EN    EN EN 
 
EN    EN  COMMISSION OF THE E UROPEAN COMMUNITIES 
Brussels, 13.2.2009 
SEC(2009) 141 
  
COMMISSION STAFF WORKING DOCUMENT 
Joint Report on Social Prot ection and Social Inclusion 
accompanying document to the  
COMMUNICATION FROM THE COMMISSI ON TO THE COUNCIL, THE 
EUROPEAN PARLIAMENT, THE EU ROPEAN ECONOMIC AND SOCIAL 
COMMITTEE AND THE COMMI TTEE OF THE REGIONS 
Proposal for the Joint Report on Soci al Protection and Social Inclusion 2009 
Supporting document 
{COM(2009) 58 final}
 
EN 2   EN TABLE OF CONTENTS 
1. Scope and Outline of the Report .................................................................................. 4 
2. Overview of the Social Situati on and Overall Strategic Approach.............................. 5 
2.1. Overview of key indicators of Social Pr otection and Social In clusion in Europe....... 5 
2.2. Progress towards the ov erarching objectives ............................................................. 20 
2.3. The European Social Fund – major tool  for implementation of strategies ................ 25 
3. Fighting Poverty and Social Exclusion...................................................................... 26 3.1. Introduction.............................................................................................................. .. 26 
3.2. Promoting Child Well-Being and Break ing the Cycle of Deprivation ...................... 27 
3.3. Addressing the needs of other groups at  particular risk of exclusion ........................ 34 
3.4. Active inclusion – bringing the most ex cluded back into society and the labour 
market......................................................................................................................... 41 
3.5. Access to services to enable social inclusion............................................................. 48 3.6. Enhancing governance of social inclusion policies ................................................... 56 3.7. Annexes to Chapter 3................................................................................................. 64 4. Adequate and Sustainable Pensions........................................................................... 76 4.1. Overall strategy for Adequacy a nd Sustainability of Pensions.................................. 76 
4.2. More people in work and working long er: The response of pension policy.............. 82 
4.3. Supplementary funded pensions: impact  on adequacy and sustainability ................. 93 
4.4. Minimum income provision for older people (MIP)................................................ 102 
4.5. Ensuring information and transparency ................................................................... 108 4.6. Conclusions.............................................................................................................. 1 12 
5. National Strategies on Hea lthcare and Long-term Care .......................................... 115 
5.1. Introduction.............................................................................................................. 115 
5.2. Addressing health inequalities and inequities in access to care............................... 122 
5.3. Quality of healthcare................................................................................................ 131 5.4. Sustainability............................................................................................................ 135 
5.5. Long-term care services ........................................................................................... 143 5.6. Conclusions.............................................................................................................. 1 48 
6. Annex: Indicators..................................................................................................... 153 
 
EN 3   EN 6.1. Definition of the 14 overarching indicators ............................................................. 153 
6.2. Data sources ............................................................................................................. 1 55 
6.3. Statistical tables........................................................................................................ 160
 
EN 4   EN 1. SCOPE AND OUTLINE OF THE REPORT  
This supporting document prepared by the Comm ission services accompanies the 2009 Joint 
Report on Social Protection and Social Incl usion [Commission proposal: COM(2009) xx]. It 
provides an in-depth assessment of the renewe d National Strategy Reports (NSRs) presented 
by EU-27 in autumn 20081. The NSRs outline each Member  State's policy priorities up until 
2011 in the second cycle of the integrated EU  process for Social Protection and Social 
Inclusion. The assessment draws on the material provided by Member States in their NSR, but 
also on analysis prepared by independent expert s and on studies and research carried out in 
the framework of the Social Open  Method of Coordination (OMC).  
Section 2 contains an overview of the social situation in th e Member States and of their 
overall strategic approach. A comprehensiv e analysis is published on the Commission 
website2 showing where each Member State stands in relation to the common objectives3 of 
the EU process for social prot ection and social incl usion based on the data available in 2008: 
The NSRs were presented at the end Septembe r 2008, and were therefore prepared before the 
fallout of the financial crisis on the real  economy took hold. Although these developments 
could not be anticipated in the NSRs, Memb er States and the Commission agree on the 
reports are still relevant, and that the actions en visaged to strengthen deliv ery on shared social 
objectives have become all the more urgent . As stated in the Joint Commission/Council 
Report proper: "Appropriate so cial policies will simultane ously support the goals of 
mitigating adverse social impact on the most vulne rable and of containing impact of the crisis 
on the economy overall."  
Section 3 below assesses the chapters in the NS Rs dedicated to social  inclusion, in other 
words the National Action Plans for social in clusion (NAP-inclusion) . Section 4 analyses 
national strategies for pensions , while section 5 looks at nati onal strategies in the area of 
healthcare and long-term care. 
The annex contains an overview of the most  recent statistical data on the indicators4 
developed to monitor progress towards the ov erarching common objectives of the Social 
OMC.
                                                 
1 http://ec.europa.eu/employment_social/spsi/strategy_reports_en.htm  
2 Monitoring progress towards the objectives of the Eu ropean Strategy for Soci al Protection and Social 
Inclusion : http://ec.europa.eu/employment_social/spsi/joint_reports_en.htm  
3 http://ec.europa.eu/employment_social/spsi/common_objectives_en.htm  
4 http://ec.europa.eu/employment_social/spsi/common_indicators_en.htm  
 
EN 5   EN 2. OVERVIEW OF THE SOCIAL SITUATION AND OVERALL STRATEGIC APPROACH  
2.1. Overview of key indicators of Social Prot ection and Social Inclusion in Europe 
• 16% of Europeans, or 79 million people, were at risk of poverty in 2007. 
• Despite overall progress on the labour ma rkets, 9.3% of working age adults and 
9.4% of children live in jobless househol ds and 7% of the employed live below 
the poverty threshold. 
• Social transfers reduce the risk of pove rty by 36% on average in the EU, but this 
impact varies from 17% to more than 60% across the EU. 
• The employment rate of older workers reached 45% in 2007 as against 37% in 
2001. 
• Current pension systems have generally reduced poverty among the elderly, but 
single elderly women face a much higher ri sk than single elderly men (28% as 
against 20%).  
• In the future for the generations who ha ve recently entered the labour market, a 
marked decline in pensions can be exp ected if the number of years worked and 
contribution rates remain the same. 
• Life expectancy is now 82 years for wo men and 76 years for men. This follows a 
gain in longevity of 4 years for women and 5 years for men over the last 20 years.  
• The gap in life expectancy between Eur opean countries is 8 years for women and 
13 years for men. 
• Total expenditure on health has increased throughout the EU in the last 20 years. 
Today it ranges from 10% of GDP or more in some countries to 6% or less in 
others. 
2.1.1.  16% of Europeans are at risk of poverty 
In 2007, in EU-27 16% citizens liv ed below the poverty threshol d defined as 60% of their 
country's median income, a situation likely to hamper their capacity to fully participate in 
society. National percentages ranged from 10% in  the Czech Republic and the Netherlands to 
21 in Latvia. 
 
EN 6   EN Figure 1: At-risk-of poverty rate in  the EU (%), total and children, 2007 
05101520253035
EU27 CZ NL SK SE DK HU AT SI FR FI LU MT BE DE CY PL IE PT EE LT RO* UK EL ES IT LV% of the relevant population
Total population Children aged 0-17 People aged 65+ Elderly 
in CY
 51%
 
Source: EU-SILC (2007); income year 2006; except for UK (incom e year 2006) and for IE (moving  income reference period 
2005-06); RO: National Household Budge t Survey 2006. BG data missing 
Children are often at greater risk-of-poverty than  the rest of the popula tion (19% in the EU-
27). This is true in most countries except in the Nordic States, Cyprus and Slovenia. Child 
poverty rates range from 10% in Denmark to 25%  in Italy and Romania. The main factors 
affecting child poverty levels in the EU are the labour market situ ation of their parents and the 
effectiveness of government intervention th rough income support and the provision of 
enabling services such as childcare. This is part icularly evident in the case of lone parents, 
who face a risk of poverty of 34%. 
While on average the elderly also face a higher risk of poverty than the overall population 
(19% against 16%) substantial differences exist acr oss countries as illustrated in Figure 1 and 
Table 1. The risk of poverty faced by people aged  65 or more ranges from 5% in the Czech 
Republic to 30% in Lithuania, and the United Kingdom, 33% in Estonia, and Latvia, 31% in 
Spain and even reaches 51% in Cyprus. These differences in the relative situation of the elderly depend on a number of factors including the adequacy of the pension systems for 
current pensioners and the age and gender stru cture of the elderly pop ulation, since elderly 
women and the very old tend to face much higher risks. 
Table 1 gives an overview of the relative situat ion of the main age groups in the population, in 
terms of levels and depth of poverty. This situ ation is assessed both in  relation to the EU 
average and in relation to the overall population. It illustrates the challenges Member States 
need to address to improve the situation of major population groups. 
 
EN 7   EN Table 1: Overview of poverty rates by age groups 
Poverty rate/gap is ++: well below; +: below; o: around; -: above; --: well above the EU and national average5 
  Children (0-17) Working age (18-64) Elderly (65+) 
2007 Risk of 
poverty* Poverty 
depth** Risk of 
poverty* Poverty 
depth** Risk of 
poverty* Poverty 
depth** 
be o + o o - o 
bg o - o ++ o o 
cz - o ++ + ++ ++ 
dk ++ - o -- o ++ 
de + + -- o + o 
ee + -- o -- -- + 
ie o o o + - ++ 
el - -- -- o o -- 
es - - + - - - 
fr o ++ o ++ + -- 
it -- - - - o - 
cy ++ ++ ++ ++ -- -- 
lv o -- - -- -- o 
lt - -- o - - + 
lu - o - + ++ ++ 
hu - + - + ++ + 
mt - + o + o - 
nl o o + ++ + + 
at o o o o + + 
pl -- - -- o ++ + 
pt - - o - - o 
ro -- - - + + - 
si ++ o + ++ o -- 
sk - o ++ + ++ + 
fi ++ ++ + + - + 
se + ++ o - + ++ 
uk - o + o - - 
  
* Risk of poverty: score based on the at -risk-of poverty (EU-SILC), relative level to EU average and to overall population 
** Poverty depth: score based on the at-risk -of poverty gap (EU-SILC), relative level to EU aver age and to overall population
                                                 
5 The scores are calculated on the basis of the at-risk  of poverty rates/gaps. Th ey are z-scores and are 
used to rank countries and to identify 5 relative levels, from ++ to --. Levels are defined so that 
countries with similar scores are grouped together and that there is a significant step between each 
group.  
 
EN 8   EN The standards of living of “poor” people vary greatly across the EU. In the Baltic States, 
Hungary, Poland and Slovakia, people at-risk of poverty live on less than €250 per month, 
whereas in the Nordic countries, as well as in  Ireland, Luxembourg, the Netherlands, and the 
UK the poverty threshold is €900 a month. When ta king account of the differences in the cost 
of living (values expressed in purchasing power standards) the monthly income of the people 
at risk of poverty vary from €-PPS 280 to  € PPS947 (and up to €-PPS1465 in LU). This 
suggests that the standard of living of the poor is 3.4 times higher in the richest EU countries 
than in the poorest countries. However, it shou ld be kept in mind that, in each country, the 
poverty threshold (defined as 60%  of the country's median income) represents the level of 
income that is considered nece ssary to lead a decent life. 
Economic growth has helped to improve overall living standards but the benefits of growth 
have not reached everyone at the same pace and to the same extent. In a number of countries 
(CZ, EE, ES, IE, CY, LV, LT, PL, SI, and SK),  strong growth rates of 3% or more over 
several years have not left the poor behind and have helped to improve their living standards 
while their relative situation either improved or  stayed the same. On the contrary, in EL, LU, 
HU and SE, growth rates over 3.5% have not had the same impact on low income households. 
The impact of the deepening economic crisis on  living standards and inequalities will need to 
be closely monitored, with a speci fic focus on the most vulnerable6. 
On average in the EU, the general improvement on the labour market between 2000 and 2008 
has had a limited impact on the people that are most excluded. The numbe r of people living in 
jobless households remains high, despite some  recent improvements. In-work poverty is a 
matter of growing concern in most Member States , as is the integration of migrants into the 
labour market. The impact of the expected de terioration of labour market conditions on the 
most vulnerable households will need to be closely monitored. 
In 2007, almost 9.3% of EU27 working age adults  (aged 18-59, and not students) were living 
in households where no one was in paid employm ent. This rate ranged from 4.7% in Cyprus 
to 11% or more in Belgium, Hungary, and Poland. On average, a similar proportion of 
children were living in jobless households, 9.4% in the EU-27 in 2007. However, families with children are more affected by joblessness in some countries than in others. The share of 
children living in jobless households varies gr eatly across Member States, and ranges from 
2.2% in Slovenia to 16.7% in the United Kingdom. Living in a household where no one works affects both children's current living conditions, and their chances to develop their full potential. 
                                                
 
6 The SPC task force on the mutual interaction betw een growth, jobs and social cohesion policies will 
address these issues in the first half of 2009. 
 
EN 9   EN Figure 2: Adults and children living in jobless households, 2007 (%) 
0,02,04,06,08,010,012,014,016,018,0
EU-
27CY PT SI ES EE LT NL CZ DK MT LV LU AT IE EL SK IT DE RO BG FI FR UK PL HU BE
Adults (18-59 - not students) Children (0-17)% of total population concerned
 
Source: Eurostat Labour Force Survey, spring results, data missing for SE 
On average in the EU, general improvements on the labour market only started benefiting 
people living in jobless househol ds over the past two years (-1 percentage point between 2005 
and 2007). These improvements have not had the same impact on families with children, since the reduction in the shar e of children in j obless households was only 0.3 p.p. between 
2005 and 2007. Unfortunately the current recession is likely to put a ha lt to this recent 
progress. 
As indicated above, having a job does not always protect people from the risk of poverty. In 
2007, 8% of EU-27 citizens in employment (aged 18 and over) lived below the poverty threshold, thereby facing difficulties in particip ating fully in society. This rate ranged from 
4% or less in the Czech Republic, Belgiu m, Denmark, Ireland, Malta, the Netherlands, 
Slovenia, Slovakia and Finland to 13% in Greece and 10% in  Poland. In-work poverty is 
linked to low pay, low skills, precarious empl oyment and often involuntary part-time 
working. It is also linked to the type of household in which workers live and to the economic 
status of other members of the household. In hous eholds with children for instance, the single-
earner family model is no longer sufficient to ward off the risk of poverty.
 
EN 10   EN Figure 3: In work poverty: at-risk-of-p overty rate of people in employment  
aged 18 and over, 2007 (%) 
0246810121416
EU27CZ BE DK MT RO FI NL SI SK AT CY FR HU IE DE SE EE LT UK LU IT LV PT ES PL EL%
 
Source: EU-SILC (2007); income year 2006; except for UK (incom e year 2007) and for IE (moving  income reference period 
2006-07); RO: National Household Budget Survey 2007; data missing for BG 
In 2007, the employment rate of third-country nationals/population bor n outside the EU was 
2.6 percentage points lower than that of the host population, a similar gap to that recorded in 
2006 (2.7 p.p.). This masks strong differences acr oss the EU. In Spain, Greece, Italy and 
Portugal, where migration is a recent phenom enon and mainly economic, migrants have 
higher employment rates than the native-born p opulation. By contrast, in Belgium, Denmark, 
Germany, France, Austria, Sweden and the Un ited Kingdom, migrants have much lower 
employment rates than the host population, with employment gaps ranging from 6% in the 
United Kingdom to 16% in Denmark.  
On average in the EU, social tr ansfers other than pensions (suc h as unemployment, family and 
housing benefits) reduce the risk of poverty by 36%. In the absence of all social transfers, the 
average poverty risk for EU Member States wo uld be 25% (as against 16% after receipt of 
government support). Social transfers are most  effective in the Czech Republic, France, 
Hungary, the Netherlands, Austria, Slovenia a nd the Nordic countries,  where they reduce 
poverty by 50% or more. Conversely, in Greece, Spain, and Italy, social transfers only reduce 
the risk of poverty by 17% or less. 
The impact of social transfers in reducing the risk of poverty is higher for children, with the 
EU average reaching 42% in 2007. Th is is true in most EU count ries, except in BE, CZ, EL, 
LT, HU, MT, NL, PL, PT and SK, where it is sli ghtly smaller. In the Nordic countries, FR, 
HU, SI and AT, social transfers (other than pensions) reduce the risk of poverty for children 
by more than 55%, while in EL and ES the redu ction is less than 20% (also for the overall 
population).
 
EN 11   EN Figure 4: Impact of social tr ansfers (excluding pensions) on  the at-risk-of-poverty rate 
for the total population and for children, 2007 (%) 
0%10%20%30%40%50%60%70%
EU27 EL ES IT BG( 1) R O ( 2 ) L VC YE EP TL TM T U KP LS KL U D EI EB ES IC Z  F R A TN L F ID K H US E
Total population Children aged 0-17
 
Source: EU-SILC (2007); income year 2006; except for UK (incom e year 2007) and for IE (moving  income reference period 
2006-07); BG: National Household Budget Survey 2006; RO: National Household Budget Survey 2007  
2.1.2.  The adequacy and sustainability of pension systems 
Ageing of the population is one of the challenges that the EU is facing. Population projections 
show that the share of people aged 65 years and over in the total population is predicted to 
increase from 17.1% to 20.1% in 2020. This m eans that there will be 103.1 million older 
persons compared to 84.6 million in 2008. The old age dependency ra tios will therefore 
increase from the current 4 persons of worki ng age (15-64) for every person aged 65 years to 
a ratio of 3 to 1.7 
The main route to ensure both sustainability of pension systems and an adequate level of 
income for pensioners is, therefore, to extend working lives. The EU's target under the growth 
and jobs strategy is to reach a 50% employment rate for older workers by 2010. In 2007, the 
employment rate for older workers in the EU -27 was 45% compared to 37% in 2001, and 12 
countries now exceed the 50% target (Denmark , Germany, Estonia, Ireland, Cyprus, Latvia, 
Lithuania, the Netherlands, Portugal, Finland, Sweden, and the UK). However, the target is 
still far away for a group of countries where th e employment rate for older workers is still 
around 30%-35%. The general increase in employm ent rates of older workers results from 
two main factors: a demographi c effect and the increased par ticipation of women. Due to the 
ageing of the baby-boom genera tion, the relative share of pe ople aged 55-59 - who have a 
higher employment rate - has grown. In additio n, most Member States experienced a higher 
increase in the employment rate fo r women than for men between 2001 and 2007. 
                                                 
7 Source: …  
 
EN 12   EN Figure 5: Change in employment rate of older workers, 55-64, 2001-2007 
-10-50510152025
EU27 RO M T DK PT PL SE EL UK ES IT FR CY IE LU SI CZ FI BE HU AT NL EE SK DE LT BG LV
Women Men Total 
Source: Eurostat, Labour Force Survey, Annual averages 
How does the income of the elderly compare to the rest of the population? Pension systems 
significantly reduce poverty  among older people, and people ag ed 65+ have an income which 
is around 85% of the income for younger people, ranging from 57% in Cyprus to more than 
100% in Poland. However, single elderly women s till face a much higher risk of poverty than 
single men (28% against 20%). 
Figure 6: Relative income of the elderl y: Median income of people aged 65+  
as a ratio of income of people aged 0-64, 2007 
0%20%40%60%80%100%120%
EU27 CY EE LV IE LT DK UK BE FI ES SE M T PT CZ SK EL NL DE IT SI RO FR AT LU HU PL
 
Source: SILC (2007) Income reference year 2006; except for UK (income year 2007) and for IE (moving income reference 
period 2006-2007). RO: National HBS 2007, income data 2007. BG: missing data. 
 
EN 13   EN Aggregate replacement ratios - which are base d on gross individual income rather than 
household disposable income - however, generally  show that current average pension levels 
can be rather low compared to current earnings . This can be due to low coverage and/or low 
income replacement from statutory pension sche mes, but can also reflect maturing pension 
systems and incomplete careers or under-declaration of earnings in the past . In this respect, it 
should be noted that the aggregate replacemen t ratio indicator is based on gross income 
figures, and that several factors besides aggreg ate replacement rates (such as differences in 
household composition and size and the overall design of social protection and taxation 
systems) can have a strong influence on th e overall living standa rds of individuals. 
Figure 7: Aggregate replacement ratio for those aged 65+, 2007 
0%10%20%30%40%50%60%70%
CY LV DK EL LT UK NL BE SI DE FI EE IE ES PT IT M T CZ SK HU PL BG FR LU AT SE EU25
Males Fe ma les Total
 
Source: SILC (2007) Income data 2006; except for UK (incom e year 2007) and for IE (moving income reference period 
2006-2007); For BG: National HBS (2006) income data 2006. Data for RO not available. 
Definition: the aggregate replacement ratio is the ratio of  median personal (non-equivalised) income from pensions of 
persons aged 65-74 relative to median personal (non-equi valised) income from earnings of persons aged 50-59. 
The future adequacy and sustainability of pensions can be assessed using theoretical 
replacement rates. Theoretical re placement rates are case study based calculations that show 
the level of pension income the first year af ter retirement as a pe rcentage of individual 
earnings at the moment of take-up of pensions. Results provided here present the difference in 
replacement rates under current legislation (e nacted by 2006) and replacement rates in 2046 
reflecting the effects of legislat ed pension reforms to be implemented gradually in the future. 
They show how changes in pension rules can aff ect pension levels in the future. The results 
show that most recently enacted pension reform s, while containing future pension expenditure 
do so through lower benefits giving a decrease in future projected replacement rates given a 
fixed age of retirement. 
 
EN 14   EN Table 2: Change in Theoretical Replacement rates for a wo rker retiring at 65 after 40 year s with average earnings  
  Change in Theoretical replacement rates in percentage points (2006-2046) Assumptions 
  NET GROSS Replacement Rate Coverage rate (%) Contribution rates*   
  Total Total Statutory 
pension Type of 
Statutory 
Scheme 
(DB, NDC or 
DC) Occupational 
and 
voluntary 
pensions Type of 
Supplementary 
Scheme (DB or DC) Statutory 
pensions Occupational 
and 
Voluntary 
pensions Statutory 
pensions ( or in 
some cases 
Social Security) Occupational and 
voluntary 
pensions: 
Estimate of 
current Occupational 
and voluntary 
pensions: 
Assumption Evolution of statutory pensions 
expenditures between 2004 
and 2050 (source 
EPC/AWG)** 
BE 3 5 -1 DB 5 DC 100 55 16.36 NA 4.25 5,1 
BG 15 15 15 DB and DC /   NA / NA /   NA 
CZ -21 -16 -16 DB /   100 / 28 /   5,6 
DK 7 20 -10 DB 30 DC 100 78 0.9  8.8 12.7 3,0 
DE 1 2 -9 DB 11 DC NA 70 19.5 NA 4 1,7 
EE 11 9 9 DB and DC /   100 / 22 /   -0,1 
EL -7 -12 -12 DB /   NA / 20 /   - 
ES -12 -9 -9 DB /   89 / 28.3 /   7,1 
FR -18 -16 -16 DB /   100 / 20 /   2,0 
IE -11 -10 -2 DB -9 DC 100 55 9.5 10-15 10 6,4 
IT 3 -3 -17 DB and DC 14 DC 100 11.4 33 5.7 6.91 0,4 
CY 16 14 14 DB /   86 / 16.6  /   12,9 
LV -12 -11 -11 NDC and DC /   100 / 20 /   1,5 
LT -3 1 1 DB and DC /   89 / 26 /   3,7 
LU 0 -1 -1 DB /   92 / 24 /   7,4 
HU 5 13 13 DB and DC /   100 / 26.5 /   6,4 
MT -21 -17 -17 DB /   NA / 30 /   -0,4 
NL 8 5 2 DB 4 DB 100 91 7 9.8 11.5 -12.5 3,5 
AT 5 1 1 DB /   100 / 22.8 /   -1,2 
PL -19 -16 -16 NDC and DC /   77 / 36.9  /   -4,6 
PT -20 -20 -20 DB /   81 / 33 /   5,5 
RO 52 39 39 DB and DC /   NA / 29 /   NA 
SI 2 -4 -4 DB /   100 / 24.35 /   8,3 
SK 2 1 1 DB and DC /   100 / 28.75 /   4,1 
FI -11 -13 -12 DB /   100 / 21.6 /   3,1 
SE -13 -13 -11 NDC and DC -2 DB 100 90 17.2 13.7 13.7 0,6 
UK -4 -2 -3 DB 1 DC 100 53 (M)/56(F) 19.85% (17.25%) 9 8 2,0 
Source: ISG calculations on Theoretical replacement rates carried out  in the OECD APEX model or in national models, AWG. Figure s for NL are preliminary. 
 
EN 15   EN *Note: Contribution rates used for statutory schemes and also even tually occupational or private schemes included in the base c ase, thus giving elements on the representativeness 
associated with the base case. Contributio n rates correspond to overall contribution rates as a share of gross wages (from empl oyees and employers) used as assumptions for the 
calculation of theoretical replacement rates. Contribution rate s may differ from current levels  reflecting for instance project ed increases in contribution rates, in particular as regards 
assumptions used for second pillar schemes. DK refers to contribu tions, to the ATP (statutory Suppl ementary Labour Market Pensi on, though it should be recalled that the financing 
of the first pillar mainly comes from the general budget. For CY one fourth (4%) comes from the general State budget. For LU on e third (8%) also comes from the general State 
budget. For MT this corresponds to a repartition of 10% from th e employee, 10% from the employer and 10% from the State. For PL  this corresponds to old-age contributions 
(19.52% of wage) and disability and survivors contribution (13% of wage). For PT this corresponds to a general estimate (ratio between overall contributions and aggregate wages 
declared to social security).  
** A number of Member States have carried out national projectio ns that better reflect the effect s of recent pension reforms on  the evolution of pension expenditure.  
 
EN 16   EN Meeting the pension challenge is essentia lly about closing the gap between shorter 
contributory lives (in terms of delayed first en trance into the labour market as well as low 
employment rates among older people) and the trend of in creased life expectancy at 
retirement. The main route to solve the dilemma is  to increase the labour market exit age. As 
pension reforms increasingly link benefits to  working and contribution years it will be 
important to monitor how the current economic s ituation will impact on developments in exit 
ages.  
Figure 8: Economic activity by age in the EU-27 (2006) 
0%10%20%30%40%50%60%70%80%90%100%
50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69
employed (full-time) employed (part-time)unemployed inactive- sick, disabled or injuredinactive-other inactive-looking after family or homeinactive-retired 
Source: LFS, SPC study on flexibility in retirement age and early exit pathways  
2.1.3.  Health and long-term care 
Life expectancy in the EU has generally increa sed over the past two decades: in 2006 the EU-
27 average was 82 years for women and 76 years fo r men, a gain in longevity of about 4 and 5 
years respectively in 20 years. However, diffe rent patterns were registered across the EU: 
while life expectancy has consistently increased in the EU-15 plus MT and CY, it has dropped in Central and Eastern European countries dur ing the economic transition of the early 1990s. 
Life expectancy in these countries has now reco vered but it is still be low the level of 1986 in 
Latvia and Lithuania (for men only). The gap in  life expectancy across European countries is 
as high as 8 years for women and 13 years for men. Some countries ar e not catching up with 
the EU average: in BG, LT, RO and SK the di fference from to the EU average has actually 
increased in the last 20 years. 
 
EN 17   EN Figure 9a: Life expectancy at birth, men, 1986, 1996 and 2006 
55.060.065.070.075.080.085.0
E U 2 7 * B E B G C ZD KD EE E I E E LE SF RI T C YL VL TL UH U M TN LA TP LP TR OS IS K F I S E U Kyears
1986 1996 2006 
Figure 9b: Life expectancy at birth, women, 1986, 1996 and 2006 
55.060.065.070.075.080.085.0
EU27* BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL A T PL PT RO SI SK FI SE UKyears
1986 1996 2006 
Source: Eurostat. LV (1986, 1996): nati onal sources. FR(1986) is for FR Metr opolitaine. EU averages are population 
weighted averages. EU27*(2006) based on 2006 except UK(2005) and IT(2004). 
The general increase in life expectancy has been accompanied by a general but small increase 
in healthy life years. However, there is no cl ear reduction in the gap between life expectancy 
and healthy life years. For the EU-15 the numbe r of healthy life years increased from 64.5 in 
1999 to 66 years in 2003 for women and fr om 62.8 in 1999 to 64.5 years in 2003 for men. 
Even if they live longer lives, women spend a highe r proportion of their li ves with a disability 
compared with men. In some countries (UK, FI , PT, NL, EL, IE) the number of healthy life 
years for women has remained unchanged or even decreased. 
 
EN 18   EN Table 3: Life Expectancy and Healthy Life Years8, 2006  
Healthy Life 
Years at 
birthLife 
expectancy 
at birthHealthy life 
years as % 
of life 
expectancyHealthy Life 
Years at 
birthLife 
expectancy 
at birthHealthy life 
years as % 
of life 
expectancy
Belgium 62.8 82.3 75.2 62.8 76.6 80.5
Bulgaria
Czech Republic 59.8 79.9 75.0 57.8 73.5 78.8
Denmark 67.1 80.7 84.5 67.7 76.1 89.9
Germany 58.0 82.4 66.9 58.5 77.2 71.2
Estonia 53.7 78.6 66.4 49.4 67.4 71.2
Ireland 65.0 82.1 78.1 63.3 77.3 81.4
Greece 67.9 81.9 82.1 66.3 77.2 85.1
Spain 63.3 84.4 74.8 63.7 77.7 81.3
France 64.1 84.4 76.2 62.7 77.3 80.2
Italy 67 84 80.2 65.8 78.2 77.4
Cyprus 63.2 82.4 70.3 64.3 78.8 75.5
Latvia 52.1 76.3 69.6 50.5 65.4 77.4
Lithuania 56.1 77.0 70.5 52.4 65.3 78.4
Luxembourg 61.8 81.9 75.8 61.0 76.8 81.0
Hungary 57.0 77.8 69.3 54.2 69.2 75.1
Malta 69.2 81.9 85.6 68.1 77.0 89.0
Netherlands 63.2 82.0 77.0 65.0 77.7 83.7
Austria 60.8 82.8 72.0 58.4 77.2 74.9
Poland 62.5 79.7 83.6 58.2 70.9 86.0
Portugal 57.6 82.3 68.9 59.6 75.5 77.4
Romania
Slovenia 61.0 82.0 73.0 57.6 74.5 75.6
Slovak Republic 54.4 78.4 71.9 54.3 70.4 78.0
Finland 52.7 83.1 63.1 52.9 75.9 68.1
Sweden 67.0 83.1 75.9 67.1 78.8 81.5
United Kingdom 65 81.1 80 63.2 77.1 82
IT figures for life expectancy at birth are estimates taken from EHEMU databaseSource: Eurostat based on EU-SILC data 2006; IT, UK 2005;  females males
 
Significant gaps in health status (e.g. self-per ceived general health a nd self-perceived activity 
limitations due to health problems) across social  groups persist in the EU: i.e. those in the 
lowest (poorest) income quintiles more ofte n report very bad health and more severe 
limitations than those in the highest (richest) quintiles. Indeed, on average, less advantaged 
groups not only have shorter lives and suffer more illness but also feel th eir health to be worse 
than more advantaged groups. Differences in th e availability, quality and use of care services, 
alongside living and working conditions, life-styl es and countries' socio-economic situation 
can explain such differences in health between and w ithin countries. As an example, Europe 
is characterised by inequalities (between and within countries) in cancer screening and 
follow-up. 
                                                 
8 For the years 2004-2006, the disability prevalence data  used in the calculation of the healthy life years 
indicator were taken from the Statistics on Income and Living Conditions survey (EU-SILC) covering all EU-25. Note moreover that the formulation of the disability/limitations question so far has not 
necessarily been the same across Member States. An swers may also be prone to cultural differences. 
Hence, cross-country comparisons may not be meaningful. 
 
EN 19   EN Several barriers to accessing care are identified. In the EU there remain significant gaps in 
health insurance coverage, i.e.  non-negligible numbers of i ndividuals are without health 
insurance coverage of any sort, or with limite d insurance coverage (e.g. only emergency care 
coverage) which deters individuals from seeking necessary health, results in belated care and 
has significant financial consequences for patients and their families. Even where rights to access healthcare services are univ ersal they have not necessarily  translated into equal access 
for all. Indeed, on average, 3.1% (5%) of thos e living in the EU, with  the exception of DE, 
BG and RO for which there is no  accurate data available, report unmet need for medical care 
(dental care) because they had to wait, or care was too expensive, or too far away. This 
percentage also varies greatly across Member States; from 0.2% (0.5%) in SI and DK to 15% 
(12%) in LV (EE), and across income groups in each country, with the poorest facing the greatest unmet need.  
In the last two decades total he alth expenditure both per capita  and as a percentage of GDP 
rose throughout the EU. There are, however, s ubstantial differences across countries. AT, BE, 
DE, FR and PT spend 10% or more of their GDP  on health, while the Baltic States, CY, PL, 
and RO spend 6 % of GDP or less. The propor tion of public sector expenditure in total 
expenditure on health is  in general substantial (more th an 70%). Nevertheless, private 
healthcare expenditure (mostly out-of-pocket payments) constitutes a very large source of 
funding in some Member States: in CY and EL pr ivate expenditure represents more than 50%, 
in LV and BG more than 40%, in RO more th an 30%. Informal payments are an additional 
direct cost to patients in SK , RO, BG, EL, HU, PL, LT and LV. 
Figure 10: Total health expenditure as a % of GDP (2006 or latest available) 
Total health expenditure as % of GDP, 2006
0.02.04.06.08.010.012.0
fr
de
be
pt
at
dk
nl
se
el
it
si
es
mt
uk
hu
fi
bg
ie
lx
sk
cz
lv
pl
cy
lt
ro
ee%
Public expenditure Private expenditure
Source: OECD Health Data 2008 and WHO, HFA-D B 
Those countries reporting lower life expectancy (BG, LV, RO , LT, HU, EE, SK, PL and CZ) 
are also those reporting the highe st proportions of unmet need fo r medical care and those with 
the lowest expenditure both per capita and as a percentage of GDP. 
 
EN 20   EN 2.2. Progress towards the overarching9 objectives 
The overarching objectives of the OMC for soci al protection and soci al inclusion are to 
promote: 
(a) Social cohesion, equality between men and women and equal opportunities for all through 
adequate, accessible, financially sustainable, ad aptable and efficient social protection systems 
and social inclusion policies; 
(b) Effective and mutual interaction between  the Lisbon objectives of greater economic 
growth, more and better jobs and greater social cohesion, a nd with the EU's Sustainable 
Development Strategy;  
(c) Good governance, transparen cy and the involvement of stakeholders in the design, 
implementation and monitoring of policy. 
2.2.1.  Overall Strategic Approaches 
Many Member States attempt to identify and coordinate the synergies between the three 
strands of the Social Open Me thod of Coordination in their po licies (notably LU, BE, EE, FI 
and PT). For many, the overall strategy takes the ageing of the population as the starting 
point. Population ageing due to low birth rates and increased life expectancy means, if not 
accompanied by extra years in good health, a larg er share of old and very old people with 
multiple and reinforcing degenerative and chronic conditions. Thiscan threaten the 
sustainability of social protec tion because it increases pensions , healthcare and long-term care 
costs.  
The number of active years currently spent on av erage in the labour mark et is not enough to 
sustain the increasing number of years in reti rement or inactivity. He nce, on the one hand, 
Member States are designing their reforms to make pension and social protection systems 
more sustainable, notably by striving to keep more people in employment longer and 
increasing the number of healthy life years by encouraging preferred paths of care. On the 
other hand, Member States are striving to support th e inclusion of all in society (by education, 
active inclusion, etc.), to ensure a minimum safety net fo r those that cannot  otherwise reach 
acceptable living standards (minimum pensions, minimum income provision and equal access for all to quality care. A more integrated vision  is present, for example, when Member States 
recognise explicitly the various social determinants of heal th, including alongside access to 
quality healthcare, also livi ng conditions, unemployment, inco me inequalities, poverty and 
material deprivation, education, th e environment, migration and more  diverse societ ies. In this 
context, policies that relate to social inclusion, pensions, h ealthcare and long-term care have 
an impact on public health just as improved h ealth of the work-force can have major positive 
impact on the long term sustainability and adequacy of these systems.  
Examples of integrated approaches are found in  some countries. In Luxembourg, it is clearly 
stated that promoting social c ohesion has a key role to play for the country's future, on a par 
with efforts relating to the economy, monetary  stability, public finance, taxation, employment 
and acquiring the necessary infrastructure to me et the challenges of globalisation. Under this 
approach, social cohesion is th e target of political action. Th e Belgian Federal government 
                                                
 
9  
 
EN 21   EN agreement describes an action framework based on five overall priorities: a global 
employment strategy, policies to reduce fiscal and parafiscal pressure  on labour, encouraging 
entrepreneurship, reinforcing the social prot ection system, and reinforcing environmental 
policy and sustainable development. Estonia se ts out to exploit the synergies between the 
three strands by adopting the overarching message that enhan ced social protection and social 
inclusion require an integrated approach, en suring coherence between the policy measures 
taken in various fields. Within this globa l vision some countries stress the employment 
dimension (UK, NL) while others stress the social  dimension (AT, PT). In  this context it is 
important to mention that in the past decade a number of countries have carried out major 
pension reform where a key aim has been  to encourage longer working lives.  
Several Member States (BG, CY, ES, FR, HU, SI, SK, RO, FI, SE, UK, IE, NL, PL) have 
made efforts to assess progres s in relation to the priorities selected in the 2006-2008 NSRs 
and the challenges identified in the 2007 Joint Report, often in re lation to one or more strands. 
In several cases, however, an evidence-based and systematic approach is hampered by a lack of appropriate monitoring arrangements. Often, quantified targets and objectives in relation to 
which progress could be assesse d are not at hand. Sometimes the stock-taking of progress 
takes the form of listing the ac tions taken but without assessmen t of their concrete impact.  
There is a considerable degree of continuity in the social inclusion priorities selected 
compared with the 2006 round, and this seems in  general well justifie d. As in 2006, active 
inclusion and child poverty are the challenges most frequently selected as incl usion priorities. 
Promoting the inclusion of groups  at particular risk of excl usion also figures prominently 
(Roma, migrants, elderly, disabled, young people), although the issues of  including migrants 
and ethnic minorities, in particular, seem not to be given due attention in some Member States 
where they are major challenges. Other priori ties quoted by several Member States include 
ensuring access to quality services, tacklin g educational disadvantage and fighting 
homelessness and housing depriva tion. Several Reports would bene fit from more clarity with 
respect to the allocat ion of resources and of responsibility.  
During the last decade Member States have re formed to their pension systems to better 
provide adequate and sustainable pensions in view of population ageing, new societal norms 
and changing behavioural patterns. Consequent ly in their national strategy reports of 2008, 
countries focus on the implementation of reform s and further incremental progress that has 
been made. Such progress in many ways involves a delicate balancing of the dual concerns of 
adequacy and sustainability: how to secure su fficient pensions for all without jeopardizing 
work incentives and financial sustainability an d vice versa. Still a few Member States have 
legislated more substantial reforms sin ce the last reporting (PT, UK, EL, CY).  
This is the second full reporting exercise under the social OMC regarding the healthcare and 
long-term care strand. As only two years have pass ed since the previous NSRs, virtually all of 
the 2008-2010 reports (except pe rhaps BG, CZ, SK) build on th e previous strategies and 
national health plans with similar priorities and policies and some additions or improvements in relation to the strategies proposed in 2006. Fo r all Member States, universality, fairness and 
solidarity, accessibility, equity, equality, effec tiveness, and efficiency are the guiding 
principles of reform. Ensuring access to quality  healthcare and long-term care services and 
improving healthcare systems efficiency i.e.  obtaining better value for money are still 
important priorities across all countries. However, there is still scope to strengthen the potential impact of policies by adopting a more multidimensional approach, and gender mainstreaming is evident only in rare cases. Se veral reports show that  more clarity with 
 
EN 22   EN respect to the allo cation of resources and the responsibility of the diffe rent actors involved is 
needed.  
2.2.2.  Interaction between economic grow th and social inclusion policies 
In this round of reporting more Member States underline the importance of positive 
interaction between economic an d employment policies and so cial inclusion and social 
protection policies and of the underlying synergie s with respect to both goals and measures. 
Many reports point out that social protection and social inclusion policies do effectively 
contribute to growth and jobs. Active inclusion measures aimed at those furthest from the 
labour market figure prominently in the 2008- 2010 NSRs. Increasingly Member States are 
tailoring social services to promote employment (e.g. DK, FR, EE, AT). Equally, policies to 
combat child poverty and the inter-generatio nal transmission of pove rty, with a specific 
attention to high quality edu cation, are pursued by several Member States. Other policies 
include measures to ensure longer working lives, often featured in reforms of pension systems 
and commonly used early-exit pathways (FR, LV , PL, SE) and policies aiming at debt relief 
to overcome over-indebtedness as an obstacle to  participation in the labour market (FI). 
Modernisation of social protecti on systems in order to ensure their long term both financial 
and social sustainability in vi ew of population ageing is also mentioned as an essential policy 
intervention by several countries (ES, AT, FR, HU,  IE, MT, PT). It is widely indicated that 
social protection policies leading to an increasingly healthy p opulation enable more people to 
participate in the labour market at all ages and lead to increa ses in productivity. Active ageing 
measures are of growing interest as pension reforms require longer contributory periods to 
ensure adequate pensions and healthy life years continue to increase. Many Member States suggest that the health and social  sector is a large and growing employer that can be used as a 
tool to improve the economy in disadvantag ed regions and increase labour market 
participation of women. 
A wide range of policy priorities are mentioned by Member States to illustrate how growth 
and jobs can promote social objectives. In many reports reference is made to measures that 
will contribute to facilitating acce ss to the labour market of people that are far from it, such as 
training and educational programmes aimed at  vulnerable groups (AT, FR, BG, CZ, SE), 
flexicurity initiatives (AT), specific active la bour market programmes (ALMP's) (DK, NL, 
PL, UK), subsidised employment for various targ et groups (LV), local em ployment initiatives 
(LT) and avoiding inactivity and unemployment traps (EE, SK). Reconciliation of work and family life also features (FI, FR, LV, NL, DE, ES). Some countries refer to policies aimed at 
the extension of working lives (e.g. AT, DK).  
In the area of pensions, the link between better jobs and l onger working lives and better 
pensions is quite clear. In stri ving for adequate and sustainabl e pensions and social protection 
systems there is a clear need to prolong working lives. There is, however, also an observed 
link between higher paid jobs and longer worki ng lives, which subsequen tly lead to better 
pensions. In order to avoid a growing retirem ent income gap, it is important for economic 
growth to filter into all segments of the labour market and society. Ample economic growth 
creates a clear forum for this , creating synergies between th e incentives to  work longer 
embedded in pension systems and job creation notably for older workers, who are often 
amongst the first to suffer job losses in strained economic times. 
 
EN 23   EN Economic growth is also seen as an important determinant of health, both directly through the 
improvement of living conditions, for example, and indirectly as it provides extra resources to 
the healthcare and long-term care sectors.  
Some NSRs point to areas wh ere the mutual positive interaction between economic, labour 
market and social policy is not at hand. Severa l countries highlight that economic growth (and 
in some cases very high rates of growth) has not benefited all groups of  society in the same 
way and indeed social inequalities (income an d health for example) persist or have even 
widened.  
There is a risk that the current economic  downturn will exacerbat e certain negative 
tendencies, e.g. an increased segmentation of  the labour market or the occurrence that 
employment growth is not reflected in wage  increases. A contracting labour market can 
ultimately affect pension levels and can lead to a reduction in resources allocated to the 
healthcare and long-term care sectors, possibly with detrimental affe cts on access. Much 
needed quality improvements could be postponed. 
Given that the economic context has changed quite  dramatically after the preparation of the 
NSRs Member States were solicited in the framework of the Social Protection Committee to provide information available at this stage on the social impact  of the current economic crisis 
- already demonstrated as well as expected  - and on related national policy actions. The 
outcome of this initial sounding out is summarised below: 
• Most Member States expect th at the global financial crisis will have a strong impact on the 
real economy, although not all of them to the sa me extent. In most countries the social 
effects of the downturn are already visible.  
• Member States underlined that in-built capacitie s of the social protection systems as well 
as social inclusion policies in the Member St ates are there to fully play their role as 
automatic stabiliser to cushion th e impact of the economic downturn.  
• A number of Member States indicated that ad -hoc additional measures have already been 
taken to protect the most vul nerable and to relax supervisory requirements for pension 
funds.  
• Some areas are more frequently indicated as deserving special attention in the present 
context, notably access to housing, the adeq uacy of safety nets, and funded pension 
schemes. 
• In general, most countries re-affirmed the commitments made in their NSRs, while not 
excluding the need for special additional measur es, which in some cases are already being 
defined or introduced. 
2.2.3.  Governance  
On the basis of information provided in the overarching section of the national reports it 
seems that in most Member States there has not been a fully integrated preparation process covering the three strands and mostly there ar e separate, different governance arrangements. 
Exceptions are AT, DK and IT. In AT, for the first time, a joint meeting was held of the 
various Federal Ministries and umbrella NGOs ac tive in social and environmental affairs to 
discuss the challenges for the national reform programme as well as interaction between the 
 
EN 24   EN OMC, the strategy of sustainable development a nd measures in these areas. A consultation on 
the future social model, covering overall soci al protection and industr ial relations, has just 
closed in Italy. 
It seems that in many Member States there has been progress as far as the participation of 
stakeholders in the policy proces s is concerned. There is increas ed attention to the quality of 
participation. Some Member States ensure stakeholder involvement  throughout the reporting 
and policy cycle. On the whol e there is still much room for better participation of 
stakeholders, e.g. representatives of regional and local governments a nd people experiencing 
poverty, but there are some inspiring good practic es. In too few cases has the preparation 
process been used as an opportunity for larg e-scale media attention and for raising the 
awareness of the public at large.  It appears that only a small minority of the Member States' 
Parliaments has discussed the plans.  For further details see section 3.6. 
Mainstreaming and coordinating social inclusion policies remains a challenge in many 
Member States. Countries are implementing diffe rent kinds of struct ural arrangements at 
national but also at regional a nd local level to contribute to  this (coordination committees, 
networks of focal points, etc.).  A few Member States report on efforts to establish or further 
develop ex ante social impact  assessment arrangements.  
As far as monitoring and evaluation are conc erned, progress is uneven and many challenges 
remain. Data sources, indicators and analytical ca pacity need to be deve loped especially also 
with regard to the groups that are most at risk and that are seldom reached by surveys. 
However, examples of national target setting ha ve been increasingly observed in the NSRs. 
Effective monitoring of targets requires regu lar monitoring. There are major differences 
between Member States in the extent to wh ich policies are systematically evaluated. 
Stakeholders and external expe rtise are often involved in ev aluation at the start of the 
preparation of a new plan. It is  good practice to star t drawing up a new plan  on the basis of a 
report on the results of the eval uation of the previous plan. 
Most Member States have count ed on the input of experts from  social partners, ministries, 
institutions involved and scien tists for the developm ent of their pension reforms (e.g. DK, ES, 
IE, FI, DE, AT, PT, GR, CZ, SE, UK). These countri es also report that the social partners do 
the job of informing politicians and the public about latest trends in social systems and 
stimulate debate to foster a broad social cons ensus. Some Member States have reported on 
more direct consultations with the public in order to obtain public c onsensus (UK, IE, MT). 
For further details see section 5.4.1.  
Safeguarding health and translating it into longer  working lives are the re sult of a set of social 
and economic factors and also a means to ensure employment and economic development. 
This holistic approach is reflected in some c ountries into a broader consultation with various 
sectors, with NGOs on social welf are and health, and wi th local and regional authorities. It is, 
however, not necessarily clear how the consulta tion has influenced the report. Some of the 
reports were prepared in join t collaboration by more  than one ministry. More multi-sector 
cooperation is necessary to ensure greate r coherence between economic, education, 
employment, environment and social and health policy.  
It should be noted that severa l European-level civil society or ganisations active in the social 
field have provided and made publ ic their assessments of the renewed Strategic Reports, in 
general drawing on contributions from network members at national level. Some of them 
examine at the strategic reports as a whole, in most cases focussing in particular on the 
 
EN 25   EN National Action Plan for social inclusion (NAPs). This goes notably for the comprehensive 
assessment carried out by the European Anti- Poverty Network which stresses as the 
overwhelming concern "the lack  of progress on th e eradication of poverty in the EU"10 and 
proceeds to assessing the NSRs/NAPs overall as well as the policy responses to address 
specific inclusion concerns. The report presented by Caritas Europe examined in particular the 
"Process and Quality of Policy Design" of Member States' preparations of the NSRs and Eurodiaconia's report assessed the degree of participation in this process.
11 Depending on 
their specific mission others concentrate on more limited, well-defined aspects of the 
NSRs/NAPs within their area of concern and interest. Brief references to the latter 
contributions are made where appr opriate in the following text.  
2.3. The European Social Fund – major tool  for implementation  of strategies 
The European Social Fund (ESF) is the main European financial instrument designed to 
support Member States in the implementation of their strategy as set out in the National Strategy Reports. In the 2007-2013 programming cycl e, the European Social Fund will invest 
approx. €76 billion to support 117 Operational Pr ogrammes (OP) across the European Union. 
Together with the European Regional De velopment Fund (ERDF) and the European 
Agricultural Fund for Rural Development (EAF RD), the ESF will make a major contribution 
to achieving the common objectives in terms of  social inclusion and social protection. The 
2008 turmoil on financial markets slowed down economic growth and employment in many EU countries, thus posing an extra challenge soci al inclusion and social protection systems. In 
this context, the ESF can help  to respond to emerging social  challenges by supporting those 
furthest from the labour market and people made redundant in the economic downturn. The 
current economic outlook underlines the added va lue of the ESF both as an expression of EU 
solidarity and as a tool to tailor the labour supply to a changing ec onomic environment. 
Effective use of ESF funding can  cushion the effects of the economic crisis in terms of 
unemployment and social inclusion. The role of  ESF in the various policy priorities is 
highlighted in most NSRs, in particular with  regard to the Social Inclusion strand. The 
Spanish report includes an annex on the cont ribution of the 2007-2013 strategy to social 
inclusion policies, focussing on the ESF-finan ced OP 'Fight against Discrimination'. The 
linkage between policy objectives  and ESF is clearly visible when ESF funding is more 
substantial in relation to the total national e xpenditure on employment and social policies (e.g. 
BG, SK, PL, RO, HU, PT, CZ). Howe ver, the absence of references to ESF is also notable in 
a number of NSRs (e.g. IE, NL, FI, FR), despite the fact that in some cases the ESF allocation 
to social inclusion is fairly high (e.g. FR, IE). 
There is general evidence of improved coordina tion between social policies and the use of the 
Structural Funds. However, the broad linkage es tablished by some of the Reports on the one 
hand, and some inconsistencies between OP ta rgets and those set ou t in the NSRs on the 
other, leave some doubts as to  the depth and quality of polic y coordination in a number of 
Member States. A challenge thus remains to en sure that co-ordination between policies and 
funding goes further than formal cooperation betw een various departments, and to monitor the 
extent to which the ESF contribut es to achieving the OMC targets. 
                                                
 
10 The full assessment Building Security, Giving Hope : http://www.eapn.eu/content/view/678/29/lang,en/ 
11 http://www.caritas-europa.org/code /en/publications.asp?choix=x2x  ; 
http://www.eurodiaconia.org/files/Anti-
Poverty%20and%20Social%20Inclusion/Eurodiaconia%20report%20on%20members%20involvement
%20in%20social%2 0omc%202008.pdf] 
 
EN 26   EN The Joint Report 2008 provided a detailed overview of Member States priorities in terms of 
social inclusion and social protection, which w ill be supported by use of the Structural Funds 
in the 2007-2013 period. As the implementation of  the current cycle of ESF programmes is 
still in its initial phase, Member Stat es could not report on the progress achieved. 
Nevertheless, some reports (e.g. EL) point out that ma ny of the measures are the continuation 
of previous ESF-funded activities, wh ich have already delivered results. 
With regard to the overall common objective of governance, a number of country-specific 
challenges were identified in the 2007 Joint Report (e.g. CY, HU, LT, PL and SK).Here, it is 
particularly important that Member States make  use of the possibilities offered by the ESF to 
promote the effectiveness of social inclusion and social protection pol icies. Several Member 
States have programmed ESF f unding to promote the design, th e monitoring and evaluation of 
social policies at national, regional and local  levels (e.g. HU, SK, RO), as well as the 
development of quality standards in social services (PL). Moreover, ESF will support the 
capacity building of public ad ministration in all EU-12 Memb er States and convergence 
regions, which will also contribute to better governance in the social field. 
3. FIGHTING POVERTY AND SOCIAL EXCLUSION  
3.1. Introduction 
The Member States renewed National Action Plan s for Social Inclusion (NAPs), presented in 
September/October 2008 as part of the integr ated NSRs focus on a limited number of key 
priorities deemed particularly important for progress on the Lisbon goal of making a decisive 
impact on the eradication of poverty by 2010. NAPs increasingly take a more strategic 
approach while also reflecting multidimensional nature of poverty and exclusion, and the need 
for integrated policies to address priority issues.  
The NAPs aim to translate into action at Memb er State level the three Common Objectives 
relating to social inclusion, which were adop ted by the European Council in March 2006 and 
confirmed in March 2008: access for all to the resources, righ ts and services needed for 
participation in society, preventing and a ddressing exclusion, and fighting all forms of 
discrimination leading to exclusion; the activ e social inclusion of all, both by promoting 
participation in the labour market and by fi ghting poverty and exclusion; and ensuring that 
social inclusion policies are well-coordinated and involve al l levels of government and 
relevant actors, including peopl e experiencing poverty, that they are efficient and effective 
and mainstreamed into all relevant public pol icies, including economic, budgetary, education 
and training policies and structural  fund (notably ESF) programmes. 
This report mirrors the particul ar attention given in NAPs to the issues of child poverty 
following up on the 2007 thematic year dedicated  to this topic, and to active inclusion. 
Further, it examines Member States' planned po licies to improve access to and quality of the 
various services that are key to enabling social inclusion overall, and to combat the persistent 
exclusion of certain grou ps of citizens. It finally reviews m easures taken or planned for better 
governance of social inclusion policies. 
 
