2009) the general scope of occupational health services in Ukraine. It deferred its conclusion pending receipt of information on medical supervision for all workers and on the proportion of undertakings running an occupational health care department.

The report states that under Act No. 2694-XII of 14 October 1992 on safety at work and Ministry of Health Order No. 246 of 21 May 2007 on the Procedure for medical examination of certain worker categories, employers must finance compulsory preliminary and periodic medical examinations of workers (including non-permanent, agency and temporary workers) employed in heavy works, works under harmful or hazardous conditions, or works requiring professional selection. Employers are required to suspend workers evading compulsory medical examinations from work and may hold them disciplinary liable. In the course of inspection, the State Sanitary and Epidemiological Service (Derzhsaniepidsluzhba) may also suspend workers on these grounds, which it did in 7 192 cases in 2011. Under Act No. 1127-XIV of 6 October 1999 on Mining, Ministry of Health Order No. 468 of 13 December 2002 on State sanitary regulations and standards for undertakings of the coal industry, and the Coal mine safety rules, occupational health care departments include health assessment and vocational selection sections, as well as health care posts. Such departments may be set up in-house or shared between undertakings. Act No. 1127-XIV sets up compulsory preliminary and periodic medical examinations for miners engaged in heavy works, works under harmful or hazardous conditions, as well as after-shift rehabilitation programmes and medical treatment in case of diseases caused by work. ILO Convention No. 161 on Occupational health services (1985) was ratified on 17 June 2010 pursuant to Act No. 1629-IV of 18 March 2004 on the National Programme for adjusting Ukrainian legislation to EU law (National Programme), and Cabinet of Ministers Resolution No. 821-p of 11 June 2008 approving the Action plan for implementation in 2008 of the National Programme.

The report provides no information on the proportion of undertakings running an occupational health care department. The Decent Work Country Profile (p. 46)1 indicates substantial problems in securing sanitary supervision for cancer-hazardous productions and in organizing medical services for workers employed in such production. The low quality of preventive medical examinations contributes to the insufficient identification of occupational diseases. The number of active factory health posts has dropped from 3 398 in 1991 to 301 in 2009. As a result, occupational diseases are identified in late phases, when a health disorder is irreversible and occupational rehabilitation has become impossible.

The Committee takes note of this information. Recalling that, when accepting Article 3ยง4 of the Charter, states undertook to give all workers in all branches of the economy and all undertakings access to occupational health services,2 it notes that access to such services is restricted to workers employed in heavy works, works under harmful or hazardous working conditions, or works requiring professional selection. It asks for information in the next report on access to occupational health services in other sectors than coal mining. It reiterates its request for information on the rate of undertakings which, either in-house or through external suppliers, provide access to occupational health services in practice. It also asks for statistics on the total number of workers who have access to preliminary and periodic medical examinations, and on the number of occupational physicians in relation to the labour force.

21

Conclusion The Committee concludes that the situation in Ukraine is not in conformity with Article 3ยง4 of the Charter on the ground that it has not been established that there is a strategy to progressively institute access to occupational health services for all workers in all sectors of the economy. ________________________ 1 International Labour Office, Decent Work Country Profile: Ukraine, Geneva: ILO 2011, available at http://www.ilo.org/wcmsp5/groups/public/---dgreports/--integration/documents/publication/wcms_167363.pdf 2 Conclusions 2003, Bulgaria, p. 23.

22

Article 11 - Right to protection of health Paragraph 1 - Removal of the causes of ill-health The Committee takes note of the information contained in the report submitted by Ukraine.

Right to the highest possible standard of health The Committee notes from WHO that life expectancy at birth in 2009 (average for both sexes) was 69.7. Despite an upward trend, the life-expectancy rate is still low relative to other European countries (for example, the EU-27 average that same year was 79.0).

The death rate (deaths/1 000 population) was 14.6 in 2011, which is also high compared to other European countries.

The Committee notes from the report that the main causes of death are diseases of the circulatory system followed by neoplasms, injury and poisoning, and respiratory diseases.

Among the measures being taken to combat these causes of mortality, the report mentions a national strategy for reducing mortality from cardiovascular and cerebrovascular diseases 20062010. Reference is also made to a national programme on fighting against oncological diseases for the period until 2016.

Infant mortality decreased slightly since the last reference period. In 2010 the rate was 9.17 per 1 000 live births, down from 20 per 1 000 live births in 2006. The Committee notes this decline, but considers that the rate is still high relative to other European countries (for example, the EU27 rate in 2010 was 4.1 per 1 000).

