Ombudsman Diana Kovacheva sent an opinion to the Minister of Health Hristo Hinkov and to the Minister of Social Policy Ivanka Shalapatova, in which she warns that five months after the latest changes in the regulatory documents for people with disabilities, their problems with expert medical assessments remain unresolved.

9 November 2023

Ombudsman Diana Kovacheva sent an opinion to the Minister of Health Hristo Hinkov and to the Minister of Social Policy Ivanka Shalapatova, in which she warns that five months after the latest changes in the regulatory documents for people with disabilities, their problems with expert medical assessments remain unresolved.

The reason for this opinion of Prof. Kovacheva reflects the numerous complaints and reports received by the Ombudsman’s institution from outraged and desperate citizens about their rights being violated during their expert medical assessment and the resulting impossibility to promptly enjoy the rights and support as disabled people. Most often, people complain that their expert medical assessment by TELK (Territorial Expert Medical Commission) is delayed several months, and until then they have no income to live on. The problem is that they remain without health insurance rights and without access to treatment.

The Ombudsman emphasizes that the Council of Ministers’ Decree on amendments and additions to the Regulation on the structure and organisation of the work of expert medical assessment bodies and of the regional files of expert medical assessments has not been adopted yet. This further hinders improvement of the activities of the expert medical assessment bodies.  

Diana Kovacheva insists that, pending the start of the work of the established interdepartmental working group to prepare the necessary regulatory changes regarding expert medical assessments, in view of its significant delay and the continued violation of the rights of a huge number of vulnerable citizens, additional measures should be taken as a matter of urgency to speed up the process of carrying out expert medical assessments and resume disability pensions until preparation and implementation of the necessary comprehensive reform in the field.

“I would like to note my strong commitment to the problems faced by people with disabilities and their relatives in getting their expert medical assessment decisions and also recall that, in accordance with the powers of the institution, I have made a number of proposals and recommendations to address the problems and ensure the rights of citizens”, writes the Ombudsman.

Diana Kovacheva recalls that, at her suggestion, the National Assembly adopted changes to the Persons with Disabilities Act and the Health Act, as well as that the Council of Ministers adopted amendments to by-laws to basically ensure the rights of people with disabilities in order to prevent interruption of social support in case of delayed re-certification, as well as fairer assessment of their permanently reduced working capacity/type and degree of disability.

However, the Ombudsman warns of a number of problems that remain unresolved and lists some of them.

“Significant delay of expert medical assessment decisions by the Territorial Expert Medical Commissions (TELK), especially in some areas of the country. The delay violates the rights of people with disabilities who have submitted an application-declaration for primary certification, as well as for early re-certification, for example due to deteriorated condition, who until the expert decision is issued and the administrative procedures are completed, are deprived of the opportunity to enjoy the rights of people with disabilities, when they need them most. It should also be noted that not all rights can be enjoyed for a past period,” Prof. Kovacheva points out.

She adds that there is a delay in expert medical assessments by the National Expert Medical Commission (NELK) and, above all, the cases of several consecutive annulments and returns to TELK of expert medical assessment decisions of the same person within one procedure. She emphasizes that as a result of the annulment of an expert medical assessment decision of TELK, until a new one is issued and enters into force, the disability pension, as well as other social rights of citizens are suspended.

She also draws attention to another problem that needs to be resolved, namely the delay in issuing and sending the expert medical assessment decision after the date announced for examination of the administrative procedure. In this context, it is appropriate to provide for a mechanism to ensure that NELK does not have the right to return the file indefinitely for re-examination by TELK.

 “The extended period of entry into force of expert medical assessment decisions, often exceeding one month, during which disabled people are left without their disability pensions. Here it is appropriate to emphasize the positive practice of the structures of the social assistance system to implement expert medical assessment decisions immediately after their issuance, even if they have not entered into force. In this way, it is ensured that citizens with disabilities can receive the support under the Persons with Disabilities Act and the Personal Assistance Act as quickly as possible, overcoming the problems with long deadlines for entry into force of expert medical assessments”, the Ombudsman writes.