EN 27   EN 3.2. Promoting Child Well-Being and B reaking the Cycle of Deprivation 
Out of the 16% of Europeans at risk of poverty, 19 millions are children. In most EU 
countries children are at greater risk of pov erty than adults, a situation which has not 
improved since 2000. Tackling child poverty and breaking the transmission of disadvantage 
between generations has been a main concern sin ce the launch of the social inclusion process. 
In 2006, the March European Council asked Member St ates to take decisive  steps to eradicate 
poverty among children. Many Member States ha ve taken this invitation to heart.  
In the new round of plans, child poverty once again emerges as a key priority for Member 
States as more than two-thirds of countries have  selected it as one of their key priorities for 
social inclusion. In support of this strong comm itment, 20 countries have set quantified targets 
related to policy goals in the area of child poverty and social exclusion, 16 of them using one 
or more EU-agreed indicators (at-risk-of-pover ty rate of children, children in jobless 
households, low reading performance of pupils ). A few Member States have also set 
intermediate targets in relation to their specific challenges: jobless households (BE, BG, HU, 
UK), families most at risk (BG, EE, CY, LT,SK, UK), intensity of poverty (NL), childcare provision (DE, IE, FR, IT, LT, LU , HU, AT, PL, PT, SK, UK, MT). 
The 2007 thematic focus on child poverty was the occasion to explore further the policies in 
place in Member States and deepen the common  understanding of the determinants of child 
poverty in each country
12. This work helped identify commo n challenges, but it also shed 
light on the reasons why considerable differences  in the situation of children remain across 
EU Member States. It also highlighted the fact that among those countries who had not 
selected child poverty as a key priority some, like France, Slovenia, Finland or Sweden have in fact comprehensive sets of support schemes in  place for children and their families. In these 
countries, child poverty is relativel y lower than in the EU as a w hole. In other countries such 
as Spain, where child poverty rates are high, th e support to families is part of a broader 
political commitment to develop the Welfare State. 
This assessment of the NAPs builds on the work  carried out in  2007. It takes stock of the 
progress in implementing the policies announced  in the 2006-08 plans and aims to assess 
whether the new measures are in line with the challenges identified in the 2007 and 2008 Joint 
Reports
13. 
The supporting documents to the 2007 and 2008 Join t Report analysed in detail the policies 
described by Member States in the 2006-08 plan s. The measures adopted by Member States in 
their 2008-10 plans are in continuation of thes e policies and an increas ing number of Member 
States adopt multidimensional and integrated ap proaches to tackling child poverty and social 
exclusion (AT, BE, BG, CY, DE, EE, HU, IE , IT, LU, PL, PT, RO, SK, UK, MT). Such 
integrated approaches typically include inco me maintenance, reconc iliation of work and 
family life, services to families including ch ildcare, housing, education, youth protection and 
                                                 
12 Social Protection Committee (2008): "Child poverty and well-being in the EU. Current status and way 
forward." http://ec.europa.eu/employment_social/spsi/d ocs/social_inclusion/ 2008/child_poverty_en.pdf
  
13 Eurochild's assessment to be published in February 2009: www.eurochild.org  
 
EN 28   EN support of the most vulnerable children, or as in Finland a specific po licy programme for the 
well-being of children, youth, and families. 
3.2.1.  Ensuring sufficient resources for children and their families 
The 2008 Joint Report stressed the importance of  fighting child poverty on all fronts through 
the implementation of comprehensive strategies . These involve a combination of adequate 
and well-designed income support, quality job opportunities allowing pa rents to progress in 
the labour market, and the provision of necessary services for children and their families (especially childcare). Below we discuss ho w far the new plans a ddress the challenges 
identified for the four groups of countries identified in the supporting document SEC(2008)91 
to the 2008 Joint Report. 
Countries in group A (AT, CY, DK, FI, NL, SE, SI) are characterised by relatively low levels 
of child poverty and by existing comprehensive support schemes for children and their families. These schemes often rely on universal benefits in cash and in kind (childcare) primarily aimed at compensating the cost of rais ing a child combined with measures targeting 
the most vulnerable children. However, some c ountries report a stagnation or an increase in 
child poverty (SE) and an increas e in benefit dependency rates (SE, NL), especially among 
families with a migrant background.
14 In these countries, the n eed to sustain the current 
comprehensive schemes and to reinforce measures  targeting the most vulnerable (increasing 
take-up rates, enhancing the pr ovision of social services) is  highlighted. Austria and the 
Netherlands are planning to reinforce income support for low-income families and especially 
lone parents and large families. In the Netherlands special focus is also on families that have been on a low income for more than five y ears and families on low incomes with school-age 
children. 
The main concern in countries in group B (BE, CZ, DE, FR, EE, IE, BG) is to bring down the 
high number of children living in  jobless households and help parents stay durably on the 
labour market. In most of these countries, furt her measures are envisaged to make work pay 
for parents while adequately s upporting their income. Measures th at are often part of a wider 
active inclusion strategy include tax rebates for low-income families (BE, CZ, EE) and activation measures targeted at parents (BE, BG, CZ). Ireland is planning to substantially 
increase child income support and to stru cture the payments to remove employment 
disincentives, especially for lone parents (and other low-income families) who are a specific target group of the Irish active inclusion stra tegy. The Irish government is also striving to 
increase the low take-up of in-work supplement for low-income families. In France, the newly 
introduced RSA (income support scheme desi gned to support indivi duals through their 
transition back to work) will take account of the size and composition of the household. 
Belgium, Germany, Estonia, Ireland and France pl an a significant increase in the availability 
and affordability of childcare to  help parents back into work. In the Czech Republic, however, 
few measures are planned to increase the low provision of childcare, and the promotion of 
longer periods of parental leave may have an adverse impact on the relatively low labour market participation of mothers (also in EE). In the Czech Republic and Estonia, the 
employment rate of mothers is 16 and 14 percen tage points respectively below that of women 
without children. Bulgaria has launched a "long-term strategy for the child" (2008-18) based on mainstreaming and specific actions aimed at families and children.
                                                
 
14 Please see footnote 12 below 
 
EN 29   EN Countries in Group C (HU, MT, RO, SK and the UK) need to address hi gh levels both of in-
work poverty and of children living in joble ss households, notably by measures aiming at 
making work pay and at enhancing the labour mark et participation of pa rents especially lone 
parents and second earners (MT, SK). In the UK, despite the substantial progress recorded 
since the launch of the strategy in 1999, th e government recognises that considerable 
challenges lie ahead before reaching the ambi tious target of eradicating child poverty by 
2020. Besides reinforcing the exis ting comprehensive set of meas ures, the UK is developing a 
strategy for the next decade in close cooperation with stakeholders. It includes the recent 
requirement for lone parents with  older children and who are able  to work to be available for 
paid work as a condition of receiving benefit.  Future policy for lone parents with younger 
children involves an emphasis on work-related ac tivity and skills development to move lone 
parents nearer to the labour ma rket and prepare them for employment. However, measures to 
enhance further childcare provision overall (a Sure Start children's centre in every 
community, and every school in England to be an extended school by 201 0) risk not meeting 
the challenge: if not fully realised the very  high costs and provision mainly on a part time 
basis can still hamper the labour market particip ation of low-income parents (especially lone 
mothers). Hungary plans to reinforce further th e set of comprehensive measures implemented 
between 2006 and 2008, by improving the targeting of universal family allowances (higher 
for low-income families) and by increasing child care services provision, the level of which is 
currently very low. While rein forcing measures aimed at pr oviding equal chances at school 
for all children, Slovakia will introduce a childcar e allowance for working parents of children 
under three. However, no specific measure is an nounced to increase the low level of childcare 
provision. In Malta, the strategy focuses ma inly on access to education and contains few 
specific measures to support families' income and encourage the labour market participation of second earners (the main cause of in -work poverty among families with children). 
Investments in childcare infrastr ucture launched in the previous plan need to be enhanced in 
support of the newly introduced childcare subs idy scheme. Romania puts emphasis on income 
support and measures supporting acc ess to employment for parent s (childcare, enabling social 
services). 
Countries in group D (ES, EL, IT, LT, LV , LU, PL and PT) were those in which 
comprehensive strategies were most needed to  address high levels of in-work poverty and 
(apart from LU) a relatively low effectiveness of  social transfers. Italy, Greece, Lithuania, 
Latvia, Luxembourg, Poland, and Portugal had al ready identified child poverty as a key 
priority in the 2006-08 plans and started imp lementing a wide range of measures to 
significantly increase income support to families a nd facilitate the labour market participation 
of parents, especially of the second earner. In most of these countries, the measures taken will 
be further reinforced. Latvia, Lithuania, Poland  and Portugal in part icular have enhanced 
income support to families through a wide rang e of measures includin g enhancing the level 
and coverage of family benefits. These coun tries also put emphasis on developing in-kind 
benefits (free or subsidised lunches at sc hool, free school books, free childcare for children) 
and services for families, especially in the area of housing (PT). From  2009, Italy will give 
priority to the implementation of the newly introduced "social card" system, which allows 
beneficiaries to buy essential goods such as food and utilities. Some countries enhance 
universal coverage by for instance  extending the covera ge of existing benefits further to all 
children (including those over 18 and still studying a nd living in the pare ntal home). Latvia, 
Lithuania, Luxembourg Poland and Portugal also pl an to enhance measures to make work pay 
for parents, and especially for lone parents (in-work benefits , tax credits, higher minimum 
wage, and childcare subsidies). Significant efforts to develop affordable childcare provision 
 
EN 30   EN are notable in Hungary, Italy, Lithuania, Luxembourg, Poland and Portugal in order to 
encourage the labour market participation of the second earner. Spai n does not explicitly 
report on overall strategies targeted at children and families.  
3.2.2.  Mainstreaming child poverty 
In addition to the emphasis put on child povert y in Member States' key priorities, greater 
attention is generally paid to children and fam ilies in the overall design of social inclusion 
policies, notably in the context of active in clusion policies (especially in ES, FR, LV). 
In addition to the range of income support measures  specifically targeted at families (see Joint 
Report 2008) some countries also highlight the important role played by general minimum 
wages and minimum income schemes in supporting families' income. Cyprus, Spain, Latvia, Lithuania, Austria, and Portugal in particular are planning to improve the level or design of 
minimum wages, and Latvia and Portugal have set targets for the planned increase. Latvia, 
Lithuania, Austria, Portugal and Spain have reinforced their minimum income schemes (ES: harmonisation of MI schemes across regions) and Romania will closely monitor the implementation of the MI scheme introduced in 2007. Austria announces the introduction of 
minimum income schemes in 2009. A number of countries (LT, ES, PL, UK) also introduced 
or reinforced tax credits and tax rebates for families with children, another way of supporting 
families' income without discourag ing labour market participation. 
Measures to reconcile work a nd family life are important tool s to foster the labour market 
participation of parents without affecting ch ildren's well-being. This concerns both lone 
parents and second earners, sin ce the one-earner family model is  not sufficient any more to 
ward off the risk of poverty for children (see 2008 Joint Report). 
The availability and affordability of quality childcare, especially  for children under three, are 
still the weak points of most EU countries. In its report on progress towards the Barcelona 
targets
15, the Commission highlights the fact that parents in the EU face a shortage of 
childcare services16. In half of EU countries 20% or fewer children under three are cared for 
by formal arrangements, well below the Barcelon a target of 33%. In several Member States 
(CZ, EL, HU, LT, MT, AT, PL, SK) th is percentage drops below 10%.  
Efforts to increase childcare provision are sign ificant in some Member States (AT, DE, HU, 
IE, IT, LU, PL, PT) where governments have se t ambitious targets for the increase (e.g. 
+100000 childcare places by 2015 in Ireland) a nd allocated the necessary budget. Other 
Member States (BE, EE, EL, IT, RO, SI) menti on their plan to enhance childcare provision 
but it is not underpinned by concrete commitme nts. France and Slovenia have adopted or are 
planning laws likely to increase the demand for childcare services, and highlight the challenge 
of developing infrastructure at the local level. IT intends to fo cus its effort in regions where 
childcare provisions is especially low. Austri a and Portugal also plan  to extend opening hours 
of childcare facilities. Opening hours vary wide ly across EU countries and in a number of 
them a particularly high propor tion of childcare faci lities operate on a pa rt-time basis only 
                                                 
15 Report from the Commission on the implementation of the Barcelona objectives concerning childcare 
facilities for pre-school-age children {SEC(2008) 2524} 
16 A Eurobarometer survey also says that more than 1.5 million women in the EU declar e that they are 
forced not to work or to work less because of lack of childcare facilities 
 
EN 31   EN (e.g. NL, UK). The availability of  childcare after schoo l hours is addressed in different ways 
across countries, either thr ough prolonging the school day or th rough specific provision at 
community level. 
High fees continue to hamper access to childca re for low-income families in many countries 
(especially IE and the UK). In this respect se veral Member States (AT, EE, IE, LV, LU, SK, 
SI, SE) are planning measures to subsidize furt her childcare either for all families (e.g. free 
childcare for the second and all subsequent children of the same family (SI)) or for low-income families in particular. 
The quality of childcare is key to ensure that it contributes to the de velopment and well-being 
of the child and that it is not just seen as a way to facilitate parental employment and sustain families' income. Promoting quality  of childcare involves measures to address staff shortages, 
the qualifications of personnel, quality standa rds for institutional care and personal services. 
Giving greater choice to parents by supportin g a wide range of care arrangements (in 
institutions or at home, on dema nd, at flexible hours) in order to meet their real needs is 
another way of facilitating family life. 
Some €2.4 billion, i.e. 3.2% of the total ESF budget, are aimed at measures designed to 
increase women 's labour market participation and reconcil iation of work and private life, such 
as facilitating access to childcare and care for dependent pers ons. In addition approximately € 
550 million will be invested from the ERDF on childcare infrastructure. 
3.2.3.  Supporting children's development 
All EU Member States have ratified the UN Convention on the Rights of the Child which 
calls for the best interests of the child to be taken into account in any action affecting children. Member States are therefore committed to pr ovide the maximum extent of their available 
resources to safeguard the economic, social and cultural rights of children. A number of 
Member States place their action to support the de velopment of all children in this context. 
Investing in education, health care and creating a favourable a nd safe environment (housing, 
parental counselling, etc.) are essential for the child to grow and develop its full potential. The 
importance of early intervention continues to be very strongly emphasised by the Member States. In particular, there is  a clear recognition th at pre-schooling can help compensate for 
socio-economic disadvantage and enhance the futu re learning capacities of  children. It plays a 
particular role for children with a migrant or ethnic minor ity background. The prevention of 
early school leaving is also essential for the well-being of these children and for the full participation in society of the adults they ar e about to become. Member States efforts to 
promote early schooling and access to education and measures to preven t early school drop-
out are assessed in Sec tion 3.5.5 of this report. 
An increasing number of Member States empha sise the need to support families in their 
parenting role (BG, DK, EE, IE, IT, FR, LV, LU , AT, FI). Counselling for parents is designed 
as preventive tool and as a means to strength en parental responsibil ity. These measures may 
be addressed to all parents an d are provided through the school system or  family services 
infrastructure. They often target families at ri sk such as families with a migrant background or 
teen parents (IE), and families in crisis (BG, LU, AT).  
 
EN 32   EN Poor housing conditions are likely to hamper ch ildren's well-being by affecting their health, 
their ability to do well at school and to build  social ties. A ccording to EU-SILC data, in two-
thirds of EU countries child de privation rates in the housing dime nsion are higher than for the 
overall population. Specific housing policy measures for families include priority in accessing 
social housing for lone parents and large families  (most Member States), greater provision of 
housing accessible to low-income families (IT), in creased housing benefits for large families, 
specific attention to the needs of families in the training of architects, urban planners and other specialists (EE), or mortgage loan guara ntees issued for purchase or construction of 
housing for families with children (LV). See also Section 3.5.2 on housing. 
Children born into low-income families are more likely to experience unhealthy lifestyles, and 
poorer access to health services. A number of Member States have launched innovative 
initiatives to increase access to health serv ices for young children and their families. They 
include preventive care such as prenatal and health care for young child ren, antenatal services 
for vulnerable pregnant mothers, regular check-u ps of children and free  maternity and child 
clinics. Health consultants in schools provide health se rvices (vaccination, dental care, advice 
on mental health, etc) and information on s ubstance misuse, sexual education and healthy 
eating habits. Barriers such as the imbalance in  professional expertise between regions and 
additional costs of access need to be overcome to  ensure fair access to health services. See 
also Section 3.5.3 on access to healthcare for the most vulnerable, and Section 5.3. on healthcare in general. 
3.2.4.  Reaching the most vulnerable children 
In the design of their strategies to support children, Member States recognise the need to 
combine a universal approach for children's we ll-being with a more targeted approach for 
children in vulnerable situations. 
Despite the increased emphasis on  prevention, a number of child ren in all Eur opean countries 
are still deprived of parental care; being or phaned, victims of violence and abuse, or for 
economic reasons (e.g. families in financial dist ress who lose their homes). Most Member 
States are striving to avoid the institutionalisatio n of these children and to promote foster care 
arrangements. Belgium, Bulgaria, the Czech Republic, Estonia, Italy, Hungary, Poland and 
Portugal set up measures to improve the status of  foster families, and to provide them with 
financial support or specific tr aining and to improve monitoring systems. In most countries, 
measures are also being taken to raise the standards and quality of institutional care. 
NGOs and MEPs from the Baltic States, Poland , Bulgaria and Romania have highlighted the 
situation of children who are left without parental  care after their parent s have moved to work 
abroad. Lithuania reports on specific measures to address this issue. 
Cyprus also mentions the specific situation of  unaccompanied foreign children who are placed 
under the protection of the Mini stry of Social Affairs. 
Measures to support disabled children and their families include supplementary financial 
support (EE, BG, LV), access to mainstream schools through adapted infrastructure and 
dedicated staff or additional support staff (LV, AT, BG), and specific social services 
(transport, housing, etc). The Czech Republic, Es tonia, Latvia and Austria have adopted 
 
EN 33   EN comprehensive sets of measures and focus on ear ly detection and interv ention to improve the 
situation of disabled children and their families. 
3.2.5.  Other children at risk 
Children and families with a migrant or ethnic  minority background receive specific attention 
in several NAPs (CZ, DK, ES, FR, LU). In Au stria and Denmark, efforts are made to better 
integrate children in schools (including by involving the parents better in school activities) 
and by providing them with specific training (l anguage). In France, newly arrived families 
receive specific information on th e rights and responsibilities of pa rents as part of the recently 
introduced integration contract.17  
Bulgaria, Cyprus, Hungary, Lithuania report on sp ecific new measures to address the situation 
of child victims of violence and abuse, incl uding help phone or inte rnet lines, awareness 
raising campaigns and special tr aining of staff from social se rvices and schools in contact 
with the children at risk. 
A number of NAPs (BG, CZ, EL, ES, IT, HU, LV , PT, RO and SI) refer to measures taken to 
improve access to education for Roma children. However, due to a lack of reliable data, most NSRs do not present a comprehensive assessme nt of what would be needed to boost pre-
school / primary / secondary education partic ipation of Roma children. Where reasonably 
reliable data do exist, they show that Roma children continue to face educational 
disadvantage. In Spain, several studies have be en carried out which show that, although much 
progress has been achieved over the last two d ecades, 71% of Roma people aged 16 and over 
have not completed primary education, and onl y 1.3% have further education. Virtually all 
Roma children go to school at the compulsory ag e, and a large part stays through the primary 
school cycle. However, there are major di fficulties in getting the young Roma population to 
enrol and remain in secondary and further edu cation, particularly Roma girls. Around 80% of 
Roma students drop out before th e end of the last year of sec ondary school. The illiteracy rate 
among the Roma can be as high as 13%, compared with 2.3% for the Spanish population as a whole. In Romania, only 2% of young Roma a dults (18–30 years old) have completed higher 
education, compared to 27% of young non-Roma adul ts. In Slovakia, one- third of Roma aged 
25 years or over did not complete primary sc hool, another third stopped after completing the 
primary school cycle, and only 15% reached secondary school or higher education. 
Ireland is expanding the Back to  Education Initiative to the Senior Traveller Training 
Programmes. In Romania and in the Czech Re public, school mediators are attempting to 
improve the graduation rate of  Roma children, as well as increase the rate of school 
enrolment. Hungary has a long-standing de segregation program under way and, more 
recently, Bulgaria reports on target s of desegregation of education.
                                                
 
17 Please see footnote 12 below 
 
EN 34   EN 3.2.6.  Monitoring arrangements 
It is too early to assess whether Member Stat es have taken significan t steps to act upon the 
recommendations adopted by the SPC in Janua ry 2008 for better monitoring and assessment 
of child poverty and well-being18. However, examples of new initiatives are worth 
mentioning. Estonia has identified  indicators for the monitoring of  each priority objectives on 
the basis of the EU agreed indicators, s upplemented by national indicators; and for each 
objective appropriate arrangements are planned fo r monitoring the actions and assessing their 
impact on achieving the objective. As part of a ge neral effort to strengthen the monitoring of 
the welfare system, Denmark has launched research  to evaluate initiati ves to help the most 
vulnerable children (not well covere d by standard monitoring tools). 
Growing Up in Ireland: The National Longitudina l Study of Children in Ireland (NLSCI)  is 
the most significant study of its kind to be undertaken in the Republic. 10,000 infants aged 9 
months and 8,000 children aged nine will be recr uited to participate in this study and the 
initial contract, spanning almost seven years, will facilitate two major data collection sweeps 
for both cohorts.  
3.3. Addressing the needs of other groups  at particular risk of exclusion 
3.3.1.  Inclusion of the Roma in society and the labour market 
Roma throughout Europe tend to face multiple di sadvantages which often result in extreme 
social exclusion and severe and persistent pove rty, though there is a gapi ng lack of clear data 
on the degrees of that poverty. Accordingly, the new NAPs give increased coverage to the 
situation faced by the Roma. In Portugal,  the High Commission for Immigration and 
Intercultural Dialogue has created an Office to Support Roma Communities' promotion of 
their social inclusion. Greece  has given the issue increased attention. In Hungary beside active 
labour market policy measures, special assistance  was provided in cases of discrimination. In 
Spain, the Roma Development Programme in place since 1989, which finances projects, and managed by regional and local governments a nd non-profit organisations working in favour 
of the Roma population, can be mentioned. But th e NAPs of countries wi th significant recent 
influx of Roma do not give details of pl anned action to promote their inclusion.  
A number of steps have recently been  taken to enhance knowledge. In Spain , numerous 
regional studies were carried ou t, aiming at a better underst anding of the Roma's social 
situation, like the "Health and Roma community",  promoted by the Ministry of Health and 
Comsumer Affairs, or the Map on Housi ng and the Roma Community, sponsored by the 
Ministry of Housing in 2007. In Romania, data on Roma remain scarce but some qualitative 
and quantitative analysis was made of Roma communities and questionnaires were sent to 
local public authorities. The Czech Republic u ndertook an analysis of socially segregated 
Roma localities which showed that the number of such neighbourhoods has grown 
dramatically over the last decade.  In Slovakia, the UNDP Report on the Living Conditions of 
Roma Households  stresses the need for regular evaluati on of the social situ ation of the Roma. 
Virtually no data are presented in the NAPs on  the involvement of Roma in adult education 
and lifelong learning or voca tional training programmes. 
                                                
 
18 [Link to website] 
 
EN 35   EN As to the health situation of Roma people, da ta provided in the Romanian NSR reported 8 to 
10 years lower life expectancy and a higher incidence of contagious-infectious diseases and HIV, deficient infant vaccination and poor di et and nutrition, mainly among children. In 
Spain, alongside the activities of the Spanish National Strategy on Equal Healthcare aimed at 
the Roma population (advice, training, a "Gui de on assisting the Roma Community in 
Healthcare Services), the firs t National Health Survey on the Roma was also conducted to 
gain knowledge of their health  status, lifestyles and ine qualities in healthcare access. 
Moreover, the health of the Roma community is  being mainstreamed in relevant policies. 
Ireland and UK report on the All-Ireland Travelle r Health Study which w ill include a census 
and an assessment of health status, mortality ra tes, and impact of health services currently 
provided.
 
Segregation remains one main obstacle to Roma  inclusion, but no general conclusions can be 
drawn from the figures on de/segregation presented by several Member States.A comprehensive approach to desegrega tion is presented in the Hungarian Strategic Plan for the 
Decade for Roma Integration  and its related action plan for 2008-2009, specifying tasks, 
deadlines, resources and comprehensive monitoring. In Hungary, drawing up and 
implementing an anti-segregation plan is a precondition for obtaining urban rehabilitation 
development resources. An anti-segregati on network was established by the Ministry 
responsible.  
In Spain several programmes, such as the ACCEDER Programme for training and access to 
employment aimed to Roma population and fi nanced by the European Structural Funds, 
promote the employability of and jobs for the Roma. In the  Czech Republic, the Agency for 
social inclusion in socially excluded Roma lo calities will implement a pilot programme in 12 
localities. Hungary points to various forms of subsidised temporary employment organised at 
local level. Romania and Bulgaria report on spec ialised job fairs helping the Roma enter the 
labour market. However, policies presented in  most NAPs stay with in the limit of pilot 
actions or have a narrow, workfare type perspe ctive. Member States with a significant Roma 
population should increasingly cons ider the important untapped potential which this category 
of citizens constitutes in view of labour force shortages and invest accordingly in education 
and training, including preparati on for (and support of) legitimate  forms of self-employment.  
The 2008 NAPs are more detailed than previous ly on the discrimination that Roma are facing 
and measures taken. In Spain, the Council resp onsible for non-discrimination on grounds of 
race or ethnic origin will promote equal treatm ent in the areas of education, health, benefits, 
social services, housing, access to goods and se rvices, as well as to employment, self-
employment and to professional practice, aff iliation and participa tion in trade union and 
employers’ organisations, working conditions, professional promotion, vocational training 
and on-going training. Hungary's Roma Anti-Discrimination Customer Service Network which 
provides complainants with legal advice is extending its network. In the Czech Republic, 
educational seminars were held for 900 police officers in all regions on the right to equal 
treatment and legal aspects of social exclusion. Italy raises  governance aspects, through the 
improvement of social inclusion and anti-disc rimination policies. However, no progress is 
reported from Romania on the problems in getti ng ID papers or from Romania and Bulgaria 
on registering in municipalities. 
 
EN 36   EN 3.3.2.  Inclusion of migrants  
In general, important gaps pe rsist between immigrants and th e majority population as regards 
poverty, income, health, employment, unemploym ent, education and early school-leaving. 
The new NAPs largely confirm the issue as a ma jor shared priority with ten Member States 
making it one of their key objectiv es. Some of them take a comprehensive approach to the 
various dimensions of social inclusion (participation in th e labour market and access to 
housing but also in social, cultu ral and political life) and focu s on involving both immigrants 
and the host society19. Still, the non-prioritisa tion of the issue and absence of details in most 
NAPs comes across as a poten tially serious omission.  
Implementation of the Regulati on on Community Statistics on migration and international 
protection20 will help ensure reliable international mi gration statistics. Nonetheless, the lack 
of data on the variety of profiles of immigr ants, ethnic minorities, asylum seekers and 
refugees remains a problem. Most often there is  not distinction made between first and second 
generations of migrants and long-established ethnic minori ties. Breaking down social 
indicators by ethnic groups or  by country of origin would he lp to document varying degrees 
of social inclusion and of vulne rability, target the specific, distinct needs of each group and 
assess the impact of policies on them. At present the Member States, with very few exceptions 
(CY, NL), provide no such information in  their NAPs, nor on whether and how they 
distinguish the beneficiaries of  their social inclusion policie s from this point of view. 
Notwithstanding this lack of precise data, social  inclusion measures targeted at migrants and 
ethnic minorities often aim to remove the barr iers blocking effective access to social and 
health services, e.g. by developing the interc ultural competences of service providers and 
through information campaigns; targeted support for children and their parents through the education system; or provision of social serv ices accompanied by language and civic courses, 
often targeted at women.  
Here are some examples from the NAPs of holistic policy measures to achieve the social 
inclusion of migrants:
21 Ireland focuses on three interlinke d policy priorities : integration, 
educational supports and follow-up action ar ising from the 2005-2008 National Action plan 
against racism. In Spain , the 2007-2010 Strategic Plan for ci tizenship and integration provides 
the framework for promoting, inter alia, the social inclusion of migrants into Spanish society, 
while the regionally-managed Fund for the reception and integration of migrants and 
educational support is the main financial inst rument used for this purpose. The strategy 
developed in Denmark provides that both refug ees and citizens of migrant background must 
have access to the necessary resources and we lfare services while making active efforts to 
                                                 
19 he Third Commission Annual Report on Migration and Integration, (COM(2007) 512 final) elaborated 
a summary report on integration policies and an annex describing the developments in the EU-27 in this 
field. The Commission Staff Working Document 'Strengthening actions and tools to meet integration 
challenges' reports on what has been  done on participation and citizenship, as far as measures targeting 
the host society are concerned and how integratio n policies have helped prevent social alienation 
20 Regulation (EC) No 862/2007, adopted by the Council and the European Parliament on 11 July 2007 
21 For a complete account of relevant activities in Memb er States beyond those that Member States choose 
to highlight in their NAPs-inclusion, see the Third Annual Report on Migration and Integration . The 
European Integration Fund supports a range of measur es relevant in this regard). .Best practices are 
described in the Handbook on Integration for polic y makers and practitioners the next edition of which 
will be published in 2009. when the European Integra tion Web Site will also be in operation, as the one 
stop shop on integration, collecting relevant info rmation and best practices from all stakeholders 
 
EN 37   EN enter the labour market and become included in the Danish society. Austria for its part adopts 
a mainstreaming approach for the social inclusion of migrants in its policy priorities, together 
with more specific measures for refugees and asylum seekers. In the Netherlands the two 
main points of the policy are social emancipa tion and social integration especially for 
newcomers with a strong emphasis on participa tion which may take various forms such as 
voluntary work without neglecting other aspect s. Germany highlights the relevance of its 
National Integration Plan also from a holistic social inclusion perspective. 
Increasing efforts are discernible to create synergies between social  inclusion policies and 
anti-discrimination measures. France, for example,  relates its actions in favour of migrants or 
people with a migrant background to its policies on non-discrimination particularly as regards 
access to employment for women, social and professional integr ation of youth and access to 
decent housing for the Gens de voyage. The UK us es the framework of the Equality Public 
Service Agreement for developing its policies in  respect of race, ethnic minority employment 
and 'Gypsies, Roma and Travellers'. Malta is  developing its policy for ensuring the social 
inclusion of non-EU nationals as part of its priority to promote e qual opportunities, with a 
specific focus on asylum seekers, refugees and irregular immigrants . Luxemburg adopts a 
similar approach, mainly through a suite  on legislation on immigration policy.  
Within the ESF, specific action to increase migrants'  labour market participation will account 
for some € 1.17 billion (1.5% of total ESF budget). 
3.3.3.  Inclusion of disabled people in society and the labour market 
With an estimated 50 million European citizen s or more having some form of disability22, the 
inclusion of disabled people is frequently mentioned in the 2008-2010 NSRs. For Estonia and 
Austria, it is among their key pr iorities. Measures in favour of  labour market integration are 
strongly emphasised in the 2008-2010 NSRs, but less emphasis is placed on structural 
accessibility measures. Economic inactivity is  commonly seen as underlying disabled 
people’s poverty, yet quantita tive evidence is scarce. 
For a number of Member States, an effective policy to promote inclusion of disabled people 
implies a mix of mainstreaming policy  (e.g. SE, SI, LV, LT, EE, MT, BG and IE), combined 
with targeted measures  where needed (e.g.  DE, FI, SE, IR, AT, BE, EE, ES, IE, CY, LT, LV, 
HU, SI, SK, SE, BG and UK), as well as enhanced access to needed resources,  (e.g. BE AT, 
EE, IS, LV, HU and UK)  and, for the bulk of Member States,  quality services . 
The reports contain evidence of alignmen t and compliance with Directive 2000/78, the 
Disability Action Plan and to  some extent with the UN C onvention, but only a few Member 
States make systematic reference to these polic y documents. More atten tion could be paid to 
mainstreaming disability in policies. 
The aim to tackle the use of disability benefits as an early exit route out of the labour market 
is addressed by virtually all countries, some of which address it as a majo r policy priority (e.g. 
LU, RO, UK, MT, HU, NL and SI)23. Inadequate accessibility in society limits the 
opportunities and choices of peopl e with consequently  lower education levels and lower 
labour market participation among disabled peop le. Nevertheless, some Member States (AT, 
SI, UK, DE, LT and CZ)  report slight improvements in la bour market participation among 
                                                 
22 LFS ad hoc module on disability 2002 combined with the Eurostat population estimate for 2008. 
23 On this issue, see also section 4.2.3.6, Restricti ng access to disability schemes 
 
EN 38   EN disabled people . and the Netherlands even reports a sh arp decline in the number of benefit 
recipients. Several reports make  a link between increas ed labour market participation through 
active labour market policy and targeted measures and the need to expand and strengthen the workforce. Ireland emphasises that  the main objective is to pr omote equal opportunities for 
people with disabilities in the open labour mark et, by means of enhanced vocational training, 
employment programmes and further development of support.  
Several NAPs treat the removal of barriers to  education and lifelong learning as key to 
increase labour market participation among di sabled people, as well as to enhance active 
participation in society and overall quality of life  (e.g. DE, SK, UK, HU, SI, AT, CZ, LU, EE, 
ES, IE, CY, LT, and LV). However, disabled people’s labour market skills are addressed by 
Member States more often in terms of speci al vocational rehabilita tion programmes than by 
tackling access to lifelong learni ng in mainstream programmes.  
Social enterprises are highlight ed by Lithuania, Latvia, UK, Romania, Bulgaria and Slovakia,  
wage subsidies by Austria, Estonia, Lithuania, Sweden and the Netherlands , flexible work 
schemes by Spain, Cyprus and Denmark , job coaching services by Austria and Malta and 
mentor schemes for mentally ill people by De nmark. In Sweden wage subsidies will be 
extended by more than 2,000 places in 2008. In the UK , workability assessment measures are 
enforced and combined with tailored empow erment and skill support to promote labour 
market participation. In France , an action plan facilitating la bour market access for disabled 
people was launched in June 2008. Only rare refe rences are made to barriers to employment, 
wider structural investme nt and legal protection. 
Synergies between different strands of soci al inclusion could be shown more clearly, 
particularly with regard to employment ac tivation policies and policies for accessible 
education, transport, housing, information technologies and personal assistance.  Accessibility 
to goods, services and infrastructure is a key f eature of the EU Disability Action Plan, but is 
not frequently mentioned in NSRs. However, accessibility to buildings and transport is 
frequently cited (EE, MT, LT, CY, IE, LU , SI, SK, SE, UK, BG and AT). Lithuania 
acknowledges the general link between inclus ion and mobility, and Slovakia and Austria 
propose specific responses. Esto nia highlights Universal design  and Hungary wants to 
eliminate discrimination and obstacles to employment by making public institutions physically accessible . 
As to independent living, Germany a nd the UK have introduced personal budgets,  Cyprus  and 
Hungary focus on improvement of services, Ireland  and Estonia highlight case management, 
and Austria and Slovenia a personal assistant su pplement. Some Member States are looking at 
benefits to compensate costs related to disabili ties in general, and for disabled children and 
their families in particular (e .g. EE, LV, SI, HU, BG and SK).  The UK, Romania and Ireland  
seem to have construed income schemes as a matter of human rights.  
There is a trend from centralisation to de-ins titutionalisation and serv ice provision closer to 
the citizen. Many Member States (CZ, BG  and RO) are making efforts towards de-
institutionalisation of care for people with disa bilities and to develop more community-based 
services. However, progress tends to be sl ow, and it seems important to strengthen the 
financial resources allocated to support this process.  Structural Funds are sometimes used to 
help revamp the crumbling system of resident ial institutions, and it should be looked at how 
this can be prioritised and st rengthened in coming years. Re-o rganisation and development of 
rehabilitation services seem to be at the forefront in several Member States. In Sweden , a 
rehabilitation guarantee has been introduced, ai med at facilitating partic ipation in the labour 
 
EN 39   EN market, and in the UK , a "One-touch service" has been  introduced to simplify access to 
services . 
Several Member States focus on measures to promote mental health and well-being (e.g. MT, 
SI, SE, AT, BE, DK, FR, CY, IE, LT and LV). Some Member Stat es recognise mental health 
problems as one of the main reasons for exclusion from the labour market and society,  closely 
linked to and re-enforcing subs tance abuse and homelessness. Accordingly, measures to 
combat mental health problems are included on th e agenda, aiming to enable people to live 
active and dignified lives, and recognised as underpinning well-being, social cohesion and 
economic growth in society.  In Finland , mental health problems and prevention are targeted in 
both the entire population and groups at ris k, including in the work place. In Slovenia , day 
care places are increased for menta lly and physically disabled people.  
Sweden is implementing major initiatives to promote mental health. Psychiatric care is a 
priority for the Government, with SEK500 m illion allocated in 2007 and 2008. The aim is to 
raise skills levels for personnel in psychiatric care and social services dealing with people 
with mental disabilities, and to improve acc ess to psychiatric care for children and 
adolescents. A development centre for children's me ntal health has been set up with the aim of 
increasing knowledge of preventive meas ures, early detection and early support. 
Several Member States highlight a need to develop more knowledge-based policy (e.g. DK, 
EE, LV, MT, HU, RO, SI , SE, UK, IE and AT),  using indicators, targets, monitoring and 
evaluation. Good examples of target settin g are available from Ireland. Looking at 
governance,  some Member States (S E, EE, MT, FR, HU, SK, UK , AT, BE, IE, CY and LV) 
are improving the participation of people with disability in policy-making processes. 
3.3.4.  Inclusion of young people in so ciety and the labour market 
Many NAPs focus on strategies aimed at young peopl e, given that some sub-groups, such as 
early school leavers and lone parents, are par ticularly at risk of poverty. Young people are a 
priority in Finland, where a cross-admini strative programme on children, young people and 
families was launched for 2007-2011. The social in clusion of young people is also a priority 
for the UK, with substantial funding.  
In France, measures are taken in the area s of non-formal educat ion, social inclusion, 
counselling, housing, health a nd policy governance. Germany  is developing strategies to 
overcome child poverty, early school leaving and youth unemployment. Measures in Spain  
and Estonia focus on entrepreneur ship, validation of non-formal l earning and identification of 
new job opportunities, even if a global strategic approach is not always detectable. Cyprus is 
planning measures to enhance youth entreprene urship and prevent juvenile delinquency. In 
Romania , several plans target young people - the National Progra mme for the employment of 
socially excluded people, programmes for home less children and young people, measures to 
increase the quality of life for young families, as well as health prevention programmes. Sweden  is set to better include young people in the national fund programme for 
competitiveness and employment. Measures in Luxembourg include the "voluntary vocational 
orientation" and protective and pr eventative measures in the fiel d of youth health care. Malta 
put forward a number of measures aimed at consolidating the personal development of 
children and young people (through education, tr aining and employment initiatives), 
enhancing their well-being (t hrough improved housing and qua lity of services), and 
safeguarding their rights and responsibilities (through more awareness and a more effective 
juvenile justice system). 
 
EN 40   EN 3.3.5.  Inclusion of older people in society and the labour market 
Older people, especially elderly women and th e very old, on average face a greater risk of  
poverty than the overall population in EU-27 (19% as agains t 16% in 2006; in BE, EE, EL, 
PT, IE, UK, LV, ES, MT, FI, CY older people s till face a poverty rate of  25% or more). The 
NAPs pay increasing attention to older people. Some Member Stat es even make the issue as 
one of their priority objectives (EE, EL, LU, PT , ES and SE) or as a cross-cutting issue (e.g. 
AT, LT). Most NSRs focus on active ageing polici es with the aim to increase the length of 
working lives, raise the employment rate of older people, and maintain and promote their 
capacity for work. Alongside this, the increasing need of accessible quality services was also 
emphasised to promote better coping by the elde rly and longer independent living. Moreover, 
the NAPs highlight the need to ensure suffi cient income for elderly people and improve 
pension adequacy. See also Chapter 4 on pe nsions, and more specifically Section 4.2.3.7. 
3.3.6.  Rural poverty and deprived urban areas 
Rural poverty tends to r eceive less attention than poverty in  urban areas. E .g. in Romania, 
with at-risk-of-poverty in rura l areas three times higher than in urban areas, the NAP is not 
very specific on how to foster social inclusion in rural areas. Addressing rural disadvantages 
figures are comparatively prominent only in th e reports from Hungar y. On the one hand the 
programme ‘For a more liveable village’ will provide opportunities for the 600 most 
disadvantaged settlements to catch up through progra mmes of employment creation, 
community development, environment protection and culture, while on the other hand the programme ‘No one left behind’ aims at cat ching-up by the 33 most disadvantages micro-
regions of the country through the coordinate d application of EU resources. Each micro-
region will draw up their development plan  and will then implement infrastructure, 
employment, social and community developm ent programmes in a coordinated way (About 
10% of the population live in these 33 micro-regions with a significant propor tion of Roma 
people). Ireland reports on measures for improve d access to services in disadvantaged areas 
(transport, rural enterprise, rural tourism, recreation, sustainable housing and broadband 
access), and Lithuania on coordination between m easures related to labour market, social 
policy, education, rural development, business support and infrastructure development to 
stimulate the development of rural areas. The UK is improving access to employment and 
skills services (Jobcentre Plus) through innovative outreach  strategies including the 
installation of 'jobpoints' in libra ries, partnering in local authority  outlets and mobile services.  
Some NAPs address the problem of disadvan taged urban areas and refer to specific 
regeneration programmes that ta ckle housing, social and economic problems in an integrated, 
bottom-up and participative way. The Czech Republic stresses its regional and local NAPs and a community approach for the integrated planning and provision of social services. 
Germany highlights the Soziale Stadt prog ramme supporting 500 urban micro-regions 
complemented by ESF support to employment a nd training measures. In Denmark's “Our 
Collective Responsibility II” programme satellite offices are established in deprived areas for 
easy access to support from public authorities. In France urban renovation is a key priority 
that must reach the most disadvantaged resident s and 'Mixité sociale' insists on facilitating 
equal access to housing for people facing mu ltiple economic and social problems. The UK 
City Strategy tests an area-based partnership approach to tackling worklessness in the most 
disadvantaged communities. In Poland a pilo t social revitalisation programme will be 
implemented in rural and urban local commun ities in the period of 2008-2010. Nonetheless, 
 
EN 41   EN the specific urban problems or the more complex deprivation issues that are present in cities 
could be more adequately reflected in the NAPs24. 
Among those countries with the highest regional dispersion of the regional employment rates 
(IT, HU, SK, ES and FR), only HU expresses co ncerns about its regi onal cohesion. But other 
NAPs (CZ, DE, FR, IE, LT, LV, PT, UK) refer to  territorial challenges and report efforts to 
improve social services in rural areas and/or  to promote access to employment and targeted 
services in a disadvant aged urban environment25. 
3.3.7.  Use of ESF to support inclusion of excluded groups 
Member States apply different approaches and focus on various ta rget groups in their 
Operational Programmes, in line with those iden tified in the NSRs. Nonetheless, actions to 
promote social inclusion are an essential part of ESF interventions in all Member States and 
are generally programmed as a separate priority within the programme s. For the 2007-2013 
period, Member States have allocated more th an €10 billion, representing some 13.1% of the 
total ESF funding available to promote so cial inclusion of disadvantaged groups. 
3.4. Active inclusion – bringing the most excluded back into society and the labour 
market 
Despite developments since the 2006-08 NAPs,  persistent rates of poverty, long-term 
unemployment and inactivity show that much still needs to be done. Access to quality 
employment is a sustainable wa y out of poverty and social excl usion. There is a need to 
design and implement integrated and comprehens ive active inclusion strategies, and ensure 
social protection systems able to mobilise people capable of working, while providing 
resources that can make it possible to live in  dignity, together with support for social 
participation, for those who cannot. 
Although most Member States refe r to "active inclusion" in th eir NAP, they te nd to treat the 
issue mainly as a means to integrate people in to the labour market. A few Member States 
construe "active inclusion" as  a holistic strategy that combines adequate income support, 
inclusive labour markets, and access to quality services. 
Bulgaria and Malta made active inclusion a priority objective for 2008-2010, while a few 
other Member States reported priority objectives  that simultaneously include reference to all 
three elements of the comprehensive active incl usion policy (LV, SI, ES, FR). Other Member 
States selecting active inclusion refer to all thre e pillars with varying de grees of coordination 
(AT, BE, BG, LV, NL, SI, ES, PL, PT, DK, FI, IE and MT). 
3.4.1.  Adequate income support 
Adequate income support is an important elem ent of active inclusion policies given that for 
those excluded from the labour market minimu m income schemes can be the only way to 
escape extreme poverty; yet, the NAPs give  limited attention to the issue. A balanced active 
inclusion policy provides minimum resources at  a sufficient level, with appropriate work 
incentives to encourage job search and labour market (re)integration. 
                                                 
24 See "EUROCITIES analysis of National Action Plans on social inclusion 2008-2010" 
(http://www.eurocities.eu ) 
25 See also Chapter 5 on healthcare, and more specifically section 5.2.6 
 
EN 42   EN Some Member States did in fact outline policie s to better link social assistance benefits to 
labour market (re)integration a nd social support. In France, th e "Revenu de solidarité active" 
(RSA), already mentioned in 3.2.1., is designed  to create a bridge between out-of-work 
benefit and in-work financial support, to impr ove incentives to (re-)enter the labour market 
and fight in-work poverty. This is combined w ith personalised employment and social support 
programmes. In Spain, the "Active Income for In sertion" (RAI) aims to make it easier for 
unemployed workers with special economic needs a nd difficulty in finding work to return to 
the labour market, by combining income support with active labour market policies. In 
Portugal, the Social Integrati on Income (MTSS) has been combined with programmes aimed 
at the social and professional in tegration of beneficiaries. Aust ria reported on the introduction 
of the means-tested guaranteed minimum in come. In Germany the previous separate 
approaches to assistance for the integrati on were brought together by combining social 
assistance for employable people with unemploym ent assistance as basic social security 
benefits for jobseekers (ALG II). Following the "rights and duties" approach, benefit recipients are required to actively participat e in schemes designed to integrate them into 
working life and to do all in their power to reduce or end their re liance on benefits. 
Cyprus reported on amendments to the revise d Public Assistance a nd Services Law that 
financially support public assistance recipients, especially for persons with disabilities and 
lone parents, and encourage th eir integration into the labour market. Bulgaria emphasised 
adequate guaranteed minimum income for people in need while maintaining incentives for labour market participation. 
Other Member States also reported on furthe r plans to modernise or reform the current 
system. The Czech Republic pointed out that a new conception of the living minimum, a subsistence minimum and fundamental change in terms of benefits (assi stance in material 
need) was introduced in 2007. Luxembourg is planning to complement its guaranteed minimum income scheme, an important modera ting factor in poverty risk since 1986, through 
adoption of a law on the modernisation of so cial assistance at local level. Romania 
emphasised that the major challenge lies in  the permanent endea vours to redistribute 
resources to specific categories of beneficiaries, and develop an assessment and monitoring 
system to measure the efficiency of granting a ssistance. Finland reports that the minimum and 
last-resort benefits will be retained at a level that safeguards a reasonable quality of life. Latvia is about increasing the guaranteed minimum income for needy families and persons, while Slovenia will review minimum income schemes to assess their adequacy. Belgium 
plans to maintain a certain level of purch asing power by raising minimum benefits and 
awarding decent minimum incomes. 
The Netherlands encourages the use of inco me support and aims to reduce non-take-up of 
support schemes. It aims to achieve this by informing people about their opportunities, by the 
active poverty policy of municipalities and by simplifying the appl ication procedure. 
3.4.2.  Inclusive labour markets 
Member States reported on a wi de range of measures aimed at promoting inclusive labour 
markets in the areas of a) education, trai ning and lifelong learning, b)  active labour market 
policies, c) financial incentives, d) non-fina ncial incentives and e) demand side initiatives. 
 
EN 43   EN Expanding and Improving In vestment in Human Capital 
As highlighted above, Member St ates are giving increased atte ntion to inclusive education 
possibilities for children and young people in a bi d to improve their future opportunities and 
reduce the number of early-school leavers and drop-outs (e.g. AT, BE, BG, DE, DK, HU, 
LU). Most Member States are introducing mo re possibilities for young people with regard to 
training and apprenticeship programmes in the transition from school to work (e.g. AT, BG, 
CZ, DE, DK, EL, IE, ES). Alongside the prev ious measures, some Member States put 
emphasis on the need to improve cooperation be tween employers and educational and training 
institutions (DE, NL, RO). 
Almost all Member States underline the need to ensure access to lifelo ng learning in order to 
secure sustainable employment and longer working lives, and al so the need for a system of 
occupational certification and of skills accred itation and recognition (e.g. EL, ES, PL). 
Member States' education and training poli cies often address the specific needs of 
disadvantaged groups, including older workers (AT, CZ, DE, EE, IE, PL, SE), disabled 
workers (AT, CY, DE, FI, EE, IE, UK), migran ts, ethnic minorities and refugees (AT, BE, 
BG, CY, CZ, DE, EL, IE, LU, MT, NL, PT, SK, SL, SE, many of them offering language courses), persons with low educational leve ls (AT, BG, DK, HU, MT, SK) and inactive 
people (EE, MT, NL). However, only a few Memb er States reported the adoption of measures 
to strengthen in-work and on-the-job training possibilities or IT skills (e.g. DK, MT). 
Active and Preventive Labour Market Measures 
In most Member States, reforms of the Pub lic Employment Services centre on functional 
restructuring, decentralisation and strengthene d cooperation between local authorities, private 
actors, non-governmental organisations and employe rs. They also aim to  develop personalised 
approaches to support job search, notably including services for specific target groups (AT: 
"occupational diagnostics"; CY: individualised counselling guidance, DK: "mentor schemes", 
"marginalised-people team" in local authorities, "s atellite offices" to offer personalised help to 
disadvantaged people, EL: customised interv ention, EE: individual action plans, case 
management, IE: new active case management; UK: Jobcentre Plus to help disabled people to 
get into paid work and to get on at work, pa rtnership approach FI; MT: Social Inclusion 
Partnership Programme; SK, ES). 
As part of the reforms, Member States are improving and adopting more  efficient counselling 
services (e.g. AT: early intervention; IE: ea rly engagement ; FI and MT: online employment 
services; FR: reinforced mentoring, including for job retention), and more comprehensive 
ones (DK: Job Plan, EL, EE, SK: Local social inclusion partners hip, ES, UK: Jobcentre Plus, 
Flexible New Deal), but also more targeted job counselling activities (HU: Start Programmes; 
SE: New start jobs, Job guarantee for young pe ople, UK: Work Related Activity Group). 
However, just a few report on measures to  extend the programmes beyond the unemployed to 
include inactive people (e.g. EE,  BG, HU, MT) and on schemes to raise awareness of career 
choices, programmes and other services (EE). 
Financial Incentives to Work 
Active inclusion policies need to ensure a bala nced interaction between  tax and benefits, both 
providing adequate work incentives and ma king work pay. In many Member States 
entitlement to benefits has been made conditi onal on active job search, availability for work 
 
EN 44   EN or participation in training (CZ, BE, BG, DE , EE, ES). Hungary men tioned that, as from 
2009, those who are capable of work ing and receive regular social allowance will increasingly 
be required to participate in public employme nt and to cooperate with employment centres. 
All NAPs indicate that Member States are impl ementing or planning reforms of their tax and 
social benefit systems. (AT: reduction of une mployment insurance contribution, and in some 
cases non-payment of this contribution by low income earners, increase of unemployment 
insurance benefits for the l ong-term unemployed, coverage of more people by unemployment 
insurance and occupational retirement schemes;  BE: increase tax-exempt income, tax-exempt 
quota, limit tax scales; CZ: decr easing the overall tax burden; FI: revision of the dual income 
tax system; FR: the RSA – see 3.4.1; LU: tran sforming employees', pensioners' and single 
parents' tax allowances into tax credits, 9% adjustment to income tax scales in 2009; SI: 
gradual abolition of payroll tax;  UK: greater support through ta x credits system, such as the 
"Better off in Work Credit" programme to ensu re that work pays, and for lone parents the 
national roll out of In-Wor k Credit, In-Work Advisory Support and In-Work Emergency 
Discretion Fund). 
In the same spirit some Member States introdu ced measures to make it possible to work and 
receive benefits at the same time. The Nether lands introduced a statutory scheme for working 
while retaining benefits; Latvia implemen ted a new regulation in 2007 entitling employed 
persons who take care of a child aged up to one  year to work and receive the full childcare 
benefit. Member States also re port initiatives to introduce and increase the minimum wage  
(AT, BE, CY, LV, ES, UK) as a tool, for instance, to supporting women in seeking 
employment and working, and narrowing the gender pay gap. 
Non Financial Incentives to Work  
In order to get people into quality and sustainable work  and avoid poverty and social 
exclusion, effective active incl usion policies should address other social factor s that can also 
represent obstacles to labour market participation , e.g. offering solutions for those who 
cannot become economically active or increase  work intensity due to inadequate care 
facilities for children, for older persons and persons  with disabilities or due to health-related 
issues. Helping people to obtain or retain  quality jobs, also entails promoting supportive, 
healthy and non-discriminative working environments . Despite this, just a few Member States 
mention measures that would offer job reten tion and progression and the reduction of in-work 
poverty (EE, UK, IE). 
One of the main issues addressed by Member State is support for reconciling work and family 
life, offering family-friendly measures and work places (e.g. with flexible working hours and 
flexible forms of work) better and more comprehensive childcare facilities  with a special 
emphasis on expanding women's opportunities to  enter the labour market (AT: increasing 
capacity of childcare, enhancing day-school serv ices; BE, BG; CY: serv ices for the care of 
children, elderly, disabled, othe r dependents; DE: extension of  care availability, modular 
parental leave; DK: public day-ca re facilities; EL: parental a nd other leaves, combining work 
with motherhood; EE: right to use paid leaves (m aternity leave, parental  leave) and additional 
childcare leave without pay, development of flex ible and accessible child care; HU: Sure Start 
programmes; IE: additional childcare places an d provision for care of older family members 
and those with disabilities; LU: more childcare centres, quality care and affordable prices with 
flexible opening hours, increase in number of parental assistants, LT, MT, PL, PT: increase 
parental leave and childcare facilities; RO, SK , ES, UK: New Deal for Lone Parents, Sure 
Start Children’s Centres). 
 