As regards the maternal mortality rate, the Committee notes that it has increased during the reference period. In 2010 the rate reached 23.31 deaths per 100 000 live births, up from 15.47 deaths per 100 000 live births in 2008. These rates are also considerably above the average in other European countries.

The report mentions that infant and maternal mortality are indicators closely linked to a country’s degree of socio-economic development.

The Committee considers that the prevailing high infant and maternal mortality rates, examined together with the other basic health indicators mentioned above, show that the situation in Ukraine is below the average in other European counries, and point to weaknesses in the health system. It therefore finds that insufficient efforts and progress has been made in respect of such indicators, and concludes that the situation is not in conformity with the Charter on this ground.

Right of access to health care The Committee refers to another source1 for a description of the health system. Ukraine has a comprehensive guaranteed package of health care services provided free of charge at the point of use as a constitutional right; nevertheless “charitable donations� are widely levied in the health system. Government attempts to define a more limited benefits package have left it to the individual facilities to determine which services are covered by the budget and which are subject to user charges. This has led to a lack of transparency in the system, which has contributed to an increase in informal payments.

According to the same source, there is no central health planning agency. The mechanisms currently in place neither reflect the health care needs of the population nor account for regional characteristics of health service provision.The Ministry of Health plays the key regulatory role in the Ukrainian health system at the national, regional and district levels. The Ministry is 23

responsible for the accreditation of all health facilities regardless of ownership, but this is more of a formality than a tool for improving quality of services. Similarly, standardisation efforts through the development of clinical guidelines and protocols have been ongoing, but they are not generally evidence-based and their efficacy has not been monitored. Since 2007, improving the quality of health care has become a more systematic activity and there is a department in charge of assessing the quality of health care services. The same source also underlines that health facilities are now functionally subordinate to the Ministry of Health, but managerially and financially answerable to the regional and local self-government, which has constrained the implementation of health policy and fragmented health financing. Health care expenditure in Ukraine is low by regional standards and has not increased significantly as a proportion of gross domestic product (GDP) since the mid 1990s; expenditure cannot match the constitutional guarantees of access to unlimited care. Although prepaid schemes such as sickness funds are growing in importance, out-of-pocket payments account for 37.4% of total health expenditure.

The Committee invites the Government to provide comments on the above matters.

The Committee has also examined the comments sent by the "All-Ukranian Council for Patients’ Rights and Safety" concerning the report submitted by Ukraine. This organisation underlines that despite the consitutional provision which guarantees everyone the right to health care, the lack of political will, poor government performance and complicated procedures effectively prevent millions of patients from getting timely access to adequate treatment. The cost of treatment in some therapeutic areas as well as the high prices of medication, which many patients cannot afford, are underlined as major problems. It also claims that the limited health care budget in Ukraine could have disastrous consequences in ensuring access to health care in particular for haemophilia and hepatitis C patients. The Committee invites the Government to provide comments on these allegations.

The Committee takes note from the report of the pilot projects on health care reform, as well as the regulations adopted during the reference period. Mention is made to Law No. 184-VI on the National Programme for the Development of Primary Medical and Sanitary Aid and on Family Medecine. The Committee asks to be kept informed on the implementation of reforms, on how these are meeting the health needs of the population, their impact on health care costs, and whether the reforms are translating into decreasing rates of avoidable mortality.

In the last examination the Committee adopted a general question addressed to all States on the availability of rehabilitation facilities for drug addicts, and the range of facilities and treatments. As the report does not address this issue, the Committee requests that information be included in the next report.

As regards the right to protection of health of transgender persons the Committee received submissions from the International Lesbian and Gay Association (European Region) (ILGA) stating that "in Ukraine there is a requirement that transgender people undergo sterilisation as a condition of legal gender recognition". Moreover, it claims that "the authorities fail to provide adequate medical facilities for gender reassignment treatment (or the alternative of such treatment abroad), and to ensure that medical insurance covers, or contributes to the coverage of such medically necessary treatment, on a non-discriminatory basis". In this respect, the Committee refers to its question on this matter in the General Introduction.

24

Conclusion The Committee concludes that the situation in Ukraine is not in conformity with Article 11ยง1 of the Charter on the ground of the prevailing high infant and maternal mortality rates. ________________________ 1 Health Systems in Transition, Ukraine, Health system review, http://www.euro.who.int/__data/assets/pdf_file/0010/140599/e94973.pdf

25

Article 11 - Right to protection of health Paragraph 2 - Advisory and educational facilities The Committee takes note of the information contained in the report submitted by Ukraine.

Education and awareness raising The Committee recalls that pursuant to this provision, States Party are required to develop policies on health education aimed at the general population as well as for groups affected by specific problems, notably through awareness-raising campaigns.

