EUROPEAN COMMISSION Employment, Social Affairs and Equal Opportunities DG - Social protection and social integration Social and demography analysis Brussels, January 2008 ISG ACTIVITY REPORT 2008 Introduction This Report is a record of activities and summarises the information given to the SPC during 2008. In 2008, ISG activities developed in 4 main areas: social inclusion (housing, inclusion of migrants), flexicurity, pensions (Theoretical Replacement Rates, and private pensions), and health (quality, avoidable mortality, expenditure on health care broken down by types of care, insurance coverage) The following priorities had been set: Adopting a balanced portfolio for the health and long-term care strand (to be used in the 2008 National Strategy Reports) adoption by SPC on 29-30 April 2008 Indicators for the monitoring of flexicurity Guidelines for reporting on the social aspects of migration in the NSR 2008 (March April 2008) Indicators in the area of housing Task force on the analysis of the interaction between social cohesion and growth and jobs (Task Force to start working at the beginning of the second semester) (1) OMC monitoring Within the OMC cycle, 2008 was a full year in which Member States had to report on there overall strategies for social protection and social inclusion. For the first time on this occasion, the Commission was in a position to review the full list of indicators of the overarching portfolio and of the three strands: social inclusion, pensions and health care and long-term care. The ISG was closely associated to this work. The group discussed and approved the outline of the report in February 2008, discussed a first draft in June and a final draft in July. During the summer, Member States were given a third possibility to review and approve the final text of the report. The early delivery of the report, at least in draft format, aimed at providing a sound analytical base to Member States for the preparation of their national strategies. The international comparison was Commission européenne, B-1049 Bruxelles / Europese Commissie, B-1049 Brussel - Belgium. Telephone: (32-2) 299 11 11.
meant to serve as a reference on which to gauge Member States own situation according to an agreed comparative framework. The report was final and approved at the SPC of September 2008. It has to be noted that in this context many new indicators were analysed for the first time either because they had just become available (e.g. anchored poverty rate) or because they had just been agreed (e.g. indicators in the area of health care and long-term care). A summary of the full OMC monitoring report was produced for the supporting document to the Joint Report 2009. In comparison to the full report, this 20 pages summary takes account of the most recent data available: e.g. SILC (2007), ESSPROS (2006), latest calculation of theoretical replacement rates, latest OECD and WHO updates in the area of health care. In addition, the ISG has discussed a method to provide a summarised overview of Member States relative poverty levels by age groups. In the future, the method to calculate countries' "scores" will need to be refined and could be applied to summarise the relative situation of Member States with regards to a choice of key indicators, thereby highlighting the relative strengths and weaknesses of Member States. (2) Health care and long-term care Completing the health portfolio In the area of health care and long-term care, the main achievement this year has been to adopt a full list of indicators to monitor the health care and long-term care objectives in the context of the European strategy for Social Protection and Social Inclusion. The updated ISG report on indicators is available on the Social OMC web-site 1. This list is the result of intensive ISG work that started in December 2004. The list is based on national data and international sources of data such as EUROSTAT, OECD health data, WHO "health for all" database (WHO-HFA), as well as various projects regarding the development of health indicators such as the European Community Health Indicators project (ECHI) and the OECD Health Care Quality Indicators project (OECD HCQI). The following indicators were adopted in 2008 2 : Self-reported unmet need for medical and dental care Cancer (cervical and breast) screening and cancer (cervical, breast and colorectal) survival rates Satisfaction with healthcare services Influenza vaccination for adults 65+ Perinatal mortality 1 http://ec.europa.eu/employment_social/spsi/docs/social_inclusion/2008/indicators_update2008_en.pdf 2 See full definition in above (footnote 1) 2
Various indicators on healthcare and long-term care expenditure: per capita, as % of GDP, public and private as % of total health expenditure, expenditure on functions of care Hospital in-patient discharges, hospital daycase, hospital length of stay, bed occupancy rates Risk factors and life-styles: obesity, smoking, alcohol, Areas for future work identified Some indicators have been agreed in terms of concept and need to be rechecked in 2010 when data for the European Health Interview Survey becomes available: out-of-pocket payments at household level, healthcare utilisation by socio-economic status, sex and age, satisfaction with services; utilisation of certain long-term care services, life-style indicators. Following a presentation by expert researchers in the area, it was agreed that an indicator on avoidable mortality was useful but it still requires further development notably in terms of calculating such a composite indicator with existing Eurostat mortality data. Other areas for future work include: mortality, life expectancy and healthy life years by socio-economic status, long-term care, mental health and patient safety (infections acquired in the course of medical care). (3) Social inclusion In the area of social inclusion, the ISG worked in three areas: Social aspects of migration