The Ombudsman underlines the position she has expressed on several occasions that sending an expert medical assessment decision from the regional expert medical assessment files to the territorial unit of the National Social Security Institute only after having verified that all parties have been informed thereof and that the time limit for appeal under Article 63, paragraph 1 has expired is the cause for the delay of expert medical assessment decisions by the medical commissions to the territorial units of the NSSI, whereas the 14-day time limit for appeal starts to run upon receipt of the expert medical assessment decision, which further extends the time for granting a disability pension and creates conditions for violation of citizens’ rights as a result of this delay.

 “In this regard, I think it is important to discuss the possibility of speeding up the resumption of citizens’ pensions, which could be achieved, on the one hand, by introducing and applying the general principle of sending of the decision issued to the interested parties. On the other hand, by providing the medical commissions with access to information and documentation in the electronic system, relating to the expert medical assessments and certifying the current health status of the persons, the activities of the commissions could be further accelerated. It is good to consider the possibility of introducing the positive practice of the structures of the social assistance system for implementation of expert medical assessment decisions immediately after their issuance and regarding the resumption of the pensions of the affected citizens”, the Ombudsman also recommends.

The other problems with the expert medical assessments mentioned by the Ombudsman in the opinion are available here: https://www.ombudsman.bg/bg/n/ombudsmanat-nastoyava-za-speshni-promeni-v-me-2131

L'Ombudsman est de plus en plus souvent contacté pour deux catégories de réclamations, pour lesquelles il ne peut en principe pas intervenir :

- la pénurie de logements abordables

- le manque de places dans les structures d'accueil de demandeurs de protection internationale

Les deux problématiques ont comme conséquence qu'aussi bien des familles que des célibataires se trouvent dans des situations désespérées. Face à des réclamations dans ce contexte, l'Ombudsman doit rappeler que des défaillances systémiques sont exclues de son champ de compétence. D'un point de vue juridique, la réclamation doit porter sur une affaire concrète concernant la personne qui saisit l'Ombudsman et non sur un problème général qui concerne toute une collectivité de personnes. Même si dans ces cas, les personnes qui saisissent l'Ombudsman sont individuellement concernées par la pénurie de logements, la problématique en soi est générale. D'un point de vue pratique, l'Ombudsman ne pourrait de toute façon ni créer, ni faire libérer une place pour une famille en détresse, ni accélérer une demande d'une famille ou d'une personne au détriment d'une autre.

L'Ombudsman regrette ces situations qui, malgré son incompétence de par la loi en la matière, ont fait l'objet de publications régulières dans ses rapports annuels avec comme suggestions d'augmenter aussi bien le nombre de logements sociaux que les structures d'accueil.

Souvent la perte d'un logement crée toute une série de difficultés administratives et l'Ombudsman continuera évidemment à analyser au cas par cas s'il peut intervenir par rapport à ces problèmes connexes.

At its session held on 18 October 2023 the Committee on Human and National Minority Rights of the Croatian Parliament unanimously voted in favor of the Ombudswoman’s Annual Report 2022. Parliamentary members of the Committee pointed out that the Report is comprehensive and well-argued, as well as that the analyses, data and the conclusions it contains are widely read and used.

The Committee also unanimously adopted the conclusion urging the Croatian Parliament to discuss the report in its plenary session by December 15 of this year.

Committee’s Chair Mr. Milorad Pupovac expressed his support for the work of the institution of the Ombudswoman by calling on the competent authorities to improve their cooperation with the Ombudswoman, mainly in terms of providing data and following-up on her recommendations. The same is in line with one of the six recommendations of the European Commission issued to the Republic of Croatia in EC’s Report on the Rule of Law for 2023 – to further improve the implementation of the recommendations and to respond more systematically to the Ombudswoman’s requests for information.

