Workmen's Compensation (Accidents) Convention, 1925 (No. 17) - Isle of Man

Observation (CEACR) - adopted 2020, published 109th ILC session (2021)

Articles 9 and 10 of the Convention. Cost-sharing with respect to medicines and appliances. The Committee takes due note of the information provided by the Government in reply to its previous request concerning the exceptions to cost-sharing with respect to medicines and appliances, and in particular the “wide range of exemptions from prescription charges targeting those who are most in need and those who have the least means to pay”, as well the financial contribution required from other persons for entitlement to prescription medicines and appliances free of charge.

The Committee has been informed that, based on the recommendations of the Standards Review Mechanism Tripartite Working Group (SRM tripartite working group), the Governing Body has decided that member States for which Convention No. 17 is in force should be encouraged to ratify the more recent Employment Injury Benefits Convention, 1964 [Schedule I amended in 1980] (No. 121), or to accept Part VI of the Social Security (Minimum Standards) Convention, 1952 (No. 102) (see GB.328/LILS/2/1). Conventions Nos 121 and 102 reflect the more modern approach to employment injury benefits. The Committee therefore encourages the Government to follow up the Governing Body’s decision at its 328th Session (October–November 2016) approving the recommendations of the SRM Tripartite Working Group and to consider ratifying Convention No 121 or accepting Part VI of Convention No. 102 as the most up-to-date instruments in this subject area.

Observation (CEACR) - adopted 2016, published 106th ILC session (2017)

Articles 9 and 10 of the Convention. Cost-sharing with respect to medicines and appliances. For many years, the Committee has been pointing to the fact that the ongoing practice to require victims of industrial accidents, apart from a few exceptions, share in the costs of the medical care and supplies which they receive, is contrary to the Convention. In 2011, on the occasion of the review of these exceptions, the Committee expressed the hope that the Government would reduce the cost-sharing requirements so as to at least not cause any hardship for persons of small means who fall victims of industrial accidents. As the report does not include any new information in this regard, the Committee reiterates its request to bring the national legislation and practice into conformity with the Convention and to indicate any additional exceptions to cost-sharing considered under the review process.

Conclusions and recommendations of the Standards Review Mechanism. The Committee notes that, at its 328th Session in October 2016, the Governing Body of the ILO adopted the conclusions and recommendations formulated by the Standards Review Mechanism Tripartite Working Group (SRM TWG), recalling that Conventions Nos 12, 17, 24, 25 and 42, to which the United Kingdom is party and which are applicable to its non-metropolitan territories, are outdated and charging the Office with follow-up work aimed at encouraging States party to these Conventions to ratify the Employment Injury Benefits Convention, 1964 [Schedule I amended in 1980] (No. 121), the Medical Care and Sickness Benefits Convention, 1969 (No. 130), and/or extend the Social Security (Minimum Standards) Convention, 1952 (No. 102), to these territories, as these represent the most up-to-date instruments in this subject area. The Committee reminds the Government of the availability of ILO technical assistance in this regard.

Observation (CEACR) - adopted 2011, published 101st ILC session (2012)

Articles 9 and 10 of the Convention. Cost-sharing in the cost of medicines and appliances. In its reply, the Government states that cost-sharing constitutes a contribution of the individual towards care and medical supplies and accounts only for a small proportion of the actual costs incurred. In principle, exemptions on cost-sharing should only apply to those who are not able or have a reduced ability to meet the statutory charges, including economically inactive persons or persons who suffer reduced incomes because of occupational accidents. Other exemptions to cost-sharing, which are related to specific conditions or diseases, are currently under review and could well be rationalized or removed in the future. The Government states that it would be inappropriate to seek to add any further exemptions to those currently in place until the review process has been completed. The Committee notes this information and wishes to recall that the purpose of Articles 9 and 10 of the Convention is to relieve victims of occupational accidents from bearing any costs of prescribed medicines and artificial limbs resulting from employment injury. Therefore, the Committee hopes that the Government will seize the opportunity of the current review of cost-sharing to reduce it so as at least not to cause any hardship for persons of small means who fall victims of industrial accidents. Please provide statistical information requested in Part V of the report form.