EN 45   EN A few Member States also put emphasis on the importance of the health and well-being  of the 
workforce (AT, DK, EE, FI: also  paying attention to age management and mental health at 
work, SE), and on measures to reduce sick leave and increase return to work  (AT, DK, SE). 
Supporting the Demand Side 
An integrated and comprehensive approach should also focus on the demand side of the 
labour market , including financial incentives for em ployers to recruit, developing new 
sources of jobs and providing support for the so cial economy and sheltered employment (see 
subsection below). 
One issue mentioned below by the National Strategic Reports concerned financial incentives 
for employers to hire disadvantaged people through subsidised employment . (AT: subsidised 
employment for different vulnera ble groups, increased financial ai d to enterprises by granting 
pay subsidies and subsidies for safeguarding jobs, “Action 500” and “Disability Flexicurity”; 
BE: employment bonus; CY; DE: employment s ubsidy for recruiting long-term and older 
long-term unemployed and younger workers, 50 plus Initiative; EE and IT: subsidised 
employment for disabled people; HU: empl oyment policy programmes based on reduced 
contributions for employers employing disadva ntaged employees (START programmes), LT: 
subsidy-based employment for people aged over 50, pregnant women, mother s, fathers, foster 
parents; NL: temporary wage cost subsidy to employers when they employ people in a step-
up job, micro-credits for entrep reneurs starting up; PT; PL: su spending contributions to the 
Labour Fund and Guaranteed Employee Benef it Fund pertaining to employers employing 
persons returning from maternity or childcar e leave; RO: employers’ subsidies for lone 
parents and people aged 45 or more, and those who are 3 years away from reaching the legal 
retirement age; SI: for long-term unemploye d beneficiaries; SE: subsidised employment 
through step-in jobs for newly arrived immigran ts, new-start jobs for elderly people, job 
guarantee for unemployed young people). 
Another issue relating to the demand side of the labour market is support for labour market 
flexibility  to increase job creation and thus – as mentioned above – address the needs of 
disadvantaged groups for which full-time or regu lar work is not always  suitable (CY, CZ, DE, 
EE, FI, HU, LT, LV, PT, SK, ES, UK). 
Some Member States encourage special forms of employment  addressing primarily the most 
vulnerable groups (e.g. HU and RO), while consid ering the higher level of in-work poverty of 
self-employed workers; others provide support for entrepreneursh ip and self-employment , 
especially among disadvantaged people (CY, DE, EL, LT, LV, NL, ES: approval of the 
Charter for the Self-Employed, PT: micro-credits for self-employment). The UK plans another type of project fo r bringing the economically inactive into work: the "Homeshoring"  
project enables call centre staff to work from home by using the Voice over Internet Protocol 
and broadband. 
As an important element related to the demand aspects, all Member States' strategies also 
focus on anti-discrimination . Since discrimination is one of th e main determinants of social 
exclusion, Member States have either enhanced their anti-d iscrimination legislation or 
reinforced their instruments to deal with it, mainly focusing on the field of mainstreaming 
gender equality and reducing the wage gap, thus targeting women as one of the most 
vulnerable group  (e.g. AT, CY, DE, EL, IE, LU, MT, SK, ES, UK). Some Member States 
also focused on the issue of age equality  (e.g. AT, CZ, PL, SE, UK). On the issue in relation 
to Roma, migrants and ethnic minorities, see 3.3.1 and 3.3.2.  
 
EN 46   EN The Role of the Social Economy 
Almost all NSRs emphasise the increasing role of the “social economy” , as it continues to 
provide employment and a path for re-entry into the mainstream labour market for the disabled and other groups with difficulties in  finding jobs. In addition to strengthening 
governance and social capital, social enterprise s' close ties to and knowledge of local areas 
also contribute to regional development objectives. For these reasons, several Member States have set the promotion and support of social ente rprises as a policy priority (BG, CZ, FR, LT, 
NL, SK, SE, UK). 
Examples of such initiatives include: increased  support for placement in social enterprises of 
people with health-relate d placement handicaps (AT); estab lishment of an inter-departmental 
commission to steer investment in socially-o riented entrepreneurial initiatives (CZ); state 
support targeted at creating ente rprises providing jobs for the disabled; (LT, see box below); 
pluriannual plan for reforming the governance of so cial enterprises; creat ion of a committee to 
investigate how labour market participation of people with an occupati onal disability can be 
encouraged (NL); increased budget assistance  and easing of rules for setting up social 
enterprises (PL); the “Establishment and Ne tworking and Social En terprises” project, 
intended to create favourable conditions for the development of social enterprises (SK); 
establishment of centres that employ a group of  at least four benefit claimants who have 
problems other than unemployment and integr ate the work in the enterprise’s normal 
operation (DK); and the national roll-out of the Pathways to Work service utilising mainly private and voluntar y providers (UK).
 
In Lithuania, the Ministry of Social Security  and Labour and the Labour  Exchange have taken 
national measures to provide support for the creati on of social enterprise s. With the disabled 
as beneficiaries, 15 new enterprises were esta blished in 2007, eleven of which were granted 
the status of a social enterprise for the disabled; 87 new workplaces were created and 20 
workplaces renovated for the disabled. The initiativ e is intended to counter a 23% increase in 
2007 in the number of registered disa bled unemployed people in Lithuania.  
Examples of measures providing social serv ices and assistance include: creation of an 
association for the priority development of co mmunity-based social services (BG); the Money 
Matters Financial Learning Proj ect providing vulnerable groups with counselling on financial 
capability and management of their finances (UK); projec ts under the EQUAL framework 
with an emphasis on non-governmental organisa tions providing commun ity public services 
(SK); municipal cooperation with  organisations of the 'Na tional Empowered Neighbourhoods 
Alliance' on sports programmes aimed at di sadvantaged children (NL) and a formal 
agreement between government au thorities and various NGOs to support the emergence of a 
substantially greater diversity of  providers and suppliers in he althcare and social care (SE). 
3.4.3.  Access to quality services for active inclusion 
As disadvantaged people tend to suffer from several, interconnected  problems, such as 
unemployment, inadequate skills, poverty, hea lth problems, poor housing, family breakdowns 
and social isolation, current policies and pr ogrammes may lack the necessary holistic 
approach. The multiple problems disadvantaged pe ople face outside the labour market require 
coordinated action from different public services in order to ensu re their social participation 
and (re)entry into the labour market. Access to so cial services of high quality has an essential 
role to play in enhancing the employability of  inactive individuals who are also at risk of 
social exclusion. 
 
EN 47   EN While few NAPs describe policies for service provision which fully take into account how 
they may complement and be reinforced by th e other two active inclusion pillars, Member 
States nevertheless identify a va riety of dimensions in the provi sion of social services which 
are part of active inclusion stra tegies. One of the chief priorities touched upon is the need to 
coordinate provision, not only between public authorities and private providers, but also 
between central, regional and lo cal levels of government. Other priorities include the delivery 
of personalised social services, not least employment services, and the involvement of users in 
both the design and provision of these services . Assuring quality in services is also 
highlighted in the NAPs, which also frequently identify equity of access as a prerequisite for 
quality. Finally, services in specific areas re ceive attention, especially housing, healthcare 
and, to a lesser extent, financial services. The objective of active inclus ion strategies is to 
(re)integrate people in society a nd, where possible, into the labou r market: social inclusion is 
not only the key objective of social policies, but also a pre-requisite for a sustainable 
integration in the labour market. This secti on focuses on services designed to enhance the 
employability of individuals while Section 3.5 covers access to services more broadly and 
those essential to support active inclusion strategies.  
Examples of efforts to improve coordination of social services  related to labour market 
participation: In Finland the city of Turku is promoting an intersectoral welfare policy 
programme on children and young people to help reconcile work and private life, which 
includes enhanced service coor dination and provision; in Spai n the governance process in the 
2nd Regional Plan for Social Integration (2nd PR IS) of the Community Bo ard of Castilla La 
Mancha emphasises cooperation between regional  and local authorities and NGOs and other 
partners in achieving better access to employment for vulnerable groups. 
Examples of personalised employment and social services  include: In Austria a project of the 
City of Vienna, 'Basic vocational guidance in  the mother tongue' which is addressing the 
labour market integration of migrants and persons entitled to asylum with counselling, 
provided on an individual ba sis, offering basic vocational guidance in the mother tongue, 
attempting to identify previous qualifications  and work experience and offering information 
about official recognition of qualifications in Austria. In Denmark the action programme 'Our 
Collective Responsibility II' aims at improving th e inclusion of socially  disadvantaged groups, 
partly through training a nd educational initiatives. 
There are some national examples of measures aimed at assuring quality in service delivery  
with regard to labour market participation: in France the quality of services offered by the 
PES will be improved, notably by simplifying access and improving reception of vulnerable groups; in Slovakia “Modernisati on of Employment Services by means of Education for Staff 
of Offices of Labour, Social Affairs and the Fa mily”, funded outside Bratislava county by the 
ESF, is aimed at providing innovative educati on for civil servants and employees in the 
employment services sections of labour offices.
 
Examples of initiatives aimed at improving access to social services related to labour market 
access: in Cyprus  the programme 'Expansion and Improvement  of Care Services for Children, 
the Elderly, Disabled persons and other Depe ndants' to improve and expand social care 
services at the local level, and promoting programmes of open social care in order to facilitate the activation and access of inactive and unemp loyed women to the labour market; in the 
Czech Republic the government is reenergizing  the vocational rehabilitation system. This 
initiative will facilitate effective communicati on between all partners involved, and attempt to 
broaden the system of vocational rehabilita tion; in Ireland an additional 100,000 childcare 
places (of all types), by 2016 is a key target under the social partnership agreement Towards 
 
EN 48   EN 2016; in Lithuania: the 'Integration of Hear ing Impaired Persons into the Open Labour 
Market' initiative funded under EQUAL is opening up access to employment placement services for this group of people which has trad itionally been reluctant to make use of PES 
facilities due to their handicap. 
Housing, as related to improving employability, is the focus of the following measures: in 
France an inter-ministerial committee (CIDOL ) aims to increase the number of homes 
available to young people with a special focus on  those requiring housing in order to follow 
their chosen occupation. In Hungary independent housing outside institutions is being provided to homeless people by two public foundations under a government decree; in Malta 
the HEADSTART initiative funded under Equal is aimed at smoothing the transition from residential care to society and gainful em ployment of young people by helping them find 
affordable housing. 
Specific labour market measures related to health  include: in Sweden the government intends 
to introduce measures for the insured that  strengthen sick-leave reform including a 
rehabilitation guarantee. 
Finally these initiatives focus on financial services in connection with gaining a foothold on 
the labour market: Austria is setting up bank accounts for poor people / persons without cash, 
including the unemployed. The programme is aimed at countering a lack of access to banking 
services for the disadvantaged; in the United Kingdom the 'Money Matters  Financial Learning 
Project' is providing vulnerable groups with  counselling on financial capability and 
management of their finances on a range of  topics including 'Employment and Money'. 
3.4.4.  The ESF contribution to active inclusion 
Most NSRs acknowledge that the ESF plays a ke y role in promoting active inclusion. While 
income support schemes fall outside the scope of  ESF, it can contribute significantly to the 
other two pillars of active inclusion by enhancing inclusiv e labour markets and access to 
quality services. In this context, the main  focus of ESF interventions is on developing 
pathways to integration and re-entry into the labour market for disadv antaged people. Actions 
in this field include providing access to vocat ional training, the development of the social 
economy, improving access to social and othe r services, and fighting discrimination. 
In addition to the € 10 billion directly targeted at social in clusion mentioned above, it is 
estimated that around € 21.6 billion (28. 4% of total ESF budget) will be spent on improving 
access to employment and sustainability. 
3.5. Access to services to enable social inclusion 
3.5.1.  Access to services overall 
Services play an essential role in preventing ex clusion and helping people at risk of poverty to 
come out of it and regain autonomy. This is wh y access to services is a priority on a par with 
access to resources and rights in the common object ives of the social inclusion strand of the 
open method of coordination. Yet, issues such  as availability, adequa cy, accessibility and 
quality are much less frequently mentioned in the NAPs than in relation to long-term care or 
healthcare, whether they apply to  social or non-social services. 
The availability of services may depend on their geograp hical location, but also on their 
ability to respond to  users' needs. A proper share of serv ices is a key component of regional 
 
EN 49   EN equality, but when services are handled by decent ralised bodies, they re ly on local resources, 
likely to be scarcer in areas with greater need s. Planning strategies and proper allocation of 
funds, help to address this ch allenge. Reports contai n less information on  the responsiveness 
of services, although this clearly influences their impact and can be monitored (e.g. time 
needed to make an appointment). Greater comp lementarity between different types of answers 
may be achieved through a variety of mean s (e.g. by using ICT for providing remote 
assistance or by sharing premises be tween different public services). 
The European Social Network in its contribution to the assessment of the NSRs and 
preparation of the 2009 Joint Repo rt stresses the need to fully recognise the role of local 
public social services.26  
The ability to check that services match users' needs is very much dependent on 
acknowledging that users have a say in the matter,  and a right to assess what is delivered. In 
this respect, all categories of  vulnerable people do not seem to  be treated equally. While older 
or disabled people are very of ten seen as customers, the un employed or the poor are more 
likely to be considered as more passive recipients. 
The non-take-up of benefits is very much linke d with accessibility of services, and several 
Member States have reported on initiatives aimed at targeting better those who do not 
spontaneously claim for help (through target ed information campaigns or merging of 
databases). 
Proper funding is a pre-requisite, but service qua lity also relies on personnel and processes. A 
shortage of qualified staff is an issue for a fe w Member States, while others give details of 
training strategies (e.g. intercultu ral competences to deal with mi grants). Standards for quality 
are obviously less developed than in the area of  long-term care and healthcare. Integrated 
services addressing multi-dimensional problems which vulnerable people may face contribute 
to a higher quality of delivery. They require  adequate coordination. Some €17 billion will be 
invested from the ERDF on social infrastructu re (including some €7 billion on education, 
€555 million on child-care, €809 million on housing and some €3 billion on other social 
infrastructure), which will enhance access to high quality social services. 
Services of general interest ar e also relevant, notably in the context of the high fuel price 
increasse in 2008: measures are being taken to help at-risk-of-poverty households access fuel 
and energy are detailed (e.g. specific allowances , social tariffs). Social tariffs in public 
transportation are also widespread. Nevertheless a lack of availability of public transport 
services in some areas may prevent people not on ly taking up a job, but al so o participating in 
society. 
3.5.2.  Access to housing and fighting homelessness 
Homelessness is one of the most severe forms of  social exclusion. It wa s highlighted as a key 
priority in the previous reporting round and most  countries continue to develop or consolidate 
actions to tackle it. In the current economic context, access to affordable housing and preventing evictions are partic ularly crucial in fighting poverty and social exclusion. 
The first NAPs showed that homelessness was of ten under-researched, with a focus mainly on 
the most visible and severe forms of homele ssness, i.e. sleeping rough. Social policies now 
                                                
 
26 http://www.esn-eu.org/ 
 
EN 50   EN increasingly approach homelessness in an integrated manner by looking at people who are 
experiencing various forms of homelessness27, and policy priorities increasingly include 
access to decent and affordable housing. Housing inclusion policies are also linked to urban 
regeneration schemes, or ot her locally-based measures aimed at promoting sustainable 
communities. 
Homeless people often face multiple disadvantag es. To promote full reintegration into 
society, a set of coordinated policies are needed  in the areas of housing, social assistance 
services, employment and health. While in most Member States, programmes are being 
implemented within separate policy frameworks , some Member States are promoting more 
integrated strategies (IE, UK) e.g. in housi ng where independent accommodation comes hand-
in-hand with offering adequate so cial support (AT, FI, DK, PT). 
Member States put forward different strategies  to promote access to affordable and quality 
housing. These include increasin g the housing supply, with spec ific attention to social 
housing (UK, AT, FI, FR, IE, IT, BE, LU, MT, PL); financial support, such as housing benefits and allowances, rent guarantees and tax rebates (UK, FI, SE, SK, EE, IE, LU, MT, 
BE); and appropriate regulatory instruments, su ch as rent controls (AT, BE, MT). Several 
Member States have also put in place polic ies to promote decent housing and energy 
efficiency (HU, FI, DK, FR, IE). The issue of preventing eviction has received renewed 
attention in relation to the current fi nancial crisis (AT, DK, FR, SE, BE). 
Housing is also one of the main components of area-based policies, and the fight against 
regional disadvantages often goe s hand-in-hand with the fight against housing disadvantage. 
These policies are targeted at urban developm ent and sustainable communities, in order to 
fight ghettoisation and promote a social mix (FI, DK, HU, FR)
28. 
Reporting on housing policies for Roma refers to  some measures for Roma neighbourhoods or 
travellers groups. In Slovenia, municipa lities received €2.7m in 2007–2009 (€1.5m for 2008–
2010) to co-finance basic public utility infrastr ucture in Roma settlements. The UK is also 
making funding available for 2006- 2008 through the Gypsy and Tr aveller Sites Grant for new 
sites and the refurbishment of existing sites. France reported about im provements made to the 
‘aires d’accueil ’ for travellers.  
As to governance issues relating to homeless policies, local stak eholders play a key role in 
promoting innovative and more effective solutions . Moreover, there is now more reinforced 
cooperation between government social and ho using departments (FI, SE, PL, DK, PT, SI) 
and between different levels of government that  take into account the central role of local 
authorities in housing inclusion policies (e.g. "Municipal Compass" plans in NL). 
In France, the right to housing is becoming lega lly enforceable. Some Me mber States have set 
specific targets for reducing the number of homeless people (FI: halve the number of long-
                                                 
27 For example people sleeping rough, people in emergency accommodation, people living in 
accommodation for homeless people, people living in inst itutions (due to lack of shelter), people living 
in non-conventional dwellings, or people living with family/friends. See ETHOS classification 
http://www.feantsa.org /files/indicators_wg/ETHOS2007/g eneral/EN_2007EthosLeaflet.pdf . For a more 
complete assessment of homelessness strategies in the NAPs 2008-2010, see also FEANTSA position 
paper "Paving the way for a European consensual framework on homelessness" 
(http://www.feantsa.org) 
28 On place-based policies and the role of cities, see also the EUROCITIES position paper on the analysis 
of the NAPs inclusion 2008-2010 ( http://www.eurocities.eu ) 
 
EN 51   EN term homeless by 2011; UK: reduce the number of  rough sleepers; IE: eliminate long-term 
occupancy of emergency homeless accommoda tion by 2010; DK: reduce and ultimately 
eradicate homelessness), while other targets rela te to increasing the supply of services and 
housing support (e.g. FR: developing 12,000 places in "maisons relais"; SI: increase the 
capacity of admission centres and shelters for the homeless). Here , there is a need for more 
reliable data on the extent of homelessness, and on the social characteristics of homeless 
people, and the causes and geograp hical spread of homelessness. 
3.5.3.  Access to healthcare 
Although overall life expectancy in the EU has increased over the past two decades, 
substantial disparities still remain.29 The reduction of inequalities between socio-economic 
groups and regional differences in  health is mentione d as the most important health policy 
challenge for Finland and the UK, and as a majo r goal for some other countries (LT, IE, AT, 
EE, SI, SK), and as part of the Belgian, Hunga rian and Spanish strate gy. Some, such as the 
UK, have allocated extra funding for direct acti on to reduce health ine qualities. As part of 
their strategies to address health status inequa lities, countries are endeavouring to improve the 
take-up rate for healthcare insurance, eliminat e barriers of access to healthcare and break the 
cycle of transfer of ill-health from one generation to the next, by focusing on vulnerable 
groups. Amongst the vulnerable groups identifie d by Member States are, for example, 
children and families, immigrants, Roma30, disabled people, peopl e with mental health 
problems31, homeless people, vulnerable elderly peopl e, and substance abus ers. Countries are 
also targeting specific deprived areas a nd regions in removing barriers to access. 
Ensuring equal access to healthcare, notably by enhancing primary and preventive care 
provision, and implementing policies to promot e healthy behaviour, are key policy areas. 
Health promotion and disease prevention activ ities include: programmes focusing on breast-
feeding, vaccination and screening system (H U); subsidised school-meals (SI); promoting 
healthy eating and access to hea lthy food and physical activity among adults in disadvantaged 
areas (IE). To reduce financial barriers, Fran ce provides free care to  people with chronic 
conditions. To increase insurance coverage, Ge rmany established mandatory health insurance 
that has given public or private health insu rance to an additional 120,000 people. Cyprus 
gives attention to the high co-morbidity and hea lth risks of people with mental disorders, thus 
addressing stigma as a major access barri er affecting this group of people. 
The reports show that there are many sources of so cial inequality in health in the EU, such as 
income disparities, differences in living condi tions, lifestyles and risky behaviour. Evidence 
suggests that low levels of income and educat ion are strongly correlated with ill-health. A 
multifaceted strategy covering health promotion and disease prevention actions in a number 
of policy fields are deemed necessary by se veral Member States. Accordingly, reports 
mention the development of cross-sectoral policie s. Some Member States (FI, IE, AT, SI, EE, 
SK and UK) use specific action plans to tackle  health inequalities by encouraging health 
protection in other policy sectors (e.g. edu cation, employment, working conditions, housing 
conditions, social work, rural development, envi ronment). Finland has adopted an action plan 
against health inequalities  for 2008-2011, whose objectives ar e 1) to impact on poverty, 
                                                 
29 See also the healthcare chapter of this report for further information 
30 For further details see the part on Roma 
31 Mental Health Europe assessed the treatment of  this issue in the 2008-10 NSRs: http://www.mhe-
sme.org/assets/files/MHE%20members%20Analysis%20of%20National%20Strategic%20Reports%202
008-2010.pdf  
 
EN 52   EN education, employment, working conditions an d housing conditions through socio-political 
measures, 2) to promote a heal thy lifestyle in general, and among those in a weaker social 
position in particular, and 3) to improve the availa bility and use of social and health services. 
3.5.4.  Access to financial services  / fighting financia l exclusion and over-indebtedness 
The study Financial Services Provision and Prevention of Financial Exclusion32 published by 
the European Commission in May 2008 highlighted  the close interaction between financial 
and social exclusion. On the one hand, groups  facing poverty and/or  exclusion encounter 
specific difficulties in accessing financial serv ices, with negative consequences for their 
personal finance or ability to find a job. Deni al of access to financial services on the 
mainstream market may lead people to turn to  more costly and risky alternative financial 
products. On the other hand, for the general popul ation, an improper use of  financial services 
may, when combined with a critical li fe event, lead to over-indebtedness. 
7% of the population in the EU -15 and 34% in the EU-10 can be  considered as financially 
excluded. This is why financ ial inclusion, defined as ev eryone’s capacity to access and 
properly use the financial services required to pa rticipate fully in economic and social life, is 
to be recognised as a dimension of the broader social inclusion objectives . In this perspective, 
financial inclusion covers several areas, in whic h those latter goals are to be mainstreamed: 1) 
effective, adequate and affordable access to basic banking services; 2) prevention and 
rehabilitation of over-indebtedness; 3) promo tion of professional and personal microcredit 
and 4) development of financial informati on and education for vulnerable consumers. 
Several Member States did not mention this is sue in their report (BG, CY, DK, EE, EL, IE, 
LT, LU, RO, SK, SI), illustrating a discrepancy between social needs and the current crisis, 
and the national policies as re flected in the NAPs. Very fe w countries claim to have a 
comprehensive policy as regards financial in clusion (AT, BE, FR, NL, UK). In the UK an 
action plan for financial incl usion 2008-2011 was published, with an associated fund. More 
Member States acknowledge that the situation is worrying. In FR and BE, indicators relating 
to the level of access to banking as  well as over-indebtedness are used in the monitoring of the 
NAPs. But the Netherlands is the only Member State where addressing over-indebtedness is one of the specific NAP objectives (as alrea dy in 2003 and 2006) consistently encompassing 
regulatory measures and initiati ves agreed with stakeholders. 
A consistent over-indebtedness policy requi res both prevention (enc ompassing responsible 
borrowing and money management; responsible le nding; and responsible arrears management 
and debt recovery) and measures to alleviate over-indebtedness and reha bilitate debtors (debt 
advice and counselling services; judicial processes, includi ng bankruptcy; and non-judicial 
procedures for debt settlement)
33. Debt advice is the dimension of over-indebtedness which is 
most commonly mentioned (FI, PT, UK). In the Netherlands, where it lies within the remit of 
municipalities, it will be furt her developed, with a special targ et for early detection. Several 
groups of the population require specific atte ntion, namely young people (AT, NL), migrants 
(AT, NL), and Roma (HU). 
                                                 
32 http://ec.europa.eu/employment_social/spsi/financial_exclusion_en.htm   
33 Study on Common operational European definition of overindebtedness, 
http://ec.europa.eu/employment_social/spsi/docs/soci al_inclusion/2008/leaflet_overindebtedness_en.pd
f  
 
EN 53   EN In Austria, in order to ensure actual access to a bank account, a specific account has been 
developed by Sparkassen, alr eady with 2,000 recipients out of  a potential ta rget of 50,000 
customers. In the UK, the Government agreed  in 2004 a shared goal wi th the banking sector 
to halve the number of adults living in households without access to a bank account. 800,000 
people have already been brought into banking, but 1.3 million households are still unbanked. 
Social credit in Belgium, and personal microcredit in France (3000 beneficiaries) help people 
without access to the mainstream credit market to restore a borrowing capacity that can be 
used for investing in mobility, home equipm ent, training or health. Spain and Portugal 
mention measures to develop microcredit as a support to active inclus ion of people excluded 
from the labour market thanks to self-employment. 
Financial exclusion is often lin ked with housing problems: unsus tainable mortgage credit may 
put families at risk; unpaid utility bills ri se among at-risk-of-poverty people; evictions are 
very often caused by situations  of over-indebtedness, and over-indebtedness seems more 
widespread among homeless peop le. Sweden implements munici pal rent guarantees. Denmark 
has been experimenting since 2004 with a remission of public -sector debt for socially 
disadvantaged groups who have received soci al assistance for four years or longer. 
3.5.5.  Access to Education/training 
Most NAPs recognise the importance of educati on, but only a few integrate it in a coherent 
long-term strategy to tackle soci al exclusion. However, there is  a general lack of assessments 
of progress and clear evaluation mechan isms, based on targets and indicators. 
Pre-school education is seen as fundamental in most strategies , both to provide a firm basis 
for competence from the start, and to help families reconcile work and private life, especially beneficial for the most disadvantaged. As mentioned under 3.2.2., some NAPs (AT, EE, ES) 
address childcare facilities for 0-3 year-olds, as well as (LT) disparities in provisions between 
regions and rural and urban areas. Germany has d ecided to considerably increase the places in 
crèches for children under 3 (750,000 by 2013). In Belgium, enrolment in pre-school education will be possible from the age of 2.5. Ireland launched a National Childcare Strategy 
for early childhood development and care. Hunga ry prioritises pre-school attendance for 
children with multiple disadvantages, also by providing attendance allowances. Other countries (SI, SK) are issuing allowances and subsidies to support enrolment of children from 
disadvantaged backgrounds. In Poland, ESF inte rvention will support pre-school education in 
rural areas. Some countries (e.g. NL) are giving  priority to reducing backlog in language 
learning by expanding and strength ening pre-school education. Sweden has targeted support 
to children who do not have Sw edish as their mother tongue. 
Targeted resources for improving access to educa tion and training for speci fic groups at risk 
of exclusion: Germany focuses on young people with a migrant background. The Netherlands 
and Belgium focus on the acquisition of basic skills and job coaching for young migrants. The 
French community of Belgium also intends to facilitate enrolment in schools for irregular 
migrants, to improve social heterogeneity in sc hools and re-establish te aching of language and 
culture of origin. Austria promotes early la nguage support in kindergarten and provides 
remedial lessons in German. Denmark strengthens advisory units for bilingual pupils in 
vocational training programmes, through mentors,  optional classes and support for parental 
involvement. In Ireland, English la nguage training is offered to migrant workers. The Swedish 
plan includes a number of strategic initiatives for the education of migrants. In Poland the 
extensive measures are undertaken to support stude nts from rural areas and help them to reach 
 
EN 54   EN higher levels of education. In Slovakia, a new law on education prohibits all forms of 
discrimination and segregation in education, an d is supported by financial mechanisms. Spain 
focuses on developing key competences and ta king better account of th e needs of students 
with an immigrant background and improving th e quality and attractiveness of vocational 
education and training, and on grants and st udy allowances. Estoni a, Germany, Slovakia, 
Lithuania and Slovenia are reviewing or exte nding grants and/or loans for students from 
financially disadvantaged families. Portugal fa cilitated access to higher education for older 
learners by making enrolment more flexible. Fo r a complete account, please refer to the Third 
Annual Report on Migration and Integration (COM(2007) 512 fi nal). The Annex provides a 
full description for all 27 Member States of the implementation of Common Basic Principle 
number 5 'Efforts in education are critical to preparing immi grants, and particularly their 
descendants, to be more successful a nd more active participants in society' '. 
Combating early school leaving:  While Member States’ ESL rates differ considerably, the 
link with disadvantage is clear. According to  the EU benchmark, by 2010 no more than 10% 
of young people on average should leave school early – but in 2007 the average EU rate for 
18-24 year-olds was still 14.8%. Many Member St ates are implementing preventive measures. 
For instance, Estonia is developing career c ounselling and guidance; in 2006 the Netherlands 
established an "Offensive on drop-outs" strateg y, aiming to halve the number of new school 
drop-outs by 2012, also focusing on smoothing tran sitions between school types. France is 
developing mentoring for pupils with difficulti es and disseminating knowledge about jobs in 
various sectors of industry and services among young people. Austria is introducing a right to 
education up to the age of 18 and endeavours to offer more places in vocational schools, while 
new educational pathways are under discussion. Denmark established an overall goal of 95% 
of a youth cohort to complete qualifying edu cation by 2015, and addresses drop-outs from 
VET through mentor schemes and practical trai ning programmes. In Finland, measures to 
combat ESL include the increase of apprentices hips and possibilities for a flexible completion 
of compulsory education ('Jo Po'). Ireland is investing addi tional resources in education 
support programmes. Portugal is creating alternat ive curricular paths a nd increasing the range 
of courses for young people. Slovakia introduced gr ants to access education and training from 
pre-primary to tertiary level. England has legi slated to raise the pa rticipation age so by 2015 
all young people will be in education or training  until at least 18. Spain promotes measures to 
ensure success at school for all students, su ch as PROA Plan to reduce school failure in 
primary and secondary education centres in so cial deprived areas, the Initial Vocational 
Qualification programmes to offer a new edu cational alternative for young people who have 
not obtained the qualification of graduate in obligatory secondar y or to establish a programme 
of pay-grants to encourage those at risk  of leaving school for financial reasons. 
Several EU-8+2 Member States are concentr ating their efforts on improving educational 
opportunities and access to the labour market for  Roma (see further in section 3.3). 
Most plans address the need  to improve access at all levels fo r learners with disabilities and 
special needs.  A trend can be observed toward inclus ive education as opposed to special 
education in separate settings. Estonia will develop counselling networks to achieve early 
identification and treatment of special educ ation needs, and will foster e-education 
programmes and flexible education opportuni ties. The Portuguese “Novas oportunidades” 
plan provides for a review of the national Special Education system, including new units 
specialised in multiple disabilities and autism , and an increase in the number of special 
education teachers in mainstream schools. Austri a is planning to adop t measures to improve 
special pedagogical support in mainstream pr imary and lower secondary schools. Bulgaria 
hopes to induce a change in pub lic attitude, even though issu es persist in relation to 
 
EN 55   EN institutional care for mentally di sabled people. In Latvia, concre te targets have been fixed to 
accommodate special education needs in mainst ream education. In Hungary, the number of 
disabled students enrolled in higher educati on increases year-on-year , and the state provides 
supplementary state subsidy for these student s, though numbers still seem low. Germany 
refers to an ESF-funded initiative to train people with disabilities and sensitise employers. 
In the area of  vocational training,  France plans to modernise V ET and to increase its labour 
market relevance. The Netherlands put in place obligatory work/schooling for young people 
without basic qualifications, and aims to make education more relevant to the labour market. 
Germany is improving access to VET for people at risk, as is Portugal through the Novas 
Oportunidades initiative. Poland is adapting V ET programmes to labour market requirements, 
and focusing on training and qualification standa rds for trainers. Both Latvia and Lithuania 
are modernising VET, and set ambitious nationa l targets on participation. Ireland aims to 
improve the quality of training for low-skille d workers. Hungary continues to establish 
regional integrated  training centres.  
Some NAPs address the  validation of prior learning  as a means of facilitating inclusion 
through better access to employment or furthe r learning. (Accreditatio n of Prior Learning 
processes (NL), a network of  specialised cent res on recognition a nd certification of 
competences (BE, PT), and initiatives for reco gnition of prior learning of migrants (LU, SE)) 
The digital divide  is mentioned in only a few reports. Measures to ensure access to ICT for 
disadvantaged groups (PT, SK), supported acc ess to ICT for young people (BE, Wallonia), 
improved school infrastructure with over 98%  of schools having high-speed Internet access 
(BG), a network of public Internet access points,  and promotion of software development for 
learners with special needs (SI). 
As to adult participation in lifelong learning (L LL) the Czech Republic has established plans, 
including networking of adult education provide rs, using structural funds. Finland plans an 
overall reform of adult training. Portugal pr omotes adult participation in LLL through the 
Novas Oportunidades in itiative. The Flemish Community of Belgium launched a strategic 
plan to tackle illiteracy, also in compan ies. In Luxembourg, training leave has been 
introduced for workers. In Lithuania, at leas t one LLL centre has been established in each 
municipality. As mentioned above, some NAPs describe measures to facilitate access to 
education and training for parents. 
The ESF will provide substantial support to re ducing inequalities in access to high quality 
education and training. A significan t part of the above measures will also be co-financed by 
the ESF.  In the 2007-13 period,  Member States will spend some €20 billion on the 
introduction of reforms in education and trai ning systems, including measures aimed at 
improving the labour market relevance of in itial and vocational education, increasing 
participation in education a nd training throughout the life-c ycle, combating early school-
leaving, and reducing gender-based  segregation of subjects. In addition, €7 billion will be 
invested from the ERDF on education infrastructure. 
 
EN 56   EN 3.6. Enhancing governance of social inclusion policies 
3.6.1.  Mobilising actors/raising awareness  
Preparation process 
Increased involvement of stakeholders in th e preparation of the na tional reports of many 
Member States should contribute to better social incl usion policies.  
In some cases, participation of stakeholders wa s organised for the preparation of the National 
Strategy Report as a whole (all  three strands) (e.g. AT, DK), but  more often as a separate 
process for the NAPs, reflecti ng the differences between the three strands, as regards the 
characteristics of the policy area and th e stakeholders traditionally involved. 
Depending on whether the NAP is the result of  a strategic decision-making process or a 
reporting exercise, participation of  stakeholders can mean different things. In the first case, 
participation can lead to direct  impact on decision-making. In th e latter, it can be an occasion 
to exchange information, discuss social inclus ion policy in an integrated framework, review 
implementation and put subjects on the agenda  for later decision-making. Assessing whether 
participation has made a difference is key. 
In most Member States, a working group c onsisting of several ministries, led by a 
coordinating ministry (often a ministry of soci al affairs and labour) drew up a draft NAP that 
was discussed by a NAP or social inclusion committee including stake holder representatives 
and/or was discussed at ad hoc events (heari ngs, conferences, seminars). Sometimes it was 
presented to existing permanent consultation fo rums (e.g. social part ners forum). Often, 
NGOs, social partners and serv ice providers were involved in  preparing the plans. Their 
participation is easier to arrange if umbrella organisations exist. Since policies are often implemented at the regional and local level a strong involvement of regional and local 
authorities in the preparation of the plan is needed. In this respect there is considerable room 
for improvement but some countries have tried to better involve munici palities and regions 
(municipalities (e.g. BE, BG, NL, PL); provin ces (e.g. AT)). Although there are some good 
practice examples (BE, LU, UK (e.g. meeting orga nised to ensure participation of children 
living in deprived areas)) in many countries th ere is room for incr easing involvement of 
people experiencing poverty and social exclusion. People who are suffering from poverty and 
social exclusion should be liste ned to when policies are devel oped to address their situation. 
Quality of participation 
As to quality of participation there have b een some positive developments. Some Member 
States started early with the preparation of th e plan informing and involving stakeholders at 
an early stage (e.g. AT, FR, NL). Several Memb er States opened up the preparation process 
and invited the public at large to send in comm ents and proposals. Sometimes a draft of the 
plan was put on a website (BG, PL) and a br oad and open consultatio n took place (DK, FI, 
HU, MT). Some countries organised a survey (E S, LT) or used consultation techniques such 
as focus groups (NL, MT). 
Some Member States ensured that high level d ecision-makers, e.g. ministers, participated in 
the seminars and conferences, thereby, highlight ing the importance of these events (e.g. AT, 
LU). Several Member States are providing or  intend to start providing capacity-building 
support to stakeholders so that their participa tion is facilitated and supported (BE subsidises 
 
EN 57   EN organisations where people experiencing povert y can speak out, PT, LT). Participation is 
often more fruitful when adequa te consultation documents are pr oduced, e.g. an early draft of 
the plan and a report on the results of policie s in the previous planning period (e.g. BG, ES, 
PT, HU). An important aspect of quality is the provision of feedback on the results of participation. Some of the plans refer to part icipation results. The Dutch plan includes an 
annex describing the results of consultation and the pl an itself indicates how consultation has 
impacted on it. The Spanish plan also contains an annex that reports on the results of the 
consultation. For each of the main objectives of the NAP and for all target groups / policy 
areas, effective measures in the previous pl an are highlighted, new problems and needs are 
identified, proposals for the new NAP are put forward, a nd actions developed by the 
stakeholders consulted are described. Luxembou rg's plan indicates how the results of the 
consultation have been taken into accoun t. The UK NAP includes quotations from a 
stakeholders' participation event.  
In several Member States codes on minimum quality standards for participation or 
consultation have been adopted (e.g. UK: Code of  Practice on Consultation; AT: Standards of 
Public Involvement (also inspired by the UK code); EE: Good engageme nt practices; Wales: 
National Children and Young Peopl e's Participation Standards) . The European Commission 
has its own minimum standards on consultati on. These examples can be a good basis for 
mutual learning. 
Insufficient attention to the quality  of participation ultimately ri sks leading to 'consultation' or 
'participation fatigue'. 
Stakeholder involvement over  the reporting and policy cycle 
Because major decisions on social inclusi on policy are taken in between OMC reporting 
deadlines and because stakeholder involveme nt in the implementation, monitoring and 
evaluation stages of the policy process can help make the policies more effective, it is important that participation in the preparation of the NAPs be embedded in a continuous 
process of stakeholder participation throughout  the reporting and policy cycle. Although 
many of the plans contain a general commitme nt to uphold stakeholder involvement, on this 
subject they are often not very specific. In several Member States more or less permanent social inclusion or NAPs committees will ensu re continued involveme nt of stakeholders 
throughout the policy process. The Belgian report  indicates that the actions working group 
met ten times during 2006-2008 to follow up im plementation of the report. In the UK a 
stakeholder working group meets regularly a nd a social policy task force grouping NGO's 
participating in the OMC process meets frequen tly with a social inclusion unit (ministry)). 
The Swedish report indicates that there may be  room for improving stak eholder participation 
in the preparation of the NAP, but it is consid ered more important that stakeholders are 
continuously involved in the work of state agencies and bodies like the Service Users 
Commission. Hungary mentions several permanen t consultation councils (on Roma inclusion, 
elderly people, disabled, gender equality). Ge rmany set up a "Permanent Council of Advisors 
on Social Integration" and orga nised a series of seminars ("FORTEIL"). In some Member 
States conferences or seminars marking the st art of the implementation of the NAPIncl have 
been planned (e.g. UK, SK, EE). 
 
EN 58   EN Awareness raising 
In general, it seems that only a few Member Stat es have used the preparation of the reports as 
an opportunity for broader awareness-raising activi ties in the media and so ciety at large. Only 
on rare occasions ha s there been a real broad public deba te. Parliament seems to have debated 
the NAP in only some countries (NL, DE, MT). The Spanish plan announces that the intention is to promote a debate in the Pa rliament. In Luxembourg some members of 
Parliament participated in a preparatory meeting with people experiencing poverty. In 
Portugal Parliament has decided that an annual social inclusion implem entation report should 
be presented to it. Several Member States a nnounce that dissemination measures will be taken 
in the future (publish plan on pa per, organise seminar, e.g. EE, PT). An increasing number of 
Member States put the NSR/NAP documents on the internet on dedicated web pages and 
announce that follow up informa tion (e.g. monitoring data) will be  added. Regular updating of 
such web pages is an important challenge. 
3.6.2.  Mainstreaming social inclusi on / horizontal coordination  
In the national reports many Member States acknowledge the need for mainstreaming social 
inclusion concerns across different policy areas  but often only limited or partial information 
on mainstreaming arrangements is provided. Severa l countries quite open ly admit that this 
still remains a challenge. Inadequate mainstream ing will result in less effective and efficient 
social inclusion policies. The extent of mainstreaming is di rectly linked to the level of 
political priority that is given to the issu e in the Member States. Mainstreaming is a 
'characteristic' of policy that should be analys ed for specific policy areas and policies. An 
analysis of the extent of mainstreaming of soci al inclusion objectives in the Growth and Jobs 
Strategy (National Reform Programmes), the Sustainable Development Strategy and the 
structural funds, in particular the European Social Fund is included elsewhere in this report. 
Mainstreaming of specific thematic issues li ke child poverty has also been touched upon in 
the thematic sections of this report . In the good governance part of the NAPIncl's Member 
States report on structural measures in place to  facilitate mainstreaming and horizontal policy 
coordination. Such measures have been implemen ted at the national, bu t also at the regional 
and local level of government. 
One important way of ensuring mainstre aming is by coordinating policies through 
coordination committees within the government (at the political level) or at the level of public 
administration (see also above: th e preparation process) e.g. Be lgium, Lithuania and Cyprus. 
Some Member States attach a l ong detailed list of ministries involved in these committees in 
an annex to the report (e.g. BG).  In many cases such committees  are coordinated by social 
ministries. Potentially the effective mainstre aming impact may be bigger when they are 
composed of high-level representatives, when they are coordinated by the prime minister's 
office (e.g. IE) or when they are 'horizontal', overarching entities with in the administration.  
The active involvement of stakeholders working on the issue of social inclusion from different 
perspectives in the policymaking process fo r different policy areas  (see above) can also 
contribute significantly to soci al inclusion mainstreaming. 
Mainstreaming at the regional and local level is encouraged by the development of regional 
and local action plans. Some Member States mention a Progress-funded project to develop a 
methodology for developing these pl ans (CZ, ES). The challenge will be to implement the 
results on a permanent basis. Regional plan s have been developed in Belgium. The 
Netherlands gives an example of social inclus ion policy coordination at local level: the 
 
EN 59   EN Groningen poverty pact. Bulgaria intends to pr ovide methodological support to regional and 
local authorities for developing re gional and municipal social incl usion plans (The goal is that 
at least half of all municipali ties should have a social incl usion plan by 2010). In Portugal 
local social networks and supra district (regi onal) territorial platforms aim to take an 
integrated approach to social  policy. In Poland a more flexible framework for cooperation 
between public administration a nd civil society, including new institutions such as public-
social partnership and lo cal initiatives, is to  be implemented in 2009. 
Another way of ensuring that social inclusion concerns are taken on board across different 
policy areas is by developing a network of focal  points. In Bulgaria a network of social 
inclusion focal points in all relevant departme nts has been established at national level and 
networks at regional and local level are also being put in place. The importance of capacity 
building is highlighted. Belgium announces that the pilot project on mediators in the field 
(federal level) will be rolled out and given a structural framew ork. Also in Portugal there is a 
network of focal points, antennas for mon itoring and evaluating different ministries' 
contribution to social inclusion policy. Also, a platform has been  created for national sectoral 
plans (16 such plans are mentioned) to ensure integrated policy. In Ireland  social inclusion 
units have been established in many government departments. At the lo cal level the social 
exclusion unit programme  is being extended. 
Another interesting way of integr ating social inclusion concerns in different policy areas is by 
putting in place ex ante social impact assessm ent arrangements. This means the potential 
social inclusion impacts of proposed measures can be assessed before the measure is adopted. 
The process provides an opportunity to increase  the transparency of decision-making and to 
involve stakeholders early in  the policy process. In Ireland Poverty Proofing / Impact 
Assessment has been around for a long time. It has been mentioned in several previous 
editions of this joint report. Revised guide lines have been adopted . There is increased 
attention to supporting departments in implem enting them. In a number of other countries 
social impact assessment is mentioned as part of a more integrated im pact assessment system 
that also looks at other impacts (on the economy, the environment etc.) In  Belgium the federal 
government announces that it intends to stre ngthen the poverty aspect  of sustainability 
development impact assessment (put in place at the start of 2007). In Slovakia an integrated 
impact assessment system (with a social impact  component) is currently being tested (a pilot 
is ongoing and the system is to be rolled out in 2009). The LT plan announces ex ante 
assessment of the impact of all proposed laws on social exclusion and poverty.  
3.6.3.  Involvement of regional and local au thorities / vertical coordination 
Despite some progress, there is still a big di screpancy between the actual role that regional 
and local authorities play on social inclusi on and their uneven involvement in the NAPs. 
Indeed, the reports mention a large number of concrete achievements in which these 
authorities have a key role, when delivering social  services on the basis of national regulations 
or within their own schemes, c ontributing to social innovations  or embedding social inclusion 
needs into broader local development requirements. But in general, the governance 
arrangements needed to ensure that they contribute and pay a ttention to the NAPs have yet to 
be developed. Many reports (e.g. CY, ES, NL, UK)  emphasise that these authorities were 
consulted when preparing the national stra tegies but do not show whether it was done 
systematically and in a strategi c manner. The various specificities  of particular stakeholders 
are seldom emphasised. Consistency between national policy and local planning seems to 
remain a challenge. That is why, when national strategies co me to be implemented, local 
 
EN 60   EN action plans (PT) can help to make the obj ectives effective and adapt them to local 
specificities. 
The Council of European Municipalities and Regions (CEMR) provided its assessment of the 
involvement of its members in the preparations of the NAPs-inclusion34 (EUROCITIES' 
contribution was referred to above).  
3.6.4.  Gender mainstreaming 
Efforts made by Member States to mainstream ge nder issues in policy priorities show a mixed 
picture. Some make explicit commitments to improve equality between genders across the 
plan (e.g. BG, ES, FR, IE, LT and PT) or re fer to the government's gender equality 
programme (e.g. CY, DK, EL, FI, SK and the UK), but how specific measur es will take this 
into account is not always reflected throughout th e plans. While a number of measures tackle 
gender-specific problems (such as labour market  integration, child poverty, lone parenthood, 
and flexible forms of work) which are likely to benefit women, a gene ral tendency is that 
these are not always analysed from a gender pe rspective or said to aim at increasing gender 
equality. 
Assessing the gender impact of policies 
Spain : The Spanish Government prepared a report on the gender impact of policies contained 
in its National Report on Strategies for Social  Protection and Inclusion,. As set out in the 
report, "learning about gender im pact in the use of Strategi es for Social Protection and 
Inclusion is also becoming a way to make a balanced inclusion of both men’s and women’s 
different interests, wishes and n eeds, thus ensuring greater efficiency of public services, better 
governance and a fairer and equa l treatment for both sexes." 
UK: The UK Government prepared a gender im pact assessment of pension reform. This 
concluded that the state pens ion reforms will narrow the gender pension gap and remove 
discrimination for carers in the pension system. The private pension reforms will ensure equality of access to a workplace scheme of a minimum standard, giving 3.5 to 4 million of 
women access for the first time. 
Labour market integration of di sadvantaged groups is a prior ity objective in most plans. 
Almost half of the Member States acknowle dged the specific problems faced by women, and 
proposed measures aimed at directly helping them (e.g. AT, CY, EL, ES, FR, HU, IT, IE, LT, 
MT, NL, RO, SI, UK). Measures to improve reconciliation of work and family life are often 
seen as the way to help women (re-)integrate  into employment. More than one third of 
Member States expressed their commitment to  increasing the availability of childcare (e.g. 
AT, BE, DE, DK, EE, EL, FR, HU, IT, IE, LU, MT, PT, RO, UK), which should be 
considered a positive development. However, it is less frequently for measures to pay 
attention to the role of men: Bulgaria will introduce leave of absen ce for fathers and child-
raising; Estonia noted that fathers can take leave in the case of childbirth; Sweden created a gender equality bonus as an incentive for parents to share parental leave as evenly as possible, 
and the UK is proposing to give a new right to fathers to take up to 26 weeks Additional Paternity Leave before their chil d’s first birthday to allow mother s to return to work earlier if 
they wish. 
                                                
 
34 http://www.ccre.org  xxx 
 
EN 61   EN Only a handful of MS have taken on board the need to combat the gender pay gap (e.g. BG, 
CY, DE, FI, LT, SK and the UK) and even fe wer expressed a commitment to eliminate 
gender-related stereotypes (e.g. BG and LT). However, a number of Member States have 
expressed a commitment to pr omote gender equality in training and education (e.g. AT, EL, 
ES, FR, IE, LT, PT, SE and SK).  Individual measures directed  specifically at women also 
include the promotion of female entrepre neurship (e.g. CY, EL , FR, LT and PT) and 
commitment to improve women's representati on in decision-making positions (e.g. BG, DK, 
EL, FI and LT). 
Some MS have designed specific measures to  help immigrant women (e.g. AT, DE, DK, ES 
and FR), but only one proposes to improve th e specific situation of  Roma women (BG). 
Social inclusion measures targeted at immigrant women* 
Austria : The Report highlights as an important elem ent in promoting inclusion of migrants 
the emphasis placed in integration programme s on women-specific measures, with language 
and health being prioritised. Child-minding services are provided while migrant women 
attend vocational guidance and qualification programmes,. In  2007, the inter-ministerial 
working group “Migrant Women" was set up ai ming to develop demand-oriented measures 
for women with a migrant background, with  cooperation by all ministries. About 30 
counselling centres for migrants and women’ s service centres, pred ominantly active in 
counselling migrants, were funded in 2008. Denmark  - Special actions for women with 
immigrant backgrounds and their families: A Women’s Programme has been launched, with 
the general purpose of helping more women with migrant backgrounds to become active 
citizens in Danish society. It comprises 11 specif ic initiatives to strengthen women’s chances 
of finding work, getting an edu cation and participating in spor ts and association life. They 
also aim to enhance women’s ability to support their children’s integration and development 
in the wider sense.   
*A range of relevant activities are carried out in the framework of the European Integration Fund; targeting 
specific groups, including women and children, is a specific priority and many national programmes foresee activities in this respect. For further information: 
http://ec.europa.eu/justice_home/funding/integration/funding_integration_en.htm
 
Improved measures to combat violence are c ited in many NAPs (AT, CZ, DK, EL, ES, HU, 
FR, LT, LV, PL, RO, SE, SI, SK, UK), but proposal s to combat trafficking are less frequently 
mentioned (e.g. DK, EL and LT). 
A few plans (e.g. AT, BE, DK and IE) pay specific attention to the need for a gender sensitive 
approach into measures to improve the situa tion of homeless people but actions designed for 
disabled people seldom take specific account of disabled women (e.g. AT and EL). 
There is very little evidence that gender equa lity actors are involve d in the consultation 
process, with some exceptions (CY, ES, HU, PT, UK), but a number of countries intend to 
allocate funding for capacity building of bodies  responsible for promotiing equality between 
genders. 
3.6.5.  Monitoring and evaluation 
There are substantial differences in the amount of detail Member States  have provided in the 
national reports on monitoring and evaluation a rrangements. Often, the information given is 
not sufficient to allow an adequate assessment. Some Member States ha ve developed specific 
 
EN 62   EN OMC monitoring systems. Others rely on regul ar national reporting tools (reports from 
ministries and statistical inst itutes) (e.g. FI, DE), or produ ce reports in line with other, 
sometimes longer-term national strategies (e.g. IE  NAPs 2007-2016 ). 
Where specific monitoring systems have been developed in the context of the OMC, it 
appears that in most Member States there are separate arrangements for the social inclusion 
strand (NAPs). Only some Member States ha ve planned fully integrated monitoring and 
evaluation arrangements covering al l strands of the OMC (e.g. SI). 
Two kinds of monitoring systems can be dis tinguished: indicator se ts that can provide 
quantitative information on input, output and out come of policies, a nd monitoring systems 
that provide information on the implementation of measures. Typically, the latter type of 
system gives a description of measures, who is  responsible, to what extent measures have 
been implemented, what resources have been committed etc. (annex to ES, PL, PT, HU report). 
Only few Member States continuously update their monitoring systems (some are available 
on-line). In most cases, annual re ports are produced or reports are updated in line with the 
OMC or national strategy reporting cycle. 
From the reports, it is not always clear how monitoring reports are to be used or who will be 
examining them. In the case of PT , the Parliament has decided that a NAPIncl implementation 
report will have to be presented to  it on an annual basis. Also in LV , each year, ministries 
have to report on the implementa tion of the plan. The re port is to be presented to the Cabinet. 
Concerning the use of indicators overall, the NSRs show how common EU indicators can be 
used to assess the situation in the wider EU context and in relation to all dimensions of the objectives. Most Member States draw on the EU  lists of overarching and social inclusion 
indicators to describe the social situation, of ten focusing on the key in dicators that are most 
relevant to their strategy. A nu mber of countries also base th eir assessment on a full review of 
the overarching and social inclusion indicators agreed in the framework of the Social OMC. 
The EU-based indicators are often supplemente d by national outcome indicators, mainly to 
cover populations such as spec ific vulnerable groups (immigr ants, ethnic minorities, the 
disabled, people living in deprived  areas, the homeless), or to re flect dimensions that are not 
yet covered by EU indicators (housing, persis tent poverty, socio-economic gaps in life 
expectancy, etc).  
Member States use EU indicators to a lesser  degree to monitor progress towards the policy 
objectives they have set. A number of countri es have nevertheless adopted targets based on 
EU outcome indicators, especially in the ar ea of child poverty (see Section 3.1). Some (AT, 
BE, BG, DE, EE, ES, FR, HU, IE, SK) have al so enhanced their us e of indicators for 
monitoring purposes. To this end, Member Stat es more often use national input or output 
indicators that are timelier and directly related to specific policy measures, such as the number 
of childcare places, the number or percentage of beneficiaries of a given programme, the 
number of homes built in the so cial housing sector, etc. In many cases, these policy-related 
indicators are accompanied by targets. 
Most but not all Member States have developed monitoring arrangements for each policy 
priority as suggested in the guidance note for the nationa l reports. Many of them frankly 
acknowledge that in this respect  much work still needs to be  done. Although specific issues 
have been singled out as policy priorities, sometimes data sources  and indicators still need to 
 
EN 63   EN be developed to allow monitoring of progress.  Especially when targets have been set, 
effective monitoring will only be possible if  regular measurement and time series are 
available. 
Some countries have set up indicator working groups that are tasked with systematically 
developing data sources and monitoring in dicators. See e.g. Ireland good practice on 
'technical advisory group and data  matrix', Spain, Belgium. Some times the priority issues the 
groups will be working on in th e near future are indicated. 
If the idea is to move to more evidence-based po licies, investment in basic data and analytical 
capacity are a sine qua non. A so -called evaluation culture needs to be fostered. In Romania a 
social observatory will be established. In Greece , a new social protection national council is to 
be created that should support a network cons isting of observatories, study centres and the 
National Statistical Institute. It is often mentione d that there is a specific need for developing 
data sources and indicators on the most vulnerable groups that are not covered by standard 
surveys (BE is developing surveys to reach population groups that are not covered under EU-SILC). One example of an area that is partic ularly challenging is the issue of the social 
inclusion of migrants and ethnic minorities. A nother example of a priority issue that is 
mentioned in the reports is the development of an absolute poverty measure (SK). 
An additional challenge, which became clear  again with the sudden economic downturn, is 
the need to develop short-term indicators of poverty and social exclusion. Several of the most 
important commonly agreed, survey-based indicators only become available with 
considerable delay. In fact, sometimes data in the plans refer to 2006, i.e. the start of the previous planning period. There seems to be no obvious solution to this problem, but in some 
cases one could consider deve loping proxy indicators that are available much faster. 
A common problem is that monitoring is often or ganised at the national, aggregate level, even 
though important social inclusion competences are situat ed at the regional or local level and 
important territorial disparities exist. Some  Member States have developed monitoring 
instruments that allow the government to keep an overview of what is happening and that at 
the same time allow municipalities or regions to compare or benchmark their performance. 
Examples of such systems are: the Work and Be nefits Core Card in the Netherlands and the 
social map website in Lithuania. The choice and development of appropriate indicators and 
context variables is especially challenging in these monitoring systems. Portugal mentions a 
database social network pr ogramme (local level).  
Various institutional monitoring arrangements ha ve been put in place. In some Member 
States, a specific NAPs Committee is involved in the preparation of the plan, its monitoring 
and evaluation (often also coordination). Some of these committees consist mainly of representatives from the differe nt ministries involved in soci al inclusion policy. A broad 
composition will ensure more effective monitoring. In Portugal and Ireland , monitoring 
involves focal points in different ministries relevant for social inclusion policy. Some 
committees are open to stakeholders and non-go vernmental experts: NGOs, service providers, 
academics, representatives of regional and local government, et c. For instance, Italy is 
planning to create a body of this kind on a perman ent basis. Monitoring will be more effective 
if there is high-quality involvement of non-governmental experts and also people 
experiencing poverty and social exclusion. 
Several Member States have started the prep aration of the new NAPs with a review or 
evaluation of the previous plan. E.g. in ES , an evaluation seminar was organised. For this, a 
 
EN 64   EN detailed implementation report and a report on the diagnosis of  poverty and social exclusion 
in Spain were prepared (annexed to the plan).  In the guidance note for this report Member 
States were asked to include a progress report and to indicate how lessons have been drawn 
from the evaluation of the previ ous action plan. Member States ha ve done this to a different 
extent. Some Member States report briefly on th e way in which the plan will be evaluated but 
generally little detail is provi ded. In many Member States it seems to be assumed that 
permanent social inclusion or NAP Committees  will be involved in monitoring and that 
evaluation will take place when preparing the ne xt action plan. More detailed information is 
provided in the Slovenian plan. He re it is announced that a speci al evaluation group is to be 
set up the end of 2008. The composition of the group is  described in detail. It will meet twice 
a year to discuss implementation and an annual evaluation report will be produced. 
3.7. Annexes to Chapter 3 
GOOD PRACTICE EXAMPLES OF SO CIAL INCLUSION POLICIES 
IN THE 2008 NAPs-INCLUSION 
To support evidence-based policy development, the examples selected below aim to cover key 
policy areas evenly and to highli ght projects that take a comp rehensive approach, to tackling 
the multiple facets of social exclusion and accu mulated disadvantages. The examples covered 
are: tackling child poverty, access to services , addressing social inequalities in health, 
housing/homelessness, migrants and minorities , addressing financial exclusion and over-
indebtedness, active inclusion /labour market integration and fighting poverty/ minimum 
income support, Roma, governance, and mainstre aming. The aim has been to select examples 
of projects that have received a positive evalua tion and seem to have a lasting impact. In some 
cases, however, projects are promising but a fu ll evaluation still remains to be carried out. 
Some examples of good practice provided by Me mber States are shown in boxes in the main 
text instead. These are listed at the end of this Annex for ease of reference. 
Tackling child poverty 
UK: Family Nurse Partnership programme. 
Target group:  Single-parent families. 
Objective:  Improving outcomes in pregnancy and birth, enhancing child health and 
development, improving parent’s life course and economic self-sufficiency. 
Actions / what they do:  Family Nurses visit parents from early pregnancy until the child is two 
years old, building a therapeutic relationship w ith the mother-to-be an d guiding parents to 
change their health behaviours, improve care given to the infant and become economically self-sufficient. 
Monitoring and evaluation:  External evaluation by Birkbeck  College, London. The evaluation 
will focus on implementation, deliverability, ta ke-up and costs, while looking at the short-
term impact on mothers'  and children's health. The evaluati on is expected to report in 2009. 
Outcome / result:  Early signs are promising. Early lear ning suggests that the FNP has high 
take up, that it is welcomed by practitioners, and that it can lead to positive changes in 
behaviour, relationshi ps and well-being. 
 
