Ms Ursula von der Leyen President European Commission

 

Dear President,

Achieving equality for all has been one of the core commitments of the European Commission in recent years. On disability, this has resulted in the adoption by the Commission of a Strategy for the Rights of Persons with Disabilities 2021-2030, as well as a new Human Resources Strategy.   

I welcome that these two strategies emphasise the Commission’s intention to lead by example in ensuring inclusiveness and diversity in its workforce. It is crucial that the EU administration, both as policymaker and as employer, plays its part in removing the structural obstacles people with disabilities face.

In 2020, following one of my inquiries, the Commission revised the general implementing provisions of its Joint Sickness and Insurance Scheme (JSIS). The revision was meant to guarantee comprehensive coverage for disability-related health needs of EU staff and their families. This would help the shift from disease-centred health care, to people-centred health systems[1]. The EU is a party to the UN Convention on the Rights of Persons with Disabilities and these changes were also in line with what UN experts had called for.

Currently, the EU is undergoing its second periodic review under the Convention. This is a moment to reflect on what has been done by the EU administration since the first review, and to assess whether the steps that were taken were effective in delivering concrete and positive change for those concerned. Could the Commission therefore please provide an update based on the questions in annex?

I would be grateful to receive the Commission’s reply by 16 May 2024. Please note that I am likely to publish your reply and related enclosures online^[2]. If the Commission prefers that these questions be discussed in a meeting, that would also be possible and we would, in that case, propose to publish a non-confidential version of the meeting report.

The responsible Inquiries Officer is Ms Amandine Le Bellec.

Yours sincerely,

Emily O'Reilly
European Ombudsman

Strasbourg, 16/02/2024

 

Annex - List of questions

 

A) Could the Commission please provide the Ombudsman with an update on the action taken following her recommendation and her suggestions for improvement related to healthcare in OI/4/2016/EA?[3]  How do the changes introduced to the JSIS General Implementing Provisions fulfil the UN Committee recommendation that the JSIS should comprehensively cover disability-related health needs in a manner compliant with the Convention?

B) The new JSIS GIPs maintain the four pre-existing criteria for full reimbursement of medical costs. Could the Commission please inform the Ombudsman about the way these criteria, and in particular those related to “aggressive diagnostic and/or therapeutic procedures”, “serious handicap”, and “shortened life expectancy” are applied to cases of disability? What happens when it is not just one, but several of these criteria that are not fulfilled?

C) Could the Commission please set out its view as regards whether it is legitimate to differentiate between types of impairments (physical, mental, intellectual, or sensory) or the perceived “degree” of disability when deciding whether to grant full reimbursement? 

D) An important change introduced by the 2020 revision of the JSIS GIPs is the increased degree of flexibility that Medical Officers have in assessing one criteria as fulfilled in light of the others. How does the Commission ensure that this greater flexibility does not result in unpredictability of reimbursements?

E) Could the Commission please inform the Ombudsman of any steps it has taken under Article 25(d) of the UN CRPD? Is awareness-raising around the CRPD and the human rights approach to disability part of the training of EU health professionals or staff working for the JSIS?

F) In OI/4/2016/EA, the Ombudsman asked for an overview of the number of applications for the recognition of a “serious illness” submitted by or on behalf of persons with disabilities, as well as their outcomes (number of rejections, number of Article 90(2) complaints, and subsequent decisions). As this type of statistics did not exist at the time, the Commission provided the Ombudsman with information about the number of complaints related to serious illness, and among these, the number of complaints in which the complainants self-declared a disability - and their final outcome. If it is now possible, could the Commission please provide the Ombudsman with an overview of disability-related applications for the recognition of “serious illness” and their outcomes, starting from 2020 and the entry into force of the revised GIPs? Alternatively, could the Commission please provide the Ombudsman with the same type of information it had communicated in OI/4/2016/EA?

 

[1] UN General Assembly High-Level Meeting, September 2023, press release available at: https://www.who.int/news/item/21-09-2023-world-leaders-commit-to-redouble-efforts-towards-universal-health-coverage-by-2030#:~:text=In%20the%20Political%20Declaration%2C%20Heads,health%20care%20(PHC)%20approach

[2] If you wish to submit documents or information that you consider to be confidential, please mark them ‘Confidential’. Encrypted emails can be sent to our dedicated mailbox.  Information and documents of this kind will be deleted from the European Ombudsman’s files shortly after the inquiry has ended.

[3] Available at: https://www.ombudsman.europa.eu/lt/decision/en/112191. The Ombudsman’s recommendation was that “The Commission should immediately set about the task of revising the GIPs (which govern the operation of the JSIS) with a view to ensuring that persons with disabilities will, in future, be dealt with under the JSIS in a manner which complies with the UNCRPD. For the purposes of its revision of the GIPs, the Commission should set out a clear timeline for consulting relevant representatives of staff members with disabilities as well as representatives of staff members with dependants with disabilities. The revision process should focus on the criteria for the full reimbursement of medical costs but other issues may also need to be considered.”

As regards suggestions, please comment in particular on suggestions 1, 4, and 5.