Presenting the Report, Ombudswoman Tena Šimonović Einwalter provided a brief overview of some of the institution’s activities in the areas of human rights protection and promotion undertaken in the course of 2022 and of the problems citizens encountered in exercising their rights.

These problems are presented in the Report through more than 60 topics and subtopics, as well as 170 recommendations that provide direction for their resolution. At the session, the Ombudswoman particularly emphasized the issues related to the impact of poverty on the exercise of human rights, the right to health, the consequences of the earthquakes, the right to good governance, migrations, the rights of national minorities, discrimination in work and employment, discrimination based on nationality, hate speech and hate crimes, problems present in the prison system, as well as trends related to the protection of whistleblowers.

When it comes to the institution’s activities in 2022, the bulk of them pertained to case-work. In 2022 we opened 4,534 new cases, which is an increase of 5.7% compared to 2021. When the cases opened in the previous years on which we are still working are added, the total of the cases we worked on in 2022 amounts to 6,099. Complaints related to healthcare (411 in total) make up the largest share in the total number in the newly received complaints in 2022.

The institution also intensively advocated for better public policies, by analyzing and commenting on as many as 36 draft bills, and later by participating in parliamentary committee sessions. This applies to discussions as part of legislative activities, but also to thematic sessions.

The Ombudswoman briefly presented her cooperation with other stakeholders as well as the national and the international activities that the institution carries out in response to the numerous invitations from various stakeholders to hold presentations and participate in

discussions, reflecting their recognition of the institution’s commitment to human rights and equality and of the quality of its work aimed at their protection and promotion.

In 2022, the Ombudswoman, her deputies and advisers held a series of training sessions on human rights and equality in several cities in Croatia. They were aimed at judicial and probation officers, employers, lawyers, civil servants, trade unions, corporate lawyers, and students. The bulk of the sessions dealt with the application of the Act on the Protection of the Persons Reporting Irregularities (so-called “whistleblowers”) and were aimed at confidential persons and judicial officials, mainly judges.

A significant proportion of our activities consisted of fieldwork in various areas of Croatia, for example with the citizens whose homes were destroyed in the earthquakes, in sites of environmental pollution, Roma settlements, and included visits to various places of detention performed by the officers of our National Preventive Mechanism for the prevention of torture and other cruel, inhuman or degrading treatment or punishment.

The Ombudswoman also spoke about the implementation of the new, fourth round of a large periodical survey on the perception and the occurrences of discrimination in Croatia, which our institution has been conducting since 2009. This is the largest and the only regular survey on discrimination in Croatia.

In her closing remarks the Ombudswoman invited the representatives of the state administration bodies present at the session to work on the further strengthening of the cooperation of their institutions and the Ombudswoman and called on the MPs to support the work of our institution, with the aim of achieving the effective protection of human rights in Croatia.

l Defensor del Pueblo, Ángel Gabilondo, y el presidente de UNICEF España, Gustavo Suárez Pertierra, han mantenido un encuentro este martes en la sede de la institución Defensor del Pueblo con un grupo de niñas, niños y jóvenes, de diferentes puntos del país, que forman parte del Grupo Asesor de Infancia de UNICEF España.

Los niños, niñas y jóvenes que han acudido a la institución con motivo del Día Mundial de la Infancia -celebrado ayer- le han trasladado al Defensor del Pueblo sus inquietudes en relación con diferentes asuntos que les preocupa. Así, han debatido sobre la pobreza infantil, los sistemas de protección y acogida familiar, el derecho a la educación, el absentismo escolar, las acciones para luchar contra el cambio climático, la protección de los menores frente a la violencia, la salud mental, las adicciones o la participación infantil y el derecho al juego y al ocio.

Ángel Gabilondo les ha informado acerca de las actuaciones que realiza la institución para defender los derechos de la infancia y les ha comentado las quejas que recibe en relación a las áreas por las que se han interesado. Además, han conversado sobre cómo pueden hacer valer sus derechos también ante la institución Defensor del Pueblo.