EN 65   EN CZ: Introducing multidisciplinary team s into Youth Court practice. 
Target group:  Children, their families and other relevant stakeholders. 
Objective:  Map out a system of care for children at ri sk or in danger in the locality, optimising 
the coordination of solutions to cases and carryi ng out strategic work with  children at risk or 
in danger and with their parents; regular evaluation and proposal s for new measures. 
Actions / what they do:  Creation of multidisciplinary teams including representatives from 
PMS, the courts, the public prosecution office, the Police of the Czech Republic, institutions 
providing social legal protection for child ren, city councils, criminality prevention 
coordinators, service providers (social, healthcare, educati onal) and other stakeholders. 
Monitoring and evaluation : Monitored and evaluated by the Czech PMS Headquarters, 
Department of Methodology, Conception and Analysis, on a regular basis. 
Outcome / result : Multi-disciplinary Youth Teams have b een introduced in almost all judicial 
districts and have been integrated into the pr actice of the Early Inte rvention Centre, greatly 
increasing the number of cases reso lved in preparatory proceedings. 
Active inclusion: Minimum income support 
ES: The minimum income system of the autonomous communities. 
Target group: The socially disadvantaged including single-parent families, the unemployed, 
the elderly, young people, the disabled, immigr ants/refugees, Roma, the homeless and drug 
abusers.  
Objective:  To guarantee minimum resources and so cial and labour market integration. 
Actions / what they do:  Creation through legislation of last -resort and basic minimum income 
guarantee system in the Autonomous Communities. 
Monitoring and evaluation:  Control and follow-up by each community and an annual report 
by central government detailing regulations, access requirements, benefit composition and an analysis of the results. 
Outcome / result: Introduction of schemes in all Autonomous Communities except the City of 
Ceuta (currently being implemented) resulti ng in total expenditure in 2007 exceeding €415 
mio.  
Active inclusion: Inclusive labour markets 
UK: National roll-out of the Provider-led Pathways to Work service. 
Target group:  Disabled people and others of work ing age receiving incapacity benefit. 
Objective:  Reducing the number of people receiving incapacity benefits by 1 million over the 
ten years ending 2015/2016 by moving pe ople into sustained employment. 
 
EN 66   EN Actions / what they do:  Building on the service provided by 18 Jobcentre Plus districts by 
contracting providers nationwid e to conduct work-focused inte rviews and provide tailored, 
job-focused support for IB and voluntary customers. 
Monitoring and evaluation:  Quality review process for all products, user assurance groups, 
quantitative assessment on exits from  benefits and process evaluation. 
Outcome / result: Roll-out accomplished in all 31 Jobcentr e Plus districts on time with quality 
and performance objectives being met. 
LT: Integration of hearing-impaired persons into the open labor market. 
Target group:  Individuals with a hearing impairment. 
Objective:  The implementation of an innovative and effective job-seeking programme for the 
hearing-impaired. 
Actions / what they do:  Arranging motivation seminars, aidi ng active work search utilising 
individual audiovisual presen tations, on-site supe rvision of employed participants, and 
utilisation of employment agents ac tive in all phases of the process.  
Monitoring and evaluation:  Quarterly reports, external  expert evaluation, semi-annual 
assessment meetings.  
Outcome / result:  126 out of 159 participants have obtai ned jobs, contacts have been made 
with 84 firms.   
Active inclusion: Access to services 
BG: Social Services for New Employment – soci al support to vulnerabl e groups, persons and 
families (SANE). 
Target group:  The elderly, people with disabilities, une mployed acting as ‘social assistants’. 
Objective:  Deinstitutionalsze and decentralize the provision of social services. 
Actions / what they do:  Development and testing of new funding management and provision 
models and development of new standard s for the ‘social a ssistants’ programme. 
Monitoring and evaluation:  Central project management  unit (PMU SANE) monitors 
procedures, carries out audits and evaluations. 
Outcome / result: Social services were provided to 2037 users by 700 trained social assistants 
in 12 pilot municipalities, capacity  was strengthened in  264 municipalities to offer the service, 
250 social workers were trained in  programme quality standards. 
Addressing social inequalities in health 
AT: ‘To your heart’s content’ – women fr om Favoriten live a healthy life.  
Target group:  Socially disadvantaged women living in  the Favoriten district of Vienna. 
Objective:  Health promotion and preventi on of cardio-vascular disease. 
 
EN 67   EN Actions / what they do:  An extensive sensitization and in formation campaign, creation of a 
women’s exercise group, invitati on to join a nutrition, exercise  and counselling programme, 
networking and cooperation with health authorities and local institutions. 
Monitoring and evaluation:  Ongoing evaluation documen ting satisfaction with the 
programme and achievement of goals among users. 
Outcome / result: Almost 1000 contacts with the target group; 250 women from a 
multicultural background participated in the programme. 
Housing/homelessness 
CZ: Strategy for the social inclusion of the homeless. 
Target group:  The homeless. 
Objective: More s ystematic and effective efforts to improve the situation of the homeless.   
Actions / what they do:  Creation of a definition and typolo gy of the homeless, establishment 
of a monitoring system, research into the provision of healthcar e to the homeless, evaluation 
of increased number of social workers workin g with the homeless, creation of a dedicated 
website. 
Monitoring and evaluation:  Permanent evaluation (e.g. the typology working groups 
consulted with experts at inte rvals) and evaluation of monito ring reports in context of ESF 
grant procedure. 
Outcome / result: All initiatives were carried out, research  was disseminated and is still being 
carried out after the completion of the projec t, documentation showing the effectiveness of 
increased numbers of social worker s was passed on to the authorities. 
PL: Social work for the benefit of  social housing development. 
Target group: The homeless, the unemployed, the elderly and young people. 
Objective: Possibilities of using programmes of soci al and vocational act ivation of social 
assistance recipients in order to improve their own housing situation. 
Actions / what they do: Local partnerships between social  assistance institutions, labour 
offices and local employers were fo rmed during the project period 2007-2008.  
Monitoring and evaluation: Monitoring was ensured through the principles of ministerial 
project "Active Forms of Count eracting Social Exclusion". 
Outcome / result: Increased initiative of municipal self-government s in 2008 within the scope 
of initiating local programs of social work and public works in the area of social housing 
facilities and in the field of care services. Greate r interest in system solutions in the field of 
state co-financing of initiatives in the area of the construction of social housing flats, night 
shelters and facilities for the homeless. All in all, 84 social housing fl ats were constructed, a 
house for the homeless was renovated and 145 persons  were engaged in so cial work, whereas 
40 persons threatened by social exclusion partic ipated in the programme in one of the cities 
participating in the programme. 
 
EN 68   EN Migrants and minorities 
EL: Training for Muslim children.  
Target group:  The minority student population, including those of Roma origin. 
Objective:  Harmonious integration of minority childre n in the system, acceptance of these 
children by the educational staff and all citi zens of Thrace, provision of knowledge and 
suitable educational material to teachers in cluding Turkish language courses, support for 
families to encourage their children’s good school  performance, awareness of the education 
administration mechanism and representatives of local administration, awareness of all 
parents and the public opinion in general. 
Actions / what they do:  Included establishment of Muslim Children Education Programme 
Support Centres offering language classes, creati ve activities for pre-sc hool children, creative 
workshops for young persons, creation of mobile s upport centres to reach rural areas, creation 
of educational materials including electronic versions, training for teachers and psychologists 
including Turkish language training, counselling.  
Monitoring and evaluation: Continuing evaluation by a scientific board.  
Outcome / result:  Five-fold increase in at tendance by the target group. 
AT: Basic vocational guidance in the mother tongue. 
Target group:  Immigrants/refugees. 
Objective:  Labour market integration. 
Actions / what they do:  Basic vocational guidance in the mo ther tongue is pr ovided at three 
group sessions covering the labou r market in Vienna, the legal framework and information on 
job-seeking. 
Monitoring and evaluation: The programme is reviewed annually in the WAFF report. 
Outcome / result: The counselling has made it possible for pa rticipants to formulate individual 
goals and plans of action leading to employment.  
Addressing financial exclus ion and over-indebtedness 
IT: Microcredit to families at zero rate for unf oreseen economic difficulties (Veneto region) 
Policy area:  Addressing financial exclusion and ove r-indebtedness – Tack ling child poverty 
Target group:  Families or lone parents facing unexpected financial difficulties 
Objectives:  Prevention of over-indebtedne ss with the aim to ensure in particular sufficient 
resources for children 
Actions / what they do:  Provide microcredits free of charge  in order to cover extraordinary 
costs related to healthcare, education, housing, debt recovery and all unforeseen costs related 
to children 
 
EN 69   EN Monitoring and evaluation:  Computerized management of th e project, regular evaluation of 
the activities and possi ble critical issues 
Outcome / result:  High number of applications rece ived and full use of allocated funds. 
Payments are in line with project forecast 
NL: Measures intended to strengthen debt  counselling and reduce over-indebtedness.  
Target group:  The over-indebted incl uding homeless people. 
Objective:  To reduce the number of homes with over-indebtedness and to improve the 
effectiveness of debt counselling. 
Actions / what they do:  Letter of intent and bilateral arra ngements with housing corporations, 
power companies, debt-counselli ng organisations and municipali ties, amendment to the Debt 
Rescheduling Act to create two new inst ruments: moratoriums and insolvency. 
Monitoring and evaluation:  Amendments to legislation on debt  rescheduling will be evaluated 
in a report to Parliament in three years time. 
Outcome / result: Letter of intent and bilateral arra ngements have improved cooperation 
between institutions/organisations, but still room for improvement.  
Governance 
IE: Technical Advisory Group and Data Matrix. 
Target group:  Government bodies, so cial partners, NGOs. 
Objective:  Advice on and support for th e development of relevant indicators on poverty and 
social exclusion and the added scope fo r research into poverty and exclusion. 
Actions / what they do:  Advise the Office of Social Inclus ion (OSI) on indicator development, 
creation of a data matrix containing indicators for each goal, target and action contained in the Irish NAPincl.  
Monitoring and evaluation:  The OSI regularly consults stake holders in order to ensure the 
timeliness of the data matrix. 
Outcome / result: The data matrix is being designed to serve as a reference point for a 
streamlined reporting mechanism of social incl usion activity across th e various Government 
strategies. 
Mobilising stakeholders 
LT: Webpage "Social map"  
Target group:  Politicians, representatives of local communities, civil organisations, local and 
central authorities, society at large. 
Objective:  Improved governance in the field of social  support to combat social exclusion and 
poverty. 
 
EN 70   EN Actions / what they do:  Webpage with information on EU and LT initiatives like e.g. legal 
acts, programmes, projects, reports, data and indicators, good exam ples, a discussion 
forum and list of stakeholders in the field of social inclusion.  
Monitoring and evaluation: Permanent monitoring of usage. 
Outcome / result:  Total number of webpage visitors  from October 2007 to July 2008; 170433. 
Sharing of good examples betwee n actors in the municipalitie s; opportunity for dialogue 
between local and national level. 
Mainstreaming 
ES: Programme for the development of local Pl ans for Social Inclusion in Cataluña. 
Target group:  The socially excluded in 103 municipalities. 
Objective:  Stimulate and generate res ources for drawing up Plans fo r Social Inclusion in the 
local sphere. 
Actions / what they do:  The government of Cataluña provide s financial resources, technical 
cooperation and advice, training and the transf er of knowledge aime d at supporting the 
drawing up of local Plans. 
Monitoring and evaluation:  A working group consisting of regional government technical 
personnel and representatives of the participat ing municipalities is developing indicators to 
monitor progress while another group has been established to identify criteria for good 
practices; the projects of 6-8 councils will be assessed.  
Outcome / result: The number of local councils with Plans in place has grown from 12 in 
2006 to 22 as at 1 July 2008. 
 
EN 71   EN LIST OF EXAMPLES OF GOOD PRAC TICE IN THE FIELD OF SOCIAL 
INCLUSION BY MEMBER STATE 
MEMBER 
STATE EXAMPLE OF GOOD PRACTICE  
Credit account for people affected  by poverty / persons without cash 
KomenskýFond (Komensky Fund): an in itiative of the ERSTE Foundation 
and Caritas 
"Mummy learns German" at nurseries and schools in Vienna 
Three City of Vienna projects:  
1. “Prospects“: vocational and educati onal counselling for pe rsons entitled to 
asylum and financial support for further education; 
2. “Competence Centre“: counselling to  assess prior learning and further 
education needs ofnew migrants; 
3. “Basic vocational guidance in the mother tongue” targeting newcomers 
“To your heart’s content” - -women from Favoriten live a healthy life Austria 
“… but healthy despite everything!” 
Les experts du vécu/médiateurs de terrain  
Les fonctionnaires d’attention  
Inclusion de personnes sans-abri  Belgium  
Validation des compétences  
Social Services Against New Employme nt – social support for vulnerable 
groups, persons and families (SANE) 
Increasing the employability of the unemployed by vocational training (German-Bulgarian Vocati onal Training Centres) Bulgaria 
Programme for targeted social protec tion for heating to the population with 
low income 
Development of local services in social welfare services 
Cyprus  Project “Expansion and Improvement of Care Services for Children, the 
Elderly, Disabled person s and other Dependants” 
Czech Three-stage permeable housing system 
 
EN 72   EN MEMBER 
STATE EXAMPLE OF GOOD PRACTICE  
Rehabilitation – Activation – Work 
Support for inclusion – Career counselling 
Introducing multidisciplinary team s into Youth Court practice Republic  
Strategy for the social inclusion of the homeless 
Evaluation of the project Focus on the Family 
Forward - To ensure work and educa tion for drug and alcohol misusers 
Integration of mothers and their children through the project Neighbourhood 
Mothers 
SPIDO (Socio-pedagogic Practice in Dementia Care) Denmark  
National Indicator Project (NIP) 
The ESF programme ‘Welfare measures  to support employment 2007-2009’ 
Estonia  
Introduction of the case management principle 
Intersectoral welfare policy programme on children and youth 
Kaiku Programme to promote occupational wellbeing Finland 
Promoting health and functional capacity 
Instaurer la fluidité du parc hébergem ent/logement /Improving availability of 
housing 
Favoriser le retour à l’emploi des bénéficiaires de minima sociaux et 
augmenter le temps de travail des travai lleurs pauvres / Return to employment 
of minimum benefit recipients and increased working hours for low-paid 
workers 
La mesure de l’atteinte de l’objectif de  baisse d’un tiers de  la pauvreté en 5 
ans /Monitorinig target to reduce po verty by one-third in five years France 
L’insertion des jeunes par la deuxièm e chance / Inclusion of young people by 
giving a second chance 
The Federal Government’s “Job – Jobs without Barriers” initiative 
Hesse’s “Experience has a Future” programme Germany 
The Free State of Saxony’s programme “Training unemployed people without 
 
EN 73   EN MEMBER 
STATE EXAMPLE OF GOOD PRACTICE  
vocational qualifications to obtain recognised vocationa l qualifications” 
Rhineland-Palatinate “InPact” programme 
Greece Training addressed to Mu slim children 2005-2008 
Micro-regional social closing-up programmes 
Subsidised housing programme for homeless people Hungary 
Senior-friendly municipality  award and grant programme 
Creation of the Office of th e Minister for Integration 
National Intercultural Health Strategy 2007 – 2012 Ireland 
Technical Advisory Group and Data Matrix 
A certificate for the Italian language : the way to know and to get known 
Prestito sull'Onore: microcredit at  zero rate for unforeseen economic 
difficulties 
Education and training of foster families of foreign minors deprived of parental care (undocumented children) Italy 
Fondo Autonomia Possible: Fund allowing Autonomy 
The "Complex inclusion programme" 
Latvia Creation of ‘one-stop shop’ for empl oyment counselling through merging of 
two state agencies 
Webpage “Social map”  
State support for the social enterprises  
EQUAL project “Integration of hearing impaired persons into the open labor 
market” Lithuania 
Development of public internet acce ss points network (alliance “Window to 
the future”) 
Luxemburg Foyer scolaire “Parc Hosingen” by SISPOLO (Syndicat intercommunal pour 
l’éducation , l’enseignement, le sport et les loisirs) - Regional initiative of 4 
neighbour communes to offer after-s chool quality childcare for school 
children aged 3-13 years, in close colla boration with pre-school and primary 
school professionals 
 
EN 74   EN MEMBER 
STATE EXAMPLE OF GOOD PRACTICE  
RESONORD Regional Sozialétude Norden : Projet d’étude sociale de la 
région LEADER+ Clervaux-Vianden en vue  d’une démarche intercommunale 
de développement social / Project fo r social study of the region aimed at 
multi/commune action on social development 
Integration of Asylum Seek ers into Maltese Society 
Equal Project - HEADSTART 
National Standards of Care for Residential Childcare Malta 
Gender Mainstreaming - The Way Forward 
Prevention Information Team (PIT) Eindhoven  
Netherlands Measures intended to strengthen debt counselling and reduce over-
indebtedness 
The Social Integration Program (t he Post-Accession Support Program for 
Rural Areas – PSPRA) 
Construction of multi-function sports fi elds generally accessible to children 
and young people Poland 
Social work for the benefit of  social housing development 
Transnational Project LAPs & RAPs (financed by the EU) 
Portugal 
Entrepreneurs for Social Inclusion (EPIS) 
Training modules for the technical secr etariats of the C ounty Commission for 
Social Inclusion 
Romania 
Job Fairs and Employment Caravan ai med at individu als with Roma 
background 
Improving the quality of social assistance provision for citizens in the Bratislava Self-governing Region (BSK ), extending and modernising social 
services provided and developing new type s of social services relevant to the 
needs and the demand 
Building a system for prevention and job placement for the long-term 
unemployed, persons with low qualifica tion and other disadvantaged groups  Slovakia 
Twinning project to improve resocialisa tion and rehabilitati on of drug addicts 
Slovenia 
‘Project Man’ programme for self-help therapy and social rehabilitation of 
 
EN 75   EN MEMBER 
STATE EXAMPLE OF GOOD PRACTICE  
people with various forms of addiction 
Network of maternity homes and she lters for women and children who are 
victims of violence 
‘Involvement of the elderly in provid ing home assistance to the elderly’ 
Programme for development of local plan s for social inclusion in Cataluña 
The minimum incomes system of the autonomous communities Spain 
Governance process in the 2nd regional plan for soci al integration (2nd PRIS) 
of the Regional Board of Castilla-La Mancha  
National guidelines on misuse and de pendency care issued by the National 
Board of Health and Welfare Sweden 
Action plan against male violence against women 
Family Nurse Partnership programme 
Provider-led Pathways to Work 
Money Matters Financial Lear ning Project, Inverclyde 
Social Firms United 
Kingdom 
Off the Streets and into Work & St Mungos: improving access to training and 
employment for homeless people 
 
EN 76   EN 4. ADEQUATE AND SUSTAINABLE PENSIONS  
4.1. Overall strategy for Adequacy and Sustainability of Pensions 
4.1.1.  Introduction 
Common objectives for Pensions 
Member States are committed to providing adequate and sustainable pensions by ensuring: 
(g) adequate retirement incomes for all and access to pensions which allow people to 
maintain, to a reasonable degree,  their living standard after re tirement, in the spirit of 
solidarity and fairness between and within generations; 
(h) the financial sustainabil ity of public and private pens ion schemes, bearing in mind 
pressures on public finances and the ageing of  populations, and in the context of the three-
pronged strategy for tackling th e budgetary implications of  ageing, notably by: supporting 
longer working lives and active ageing; by balancing contribu tions and benefits in an 
appropriate and socially fair manner; and by pr omoting the affordability and the security of 
funded and private schemes; 
(i) that pension systems are transparent, well adapted to the needs and aspirations of women 
and men and the requirements of modern so cieties, demographic ageing and structural 
change; that people receive the information they n eed to plan their retirement and that reforms 
are conducted on the basis of the broadest possible consensus. 
The 2006 Synthesis Report on Adequate and Sustainable Pensions outlined the main 
challenges to be met in the area of pensio n provision. Over the past  decade reforms have 
improved sustainability by brak ing and counteracting the eff ects of declining ratios of 
working years to retirement years and of wo rkers to pensioners. Th e 2006 report reiterated 
that financially sustainable systems must be ba lanced with adequate be nefits. Member States 
have increasingly employed a mix of different types of pension designs: public and private, 
pay-as-you-go and funded, mandatory and volunt ary in order to reach these goals. At the 
same time they have sought to underpin ch anges to pension systems by improvements in 
labour markets, notably by raising employme nt rates of women and older workers.  
The 2007 and 2008 joint reports have included in-d epth analyses of specific issues, policy 
findings and indicators to measure progre ss towards the common objectives. The SPC has 
also adopted reports on curr ent and prospective theoretical replacement rates, minimum 
income provision for older people, promoting longer working lives through pension reforms 
and privately managed pension provision. Other issues such as pension information and 
financial literacy have been  covered through peer reviews 35. Countries have contributed to 
these studies by responding to questionnaires and participating in peer review processes. 
National Strategy Reports delivere d in the early autumn of 2 008 where Member States report 
on their responses to the cha llenges identified in the 2006 a nd 2007 Joint Reports form the 
                                                 
35 For information from the peer review on Public information on pension syst ems and pension system changes please 
refer to: http://www.peer-review-social-inclusion.net/peer-r eviews/2008/public-information-on-pension-systems-
and-pension-system-changes  
 
EN 77   EN foundation for the policy analysis in this documen t, which is issued in  support of the Joint 
Report 2009. 
4.1.2.  Reforming pension systems to meet the demographic challenge 
Over the last decade Member States have refo rmed their pension systems to better provide 
adequate and sustainable pens ions in view of population ag eing, new societal norms and 
changing behavioural patterns. Consequently in  their 2008 national strategy reports, countries 
focus on the implementation of reforms and furthe r incremental progress that has been made. 
Such progress in many ways involves a delicate balancing of the dual concerns of adequacy 
and sustainability: how to se cure sufficient pensions for all without jeopardizing work 
incentives and the financial sust ainability, and vice versa.  
Still a few Member States have legislated more  substantial reforms since the last reporting. 
The Portuguese pension reform, following an agreem ent with the social partners, entered into 
force in May 2007. The reform entails increasi ng the pensionable age and the eligibility 
periods until 2015, as well as changes to the benefit formula, that will lower replacement 
rates. The reform covers both government and pr ivate sector schemes. Changes in the latter 
include larger benefit reductions in case of early retirement and creation of incentives to postpone retirement, the introduc tion of a 'sustainabil ity factor' that automatically adjusts 
benefits to changes in residual life expectancy and indexation rules for pension benefits as a 
function of real GDP growth and consumer inflation. 
The Czech Republic has started a pension reform in three phases. The first phase adopted in 
July 2008 included new legislatio n that increases the pensi onable age to 65, prolongs the 
eligibility criterion for contributory years and introduces new incentives for prolonging 
working lives by strengthening th e bonus-malus system for earlier  or delayed retirement. The 
second and third phases of the reform which ar e to be carried out by 2010 concentrate more 
on strengthening the role of funded, privately managed pension provision.  
Greece has adopted legislation reducing the nu mber of pension funds, harmonising pension 
eligibility ages, limiting access to early reti rement, crediting child caring years and 
introducing a social security number for benefici aries. While still rather complex the system 
has been simplified to improve its financial efficiency. 
Cyprus has introduced a reform that will entail gradual increases in the contribution rate and 
in the minimum eligibility requirements. The pensionable age for civil servants has been 
increased to 63 years. In Cyprus, the introducti ons of a Special Allowance and some ad hoc 
increases in the minimum pension have been legi slated in order to a ddress the high risk-of-
poverty in old age. Given these improvements, th ere is still a need to monitor the incomes of 
those claiming solely a social pension and those living in single-person households. 
The UK is continuing its programme of pension reforms affecting public and private pillars. 
Reforms adopted or proposed since the 2007 Joint Report include a major easing of 
entitlement criteria for basic pension, earnings  related indexation from  2012 and much wider 
coverage of supplementary pensions encouraged  through means of auto-enrolment and further 
financial incentives for people to contribute to these schemes.  
A number of Member States have introduced qu antitative national targets or monitoring of 
national indicators as methods of motivating progr ess in the area of pe nsions. Bulgaria and 
 
EN 78   EN Romania have targets to decrea se contributions in order to encourage participation in the 
labour force. Slovenia has set a target to ach ieve a coverage rate of 70% by 2030 in the 
voluntary funded scheme. Ten Member States have succeeded in reaching the Lisbon target of 
a 50% employment rate for older workers ag reed by all Member States. In Poland a 
programme has been introduced to increase the em ployment rate of older workers to 40% in 
2013 and 50% in 2020. Germany has set national targets on the employment rate of older 
workers beyond the Lisbon target. The United Kingdom is assessing progress using indicators 
on the employment rates of those ages 50-69 as  compared with the ove rall employment rate. 
Some countries have defined targets on the ad equacy of pension benefits or adopted an 
indicator-based approach to monitor and impr ove the welfare of th e elderly. Cyprus has 
introduced a target to reduce th e at-risk-of-poverty from 52% to 40% by 2011 with the intent 
to pursue a risk-of-poverty rati o for the elderly that is lower than 20% by 2013. Other 
countries have pegged the adequacy of pe nsions by quantifying targets in terms of 
replacement rates, although the definitions of replacement rates may vary in the targets set. 
Ireland has endorsed a target of a 50% replacement rate from all sources of pension income in 
the Programme for Government. In Belgium, th e current government wants to increase the 
old-age pension replacement rate for workers w ho are currently active. In Lithuania, targets 
correspond to a long-term adequacy goal of manda tory pension levels e quivalent to 50% of 
average net wages. In the Unite d Kingdom, the percentage of pensioners with low income 
will be monitored as part of a public service agreement to ‘tackle poverty and promote greater 
independence and wellbeing in later life’. 
4.1.3.  Prolonging working lives to addr ess the pension challenge 
Meeting the pension challenge is essentia lly about closing the gap between shorter 
contributory lives and longer retirement periods – with the first resulting from later labour 
market entrance and decreased employment rate s of older workers and the second triggered 
by premature exit and rising life expectancy. Ma intaining the adequacy and sustainability of 
pension provision in an ageing society depends  crucially on more people working more and 
longer.  
Pension systems can support labou r market objectives by incl uding all active groups, by 
signalling appropriate ages of retireme nt and by establishi ng economic incentives 
(bonus/malus) in support of desi red behaviour. Activity and empl oyment rates are influenced 
by a whole range of factors unre lated to pensions. Yet, norms for pensioning and retirement 
practices are influenced by the institutional framework created by the state. Rules of pension 
accruals, the pensionable age and designs of earl y retirement benefits represent signals for 
workers and employers that impact on age management.  
As Members States are seeking to re-establis h a sustainable balance between contributory 
working years and years spent in retirement they are faced with a combined need for: 
(a) lowering the entry age, (b) lowering the incidence and length of  careers breaks and 
(c) increasing the effective exit age. So far most  efforts have been directed at influencing the 
effective exit age. 
 
EN 79   EN Table 4.1: Average labour market exit age a nd life expectancy at 60 in selected EU 
Member States in 2006 
Member State Statutory pensionable age Effective exit age from the 
labour market Life expectancy at 60 
  Males Females Males Females Males Females 
Belgium 65 64 61.2* 61.9* 80.8 84.9 
Bulgaria 63* 59* 64.1 64.1 76.2 80.3 
Czech Republic 61y 6m 59y 8m 61.8 59 78.2 82.4 
Denmark 65 65 62.5 61.3 80 83.3 
Germany 65 65 62.1 61.6 81.1 84.8 
Estonia 63 59y 6m 62.6+ 62.6+ 75.9 82.2 
Ireland 65 65 63.5 64.7 80.8 84.5 
Greece 65 60 61.8 60.4 81.4 83.9 
Spain 65 65 61.8 62.3 81.7 86.5 
France 60 60 58.7 59.1 82 87 
Italy 65 60 60.5 60 81.4*** 85.9*** 
Cyprus 65 65 : : 81.8 84.2 
Latvia 62 61y 6m — 62 : : 75.2 81.1 
Lithuania 62y 6m 60 : : 75.5 81.5 
Luxembourg 65 65 : : 80.7 84.4 
Hungary 62 60 61.2** 58.7** 76.5 81.6 
Malta 61 60 : : 80.1 83.8 
Netherlands 65 65 62.1 62.1 80.8 84.5 
Austria 65 60 61.3 60.6 81.1 85.1 
Poland 65 60 61.4* 57.5* 77.7 82.9 
Portugal 65 65 62.9* 62.3* 80.4 84.6 
Romania 63* 58* 65.5 63.2 76.7 80.5 
Slovenia 63 61 : : 79.4 84.3 
Slovakia 62 62 59.7* 57.8* 76.5 81.4 
Finland 65 65 62.3 62.5 80.6 85.5 
Sweden 61-67 61-67 64.2 63.7 81.8 85.2 
United Kingdom 65 60 63.8 62.6 80.9** 83.7** 
Source: Eurostat Note: * — 2007 data, ** — 2005 data, *** — 2004 data, + — common data for both sexes 
The 2007 Joint Report identified the challenge of increasing the empl oyment rate of older 
workers (or promoting longer working lives) for 16 out of 25 Member States (CZ, DK, GR, 
ES, FR, IT, CY, LT, LU, MT, NL, AT, PT, SI, FI , and SE). Some of these have sought to 
respond through new initiatives in pension and labour  market policies. Yet,  despite significant 
progress in recent years in many Member Stat es (for instance LV, BG, LT, DE, SK, EE and 
NL), there is still a need to extend working lives across the Un ion, as illustrate d by Table 4.1 
which shows that the difference between remain ing life expectancy at age 60 and the average 
labour market exit age is over 20 years for women in most Member States (see 4.2). 
4.1.4.  The increasing role of privately managed pensions 
Most Member States have reported on increasing  contributions to privately managed pensions 
as a means of improving the adequacy and sustainability of overall national pension 
provisions. In recent reforms, some Member St ates promote or mandate extra contributions 
for occupational and private pension provision (e.g. BE, DK, DE, IE, UK).  
 
EN 80   EN A number of Member States that have intr oduced mandatory funded schemes recently have 
done so by allowing for a transfer of contribu tions from old pay-as-you-go systems to the 
funded schemes, instead of incr easing the overall contribution rates (e.g. HU, LT, LV, SK). 
Romania has introduced a voluntary funded scheme that implies moderate extra contributions 
for privately managed pension savings. In Bulgar ia participation in the new funded scheme of 
supplementary pensions is mandatory. The inte rest in these schemes has often been higher 
than expected possibly because they were in troduced in years of relatively high economic 
growth. The large number of people shifting part of their contribution ha s caused deficits in 
the pay-as-you-go systems. Slovakia has re sponded by allowing cont ributors who earlier 
chose to opt out of the pay-as-you-go system to  review their choice. This has resulted in an 
increase of revenue in the pay-as-you-go system s and a delay in the full establishment of the 
mandatory funded scheme. Changing the rule s within such a short timeframe though 
temporarily expedient may erode the legitimacy and stability of the reforms enacted and the long-term sustainability of the diffe rent tiers of the pension system. 
The Joint Report of 2008 showed th at the broader use of private pensions is equivalent to a 
transfer of the risk of maintaining the value of  pension accruals from governments to pension 
funds and in some cases ultimately to indivi duals. Member State expe riences indicate a need 
to monitor the effects of this trend on the ad equacy of pensions, and underpin private funded 
provision by an appropriate and careful design of public regulation clarifying the definition of 
pay-out conditions, government supervisory role s, and the definition of new instruments. 
Current reporting shows that Bulgaria has chos en to curb risks by in troducing guarantees and 
putting restrictions on the risk levels of investment portfolio s. Slovakia is introducing a life-
cycle approach to fund investments on behalf of individuals (see 4.3). 
4.1.5.  Maintaining pension adequacy while ensuri ng sustainability: ind exing and automatic 
adjustments 
The adequacy of retirement income systems va ry widely between Member States. In recent 
years some countries have improved the share of income from earnings-related pensions 
considerably, while in others reliance on basic pens ions is just beginning to decline as a result 
of the maturing of earnings-relate d pensions and higher employment rates. In this context, the 
2007 Joint Report identified that Member States need to monitor whether the income of 
pensioners, including those with the weakest pr ior links to the labour market, maintain their 
value relative to prices and do not fall  too far behind wage developments.  
Adequacy is not just about replacement levels at the time of retirement and pension take-up 
but also about how the value of benefits relative  to prices and wages is maintained over time. 
Indexation allows pensions to keep a certain value over time ensuring adequacy not only at 
the time of retirement and pension ta ke-up but also in the following years. 
Not all Member States have systems of regular indexing. But a few of those without 
introduced it in this reporting period (e.g. LT). A number of Member States have chosen to 
boost the adequacy of pensions by reforming of th e indexation rules or by ad hoc increases in 
pensions – sometimes in combination.  
Some countries report a shift towards a higher degree of earnings-linked indexing of statutory 
old age pensions (e.g. CZ, HU, PL, UK). To what  extent this shift entails higher up-rating 
depends on the economic situation. In many Memb er States 2006-2008 has been a period with 
higher growth and increasing inflation. Pensions have typically been indexed to prices in 
order to ensure a constant purchasing power over time. Wage  or GDP growth oriented 
 
EN 81   EN indexation of pensions has been advocated as it allows the incomes of retirees to track those 
of the working population more closely. It is al so positive from a financial sustainability point 
of view as the up-rating of pensions be come more closely c onnected to economic 
development. The coming period 2008-2010 is likel y to see very moderate economic growth 
and lower inflation.  
Member State experience, as reported in the Nati onal Strategy Reports, indicates that it is also 
important to weigh the adequacy effects of diffe rent types of indexati on carefully against the 
sustainability impacts.  
The use of automatic annual indexation rather  than ad hoc increas es is an important 
development for ensuring the transparency an d legitimacy of a pension system. Some 
Member States have also introduced automatic or semi-automatic adjustments to the level of outgoing pensions through period ic assessments of pressures on pensions. These are designed 
to stabilise the financial sustainability of pe nsion systems through automatic adjustments of 
benefit levels (e.g. SE, FI, PL, LV or DE) or periodically required re views and fine-tuning 
(e.g. AT, IT or FR).  
Automatic adjustment and indexing rules only boost the transparency and credibility of a 
system if the triggers are allo wed to function. Most automatic mechanisms have not yet been 
applied in practice and experience from 2006-2008 highl ight that it is critical to monitor the 
functioning of these mechanisms. A few c ountries have already postponed automatic 
adjustments by political means (e.g. the delay in the automatic updating of life-expectancy 
projections for annuity calculations  in IT or increases to benef it levels above those guaranteed 
by stability enhancing factors in adjustment ru les in DE). This may undermine the credibility 
of such reforms.  
4.1.6.  The role and quality of minimum income provision for older people 
Amid the increasing importance of  pension schemes where benefit levels are linked to work-, 
earnings- and contribution records many pensioners - including some of those currently taking 
up a retirement income - have to rely on the systems of mini mum income provi sion for older 
people (MIPs) found in all Member States. The role, design and benefit levels of these vary widely across the Union. But everywhere they ar e meant to cater to th e needs of people with 
insufficient or no rights in the employment rela ted pension schemes and gender role legacies 
entail that women constitute the bulk of recipien ts. As these benefits re present a particularly 
fragile part of the ove rall adequacy of reti rement income the 2007 Joint Report called for 
greater attention to the role, levels and i ndexing of minimum income  provisions for older 
people. MIP-recipients spend a relatively high  share of their income  on basic needs price 
developments in certain commodities are therefor e of particular concern. Phenomena such as 
the sudden hike in energy and food prices in the spring of 2008 have presented a particular 
challenge to adequacy. Only a few Member St ates have reformed their MIPs and those 
countries with particular chal lenges with regard to MIP ade quacy have primarily adjusted 
their systems in smaller ways. But ad hoc up-ratings and improvements to indexing 
mechanisms have been both frequent and widesp read. Indeed, in many Member States such 
measures have meant that the relative value of  MIPs has been reasonably maintained despite 
rapid growth and risi ng inflation (see 4.4). 
 
EN 82   EN 4.1.7.  Ensuring information and transparency 
Pension reforms have resulted in a move towa rds multi-pillar systems with defined-benefit 
elements and made eventual retirement income  considerably more dependent on individual 
behaviour and decisions in the active years. Pe nsion systems have become more difficult to 
understand and pension benefits less easy to predict.  In order to be able to respond well to the 
new incentives in pension systems and make the decisions most befitting their set of 
circumstances and preferences workers need far more information than before. Providing this 
in an effective way has become another part of the pension challenge which Member States 
increasingly have to take up to ensure that  pension reforms are well understood, gain popular 
support and achieve their in tended results (see 4.5). 
4.2. More people in work and working lo nger: The response of pension policy 
Getting more people to work more and for longer  has been identified as one key solution to 
the pension challenge that allo ws for both financia lly robust pension systems and adequate 
benefits. While raising the likelihood that adeq uate pension rights are earned, the extra years 
of contributions also improve the financial situati on of the system. 
4.2.1.  Increasing the contributory base to meet  the challenges of sustainability and 
adequacy 
In a number of Member States  improving the financial base of a pension system through 
increases in the contribution rates has been iden tified as a solution to the complex problem of 
providing adequate pensions without compromi sing the financial standing of the pension 
system.  
A few countries report on reforms to increas e their contribution revenue through higher 
contribution rates to existing schemes, thus securing the adequacy and sustainability of 
pensions (e.g. CY, DE, HU, IT). Low contributi on rates can lead to inadequate benefits or 
insufficient financing of benefits. From a solidarity point of view it is, however, important to 
ensure that mandatory contributions are at a reasonable level so as to not over-burden the 
income of the working population.  
Too big a contributory burden on work income can create strong incen tives to contribution 
avoidance and may endanger the financial and political legitimacy of the pension system. Romania report on reductions in contribution rates to the pension system from extraordinarily 
high levels. The idea is to improve sustainabil ity by encouraging more workers to participate 
in the formal sector, thus widening the contribu tory base and the volume  of contributions. In 
countries with a large informal sector, broadening th e tax or contri butory base also increases 
adequacy as more people are covered by the re tirement insurance. At the same time it 
contributes to the long-term sust ainability of the system because  the financing base increases 
as more people become active in the formal economy. Most Member States with problems in their contribution base are looking at ways to include groups at the marg ins of labour market 
and social security systems, such as the self-employed, immigrants and the disabled.  
In many Member States young people are increas ingly employed on temporary contracts. But 
membership of pension schemes is usually link ed to permanent employment status, so young 
workers are very often exempted from mandato ry pension contributions. For example Italy 
has made improvements allowing more people with  atypical contracts to be better covered by 
 
EN 83   EN social security and pension schemes. Member St ates have also made it easier to transfer 
entitlements between pension funds a nd thereby improved labour mobility.  
If younger workers join th e labour market later it can reduce  the cumulative yield of accrued 
pension rights in notional defined-contribution or funded schemes, because the yield depends 
on the length of time that retu rns are accumulated. But even in  PAYG schemes late entry will 
increase the risk of being una ble to accrue enough contributor y years to earn a full pension. 
4.2.2.  Protecting those with non-standard careers in reforms 
Typically pension reforms have extended the numb er of contributory years needed for a full 
pension and have based calculations of earnings -related benefits on income from a greater 
number of working years. Thus, length of car eer and income earned over the career have 
become much more important for the pension benefits accruing to individuals. In view of this 
development, the 2007 report advocated more in-dep th analysis of the impact of these reforms 
on people u able to meet these conditions due to  atypical career patter ns. Future risk groups 
would include the low skilled, low waged women and men, individuals affected by long-term 
unemployment or illness, people with carin g duties and people excluded from pension 
coverage due to short term, temporary contr acts or self-employed status. The 2008 national 
strategy reports show that the lowest pensions currently are received by those that have had 
the weakest link to the labour market in the pa st. De facto inactivity and longer spells of 
unemployment will impact on the future pension benefit of individuals. Past levels of long-
term unemployment in many new Member States  are already likely to result in lower 
retirement incomes in conjunction with recent reforms. Widespread future unemployment in 
generations where the old-age dependency ra tios are already high wi ll impact on the long-
term financial sustainability of pension system s, but also affect th e adequacy of pension 
accruals for some.  
While maintaining scheme incentives to return to work as quickly as possible many Member 
States have two mechanisms for addressing th e issue of adequacy for those with career 
breaks, minimum pensions and the accrual of  pension rights in non-contributory periods. 
Earnings-related systems usually offer a mi nimum pension calculated on more favourable 
terms for those with lower incomes or shorte r working lives (e.g. BE, BG, CZ, ES, FR, LV, 
LT, LU HU, PL, PT, SE, SI). In their main st atutory schemes all Member States offer some 
form of protection of the ac crual of pension entitlements in typical contingencies of 
involuntary interruption of empl oyment. Usually periods of unemployment, long-term illness 
and maternity are credited by pension contribu tions being paid on behalf of the affected 
individuals by the relevant social  insurances dealing with the contingency. Yet, contributions 
are mostly only continued at a general low leve l of income equivalent to the minimum wage. 
Pension accruals will therefore be much smaller in such period s. Similar protections may exist 
in many occupational schemes, but would not be present in voluntary funded schemes.  
All Member States provide some kind of recogn ition of caring duties in  pension entitlements. 
Many Member States have recently improved th e crediting of caring years (e.g. EL, ES, LT, 
MT, PT, UK). The most common approach is to credit caring years at the same level for 
everybody irrespective of the level of income  lost or foregone. Malta has introduced and 
Luxembourg plans to introduce credits for childcar e years. In Spain new rules allow a person 
restricted to part-time work due to child or fam ily care to be credited for a full day's work in 
the eligibility calculations. Other Member States  provide a protection of  pension entitlements 
during childcare which is linked to the employment situation a nd income of the individual 
 
EN 84   EN (e.g. EE, HU, IE, PL, PT, RO, SE). Some countries , however, still deal w ith the issue of care 
years by lowering the pension eligibility ag e for women with children (e.g. CZ, SI). 
In recent years, a number of memb er States have also introduced care credits for other types 
of care than for children. These are usually linke d to a general reference value rather than 
earnings (e.g. BE, DE, AT) or simply include car e periods as a part of eligible qualifying 
periods (e.g. EL, IE, LT, PL, UK). 
Box 1: Illustrations of the result of absen ces from the labour market on pensions 
Calculations show that in most Member Stat es absences from the labour market due to 
unemployment or childcare, though partially pr otected, generally le ad to decreases in 
theoretical replacement ratios. 
In many Member states, absences from the labour  market for childcare are typically protected 
to a certain extent for the first few years of  absence and usually the protection is equally 
spread over these years. In a few Member St ates pension rights for up to three years of 
absence are so well protected that calculations show no drop  in replacement rates (e.g. CZ, 
ES, LU, MT). Whereas this improves the adequ acy of benefits accr uals during childcare 
absences, the work incentives in the system can be questioned. In the Czech Republic, the 
retirement age for women is decreased depending  on the number of children they bear and the 
years of retirement before the age of 65 are accredited giving no change in the replacement 
rates. In Malta, where the minimum statutory re tirement age is 61 and only 30 contributory 
years are needed for a full pension, the replace ment rates do not change with a prolonged or 
shortened retirement age in this exercise wh ich is based on a 36 year contributory period. 
However, recent legislation credits social securi ty contributions for inte rrupted careers of up 
to 2 years.  
In some countries childcare cred its are connected to the birth of the child rather than an 
absence from the labour market (e.g. DE, FR, IT) resulting in an increase in pension 
entitlements when a child is born. In Romania, ch ildcare breaks are less well protected than in 
most other Member States. In the UK the decline on the state pension side is marginal, and 
results depend more on whether private pension schemes awar d care credits or not.  
 
EN 85   EN Figure 11: Difference in net theoretical replacement rates for an average earner entering the 
labour market at 25 and retiring at the statutory retirement age with a 1, 2 and 3 year career 
break for childcare compared with no break*  
-8,0-6,0-4,0-2,00,02,04,06,0
FR CZ ES LU M T FI AT BE EL SE EE SK IE DE NL DK LT IT UK PL CY HU PT BG LV SI ROI year 2 years 3 years
 
Source: ISG calculations on Theoreti cal replacement rates carried out in the OECD APEX model or in national 
models. The figures for NL are preliminary. 
* The calculations assume two children are born and that the timing of the childcare years is such that full 
childcare benefits are received for each ch ild. Retirement at the legislated st atutory retirement age for women is 
calculated here 
In some Member States (e.g. CZ, DE, EE, EL, ES, FR, IT, CY, LT, LU, AT, PL, SK, FI, SE, 
UK) the protection for childcare is better th an for unemployment over a three year period. 
Yet, in many Member States absence for child care translates into lo wer replacement rates 
than unemployment absence.  
Whiles important to protect certai n types of absences from the la bour market it is important to 
consider the work incentives within the retirement and unemployment systems.  
On the other hand, the drop in replacement rate s are much higher in some Member States 
during the three years of unemployment (e.g. SK, ES), bringing the adequacy of protection of 
pension entitlements during unemployment into que stion. In most Member States the drop in 
theoretical replacement rates is equal throughout the three years of unemployment. In a few 
cases the drop is lower (e.g. BG, DE, FI, HU, SE, UK) or bigger (e.g. DE, ES, FR, IT, CY, 
PL, LU, SK, SI) after the first or  second year of unemployment.  
 
EN 86   EN Figure 12: Difference in net theoretical replacement rates for an average earner entering the 
labour market at 25 and retiring at the statutory retirement age with a 1, 2 and 3 year career 
break for unemployment compared with no break* 
-18,0-16,0-14,0-12,0-10,0-8,0-6,0-4,0-2,00,02,0
M T FR CZ HU BG EL DK IE AT NL SI UK BE LU CY PL PT LT LV IT FI RO EE SE DE SK ES I year 2 years 3 years
 
Source: ISG calculations on Theoreti cal replacement rates carried out in the OECD APEX model or in national 
models. The figures for NL are preliminary. 
* The unemployment break is assumed to take place in the years just prior to ol d age retirement which is 
assumed to take place at the legislated  statutory old retirement age for men.  
4.2.3.  Improving gender equality in pension policy 
Many Member States report on significant wage  gaps between employed men and women, 
ranging from under 5% (MT) to 25% (EE). Women also tend to work part-time and so their 
earnings often develop more sl owly than men's. Though substa ntially reduced the resulting 
gender gaps in retirement income are set to pers ist. Equalising the pension eligibility ages for 
men and women is part of the solution legislated by Member St ates to ensure that women 
have a decent retirement income. Some Member States plan to equalise pensionable ages in 
the near future (e.g. BE, LV, HU) whiles others have longer transition al rules (e.g. EL, EE, 
LT, MT, AT, CZ). Some Member States will na rrow the gap between the pensionable ages for 
men and women without making them identical (e .g. BG, RO, SI). Others have so far made 
no steps in this direction (e.g. PL).  
Constant observation and efforts are needed to  achieve gender equali ty on the labour market 
and in the distribution of care bur dens, which today are still mainly  borne by women. It is also 
important to monitor the effects of polic ies whereby replacement incomes and pension 
entitlements are given for care-related absences fr om the labour market in order to avoid that 
such protections become new dependency traps. As caring years have a significant negative 
effect on women's long-term participation to the labour market in many Member States, a 
careful balance must be struck  between care crediting and incentiv es to get women back into 
paid work. Tailoring pension scheme mechanisms  to the new gender roles would promote the 
 
EN 87   EN reconciliation of work and family life, enabling women (and men) to resume their careers 
quickly and combine parenting with work. 
4.2.4.  Increasing the employment of older workers 
Member States have sought to encourage more  employment of older workers by raising the 
pensionable age, closing early exit routes and allowing for flexible combinations of work and 
pensioning. Employment rates of  older workers (aged 55-64) have  improved in recent years, 
reversing a long-lasting downw ard trend (see section 2.1.2). 
4.2.4.1.  Increasing the pensionable age in statutory schemes 
Politically pension reforms are di fficult to initiate and implement. Raising the pensionable age 
in the statutory scheme is notoriously difficult as this age is intimately connected to the social institution of retirement and signals the reco gnised age at which it should take place. A 
number of Member States have legislated an increase in the pensiona ble age for both genders 
in recent reforms. In most of these Member States the higher eligibility ages for a statutory 
pension will be phased in over a long period and have more effect on younger cohorts (e.g. 
CZ, DK, DE, LT, MT, UK). It is therefore important to monitor the actual implementation of 
these reforms and study the political  climate that allows for increases in the pensionable age 
to be carried forward. Despite the general trend towards increases in the pensionable age, 
there are Member States where the pension elig ibility age is still re latively low (e.g. BG, EE, 
FR, LV, HU, SK). 
4.2.4.2.  Increasing the contribution period 
Usually the length of contributory periods co rresponds to pensionable ages. However, some 
Member States (e.g. France) have  kept the formal pensionable age at the same level while 
increasing the contribution period needed for a full pension. This solution might be more 
acceptable from a political point of view than  increasing the pension eligibility age in 
statutory schemes. If the righ t to receive a full pension depe nds on the contribution period, 
people who start working at a la te age are not unduly rewarded. 
Contribution periods required for a full pension have been increased in some member States 
(e.g. CZ, FR, AT), so the link between contributi ons paid into the syst em and benefits paid 
out has been tightened. Nevertheless, conditions  for drawing a full pens ion are very diverse 
and sometimes they are not sufficient to make pe ople work longer, as th ere are Member States 
which still require only 30 years of contribution (e.g. LT, RO).  
The qualifying period for a minimum pension has re cently been extended in CZ, CY, ES, and 
RO. If a minimum pension scheme guarantees th e major part of pensio ners' income, and the 
contribution period is too short, it can act as a disincentive to  stay in the labour market.  
With the aim of ensuring that more women an d men with caring dutie s and shorter careers 
gain entitlement to a basic pension, the Unite d Kingdom has gone against the general trend by 
reducing and equalising the number of qualifying years. This example highlights the need to 
study the effects of longer qualifying pe riods on those with  shorter careers. 
 