The report mentions that the Ministry of Health cooperates with non-governmental organisations and international projects with the aim of promoting healthy lifestyles, advocating family values, preventing mortality and improving the system of medical provision to adolescents and youth.

In its previous conclusion, the Committee asked whether there were specific information campaigns intended to inform the public about issues such as alcohol and illegal drugs, food, sexuality and the environment (Conclusions 2009). The report provides no information on this matter. The Committee therefore asks the next report to include up-dated information on the whole range of activities undertaken by public health services, or other bodies, to promote health and prevent diseases. In the meantime, it considers that it has not been established that public information and awareness raising is a public health priority.

As regards health education in schools, the report mentions the network of Youth-Friendly Clinics (YFC) which have been established in co-operation with UNICEF. In 2010, there were 91 YFC’s operating in the country. Among their core activities was the conducting of awarenessraising and educational work to promote healthy lifestyles and prevent diseases in educational institutions. Events such as round tables, video lectures and workshops were organised in pursuance of the educational activities.

The Committee recalls that health education should be provided through school life and form part of school curricula. It therefore asks whether providing health education at schools is a statutory obligation, how it is included in school curricula (as a separate subject or integrated into other subjects), and the content of health education. Pending receipt of this information, the Committee reserves its position on this point.

Counselling and screening The report states that with a view to improving the organisation and provision of outpatient obstetrical and gynecological care the Ministry of Health issued Order No. 417 on 15 July 2011.

This regulation deals with the frequency of a pregnant woman’s visits to a maternity clinic, and the pregnancy management algorithm for normal and a complicated pregnancy. All pregnant women are entitled to free observation and examination during pregnancy and in the postnatal period. The Committee notes that despite the availability of these examinations, the rate of maternal mortality remains high (see conclusion under Article 11§1).

A regards health examinations for children, the report indicates that Article 22 of the Law on General Secondary Education (No. 651-XIV) foresees that health care facilities, together with education authorities and health care authorities, guarantee, on an annual basis, free medical examination of pupils, as well as treatment and preventive measures in general education institutions. Ministry of Health Order No. 434 of 29 November 2002 on the approval of outpatient and polyclinic care for children specifies the scope of medical examinations in school and preschool. According to the latter, regular medical examinations are carried out in schools by 26

expert teams of territorial health care facilities, or by a pediatrician working in the school. Finally, another Ministry of Health Order No. 682 of 16 July 2010 on the improvement of medical services for pupils of general primary education classes is a step further in this field, by making regular medical examinations result-oriented and involving parents in the process of children’s health development.

The report fails to provide, for the second time, any relevant information on counselling and screening for the population at large. The Committee recalls that pursuant to this provision there should be screening, preferably systematic, for the diseases which constitute the principal cause of death. Preventive screening must play an effective role in improving the population’s state of health. The Committee therefore asks again what mass screening programmes are available in the country. In the meantime, it considers that it has not been established that prevention through screening is used as a contribution to the health of the population.

Conclusion The Committee concludes that the situation in Ukraine is not in conformity with Article 11§2 of the Charter on the grounds that it has not been established that: •

public information and awareness raising is a public health priority;

•

prevention through screening is used as a contribution to the health of the population.

27

Article 11 - Right to protection of health Paragraph 3 - Prevention of diseases and accidents The Committee takes note of the information contained in the report submitted by Ukraine.

Healthy environment The Committee takes note of the different pieces of legislation and regulations adopted by Ukraine during the reference period for the reduction of environmental risks, in particular in the field of air quality, water management, waste management, environmental noise, ionising radiation and food safety. The report mentions that the goal of environmental policy is to stabilise and improve the country’s environment, guaranteeing a safe environment for human health and preserving natural ecosystems.

The Committee notes from another source1 that several groups of environmental indicators are traditionally used in the development of the national state of the environment reports. They are: air pollution and depletion of the ozone layer; climate change; water resources; biodiversity; land resources and soils; waste; agriculture; efficiency indicators of the environmental policy implementation. Since 2007, indicators on energy and transport have also been used in the reports. The development of the annual National State of the Environment Report in Ukraine is regulated by section 25-1 of the Law of Ukraine "On the Protection of the Natural Environment".

The Ministry of Ecology and Natural Resources has been designated as the body responsible for the preparation of the report. The Committee asks the next report to provide information on such environmental indicators, namely the trends in respect of air pollution, contamination of drinking water and food intoxication during the reference period.

Tobacco, alcohol and drugs The report indicates that pursuant to WHO Framework Convention on Tobacco Control (ratified on 15 March 2006), advertisement of tobacco on television, radio, outdoor advertising media and in printed media is prohibited. Moreover in May 2012, the Parliament passed a law which completely prohibits smoking of tobacco products in public places, transport, enterprises, institutions and organisations.