Los menores de edad y jóvenes que han asistido al encuentro con Ángel Gabilondo representan a otros espacios de participación infantil como los Consejos Locales de Infancia y Adolescencia o el Consejo Estatal de Participación Infantil y Adolescente, un órgano permanente y estable de consulta, representación y de participación de las niñas, niños y adolescentes, adscrito al Ministerio de Derechos Sociales y Agenda 2030.

En la reunión también han estado presentes por parte de UNICEF España su director ejecutivo, José María Vera, y la especialista en participación infantil, Helena Serrano.

In occasione della Giornata internazionale dedicata a infanzia e adolescenza, prevista per il 20 novembre, Giancarlo Giulianelli fa il punto su uno dei settori di sua competenza, delineando il quadro degli interventi già effettuati e di quelli da concretizzare nel prossimo futuro

Il resoconto di un’attività a tutto campo, che proietta progetti ed iniziative nel prossimo futuro. In occasione della Giornata internazionale dedicata a infanzia e adolescenza, prevista per il 20 novembre, il Garante Giancarlo Giulianelli fa il punto su uno dei settori di sua competenza.
“In questi anni – spiega – ho avuto modo di approfondire le sfaccettature di un mondo sempre più complesso e in continua trasformazione, che ha bisogno di essere fotografato più attentamente. Perché al centro di tutto ci sono fragilità che si amplificano ed altre che fino ad oggi non sono state prese nella giusta considerazione. Ce lo confermano le segnalazioni che riceviamo abitualmente, ma anche l’approfondimento che abbiamo inteso portare avanti in alcuni settori specifici”.
Come, ad esempio, sulla realtà dei minori portatori di handicap, che ha visto l’attivazione di numerosi progetti, anche con la collaborazione di enti locali ed associazioni presenti sul territorio, seguendo il percorso “Disabile a chi”, che interviene su base triennale per garantire l’inclusione attraverso diverse forme di partecipazione diretta dei minori, non ultima quella della pratica sportiva contemplando diverse discipline. E ovviamente non sono mancate iniziative sul versante dell’inserimento scolastico, al fine di contrastare l’emarginazione e, in alcuni casi, l’abbandono degli studi.
“Particolare attenzione è stata riservata – spiega Giulianelli – alla situazione socio-sanitaria, con un’indagine relativa alla conoscenza dei servizi deputati alla prevenzione, alla presa in carico e alla cura del disagio psichico e psichiatrico degli adolescenti e dei giovani adulti. Nel 2024 contiamo di definire il quadro complessivo con la collaborazione ed il supporto delle strutture regionali”.
Sul fronte dell’accoglienza dei minorenni fuori dalla famiglia di origine il Garante intende concretizzare un percorso finalizzato all’elaborazione di un protocollo interistituzionale, che garantisca una reale tutela dello stesso minore ed una presa in carico rispettosa delle normative vigenti, con modalità uniformi su tutto il territorio delle Marche. Un lavoro di rete allargato, che veda il coinvolgimento di istituzioni e attori sociali competenti in materia.
Altro aspetto dell’intervento del Garante, quello legato alla promozione della “cittadinanza attiva”, della partecipazione dei ragazzi alla vita delle comunità in cui vivono.
Anche in questo caso si è rivelato determinante il rapporto allacciato con gli enti locali, non solo grandi centri, ma anche piccole realtà comunali con le quali è stato possibile dare vita ad una progettualità diffusa.
Non poteva mancare di essere attenzionata anche la situazione dei minori sottoposti, per motivi diversi, a procedimento penale, attraverso un contatto costante con l’Ussm (Ufficio Servizi Sociali Minorenni).
“E’ questo solo uno spaccato – conclude Giulianelli – di quello che abbiamo fatto e della strada che intendiamo seguire. Convinti che la conoscenza delle problematiche, la collaborazione e la concertazione siano elementi essenziali perché nessun ragazzo venga lasciato indietro”.

A.Is.