EN 88   EN 4.2.4.3.  Promoting flexible retirement options 
Under specific circumstances more flexible path s out of employment into retirement can help 
to promote longer working lives. For instance,  the increase in the employment of older 
workers over the past decade is partly due to a rise in part-time work, notably by men. About 
25% of employment among older workers in the EU-15 is now part-tim e (22.5% in the EU-25 
and 22% in the EU-27). 
Another issue for the design of flexibility in pensionable age is the conditions for partial 
pensions, and where individuals can take a shar e of their pension whilst continuing to work 
(given particular conditions). Th is type of provision is reported in a number of Member States 
(CZ, ES, FR, IT, NL, FI, and SE). Individuals ’ motives for choosing these options include 
reducing the number of hours worked and accruing further pension rights in  order to ensure a 
higher pension in the future. Member Stat es are fine-tuning both arrangements, and 
sometimes restricting flexibility in the name of  preventing abuse is required. It has recently 
been seen in the case of Spain, where the ag e when partial pension is accessible has been 
raised, and in Hungary where the rules on cu mulating the early retirement benefits and 
income from work have been tightened.  
Providing flexibility in combinations of work and partial pension may enable people to work 
longer. Work time reduction can be essential for facilitating and encourag ing people to remain 
in work after 60. Nevertheless, introducing more  flexible retirement  provision requires a 
careful design of the structure of incentives and a focus on a proper target group of workers 
(for instance in  terms of age). 
One solution is to link the pensionable age to  the length of the contribution period and a 
bonus/malus system for earlier or later take-up of  the pension. This is for instance the case in 
Sweden, where the pensionable age is op tional within the 61- 67 age brackets.  
A common way to promote longer working lives pur sued in recent reforms is to strengthen 
the bonus-malus system in schemes with delaye d and early retirement possibilities. A number 
of Member States (BE, BG, CZ , ES, GR, HU, NL, PT and UK) ha ve recently introduced or 
increased bonuses (higher accrual factors) as re ward for later retirement, and/or maluses as 
penalty for early re tirement. Workers who decide to wo rk longer are usually rewarded for 
every additional month or year in work. One of the dilemmas concern deadweight problems 
connected to the risk of subsidising those w ho would in any case have postponed retirement. 
The impact of these specific measures can be  rather limited. For in stance the pension bonus 
introduced in France by the 2003 reform attracted only 7.6% in 2007. Furthermore, it seems that incentives to defer retirement have le ss impact than opportun ities to retire early.
 
EN 89   EN Box 2: Illustration of the effects of longer and shorter working lives  on pension adequacy 
Calculations of theoretical replacement rates point  to a decline in future pension levels and the 
subsequent replacement rates at a given pension age (please refer to Table 2, Chapter 2). This 
reflects the fact that reforms of  statutory pensions will be lo wering pensions to meet the 
challenges caused by increased life expectancy. Member States are planning to compensate 
for this decline by extending working lives a nd increasing supplementary pension savings. 
Most countries have incorpor ated incentives to prolong working life into their pension 
systems. Many of these incentives take the form  of reductions for early retirement or bonuses 
for later retirement. These may be carried out in an actuarial manner often based on remaining 
life expectancy or through bonuses and penalties fixed by legislation. Other incentives to 
work more and longer are generated by increasi ng the contributory period in pension systems 
and strengthening the link between pensions and contributions. 
Calculations show that in most Member St ates delaying retirement results in higher 
theoretical replacement rates, while earlier re tirement usually results in lower theoretical 
replacement rates. In all but a few Member St ates (e.g. DK, ES, FR, HU, IT, LU, SI, UK) the 
increments in pensions for prolonged working lives are higher than the fall in replacement 
rates with earlier retirement. In most cases the difference is small, but there is a clear trend 
towards rewarding late retirement mo re than early exit is penalised.  
In Member States where the retirement age is  lower than 65 the calculations show how the 
bonus-malus system would work if the retireme nt age was set at 65 (e.g. BG, CZ, EE, LV, 
LT, HU, MT, SI, SK). In Malta, for example, wh ere the minimum statutory retirement age is 
61 and only 30 contributory years are needed for a full pension the replacement rates do not 
change with a prolonged or shortened retirement  age in this exercise which is based on a 40 
year contributory period. In Member States wh ere the pensionable age is  planned to be higher 
than 65 in 2046 (e.g. DE, UK), the effects of deferring retirement beyond the legislated 
retirement age are not captured by the exercise.  
In the Netherlands it is interesting to note that  the replacement rates from statutory scheme 
does not change with shorter or  longer working lives as the pe nsion is resident based. There 
are, however, clear changes in the occupational sc hemes that play an important role in Dutch 
pension income. In Italy, it is obs erved that the annuity coefficien ts used in the public notional 
defined contribution system currently do not  increase above 65 years of age.  
 
EN 90   EN Figure 13: Difference in net theoretical replacem ent rates for an average earner working until 
the age of 63 and 67 with 38 and 42 contributory years respectively as compared with working 
until the age of 65  
-15,0-10,0-5,00,05,010,015,0
M T NL CY EL IE DK UK PT PL BE RO LU LT SE FI DE LV SI BG CZ FR EE AT SK IT ES HU
retirement at 63 retirement at 67
 
Source: ISG calculations on Theoreti cal replacement rates carried out in the OECD APEX model or in national 
models. The figures for NL are preliminary. 
 
EN 91   EN 4.2.4.4.  Restricting access to early retirement 
Most transitions from work into retirement ar e not direct. The average age of exit from the 
labour market is often lower than  the average age at which an old-age pension is drawn. Only 
35% of older workers leave their last job or business to take up a pension. 20% take up an early retirement benefit, 13% leave due to unemployment and 12% for reasons of long-term 
sickness or disability.  
The proportion of early or indirect exits vari es considerably from one Member State to 
another. Nevertheless, a positive trend is visible, as a number of  Member States adopt reforms 
to discourage the take-up of, or even to close access to, early retirement paths from the labour 
market. Member States increase the age of en titlement to early retirement (e.g. BE, CZ, SK, 
UK), equalise the rules of access for both genders  (e.g. DE, HU), plan to limit the number of 
professions entitled to benefits (e.g. PL), ti ghten the rules of access to recently introduced 
schemes that turned out to be  unexpectedly popular  (e.g. FR), or simply phase out the 
schemes (e.g. IE). Other Member States strength en the financial disincentives to retire early, 
by increasing the value of  penalty factors (e.g. CZ, GR, PT , UK). Another solution adopted is 
suspension of early pension benefits for thos e who earn more than a minimum wage (e.g. 
HU). Since January 2006 the Netherlands has tight ened fiscal treatment of early retirement 
and pre-pension schemes, and a reform of unemployment benefits  is aimed at preventing the 
use of the scheme as an early retirement pat h. Yet some Member States have delayed planned 
reforms. Italy, Austria and Poland decided to slow down the process of tightening the 
minimum requirements for early retirement.  
Some early retirement schemes automatically create exceptions from general rules for certain 
occupations which are thought to be ‘arduous’ or dangerous for health. The National Strategy 
Reports do not report the details of such rules,  so the differences and similarities between 
Member States would be an issue for further study.  
Attempts to restrict or close early retirement options often l ead to a run on schemes in the 
period before the changes take effect. This wa s the case in Poland and Slovakia, for example, 
where announcements of restric tions on early retirement from  2008 caused a massive increase 
in applications in the final months of 2007. The French National Strategic Report mentions 
that a similar situation occu rred in France between 2003 and 2006 with the early retirement 
option for those with long work ing records. Latvia  experienced a drop in the effective 
retirement age in 2007 due to early exit paths fo r certain categories of workers, and despite 
the fact that the pension elig ibility age had been raised.  
In general Member States are closing access to early exit paths from the labour market. 
However, developments in the labour market will  also have a strong influence on future take-
up of benefits, and expectations of a decline in the take-up might be questioned in the light of 
the global economic downturn. 
4.2.4.5.  Restricting access to disability schemes 
In line with the challenge hi ghlighted in the 2008 Joint Repor t some Member States have 
sought to extend working lives by curbing exits through sickness and disability schemes (e.g. 
CZ, DK, ES, HU, MT, NL, PL, AT, SE). Measures  generally involve rehabilitation efforts in 
connection with stricter eligib ility rules and greater cooperati on between institutions involved 
to allow for a quicker transition back into th e labour market. Restricting the use of sickness 
 
EN 92   EN and disability schemes as pathways for early ex it should however not prec lude the use of such 
schemes for the contingencies they were meant for.  
Some Member States have recently introduced a distinction between re lative and absolute 
invalidity (CZ, PT, UK). These reforms aim at reducing early exits from the labour market by 
differentiating between those clai mants potentially fit to be em ployed on a full or part-time 
basis and those more severely impaired. Memb er States are looking for ways to activate 
everyone according to their capabilities and the dichotomy of "employable" versus 
"unemployable" persons with disa bilities is being challenged. 
4.2.4.6.  Improving employment opportunities for older workers 
To sustain pension promises it is essential to  have both a well-functioning labour market and a 
high activity rate among the population of worki ng age. Lack of progress in the employment 
rate of older workers is often cau sed by poor employment opportunities.  
The National Reports present two major kinds of instrument to boost activity. First, Member 
States are adapting lifelong lear ning, offering more training desi gned to make older workers’ 
skills more adaptive and to he lp them keep their jobs (e .g. AT, BG, and CZ). Second, by 
subsidising employment and gi ving employers financial incen tives, they are making it more 
attractive to employ elderly pe ople (e.g. AT, DK, ES, LT, HU, and SE). There are also 
approaches that involve shifting part of the financial burden of early retirement schemes on to 
employers and committing them to employ a cert ain share of older workers in their work 
force (e.g. FR).  
As a number of National Strategy Reports point out, the European Social Fund (ESF) 
contributes to the financial sustainability and adequacy of pension systems (€ 1 billion, 1.3% 
of total ESF budget) by enc ouraging active ageing and prol onging working lives (e.g. AT, 
HU, SK), as well as by developing life long lear ning systems in enterprises and improving the 
adaptability of workers (€ 9.4 b illion, 12.4% of total ESF budget). 
Member States are also using European anti-d iscrimination law in their promotion of better 
age management (e.g. DK, NL, UK). European  legislation on age-based discrimination 
(Council Directive 2000/78/EC) st ates that less favourable tr eatment of employees on the 
grounds of age needs to be objectively justif ied. Judgments from the European Court of 
Justice have recently confirmed that the prov isions of the Directive also apply to the 
mandatory pensionable age. So the fact that a worker has reached pensionable age cannot be a 
sufficient reason to terminate the employment . Moreover, some Member States encourage 
employers, particularly in small and medium ente rprises, to change ageist practices and to 
provide more opportunity and choice  for their older workers (UK). 
 
EN 93   EN 4.3. Supplementary funded pensions: impact on adequacy and sustainability 
4.3.1.  The growing importance of funded schemes 
Member States are attaching increasing im portance to privately funded supplementary 
pensions as a way of helping to maintain adequa te and sustainable pensions in the face of the 
demographic challenge36. So whilst public Pay-as-you-go (P AYG) pensions are and will 
remain the most important element in Europ ean pension provision, pr ivate funded pensions 
will have a growing role w ithin the overall pension income of EU citizens.  
This and the impacts on the financial market s from the credit crunch and ensuing economic 
problems make it more important than ever for systems to be car efully designed. In particular 
systems need to strike the right overall ba lance between public PAYG and private funded 
provision and ensure that  funded schemes take an appropriate  approach to investment risk.  
Member States employ three types of funded pe nsion provision: stat utory funded pensions 
(pillar I); occupational pensions (pillar II ); and voluntary pens ions (pillar III). 
Statutory funded pensions are generally a recen t phenomenon with little relevance for present 
pensioners. Only Denmark has a mature scheme of this sort and its role in overall pension 
provision is very limited. However, such pensio ns will gradually become  more important with 
Latvia, Lithuania, Hungary, Poland, Romania, Slovakia and Sweden a ll relying on statutory 
funded provision to some degree as an element in overall future pension income. Romania is 
the most recent Member State to introduce st atutory funded provision, with a system of 
compulsory individual accounts starting in 2008. This pre-funded pension will sit alongside 
the traditional PAYG first pillar pension and be funded by compulsory cont ributions of 2% of 
salaries rising in 0.5% increm ents over 8 years until they reach 6%. Like all the other 
statutory funded schemes this is  defined contribution (DC) in character, where the risks are 
with the individual. 
Occupational funded pensions are the most si gnificant form of funded provision for people 
retiring today particularly in the Netherlands , Ireland the UK and Sweden. Belgium, Cyprus, 
Denmark and Germany also have pertinent occ upational provision for those retiring today. 
Traditionally these schemes were normally define d benefit (DB) in nature. However, there is 
a longstanding trend away from DB occupationa l pensions to DC occupational pensions, 
particularly in Ireland and the UK, and in  Denmark major schemes were DC from the 
beginning. For the future occupati onal pension schemes are expected  to grow in importance in 
a number of Member States, but these schemes will increasingly be DC in nature. 
Voluntary pension provision is typically not a very significant element in today's pension 
incomes except in Germany and to a lesser extent the UK, Ireland and the Czech Republic.  
Germany is one of the few Member States anti cipating significant streng thening of this type 
of provision on the back of the gene rous incentive structure in place for Riester pensions.  
The role these different pensions schemes are e xpected to play in th e wider system varies 
considerably. Some, in particular statutory f unded pensions, are meant to support or replace 
                                                 
36 such as the 2005 SPC study on privately managed funded pensions, the 2006 Synthesis Report on 
Adequate and Sustainable pensions, the 2007 Joint Report and the 2008 SPC report on privately 
managed funded pension and their contribution to adequate and sustainable pensions 
 
EN 94   EN pension income from the main public PAYG sc heme. Others, notably voluntary saving, may 
except for the self-employed simply have the ro le of providing a top-up  to other substantial 
pension income, perhaps to allow high earners to  match the replacement rates of those with 
lower pre-retirement income. Occupational pension schemes tend to sit between these two, offering significant support to st atutory PAYG pension provision. The important thing is that 
factors like the coverage and ad equacy of any particular funded pension appropriately match 
its intended role in the wider pension system. 
4.3.2.  The double payment problem  
Funded pension provision that is intended to replace some elements of PAYG pensions 
effectively brings forward the costs. This can help with smoothing the expected future 
increases in pension expenditure that demographic change will bring and so help with sustainability. But it means that the present acti ve generations will ha ve to pay for both the 
PAYG schemes and the new funded schemes at th e same time. Often Member States divert 
part of the contribution for the PAYG scheme into the funded scheme while covering the shortfall from the state budget though gene ral taxation (e.g. SK, LV, LT, EE, HU). 
Irrespective of the way it is done , bringing forward costs by in creasing pre-funding can place 
strains on Members States' fiscal positions and the current economic situation provides a 
serious stress test of the viability of such arrangements. 
For instance, the 2007 report flagged up Slovaki an transition costs on the one hand and long-
term sustainability on the other. Even before the financial crisis, SK had taken various actions 
to reduce the amounts of costs brought forward by earlier reforms enacted a few years earlier. 
Thus on 1
st January 2008, SK re-opened the statutor y funded pension scheme for a 6 month 
period giving savers a chance to join or leave. 104,000 people left and 20,000 joined. From 
the same date new entrants to the labour market  will have six months to decide whether they 
want to take part in funded pension savings or not. All of this means more Government 
revenue now at the expense of gr eater pension costs later. An unw elcome side effect of rapid 
changes of direction can be th e uncertainty it creates about th e long-term stability of pension 
reforms. 
4.3.3.  Privately managed funded pension and th eir contribution to adequate and 
sustainable pensions  
The 2008 SPC study Privately managed funded pension and their contribution to adequate 
and sustainable pensions37 highlighted a number of issues which also emerge from the 
National Strategy Reports. These included:- 
There is a need to improve the data on this growing segment of pension provision. 
The role and development of private pensions  is very diverse across the EU, reflecting 
cultural and historical issues as well as the wi der pensions systems in place in the different 
Member States. Thus private schemes must be assessed in the context of the role envisioned 
for them in the wider pension systems of par ticular Member States. Low coverage and breaks 
in contributions can be a cause for concern ab out future adequacy, in particular for women, 
the young, the less educated and the low paid. 
                                                 
37 Published 20/10/08 and available at  
http://ec.europa.eu/employment_social/spsi/adequacy_sustainability_en.htm  
 
EN 95   EN As investment and longevity risk increasingly  are shifted onto individuals they will need 
better financial education and information. Life styling/lifecycling appro aches to investment 
and flexibility around when a pension must be taken represent important ways of mitigating 
financial risk for individuals.  The payout phase of funded sche mes must be carefully designed 
if adequacy is to be properly ensured. Given the significant impact of  administration charges 
on the pension ultimately accrued they must be kept as low as possible and this cannot be left to market forces alone. 
4.3.4.  Coverage 
For statutory funded schemes we could expect coverage to be near universal given the role 
they are intended to play. However, such coverage does not happen instantly - schemes are phased in and have varying transitional arrange ments. At the time of the 2008 SPC report it 
ranged from 25% (in IT) to 90% (DK) or 100% (SE). In most Member States, where such 
schemes have been introduced, coverage ra nges around between 50% and 70%: BG (50%), 
EE (50%), LT (54%), LV (80%), HU (70%), PL (70%), SK (65%).
38 Coverage should 
approach 100% as schemes mature (since mos tly only younger workers ar e required to join), 
but it may take a generation. 
For coverage of occupational pension schemes, we can divide Member States can into three 
broad groups:  
– High coverage (over 75%): DK (aro und 75%), NL and SE (over 90%); 
– Medium coverage (between 40 and 70%): IE (around 40%), CY (around 45%, including 
both occupational schemes and provident f unds), UK (around 47%), BE (around 55%) and 
DE (around 60-65%, which includes a signifi cant share of Entgeltumwandlung);  
– Low coverage (under 20%): IT (17%), AT (13%  at the time of the SPC report, now 15%), 
FR (around 15%), ES and FI (8%), LU (5%), PT (4%), or very low (around 2.2% in PL).39  
Coverage levels may change as schemes evolve. The closure of existing schemes to new 
members as employers seek to control costs will cause it to fall. Initiatives such as the UK's auto-enrolment legislation are likely to expa nd coverage and revers e this trend. From 2012, 
employees, who are not already in a good qua lity workplace pension scheme, will be 
automatically enrolled into either their empl oyer’s sponsored scheme (if it meets quality 
requirements) or into a new savings vehi cle, known as personal accounts. The personal 
accounts scheme is expected to have between four and seven million members, with up to 
£200 billion of assets under management by 2040. The UK’s Pensions Act 2008 ensures that 
for the first time in the UK all employees will  have access to an occ upational pension scheme 
supported by employer contributions and tax relief. 
Another innovative approach is in It aly. The 2004 reform modified the TFR ( Trattamento di 
Fine Rapporto ) workers’ severance pay (a portion of the worker’s pay set aside by the 
employer formerly paid as a lump sum at th e end of employment pe riod) so that it is 
automatically transferred to defined contri bution occupational pens ion schemes unless the 
                                                
 
38 All figures from 2008 SPC report Privately managed funded pension and their contribution to adequate 
and sustainable pensions available at:  
http://ec.europa.eu/employment_social/spsi/adequacy_sustainability_en.htm 
39 ibid 
 
EN 96   EN employee actively chooses another option. With th is so called ‘silent-assent’ mechanism if 
workers do not express their desire not to be me mbers within a six month deadline, the TFR is 
transferred to the pension schemes set up by collective agreements between employers and 
trade unions at sector or loca l level. Employees remain free, however, to make an active 
choice to decide to keep the TFR with their employer, a decision that can be subsequently 
revoked. There has been a 43.4% increase in take  up in 2007 compared to the previous year. 
Larger employers with good worker communicati on and union presence were key factors.  
For voluntary pensions, coverage is generally neg ligible at a few percent or less, for example 
the French PERP has coverage of around 2.8%. The Czech Republic introduced the 
Supplementary Pension Insurance in 1994 which covers 49% of those aged 18 (minimum age 
to take part) to 64, though contributions tend to be low and funds are often taken as lump 
sums. The German Riester pensions  have expanded rapidly, doubling in coverage to 28% 
between 2005 and the end of 200740 and as at March 2008 there were 11 million Riester-
Rente contracts41. The UK at 19% and Ireland at 15% are the other exceptions with relatively 
high coverage levels42. In Portugal a Public Funded Re gime (RPC) was introduced in 2008, 
based on individual accounts to which individuals  can pay supplementary contributions (from 
2% to 6%) on a voluntary basis. The fund assets  are invested and managed in the Portuguese 
Reserve fund, with a prudential profile and with  very low administrativ e charges. Every year, 
individuals have the option to suspend, increas e or decrease contributions. When retirement 
conditions are met, the balance of the individua l account can either be transformed into an 
annuity or taken as a lump sum payment.  
As such saving is voluntary it is hard to pr edict how coverage might develop as it can be 
influenced by a range of factor s. These include tax and othe r incentives, other long-term 
saving options, information provision, perceptions of likely investment growth and the levels 
of other retirement income and the availability of the necessary spare income to be able to 
contribute. Current economic conditions are like ly to negatively impact on such saving at 
least in the short term. For most Member States we could perhaps expect little change or some 
continued modest growth in this area. The exce ption is Germany where, on the back of strong 
incentives, the coverage and significance of the Riester pensions are expected to grow 
considerably. The reason for th e increasing popularity of the Ri ester pension is the attractive 
design of State assistance owing to the supplemen t system, which is particularly true for low-
income earners subject to pension insurance a nd for large families. At the beginning of 2008, 
the Riester pension reached its highest level of support. The basic supplement is now € 154 
and the child supplement € 185 per year for each  child for whom the beneficiary receives 
child benefit. For children born from 2008 onwards , the child supplement is  as much as € 300. 
Retirement pension contributions  (taking into acc ount the supplement) up to € 2,100 can be 
offset as additional special expenditure against tax. 
4.3.5.  Contributions 
Contributions vary considerably between Member  States and scheme type and also between 
occupational and voluntary pension schemes. Bu t very broadly, DB occupational pensions 
tend to have the highest contributions. For in stance in the UK, contributions to DB funds 
                                                 
40 ibid 
41 NSR for DE 2008 
42 Figures from 2008 SPC report Privately managed funded pension and their contribution to adequate 
and sustainable pensions available at 
http://ec.europa.eu/employment_social/spsi/adequacy_sustainability_en.htm 
 
EN 97   EN amount to just over 20% of the gross wage whils t they are just over 16% in the Netherlands. 
DC occupational schemes tend to have lower contributions, around 9% in the UK with about 
10% in Ireland and 11% in Cyprus, though in Denmark they are at 12-17%. But contributions 
can also be quite low for occupational scheme s in general for instance between 1 and 5% in 
Belgium. 
For statutory funded schemes c ontribution levels ar e typically below th e levels of DC 
occupational schemes and well below DB occupati onal scheme levels. Some levels are very 
low such as 1% on ATP and 1% on SP in Denm ark, or the severance pay in Austria with 
1.53%, or the Premium Pensions in Sweden with  contributions of 2.5% of gross wages. But 
more typical, particularly for the new Member  States, are contributi ons between 5% and 10% 
for instance Lithuania at 5.5% and Slovakia at  9% with Italy around the mid-point at 6.9%. 
Also within this range are some Member States that have chosen to gradually increase contribution levels. For instance in Latvia they  were 4% in 2007 and wi ll rise to 10% in 2011, 
whilst in Romania they were 2% in 2008 and will rise to 6% by 2016.  
There is little data on voluntary schemes and clearly by definition contributions will vary 
considerably. For the Czech Republic, which has th e highest coverage of this type of scheme, 
levels are low at 2.1%. Better data are needed, particularly in DE where the Riester schemes 
are expected to grow significantly in importance,  as coverage alone does not tell the full story. 
What we can say for now is that overall it is li kely that contributions will typically be the 
lowest in voluntary schemes.  
Very broadly DB occupational schemes tend to rely more on employer contributions than DC 
schemes. Other than that there are no real pa tterns with statutory schemes varying from 100% 
of contributions from the employer and 0% from the employee to the opposite.  
One important element on contributions for DC schemes is administrative charges. Clearly 
schemes have to cover their various costs, but even quite modest charges can eat significantly 
into investment returns over the many years of pe nsion saving. So costs need to be kept low, 
but their complexity and the typical informati on and skills disparity between individuals and 
providers means the market does no t necessarily do this efficiently
43. 
4.3.6.  Vulnerable groups 
One aspect of increasing the proportion of funded provision is that , despite variable 
investment returns, this typically brings with it a more direct relationship between actual 
contributions paid and actual pension received than is the case with PAYG schemes. This can 
help to foster personal respons ibility and increase choice and tr ansparency. On the other hand 
the reduction in cross-subsidy can mean that groups vulnerable to low or missing 
contributions more exposed to poor retireme nt outcomes in Member States where funded 
pensions are expected to play  a significant overall role in  pension provision. Because of 
current labour market characte ristics, women are more at ri sk than men of having poor 
outcomes from funded provision. Where these la bour market inequalitie s are expected to 
persist the pension system will also give unequal outcomes unless it is designed to mitigate them.  
                                                
 
43 ibid 
 
EN 98   EN Some countries have introduced solidarity elemen ts into their statutory funded schemes, while 
some others have also done so in occupati onal schemes, for example, by compensating for 
certain periods outside active employment, e.g. with the state paying  contributions during 
periods of childcare or unemplo yment. In LV, HU, PL and SE, the same periods are credited 
in both tiers of statutory schemes (in SE al l non contributory periods are provided with 
crediting, whatever the tier of the statutory scheme). In BG, EE, LT, SK and the UK only 
some risks covered under the unfunded tier are al so covered by the funded tier (in BG, LT and 
UK none, in EE parental leave, in SK child care).  
Furthermore, when the same risks are covered u nder the two tiers, there can be differences in 
the treatments, for instance for child-raising and unemployment periods. In LV, PL, SK and 
SE, these periods are treated in the same way in  both tiers, both in terms of the duration of 
payment of contributions and the applicable contribution base. On the other hand, BG, EE, 
HU and LT treat individuals differently in both  tiers, either by not c overing them or with a 
less extensive coverage. 
4.3.7.  Risk sharing 
No pension system is risk-free, including PAYG systems. But the move towards greater 
private pension provision means the addition of investment risk and a different sharing of 
risks. For DB occupational pensions the ri sks like longevity, inflation and investment 
performance are shared in different ways de pending on the nature of the scheme. Some DB 
schemes have explicit mechanisms for sharing th e risks with pensioners  and/or contributors 
via indexation and/or contribution adjustment s (as in the Netherlands). Others rely on 
employer sponsors (as in the UK) to take on th e risks, though even here ad hoc employer 
negotiations with social partners may result in  a sharing of the burden of cost increases, for 
instance by agreeing to reduce the generosity of the pension scheme or increase employee 
contributions. DB schemes also smooth out the ri sks from shorter term investment volatility 
by spreading it between large numbers of  people retiring at different times. 
DC schemes expose individuals most  directly to risk. So-called 'lifestyling' or 'lifecycling' 
investment strategies44 can help to manage risk over th e saving cycle and give a reasonable 
rate of return at appropriate levels of risk. Strong considerat ion should be given to such 
investment approaches, particular ly for statutory funded pension pr ovision that is meant to be 
a crucial element of overall pension in come. The right framework, including good 
information and appropriate use of default45 options, needs to be in place to ensure people 
make the right choices. In SE the premium pens ion system had a choice of 785 different funds 
in 2007. When the system started in 2000 33% of people made no active choice and were 
defaulted into the Premium Savings Fund. By th e end of 2007 41% had made no active choice 
and were in Premium Savings Fund. The Premiu m Savings Fund is described as medium-risk 
and has 85% of the capital invested in equiti es. Currently many Member States with DC 
funded provision, including the vast majority of  those with statutory funded pensions, do not 
have lifestyling as the mainst ream option. This needs to be critically re-examined as these 
schemes grow in importance and particularly  in the light of recent market events. 
                                                 
44 With "lifestyling" or "lifecycling" approaches, invest ment risk is concentrated in the earlier part of a 
person's working life with investments gradually shif ted over time into lower yielding but less volatile 
assets. By the time someone is approaching retiremen t, where there may not be sufficient time for falls 
in investments to recover, their investments would be mostly protected from significant investment risk. 
45 For instance ensuring that those who don't make an  active choice of investment are automatically placed 
in funds with the best chan ce of meeting their needs. 
 
EN 99   EN 4.3.8.  Decumulation – taking a pension 
With PAYG or DB occupational pensions people  acquire rights to a ce rtain level of regular 
payments in the payout phase from retirement age until their death. With DC pensions instead 
of rights to a stream of payments, a pension f und builds up. This sum of money is then used 
for financial support in retirement.  
Where DC pension provision is only a small part  of overall pension in come, the exact design 
of the payout phase may be less critical. But where DC pensions are significant, or will 
become so, the payout phase rules can have impor tant implications for adequacy and risk in 
retirement. At the extreme, poor ly designed payout rules can thr eaten the viabil ity of pension 
policies that are based on a significant elem ent of DC funded pension provision, as money 
intended for pensions is instead used for other purposes. 
As individuals don't know how long they will li ve, they face longevity risk. They could run 
out of money by using up their DC pension fund too quickly or they could have pension fund 
money left over on death that they could have used to have a more comforTable retirement. 
PAYG and DB schemes do not present this prob lem and share the risks, with those who die 
early cross-subsidising those who live longer. 
Annuities provide a regular and secure income for life and offer DC pensions with the closest 
match to the way PAYG and other DB schemes work in the payout phase. As an insurance 
product, annuities pool risks and just as w ith PAYG and DB pensions there are cross-
subsidies from those who die early to those w ho live longer. Where annuities are used in the 
payout phase there are also further design choices.  These include how to mitigate the spot risk 
of annuity purchase (for instan ce by allowing annuiti es to be purchased within a period of 
time rather than at a fixed point) whether to include inflation protec tion (by having indexed 
annuities) and how much cross-subsidy should be maintained (for instance mandating unisex 
annuities implies a cross-subsidy from men to women, allowing impaired life annuities 
implies a reduction in cross- subsidy from the short li ved to the long lived).  
However, with a few exceptions (notably the UK  which has the biggest annuity market in the 
world on the back of compulsory DC pension fund annuitisation) annu ity markets are often 
small and underdeveloped. Often DC payouts can be  via phased withdraw al leaving longevity 
risk and continued investment ri sk with the individual. Most risky are lump sum payments as 
these do not provide a retirement  income, threatening adequacy. 
But whilst building up a DC pension fund may e ngender a sense of personal responsibility in 
pension savers, one difficulty this sense of owners hip brings is that peop le do not wish to be 
restricted in how this money is ultimately used. This is in contrast to PAYG and DB pensions 
where it is accepted that contributions (or taxes)  will lead to regular pension payments ending 
on death, with the inherent cross subsidies thes e arrangements bring. So for significant DC 
pensions it is important to be clear that the m oney is to provide a pension and how this will be 
done in practical terms.  
Some Member States which have established stat utory DC pensions have yet to fully set out 
the payout phase rules. For example in the 2007 Re port it was noted that PL needed to put in 
place payout phase arrangements.  These arrangements are s till not comple te, although the 
issue is currently being addresse d. The PL Government has intr oduced a bill to  Parliament on 
the pay-out phase of the mandatory funded sc heme proposing two kinds of payments, life 
annuities and temporary funded pension benefits (for women aged 60 – 64). EE has stipulated 
 
EN 100   EN the basic features of the f unded pension payout phase, which includes compulsory annuities 
as the main mode of payout, but  the regulatory framework needs completing. In others such as 
SK where annuities are mandated, there remain que stions about how viable this might be for 
small pension funds, although it will be  some years before payouts begin. 
4.3.9.  Pension security and fin ancial crisis impacts 
Pension funds are not immune to the financial cr isis, though their inherent nature and the way 
overall pension systems are organised in Europe means that for those retiring today  we can 
expect the impacts to be limited for most peopl e. The impacts are dependent on the mix and 
proportions of various types of pensions in Member States' overall systems, the detailed 
design of these various elements  and the severity and length of the ongoing financial crisis 
and wider economic impacts. 
The overall pension income of pe ople retiring today in Europe is still made up in the main of 
statutory public pensions funded on a PAYG basi s, rather than from funded pensions which 
are invested. So the overall pension income of Eu ropean people is typically less vulnerable to 
impacts on investments. In the majority of Me mber States PAYG provides almost all of the 
pensions for those retiring toda y. There are only five Member  States where funded provision 
is above 10% (these are DK on 16%, SE a nd UK both on 22%, IE on  54% and NL on 60%) 
with a further three at or slightly  below the 10% level (DE, CY, BE).46  
Funded provision that is DB helps mutualise th e risks of investment volatility reducing the 
impacts on individuals who can expect to get a pension base d on their contributions and 
service. The DB pension funds themselves have  long-term liabilities a nd assets and so can 
cope in the short term with fa lls in the value of investments.  They will, though, need to take 
action to continue to preserve their long-term health and this will impact on pension scheme 
members to the extent that risks are shared via formal or informal mechanisms.  
Within the broad European framework, differe nt Member States have different funding 
regimes and protection systems in place to ensu re the security of DB pension funds. Some, 
such as the Netherlands, have long established methods for risk sharing via lower indexation 
and higher contributions and these will need to be allowe d to operate for the long-term good. 
From January 2007 a new supervisory fram ework for pension funds, the Financial 
Assessment Framework (FTK) was introduced. Othe rs such as the UK, where employers have 
a legal obligation to support the pension sche mes they sponsor, have strengthened their 
funding regimes. In addition the UK brought in a compulsory insurance-style protection fund 
to pay most of the benefits of pension sche me members should the worst happen. DE also has 
extensive arrangements to protect pension benef its including were necessary insurance type 
protection for pension scheme me mbers benefits. However, there could be concerns that some 
other Member States regimes ar e not sufficiently strong to w ithstand serious economic stress 
and they will need to critically examine thei r systems to ensure they are robust for the long-
term. Indeed some, such as IE, were al ready looking at options for reform.  
For DC schemes, temporary falls in the valu e of investments of those some way from 
retirement should be seen as part of natural in vestment volatility and nothing to particularly 
worry about. Financial information and education n eeds to stress the nature  of investment risk 
                                                 
46 According to Table 7 "Contributi ons of various schemes to theoretical replacement rates (base case)" 
page 19 of the SPC report "Privately managed pension provision and their contribution to adequate and 
sustainable pensions" http://ec.europa.eu/employment_social/spsi/adequacy_sustainability_en.htm 
 
EN 101   EN in order to encourage informed decisions and to  help maintain confidence in these schemes. 
For those close to retirement who are taking sign ificant investment risk with insufficient time 
for investments to recover, falls in DC pe nsion investments will mean delayed or poorer 
retirements. Lifestyling investment approaches can mitigate this, but may not even be an option currently in some Memb er States with funded DC pr ovision. Given the typically low 
importance of funded DC provision  for those retiring today, this may not be critical. But in 
Member States where these funds are, or wi ll be, an important element of overall pension 
provision, the mainstream investment strategy  choice needs to match this role providing 
reasonable returns but also not being subject to  unaccepTable volatility cl ose to retirement. In 
HU, an optional portfolio system has been intro duced in the statutory funded pension as from 
2007. This creates the opportunity for long-term optimisation of investments adjusted to age 
and individual risk-taking ability and this system will become compulsory from 2009. 
4.3.10.  Pension policy responses to financial crisis 
It is too early to see how the cr isis will develop and if it will a ffect pension schemes, but some 
Member States and their pens ions regulatory bodies have ta ken initial policy steps. For 
instance in DK pension rules on the composition and size of assets would have forced pension 
funds to sell real estate bonds due to their fall in value. Apart from the knock-on effects to the 
market for such bonds, this would have forced pension funds to realise the value of these 
assets at a low point in the market. The Danish FSA therefore changed the method of 
calculating solvency requirements to allow pe nsion funds to continue  to hold these bonds. 
Similarly in FI the government put a Bill to Pa rliament on 17 October 2008 to strengthen the 
employment pension funds of the earnings-related pension scheme in view  of the decline in 
the equity market. The proposal aims at ensu ring the solvency requirements of the pension 
funds can be met without leading to forced se lling of equities in a disadvantageous market 
situation.  
Another action taken in several Member States (notably IE and NL) has been to give DB 
pension funds more time to report their fund ing position and recovery plan in the hope 
markets become less volatile making valuati ons, planning and negotiations with social 
partners and others easier.  
A number of national regulators have also signalled that they will use their existing flexibility 
as regards recovery periods and plans for DB schemes (for instance the UK, NL, IE) to allow 
more time for pension schemes to recover their funding positions. 
PL is considering introducing lifestyling inve stment for its statutor y funded pension; the 
option had been considered previously, but the fi nancial crisis has now gi ven it sharper focus.  
In SK, a law approved in October 2008 will ma ke it possible, between 15 November 2008 
until 30 June 2009, for pe ople to switch back from the f unded second pillar as well as 
allowing people to move into th e second pillar who are not yet in it. The Slovak Government 
decided to open the second pillar because of the negative impact of the financial crisis on 
assets, especially for those who ar e relatively close to retirement. 
As things develop further, shorter-term po licy responses may be necessary following the 
essentially pragmatic approaches taken so far. In addition there may be longer-term lessons requiring policy action on issues like the bala nce of funded and unfunded provision and the 
approach to investment risk. 
 
EN 102   EN 4.4. Minimum income provision for older people (MIP)  
Building on the SPC study on minimum inco me provision the 2007 Joint Report - while 
noting that several Member States have improved their minimum income provisions 
significantly - called for greater attention to what minimum incomes are likely to deliver for whom and to the way improved minimum guarant ees may impact on incentives for accrual of 
proper pension rights. Consideration should be  given to levels of minimum incomes and 
mechanisms of indexing. In the 2006 & 2007 Joint Report improving the adequacy of minimum pensions/income provision formed part of the challenges to be addressed for eight 
Member States (BG, EE, IE, CY, LV, LT, RO & UK). 
Member States are using different types of provision and delivery mechanisms: (1) Minimum 
pensions within contributory earnings-related pension schemes for people with low income or 
short contribution records (e.g. in BE, BG, CZ, ES , FR, LV, LT, LU HU, PL , PT, SE, SI ). (2) 
Basic flat-rate pensions that may be non-contri butory or contributory  and include years of 
residency in their qualifying criteria (e.g. in NL , DK, FI, IE). (3) Separate social assistance-
like, means tested benefits for older people with few or no other pension rights – often 
referred to as ‘Social Pensions’ (e.g. in SI, PT , IT, LV, CY) or as ‘guaranteed minimum’ for 
the elderly (e.g. AT, DE, BE, FR , UK). Many Member States oper ate parallel or combined 
systems of minimum pensions and mean s-tested guaranteed minimum income.  
In addition all Member States to varying extents use a transversal category of old-age related 
benefits in cash and kind that contribute to the livi ng standards of pensioners and are of 
particular importance to those who rely on mi nimum income provision. Beyond these, there is 
considerable variation between Me mber States in the reference points for MIP levels and their 
coverage, means-testing, taxation and indexing.  While poverty avoidance classically has been 
a goal of pension systems, minimum provision fo r older people tends to be aimed more at 
reducing  the poverty risks to accepTable levels.  
Currently minimum pensions and minimum income  provisions cater primarily to the needs of 
women, who are poorly covered by the employment-related entitlement mechanisms of most 
pension systems owing to historical gender roles and subsequent gendered patterns of activity, 
employment and income. Though gender differen ces in longevity make women the great 
majority of recipients in any provision for old age,  they have typically had to rely on benefits 
at the margin or outside of pension system s: Widows/survivors and minimum pensions or 
MIPs — possibly in combination. Thus minimu m pensions and MIPs are very much about 
ensuring a minimum of adequacy for women. 
4.4.1.  Developments and progress 2006-2008 
In some Member States poverty ra tes grew substantially as the re lative value of benefits fell 
behind rapidly growing wages (e.g. EE, LT, LV).  High inflation added to problems of people 
on MIP in these Member States. In others effort s directed at improving  MIP apparently lost 
most of their impact on relativ e poverty rates because of wage  growth (e.g. ES, CY, FI, UK). 
Still, in these countries as in most Member St ates, the negative effects of growth not captured 
by indexing mechanisms on the income position of minimum pensioners and recipients of 
MIP, and the sudden price hikes in food and en ergy in the second quarter of 2008, have to a 
large degree been corrected through ad hoc  up-ratings and structural improvements. 
A couple of Member States reformed their MIP in major ways (e.g. PT, LT). Parametric 
changes did also occur. Change s to up-rating and indexing mech anisms or ad-hoc increases 
 
EN 103   EN were particularly frequent (e.g. BE, CZ, ES, FR , IE, MT, PL). Several Member States efforts 
were more directed at implementing earlier a dopted reorganisations (e .g. UK, SK, DE, AT).  
Member States where adequacy was seen as a particular challenge addressed the problems 
primarily through incremental upratings and smaller parametric adjustments; a couple of countries prepared major future advances  
A number of Member States are reviewing the results of reforms to minimum income 
provision and highlighting progress over a l onger period (e.g. BG, DK, IE, SE, UK). For 
some important advances until 2005 seem to have been reversed in the heat of hectic growth (e.g. LT, LV). 
Though many highlight their importance very few Member States report in detail on 
improvements to the MIP elements that take th e form of exemptions, rebates and subsidised 
services. Attention goes first to minimum pensi ons and secondly to the main cash element in 
MIP. 
Recently the role of MIPs has been solidified through various improvements to benefit levels 
and access (e.g. DE, AT, UK, PT, BE, BG). In the medium to longer term there are both 
trends that will reduce (i.e. increasing employme nt rates of women and OW) and trends that 
would seem to increase their role (i.e. reducti on of replacement rates in statutory systems).  
Generally the period 2006-2008 saw fewer reforms  than the former period 2003-2006. 
Member States tended to be more preoccupied with implementing adopted reforms than with 
introducing new ones. Still changes to minimu m pensions and minimum income provision 
were adopted in a few Member States. In the prior period a number of countries have made 
reforms to their minimum income systems with the purpose of: increasing levels of benefits, making access to benefits easier or replacing exis ting benefits with new systems. This reflects 
the growing attention that minimum incomes have  received in recent years, alongside reforms 
that many Member States have undertaken to their general pension systems. Major 
improvements of the inclusiveness and the benefit levels of basic pensions were enacted in the 
UK and were being planned in Ireland. Structural upgrading of minimum pension benefits 
came on track in some Member States (e.g. ES, PT, SL). In Spain minimum pensions where 
raised by 26% between 2004 and 2008. MIP reforms in this pe riod resulted in  the Solidarity 
Supplement in Portugal (2006-08) and social assistance pensions in Lithuania (2006). 
Supplements to existing benefits were introduced  in Latvia (Monthly supplement) and Cyprus 
(Special allowance). Denmark, Hungary and others increased the supplements introduced in 
the last period. Slovakia's top-up scheme for reti rees with pension lowe r than the subsistence 
level will be significantly impr oved as this is raised. Parametric adjustments that made access 
to benefits easier or allowed for better combin ation with other income happened in several 
Member States (e.g. BE, CZ, DE, ES, MT). Vari ous improvements to transversal benefits in 
cash and kind included a health allowance in PT. While MIPs typically are targeted on the 
older and poorer elderly they may only be delivered after application wherefore some 
Member States also step up e fforts to raise the take up ra te (e.g. BE, PT, UK). In some 
Member States, minimum guarantee pensions ma intain an accepTable living standard to a 
reasonable degree (e.g. BE, CZ, DK, FR, LT, LU, PL, SE, SK). In many cases, however, the 
risk of poverty for those living solely on mini mum pension is still very high, despite the 
improvements made in the last few years (e .g. EL, ES, HU, MT, NL, PT, SI, FI, UK, BG). 
Improving the adequacy of minimum pensi ons and/or minimum income provision was 
highlighted as a key challenge for seven Member  States in the 2007 Joint Report (BG, EE, IE, 
 
EN 104   EN LT, LV, IE, UK). Assuring adequate minimum income for older people was a problem for 
lower GDP-per-capita Member States such as BG , RO, LV, LT, and to a lesser extent EE, but 
it also created problems in higher-income fast -growing Member States like CY, IE and the 
UK. It may be because the results of policy e fforts are not captured by the common indicator 
data available, but it seems that most Member  States facing serious challenges with minimum 
adequacy have made only moderate advances fr om 2006 to 2008. Yet in a couple of countries 
major new approaches which would significantly  reduce at-risk-of-poverty-rates are planned 
or about to be presented (e.g. CY , IE). In the context of rapid wage growth and rising inflation 
and pressure of other priorities some may have  limited themselves to alleviating poverty for 
the worst-off (e.g. LV, EE, RO). Others have worked at the inclusiveness of the pension 
system particularly in relation to women while  at the same time improving their MIP systems 
(e.g. LT, UK, IE). The UK has reformed its basic pension so that by 2010 around 75% of women (over 90% by 2025) will receive the full amount, up from 35% at present, while 
lifting a large number of pensioners out of ta xation and providing home visits to vulnerable 
pensioners. In a few Member Stat es moderate progress reflects th e amount of efforts invested. 
Yet, some have experienced a jump in poverty rates 65+ despite considerable efforts (e.g. UK, 
LV, LT). Ireland managed to lower the at-risk- of-poverty-rate for people 65+ despite rapid 
growth. Generally the adequacy of minimum pe nsions has received the bulk of attention 
whereas MIPs were less in focus. But Lithua nia reformed widows/surv ivors pensions as well 
as its MIP scheme and in troduced regular indexing. 
4.4.2.  Maintaining a minimum of ade quacy: the issue of up-rating 
As minimum incomes are utilised to alleviate po verty the indexation of benefits in payment is 
an important aspect of the efficacy of the provision. In a context of rapid growth and sudden price increases on food and energy many Member  States have introduced extra ad hoc 
increases of minimum income provision and minimum pensions, (e.g. AT, CY, ES, LT, LV, 
SI, SK, IE, IT) or have opted to offer or incr ease an extra annual payment of pensions (e.g. 
BG, CY, UK). While the intensity has vari ed 2005-2008 has been a period of higher 
economic growth in almost all Member St ates. Which effects have existing indexing 
mechanisms had in this period and to what exte nt have indexing been corrected or changed? 
While common indicator data only cover the beginning of the peri od National Strategy 
Reports recount part of the stor y since and allow for generalisa tions. In as much as many MIP 
65+ schemes tend to be price-indexed (if au tomatically adjusted) one should expect the 
relative incomes to have fallen behind. This is also the case in the many Member States where minimum pensions and minimum income provisi on primarily have been price indexed (or 
only ad hoc up-rated) and the at -risk-of-poverty-rate of 65+ th erefore has increased (e.g. RO, 
LT, LV, EE, ES) and older people’s share of medi an equalized income fo r 0-64 year olds has 
declined. Yet, it would seem that the relative  erosion is mostly substantially smaller than 
could be expected. In many Member States the extra wealth and tax re venues generated have 
been used to introduce ad hoc up-rating or stru ctural improvements to pension benefit levels 
and/or their indexing. This may have benefitted re cipients of minimum income in particular or 
have been granted to benefit leve ls of 65+ in general. The insu fficiency of ad hoc mechanisms 
in the period caused some Member States to introduce or plan regula r indexing (e.g. RO, LT, 
or LV). Others changed the indexing towards wages (e.g. PL). In 2007, the UK introduced a statutory commitment to uprate the minimum gu arantee by earnings on a regular basis. Some 
countries are planning further corrections to the erosion of  relative incomes (e.g. FR). 
Various patterns emerge. In EE, LT and LV at -risk-of-poverty-rates 65 + were being reduced 
until 2005. While high growth and increasing inflati on rates since made it difficult to maintain 
minimum adequacy ad hoc up-ratings together with structural improvements have allowed 
 
EN 105   EN recipients of minimum pensions and MIP to re tain purchasing power and not to fall too far 
behind. In Lithuania, for example, the at-risk -of-poverty-rate from 2005 to 2006 jumped from 
17% to 22% as rapid wage development cause d ad hoc up-rated benefits to fall behind. 
Likewise the median equalized income of 65+  as percentage of the one for 0-64 dropped 
about 6 pp. These measurements however fail to  capture further up-ratings and improvements 
which from 2006-2007 caused the average social in surance pension to increase from 31.9% to 
32.9% of the average wage. In LV and EE mini mum pensions fell radically behind wages but 
their purchasing power was maintained. In LV a referendum on mini mum pensions provoked 
extra up ratings even though it failed. Through regular and extr a up-ratings ES has largely 
been able to maintain the relative income pos ition of the elderly despite rapid growth. On the 
other hand the latter has prevented substantial up ward adjustments from registering in the at-
risk-of-poverty-rate 65+. In PT where growth ha s been lower the targeted implementation of 
the Solidarity Supplement and improvements to minimum pensions has helped reduce poverty 
rates. In the context of rapid growth the Special Allowance introdu ced in CY has had no 
discernable impact on poverty rate s. Despite considerab le growth in the period CZ, SK and 
PL relying on mixed price/wage indexation have managed to k eep relative poverty rates at 
almost the same level. By contrast HU with some economic difficulties has seen an increase 
from 6% to 9% despite a ba lanced index and some extra up-rating. In Malta the national 
minimum pension has been pegged to poverty thresholds. Some Member States have 
improved the indexation of minimum income provision (e.g. BG, IT, AT). Turning to 
Member States with flat-rate pensions (UK, IE , DK, NL, FI) recipients of basic pensions in 
the NL have retained their absolute and rela tive income position. In Denmark older people 
relying solely on the people’s pension have seen  moderate improvements in their situation. 
From a less comforTable income position pensioners dependent on flat-rate pension in Ireland have seen marked improvements. The same goes for the UK. Fast growth in FI has generated 
a sudden increase in the 65+ povert y rate. By contrast SE where the minimum pension also is 
price indexed has maintained a m oderate at-risk-of-poverty-rate.  
While inflation rates generally remained rather low in most Member States the large rapid 
increases in energy and food pri ces in the spring and summer of 2008 presented a particular 
challenge to mechanisms for safe-guarding th e purchasing power of older people on minimum 
pensions or minimum income provision acro ss the Union. Many countries have sought to 
counteract the effects of these and other price hikes by special up rating of minimum pensions 
and/or MIPs (e.g. AT, BG, CY, CZ, DE, LT, LV, MT, SI, SK, IE, IT, UK). In AT, where 
lower pensions are indexed at  a higher rate, it was decided to move pension indexation 
scheduled for January 2009 two mo nths forward to compensate fo r the price rises in energy, 
food and basic goods. In the 2008 bu dget MT introduced a cost of living increase (COLA) for 
pensioners comparable to that of employed pers ons. FR, reacting to erosion of benefits, paid 
MIP pensioners a one-off lump sum in Marc h and added supplementary indexation in 
September 2008 and plans to do so until 2012. As supplement to the normal annual indexing 
CZ introduced extra up rating whenever price in flation exceeds five percent. Reacting to a 
number of factors Germany has achieved a simi lar effect by suspending the lowering impact 
of the so-called Riester Treppe in the pension formula to allow for a higher increase of benefits in 2008 and 2009, which will be matched by smaller increases in 2012 and 2013. 
On average older people spend a higher share of  their incomes paying for basic needs (food, 
housing, energy and health) than  the working age population. As  indicated by Table 4.2 the 
Member States where food costs have risen the most, are also the Memb er States where food 
costs dominate the spending of the elderly (i.e. BG, CZ, EE, LT, LV, HU, MT, RO, SI) 
Generally speaking, the actual incr ease in pensions, including ad  hoc increases, have been 
 
EN 106   EN higher than price inflation but lower than real wa ge increases. This has meant that pensioners 
have fared better than what could be expected given the indexing mechanisms in the 
economic situation. 
Table 4.2: Structure of consum ption expenditure by age in 2005, 
and inflation in October 2008 
Les s  than 
30 yearsBetween 
30 and 44 
yearsBetween 
45 and 59 
years60 years 
and overAverage 
inflation 
Oct. 07 - 
Oct. 08
EU-27 All items 3,8
Food 13,1 14,3 15 16,5 6,6
Housing, ex cl. imputed rents 16,3 11,5 10,6 13,2 5,7
of which, energy 4,3 4,6 5,1 6,4 10,1
Health 1,8 2,3 3 4,6 2,3
Bulgaria All items 12,6
Food 30,3 29,7 30,2 35 19,2
Housing, ex cl. imputed rents 11,7 12,7 12,6 13,1 9,5
of which, energy 8,2 8,9 8,9 10,1 8,9
Health 2,5 2,6 3,6 7 6,3
Czech Republic All items 6,5
Food 16,5 19,4 19,8 25,3 9,9
Housing, ex cl. imputed rents 19,6 17,6 19,4 25,6 11,4
of which, energy 8,8 9,7 10,8 14,9 12,2
Health 1,5 1,5 1,9 3 26,1
E stonia All items 10,9
Food 18,6 21,6 23,5 24,4 15,9
Housing, ex cl. imputed rents 14,4 11 12,5 15,1 15,9
of which, energy 5,2 5,4 6,2 8,6 23,3
Health 1,2 1,7 2,6 4,7 8,4
Greece All items 4,4
Food 13,9 14,5 14,4 18,6 5,3
Housing, ex cl. imputed rents 15,5 10 8,7 9,7 11,6
of which, energy 2,8 2,7 2,8 4 23,6
Health 4,3 5,7 5,1 7,5 3,6
Latv ia All items 15,8
Food 24 27 29,7 36,9 19,9
Housing, ex cl. imputed rents 10,2 10 11 15,6 27,3
of which, energy 5,6 5,8 6,6 9,9 31,1
Health 2,4 2,4 3,5 7,8 12,8
Lithuania All items 11,0
Food 26,8 32,6 34,6 39,6 16,5
Housing, ex cl. imputed rents 10,9 9,9 10,9 13,5 17,5
of which, energy 6,2 7 7,9 10,4 17,0
Health 2,4 3 4,2 10 10,6
Hungary All items 6,7
Food 21,1 21,3 21,6 26,5 12,0
Housing, ex cl. imputed rents 19,2 17,8 18,1 22,4 11,2
of which, energy 10,2 10,4 10,8 14,9 12,4Health 2,5 2,5 3,4 8,1 3,6
Romania All items 7,9
Food 42,9 42,5 50 51,4 10,0
Housing, ex cl. imputed rents 14,7 15,5 17,9 19,1 9,2
of which, energy 10,5 11,6 14,6 15,5 7,7
Health 2,3 3,6 7,5 10,3 -1,5
Slov enia All items 6,1
Food 16,1 15,4 16,2 20 10,9
Housing, ex cl. imputed rents 9,8 9,7 10,1 13,1 11,3
of which, energy 6 6 6,4 8,6 15,4
Health 1,3 1,1 1,5 2,2 2,6Structure of consumption ex penditure by age 
Note:  in HU, MT and RO, imputed rents are unknown and supposed to be 0.
 