According to the Global Adult Tobacco Survey, the share of those exposed to passive smoking has decreased from 53% to 33% as a result of the strengthened measures prohibiting smoking in public places and at workplaces.

During recent years, consumption rates of tobacco products have been raised several times, and the prevalence of everyday smoking among the population aged 15 and older has decreased from 37% in 2005 to 26% in 2010.

Law No. 481/95-BP of 19 December 1995 on the State Policy concerning the Consumption of Alcoholic Drinks and Tobacco Products prohibits the sale of beer (except non-alcoholic), alcoholic and low-alcoholic drinks, table wines, and tobacco products to persons under 18 years.

Concerning drugs, the Cabinet of Ministers’ Executive Order of 13 September 2010 No. 1808 approved a state policy on counteracting the spread of drug addiction and on combating trafficking in narcotic agents and psychotropic substances for 2011-2015. The Committee asks to be kept informed on the implementation of this policy, namely on its impact concerning trends in drug consumption.

28

Immunisation and epidemiological monitoring The report indicates that a programme for immunisation for the period 2009-2015 was approved

by Law No. 1658-VI of 21 October 2009. The programme envisages state targeted financing for immunisation activities. The National Immunisation Programme allowed the following vaccination coverage rate of infants in 2011: tuberculosis – 89.9%; poliomyelitis – 54.3%; pertussis, diphtheria, tetanus – 45.9%; hemophilic infection – 26.2%; measles, parotitis, rubella – 67.0%; hepatitis B – 21.6%.

The Committee has also examined the comments sent by the "All-Ukranian Council for Patients’ Rights and Safety" concerning the report submitted by Ukraine. This organisation claims that there is no comprehensive multi-year plan in place to update the National Immunisation Programme. Moreover, the lack of continuous funding and inefficiency of public procurement has significantly slowed down the implementation of the programme. The Committee also notes from another source2 that an external review of Ukraine’s National Immunisation shows that programme performance in Ukraine has declined in recent years due to vaccine stock-outs, excessive medicalization of vaccine delivery, and the loss in public confidence in immunisation.

The Committee invites the Government to submit comments on this matter. In the meantime, it reserves its position on this point.

Accidents The Committee takes note of the different regulations which have been adopted in Ukraine for the prevention of non-occupational injuries. The report mentions that the practice of implementing such regulations has had a positive impact in the reduction of the number of deaths caused by non-occupational injuries since 2008 when the number of deaths outside workplace was 60 516, whereas the figures for 2010 and 2011 were 42 826 and 41 217, respectively.

Conclusion Pending receipt of the information requested, the Committee defers its conclusion. ________________________ 1 European Environment Agency 2 WHO and UNICEF estimates of immunization coverage: 2011 revision

29

Article 14 - Right to benefit from social services Paragraph 1 - Promotion or provision of social services The Committee takes note of the information contained in the report submitted by Ukraine.

Organisation of the social services The right to benefit from social welfare services provided for by Article 14§1 requires Parties to set up a network of social services to help people to reach or maintain well-being and to overcome any problems of social adjustment. The Committee reviews the overall organisation and functioning of social services under Article 14§1. Social services include in particular counselling, advice, rehabilitation and other forms of support from social workers, home help services (assistance in the running of the home, personal hygiene, social support, delivery of meals), residential care, and social emergency care (shelters). Issues such as childcare, domestic violence, family mediation, adoption, foster and residential childcare, services relating to child abuse, and services for the elderly are primarily covered by Articles 7§10, 16, 17, 23 and 27. Co-ordination measures to fight poverty and social exclusion are dealt with under Article 30, while social housing services and measures to combat homelessness are dealt with under Article 31. The provision of social welfare services concerns everybody lacking capabilities to cope, in particular the vulnerable groups and individuals who have a social problem. Groups which are vulnerable – children, the family, the elderly, people with disabilities, young people with problems, young offenders, refugees, the homeless, alcohol and drug abusers, victims of domestic violence and former prisoners – should be able to avail themselves of social services in practice. Since many of these categories are also dealt with by more specific provisions of the Charter, under Article 14 the Committee reviews the overall availability of such services and refers to those other provisions for the detailed analysis of the services afforded (Conclusions 2005, Statement of interpretation on Article 14§1). The Committee notes that the report deals partly with aspects which are covered primarily by other articles of the Charter. It asks therefore for specific information to be included in the reports submitted under these articles.

The Committee refers to the description of the organisation of social services set out in its previous conclusion (Conclusions 2009).