Early in the year, the ISG discussed and agreed a set of guidelines for reporting on the social aspects of migration in the 2008 National Strategy Reports. In there national reports, Member States followed these guidelines only to a certain extent, and there will be a need to reflect further on how to best collect national information on the social aspects of migration in support of the planned mainstreaming of migration issues in the context of the OMC. Housing In 2008, the ISG made significant progress in the development of indicators in the field of housing exclusion on the basis of newly available SILC data. 2 indicators were discussed on the basis of extensive exploratory work by Eurostat: an indicator of housing deprivation (which also built on the work of the ESTAT/ISG task force on material deprivation) and an indicator reflecting the burden of housing costs, especially on low income households. Labour market transitions The ISG started reflecting on the way to use information on labour market transitions available in SILC. Eurostat presented the on-going development work carried out in the context of the EMCO indicators group. The types of transition reviewed are transition by employment status (inactivity, unemployment, employment), by type of contract (fixed 3
term, permanent) and by pay levels. In the future the ISG will continue to follow the work by the EMCO indicators group. (4) Pensions In the area of pensions, the ISG held two meetings in 2008. Theoretical replacement rates Most progress was made in the area of theoretical replacement rates. In 2008, updated calculations were carried out either in national models or in the OECD APEX model. Prospective calculations were almost completed for all of the ISG agreed upon cases and two new cases have been developed indicating the effects of different types of career breaks on future pension adequacy. Some of this work was included in the Supporting Document of the Joint Report of 2009. The updated calculations will be synthesized in a report on theoretical replacement rates in the first half of 2009. Developments on longitudinal adequacy indicators In 2008, a study on the existing possibilities to monitor pensions accruals and benefits in pension systems contracted to the TARKI Social Research Institute by the Commission was completed. This study reviewed national tools and data availability that can be of use in future policy making and indicators with the help of the ISG. The study was presented to the ISG as well as future development work planned by the Commission in the area. Indicators on private pensions Furthermore, effort has put into a SPC report on privately managed pension provision that provides a lot of information on the subject but at a national (non-comparable) level. This report will provide a basis for further discussions on further work on indicators relating to privately managed or funded pension provision, as included in the 2009 work program for the ISG. On the basis of the Commission proposal the ISG will continue working on the development of indicators in this field, notably by addressing the following issues: scope of private pensions, precise coverage of the sources used, contribution of private pensions to the overall adequacy of pension systems. (5) Flexicurity In 2008, the ISG followed the work of the EMCO indicators group in the area, notably by commenting and contributing through the secretariat to their working papers. The ISG chairman brought the views of the ISG to the plenary meetings of EMCO. The ISG especially reflected on indicators related to the security strand of flexicurity, and to aspects of social security that interact with the functioning of the labour market and in July presented a list of indicators to the EMCO indicators group covering the dimensions of poverty, pensions, healthcare and disability. It was agreed that this paper will be further discussed in 2009. Further work will also be needed on the presentation and interpretation of the indicators. 4
(6) The ISG/SPC task force on the interaction between growth jobs and social cohesion In 2008, the ISG discussed and finalised the proposal for a mandate of the ISG/SPC task force on the interaction between growth, jobs and social cohesion. By joining forces from both SPC and ISG members, the task force has the ambition to combine a strong analytical base with the policy conclusion that can be derived from this analysis. The mandate was approved by the SPC in September. The Task Force met for the first time in November. On this occasion, Members were introduced to the "Growing Unequal" OECD report which provide an extensive review of empirical evidence at the international level of the trends in inequalities in OECD countries. The Task Force also had a first reflection based on the presentation by selected Member States who had experienced significant trends both in times of economic expansion (IE) and of severe downturns (FI). The Task Force also discussed the organisation of the work; the need to focus the work of the Task Force on the core issues; and the need to take account of the recent crisis. (7) Statistical capacity In 2006, Eurostat launched a taskforce on life expectancy by socio-economic groups gathering renowned academic experts in the field. Available evidence indicates that gaps in life expectancy between different socio-economic groups remain large and could increase in the future. The ISG has strongly called for having this type of information available in an EU context. The first aim of the task force is to produce recommendations on how to collect this information which is not available in all countries. Unfortunately little progress was reported by Eurostat in 2008. In 2008, the ISG continued to follow Eurostat's work on implementing EU-SILC. Eurostat gave a first positive assessment of the year to year comparability of EU-SILC aggregates based on the cross sectional data. 5