 
EN 107   EN The period 2008-2010 is likely to be marked by an  economic downturn in all Member States. 
The question is how minimum pensions and mi nimum income provision will fare in this 
period. Obviously much will hinge on price developments in the period and the mechanisms of indexing. Much also depends on political in tention. A few Member States have already 
indicated that up-rating of pens ions planned for 2009 will be main tained (e.g. ES, IE). Others 
have announced major retrenchments across the board (e.g. LT and LV). 
4.4.3.  Shifting relations between pensions proper and MIPs 
The boundaries between minimum income provis ion and minimum pension may shift as a 
result of pension reforms and developments in labour markets. Some Member States are 
making major efforts to include hitherto excluded gr oups in the pension system (e.g. UK, ES, 
FR, RO). Others are making efforts not to lose  groups as pension systems diversify (e.g. DE). 
The UK has fundamentally widened the access of women to full entitlement to the Basic State 
Pension. In the Netherlands, occupational pensio n coverage is now extended to young people 
from the age of 21. In Germany extraordinary efforts are being made to include low-waged 
groups in the voluntary ‘Riester’ pension sche mes that are meant to supplement pension 
entitlements in the main statutory scheme. A combination of direct subsidies and tax 
deductions for these groups mean that their premiums are substantially lowered. In many 
Member States crediting of childcare has been  improved (e.g. AT, DE, PT, EL, LT) while in 
DE subsidies for private pension insurance are also tied to the number of children one is 
raising. 
The structural increase in fema le labour force participation is affecting the relative income 
position of the retired. The growing share of wo men with pension entitlements of their own 
among present retirees is already lowering th e number of women w ho have to rely on 
minimum income instruments in a number of Member States (e.g. SE, DE, AT, FR, UK). The 
long standing trend towards higher activity and employment rates of women will increasingly tend to reduce the role of MIP in all Member States. So will the more recent growth in employment rates of older workers and the ma turing of supplementary pension schemes. The 
same goes for reforms that extends the reach and inclusiveness of pensions prober through 
wider entitlements and easier access – for example for women with careers interrupted by 
caring duties (e.g. EL, PT, AT, DE, UK,) or  for young people such as in occupational 
schemes in NL. Long-term reductions in replac ement rates of statutor y schemes will pull in 
the other direction. In the short to medium te rm recent improvements of MIPs including easier 
access will also tend to solidify and expand their role. Cohorts that experienced high rates of 
long-term unemployment during the transiti on/unification period in Central European 
Member States are rapidly appr oaching retirement (e.g. in CZ , PL, SK, HU [DE]). This will 
lead to lower pensions and in crease the need for MIP.  
But present pension scheme designs are not just challenged to adapt better to historical gaps in 
coverage and set to benefit from or make up for labour market developments. Member States 
with scheme designs that used to relegate MI P features to a minute role are seeing evolving 
phenomena that cause the role of MIPs to grow. Thus even all- inclusive pension designs such 
as the residence-based pensions in DK, NL, (S E) and FI may increasingly find that a growing 
share of new pensioners is unable to meet entitlement criteria. The bulk of these are 
immigrants - including older parents brought in through family unification. But there is also a 
growing number who have worked abroad in their careers. In th e Netherlands a possibility to 
buy in missing years of entitlement has been introduced. 
 
EN 108   EN The change in women's role in the labour mark et is gradually leadin g to a change in the 
dependency on the traditional breadwinner’s in come. In some Member States, survivors 
pensions are being phased out completely a nd being replaced by minimum pensions (e.g. DK, 
SE). But in many Member States the quality of su rvivor pensions still pl ay an important role 
in the risk of poverty for those women who surv ive to the death of their husbands and have 
not earned full entitlements to a pension in thei r own right. To what extent these benefits 
provide a sufficient income in old age is an area for further study.  
A special dynamic in the rela tion between pensions prope r and guaranteed minimum 
provision for older people has to  do with the disincentive eff ects of MIPs. Where the National 
Strategy Reports discuss this, they tend to se e the potential negative effects of MIPs on 
propensity to build up pension rights and to sa ve as rather small (e.g. DE, SE). In systems 
where membership of state, occupational or sa vings schemes are mandatory or de facto very 
difficult to avoid, eventual access to minimu m income guarantees do not discourage take-up 
of work. In practice workers cannot deselect  pension insurance when working. Moreover, 
since MIP guarantees are rarely if ever available before pens ionable age, their existence 
would not in themselves erode incentives to co ntinue working until that age arrives. But in 
combination with early exit routes they may. For some low-wage groups with incomplete 
contribution records it may then be of lit tle importance that no or only small pension 
entitlements can be earned from spending the last years before retirement on unemployment, sickness or disability benefit. Through MIP th ey would anyway obtain a standard of living 
equivalent to that which coul d be achieved through pension contributions on a working wage. 
MIP may also make pension contributions/savi ngs less legitimate for low-waged workers as 
these would not buy them a standard of living a bove what anyway is guaranteed for all. I.e. 
the income testing of MIP appears to function as a tax on the entitlements and savings of 
those who (continue to) contribute. This is a standard problem of targeted benefits which 
crops up in public debate in Member States  from time to time (e.g. UK, DK, SE) in 
connection with incentives for low-income gr oups to save for pensions. The discussion 
centres on whether it is the low income or th e MIP that constitutes the main barrier. 
4.5. Ensuring information and transparency  
Pension reform all over Europe has lead to a trend away from simp ler singular systems, 
usually of a defined-benefit nature, towards mu lti-pillar pension provision with elements of 
defined-contribution design. Multi- pillar systems, while offering different risk profiles, also 
make pensions systems more complicated to und erstand and retirement income more difficult 
to predict.  
Pension reforms have, furthermore, implied a tr ansfer of risk from pension scheme sponsors 
to the beneficiaries. Increasing links between contributions and benefits, and a transition to 
more individually funded pens ion provisions, require more decisions by the individual 
beneficiary concerning time of re tirement and investments in or der to secure an adequate 
income in old age. Reforms have already been  implemented in most EU Member States. But 
evidence shows, both from this round of repor ting and a peer review on Information on 
pension systems held in Warsaw, that in orde r for these to work and gain full acceptance, 
pension scheme members will have to be better furnished with reliable, intelligible information. 
 
EN 109   EN 4.5.1.  Public consensus building and info rmation during pension reform 
Member States report that gaining a wide consen sus for reform is vital to its success. Where 
pension reforms have been carried out there has often been a political consensus and a 
consensus between politicians and social partne rs. Most Member States  have counted on the 
input of experts from social pa rtners, ministries, institutions involved and scientists for the 
development of their pension reforms (e.g. DK , IE, FI, DE, AT, PT, GR, CZ, SE). These 
countries also report th at the social partners fulfil the ta sk of informing pol iticians and the 
public about the latest trends in social systems and stimulate debate in order to foster a broad 
social consensus. One example is the Toledo Pa ct Commission that stretches over all the main 
political parties in Spain and debates reform  proposals with the objectives recommended by 
consensus among all political parties.  
However, some Member States have reported on more direct consultations with the public in 
order to receive public consensus. To study options for pension reform, the United Kingdom 
government set up an independent Pension Commi ssion. In more recent reform efforts in 
Ireland, a pensions green paper was published followed by an extensive consultation which 
will influence long-term pensions policy. A na tional awareness campaign was launched at the 
same time inviting citizens to make submissions  on the Green Paper either in writing or via a 
website. In Malta the White Paper entitled ‘Pensions: Adequate & Sustainable’ was 
distributed for public consultation and subse quently the Pensions Working Group developed 
various models of reform scenarios to reflect pu blic concerns. In Portug al, building social and 
political consensus in favour of reform was c onsidered of great impor tance. The involvement 
of social partners and advisory councils for soci al security bodies was an important part of the 
Agreement on Social Security Reforms, signed after thorough consulta tion and broad debates 
in Parliament and other forums.  
A few Member States have reported on the info rmation provided to citizens at the time of 
reform and the effects it had on the choices ma de by individuals. Th is is particularly 
interesting where an active choice was required by beneficiaries, for example where there was 
an opt-in/ opt-out choice (e.g. SK, PL, BG, LT,  LV, RO, EE). Judging from presentations and 
comments at the peer review it appears that in  some cases citizens opted to join the newly 
developed funded pillars in their systems due to ambitious information campaigns, although this may not have been the best choi ce for them financially (e.g. BG, SK). 
In order for people to make economically rati onal pension decisions appropriate to their 
individual circumstances they will need to ha ve access either to unbiased information or to 
equally balanced information from different par tisan sources. In the absence of this they may 
be persuaded to make erroneous choices. If this happens on a large scale it can obviously 
undermine popular confidence in pension reform. How to better involve social partners and 
other stakeholders in the provision of unbiased or  equally balanced information is a field for 
future study.  
4.5.2.  Pension projections and their eff ects on incentives to work longer 
In many pension reforms, work incentives have been built into the structure of the pension 
systems, by a closer link be tween contributions and benef its, increasing the number of 
contributory years necessary to be eligible for a full pension or introducing a bonus/malus system with deferred or early retirement.  
 
EN 110   EN The strengthening of work incen tives in pensions means that  individuals should keep the 
effects on their retirement income in mind as  they make work-rela ted decisions throughout 
their working life. Prolonging working lives no t only entails decisions for the individual 
regarding the age at which they retire or take up a pension but also regarding full or part-time 
work, career breaks and the age of entry into the labour market.  
Most Member States have information regulatio ns requiring pension schemes of all types to 
provide information on the accumulation of pensi on rights, but the amount and character of 
information provided differs. Some may provi de information on accumulated pension rights 
only if requested by individuals, while in others it is sent out automatically. This can affect 
how the information is absorbed and spread. Having to actively seek pension information probably limits it to certain gr oups, excluding the people who may need the information most.  
A growing number of Member St ates are now also providing or  developing calculations of 
how these pensions rights may translate into  a pension income, based on projections given 
certain economic assumptions (e.g. BE, DE, DK , IE, ES, FR, LT, FI, SE, UK). Finland and 
Portugal have recently introduced pension projections. In Finla nd these are available only for 
those closest to retirement, as projections for younger cohorts are considered too hypothetical. 
Yet with a move towards longer contributory peri ods it would seem impor tant that individuals 
understand the effects of shor ter careers early on. As the pr os and cons of different 
approaches are weighed, even younger cohorts  might appreciate forecasting tools which 
provide different scenarios de pending on economic assumptions, contributory years and point 
of retrieving the pension.  
Projections are mostly provided for each scheme in isolation even thou gh individuals ideally 
would need to know how their different entitlem ents combine into a full package of potential 
retirement income. But in a few of the Memb er States with widespread occupational and 
private pension provision, steps are being taken to develop we b-based pension portals where 
people can check how their pension accruals from  different schemes would come together in 
an overall amount of pension in come (e.g. DK). This will help  citizens to avoid making 
retirement decisions based on incomp lete or fragmented information. 
4.5.3.  Financial education and adequate private pension provision 
Providing information on accumulated pension entitlements and pension projections can 
involve many uncertainties even in the simplest of schemes. There is a greater element of 
choice, and therefore complicati on, in funded schemes with indi vidual accounts than in pay-
as-you-go schemes. As funded pensions overw helmingly tend to be or become defined 
contribution schemes most of the risks are fu rthermore placed with the insured individuals. 
Improving information and levels of financial li teracy of people covered by individual funded 
schemes is therefore integral to the success of  private pensions especially given times of 
financial volatility. While this may have presented less of a problem earlier, as the new funded schemes were generally in troduced during times of econom ic growth, developments in 
2008 have shown that sufficient levels of informa tion and financial litera cy are a prerequisite 
for individual choices on investment risk. It is vital for the continued success of schemes 
already launched that indivi duals have a basic understand ing of the risks involved.  
The SPC report on Privately Managed Pension Provision published in  October 2008 shows 
that while the increased need for financial info rmation has been widely recognised, the type 
and standard of financial information varies greatly between Member States. Information is 
regulated in a number of Member States (e .g. AT, BE, IE, IT, HU, MT, NL, UK, BG) by the 
 
EN 111   EN supervisory authority or thr ough self-regulation by partnership bodies. Presenting complicated 
financial information to people who may not have  the ability or interest to take it in is 
difficult. Improving accessibility and absorption  of information thr ough simplification of 
information presented is a key concern (e .g. ES, IE, UK). Yet simplification of the 
information has to be strategic in order not to  leave out any important information that might 
affect any savings decision. The number of inve stment choices in funded schemes varies 
vastly from just three or four (e.g. HU, BG , PL) to several hundred (e.g. SE, UK, IE, NL). 
Obviously the amount of choice will determine th e depth of financial knowledge required by 
beneficiaries. Member States  are trying various approaches . The ‘Altersvorsorge macht 
Schule’ (pension provision goes to  school) project in DE is a government initiative together 
with social partners, consumer organisations and adult educational institutions, and courses 
focus on all relevant issu es of old-age provision.  
In most Member States, information is provided  on current and past re turns of pension funds, 
but there is limited information on fees and administration costs and the compounded effects 
of these on effective investment returns. Some  countries oblige pensio n funds to list their 
administration costs (e.g. DK, S) but these may not  include the effect of all investment fees. 
This is a vital element when comparing funds and also when consider ing guaranteed returns. 
The SPC report on privately managed pension pr ovision shows, for example, that minimum 
returns may help to support adequacy. Yet they may also entail higher direct insurance costs 
and indirect costs due to changes in the portf olio structure. Circumstances are not always 
clearly presented and this may disfavour the least knowledgeable , often including people with 
risk-averse investment behaviour who mi ght have benefited from less choice. 
The peer review in May 2008 c oncluded that there is a need  for independent parties who 
could provide information on effective yield perfo rmance in the light of administration costs. 
Companies that rate pension pr oviders and assist consumer c hoice with information on market 
concentration, corporate reputation and informativ e advertising appear to be very successful 
in some countries. 
Whilst risks associated with pension saving are often highlighted, partic ularly given recent 
turbulence in investment markets, less attention is given to risks asso ciated with the payout 
phase of pensions. The options for payout phase s vary, with little stan dardisation and often 
limited restrictions. In some Member States  where funded schemes are still maturing, the 
payout phase is yet to be fully legislated (e.g. PL).  
Proper information on the payout phase can help mitigate some of the risks otherwise borne 
by individuals such as longevi ty, investment and inflation risks, depending on the payout 
options available. For example where lump-s um payments are given at retirement, the 
investment, inflation and longevi ty risks lie with the retire d person. Where the possibility 
exists of purchasing an index-linked annuity, an individual could tr ansfer the longevity, 
investment risk and inflation risk to the insu rance company offering the annuity, but often at a 
cost that needs to be made clear to the indivi dual. The advantages of annuities are not always 
well understood even in countries, such as the UK, where they are prevalent. It seems safe to 
assume that little is known in  countries where the payout phas e has typically not yet begun for 
the first cohort affected. This is an issue that  needs to be further addressed to avoid future 
policy problems and perhaps problems with income  adequacy of older retirees due to an 
underestimation of the longev ity risk in particular. 
 
EN 112   EN 4.5.4.  The effectiveness of information channels 
Beneficiaries generally rece ive pension information through the pension providers, and 
government agencies are the main source of pe nsion provision (the main source of pension 
income is statutory schemes, except in NL ). These are complimented by non-governmental 
pension providers and information sources such as agents, employers and advertisements. A growing number of Member St ates have reported the deve lopment of websites gathering 
pension information from different schemes. There is, however, clear room for improvement 
regarding the content of the information provided and the information channels used.  
Information and information channels are of ten standardised for the entire population, yet 
surveys have found that certain groups have di sadvantages in absorbing information. There is 
a need for targeted information, but experiences differ when it comes to reaching target groups. People are unlikely to make much effo rt to obtain information, so campaigns and 
information should focus on the communication me thods people tend to trust and use anyway. 
Local culture must be taken into account. For example, call centres may be a success in one 
country but remain basically unused in anot her. The internet has growing importance, 
especially with regard to forecasting and comp aring different providers. However, internet 
access differs greatly in different countries, an d tends to be more suited to younger better-
educated groups. The young and low-educat ed groups are the hardest to reach. 
Most Member States reported that young people are not usually interested in pension-related 
issues. This could cause problems in the future , as reformed pension systems tend to require 
an early interest in pensions. But it may not be realistic to expect young people to show an 
interest in issues relating to their financial situation in old age.  
The information campaigns have typically been held in conjunction with reform (e.g. DE, PL, 
EE, SE). Few countries have, however, reporte d on how the campaigns went, which can be 
vital when parametric changes to a pension system are made, for example increasing the 
pensionable age or extending eligibility rules.  In Sweden, an inform ation campaign has been 
carried out annually since the pension reform in 1999 in conjunction with the annual pension 
rights information sent to all insured persons. 
Few countries monitor the results  of their campaigns. Even fe wer Member States report on 
efforts to evaluate annual pension information to  the public and try to assess developments in 
public knowledge on pensions. In Sweden, a survey is carried out  annually to gauge the level 
of knowledge of the pension system, which de spite extensive information, is improving only 
slowly. Surveys and evaluations tend, to be rest ricted to the main source of pension provision. 
Yet as other forms of pension pr ovision grow in importance, it is also essential to measure 
public knowledge of all sources of pensions, as these collectively constitute incentives or disincentives to work longer or to save more for retirement. 
4.6. Conclusions  
The employment rate of older people has in creased markedly over the past decade, and 
improvements are particularly visible in a number of Member States. Nevertheless, much still needs to be done to reach the EU target of 50% employment among older workers by 2010 
which, given current demographic trends, is in itself insufficient in th e long run. So it is 
encouraging that some Member States ratchet up their targets as soon as they pass the 50% 
mark. Throughout Europe there is a growing w illingness to act on the realisation that the age 
when people stop working has to increase. Member  States are starting to increase the pension 
 
EN 113   EN eligibility age in statutory schemes. Through b onus/malus rules they are also strengthening 
the economic incentives in pension systems to  avoid premature exit and motivate people to 
work to higher ages. These are important si gnals for employers to adjust their age 
management practices and for employees to plan for later retirement. Member States are also 
trying to close early exit routes and remove  unintended incentives to early retirement. 
Building a broad consensus for this, including the social partners, is often very difficult and in 
many countries there are still certain occupatio ns for which exemptions or special regimes 
apply.  
Properly designed pension systems can provide important flanking support for developments 
in labour markets by signalling to workers, ma nagers and employers which age management 
practices are acceptable and rewa rded. Pension systems need to be complemented by Active 
Labour Market Policies, Life Long Learning and active ageing measures, as the lack of 
progress in activity and employment rates often can be explained by poor employment 
opportunities for older workers, thus undermining th e incentives created in pension systems.  
Unfortunately, further progress is now threat ened by the worsening of the economic outlook. 
The economic downturn will be a real test for the dur ability of th e achievements of the last 
decade. There is a risk that if labour sheddi ng is again concentrated on older workers the 
problem may be off-loaded to retirement sy stems through various early exit paths, thus 
reversing recent gains in activity ra tes and effective retirement ages. 
More people working more and longer while be ing covered by and contributing to pensions 
schemes has been identified as the single solu tion to providing both ad equate and sustainable 
pensions in an ageing society. This entails increasing the participa tion not only of older 
workers but also of all other groups of working age, thus widening the contributory base and 
the coverage of the pension systems. More stringent eligibility requirements, such as 
increasing the length of requir ed contributory peri ods for pensions and a tighter link between 
the levels of benefits paid out  and contributions pa id in are also becoming a commonly used 
practice in pension reform to ensure longer working lives. While providing beneficial work 
incentives, this makes it increasingly important to protect justified career breaks in order to 
avoid a reduction in pension ad equacy for those who are not ab le to meet these conditions 
during their working lives, notab ly women who often take on a carer role. In view of the 
current economic situation, it is also importa nt to consider the position of the long-term 
unemployed.  
Since pension schemes are being made more incl usive, with more and longer employment of 
women and older workers, the role of minimu m income provision will decline. Yet the long-
term trend towards longer contribution periods and falling replacement rates will tend to make 
more people dependent on schemes that top up or replace their pension incomes, especially 
groups with lower lifetime incomes and shorter contribution records. 
For Member States with special challenges in minimum income provision adequacy, there 
have been only moderate advances. The best so lution would be fundamental reform, but in the 
absence of that, determined strategies are needed  for adequate indexing and gradual structural 
improvements over a longer period.  In general the absolute a nd relative incomes of older 
people have weathered this peri od of rapid wage growth and higher inflation better than 
expected, thanks to ad hoc measures in many Member States. But the Member States that 
have fared best are those that have adopted regul ar indexing mechanisms that help to maintain 
both the absolute and the relative income position of MIP recipients by a combination of links 
to prices and wages. 
 
EN 114   EN In Member States that recently introduced substantial funded schemes to boost overall 
pension provision, private-funded pensions have shown themselves  to be less appropriate for 
groups of workers with low income and short career s. As workers are asked to opt in or out of 
alternative arrangements, it is crucial to tell  them which options are better suited to their 
profile. 
In order to optimise reasonable returns whilst reducing the impact of investment volatility 
close to retirement, it is advisable that Member  States with significant funded provision of the 
defined-contribution type adopt a ‘lifestyle/lifec ycle’ approach to investment: a gradual move 
from riskier profiles in younger ye ars to low risk, stable yield i nvestment later in the career. 
Given the difficult investment climate, Member States are also learning that unresolved 
issues, such as the pension payout phase rules in  funded schemes, need to be clarified. Where 
these pensions are a significant part of overall pension provision th e rules need to ensure that 
pension savings are ultimately used to provide  pensions and not lump sums in order to 
properly address adequacy. Annuities provide the payout solution most closely resembling 
payout structures for pay-as-you -go and defined-benefit pensi ons. Some countries are also 
considering supporting continue d provision of defined-benef it occupational pensions by 
establishing greater risk-sharing elements and learning from the negative and positive 
experiences of the Member States that pioneered these. Risk-sharing is also raised in the 
context of collective defi ned-contribution schemes. 
In some Member States where funded provisi on was recently introduced, it has been difficult 
to get unbiased information. Introducing individual  choice of risk profile s creates the need for 
targeted financial education of  the public and in particular of vuln erable groups. But 
information and the channels for providing it ar e often to the same fo r the entire population, 
and surveys show that certain groups have difficulty absorbing this information. The need for 
information is a broad issue. In pay-as-you -go schemes too, workers need to make well-
informed decisions on employme nt choices and the need for supplementary savings. Partial 
information may mislead individuals into eco nomically irrational ch oices and may even 
undermine the legitimacy of pension policy. One solution would be to involve the social 
partners and other stakeholders  in providing equally balanced  information from different 
sources. 
 
EN 115   EN 5. NATIONAL STRATEGIES ON HEALTHCARE AND LONG-TERM CARE 
5.1. Introduction 
Common objectives for healthcare and long-term care 
Member States are committed to accessible, high -quality and sustainable healthcare and long-
term care by ensuring: (j) access for all to adequate health and long-term care and that the 
need for care does not lead to poverty and financ ial dependency; and that inequities in access 
to care and in health outcomes are addressed; (k) quality in health and long-term care and by 
adapting care, including developing preventive care, to the changing needs and preferences of 
society and individuals, notably  by developing quality  standards reflecting best international 
practice and by strengthening the responsibility of  health professionals and of patients and 
care recipients; (l) that adequate and high quality health and long-term care remains 
affordable and financially sustainable by prom oting a rational use of  resources, notably 
through appropriate incentives for users an d providers, good governance and coordination 
between care systems and public and private ins titutions. Long-term sustainability and quality 
require the promotion of healthy and active life styles and good human resources for the care 
sector. 
5.1.1.  Health as a goal and as a determinant of wealth 
Throughout the 2008-2010 National Strategy Reports  (NSRs) good health is seen as an 
important goal, as it contributes to each indivi dual's general well-being. There is also wide 
recognition that good health enables people to part icipate in the labour market, as well as in 
social and political activities, reduces sick l eave and absenteeism, increases productivity and 
postpones retirement, allowing for longer wo rking lives. Ensuring good population health 
reduces dependency on government transfers su ch as disability benefits and pension 
expenditure through reducing early re tirement (due to ill-health).47 Health (and good 
healthcare services through promotion, preven tion and curative care) contributes to the 
improvement of welfare levels of a country a nd its sTable economic and social development 
and social and territorial cohesion. Moreover, many suggest that the health and social sector is 
a large and growing employer that can be us ed as a tool to improve the economy in 
disadvantaged regions. It can al so contribute to achieve the Lisbon objective of increasing 
women's participation in the labour market in view  of the fact that a va st majority of this 
sector's employees are women. It is, therefore,  not surprising that for all countries the 
objective of health policy and healthcare services is more than just saving lives but that of ensuring healthy and active lives at all ages.  
Regarding health, countries iden tify a number of health risks a nd ill-health conditions that 
remain important and require attention. Ri sks include increasin g alcohol and drugs 
consumption by younger people, and smoking, poor diet and lack of physical exercise in 
general. The main ill-health conditions in th e EU are obesity, cancer, cardiovascular and 
respiratory diseases, mental ill-health and inju ries and accidents, alon gside some infectious 
diseases such as HIV and tuberc ulosis. Mental health  diseases are seen to be gaining ground 
and appear to be related to working conditio ns and exclusion. These risks and ill-health 
conditions are deemed avoidable to a large extent, es pecially by those c ountries that report 
                                                
 
47 For example the UK suggests that the UK economy loses over £100 billion a year due to ill health. 
 
EN 116   EN poor health status performance (HU, EE, LV, LT). This pattern of risks and diseases is 
determining the policy choices in the health sect or (public health and he althcare services) to a 
large degree. 
5.1.2.  Health as the result of complex social, economic and environment factors  
Together with accessibility and qua lity of healthcare services a nd healthy lifestyles, living and 
working conditions, employment and income can play a vital role in determining health status. In this context, Member States identi fy the high rates of long-term (structural) 
unemployment, income inequalities (which have  risen in recent times) and poverty, and an 
economic development that has not necessarily preserve a healthy environment, as further 
determinants of health, contributing to social and regional health ine qualities and creating an 
extra burden to the health sector. Evidence indi cates for example that poorer households tend 
to experience a poorer quality environment a nd less access to environmental 'goods' such as 
parks and green areas.
48 Things as varied as climate cha nge, migration, more diverse societies 
and ageing are listed as additional challenges to  policy in this field. Moreover, even economic 
growth is said not have been enjoyed by all in the same way and regional and social inequality 
(including health inequality) has increased in many countries in recent years. 
According to the NSRs, ageing (related to long er life expectancy, lower birth rates and, in 
some countries, strong emigration of the work ing age population) no t only means a larger 
share of old and very old people with multiple and reinforcing degenerative and chronic conditions, and thus stronger demand for h ealthcare and long-term care services,
49 but also 
more workers needed and fewer workers available (including fewer informal/family carers), and thus high labour costs. As it is not age per se but the health status of the elderly population that results in greater needs for care, preven ting ill-health at all ages (delaying the 
onset of disability/ dependency) is deemed cruc ial to ensure higher quality of life in old age, 
control healthcare and long-term care co sts and ensure longer working lives.  
Patient expectations (translating into having more informed patients wanting top technology, 
more choice and faster treatment) and the chan ging epidemiological situation imply a need to 
adapt the healthcare sy stem to new patient needs and wishes, while ensuring long-term 
sustainability of systems. 
5.1.3.  Main priorities for 2008-2010 
This is the second full reporting exercise under the social OMC regarding the healthcare and 
long-term care strand. As only two years have pass ed since the previous NSRs, virtually all of 
the 2008-2010 reports (except pe rhaps BG, CZ, SK) build on th e previous strategies and 
national health plans with similar priorities and policies and some additions or improvements in relation to the strategies proposed in 2006. Fo r all Member States, universality, fairness and 
solidarity, accessibility, equity, equality, effec tiveness, and efficiency are the guiding 
principles of reform. Between 2006 and 2008 a number of countries (e.g. RO, SE, UK, IE, 
NL) have produced inquiries/assessments of popul ation needs and/ or health sector policies 
                                                
 
48 See for example "The linkages between environmental and social sustainability in Europe" at 
http://ec.europa.eu/social/Bl obServlet?docId=1574&langId=en   
49 See for example the report Europe’s Demographic Future: Facts And Figures, European Commission, 
May 2007, which states: "An ageing population will pl ace a strong upward pressu re on public spending 
for long-term care as frailty and disability rise shar ply at older ages, especi ally amongst the very old 
(aged 80+)". 
 
EN 117   EN and, on that basis, have introdu ced/ plan to introdu ce additional policies (e.g. specific policy 
programme for health promotion in FI). Most co untries have limited their reporting to a small 
number of policy areas, potentially those where they see more is happening or they see as 
priorities. Thus, the 2008-2010 NSRs are not al ways as detailed in  relation to all the 
objectives as the 2006-2008 reports were. 
In general the 2008-2010 NSRs in comparison to the previous 2006-2 008 NSRs have seen 
more emphasis placed on health promotion and disease prevention to improve population 
health status at all ag es and counteract the rise  in expenditure expected as a result of ageing. 
There is substantial information on the implementation of national vaccination schemes and national screening programmes for cancer, diabetes  and cardiovascular diseases. There is also 
considerable information regarding national or group-targeted campaigns to encourage 
healthy life styles and develop environments that  promote healthy choices, involving a variety 
of settings (from nurseries and schools to bus inesses). In 2008, more and growing interest 
(although still restricted to a number of c ountries) is placed on disease management 
programmes in the context of chronic disease (e.g. obesity, di abetes, heart disease, renal 
failure) as well as some infectious dis eases such as tuberculosis and HIV.  
Also high in the 2008-2010 agenda is the need to address geographic disparities in the 
availability and quality of care and, relatedly, th e development of primary care as a means to 
address those disparities and improve access, as  a vehicle for promotion and prevention, as a 
tool to ensure better care coordination betw een types of medical care and between medical 
and social care, and as a means to ensure a ra tional use of resources in the sector and obtain 
greater value for money.  
Considerable attention is paid to technology
50 in a variety of ways: to improve information 
and access, as a dimension of quality, to allow for a better use of re sources, notably in the 
context of shortage of staff and high labour co sts, as a means to ensure good data collection 
and monitoring in the sector, to allow for better coordination of care, and as one of the drivers 
of expenditure, as technology allows for new treatments previously unavailable.  
Also there is considerably more consideration of staff issues and human  resources policies in 
2008 than ever before, including policies directed  at informal/family carers, in view of an 
ageing population and ageing staff (a nd thus future staff shortages)  and current staff shortages 
due to emigration. Policies are articulated ar ound increasing training of staff and carers, 
improving work organisation, increasing sta ff motivation through remuneration and better 
working conditions, and developing support st ructures for informal/family carers. 
Significant importance is attribut ed to the coordination of care,  between levels of government, 
between sources of funding and budget lines, be tween types of medical care, between health 
and social care, between public and private provision, between the public and the third 
sector51 which is strongly involved in the care for vulnerable groups and the elderly.  
                                                 
50 Technology should be seen in a broader way including not only information and communication 
technology (ICT), devices and equipment, but also pharmaceuticals, procedures and services. 
51 The third sector is typically made up of all those organisations that are not-for-profit and non-
government, those that are involved in community servi ces or charity, those that relate to volunteering, 
and associations, co-operatives, founda tions, church, charities, unions, cl ubs, societies, etc. While they 
differ between themselves as a group they also differ from profit businesses and from government 
departments and authorities. 
 
EN 118   EN The contribution of the Structural Funds to th e improvement of accessibi lity and quality of 
healthcare and long-term care is underlined in several NSRs. ESF interventions target human 
resources development and training of health  personnel (e.g. CZ, EL , LT, LV, PT, PL, HU, 
SK), as well as health campaigns (e.g. HU, EL)  while the ERDF will invest some € 5.2 billion 
in health infrastructure in Convergence regions  (EU 12, PT, ES, EL, IT, DE). An effective use 
of Structural Funds support can contribute to reducing health inequalities across and within 
Member States. Therefore it is important to st rengthen coordination between health strategies 
and investments from the Structural Funds, and impr oving monitoring mechanisms. 
5.1.4.  Progress in relation to 2007 Joint Report 
Overall, Member States have been implementing reforms in relation to the challenges 
identified in the 2007 Joint report on social  inclusion and social protection. Most have 
continued with the implemen tation of the reforms proposed in 2006, with the exception 
perhaps of: SK, that has retracted on some of the previous reforms, CZ and BG which propose 
new reforms, SI who has appr oved a health plan  in 2008 and CY where the reform to 
implement a national health scheme is still pe nding. In PL some steps have been taken but 
delays have been registered. For LU the fo cus should now be on implementing the proposed 
measures rather than focusing on new ones. For most Member States the 2007 challenges 
remain valid. 
Based on the 2008-2010 NSRs, since 2007 the Baltic States (EE, LV, LT)  plus BG and RO 
have allocated more (public) resources to the se ctor to improve access and quality of care and 
have placed more emphasis on h ealth promotion and disease pr evention and in accordance to 
what had been suggested in the 2007 Joint Report. However, there are concerns that the economic crisis will have a retract ing effect in relation to this trend. A state of crisis has been 
declared in LV and a number of proposals has been put on hold, while in EE the budget rules 
suggests that a smaller amount of resources will be available to for healthcare. In LV, there 
are concerns that cost-sharing and out-of-pockets will increase as a result of the crisis, thus 
potentially undermine the progress so far in improving access to care. 
Since 2007 several countries, such as EE, BE and DE, have been successful in improving 
population coverage, although some  gaps still remain. Other countries send more mixed 
messages. For example, in AT, gaps in insu rance coverage have not improved despite 
concerted efforts with the third sector and local  authorities to provide access to basic care to 
non-insured individuals. In CY the National H ealth Scheme that would ensure universal 
coverage has been postponed for some years. In  addition, PL, LT, SK, and SI do not refer to 
specific policies that can lead to universal coverage. In NL, though health insurance is 
mandatory and universal, it is not clear what ha ppens to those individua ls who do not register 
with an insurance company and how many these are. It is estimated that approximately 1.5% of the Dutch population is not insured. Inte restingly, RO has conducted a population needs 
assessment exercise which showed a high pr oportion of the populati on lacking insurance 
coverage. This can be seen as a first step towards improving access to care, by identifying the 
extent of the problem. 
Reducing the financial barriers to access was an  identified challenged in 2007. While all 
countries appear to have exemptions or redu ctions in relation to cost-sharing, some have 
actually increased the number of  cost-sharing schemes (CZ, FR , NL with a deductible, and 
LV in the future and in view of the financial crisis). The reduction in care utilisation in CZ, 
for example, has been significant. It remains to be seen what the impacts of these schemes on 
more vulnerable groups are. In LV, where direct financing costs of care are more than 40% of 
 
EN 119   EN expenditure, extra payments may translate into an extra financial burden on patients especially 
those more vulnerable. The financial costs of  care remain high in CY and EL and no specific 
policies have been mentioned to  address this. In IE, while the income threshold for free 
medical care has increased, the entitlement to free care based on age has been removed causing quite an internal uproar. Interestingl y, HU and SK have withdrawn cost-sharing 
schemes that had been recently implemented. Following the 2007 Joint Report, BE has made 
substantial efforts in reduci ng the risk of impoverishment due to healthcare use. Some 
countries (e.g. PT)have since 2007 been improving system coverage for dental care for certain 
groups of the population (such as children, youth, and low income individuals). Just as in 
2007, dental, ophthalmic and aural care remain, fo r the most part, outside the public basket 
and more countries need to make an effort to ensure their coverage for more vulnerable 
groups. Moreover, informal payments still persis t in several countries (SK, RO, BG, EL, HU, 
PL, LT, LV, IT) and it is not cl ear if any policies were put in place to address them and if 
indeed they have decreased.  
Some policies appear to have been extended to  many countries (FI, LT, HU, IE, AT, SI, EE, 
PT, MT, DK, SE, ES, UK, CZ) such as those re garding the more centralised management of 
waiting lists for treatment often accompanied by the establishment of time frames/ limits/ 
guarantees and more public information on waiting times by health facility. These policies are 
in some cases accompanied by the possibility  to use other regional hospitals or private 
providers when the wait goes beyond the specif ied limit. Note though that a number of 
patients prefer not to exercise the right to go elsewhere for treatment. In general these policies 
appear to have reduced waiting times for certain treatments.  
In relation to the 2007 challenges, some countri es (e.g. FR, FI, SE, ES ) continued working on 
reducing geographic disparities in access and quality of care through the implementation of 
harmonised minimum criteria for access and qual ity or through in centives to staff (FR, BE, 
BG, RO, LV) or better data on regional age and h ealth status profiles and inequalities in the 
use of healthcare (HU). Others (e.g. EL, IT) do not  appear to have gone so far in addressing 
such disparities. 
The implementation of screening programmes (e.g. cancer) and disease management 
programmes (diabetes) is becoming more comm on across the whole EU. Some countries, as 
compared to 2007, are encouraging more promoti on and prevention at th e primary care level 
through increased competences of general practitioners / family  doctors (IE, LT, HU, EE, SI, 
RO, CY, SK, PT, BE, LV) and th rough extra remuneration based on prevention activities (LT, 
HU, EE, SI). In relation to cancer, DK and IE are gradually establishing nationwide cancer 
pathways to improve access to and quality of a ssociated care, which has nevertheless required 
some rearrangement of services . The establishment of patient rights and more formal means 
of patient involvement in decision making are also taking a growing space in the EU. Most 
countries show progress in the establishmen t of quality standards and accreditation of 
facilities and staff, as well as in the use of clinical guidelines . Some (e.g. BE, ES) have also 
shown more use of health technology assessment. Most EU countries, however, are at an early 
stage in terms of using hea lth technology assessment in hea lth policy decision making. 
Quality differences are still significant across the EU countries.  
As the biggest spenders in the EU, BE, FR, AT , DE and PT face the important challenge of 
ensuring long-term sustainability and obtaining gr eater value for money. While an array of 
policies have been proposed and some implemente d, which translates in th e fact that in recent 
years expenditure levels have been more sTab le (as a % of GDP), more needs to be done. 
Amongst other measures, AT still needs to work towards more integrated funding as 
 
EN 120   EN announced in 2007, DE still need to reap the fru its of selective contra cting, FR is focusing 
mainly on the demand side (e.g. cost-sharing,  with a possible burde n on more vulnerable 
patients) and need to look at the supply side incentives (e. g. contracting, h ealth technology 
assessment), PT needs to continue the implementation of primary care units and centres of excellence. Strict budgeting and cost-containment are measures  that have allowed BE to 
control expenditure growth in recent times. BE is  still to implement a "future fund" to build 
up reserves for future use. Greater use of primary care and more cost-effective use of pharmaceuticals may be of releva nce to all these countries.  
Still in relation to sustainability  reforms, note that while NL expe cted to reap efficiency gains 
from competition in the insurance sector, 4 comp anies currently hold 90% of the market, fact 
that requires further monitoring and may question the ability for this type of competition to 
ensure efficiency gains. Furthermore, selectiv e contracting is not fu lly implemented and the 
authorities' strong focus on increasing patient choice may go against sele ctive contracting and 
efficiency. SK, that appeared to be followi ng the Dutch example, does appear to have 
somewhat retracted from their focus on privat e insurers and providers. Since 2007 CZ and DE 
appear to have improved risk-adjustment/equa lisation across insurance funds. Nonetheless, 
there are concerns that, in CZ, the possible priv atisation of insurance funds may not consider 
risk-equalisation, thus questioning the solidarity a nd equity elements of healthcare financing 
and the sustainability of funds. It is also important to consider whether the required 
institutional capacity is available in CZ to pr oceed with such a reform. In relation to 2007 
challenges, HU appears to have improved on e xpenditure control notab ly through a more 
strict controlled of patient care paths, the restructuri ng of the inpatient system, and greater use 
of generics. 
In line with the 2007 challenges all countries want to increase the provision of home and 
community care and enhance the quality of existing f acilities. Some countries are redesigning 
their financing and provision system. NL, for ex ample, is limiting the scope of the benefits 
provided by their long-term care insurance sche me and making provision a responsibility of 
local authorities, which may have access, qual ity and sustainability implications. Many 
countries are, however, still at an early stage of th ese developments. 
5.1.5.  The financial crisis and economic slowdown  
High growth, low inflation, low in terest rates and monetary st ability witnesse d in a large 
number of Member States in recent years ha ve allowed a positive environment to address 
social challenges and improve social cohesion. In contrast, the current economic uncertainty 
and slow down, due to unfavourable global te ndencies including the ear ly 2008 high inflation 
(increase in energy and food pri ces), adverse exchange rate m ovements, and more recently the 
severe financial market crisis ("biggest global financial shoc k since the great depression" - 
IMF), can have a negative impact on welfare and well-being, including the health status of the 
population notably those in more vulnerabl e groups. The Commission Communication on the 
financial crisis (COM (2008)706) forecasts that  shocks hitting the European economy will 
reduce the potential growth rate in the medium term and cut actual growth significantly in 
2009 and 2010. The economic downturn will affect families, households and the most vulnerable people in our societies. Those with  low income, low education, living in poorer 
neighbourhoods, single parents,  and children are likely to be worst affected.  
 
EN 121   EN Some of the consequences of a severe economic  crisis include signif icant risks for health52 in 
two ways: on the supply side and on the demand side. On the demand side, depending on the severity of the crisis, the dema nd for healthcare increases as a re sult of poor health due to a 
combination of factors: increased job insecuri ty, unemployment and lower disposable income 
typically relate to increased levels of psycho- social stress and more frequent health damaging 
behaviours such as increased consumption of  alcohol, tobacco, and drugs, together with 
poorer nutrition. Severe past econom ic crisis have led to sharp rises in many causes of death 
particularly cardiovascular disease but also to alcohol related accidents and death and 
increased cancer incidence. Rises in chronic illness and mental health problems have also 
been observed. Furthermore, negative health  impacts may persist long after the economic 
circumstances have changed. 
On the supply side, the bases for spending on h ealth are typically taxation and employment-
based contributions. With slow economic grow th and recession such re venues decrease, as a 
result of higher unemployment, and thus constrain the level of resources that can be spent on healthcare and long-term care services. How much is then sp ent on care services depends on 
the budgetary reserves Member States have ma de in good times and can use in worse times, 
as well as budgetary rules (e.g.  Can the health insurance funds run a deficit or not?) which are 
stricter in some countries than in others. In  this context, governments may be under pressure 
to cut expenditure and services or, in other word s, to focus on the short-term rather than on 
long-term agendas.  
Thus, it is likely that the ambitious plans exposed  in the NSRs may be delayed or made more 
gradual or even frozen. Indeed, recent country experiences related to macroeconomic stability (BG), high budget deficits lead ing to macroeconomic converg ence plans and structural 
reforms (HU, EE, PT, DE and FR), have sh own that additional economic constraints are 
placed on social policy budgets in economically difficult times. Additionally, lack of societal 
support for reform has delayed or brought reform  to a standstill (e.g. HU). Hence, it is 
realistic to expect that  the current crisis will place economic  constraints in all Member States. 
In general, more than healthcare, long-term car e stands to lose as it is more often based on 
local authorities' budget and this is often and quickly adjusted in view of the macroeconomic 
situation. As long-term care represents a smalle r share of the budget, focus on only a part of 
population, and in most countries it is at an in itial stage of development it may be perceived 
as an easier target for financial cuts. This is the more worrying when so many countries have 
seen a recent impetus in the provision of services.  
In this context some crucial questions come to one's mind: "how well prepared is each of the 
27 Member States to face this economic cris is/slow growth and the social and health 
challenges that come with it?" a nd also, "in view of the ambiti ons expressed in the NSRs how 
will Member States reconcile the pressure on expenditure with the need to reinforce the safety net in a difficult economic context?".  
These are important especially when Member Stat es recognise that soci al protection including 
social security and social and health servi ces have significantly c ontributed to improving 
health and reducing the risk of poverty and exclusion including that  associated w ith ill-health, 
old age or accident. Indeed, the values of uni versality, solidarity and equity including the 
protection of the most vulnerabl e in our societies become even  more pertinent and should be 
                                                
 
52 For example the Finnish recession in the late 1980s and early 1990s and the economic crisis following 
economic transition in Central and Eastern European  Countries had significant health consequences. 
 
EN 122   EN emphasised as the basis for policy responses. Th e most relevant policies in such economic 
circumstances are those which protect health  such as access to f ood and housing and those 
that ensure universal access to good quality care especially prim ary care and in particularly 
for children and vulnerable groups. Public hea lth policies aimed at creating a culture of 
solidarity and resilience, promoting mental health  and dealing with stre ss and at reducing risk 
taking behaviour such as smoking and harmfu l alcohol use are also very important. 
The remaining of the chapter goes as follows . Section 2 looks at access to healthcare in 
greater detail, while section 3 identifies the main issues in relation to quality. Section 4 describes the main challenges and associ ated policy measures regarding long-term 
sustainability of healthcare. Section 5 then ad dresses the specific fiel d of long-term care. 
Some issues such as primary care or care coor dination cut across several sections. Section 6 
concludes and identifies key i ssues for further work and be st practice exchange under the 
OMC. 
5.2. Addressing health inequalities a nd inequities in access to care 
Member States argue that good he alth and longer working lives require, amongst other things, 
effective health-in-the-workpl ace policies (notably those emphasising age management and 
mental health) and, importantly, that healthcare services (including health promotion, disease 
prevention, curative care and rehabilitation) are accessible for all. Inequalities in health status 
between social groups and between different parts of Member Stat es are seen as an important 
problem by about half of all Member States . Across the EU the gap in life expectancy 
between Member States has wi dened to 13 years for men and 8 years for women For the EU 
as a whole there is significantly more (repor ted) long-term illness and disability in lower 
income groups. Strategies to t ackle health inequalit ies range from those which focus mainly 
on tackling inequities in access to healthcare to those which aim to also tackle the underlying 
social and economic determinants and involve policies across all area s of government. This 
area represents major challenges to health and social policy and is of  increasing importance. 
5.2.1.  Health inequalities 
On average, general health (measured by e.g. life expectancy) has incr eased in the EU over 
the past two decades as a result of health policy, more widely available medical care and 
improvements in living and working conditio ns. However, improvements have followed 
different patterns across count ries. Economic transition, for example, had a negative impact 
on life expectancy in th e early 1990s in Central and Eastern European Countries, followed by 
strong recovery in many but not al l countries (e.g. life expectancy  in LV and LT (for men) is 
still below the 1986 level). Across the EU the ga p in life expectancy be tween Member States 
has widened to 13 years for men and 8 years fo r women, with individuals in the new Member 
States of Central and Eastern Europe typica lly living shorter lives than their Western 
counterparts.  
In addition, within country socio-economic diff erences in health have remained or even 
increased in a large number of countries for wh ich there is data available. For example, FI, 
LT, EE, AT, IE, UK, and DK all report in the 2008 NSRs that life expectancy, healthy life 
years, long-term illness, functional capacity, se lf-reported working ability, and severe mental 
problems are more common in the lower socio- economic groups (measured using income or 
education) than in the higher ones. More specifi cally, in AT those with higher education a) are 
less often smokers, b) are less frequently overw eight and obese, c) have preventive health 
checks more often, and d) more often perceived their health to be good or very good. In EE 
 
EN 123   EN women with higher education live on average 13 years longer than men with basic education 
(against the average 11-year gender gap). The UK states that parts of Wales (notably the 
former mining and industrial areas of south Wa les) and parts of Scotland have some of the 
worst health indicators of Eu rope and certainly Western Eur ope. DK indicates that the most 
disadvantaged groups generally have poorer hea lth and fewer healthy years to live than the 
rest of the population. In BE life expectancy at birth of those with low qualifications 
compared to those with higher education is 5.5 years less for men and 3.5 years less for 
women. At 45 a 5-year difference for men and wo men is observed. Recent EU-SILC data also 
indicates53 that lower income groups feel their hea lth to be worse than  more advantaged 
groups and that in some countries the gap has increased.  
Inequalities in health status between social groups and between different parts of Member 
States are seen as an important problem by a bout half of all Member States. Reducing socio-
economic and regional health inequalities has become the mo st important health policy 
challenge for FI and UK, a major goal for LT, IE, AT, EE, SI and SK and part of BE, HU and ES strategy. In the UK extra funding has been allocated to implement direct action to reduce 
health inequalities, and in FI a national programme has been launched. DK reports the 
reduction of socio-economic heal th inequalities as a high poi nt of discussion during the 
national forum on social protecti on and social inclusion and MT recognises the need to look 
further into this issue. Intere stingly, a number of countries recognise that action to reduce 
health inequalities (i.e. improving the health of specific groups) can actually increase general 
population health at faster rate.  
Socio-economic differences in health status suggest that not all population groups have 
benefited in the same way, either from the economic progress that delivers better health 
through better living and monetary  conditions, or, and importantl y, from the availability of 
and improvements in medical care. Differences in care access and care util isation explain part 
of the observed inequalities (e.g. EE reports that  poorer households make a different use of 
care vis-à-vis richer households). Several countri es argue that access care  is not understood by 
those to whom it was designed and in greater  need. EU-SILC data shows a clear socio-
economic gradient in self-reported unmet ne ed, which may proxy differences in care use 
across socio-economic groups.
53 A crucial aspect in tackling health inequalities is therefore 
that of addressing socio-economic and regional di fferences in the availability and use of care 
and creating health-supportive environments (see  next section). As th e UK puts it, we need 
better, local and faster access to care in so me more deprived areas and for some groups.  
The set of measures put forwar d include routine monitoring of health status of different 
population groups (DK, UK, IE, MT ) and geographical areas (UK), which indeed can be an 
important step in drafting informed policy. Mon itoring should also done in relation to care 
utilisation by the different population groups (e .g. IE proposes looking at cancer screening by 
different socio-economic groups). In the UK, mo nitoring is to be accompanied by targets (for 
life expectancy and infant mortality by 2010 for th e so-called most deprived areas). In DK, an 
ill-health survey ("SUSY UD SAT") provides comprehensive health-information on alcohol 
and drug users, homeless, mentally ill and poor people, and shows significant differences between their health and that of the overall  population (61 % suffer from long-term illness 
compared to 39% of the general population). 
                                                
 
53 See http://ec.europa.eu/employment_social/spsi/docs/social_inclusion/2008/omc_monitoring_en.pdf   
 
EN 124   EN Some countries have designed health programme s targeting specific groups in society: the 
national intercultural health strategy in IE, including for Travellers; Roma and disability programmes in SI; health checks and health prom otion for the Roma in LT; health mediators 
for Roma in RO and BG; the health strate gy for disadvantaged communities (for Roma, 
homeless) in SK; Travellers programme in the UK; the strategic citizenship and integration 
plan in ES which looks at the health of immi grants; a plan for health of migrants in MT; 
mobile units directed at minorities and migrants in PT; improve services delivery to homeless, 
illegal migrants and drug addicts in BE; prev ention programmes for disadvantaged groups in 
DK; the phone counselling line available in Estonian and Russian in EE.  
More general policies relate to training care sta ff to make them aware of possible inequities of 
access (UK) and of obstacles faced by those w ith disabilities (CZ). In addition, Member 
States suggest that there is a need to reinfo rce the existing national structures of health 
promotion to ensure community education on health promotion. Hence, health promotion 
(based on national messages) is becoming a local responsibility as a means to reduce 
disparities. Municipal public health offices in LT, local authorities in DK and regional offices 
in AT, SI and SK are now responsible to adapt national health promotion policy to their local 
features and monitor health status and access to care. Countries also propose that health 
promotion is adapted to those at higher risk  (e.g. IE proposes actio n to promote healthy 
eating, access to healthy food and physical activity among adults in disadvantaged areas). 
Nurseries and schools are seen as important vehi cles for health promotion for all, notably 
through appropriate curricula in schools and as healthy environments. Children and youth 
health is a priority in several count ries (IE, SK, SI and BE, and LV).  
Given the various social determinants of heal th above, some countries (FI, IE, AT, SI, EE, 
SK, UK) have encouraged health protection and the reduction of health inequalities in other 
sectors' policies (e.g. educa tion, employment, housing, social  work, rural development, 
environment). This is in line, for example,  with a study looking at the links between 
environment and health
54 that recommends that the policy developmen t process be 
strengthened by making distributio nal aspects a more important part of the policy impact 
assessment process, and by providing guidance on methods and approaches. This would both 
avoid/mitigate negative distributional impacts and identify (and enhance) positive synergies between environmental and social objectives.  
Overall, however, only half of the countries refer to health inequa lities across population 
groups and some do it quite ligh tly. Even those who put forw ard the reduction of health 
inequalities as a major goal, are not too detaile d in relation to what policies are pursued, let 
alone effective, in reducing unnecessary inequalities in hea lth. This suggests that more 
awareness and exchange is needed in this area. 
                                                
 
54 See for example "The linkages between environmental and social sustainability in Europe" at 
http://ec.europa.eu/social/Bl obServlet?docId=1574&langId=en  
 
EN 125   EN 5.2.2.  Access 
All Member States are committed to the object ive of ensuring access for all to adequate 
healthcare and long-term care55. Some of the goals expressed in the NSRs ar e "to develop a 
network of quality servi ces accessible to all"; "create equa l conditions for all citizens to get 
access to the care they need"; "saf eguard services for all, indepe ndently of their financial or 
social status background, gender, age, reside nce, race or religious  background"; and "that 
access does not cause financial dependence and povert y". Universal or almost universal rights 
to access to healthcare can be found in all EU Member States and, by design, countries want 
to ensure that, while financing is based on  ability to pay (taxation, social insurance 
contributions), access to services is not dependent on income or wealth.  
Nevertheless, EU-SILC data (with the excep tion of DE, BG and RO ) indicates that, on 
average, 3.1% and 5% of those li ving in the EU report unmet need  for medical care and dental 
care respectively. Percentages vary from 0.2% in  DK and SI to 15% in LV when looking at 
medical care, and from 0.5% in SI to 12.2% in EE in relation to dental care.53 In 8 Member 
States, 40% or more of the population says that  access to home services and nursing homes is 
difficult.56 As in the 2006 NSRs, the 2008-2010 NSRs  identify disparities in access on a 
socio-economic and regional basis (e.g. availabl e income, unemployment, ethnical and racial 
basis, geographical areas). Barriers to access incl ude lack of health insurance coverage, direct 
financial costs of care, includ ing direct payments for care  and transport, geographical 
disparities in the availability of services a nd their quality, waiting tim es for receiving care, 
lack of information regarding access to the hea lthcare and long-term care packages, lack of 
registration with health insurance or family doctor, complex and very lengthy administrative 
procedures in relation to e ligibility and enrolment for long-term care services, and 
discrimination, language barriers and socio-cultur al expectations in re lation to life and care 
services. As the current supply of long-term car e services is deemed insufficient to meet 
current and future needs, these obstacles are often more acute in  the context of long-term care. 
Differences in provision and qua lity across EU countri es are more marked here than in the 
context of medical care.57  
To improve manners, more public investment is being allocated to the healthcare sector in a 
number of countries (FI, LT, HU, IE, RO, UK, DK) notably to improve infrastructure 
(facilities and beds), staff availability and technology. Additional publi c funding has been/ is 
to be allocated to expand community and home care (LV, CZ, HU, LT, MT) and improve 
residential care (BE, FR, LV, HU). Many Member States wish to  promote rehabilitative care 
(PT, BE, CZ, EL, FI, FR, DE, LT) with a view to  restoring patients' skills to regain maximum 
self-sufficiency. Significant emphasis is being put on improving coordination between 
primary and secondary care and between health care and long-term care. However, the reading 
of the reports suggests that we are still  at an early stage in this process. 
                                                 
55 Although different definitions exist, long-term care is often defined as a combined range of health 
(nursing) and social services provided for an extended period to individuals who are dependent and need assistance on a continuing basis due to their physical or mental disability/limitations. Services 
relate to the basic activities of daily living (bathing, dressing, eating, getting in and out of bed or chair 
and moving around, using the toilet and incontinence) but also include help with instrumental activities 
of daily living (meals, shopping, housework). 
56 See for example Special Eurobarometer 283 at 
http://ec.europa.eu/public_opinion/archives/ebs/ebs_283_en.pdf   
57 See for example Special Eurobarometer 283 at 
http://ec.europa.eu/public_opinion/archives/ebs/ebs_283_en.pdf  
 
EN 126   EN 5.2.3.  Lack of insurance coverage  
All Member States express the wi sh to have full universal co verage of their population. While 
this is implicit in national he alth systems (NHS), the state usually pays for non-contributory 
groups where the right to care is related to contributions to soci al insurance. While emergency 
care is available for all (though sometimes i nvolving a fee), there re main a number of 
individuals not covered for ot her and more common care serv ices. The proportion of the 
population not covered is 4% in EE,  1.5% in AT, 1% in  LT, 0.84% in SI, 0 .4% in BE, 0.2% in 
DE and (as OECD health data suggests) 2.7% in PL, 2.4% in SK, and 0.1% in FR. In RO, 
5.7% of those who visited the doctor during a national health assessment were not insured, 
suggesting a significant proporti on of uninsured in RO.  
The reports, though, are not always clear about who the individuals th at lack insurance 
coverage are. In EE the figure includes thos e on long-term unemployment, while in SI it 
relates to refugees, asylum seekers, former pris oners and foreigners with temporary residency. 
In general, in addition to those who fall out of social security (long-term unemployed, 
homeless), they appear to incl ude those who lack residency, ci tizenship or official papers 
(illegal immigrants, asylum seekers, refugees) or lack information rega rding registration with 
the system (minorities). Informal unemployment and the grey economy under which 
individuals do not pay contribu tions also imply a lack of health insurance coverage.  
Moreover, for example in PT, certain groups  (e.g. civil servants) have double coverage 
through the NHS and own social insurance sche me, while CY highlights that the current 
system favours civil servants who get a wide range of free public healthcare.  
The numbers above show a reduction vis-à-vis 2006 and thus a positive outcome of the policy 
efforts put in place by Member States (e.g. in BE coverage wa s extended to all those self-
employed; in EE coverage was extended to  those on unemployment benefits; in DE 
mandatory health insurance led to 134000 person s formerly without coverage entering public 
health insurance and 5000 persons  entering private health insura nce). Further steps have been 
taken since or are proposed. In DE, legislati on introduced in 2007 enable s people to re-enter 
social or private health insurance and ensures individuals are not ‘kic ked out’ of insurance. 
DE expects to reach full coverage by 2009. AT  wants to improve coop eration with private 
social welfare organisations to improve access to health and long-term care of those more 
vulnerable and not currently covered. EE and RO are encouraging local governments to 
provide primary care to those who lack insuranc e and EE wants to ensure that all unemployed 
persons participate in active labour market measures to which insurance coverage is 
associated. CY is planning to  introduce universal residenc e-based coverage under the 
National Health Scheme (though it has been a ve ry lengthy process). Some countries (IE, HU, 
RO, ES, CZ, PL) are working on clarifying the statutory provisi ons on eligibility for health 
and social services (i.e. defining the who, what , when and where), in relation to a minimum/ 
common basket under social health insurance or NHS . While clarity is a first step in ensuring 
coverage, notably by reducing discrimination and regi onal/ local discretion, and thus 
disparities in service provision, more needs to be done to ensure access to care for all. 
 