The system of social services has been reformed to increase its efficiency and bring it into line with beneficiaries’ needs (concept for reform up to 2012 adopted in 2007; action plan for implementation approved in 2008; law passed amending some legislative acts on the provision of social services, in particular the 2003 Act on Social Services). In addition, the model regulations on territorial centres of social servicing were reviewed in 2009, along with the list of social services which the territorial centres can provide and the relevant conditions and procedures.

The Committee requests confirmation that entitlement to general social welfare services applies to the whole population.

The report seems to indicate that relatives of individuals in need are required to help them. The Committee wishes the next report to provide clarification on whether social welfare services are only available to persons in need who have no relatives to help them, the type of assistance which relatives are required to provide and the consequences for the relatives if they refuse.

The Committee recalls that family solidarity cannot be regarded as a sufficiently determinate source of income for a person without resources, where it takes the form of a moral value not legally defined. Family solidarity in such circumstances does not provide persons in need with a clear and precise basis of social support and in addition many families may not be in a position 30

to supply the necessary minimum level of assistance (see Conclusions 2009, France, Article 13ยง1).

Effective and equal access The Committee points out that fees may be charged for social services provided that they are not so onerous as to prevent effective access. For persons who do not have the necessary resources, service must be provided free of charge. The Committee notes the list given in the report of services for which fees may be charged. It also notes the existence of guidelines for calculating the fees for such services. It asks what is the average fee charged to users. While underlining the list of categories of individuals entitled to free access to social services (included in the 2003 Act and set out in the previous conclusion, Conclusions 2009), it asks whether these services are available free of charge for persons who are not on this list but do not have the means to pay for the social services they need.

As the report does not answer the question about the geographical distribution of social services, the Committee reiterates the question in order to be able to assess whether it is broad enough for social services to be available in practice for persons who need them regardless of where they live. The Committee underlines that if the necessary information is not provided in the next report there will be nothing to show that Ukraine is in conformity with the Charter.

On the basis of Law No. 393-96-BP, citizens may appeal to public authorities regarding the exercise of their rights. The Committee notes the detailed description of this possibility given in the report. However, it requests clarification whether the authority to which the beneficiaries of social services may appeal in urgent cases of discrimination and infringements of human dignity is an independent body.

Under Article 26 of the Constitution, foreigners and stateless persons residing lawfully in Ukraine enjoy the same rights and freedom and bear the same duties as nationals, except in cases provided for in the Constitution, laws or international treaties by which Ukraine is bound.

Section 6 of the 2003 Act provides that social services are provided to nationals, foreigners and stateless persons (including refugees) residing lawfully in Ukraine who experience hardship. As there is no exception in the act regarding its application to foreigners, the Committee asks that the next report confirms that equal treatment is thus ensured.

Quality of services The previous conclusion (Conclusions 2009) noted that under the 2000 legislation on the licensing of certain economic activities, private social services agencies need a licence to operate, whether or not they are working for the State. Local authorities supervised their operation. The report indicates that the licensing conditions for professional activities in social services and the procedure for supervision thereof were approved in 2008, with the licensing procedure promoting a higher quality of social service provision. However, the report adds that the requirement to obtain a licence was abolished under Law No. 1759-VI (in force since 15 December 2009) on amending certain laws to simplify the business environment. The report cites the global financial crisis as the reason for this change.

The Committee recalls that under Article 14 of the Charter, there must be mechanisms for supervising the adequacy of social welfare services, public as well as private. The report indicates that mechanisms of this kind no longer exist. The Committee therefore holds that the situation is not in conformity with the Charter.

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According to the report, the number of social welfare centres for families, children and young people rose from 845 in 2008 to 1 900 in 2010. The aim of the centres is to provide social services to families, children and young people in difficult life circumstances in all towns and villages in the country. The number of specialist staff in the centres increased from 3 900 in 2008 to 4 635 in 2011. The Committee refers to the other detailed statistics in the report describing the centres’ activities and the number of persons assisted.

Section 17 of the Act on Social Services refers to staff qualifications. To implement this provision, the Ministry of Labour and Social Policy in 2005 developed procedures for the assessment of social workers and a guide to job descriptions for the profession. The report indicates that higher vocational education is a requirement for social workers.

In the absence of a reply in the report, the Committee reiterates its questions concerning the amount of public spending on social services and the legal basis for data confidentiality and respect for privacy. The Committee underlines that if the necessary information is not provided in the next report there will be nothing to show that Ukraine is in conformity with the Charter.

Conclusion The Committee concludes that the situation in Ukraine is not in conformity with Article 14§1 of the Charter on the ground that there are no mechanisms for supervising the sufficiency of social welfare services.