Observation (CEACR) - adopted 2007, published 97th ILC session (2008)

Articles 9 and 10 of the Convention. Cost sharing in the cost of drugs, medicines and appliances. In reply to the Committee’s previous comments concerning the cost sharing by the victims of employment accidents in the cost of drugs, medicines and appliances prescribed for outpatients, the Government reiterates that the current arrangements for exemption from cost sharing are considered adequate in so far as they protect victims of occupational accidents who may have difficulty in meeting the cost of prescription charges. The Government considers that the existence of these extensive exemption and charge remission arrangements are intended to ensure that no one in need be deterred from obtaining any necessary medication on financial grounds and indicates that currently 87 per cent of all prescription items are dispensed free of charge. Furthermore, the level of prescription charges is nearly half of that applied, for example, in England or Scotland. While it takes due note of this information, the Committee is bound to once again recall that any provision envisaging the sharing by the victim of an occupational accident in the cost of prescribed drugs, medicines and artificial limbs and surgical appliances is contrary to the provisions of Articles 9 and 10 of the Convention. These provisions are intended to prevent workers from having to bear the financial costs resulting from employment injury. In these circumstances and considering the numerous exemption arrangements that already exist, the Committee considers that the Government should be able to include all victims of occupational accidents, irrespective of their income level, within the category of insured persons exempt from cost sharing so that medical assistance and appliances dispensed to outpatients are provided free of charge to all victims of industrial accidents. The Committee trusts that the Government will re-examine this question and take the measures necessary to ensure the full implementation of the Convention on this point. In this respect, it also requests the Government to refer to the observation concerning the application of the Convention by the United Kingdom.

Observation (CEACR) - adopted 2000, published 89th ILC session (2001)

Articles 9 and 10 of the Convention.  In reply to the Committee’s previous comments concerning the cost sharing by the victims of employment accidents in the cost of drugs, medicines and appliances prescribed for outpatients, the Government repeats the argument that the current arrangements for exemption from cost sharing are considered satisfactory in so far as they protect victims of occupational accidents who may have difficulty in meeting the cost of prescription charges. The Committee once again reminds the Government that any provision envisaging the sharing by the victim of an occupational accident in the cost of prescribed drugs, medicines and artificial limbs and surgical appliances is contrary to the provisions of Articles 9 and 10 of the Convention. These Articles are intended to prevent workers from having to bear the financial costs resulting from employment injury. In these conditions, the Committee is bound to hope once again that the Government will be able to reconsider this question and take the necessary measures to give full effect to the Convention on these points. In this respect, it also requests the Government to refer to the observation concerning the application of the Convention by the United Kingdom.

Observation (CEACR) - adopted 1995, published 82nd ILC session (1995)

Articles 9 and 10 of the Convention. In reply to the Committee's previous comments concerning the participation by victims of industrial accidents in the cost of drugs, medicines and appliances prescribed for out-patients, the Government states that the Isle of Man is content to follow and adopt United Kingdom practice in this area and that the Government believes that the existing arrangements are satisfactory in terms of assisting, amongst others, those people who have sustained an injury as a result of an occupational accident and who have difficulty in meeting the cost of prescribed charges. In this connection, the Committee wishes to point out that any provision laying down participation by victims of industrial accidents irrespective of their resources in the cost of pharmaceutical aid and surgical appliances is contrary to the Convention. It therefore hopes that the Government will reconsider its position so as to ensure the application of the Convention on this point. It asks the Government to refer in this respect also to the observation concerning the application of Convention No. 17 by the United Kingdom.

Direct Request (CEACR) - adopted 1991, published 78th ILC session (1991)

With reference to its earlier comments, the Committee notes with interest the statement in the Government's report that the appropriate authorities in the Isle of Man are currently considering the extent to which measures are necessary to give statutory effect to the provisions of Articles 9 and 10 of the Convention. The Committee requests the Government to furnish any information on the progress made and the text of any legislative provisions adopted for the purpose.

Direct Request (CEACR) - adopted 1990, published 77th ILC session (1990)

The Committee notes that the Government's report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the matters raised in its previous direct request, which read as follows:

In its earlier comments the Committee has asked the Government to state whether, and if so under which provisions, the aid prescribed by Articles 9 and 10 of the Convention are guaranteed free of cost to the victims of occupational accidents. The Government stated in its reply that since 1979 the Isle of Man Health Services Board, which deals with exemptions from medical charges, deals also with cases relating to occupational accidents, which it does in agreement with the Isle of Man Board of Social Security.

Although these arrangements appear to ensure that the aid prescribed by these provisions of the Convention is furnished free of cost, the Committee would be grateful if the Government would take the necessary measures to give statutory effect to this practice so that the right of the workers concerned to receive the aid prescribed free of cost shall be recognised, as provided by the Convention. The Committee also asks the Government to furnish the text of any provision in laws or regulations adopted for the purpose.