EN 127   EN 5.2.4.  Lack of coverage of certain types of care and high direct financial costs of care  
While most EU countries rely heavily on public finance, priv ate healthcare expenditure is 
significant (about 20-30% on aver age) and consists primarily of out-of-pocket payments 
(direct payments made at the point of access to  care) for services excluded from the public 
basket and increasing cost-sharing58 for public services. In some countries the share of private 
expenditure, mostly made up of out-of-pocket payments, is rath er high: CY (57%), LV and 
BG (39%), and EL (38%). The 2008 NSRs men tion (though perhaps less strongly than in 
2006) that dental, ophthalmic and aural care se rvices continue to be some of the common 
services not covered by social health insura nce or the NHS. Additiona lly, the lack of public 
provision or funding for home, comm unity and residential care pl aces a large direct financial 
burden on patients and their families/relatives and large out-of-pocket payments are common for these services.
59 Additionally, differences in the eval uation of 'dependenc y' and its scope 
may determine whether individuals are entitled to publicly funded servi ces or not. Moreover, 
cost-sharing, in place in all Member States (to a greater or lesser extent), applies to pharmaceuticals, specialist and hospital care, home  visits and, in some countries, to primary 
and emergency care. In some countries informal  payments are an additional cost to patients 
(SK, RO, BG, EL, HU, PL, LT, LV).  
As highlighted in the 2007 Joint Report, while cost -sharing can have a role in the health sector 
in raising cost-awareness, reducing unnecessary  consumption, and encouraging a preferred 
path of care, it is a component of  healthcare that must be carefu lly designed so that it does not 
deter or delay access to necessary care by thos e more vulnerable (lower income, chronically 
ill) who may face the greatest need.
60 This is the more important in the context of high 
expenditure and growing demand wh ere cost-sharing may be seen as unavoidable. Hence, it is 
crucial to design it so that it minimises any nega tive impacts and maximises efficiency gains.  
All countries have redu ctions or exemptions of cost-s haring for certain population groups 
based on income, age and severity of disease (e .g. children, students, elderly, chronically ill, 
benefit recipients, low income, pregnant wome n, disabled, victims of  violence). In many 
countries a minimum basket of care is available free of charge for all re sidents. For example, 
in BE and LV a set of preventive care (vaccina tion and screening) is free for all. In NL, 
primary, obstetric and maternity care, and dental  care for those up to 22 are not included in 
the compulsory excess (deductible). Some (RO) plan to extend the basic care basket covered 
by social insurance. Several count ries (BE, FR, IE) want to d ecrease the financial burden of 
care in general and for those in more vulnerabl e groups in particular (low income and/or 
chronically ill patients). In FR free care is now available for those with chronic conditions. In 
IE medical and GP cards entitle those in lowe r incomes to access free care or free primary 
care. IE is increasing and inde xing the income threshold that qualifies for free care (though 
decreasing age eligibility). In BE a medical  card allows full reimbursement for some 
                                                 
58 Cost-sharing includes: a) co-payments or fixed amounts paid by patients for a service (common for 
visits and hospital stays); b) co-insurance or a percentage of total cost of service (common for pharmaceuticals); and c) deductibles or a fixed amou nt paid (e.g. first €100) by the insured person 
before any reimbursement occurs. 
59 According to the Special Eurobarometer 283 in 9 Member States, 40% or more of the population says 
that home services are unaffordable while in 19 Memb er States residential services are unaffordable 
(please tell me if for you personally, or for your close ones, each of the follo wing are very affordable, 
fairly affordable, not very afford able or not at all affordable.). 
60 Evidence indicates that charging can reduce utilisation and has negative consequences on the health 
status of those poor and with poor health. 
 
EN 128   EN individuals and for some conditi ons. Some countries operate expe nditure ceilings to alleviate 
the burden of those using servic es (including medication) freque ntly (FI, BE, LV). In AT, 
prescription charges for those with chronic illnes ses are capped at 2% of individuals' income.  
Plans are put forward to increase the reimbur sement of drugs (RO, PT, LV, MT for cost-
effective drugs) or decrease/control the price of  drugs (PT, BE, MT, BG) especially for those 
with special difficulties and the elderly (ES, UK) , or chronic disease (MT) or children (UK). 
Some see a greater use of generics (PT, MT) as a way to increase the affordability of drugs 
and ensure extra reimbursement.  
FR sustains that the Couverture Maladie Univ erselle complémentaire funded by the State for 
those with low incomes plus financial aid to acquire complementary in surance to those around 
the CMUc income threshold have reduced fina ncial barriers (although there are reports of 
doctors refusing CMUc patients) . NL has increased the allowance to lo w income groups and 
those chronically ill to help pa ying for health insurance premiums and direct costs of care. 
Vouchers for dental care and home help servic es and home healthcare are now available in PT 
(for children, pregnant women and elderly with lower income) and in FI respectively. Extra 
financial aid/ welfare benefits are granted to the elderly dependent, di sabled and chronically 
ill (FR), while State coverage of long-term care for low-income households is provided within 
social assistance (FR, NL, BE, HU, DE, SK, LV) and State subsid ies are given to use private 
services (FR). 
5.2.5.  Waiting times  
Waiting times for a number of treatments are seen as another obst acle to access, although 
often seen as a dimension of car e quality. They appear to rece ive greater attention in this 
reporting exercise than in the previous one. Waiting times va ry by ill-health condition and 
between regions (FI, SI). For some countries they are important in the context of elective 
(non-urgent) surgery, while for others improveme nt is needed also in relation to primary, 
specialist or emergency care, ch ronic disease and malignant diso rders. In several countries, 
waiting times are also long in the context of lo ng-term care services, particularly residential 
care, due to the current inadequate public prov ision/funding and limited availability of nursing 
staff.  
Several policies are proposed on the line of more centralised  and transparent waiting list 
management (FI, LT, HU, IE, AT, SI, EE, PT, MT), especially for non-urgent surgery. A first policy is that of implementing a national mo nitoring system on waiting lists and times for 
different healthcare facilities, whose informati on could be made publicly available to staff and 
patients, thus helping these c hoose the facilities with the shor ter wait (FI, SI, DK, EE, ES). 
This is typically, though not necessary, related to the implementation of time frames/ time limits/ time guarantees that are applied to either all or some of the following: primary care, urgent treatment, non-urgent surgery, chronic and malignant disorders (FI, SI, SE, DK, UK, 
ES, CZ, PT, MT). The aim is not only to ensu re that no one waits to o long, and thus bears 
negative repercussions on his/her health status, but also that there are harmonised principles 
for all regions in an attempt to decrease geogr aphic disparities in waiting times. When time 
limits are reached, other public facilities in other regions or in the privat e sector (FI, UK, DK, 
LT, SE, IE, PT) can be used, following agreements  with private institutions. For example, in 
IE, the National Treatment Purchase Fund that ma nages those on the waiting list (i.e. checks 
if patients still require treatment), arranges treatment for those who have been waiting the 
longest. Interestingly, not all patients accept bein g treated elsewhere from originally planned 
(IE, PT, DK, SE) and prefer to wait longer but be treat ed closer to home . Further to these 
 
EN 129   EN measures, in DK the patient ombudsman is to deal with waiting time complaints. In addition, 
extra funding has been put in to increasing the number of public beds (IE, UK, MT) or 
directed at those conditions with very long waits (S I). It is expected that  an increase in long-
term care services also increases capacity and reduces the wait by reducing bed-blockers 
(MT). Moving certain healthcare se rvices from the tertiary/seconda ry to the primary sector is 
also expected to reduce waiting times for su rgery (MT). The implementation of electronic 
referral systems may cont ribute to faster eval uation of referrals to hospitals (UK). Longer 
hours for surgical and outpatient wards are to decrease the waiting (MT). In general, better 
coordination between primary and secondary care is crucial to achieve faster referrals and 
treatment. Policies centralising the management of waiting lists together with time frames are 
becoming common around the EU and appear to have reduced waiting times for several conditions. 
5.2.6.  Geographic differences in servic es availability and quality  
Virtually all countries report geographic diffe rences in the availability and quality of 
healthcare and long-term care services, and recognise  the need to ensure territorial cohesion in 
these fields. Typically, the 2008 NSRs report a concentration of heal th and social care 
professionals, facilities and equi pment in cities and major urba n centres vis-à-vis rural and 
remote areas. Member States report uneven us e of care together with regional and social 
economic differences in lifestyle s and even in the compliance to therapies (LT). In many 
cases the differences are regional and coinci de with the socio-economic structure of the 
population (e.g. high income versus low income  regions, high unemployment versus high 
employment regions). Some countri es refer to deprived  areas that are part of urban centres. 
Disparities are more acute in the case of long-te rm care, which is more often a responsibility 
of local authorities or regions than healthcare.  Differences in assess ing dependency and thus 
eligibility are common across regions.  
In some countries differences are related to th e decentralisation in the provision and financing 
of services, which provides an opportunity to adapt se rvice to local circumstances, but makes 
services dependent on the region's income and discretion in decision making (FI, ES). Some 
argued that ageing and urbanisation have led to thinly populated rural areas and highly 
populated cities, making it difficult  to plan and distribute servi ces. Some state that geographic 
differences are the result of pr evious "no-policy" si tuation. A lack of coordination between 
public and private provision/fundi ng leads to the concentration of private provision in big 
centres (CY, EL). Shortages of pr imary care doctors, which is not always seen as an attractive 
discipline, result in an uneven distribution of care (e.g. th ere are unoccupied facilities in 
disadvantaged areas in BG and PT as a result).  
Measures proposed relate to improving infras tructure, resource allocation and staff support 
structures in needed areas. A large numbe r of countries are focusing on building new 
infrastructure and modernising facilitie s focusing on primary, common outpatient and 
emergency care. The attraction of health personnel (i.e. primary care doctors) in isolated or 
economically disadvantaged areas is also a pr iority, and some (FR, RO, BE, BG) provide a 
related package of incentives (also for emer gency staff in LV). In some countries the 
municipal and regional reform to broaden the population base conti nues (FI) and cooperation 
and partnerships between local authorities (FI,  SI) or groups of hea lth centres (PT) is 
encouraged to enhance provision. Another impor tant aspect is to develop an adequate 
financial framework that guarantees a uniform s upply of basic health se rvices of standard 
quality by adjusting regional funding to populat ion characteristics with annual updates (IE, 
AT, HU, RO, UK) or where health indicators de viate most from the average (SI). A maximum 
 
EN 130   EN distance to hospital (BE) and m obile services in remote areas  (RO, BG) are also foreseen, 
together with the setting up of pharmacies or outlets in disadvantaged areas (RO). SE is 
working with local authorities to provide mo re psychiatric care while DK is implementing 
cancer pathways throughout the country. FR is setting up regional health agencies comprising 
medical and social care professionals to im prove the organisation of healthcare services 
across regions. Interestingly, in ES the ministry  of health is working with the ministry of 
environment and rural affairs to ensure quality  primary and emergency care in rural areas.  
The structural funds can provide extra f unding for regional development including in 
healthcare. Although some Member States menti oned their use, (HU, SK, EE, LT) there is, 
room for improvement in terms of more a nd better use of funds in this field.  
5.2.7.  Primary care 
An important conclusion is that  primary care is an important  tool in ensuring greater 
accessibility for all and is at the heart of addr essing disparities in care supply. All countries 
indicate that efforts must be made to have a country wide and effective primary care network 
as well as a minimum emergency care structur e (FI, RO, SK, UK, LT, HU, PT, LV, BG, PL). 
Primary care should be available ne ar to the place of re sidence, i.e. all in dividuals should have 
a family/ personal doctor close to where they live and when they need. To this aim RO is 
establishing more agreements between county h ealth insurers and primary care practices for 
those in rural areas; IE wants to increase the number of primary care teams; BG, FI and LT 
want to establish greater cooperation between m unicipalities, and SK is defining primary care 
districts where GPs have to serve all patients, including Roma communities. Better coordination between private and public provis ion of primary care (CY), allowing all those 
who meet certain requirements to establish themselves as primary care providers (SE), 
increasing out of hours GP services (IE, BG) and increasing service hours of health centres 
(PT) are other policies designed at strengthening primary care.  
And important element is that the attractivenes s of primary care must be improved. To this 
end, FR established a forum with health professionals and policymakers and patients, while FI 
is developing a national development centre for primary healthcare and a network of health 
centres, together with institutes of general practice in universities and units of general practice in hospital districts. To increase motivation, countries (LT, HU, EE, SI) propose changes in 
payment for primary care doctors including a mixe d system of age-adjusted capitation (money 
follows the patient) plus a fee for preventive services. Motivation is also provided through 
greater competences attributed to primary car e doctors and nurses (promotion and prevention 
- screening and immunisation in IE, LT, HU, EE, SI, RO, CY, SK, PT, BE, LV and disease 
management of e.g. diabetes, obesity and heart di sease in IE and BE). Primary care (primary 
care teams) is also to be the basis of multid isciplinary networks involving GPs, nurses, 
healthcare assistants, physiotherapists, occupation al therapists, obstetricians, social workers, 
among other (BE, FR, IE, LT, MT, PT and UK, ) to ensure better ac cess through better 
coordination of care (i.e. referrals to secondary and social care).  
Indicators to monitor progress in national primary care strategy are also proposed (ES). This 
is quite pertinent given that a country wide primary care ne twork requires sufficient numbers 
of staff which may prove difficult in the co ntext of increasing sta ff shortages and when 
primary care physicians are fewe r than specialists in many c ountries. Strengthening primary 
care is strongly related to the availability of  human resources and only few countries currently 
acknowledge that. 
 
EN 131   EN 5.2.8.  ICT as a means to improve access to as well as quality of care 
A vast number of countries places high hopes on ICT to improve access and quality. ICT, 
through health websites/porta ls, can allow for more comp lete and always available 
information regarding rights to access (how one can use what services when) and health promotion, disease prevention, treatment or re habilitation. Aside inte rnet guidance, booking 
of services (HU, RO, EE, FI, PT, ES), choos ing providers (SE, DK), a centralised free 
medical counselling phone (SE, FI, EE, DK, PT, MT) and remote electronic diagnosis (HU, 
LV, ES) or ICT alternatives to staff in re mote areas (EE) can help improving access and 
diminishing regional differences. Tele-monito ring, telemedicine and independent living 
systems can contribute to ensuring independent liv ing and more user-orien ted services. It can 
enable better self-management of chronic condi tions and can support info rmal carers in their 
role. All countries are investing in the computer isation of services whic h allows for personal 
identification systems and patient electronic r ecords (ES, SE, EE, FI, IE, AT, LV, BG, RO 
also for chronic disease, UK for health and so cial care). Electronic referrals (SE) and e-
prescriptions (PT, LV, ES, FI) can ensure fast er patient flows in the system. Finally, ICT 
allows for data collection, m onitoring and planning (EE).  
In this optimistic scenario two issues need re flexion. Indeed, if bett er care coordination and 
thus faster and better quality  care is to be achieved, it is  fundamental th at technology is 
compatible across all care facili ties to ensure that informati on flows across different medical 
facilities and from these to soci al care facilities. Moreover, a nd some countries recognise that 
ICT use is still limited, there is the problem th at ICT can create a further gap between those 
richer and those poorer (as a computer and inte rnet access is needed, for example) but perhaps 
in greater need of care. Hence, it remains to be seen how the be nefits of ICT can spread across 
the whole population. 
5.3. Quality of healthcare 
5.3.1.  Introduction 
Quality of care is an emerging policy issue across the EU. Europ ean healthcare and long-term 
care systems are currently facing a number of challenges, includi ng population ageing, 
migration, mobility of patients and health prof essionals, and rising expectation of citizens. 
While rapid progress of medical and ICT techno logies is seen as a source of demand and 
expenditure growth because it allows for the treat ment of conditions that  would previously go 
untreated, they can also contribut e to innovative solutions and ch anges in organisation of care, 
for example, shifting from hospital care to pr eventive and primary care. In these changing 
systems it is crucial to ensure the provision of  high quality healthcare and long-term care for 
the European citizens, i.e. ca re that is effective, safe and responds to the needs and 
preferences of patie nts and society.  
The European Observatory on Health Systems and Policies
61 uses the definition of the 
American Institute of Medicine (1990) that defines quality as "The degree to which health services for individuals and populations increa se the likelihood of desired health outcomes 
and are consistent with current  professional knowledge". The C ouncil of Europe (1998) adds 
to this "increases (…) and diminishes the ch ances of undesirable results (…)". More recently 
the WHO (2000) defined quality of care as "the leve l of attainment of hea lth systems' intrinsic 
goals for health improvement and responsiv eness to legitimate e xpectations of the 
                                                
 
61 http://www.euro.who.int/observatory/Glossary/TopPage   
 
EN 132   EN population". Several Member States also propose  a definition of quality: for example, the UK 
Department of Health (1997) states  that quality is "doing the righ t thing, at the right time, in 
the right way, for the right person ". Such definitions cover the dimensions of effectiveness, 
safety, timeliness and patient centeredness. Under the social OMC we focus on all these aspects which relate directly to the common obj ectives and indicators that have been agreed. 
The previous NSRs provided a number of tools th at had been developed in Member States to 
increase high quality of care. They were ca tegorised into three groups: effectiveness, 
evidence-based medicine, and integrated care. They covered issues such as quality assurance systems, prevention schemes, evidence-based medi cine and clinical guidelines, patient safety, 
care coordination, and patient choice, rights, and involvement in decision making. Current 
reports continue along these lines but give furt her details about preventive care and primary 
care as a vehicle for prevention; they point out  the management of chronic diseases as an 
issue of growing concern; they present work  on quality standards; finally, they give an 
overview of how the Member States  introduce patients-centred care. 
5.3.2.  Quality assurance systems 
As in 2006, most Member States report on their progress in re lation to the implementation of 
quality standards. The 2008 NSRs provide further details about elaboration and 
implementation of quality standards for hospita l care (DE, DK, IE, CZ, EE, NL, UK, SI, FR, 
PL and AT) but also for othe r healthcare providers (e.g. FR, AT). The standards are 
elaborated internally bu t often are inspired by internationa l organisations' work (e.g. the Joint 
Commission – CZ). Many Member States created  devoted bodies at na tional level (national 
quality agencies) aiming at quality improvement (ES, DE, IE, CZ, EE, NL, SI, MT and AT) and in some cases with the new mission of  studying the medico-economic aspects of 
healthcare (FR). While in some countries qual ity standards are not binding, in most cases 
national agencies are in charge of accreditation or certification of hospita ls and other health 
providers based on the specified quality standard s (e.g. BE, FR). Some Member States also 
issue national clinical guidelines (FI, BE , UK and DK), which ar e sometimes based on 
evidence-based medicine or health technology assessment.  
The work on standards is in line with th e Commission's proposal for a Directive of the 
European Parliament and of the Council on the application of patients'  rights in cross-border 
healthcare which refers to Member States defining clear quality and safety standards for healthcare provided on thei r territory and ensuring  their implementation.  
The level to which the defined standards have b een met by healthcare providers is seen as 
necessary source of information about the quality  of services provided, to help decision 
makers in planning actions aimed at reduci ng unaccepTable variation and to help patients 
choosing care facilities (i.e. more  informed choices by patients). 
5.3.3.  Effectiveness: disease prevention and chronic disease management programmes 
According to the European Observatory on Hea lth Systems and Policies effectiveness means 
"The extent to which a specific intervention, pr ocedure, regimen of se rvice … does what it is 
intended to do for a defined population" (WHO). Th e OECD also defines effectiveness as "the 
degree of achieving desirable ou tcomes given the correct provision of evidence-based 
healthcare services to all who could benefit"
62; "the extent to which attainable improvements 
in health are, in fact, attained". 
                                                 
62 http://www.oecd.org/dataoecd/1/36/36262363.pdf   
 
EN 133   EN Rendering healthcare systems more effective is an issue for the vast majority of Member 
States and is the driver of several reforms currently undergoing or being prepared in Europe. In this context, improving disease prevention is  reported as a way of improving health system 
effectiveness and efficiency (as disease prevention interventions such as vaccination and screening can prevent disease or provide early dia gnosis that result in lo wer healthcare costs). 
Many preventive interventions are deemed eff ective and cost-effective to reduce disease. 
They may also offer opportunities to increase  social welfare or enhance health equity
63.  
In many Member States, preventive care has a hi story, especially with regard to newborn, 
young mothers, and children, with a free of charge follow-up in  schools for example (AT, BE, 
SI, LV, CY, LT and PL), and notably vaccinati on and oral health. More punctual preventive 
programmes also exist and are gaining more  ground concerning specific diseases 
(tuberculosis, AIDS, cardiovascul ar diseases, diabetes). Can cer prevention, notably routine 
screening and follow-up, have however received greater attention in the 2008 NSRs and are 
well documented in the majority  of the reports, although the statistic al data about the 
percentage of population screen ed are not always provided. Breast cancer screening is 
implemented in the majority of Member Stat es, followed by cervi cal cancer screening. 
European Guidelines on Breast Cancer Screenin g are/ planned to be implemented shortly in 
almost all Member States. Other measures in clude introducing (LU)  or considering the 
introduction (IE) of vaccination programme against HPV. This is potentially related with the 
implementation of the Council Regulation on cancer  screening, in relati on to which the first 
report was launched. This report identifies di fferences in cancer diagnosis and follow-up 
across Member States and that the EU is only about half-way to  the goal of 125 million 
examinations per year.64  
Chronic diseases are the subj ect of growing awareness in Europe. Characterized by long 
duration and generally slow progr ession, they represent a consid erable burden from societal 
and economical perspective. Europe today has a high prevalence of non-communicable 
diseases such as diabetes, obesity, and osteoporosis65. They can lead to death or long-term 
disability. Chronic diseases ca n be attributable to the interaction of various genetic, 
environmental and especially lifestyle factor s, including smoking, alcohol abuse, unhealthy 
diets and physical inactivity and therefore can be to certain point preventable. Good quality and evidence-based care of patients presenting ch ronic conditions may bring better quality of 
life to the patients and savings  to the healthcare systems. 
Different aspects of chronic diseases manageme nt (often diabetes, kidney failure and heart 
disease) are addressed at the Me mber States level. Clinical pr otocols and guidelines for use in 
primary and specialist care were introduced in Ireland. The French nati onal plan for chronic 
diseases considers as a priority  the introduction of educational programme for chronic patients 
on one side, and foresees a new system of paymen t (other than fee for service) for physicians 
following patients with chronic conditions. Th is new financial mechanism, rewarding 
preventive actions and better care coordination in ambulatory sector, hopes to contribute to 
provision of better quality care. 
                                                
 
63 Franco Sassi and Jeremy Hurst The Prevention of  Lifestyle-Related Chronic Diseases: an Economic 
Framework, OECD Health Working Paper No. 32, 2008. 
64 http://ec.europa.eu/health/ph_information/dissemination/diseases/cancer_en.htm#4   
65 Health-EU. The Public Health Portal of the European Union. 
http://ec.europa.eu/health-eu/health_problems/other_non-communicable_diseases/index_en.htm   
 
EN 134   EN Investing in primary care as a vehicle for di sease prevention and care coordination is also 
proposed by a number of Member States. 
5.3.4.  Patient safety  
The WHO defines patient safety as "freedom fo r a patient from unnecessary harm or potential 
harm associated with healthcare" and the OECD defines it as "the degree to which healthcare processes avoid, prevent and amel iorate adverse outcomes or injuries that stem from the 
processes of healthcare itself"
66, The American Institute of Medicine's definition of patient 
safety is "avoiding injuries to patients from th e care that is intended to help them". It is 
estimated that, in the EU, between 8% and 12% of patients admitted to hospital suffer from adverse effects while receivi ng healthcare, although harm to patients can occur in all 
healthcare settings. The 2005 Eurobarometer survey  on the perception of medical errors in the 
EU
67 showed that over half of Europeans believed  they cannot avoid seri ous medical errors in 
hospitals. 
Although patient safety is narrower in its defini tion than healthcare quality more generally, it 
is a key foundation of any high quality health system. Implementing effective quality and 
patient safety improvements is of interest to  many international orga nisations (e.g. WHO, 
OECD). The European Commission has also taken specific steps in many areas to address the 
issue of patient safety. However, these have focu sed mostly on specific sources of risk such as 
the safety of medicines, medical devices and resistance to antimicrobials. Building on those 
achievements, the Commission is currently preparing an initiative on patient safety which aims to outline an integrated approach, placing patient safety at the core of high quality healthcare systems by bringing together all fact ors that have an impact on the safety of 
patients, including a specific focus on healthcare-associated infections.  
However, in the 2008 NSRs patient safety is re ported as a priority by only a few Member 
States. The efforts towards impr oving patient safety focus on re ducing healthcare associated 
infections (which are among the most frequent  and potentially harmful causes of unintended 
harm) and other avoidable incidents in curative ca re. Member States which invested in patient 
safety strategies set up very ambitious ob jectives (reducing by 50%  the health related 
infections over 2-year period in SE or reduci ng the number of avoidable incidents in curative 
care by 50% within 5 years in NL). Some of th e measures proposed to achieve those goals are 
as follows. The introduction of a reporting system  that obliges the health providers to report 
harm connected to healthcare, albeit within  a blame-free culture of  reporting that makes 
healthcare providers feeling c onfident that they can report without fear of negative 
consequences (SE, UK, IE). Collecting and sharing examples of good practice between the 
health providers is another way of addressing patient safety a nd it was introduced in several 
Member States (NL, FR, UK, IE) to facilitate mutual learning. The introduction of statutory complaints and redress systems and informati on ensures a possibility for patients and their 
families to get compensation for harm. Protected disclosures or "whistleblowing" on issues of 
patient safety proposed, for example, by Irish hea lth authorities, helps to capture the extent, 
type and causes of adverse events. This information also enables efficient use of resources, through developing solutions addressing the problems as evidenced by the reporting. 
Examples provided by the National Reports, alth ough not abundant, are very constructive and 
show the political awareness of patient safety  issues, and the willingness to place patient 
safety as a public health priority. 
                                                
 
66 http://www.oecd.org/dataoecd/1/36/36262363.pdf   
67 http://ec.europa.eu/health/ph_publication/eurobarometers_en.htm   
 
EN 135   EN 5.3.5.  Patient centeredness 
Although there is an overall awar eness of the need to make th e patient the central point of 
healthcare and especially long-term care system s, the level of effort and the measures 
undertaken by Member States to as sure the patient's cen tral role vary across Europe. This is 
partly due to different departing points and par tly due to different systems of delivering care. 
The most common way to address patient cent eredness is defining the patient rights. A 
Charter of Patient Rights, either  already in existence or unde r preparation, is reported as a 
measure being used by most EU countries. For example, CY issued, in 2008, the Charter of 
Citizens' Rights regarding health care in public medical instituti ons and in the NL there is 
ongoing work on establishing seven rights for patients , giving them a central  role in the Dutch 
healthcare system.  
In some systems patient centeredness is addres sed by providing more choice of physician or 
hospital (e.g. DK, EE, UK).  
The National Reports stress also the importanc e of providing information for patients (SE, 
DK, EE, BE, CZ) about quality in care settings, level of patient safety, waiting lists, etc. in a 
form easily accessible for everyone (e.g. webpage s) and that may help patients choose 
between care facilities. An  interesting example of informati on to a specific target group of the 
population is reported by BE where the right to information for foreigners is assured by the 
presence of a mediator and translator.  
Active participation of patients in the decisi on-making process is becoming a reality across 
Europe. Recently reported efforts in this area come from EE (where patients' associations 
actively participate in policy-making) and DK (whi ch encourages participation of patients in 
advisory boards of the legal health insurance).  
Patient's satisfaction with healthcare services is rarely mentioned in the NSRs. Indeed, only a 
few Member States report abou t the satisfaction of patients with healthcare services. Data 
exist in BE and a study is planned for the last quarter of 2008 for hospitalis ed patients in LU.  
Strengthening self-responsibility and self-deter mination of patients is a priority for certain 
Member States (AT, FI). 
Only a few Member States (IE, FR ) underline the role of patients' relatives and carers as being 
part of the policy-making process. 
5.4. Sustainability  
5.4.1.  Introduction 
The sustainability of the hea lthcare system is a complex issu e depending on many factors, but 
especially two: financial sust ainability and a continuous and sustainable flow of workers. 
Regarding the first aspect, as demand for healthcare increases, it is difficult to impose restrictions on financing without jeopardis ing quality and access at the same time. As 
healthcare systems can be financed publicly or privately, it is essential to find the best combination of financial sources in order to solve existing trade- offs in the de sign of incentive 
mechanisms i.e. maximise efficiency gains and minimise the negative impact on the access of those more vulnerable (e.g. lower income and seve rely or chronically ill). Regarding staff, 
societal changes, mainly the ageing of the popul ation and staff migration trends, will have an 
enormous impact on the inflow of workers to the healthcare sector, putting at risk access, 
quality, and long-term sustainabil ity at the same time. Additiona lly, the health status of the 
 
EN 136   EN population, which determines the need for care , can have a significan t impact on expenditure 
and long-term sustainability as s hown in the EC/EPC forecasts.  
Most EU Member States prioritis e highly the health of  their population, as the high level of 
expenditure in healthcare shows.  Nevertheless, there are big di fferences in the amounts spent, 
as it can be seen in Figure 10 above (section 2.1). 
Data from the OECD and the WHO show that h ealth expenditure varies from 11.1% of GDP 
in FR to 5.0% of GDP in EE. DE, BE, PT and AT also spend more than 10% of GDP in the 
health sector, while PL, CY, LT and RO sp end only around or less than 6% of GDP. A 
previous European Commission document68 states that in order to  ensure more equiTable 
access to care, improve the hea lth status of the general population and reduce health 
inequalities in these last countries, it may be  necessary to increased funding – notably public 
funding to the sector, given the structure of e xpenditure in most of these countries (high 
private expenditure). As regards the composition of expenditure, public health expenditure as 
a percentage of total h ealth expenditure ranges from 90.9% in LU to 42.8% in EL. It is more 
than 80% of total expenditure in the CZ, th e UK, DK and SE and less than 70% in PL, RO, 
NL, BG, LV and CY. 
Nevertheless, both public and private expendit ure have increased during the last decades 
throughout the EU, especially in those countries that had a very  low departure level and are 
now catching up in improving the general availability of healthcare services to their citizens 
such as CY, LT, LV or RO. In addition to this catching-up trend, the main drivers of 
expenditure have been the demographic compos ition of the population, where the weight of 
the elderly drives costs up, changes in the he alth status of the population and morbidity 
patterns, the income level of the population, which increases demand for more and better 
services, the rising expectations of  people to receive qual ity care at an affordable price and the 
surge of new medical and pharmac eutical technologies that most people are willing to take 
advantage of. 
The projections of public expenditure on healthca re as % of GDP show a rise from 6.4% of 
GDP in 2004 to 7.9% of GDP in 2050 in the EU -25 (EU-15: from 6.4% of GDP to 8.1% of 
GDP and EU-10: from 4.9% of GDP to 6.2% of GDP). The Commission se rvices have carried 
out an analysis to assess the impact of  medical technology on healthcare expenditure69. In the 
model, aggregate healthcare spending is determ ined both by demographic factors, such as the 
size and the structure of a population, and by non- demographic factors, such as aggregate 
income (GDP), technological factors growth and relative-price movements in the supply of 
health services. As it is not possible to make reliable forecasts of the future developments in the medical technology the docum ent concentrates on an economet ric analysis of the past 
trends, which suggests that between 2% and 3% of  yearly growth in the health care spending 
can be associated with non-demographic and non- income factors. However, given high level 
of uncertainty and strong assumptions underlying the calculations, the results of this exercise 
should be interpreted with cauti on in the future policy debate. 
                                                
 
68 Monitoring progress towards the objectives of the Eu ropean Strategy for Soci al Protection and Social 
Inclusion. Commission Staff Working Document - October 2008. 
69 European Commission, DG ECFIN (2008), Alternative scenarios for assessing the impact of technology 
on health care expenditure projections. Note for the attention of the Ageing Working Group attached to 
the EPC, REP. 56451.  
 
EN 137   EN 5.4.2.  Progress on reforming healthca re financing and provision 
Due to the above mentioned expenditure tr ends, the 2008-2010 NSRs show that most 
countries are adjusting the structure of health financing and delivery in  order to rationalise 
resources, make their systems more effici ent and cost-effective, avoid duplication and 
improve the link between the provision of  health services and their financing. 
However, Member States face a big dile mma between access, quality, and financial 
sustainability. In some Member States, financial sustainability seems assured but either at the 
cost of lower quality of the services or  by not guaranteeing access to everybody. Once the 
intended measures to improve both quality and access are implemented, su stainability is not 
longer certain. In other Member States, measures  intended to improve financial sustainability, 
as for instance, making the system more depe ndent on social contributions or improving the 
incentive mechanisms in order to contain cost s, could jeopardise the access to healthcare 
services of the poorest people. Finally, in anot her group of countries, fi nancial sustainability 
does not appear to be the binding constraint but th e scarcity of human resources. This is a real 
problem, especially in those countries that ar e currently loosing quali fied healthcare personnel 
to countries that may offer bett er working and salary  conditions. The measures presented in 
the reports can be articula ted around the following core lines: reinforcing funding, 
rationalising care provision, containing costs, improving incentive mechanisms, rationalising 
administration and strengthening health promotion policies. 
Reinforcing and improving financing 
In the EU, sustainability problems regarding fundi ng have mainly two different origins; one is 
insufficient financing, the other is  the design of the funding stru cture. In the first case, the 
problem relates to a) non-mature/still develo ping health insurance systems which witness 
constant reforms, and/or b) to the existen ce of relatively high unemployment and extensive 
informal labour markets, which imply that cont ributions are not always  paid and revenues are 
limited. In the second case, the coexistence of  compulsory social health insurance and 
voluntary private health insuranc e combined with a lack of ri sk adjustment mechanisms may 
have the undesirable outcome of a segmented ma rket due to adverse selection effects. This 
can in turn imply an underfinanced social health  fund for the poor together with rich private 
health funds for the well -off part of the population. 
The required solutions are therefore different. M easures to increase funding are taking effect 
in many countries that are improving the co llection mechanisms of health insurance 
contributions (BG), imposing more control ag ainst the avoidance of contributions (HU), 
increasing the health insurance tax base (EE) or earmarking the revenues  from some so-called 
“sin” taxes as tobacco and/or alcohol excise duties (RO, AT). Regarding the lack of risk-
adjustment, DE has carried out an extensive refo rm that will centralise contributions in a new 
National Health Fund. On the basis of a unified  contribution rate, the National Health Fund 
will allocate resources to each of  the other funds based on a risk-adjusted capitation formula, 
which will be adjusted to take account of morbid ity in addition to gender and age. The Social 
Health Insurance and the Private Health Insuran ce systems will be modified so that the first 
will become more competitive, while more soci al elements are introduced in the second. The 
German authorities will evaluate the effects of the new risk adjustment system in due time. In 
AT, there are some measures intended to im prove financing, such as increasing health 
insurance contributions and increasing patien t' co-payments. In HU, health insurance 
coverage was linked to employment and this resulted in an increase in the number of 
 
EN 138   EN contribution payers and in the revenue of the health insurance fund and in a surplus of the 
Health Insurance Fund in 2007. 
Making healthcare provision more rational 
A group of countries are restructuring the provisi on of healthcare services in order to make a 
more rational use of public resources by avoidi ng waste, duplication or expensive treatments 
in expensive facilities when it is possible to offer effective, high quality care using less 
money. The main idea is to develop and reinfo rce primary healthcare and the role of the 
general practitioner (GP)/ family  doctor as a gatekeeper, channe lling resources from inpatient 
to outpatient care, concentrati ng some hospital care in a smaller number of hospitals and 
modulating rehabilitation and nursing  care in case of chronic illness. 
Therefore, EE, IE, GR, FR, LV, HU, AT, PT, RO, SE, UK are reinfo rcing primary care by 
developing the GP or family physician sy stem, by reorganising existing professional 
resources and by introducing financ ial incentives to increase and strengthen the use of a GP as 
a gatekeeper and avoid the exces sive use of specialists. As a novelty, in IE there is active 
community involvement in the planning and the delivery of primary care services. 
Cost-effectiveness is thus achieved by reinforci ng the patient routing (i.e. ensuring preferred 
and cost-effective paths of care) and restructurin g outpatient and inpatien t healthcare services 
in order to increase the share of  outpatient care and channelling se rvices from inpatient care to 
ambulatory, outpatient and home care. This make s possible a concentration of the specialised 
care and the optimisation of th e work of inpatient care institutions, strengthening the 
efficiency of inpatient treatment and containing costs. 
Finally, the management of chronic diseases wi ll be improved through a reorientation of care 
towards primary and prevention care and self-care and coordinating these efforts with those of 
the specialists. 
Containing costs 
In some countries health expendi ture has risen in GDP terms more  than the aver age in the EU, 
so they are taking measures in order to contain costs. Several Member States argue (EL, ES, LV, LU, AT, FI) that one of the reasons behind th e growth in expenditure is the extended use 
of pharmaceuticals or their increasing price. To contain pharmaceutical  expenditure growth 
they are implementing a wide array of solutions  to curb overuse and control prices including 
more rational methods of prescr iption, better purchasing policie s in hospitals (such as better 
negotiations i.e. licensing deals with the pha rmaceutical companies), a better administration 
and more efficient use of medicines in hospitals  and extending the use of generics (see Box on 
pharmaceutical expenditure in the EU). 
Some measures improve the mechanisms of pa y m e n t s  a s  i n  B G ,  E E  o r  L T .  I n  E E ,  f o r  
instance, the control and optimis ation of health insu rance costs will be done via cost-based 
prices and diagnostics-related group prices Other measures ar e: more rational criteria for 
purchasing management (ES, LU, LV and MT),  making costs more transparent (NL) or 
stronger incentives (e.g. performance based cont racts) for providers to deliver high quality 
care whilst controlling costs (MT and UK). Co st control at macro level by the use of 
expenditure ceilings has been implemented in some countries, more or less successfully. In 
 
EN 139   EN BE financial resources not used in the corre sponding budget will be allocated to a "Fund for 
the future of healthcare", whose purpose is to constitute reserves that can be used when the 
ageing of the population will require greater gr owth of the budget of mandatory healthcare 
insurance. 
Pharmaceutical expenditures in the EU 
Spending on pharmaceuticals has risen rapidly across most OECD countries, consuming an 
increasing share of overall health expenditure. Since 1995, growth in pharmaceutical spending 
has averaged around 4.6% per year, compared w ith the 4.0% annual ri se in total health 
spending, to account for around 17% of h ealth spending or 1.5% of GDP by 2006. 70  
In 2007, the total size of the pharmaceutical market in the EU was € 214 billion at retail price 
level.71 On ex-factory price level this corresponded to € 138 b illion, of which 88% was for 
medicines that required a prescription from a medical doctor. The remaining part of the 
market was non-prescription medicines, which usually can be bought freely over the counter 
by the consumers. For the medicines sold vi a pharmacies in the EU , public funding (tax-
financed or by compulsory health insurance) cover on average 82% of the prices, and patients 
have to pay some 18% themselves.72 This ratio varies between 60% / 40% and 99% / 1% in 
the EU Member States. On the demand side, the pharmaceutical sector is unusual in that for 
prescription medicines the ultimate consumer (t he patient) is not th e decision maker, but 
generally it is the prescribing doctor and in certain Member States the pharmacist. Nor does 
the ultimate consumer usually di rectly bear the costs, as these are generally paid for by a 
public health scheme. Because of this uniqu e structure, there is usually limited price 
sensitivity on the part of decision makers and patients.73  
Given the limited public financial resources av ailable for healthcare  and the constantly 
increasing expenditures, it is hi ghly important for the Member States to continuously optimise 
the use of different pharmaceuticals and achieve the best value possible for the money spent. 
In doing so Member States can apply a range of various strategies, for instance: regulation of 
prices, reimbursement conditions for prescripti on medicines, optimise the use of generic 
products that replace more expensive original medicines. These issues were addressed by 
Member States, EFTA, members of the European  Parliament, various stakeholders and the 
European Commission in the Pharmaceutical Forum74. 
The actual market conditions for, and effects of , the entry of generic medicine products into 
EU markets are currently being studied by the Eu ropean Commission with a sector inquiry. In 
markets where generic medicines become availabl e, average savings to the health system (as 
measured by the development of a weighted pr ice index of originator  and generic products) 
are almost 20% one year after the first gene ric entry, and about 25% after two years (EU 
average). Generic companies began selling generic medicines, on average, 25% lower than 
the price of the originator medi cines. Two years after entry, ge neric medicine prices were on 
                                                 
70 Introductory Presentation: Some key features of growth and cross-country differences in health-care 
spending, at the conference Improving Health-syste m efficiency - achieving better value for money,  
jointly organised by the European Commission and the OECD 17 Sept. 2008 
http://ec.europa.eu/social/main.jsp?catId=88& langId=en&eventsId=106&furtherEvents=yes   
71 Pharmaceutical Sector Inquiry,  Preliminary report (28 Nov. 2008), European Commission, DG 
Competition http://ec.europa.eu/competition/sector s/pharmaceuticals/inquiry/index.html   
72 The pharmaceutical indust ry in figures 2008, European Federa tion of Pharmaceutical Industries and 
Associations http://www.efpia.org/conten t/default.asp?PageID=322   
73 Pharmaceutical Sector Inquir y, Preliminary report, Europe an Commission, DG Competition. 
74 The Pharmaceutical Forum: http://ec.europa.eu/pharmaforum/   
 
EN 140   EN average 40% below the former originator price. The inquiry  points to considerable 
differences, however, in the entry of generics in various EU Member States and in the effects. 
However, a generic alternative product can usua lly only enter the market  20-25 years after the 
first introduction of a new, patenTable original  medicine. Thus, Member States apply a range 
of policy measures to optimise the use of and expenditures for prescription medicines. 
Pharmaceutical policies are expected to attain multiple goals that reflect different 
perspectives. So, market interventions, such  as regulating prices  and reimbursement 
conditions for pharmaceuticals, aim to limit dyna mic expenditure increases while ensuring 
affordable access to medicines, and maintain ing the incentive for pharmaceutical companies 
to continue with research and deve lopment on new, useful medicines. 
In the National Strategy Reports  2008-2010 several member States report on actions that have 
been carried out to either increase citi zens access to pharmaceuticals (e.g. BG), make 
prescription medicines more affordable to the patients (BE, DE) and/or limit the increases in 
public expenditures for pharmaceuticals (AT). Some  Member States also report on planned 
actions (e.g. FI). The improved affordability for patients is often achieved by ensuring that the 
co-payment amounts do not grow too fast. For instance, BE states that various policies 
enacted to reduce the cost of  medicines have reduced the average cost (all medicines 
prescribed for ambulatory care) for the patient by 8% from 2003 to 2007. To achieve this BE 
apply a whole range of measures with both de tailed expenditure budgeting, use of generic 
alternatives and regular decreases in the pri ce of medicines older than 12 years. However, 
there are also Member States that introduce (or increase) the patients' co-payment share trying 
to reduce the consumption of pharmaceuticals (e.g. CZ). Such measures typically also include 
maximum co-payment limits to ensure that more vulnerable groups can still access the 
medicines needed (e.g. SI). 
A peer review to exchange pr actical experiences and ideas ab out pricing and reimbursement 
of pharmaceuticals was held in Berlin mid 2008.75 The peer review c oncluded that it is 
essential to promote the transparency of the pharmaceutical markets in the EU, especially on 
the efficacy and safety of the products, the pric es actually paid by consumers and insurers, as 
well an on the price-setting, reimbursing and other regulatory mechanisms for 
pharmaceuticals. Future work within the OMC c ould aim to contribute significantly to the 
needed transparency. 
Improving incentive mechanisms for patients 
Some countries can contain co sts by reducing the overuse of  resources caused by a wrong 
mechanism design. This is done by implementing policies to motivate people to use healthcare services in a more  responsibly manner as in CZ , where the introduction of 
regulatory fees is giving good fi nancial results – after the intr oduction of the fees, the number 
of specialist outpatients visits , the length of hosp italisation and the use of pharmaceuticals 
were reduced – or in FR where the financial participation of patients in the form of co-
payments was augmented in order to moderate  demand. More innovative  is the coordination 
of care, in order to avoid duplication, and the in troduction of a financial incentive to increase 
the use of a GP as a gatekeeper. In case the pa tient does not use the GP and goes directly to 
the specialist, the patient will face reductions in the amount paid  by the social insurance and 
the specialist would be allowed to surpass the established tariffs. ES will establish 
mechanisms to promote responsible demand. 
                                                
 
75 See http://www.peer-review-social-inclusion.eu/pe er-reviews/2008/cost-containment-in-the-
pharmaceutical-sector-innovative-app roaches-to-contracting-while-e nsuring-fair-access-to-drugs   
 
EN 141   EN Rationalising bureaucracy 
To render the system more cost-effective, anothe r type of measures ai ms at rationalising and 
simplifying bureaucracy. Thus in BE, DK, SE a nd FI there are administrative simplification 
policies, which intend to identify and eliminate needless bureaucracy in order to get more time to core activities. Many countries like BE, EL, ES, FR, LV, LT, MT and AT, are 
developing e-Health systems to integrate information files about  patients, organize medicine 
prescriptions, ensure a quicker examination of  patients and assessment of the results, optimise 
therapeutic processes and increase quality, and avoid duplication. 
Health promotion policies 
Many countries have recognised in their policies that better prom otion will help to trim costs 
down in the future by reducing the need for h ealthcare services. Health promotion in early 
ages can result in a better health status later in life, requiring thus fewer resources from the 
healthcare system. Therefore, CZ, DK, DE, ES, LV, LU, MT, NL, AT, SE, and the UK will intensify the promotion of healthy lifestyles re garding better eating an d exercise habits to 
improve the general health of  the population. With the same  objective, DE, EE, LV, LU, HU 
and the UK will pay particular attention to he alth promotion of children and young people and 
to the promotion of better food at schools and child care institutions.  
Furthermore, EE, NL, AT, RO, SE, and the UK will implement policies aimed at reducing the 
consumption of addictive substances, tobacco  and alcohol, accompanied in some cases (AT 
and RO) by financial disincentives in the form of excise duties that will be assigned to health 
expenditure or (NL) by encouraging health insu rance funds to promote healthy behaviour and 
reward it. Even if it may sometimes seem an exaggerated intervention of public policies in individual decisions, in genera l it is considered that prev ention policies regarding smoking, 
alcohol and obesity are neede d, as these lifestyle risks ar e increasing the number of the 
chronically ill. In the last y ears, many countries, as BE, DK, ES and the UK, have banned 
smoking from public spaces. Moreover, policies intended to raise awareness concerning the 
prevention of some specific diseases such as diabetes, obesity, cardiovascular diseases and 
several types of cancer are being implemented  in CZ, DK, EE, IE, HU, NL and SE. DK has 
decidedly set up a Prevention Commission, which w ill study the possibil ities of reducing the 
need for healthcare services in the future. Ther e are also some country-s pecific policies: LU’s 
Action Plan will promote health in the area of  sexual education, EE will improve the physical 
and psychosocial environment and the UK will implement a health improvement policy aimed to support people to make health ier lifestyle choices, particular ly children and young people, 
adults of working age and those who are so cially excluded or are "hard to reach". 
Long-term sustainability of human resources 
Over the next 20 years, the EU will face a seri ous challenge in the availability of human 
resources in the healthcare sector. This also  casts doubts on its long-te rm sustainability. One 
reason for this development is to be found in  the ageing of the population. This implies not 
only an increase in the needs for care in general, but also an increase in the age profile of the 
health workforce. A second re ason is the underinvestment in education and training of 
professionals, which was seen in the late 80s an d early 90s in some countries. The insufficient 
training of professionals was due to restrictio ns in the access to training in healthcare 
professions (numerus clausus). This trend is  now reversed, but will not have any immediate 
effect. It shows both the difficulty of long-term  planning the availabili ty of human resources 
 
EN 142   EN and the existence of trade-offs between fina ncing more training and lacking doctors and 
healthcare workers. In other count ries, even if training and edu cation has been sufficient, the 
emigration of trained personnel has led to a seri ous drain of human resources. The healthcare 
sector in some countries also faces the dilemma that it needs people with high qualifications, but neither wages nor working conditions are esp ecially attractive compared to other sectors. 
Keeping the wages of health workers low is also  used to contain expenditure growth, so in 
some countries working conditions in the health  professions do not motiv ate health workers to 
stay in the sector, but rather pr ovoke an exodus to other sectors. 
Figure 14: Medical and nursing graduates,  practising physicians and nurses, 2006 
Practising physicians and nurses, density per 1000 persons, 
2006
02468 1 0 1 2 1 4 1 6 1 8Austria
Belgium
Czech Republic
Denmark
Finland
France
Germany
Greece
Hungary
Ireland
Italy
Luxembourg
Netherlands
Poland
Portugal
Slovak Republic
Spain
Sw eden
United Kingdom
Practising physicians Practising nursesMedical and nursing graduates per 1 000 practising physicians 
and nurses, 2006
0 2 04 06 08 0 1 0 0Austria
Belgium
Czech Republic
Denmark
Finland
France
Germany
Greece
Hungary
Ireland
Italy
Luxembourg
Netherlands
Poland
Portugal
Slovak Republic
Spain
Sw eden
United Kingdom
Medical graduates Nursing graduates 
Source: OECD, Health data 2008 . 
Hence, policies regarding human resources are articulated around a) granting more financial 
resources to the training of qua lified doctors and nurses, b) or ganising work more efficiently, 
c) restructuring care between pr imary, outpatient, inpatient and long-term care, d) improving 
the structure of incentive mechanisms in order to  motivate the health work force to stay in or 
to return to the profession a nd e) smoothing regional differences  in the allocation of human 
resources. 
CZ, IE, HU, MT, NL, FI, and the UK are granting more financial resources to the training of 
qualified doctors and nurses, im proving the systems of training and re-training (including on-
the-job training) and increasing the infl ux of new personnel focusing on young people, non-
natives and people with low qualifications. The Eu ropean Social Fund interventions in this 
field are targeted at developing human resources  for the health sector (CZ, EL, LT, LV, PT, 
PL, HU, SK). 
In DK, NL, SE and FI the main long-term ch allenge is to attract sufficient and qualified 
labour, so efforts aim at ensuring efficient wo rk organisation and avoid needless bureaucracy 
to devote staff time mostly to  core activities. Th ey are making efforts to raise productivity 
introducing modern techniques, us ing IT more effectively and developing new care concepts, 
 