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Article 14 - Right to benefit from social services Paragraph 2 - Public participation in the establishment and maintenance of social services The Committee takes note of the information contained in the report submitted by Ukraine.

The legal framework governing relations concerning voluntary activities is Law No. 3236-VII of 19 April 2011 on volunteer activities. The State supports volunteer activities and guarantees and protects the rights, freedoms and legitimate interests of volunteers, voluntary organisations and beneficiaries. State social services (such as territorial centres of social servicing and homes for elderly persons and persons with disabilities) co-operate with volunteers.

Non-profit organisations are actively involved in the provision of social services in all regions and for all types of vulnerable groups. For instance, the social services centres for families, children and young people co-operate with 180 non-governmental organisations and charitable foundations. Overall, around 3 000 social service providers operate and provide services for approximately 3 million people. The number of volunteers increased by 29 000 during the reference period to a total of around 700 000. The number of beneficiaries also increased, by almost 100 000 to 700 000.

The previous conclusion (Conclusions 2009) indicated that State subsidies could be paid to voluntary organisations which conclude co-operation agreements with local authorities. The Committee requests the next report to provide statistical data on subsidies paid by the central government and local authorities to voluntary organisations which provide social services. It also requests that the next report describe any other types of support that may exist for voluntary organisations, such as, for example, tax incentives.

The Committee points out that a supervisory machinery must be put in place to monitor the quality of the services provided by individuals and voluntary or other organisations, while safeguarding users’ rights and ensuring respect for human dignity and fundamental freedoms. It wishes the next report to clarify the situation in this respect.

Conclusion Pending receipt of the information requested, the Committee concludes that the situation in Ukraine is in conformity with Article 14§2 of the Charter.

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Article 23 - Right of the elderly to social protection The Committee takes note of the information contained in the report submitted by Ukraine.

Legislative framework The Committee notes from the report that the Law on the Basic Principles of Social Protection of Labour Veterans and Other Elderly Persons in Ukraine (No. 3712-XII of 16 December 1993) prohibits discrimination against elderly persons in, inter alia, employment, health care, social security and housing “and the officials violating these guarantees shall be held liable according to legislation in force”. The Committee asks for a clarification whether the prohibition of discrimination applies to both public and private sectors and what remedies are available to victims of discrimination.

The report further states that according to the above-mentioned Law, associations of war veterans and elderly persons have the right to: participate in making administrative decisions which directly concern their interests; represent and protect legitimate interests of their members in public and non-governmental bodies; exercise other powers provided for by the provisions related to citizens’ associations.

The Committee asks for information on the legal framework related to assisted decision making for the elderly, and, in particular, whether there are safeguards to prevent the arbitrary deprivation of autonomous decision making by elderly persons. In this respect, the Committee refers to its Statement of Interpretation in the General Introduction.

Adequate resources When assessing adequacy of resources of elderly persons under Article 23, the Committee takes into account all social protection measures guaranteed to elderly persons and aimed at maintaining income level allowing them to lead a decent life and participate actively in public, social and cultural life. In particular, the Committee examines pensions, contributory or noncontributory, and other complementary cash benefits available to elderly persons. These resources will then be compared with median equivalised income. However, the Committee recalls that its task is to assess not only the law, but also the compliance of practice with the obligations arising from the Charter. For this purpose, the Committee will also take into consideration relevant indicators relating to at-risk-of-poverty rates for persons aged 65 and over.

Eligibility for an old-age social pension starts at age 63 (men) or age 58 (women). According to the report, the minimum pension benefit has been fixed at the level of no less than the minimum of subsistence established for persons who have lost working capacity, including persons having no pension entitlement. In December 2011, the minimum of subsistence for persons who lost working capacity and the minimum pension benefit amounted to UAH 800 (approx. €77) per month.

According to the report, the Methodology for Integrated Assessment of Poverty determines two indicators: poverty level as per the relative criterion (75% of median cumulative income (spending) per typical adult), and extreme poverty level (60% of median cumulative income (spending) per typical adult). The Committee notes from the report that in 2011 the poverty line equalled UAH 1 062 (approx. €101), and the extreme poverty line (as per the relative criterion) – UAH 850 (approx. €80). The Committee notes that the amount of the minimum pension, although increased compared to previous reference period (see Conclusions 2009) still falls below the poverty level and even slightly below the extreme poverty level. It asks what 34

additional cash benefits/allowances are available for recipients of minimum old age pension (or guarantee pension for low income elderly persons as the case may be). The Committee further notes from the report that the relative-criterion-based poverty rate for elderly persons was 24.3% in 2011, and the extreme poverty rate was 10.7% in 2011 against 11.2% in 2010.

The Committee concludes that the situation is not in conformity with Article 23 of the Charter on the ground that the level of the minimum pension is manifestly inadequate.

Prevention of elder abuse In its previous conclusion the Committee asked what was done to evaluate the extent of the problem, to raise awareness on the need to eradicate elder abuse and neglect, and if any legislative or other measures were taken or envisaged in this area. The report does address this issue. The Committee reiterates its question.

Services and facilities The Committee notes from the report that as of 1 January 2012, 894 departments of social assistance at home operated in Ukraine, providing social services to about 500 000 persons. It further notes that the introduction of new provisions concerning provision of social services, in particular the Cabinet of Ministers of Ukraine Resolution No. 1 417 of 29 December 2009 aims at improving the structure and content of the services offered.

Nevertheless, the Committee reiterates its question whether in general the supply of home help services for the elderly matches the demand for them and how their quality is monitored. The Committee would also like to receive more detailed information on the services available, their scope and cost, and how elderly person are informed about the services offered and whether their provision differs from one municipality to another.

According to the report, the Law on Social Services provides that a decision issued by public or local authorities denying provision of social services, limiting their scope or terminating their provision can be appealed against to the relevant central or local executive authority or local government or to a court.

The Committee notes from the report the learning opportunities offered by the Third Age Universities. It asks how the participation of elderly persons in cultural and leisure facilities is ensured and encouraged.

Housing According to the report, elderly persons, on equal terms with other citizens, have the right to housing that includes the right to receive and permanently use suitable residential space in state-owned stock houses. Elderly persons may also exchange their accommodation on top floors for one on lower floors or in elevator-equipped buildings, or an excessive living space for a smaller one. The Committee takes further note of the information provided in the report on the social housing stock and the specialised residential homes for the elderly.

The Committee wishes to receive more information about how the right to suitable social accommodation for the elderly is implemented in practice, in particular what are the eligibility criteria, whether the supply of such housing is sufficient and whether the waiting periods are reasonable. Finally, it asks whether assistance for adaptation of private homes is available.

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Health care The report provides information on the Intersectoral Integrated Programme ‘The Health of the Nation’ (2002-2011). The Programme includes Section VI ‘Old-Age Health Maintenance’, addressing issues of improving elderly people’s health and increasing average life expectancy.

The Committee would like to receive more information on the implementation of the programme.

According to the report, the website of the Gerontological Information and Consulting Centre under the Institute of Gerontology of the Academy of Medical Sciences of Ukraine, created in 2009, provides information on the ways of addressing medico-social, domestic and other problems of elderly people, promotes their active participation in community life, and fosters interaction between relevant public and non-governmental organisations.

The Committee further notes that the curriculum of the General Practice – Family Medicine faculty now includes lectures on the role of family physicians in the organisation of medicosocial assistance for elderly persons; family medicine standards in the geriatric service; family medicine’s interaction with social and non-governmental services; peculiarities of sociopsychological rehabilitation of patients of older age groups; methods of teaching people healthy lifestyles; forms of work with families having severely ill persons; patients’ rights; specific features of palliative medicine. It further notes creation of four centres specialised in geriatrics, gerontology and osteoporosis treatment. These centres, together with specialised associations, such as the Ukrainian Association of Parkinson Patients and the Association for Alzheimer’s Disease Problems provide treatment and counselling assistance to elderly patients from various Ukrainian regions, and develop programmes for their medical and social rehabilitation.

The Committee asks whether these centres are sufficient to meet the needs of elderly persons in all regions of the country, taking into account their capacity and geographical location. The Committee would like to receive more information about the possibility of receiving primary health care services at home, including domiciliary nursing services.

Institutional care According to the report, as of 1 January 2012 the network of residential institutions consisted of 324 boarding homes with 56 000 residents, including 20 000 elderly persons and persons with disabilities, 7 000 war veterans, and 5 000 labour veterans. Residential homes may provide health care, social and medical rehabilitation, and consulting services.

In addition, smaller residential homes (between 10-50 residents) are available to dependent elderly persons, permitting them to stay in their region, familiar environment, and to preserve social relationships. 340 of such residential homes accommodated more than 10 000 persons.

The Committee asks what kinds of services are offered in both types of institutions, and whether the supply of institutional facilities for elderly persons is sufficient and their cost affordable. The Committee reiterates its questions how these facilities are licensed and inspected, and whether procedures exist for complaining about the standard of care and services or about ill treatment in this type of institutions. It also wishes to receive information about the requirements regarding the staff qualifications and the use of physical restraints.

Conclusion The Committee concludes that the situation in Ukraine is not in conformity with Article 23 of the Charter on the ground that the level of the minimum pension is manifestly inadequate.

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Article 30 - Right to be protected against poverty and social exclusion The Committee takes note of the information contained in the report submitted by Ukraine.

The Committee refers to its statement of interpretation on Article 30 in the General Introduction to these Conclusions and invites the Government to take it into account when drawing up the next report.

Measuring poverty and social exclusion According to the Methodology for Integrated Assessment of Poverty used in Ukraine, two relative indicators are determined: the poverty level as 75% of median cumulative income (spending) per typical adult and the extreme poverty level as 60% of median cumulative income (spending) per typical adult.

Analysis of the main poverty indicators over 2008-2011 show: as the poverty line increased from UAH 778 (70€) in 2008 to UAH 1 062 (96€) in 2011, the relative-criterion-based poverty level was 27% in 2008, 26.4% in 2009, 24.1% in 2010, and 24.3% in 2011. The extreme poverty line (as per the relative criterion) was UAH 850 (77€) in 2011; it was UAH 95 (8€), or 12.6%, higher than in the previous year. The extreme poverty line was 10.7% against 11.2% in 2010. The poverty depth ratio, demonstrating how much an extremely poor population prevails among the poor population, was 20.6% against 20.9% in 2010.

As regards the indicators concerning the population that is socially excluded, the Committee notes from other sources, that as of 2011 acute social exclusion (relating to households with five or more exclusion characteristics) was experienced by 37.7% and critical exclusion (relating to households with seven or more exclusion characteristics) was experienced by 16.9% of Ukrainians1.

The Committee recalls that Article 30 does not only cover poverty but also social exclusion and the risk of social exclusion and it therefore asks that the next report contain detailed information in this respect.

Approach to combating poverty and social exclusion The Committee points out that Governments must adopt a global, coordinated approach, which must comprise an analytical framework, and provide for measures promoting access to social rights, in particular employment, housing, training, education, culture and social and medical assistance for persons in, or at risk of finding themselves in, a situation of poverty or social exclusion.

The report provides information on the labour market as to growing employment and decreasing unemployment (according to the ILO methodology employment increased during 2011 by 58 200 compared to the previous year, to 20.3 million; employment rate rose from 58.5% to 59.2%) and on a gradual increase in the amount of state social assistance for low-income families with children. However, the report does not provide detailed information concerning all the measures taken during the reference period and their impact.

Considering the urgency of addressing the poverty problem, pursuant to the Decree of the President of Ukraine No. 274/2010, the Cabinet of Ministers of Ukraine Resolution No. 1057 of 31 August 2011 approved the State Targeted Social Programme for Overcoming and Preventing Poverty through 2015 (hereinafter referred to as the Programme). The Programme defines basic challenges for overcoming poverty, namely raising social standards, promoting employment, improving labour remuneration, increasing pensions, and reforming of the pension 37

system, social insurance, social protection, health care services, social support for youth and families, and protection of children’s rights. The goal of the Programme is to reduce the number of poor population among working persons, families with children, especially large families, orphan children, children deprived of parental care, homeless children, unemployed, persons with disabilities, pensioners, derelict persons in rural areas, and to prevent chronic poverty.

The information on funding allocated for the realization of the targeted goals can make a significant contribution to the assessment of the measures taken to combat poverty and social exclusion. The Committee asks the next report to provide information on resource allocations for these measures.

The Committee asks for the next report to provide more detailed information on measures taken to combat poverty and social exclusion and on any progress achieved.

Finally, the Committee recalls that rights relating to civic and citizens’ participation, such as the right to vote, constitute a necessary dimension in achieving social integration and inclusion and they are thus covered by Article 30. It asks that the next report contain information in this respect.

In view of the paucity of the information at its disposal and having regard to the extent of poverty and social exclusion, the Committee does not consider it established that there is an effective overall and coordinated approach to combat poverty and social exclusion and it therefore holds that the situation is not in conformity with Article 30.

Monitoring and assessment The Committee recalls that Governments must show how they monitor and evaluate poverty reduction measures as well as provide information on the results of such monitoring and evaluation (including on any changes/adaptations undertaken in consequence).

The report contains no information on how activities to combat poverty and social exclusion are monitored and assessed and ways in which civil society (including employers’ and workers’ representatives, NGOs and private citizens) are involved in these processes. The Committee asks that the next report contain information on these aspects of Article 30.

Conclusion The Committee concludes that the situation in Ukraine is not in conformity with Article 30 of the Charter on the ground that it has not been established that there is an effective overall and coordinated approach to combat poverty and social exclusion. ________________________ 1 http://www.undp.org.ua/files/en_95644NHDR_2011_eng.pdf

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