EN 143   EN dropping inefficient and outdated administrative routines and thus reducing waiting times and 
costs. Also in order to attain a more effec tive utilisation of health care personnel, EE and SE 
are restructuring their systems by reinforc ing primary care, making hospital care more 
efficient, e.g. by concentrating highly specia lised care at national level, and modulating 
rehabilitation and nursing care in case of chronic illness.  
Regarding incentive mechanisms, IE, ES, LT, HU,  MT, NL and FI are all trying to improve 
the working and professional de velopment conditions of health workers through a broad range 
of measures in order to restore the prestige of the professions and to get them to remain in or 
return to the profession. These measures involve the development of new systems for 
attaining and recognising qualifi cations in medical care (CZ and MT), better career prospects 
and on-the-job training that o ffer opportunities for learning and personal improvement, more 
competitive payroll systems and new salary conditions for young doctors, more decision capacity in developing the cont ent of work, management system s and the assignment of duties 
and last but not least offering the personnel more flexibility in general and, in particular, more 
flexible working hours. 
Finally, some countries (BE, BG, FR, RO) show strong regional differences in the allocation 
of human resources and are trying to implem ent plans that will motivate young professionals 
to go to less attractive regions. Others, like  LV and LT, face the challenge of emigration 
through a better planning of human resources. 
5.5. Long-term care services 
5.5.1.  Introduction 
Long-term care is often defined as  a variety of health and soci al services provided for an 
ongoing or extended period to indi viduals who need assistance on a continuing basis due to 
physical or mental disability
76. The definition of long-term care, the services and benefits 
provided and the population coverage vary between Member States.  
Member States have continued in their quest for modernising social protection systems, 
particularly in light of ageing and the c oncerns over expanding expenditure. The growing 
demand for long-term care continues repres enting a major policy challenge for many 
countries as current supply is c onsidered to be insufficient and inadequate to meet current and 
future long-term care needs. Recognition that  there is no comprehensive system for the 
provision of long-term services in the EU is couple d with a firm commitment on the part of 
EU countries to ensure universal access to high quality and affordable long-term care.  
2008 saw an impetus in the attempts to address the expanding long-term care needs of the 
population. The majority of Member States ack nowledged that policy actions were necessary 
in order to secure adequate a nd sustainable funding structures fo r current and future long-term 
care (LTC) provision, particularly in light of demographic ageing and its consequences. The 
work carried out in cooperation with the Soci al Protection Committee within the framework 
of the social OMC resulted in the publica tion of a European Report on LTC in April 200877. 
Following the submission of the 2006 nationa l reports, the 2007 and 2008 Joint Reports on 
Social Protection and Social Inclusion identified several challenges that were assessed in the 
                                                 
76 OECD Observer 2007, Long-ter m care: a complex challenge. 
77 See http://ec.europa.eu/employment_social/spsi/docs/social_protection/ltc_final_2504_en.pdf   
 
EN 144   EN European Report. The 2008-2010 national reports  are examined in relation to those 
challenges, focusing on four specific themes and stressing the progress si nce the last reporting 
round: the search for financial sustainability, care coordination practices, high level of quality 
in LTC services and the LTC workforce. 
5.5.2.  The search for financ ial sustainability  
Long-term care funding and expenditure varies ac ross the EU as shown in Figure 15, with an 
upward resource-alloca tion trend over time. 
Figure 15: Long-term care expendit ure as percentage of GDP, 2003-
2005
Long-term care expenditure as % of GDP
00,250,50,7511,251,51,752
be Belgium
bg Bulgaria
cz Czech Republic
dk Denmark
de Germany 
ee Estonia es Spain
fr France
cy Cyprus
lt Lithuania
lu Luxembourg
nl Netherlands
pl Poland
pt Portugal ro Romania si Slovenia2003
2004
2005
 
Source: Eurostat Health expenditure data 
Several Member States are concerned by the n eed to create a solid financing basis for long-
term care and ensure the availa bility of devoted resources. So me established or are in the 
process of establishing dedicated universal soci al insurance schemes (DE, LU, NL, SI). Due 
to the important increase in expenditure sp ent through the LTC insurance and concerned by 
the future funding of the system, the NL are plan ning a reform that woul d reduce/ redefine the 
entitlements of the LTC insuranc e scheme and thus address the observed increase in spending 
and duplication with other policy fields such as social support and domestic care. Though 
improving financial sustainability, there are reports  that local authorities may initially struggle 
with the role of buyers of services. Others address LTC via general taxation (AT, SE) or 
within a more restrictive social assist ance framework, defining access and allocating 
resources through means or dependency testing (UK, CY, HU). Other c ountries intend to or 
have implemented a combination of healthcare  insurance elements with tax funded social 
assistance mechanisms such as social care (FR). 
Most Member States are concerned by the expe cted increases in demand for LTC services. 
Some intend to foster, via an increase in prov ision, the services provided (AT, FR, LT, BE, 
HU, DE) reinforcing the capacity of their sy stems to address the resulting multiplicity of 
health and social care needs. Others, wish  to expand the range of provision through the 
 
EN 145   EN establishment of new and amelioration/adaptati on of existing services, responding to patients 
needs and reflecting their preferences in term s of locus of care (SK,  LV, BG, MT, PT, LT, 
DE).  
Independent of a country's public financial arra ngements, private direct payments play an 
important role, with a differentiated impact  on the devised system s' accessibility. Some 
countries envisage including the assets of depe ndent and elderly people in the calculation and 
aggregation of financial benefits with a targ eting for vulnerable groups (FR, LT, SK). The 
2008 National Reports point to a potential mix of public, privat e and third-sector provision 
(CY, EL). Private sources of finance refer to pr ivate health insurance coverage of LTC (often 
supplementary or for high income groups) and to private household payments (either co-
payments for publicly provided car e, and/or out-of-pocket payments for which very little or 
no reimbursement is offered). 
High private costs impose a major financial burd en on users and their relatives and act as a 
barrier to access, particularly for low-in come groups, with private payments having a 
significantly regressive e ffect. Some countries ha ve recourse to privat e health insurance in 
order to address the regressive incidence, w ith the introduction of s upplementary insurance 
(FR). Policies to reduce the individual direct  costs of care include amongst others: co-
payment exemptions, means-tested co-payment s capping (FR); extra financial aid/welfare 
benefits granted to the elderly dependent, disabl ed and chronically ill (FR); state coverage of 
LTC for low-income groups in a social assist ance framework (FR, NL, CY, BE, HU, DE, SK, 
LV, RO); nationwide standardisat ion of copayments; state subsid ies to use private services 
and coordination between the different benefi ts provided through the social welfare budget 
and the healthcare budget (FR, FI, DE). 
Since demographic developments point to in creasing longevity of the population, a serious 
challenge, or opportunity, in terms of public health  is the prevention of ill-health in old age, 
i.e. delaying the onset of disability or dependence. Successful health promotion and disease prevention programmes can delay the onset of dependency/disability and could result in 
financial savings, which is a major concern for c ountries that aim to limit or curb long-term 
care expenditures (DK). Equally important is  the degree of care coordination between 
different contingency-based soci al benefits, which can help in avoiding the duplication of 
support and care services provision, leading to a more rational us e and allocation of resources. 
5.5.3.  Care Coordination and integrated  long-term care provision  
Several Member States emphasise  their strategies to addre ss often new and (re)emerging 
health threats such as chronic conditions (LT) and me ntal illnesses, with  national action plans 
aimed at holistically addressing the needs of mentally affected patients (AT, BE, LV, LT, HU, 
BG, PT, MT). Equally related to  the ageing of the population is the emerging health threat and 
necessity to address a growing number of pati ents affected by Alzheimer's disease, with 
countries proposing national plans (FR, AT, SK).  Some countries focused on the provision of 
integrated geriatric and palliative care (LT,  LU). Many Member States wish to promote 
rehabilitative care (PT, BE, CZ, EL, FI, FR, DE, LT) with a view to rest oring patients' skills 
so that they regain maximum self-sufficiency in order to function in a normal or as near a normal manner as possible, also aimed at allo wing, where possible, the patients' reintegration 
within the labour market (BE, DE). 
Several countries have made significant st eps towards increasing the public spending 
dedicated to home and/or community care (LV, CZ, HU, MT, DE) and develop homecare 
 
EN 146   EN provision for particular target groups such as the elderly (LT, BG), patients affected by 
Alzheimer's disease (DE) and/or disabled pe rsons (BG). Countries ar e firmly focused on 
enhancing tailored home and community care se rvices (LT, HU) and moving away from 
institutional care, whilst allowi ng and/or securing institutional care access if alternatives are 
unsuiTable or unavailable (BE, FR, LV, HU, BG, DE, RO). Information and communication 
technology can enable better self-management of  chronic conditions and can support carers in 
their role (DK). The provision of home car e services in conjunc tion with enhanced 
information and communication technology depends  on resource availab ility (SK, LV) and 
the degree to which long-term care is pr ovided in an integrated framework.  
The uniform and tailored provision of long-term  care services depends on the organisational 
features of each system and on the degree of  coordination between the different services 
operating within these systems. Care coordination is mainly aimed at enabling a high level of 
quality and efficient use of resources in the prov ision of LTC services in an institutional or 
community setting (FR, DE); ensuring an adequate continuum of care irrespective of the different levels of long-term care provisi on and organisation (B E); and promoting a 
sustainable funding base streamlining the various  related social benefits such as health 
insurance and social assistance benefits (FR, FI). Care coor dination policies, particularly 
between different associated budgets, can help  addressing differentiated provision modes and 
result in a more integrated financing struct ure clarifying entitlement  rules for dependent 
persons and addressing the sustainability a nd adequacy of the provided social benefits. 
Equally important is the demar cated address of different c ontingencies that can become 
mutually reinforcing (disability, dependency and old-age).  
Coordination problems in the interface between medical care, social services and informal 
care can result in negative outcomes for users and inefficient use of resources, with 
duplication of care provision or of  financial and in-kind benefit provision. In some instances, 
care professionals, or dedicated teams are resp onsible for ensuring that patients can follow a 
coherent path of care with the appropriate trea tment provided in the ap propriate setting, with 
an integration of the various so cial benefits or insurance co verage (BE, DE, FR, FI). Long-
term care is often associated with the notion of a 'care continuum' and an integrated care 
provision including elements of other public health policies su ch as preventive measures, 
active ageing, autonomy promotion and empowe rment, social assistance, healthcare and 
palliative care. The care continuum approach is  aimed towards the coordinated provision of a 
range of services (particularly homecare) on one hand and the bettered management of the 
transitions between services and settings. Seve ral Member States encourage care coordination 
practices and integrated long-term car e provision (FR, DE, MT, NL, and FI). 
The uniform allocation of resources across ad ministrative levels and loci of care can be 
sought on dependency profiles for example (BE, HU, NL). Since long-term care is usually 
provided in a devolved contex t and run by sub-national leve ls of government, national 
standards can ensure uniform provision and financ ing for all the regions of the country (ES, 
SE, UK, BG). Another mechanism relie s on framework cont racts and binding 
recommendations between long-term care insure rs and providers (DE). The alignment of 
long-term care funding between health and so cial care components (HU, FR, BE) are also 
aimed at a care continuum pr ovision. When resources are l acking, in addition to the 
integration between health and social care budge ts, several countries are engaging with the 
private and voluntary sectors of  the economy (HU, LV, LT, EL, CY). The integration of long-
term care delivery involves creating single entr y points or local assessment teams (NL, PT, 
UK, DK, DE) on one hand and the devolution of l ong-term care services at sub-national level 
(ES, PT, SE, UK), for a bettered manageme nt, on the other. Several countries are 
 
EN 147   EN encountering financial complications as the sought decentralisation in the provision of 
services is not backed by a solid funding ba sis for the local, devolved or decentralised 
responsible level (LT, SK, BG, RO). 
5.5.4.  High level of quality in l ong-term care services 
The quality of long-term care se rvices for dependent persons va ries widely both between and 
within countries. Many Member States have introduced or improved regulation and 
legislation for assessing and enhancing the quality of long-term care services. The 
increasingly pervasive and all- encompassing nature of long-term  care services renders quality 
definition and measurement a comp lex task. Indicators of the quali ty of care are used in some 
countries to assess and evaluate the quality of the se rvices provided in both institutional and 
community settings (BE). Quality  regulations for l ong-term care are evol ving from basic or 
minimum requirements for the structure and process of care into more comprehensive and complex quality assurance mechanisms comb ining procedural, stru ctural and outcome 
oriented indicators such as continuous sta ff training requirements (BE, LT) coupled with 
patient rights mechanisms allowing greater pa tient participation and consultation (DK, HU, 
and MT). Inevitably, they refer to formal l ong-term care services rather than informal 
provision, which is much more difficult to measure and evaluate.  
For some countries with devolved responsibil ity for LTC provision at  municipal or local 
level, quality in LTC services is mainly assessed through formal regulatory and licensing 
mechanisms, determining the scope and accredita tion processes of the services provided (SK, 
LT, DE, RO). Others focus on the establishmen t of national quality st andards (CZ, ES, HU, 
LT, MT, RO) throughout the concer ned territories. The use of out come indicators for quality 
monitoring still remains in its infancy and diffe rent modes of quality assurance coexist such 
as internal (DE) or external quality assura nce mechanisms and national inspectorates (FR, 
UK) with varying sanctioning capacities. Accessi bility of internal and external auditing 
results to service users and the general public also has been taken up as an important measure of quality control (DE). Quality of care and its evaluation are increasingly viewed as encompassing other important factors such as the support given to family caregivers (DE), 
increasing consumer choice through the promoti on of consumer-directed care (BE), ensuring 
the capacity of the long-term care workforce an d assistive technologies. Examples of poor or 
inadequate care quality in both institutional a nd community settings include: inadequate 
housing (nursing homes), lack of privacy, poor so cial relationships an d use of restraints, 
amongst others. One basic requirement for quality assurance, of particul ar relevance to long-
term care, is also the active deterrence of patient maltreatment or abuse (SK, LT, RO), 
particularly in the institutional setting.  
5.5.5.  Workforce shortages 
Most countries have expressed concerns with re gard to expected sta ff shortages in the LTC 
sector (LT, SK, LV, NL, DK). The availability of carers a nd their competence and skill 
specialisation are inseparable concerns (SI). LTC  needs have traditionally been met within the 
private sphere or the extended network of fam ilies. In a home or community care setting, the 
problem of insufficient and inadequately trained caregivers is more difficult to tackle than in 
institutional settings, even if formal home or community care te nds to be cheaper than acute 
institutional care. The support of  relatives (as care providers) and volunteers is and will 
remain an indispensable part of LTC provision. It is important to ensure that family or 
informal caregivers receive adequate traini ng, guidance and support (DE, LV, RO). Supply 
 
EN 148   EN shortages in the homecare sector cannot be viewed  in isolation, but are related to the labour 
situation in other care settings.  
Recognition that the bulk of long-term care is pr ovided within informal settings has prompted 
national concerns re garding the availability and role of informal carers. While informal home 
care is not included in cost calc ulations, the lack of support of informal carers does not entail 
that it is a budget-neutral option for society. Informal carers are often relied upon heavily 
without necessarily receiving compensation, whilst foregoing employment. The expected increase in the demand for LTC services transl ates into an expected increase in demand for 
formal LTC services since the number of working age women able to provide informal care will decrease at a time when the number of elderly dependent people is increasing; the 
increased labour market particip ation of women means less time at  their disposal to devote to 
providing care and the changing family structures such as smaller families and an increase in the prevalence of single-parent families, mean that family members are further apart and less able to care for dependent family memb ers in an informal, unsupported setting.  
In both the institutional and home care settings, the main concern is recruiting and retaining 
an adequately qualified and skilled workforce. In  an institutional setting, developments in 
medical and assistive technologies necessita te an upgrading of workforce skills and 
qualifications as well as measures to ensure th eir retention in the LTC sector, with reports of 
difficult working conditions and low pay levels  (EL, DK). The earmar king of specific funds 
to upgrade working conditions and training (DK) is  all the more difficult in light of existing 
budgetary constraints and several countries inte nd complementing the devoted resources with 
Structural Fund support (BG). The increased re course to cost-sharing mechanisms coupled 
with limited financial resources dedicated to LTC and coordination problems between 
competing budgets, inevitably limit the possibi lities for upgrading working conditions and 
raising pay for the staff forma lly employed in the sector.  
Several measures are proposed in  order to support informal car ers. These measures depend in 
turn, on the organisational, administrative and funding mechanisms prevalent in each country. 
A overview of measures can be found in the fo llowing list: in-kind benefits (DE); financial 
benefits such as care allowances dedicated to  paying the informal car ers (HU, BG, AT, DE, 
RO) and to provide some additional financia l support to the person in need (FR), amongst 
others; respite care services to allow time-off and maintenance of empl oyment activities for 
informal carers (UK, MT, AT, DE); counselling and training services (MT, DE) and informal 
carers' needs-assessment and social security inclusion and formalisation measures for the 
informal carers (BG, DE). 
5.6. Conclusions 
As mentioned, the 2008-2010 NSRs build on the previous 2006 NSRs and national health, 
inclusion and/or social protection plans. They te nd to focus on some more specific topics that 
are seen as priorities or on the most recent pol icies. The fact that reforms often require the 
approval and implementation of legislation, wh ich are often lengthy processes, may partly 
explain the similarities between  the 2006 and the 2008 NSRs. As in the 2007 Joint Report, the 
2008 NSRs show the strong interlinks betw een improving access, enhancing quality and 
ensuring sustainability in a number of policies.  Moreover, all Member States recognise that 
social protection including healthcare can have  a significant impact in improving health and 
reducing poverty.  
In assessing the 2008-2010 NSRs a num ber of issues can be raised. 
 
EN 149   EN While important efforts have been made to ensure  universal care coverage , some gaps can still 
be identified in a number of Member States. In  some countries privat e expenditure (direct 
payments for care) is large and in all countries  some types of care (dental, aural, ophthalmic, 
residential care) are not covered by the public basket of health or social  care. In addition, 
large differences in the availability and quality  of healthcare and long-term care services can 
be observed. This suggests that barriers to  access still remain that need addressing. 
As said, for all countries primary care is s een as the way forward to address geographic 
disparities and improve access, as a vehicle fo r promotion and prevention, as the basis for 
better care coordination, and as a means to ensure a rational use of resources in the sector and 
obtain greater value for money. However, in ma ny countries the shortages in GPs/ primary 
care doctors are structural i.e. they have been  going on for a long time and appear to continue. 
Ageing may render them even more acute. Theref ore, it is difficult to  see how the ambition 
expressed in the reports of having primary car e close to residence of all individuals and 
reducing regional disparities may be met without a proper primary care policy that 
encompasses more training and motivation of GP s (competences and remuneration related to 
additional competences on health promotion, dis ease prevention and care coordination and if 
are to go to deprived areas). Additionally, there is a widespr ead consensus of the need to 
address the expected workforce s hortages in the long-term care se ctor (formal care) as well as 
devising ways to support family or informal carers. Adequately recr uiting, (re)training, and 
retaining long-term care workers remains a cha llenge. Again, measures  proposed relate to 
training and motivation (higher wages and better working conditions), a nd the formalisation, 
where possible, of informal carers into social security schemes. The looming/ current staff 
shortages may remain a challenge for years to come as even training (which is proposed by 
some countries in their attempt to address th e ageing consequences on healthcare staff) 
requires time to bear fruit. Finally, several count ries are currently advertising for doctors and 
nursing staff in nearby countries while some ar e experiencing massive brain-drain of care 
staff. This suggests that more responsibility is needed in recruiting staff and that there may be 
place for improved exchange of information and coordination between Member States regarding staff policies.  
Another issue is technology and more specifically e-health. Vi rtually all countries propose a 
package of e-health measures to  improve access, quality and su stainability. While this may be 
the case, they require importa nt sums of investment (informatisation of the system, e-
prescription, e-booking) and, im portantly, they require that technology is compatible across 
all facilities in the sector, if  technology is to bring about be tter care coordination. Moreover, 
despite claims that technology may improve acce ss, some of the measures (internet-based 
measures) may actually create a gap, as those more  vulnerable are also like ly to be those more 
computer illiterate or have fewer me ans to access computers and internet. 
The 2008-2010 NSRs show a growing awareness of  the need to ensure  healthcare and long-
term care quality and present different initiat ives aimed at providing their citizens with good 
quality and safe preventive and curative heal thcare as well as long- term care services. 
However, quality is being addressed to vary ing degrees from one country to another. The 
2008 NSRs reflect the lack of consensus across Europe about the definition and perimeter of 
quality of care. While investing in health pr omotion, disease prevention and primary care does 
not appeared to be controversial and Member St ates continue developi ng related strategies – 
though some more successfully than others gi ven their available re sources, existing care 
delivery structures and primary care attractiven ess in each country –, huge disparities are 
observed regarding patient centeredness and patient safety.  
 
EN 150   EN While patient centeredness is often declared as an important issue, only a few concrete 
examples of action are provided. Some Member Stat es are advanced in their efforts to ensure 
that the patient act as an actor in their healthcar e systems, in others aw areness of the issue is 
growing, and others are still at the beginning of their reflection process in this area. Patient 
safety is addressed in a very advanced way in  several reports, but not even mentioned in 
others. Some of these disparities may be e xplained by the limited resources allocated to 
healthcare in some Member States and the need to address other more urgent issues. Patient 
safety strategies, for example, require a cons iderable initial investment, with long-term 
expected results. Member States may therefor e choose allocating thei r limited resources to 
other areas of healthcare which are supposed to bring immediate improvement of health 
indicators of the population (f or example the emergency care system). Hence, enhancing 
quality of care and notably pati ent safety remains a significant challenge for healthcare, while 
quality of facilities, ca re coordination and the need for qualif ied carers are important issues in 
the context of long-term care. Growing interest  is placed on prevention and management of 
chronic diseases, which are addressed through targeted health promotion actions, clinical 
guidelines and financial encouragement of docto rs to provide better quality care for patients 
presenting chronic conditions. Fina lly, a number of indicators exis t and are used with regard 
to quality of care, but available data do not, however, enable solid international comparisons 
about care quality in European countries. Furt her effort is needed to develop common 
terminology and gather comparable data on differe nt aspects of quality at European level.  
The NSRs also show that several Member States have been going down the avenue of 
privatisation and decentralisation as a way to improve access, quality and especially efficiency of the health system. However, it is important to note that these should be treated as 
means to an end and not a goal in itself or a de cision taken on the basis of political whims. It 
is important to assess whether it is possible to  achieve efficiency gains by privatisation and 
decentralisation in each na tional context. In general, it is ne cessary to consider if there is the 
institutional capacity to monitor and regulate private practice, to  ensure risk equalisation and 
quality standards, to identify wh at the private and what the public  can do better, or to induce 
the geographic location of private entities in or der to tackle geographic disparities. Whether 
private entities promote quality and efficiency  depends on the number of entities and the 
incentives they face notably the nature of contr acts established in the market. The experience 
with decentralisation in some Me mber States is a mixed one, resu lting in variations in supply 
and quality of care which have lead these countries to rethink their resource allocation mechanisms and establish nationw ide norms and guidelines. Some countries that have a large 
private provision report duplication of care a nd waste of resources and thus the need to 
coordinate private and public provision. Hence, a number of issues must be taken into account 
when going down the avenue of more private insu rance, private provision and decentralisation 
of provision. 
All countries have cost-sharing schemes in pl ace, complemented with exemptions. In some 
countries these have increased and have led to  a reduction in care utilisation while in others 
they do not appear to have much effect on patie nt behaviour as they ar e covered by insurance. 
It is also not always clear whether there is a coherent logic behind their design i.e. are they 
inducing preferred pathways of care? Are they  based on what is cost-effective? More 
monitoring is needed to ensure they achieve maximum efficiency gains while minimising the 
impact on necessary care ut ilisation by vulnerable groups. 
Another interesting trade-off relates to increased patient choice. While a large number of 
countries see increased patient choice as a di mension of patient centeredness, it is not 
acknowledged how greater choice impacts on the goal of increasing system efficiency. 
 
EN 151   EN Several countries claim they will increase patient choice but at the same time refer to the 
establishment of selective contra cting between insurers and provi ders as a means to encourage 
efficiency. This would mean that what countries refer to as choice is additional choice within 
a preferred care framework. From the point of view  of efficiency this is logical as evidence 
suggests that free choice is relate d to increased costs of care.  
Member States are looking at various mechanisms  to address the expected increase in demand 
for long-term care services  in light of the demographic ageing and the prevalence of disability 
and dependency, particularly in old age. In their quest for a sound financial footing for the 
long-term care sector, Member States are fostering and upgrading existing services and 
establishing new ones, on one hand, whilst deve loping sound financial mechanisms to cover 
the multiple contingencies, on the other. Secu re long-term care financing is still to be 
achieved in many countries and changes to fina ncing mechanisms are required, with several 
countries engaging in reforms. Ca re coordination is seen as cruc ial in enabling a high level of 
quality and efficient use of resources in the provision of long-term care services and thus 
ensuring an adequate continuum of care. It al so encompasses the search for coordination of 
budgets and thus sustainability  of long-term care systems. 
Ageing is seen as an important challenge as it leads to multi-morbidity and increased 
disability and dependence if in creased life expectancy is not  accompanied by healthier lives. 
Hence, the intensification of health promoti on and disease prevention in all Member States, 
seen as crucial means to improve health at all ages, thus increasi ng quality of life while 
reducing the demand and costs of healthcare a nd long-term care. Several countries expect 
successful health promotion and disease pr evention programmes to delay the onset of 
dependency/disability and eventually  result in financial savings. In this context, there may be 
room for more effective and ta rgeted health promotion actions . Interestingly, though, while all 
countries put a stronger emphasis on promo tion and prevention, curative care, notably 
hospital care, engulfs the largest part of the expenditure and a large number of countries are 
still directing extra funds towards the hospital sector. Hence, the expenditure share allocated 
to promotion and prevention may be too small in  relation to the goals they are to achieve.  
Ageing is also seen as a window of opportun ity to use in relation to older employees, 
immigrants, people with disabilities and socia lly disadvantaged and th e young and contribute 
to attaining the Lisbon objectives , if these groups are provided w ith relevant training. On the 
other hand, it may mean that c ountries need to be more in novative and improve the use of 
technology and methods of work as  well as working with  third sector to tr y and reach those in 
more remote and disadvantaged areas or at risk groups when in th e presence of staff 
shortages. 
A final number of issues are worth menti oning. Firstly, as mentioned in the introduction, 
health is seen as goal in itself but also as  a means to ensure employment and economic 
development, while the result of a set of social and economic factors. This  holistic approach is 
translated in some countries by a broader c onsultation with various sectors, with NGOs on 
social welfare and health, and with local and regional authorities . It is, however, not 
necessarily clear how the consulta tion was taken into consideration in the report. Some of the 
reports were prepared in join t collaboration by more  than one ministry. More multi-sector 
cooperation is necessary to ensure greate r coherence between economic, education, 
employment, environment and social policy includ ing health and housing po licies if we are to 
ensure a high level of health protection in all policies.  
 
EN 152   EN Secondly, only a handful of countries report using the European Structural Funds in the field 
of health, even if h ealth is a priority fo r the 2007-2010 funding programme. This may reflect 
general lack of awareness of th e possibility to use structural  funds for developing health 
promotion, address geographical gaps in infrastr ucture, or increased staff training. At the 
same time, some argue that more technical support and monitoring of  the investment is 
needed.  
Finally, some countries show a de parture from previous reforms.  While this may be expected 
in the field of healthcare due to a conti nuous change of treatment practices and staff 
qualifications, in some cases new reform choices ar e political in nature an d their design is not 
necessarily thought through. Ensu ring a rationale for reforms and avoid leaving health 
systems in a limbo is also an important responsibility of policy makers.
 
EN 153   EN 6. ANNEX : INDICATORS  
6.1. Definition of the 14 overarching indicators 
1a. At-risk-of-poverty rate: Share of persons aged 0+ with an  equivalised disposable income 
below 60% of the national equivalised median income78. Source: SILC. 
+ Illustrative threshold value: Value of the at-risk-of-pove rty threshold (60% median 
national equivalised income) in PPS for an illustrative househol d type (e.g. single person 
household). Source: SILC. 
1b. Relative median poverty risk gap: Difference between the median equivalised income 
of persons aged 0+ below the at-risk-of povert y threshold and the thre shold itself, expressed 
as a percentage of the at-risk-o f-poverty threshold. Source: SILC. 
2. S80/S20: Ratio of total income received by the 20%  of the country’s population with the 
highest income (top quintile) to that received by the 20% of the country’s population with the 
lowest income (lowest quintile ). Income must be understood as equivalised disposable 
income. Source: SILC. 
3. Healthy life expectancy Number of years that a person at birth, at 45, and at 65 is still 
expected to live a healthy life (also called disab ility-free life expectancy). To be interpreted 
jointly with life expectancy. Source: EUROSTAT. 
4. Early school-leavers: Share of persons aged 18 to 24 who have only lower secondary 
education (their highest level of education or  training is 0, 1 or 2 according to the 1997 
International Standard Classification of E ducation — ISCED 97) and have not received 
education or training in the four w eeks preceding the survey. Source: LFS. 
5. People living in jobless households: Proportion of people living in jobless households, 
expressed as a share of all people in the same age group79. This indicator should be analysed 
in the light of context indicator  No 8: jobless households by  main household types. Source: 
LFS. 
6. Projected total public  social expenditure: Age-related projections of total public social 
expenditure (e.g. pensions, h ealthcare, long-term care, education and unemployment 
transfers), current level (% of GDP) and project ed change in share of GDP (in percentage 
points) (2010-20-30-40-50).  Specific assumptions agreed in the AWG/EPC. See ‘The 2005 EPC projections of age-related 
expenditures (2004-2050) for EU-25: underlying assumptions and projection methodologies’ 
Source: EPC/AWG. 
7a. Median relative income of elderly people: Median equivalised in come of people aged 
65+ as a ratio of income of pe ople aged 0-64. Source: EU-SILC. 
                                                
 
78 Equivalised median income  is defined as the household’s total disposable income divided by its 
‘equivalent size’, to take account of the size and composition of the household, and is attributed to each household member (including children). Equivalisation is on the basis of the OECD modified scale. 
79 Students aged 18-24 who live in households composed solely of students are not counted in either the 
numerator or denominator. 
 
EN 154   EN 7b. Aggregate replacement ratio: Median individual pensions of  65-74 year-olds relative to 
median individual earnings of 50-59 year-olds,  excluding other social benefits. Source: EU-
SILC. 
8. Self-reported unmet need for medical care: Total self-reported unmet need for medical 
care for the following three reasons: financial barriers + waiting times + too far to travel.  
+ Care utilisation: To be analysed together with care utilisation defined as the number of 
visits to a doctor (GP or specialist) du ring the last 12 months. Source: EU-SILC. 
9. At-risk-of-poverty rate anchored at a fixed moment in time (2005): Share of persons 
aged 0+ with an equivalised disposable in come below the at-ris k-of-poverty threshold 
calculated in the year 2005 (1st EU-SILC income  reference year for all 25 EU countries), 
adjusted for inflation over the years. Source: SILC. 
10. Employment rate of older workers: Persons in employment in the 55–59 and 60–64 age 
groups as a proportion of the total populat ion in the same age group. Source: LFS. 
11. In-work poverty risk: Individuals who are classified as employed80 (distinguishing 
between ‘wage and salary employment plus  self-employment’ and ‘wage and salary 
employment’ only) and who are at risk of poverty. 
This indicator needs to be analysed according to personal, job and hous ehold characteristics. 
It should also be analysed in comparison w ith the poverty risk faced by the unemployed and 
the inactive. Source: SILC. 
12. Activity rate: Share of employed and unemployed people in the total population of 
working age, 15-64. Source: LFS. 
13. Regional disparities — coefficient of variation of employment rates: Standard 
deviation81 of regional employment rates divided by the weighted national average (15-64 age 
group). (NUTS II). Source: LFS. 
14. Total health expenditure per capita: Total health expenditure pe r capita in PPP. Source: 
EUROSTAT based on system of health accounts (SHA) data. 
                                                 
80 Individuals classified as employed according to most frequent activity status. The most frequent activity 
status is defined as the status that individuals declare having for more than half the number of months in the calendar year. 
81 Standard deviation measures how, on average, the situation in regions differs from the national average. 
As a complement to the indicator, a graph show ing max/min/average per country is presented. 
Possible alternative measures:   
Regional disparities — underperforming regions . Source LFS 
1. Share of underperforming regions in terms of employment and unemployment (in relation to all 
regions and to the working age popu lation/labour force) (NUTS II).  
2. Differential between average employment/unemployment in underperforming regions and the national average for employment/unemployment (NUTS II).  Thresholds to be applied: 90% and 150% 
of the national average rates for employment and une mployment, respectively. (An extra column with 
the national employment and unemployment rates would be included). 
 
EN 155   EN 6.2. Data sources 
Indicators of income and living conditions: EU-SILC 
For the first time this year, EU-SILC data are available for 25 EU  countries. The newly 
implemented reference source of statistics on in come and social exclusion is the Framework 
Regulation (No 1177/2003) for the European Su rvey on Income and Living Conditions (EU-
SILC). The technical aspects of this instrument are developed by Commission implementing 
regulations, which are published in the Official  Journal. The data for Bulgaria and Romania 
are still based on the national household budget surveys under the transitional arrangements 
agreed for the European Statistical System82. 
The EU-SILC definitions of total household gro ss and disposable income and the different 
income components keep as clos e as possible to the internati onal recommendations of the UN 
‘Canberra Manual’. A key objectiv e of EU-SILC is to deliver timely, robust and comparable 
data on total disposable hous ehold income, total disposab le household income before 
transfers, total gross income and gross income  at component level (in the ECHP, the income 
components were recorded net). This objective w ill be reached in two st eps, in that Member 
States have been allowed to postpone the delivery of gross income at component level and 
total household gross income data until after the first year of operation.  
Although certain countries (e.g. Denmark) are already able to supply income including 
imputed rent — i.e. the money that one saves on full (market) rent by living in one’s own 
accommodation or in accommodation rented at a price lower than the market rent — for 
reasons of comparability, the income defin ition underlying the calculation of indicators 
currently excludes imputed rent. This could have a distorting e ffect in comparisons between 
countries, or between population sub-groups, when  accommodation tenure status varies. This 
effect may be particularly apparent for the el derly who may have been able to accumulate 
wealth in the form of housing assets. In the st atistical annex, data for Denmark are therefore 
shown both with and without imputed rent, as an  illustration of the impact of this income 
component on the results. Once imputed rent is ta ken into account, the at -risk-of-poverty rate 
falls for people aged 65 and over, the inactive other than pensioners and those living in owner-occupied accommodation.  
It should also be noted that the definition currently used for income excludes non-monetary 
income components, which include the va lue of goods produced for own consumption
83 and 
non-cash employee income. This component will be  available for all countries from the SILC 
(2007) exercise onwards, and will therefore be included in the indicators to be published in 
January 2009. 
The reference year for the data is the year to  which the income information refers (i.e. the 
‘income year’), which in most cases differs from the survey year in which the data were collected. Accordingly, 2006 data refer to the in come situation of the population in 2005, even 
                                                
 
82 National data sources are adjusted ex-post and as far as possible using the EU-SILC methodology. 
While the greatest effort is made to maximise the consistency of definitions and concepts, the resulting 
indicators cannot be considered to be fully co mparable with the EU-SILC-based indicators. 
83 Before the introduction of EU-SILC in the new Member States, the value of goods produced for own 
consumption was included in the calculation of th e EU indicators estimated on the basis of national 
sources. This transitional arrangement  was intended to take account of the potentially significant impact 
of this component on income distribution in these countries. 
 
EN 156   EN if the information was collected in 2006. EU a ggregates are computed as population-weighted 
averages of available national values.  
Note on trends 
During the transition to EU-SILC, income-based  indicators were calculated on the basis of 
available national sources (household budget surve y, micro-censuses, etc) that were not fully 
compatible with the SILC methodology ba sed on detailed income. Following the 
implementation of EU-SILC in a given country, th e values of all income-based indicators (at-
risk-of-poverty rates, S80/S20, a ggregate replacement ratio, etc)  cannot be compared to the 
estimates presented in previous years. This is  why no trends for income-based indicators are 
presented in this year’s report. 
Limitations 
The limited sample size for certain data sources us ed for the collection of income data and the 
specific difficulties of collecting accurate info rmation on disposable income directly from 
households or through administrative records rais e certain concerns as regards data quality. 
This is particularly the case for informati on on income at the two ends of the income 
distribution. 
Furthermore, household surveys do not cove r persons living in collective households, 
homeless persons or other di fficult-to-reach groups.  
It must also be acknowledged that self-employm ent income is difficult to collect, whatever 
the data source. It must also be kept in mind that the difficulty in recording income from the 
informal economy can introduce a bias in in come distribution as measured by surveys. 
Finally, while it is considered to be the best  basis for such analyses, current income is 
acknowledged to be an imperfect measure of consumption capabilities and welfare, as, among 
other things, it does not reflect access to credit , access to accumulated savings or ability to 
liquidate accumulated assets, informal comm unity support arrangements, aspects of non-
monetary deprivation, differential pricing, etc. These factors may be of  particular relevance 
for persons at the lower end of the income distribution. The bottom 10% of the income 
distribution should not, therefore,  necessarily be inte rpreted as being the bottom 10% in terms 
of living standards. This is why reference is ma de to the ‘at-risk-of-poverty’ rate rather than 
simply the poverty rate.  
Confidence intervals 
Indicators are estimated values based on a samp le drawn from the target population and thus 
are affected by sampling error. Statistical theo ry provides us with tools for calculating 
confidence intervals in which the population value lies with a high probability. The 
confidence intervals are centred around the estim ated values reported and their length is a 
measure of the precision of these estimates. The precision depends on the design of the survey 
and can thus vary between countries. However,  the EU-SILC Regulati on provides for national 
samples to be designed so as to achieve a confidence interval  of +/-1% around  the estimated 
value of the total at-ris k-of-poverty rate. Eurostat  is computing these inte rvals for a number of 
indicators and exact values will be reported in  EU quality reports. First computations show 
that the confidence intervals ar ound the total at-risk-o f-poverty rate are of the order of +/-
0.8%. For the S80/S20 income quintile share ratio, the confidence intervals are of the order of 
 
EN 157   EN +/-0.2. For the relative median at -risk-of-poverty gap, they are of  the order of +/-1.7. For the 
Gini coefficient, they are of the order of +/- 0.9. These indications of precision must be taken 
into account when interpreting the data. 
LFS: the European Union Labour Force Survey 
The European Union Labour Force Survey (LFS ) is the EU's harmonised survey on labour 
market developments. The survey has been car ried out since 1983 in the EU Members States, 
with some states providing quart erly results from a continuous labour force survey, and others 
conducting a single annual survey in the spri ng. From 2005, all EU Member States have 
conducted a quarterly survey. If not mentioned otherwise, the results based on the LFS refer 
to surveys conducted in the spring ('second quart er' in all countries except for France and 
Austria, which is 'first quarter') of each year. It also provides data fo r Bulgaria, Croatia and 
Romania. 
The Annual Averages of Labour Fo rce Data series is a harmonise d, consistent series of annual 
averages of quarterly results on employment statistics based on the LFS, completed through 
estimates when quarterly data are not available.  It covers all the EU-15 (for the period from 
1991 to present) and all new Member States a nd Candidate Countries (s ince 1996 or later, 
depending on data availability) except the Former Yugoslav Republic of Macedonia. The 
Annual Averages of Labour Force Data consist of two series: 1) population, employment and 
unemployment, and 2) employment by economi c activity and employment status. The first 
series is based mainly on the EU LFS. Data c overs the population living in private households 
only (collective households are excluded) and refers to the place of residence (household 
residence concept). They ar e broken down by gender and ag gregate age group (15–24, 25–54, 
55–64 and 15–64). Unemployment data  is also broken down by job search duration (less than 
6 months, 6–11, 12–23, 24 months or  more). The second series is based on the ESA 1995 
national accounts employment data. Data covers  all people employed in resident producer 
units (domestic concept), including people liv ing in collective households. They are broken 
down by sex, working-time status (full-tim e/part-time) and contract status 
(permanent/temporary) using LFS distributions . All key employment indicators presented in 
this document are based on the Annual Averages of Labour Force Data series. They represent 
yearly averages unless stated otherwise. Where the Annual Averages of Labour Force Data series does not provide the releva nt breakdowns, the original LFS data has been used for this 
report. 
Age-related expend iture projections 
Long-term budgetary projections were prep ared in 2006 by the Economic Policy Committee 
and the European Commission (DG ECFIN) — see European Policy Committee and 
European Commission (2006), ‘The impact of ageing on public expenditure: projections for 
the EU25 Member States on pensions, h ealthcare, long-term care, education and 
unemployment transfers (2004-2050)’, Europe an Economy, Special Report No 1/2006.  
The projections are made on the basis of a common population pr ojection and agreed 
common underlying economic a ssumptions that have been endorsed by the EPC. The 
projections are made on the basis of ‘no policy change’, i.e. onl y reflecting enacted legislation 
but not possible future policy changes (althoug h account is taken of provisions in enacted 
legislation that enter into force over time). Th e pension projections ar e made on the basis of 
legislation enacted by mid-2005. They are also made  on the basis of the current behaviour of 
economic agents, without assuming any future ch anges in behaviour over time: for example, 
 
EN 158   EN this is reflected in the assumptions for part icipation rates, which are based on the most 
recently observed trends by age and gender. While the underlying assumptions have been 
made by applying a common methodology uniforml y to all Member States, for several 
countries adjustments have been made to avoid an overly mechanical ap proach that leads to 
economically unsound outcomes and to take due  account of significant country-specific 
circumstances. The pension projections were ma de using the models of  national authorities, 
and thus reflect the current inst itutional features of national pension systems. In contrast, the 
projections for healthcare, long-term care, ed ucation and unemployment transfers were made 
using common models developed by the Europe an Commission in clos e cooperation with the 
EPC and its Working Group on Ageing Populat ions. The projection results show the 
combined impact of expected changes in the size and demographic structure of the 
population, projected macroeconomic developmen ts and assumed neutral evolution in the 
health status of the population in each Member State of the European Union. 
Pension expenditure 
The ‘pension expenditure’ aggregate accordin g to the ESSPROS definition, goes beyond 
public expenditure and also includes expendit ure by private social protection schemes. 
‘Pension expenditure’ is the sum of seven different  categories of benef its, as defined in the 
1996 ESSPROS Manual: disability pe nsion, early retirement bene fit due to re duced capacity 
to work, old-age pension, anticipated old-age pension, partial pension, survivors’ pension and 
early retirement benefit for labour market reas ons. Some of these benefits (for example, 
disability pensions) may be paid to people who have not reached the stan dard retirement age. 
Replacement rates 
The figures for current and prospective pension replacement rates are based on the 
methodology developed by the Indicators Sub-Gr oup of the Social Protection Committee. The 
results are based on the base line assumption of a hypothetical  person (male where gender 
matters) retiring at the age of 65 after a 40-year full-time worki ng career with a flat earnings 
profile at average earnings with  contributions to the most ge neral public pension scheme as 
well as to occupational and private pens ion schemes for some Member States.  
The replacement rate represents the individua l pension income during the first year of 
retirement relative to the individual income  received during the year preceding retirement. 
Calculations are by the Member States. 
Healthcare expenditure — WHO Health for All database (www.who.int\nha) 
This information is based on national hea lth accounts (NHAs) co llected within an 
internationally recognised framework. NHAs depict the financing and spending flows 
recorded in the operation of a health system. In  future, the System of Health Accounts (SHA) 
will contain uniform data for Eurostat, the OE CD and the WHO. In the meantime, the WHO 
database is the only one to cover all Member States.  
About 100 countries have either produced full national health accounts or  report expenditure 
on health to the OECD. Standa rd accounting estimation and ex trapolation techniques have 
been used to provide time series (1998-2004). Mi nistries of Health have responded to the draft 
updates sent for their inputs and comments. The pr incipal international re ferences used are: 
the International Monetary Fund (IMF), Govern ment Finance Statistics and International 
Financial Statistics; OECD health data; and the United Nations Nationa l Accounts Statistics. 
 
EN 159   EN National sources include: national health accounts reports, public expenditure reports, 
statistical yearbooks and other periodicals, budgetary documents, natio nal accounts reports, 
central bank reports, non-governmental organi sation reports, academic studies, reports and 
data provided by central statistical offices and ministries, and statisti cal data on official 
websites.
 
EN 160   EN 6.3. Statistical tables 
1a. At-risk-of-poverty rate by age and gender, 2007
EU27 EU25 BE BG(1)CZ DK DK(2)DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO(1)SI SK FI SE UK
Total population Total 16ps 16p 15 14i 10 12 13p 15p 19 18 20 20 13 20 16 21 19 14 12 14 10 12 17 18 19p 12 11 13 11 19
Men 15ps 15p 14 12i 9 11 13p 14p 17 16 20 19 12 18 14 19 17 13 12 14 10 11 18 17 18p 10 10 12 11 18
Women 17ps 17p 16 16i 10 12 13p 16p 22 19 21 21 14 21 17 23 21 14 12 15 11 13 17 19 19p 13 11 14 11 20
Children aged 0-17 Total 19ps 19p 17 16i 16 10 12p 14p 18 19 23 24 16 25 12 21 22 20 19 19 14 15 24 21 25p 11 17 11 12 23
People aged 18-64 Total 15ps 15p 13 12i 8 11 13p 15p 16 15 19 16 12 18 10 18 16 13 12 12 9 11 17 15 17p 10 9 11 10 15
Men 14ps 14p 12 12i 8 11 13p 14p 15 14 18 15 11 16 8 18 15 12 11 10 8 9 18 14 17p 10 9 12 11 14
Women 15ps 15p 13 12i 9 11 13p 16p 17 16 19 17 13 19 12 19 16 13 12 14 10 12 17 16 16p 10 10 11 10 16
People aged 65+ Total 19ps 19p 23 18i 5 18 14p 17p 33 29 23 28 13 22 51 33 30 7 6 21 10 14 8 26 19p 19 8 22 11 30
Men 16ps 17p 21 9i 2 16 12p 14p 21 24 21 26 12 18 47 21 15 7 3 24 9 10 6 24 13p 11 3 18 7 27
Women 2 2 p s 2 1 p 2 5 2 4 i8 1 9 1 6 p 2 0 p 3 93 32 53 01 42 55 4 3 9 3 7 8 81 81 11 8 92 7 2 2 p 2 5 1 1 2 4 1 43 2
1a. At-risk-of-poverty threshold (illustrative values), EUR and PPS, 2007
EU27 EU25 BE BG(1)CZ DK DK(2)DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO(1)SI SK FI SE UK
EUR '- One-person household : 8368s 10538 :i 3251 14004 15002,73 10624p 2668 13291 6120 7203 9938 9003 9590 2010 1966 17929 2361 5475b 10924 10945 210 1 4544 90p 5944b 2382 11222 11132 12572
       '- Two adults with two dep. c h : 17573s 22129 :i 6828 29409 31505,91 22310p 5603 27911 12852 15127 20870 18907 20140 4222 4128 37650 4959 11498b 22941 22985 4413 9542 140p 12482b 5003 2 3565 23378 26402
PPS '- One-person household : : 10035 :i 5348 10175 10819p 10403p 4059 10706 6946 7807 9363 8748 6298 3356 3512 17575 3979 7543b 10631 10933 3422 5360 1 89p 7979b 4133 9321 9581 11366
       '- Two adults with two dep. c h : : 21075 :i 11231 21367 22720p 21846p 8524 22483 14588 16394 19661 18371 13226 7049 7376 36908 8355 15841b 22325 22960 7187 11255 295p 16756b 8678 19573 2 0120 23868
Notes: i See explanatory text (Eurostat website) p = provisional value  s = Eurostat estimate  u = unreliable or uncertain data   (:) = data not available 
EU Aggregates: Eurostat estimates are obtained as a population size weighted average of national data.
1b. Relative median at-risk-of-poverty gap by age and gender, 2007
EU27 EU25 BE BG(1)CZ DK DK(2)DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO(1)SI SK FI SE UK
Total population Total 22ps 22 18 17i 18 17 18p 24p 20p 18p 26p 24 17p 22 20 25 26 19 20 17 17p 17 24 24 23p 19 19 14 20 23
Men 23ps 23 19 18i 19 19 20p 25p 24p 18p 26p 24 17p 24 18 27 28 19 21 17 18p 19 25 24 23p 19 22 15 22 23
Women 21ps 21 17 17i 17 16 17p 23p 19p 17p 26p 24 16p 22 21 24 23 19 19 18 17p 16 23 24 24p 20 17 14 18 23
Children aged 0-17Total22ps 22 18 22i 19 21 16p 21p 26p 19p 29p 25 15p 25 16 28 30 20 19 16 18p 19 26 26 26p 21 21 12 17 22
People aged 18-64 Total 24ps 24 21 18i 19 24 24p 26p 26p 20p 26p 27 17p 25 18 30 29 20 21 19 18p 21 25 27 23p 19 20 17 24 25
Men 25ps 25 22 19i 21 24 25p 28p 29p 20p 25p 27 18p 25 17 32 30 20 21 17 22p 23 25 27 23p 20 22 18 26 26
Women 23ps 23 20 18i 19 22 23p 24p 23p 20p 26p 27 17p 25 19 28 28 19 21 20 18p 20 24 27 23p 19 19 16 22 24
People aged 65+ Total 19ps 19 15 14i 7 9 7p 19p 14p 10p 24p 21 19p 19 23 19 15 9 13 17 10p 12 14 19 19p 20 12 10 11 20
Men 18ps 18 17 8i 14 7 8p 19p 14p 10p 24p 21 19p 17 21 12 12 8 10 17 9p 12 15 14 17p 15 19 10 11 18
Women 19ps 19 14 16i 7 9 7p 19p 14p 10p 24p 20 19p 20 24 19 16 12 15 16 11p 12 14 22 20p 20 11 10 12 21
Notes: i See explanatory text (Eurostat website) p = provisional value  s = Eurostat estimate  u = unreliable or uncertain data   (:) = data not available 
EU Aggregates: Eurostat estimates are obtained as a population size weighted average of national data.
2. Inequality of income distribution: S80/S20 income quintile share ratio
EU27 EU25 BE BG(1)CZ DK DK(2)DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO(1)SI SK FI SE UK
S80/S20 Total 4.8ps 4.8p 3.9 3.5i 3.5 3.7 3.6p 5p 5.5p 4.8p 6p 5.3 3.8p 5.5 4.5 6.3 5.9 4 3.7 3.8 4p 3.8 5.3 6.5p 5.3p 3.3 3.5 3.7 3.4 5.5
Notes: i See explanatory text (Eurostat website) p = provisional value  s = Eurostat estimate  u = unreliable or uncertain data   (:) = data not available 
EU Aggregates: Eurostat estimates are obtained as a population size weighted average of national data.Source: SILC 2007, Income data 2006; except for UK, income year 2007 and for IE moving income reference period (2006-2007);  (1) BG HBS 2006, income data 2006and RO National HBS 2007, income data 2007; (2) with imputed rent data 2006 (see methodological note).
Source: SILC 2007,  Income data 2006; except for UK, income year 2007 and for IE moving income reference period (2006-2007);  (1) BG HBS 2007, income data 2007 and RO National HBS 2006, income data 2006; (2) with imputed rent data 2006 (see methodological note).
Source: SILC 2007,  Income data 2006; except for UK, income year 2006 and for IE moving income reference period (2005-2006);  (1) BG and RO National HBS 2006, income data 2006; (2) with imputed rent data 2006 (see methodological note).
 
EN 161   EN 3. Healthy life years : Disabilit y free life expectancy (+ life exp ectancy at 0, 45, 65) 1995-2005
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
life expectancy at birth - males eu27 : : : : : : : 74,5 74,6 75,2 :
life expectancy at 45 - males eu27 :::: : : : 31,9 31,9 32,5 :
life expectancy at 65 - males eu27 : : : : : : : 15,9 15,9 16,4 :
life expectancy at birth - females eu27 : : : : : : : 80,9 80,8 81,5 :
life expectancy at 45 - females eu27 : : : : : : : 37,2 37,2 37,7 :
life expectancy at 65 - females eu27 : : : : : : : 19,5 19,4 19,9 :
life expectancy at birth - males eu25 72,8 73,2 73,5 73,5 73,8 74,4 74,7 75 75,1 75,7 75,8
life expectancy at 45 - males eu25 :::: : 31,8 32,1 32,3 32,3 32,8 :
life expectancy at 65 - males eu25 : : : : : 15,7 15,9 16,1 16,1 16,6 :
life expectancy at birth - females eu25 79,7 79,9 80,2 80,2 80,4 80,8 81,1 81,3 81,2 81,9 81,9
life expectancy at 45 - females eu25 : : : : : 37,2 37,4 37,6 37,5 38,1 :
life expectancy at 65 - females eu25 : : : : : 19,4 19,6 19,7 19,6 20,2 :
life expectancy at birth - males eu15 73,9 74,2 74,6 74,6 74,9 75,4 75,7 75,9 76 76,8 :
life expectancy at 45 - males eu15 31,5 31,7 32 : : 32,6 32,9 33 33,1 33,7 :
life expectancy at 65 - males eu15 15,3 15,4 15,6 : : 16,1 16,3 16,4 16,4 17,1 :
Disability free life expectancy at birth - males eu15 : : : : 63.2 e 63.5 e 63.6 e 64.3 e 64.5 e : :
life expectancy at birth - females eu15 80,4 80,6 80,9 80,9 81,1 81,4 81,7 81,7 81,7 82,8 :
life expectancy at 45 - females eu15 36,9 37,1 37,3 : : 37,7 37,9 38 38 38,9 :
life expectancy at 65 - females eu15 19,1 19,2 19,4 : : 19,7 20 20 20 20,8 :
Disability free life expectancy at birth - females eu15 : : : : 63.9 e 64.4 e 65.0 e 65.8 e 66.0 e : :
Source: Eurostat - Demography; e: estimate
 
EN 162   EN Disability free Life expectancy (+ Li fe expectancy at 0, 45, 65) 1995-2006
Source: Eurostat - Demography
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males BE 73,5 73,9 74,2 74,4 74,4 74, 6 75 75,1 75,3 76 76,2 76,6
Life expectancy at 45 - males BE 31,1 31,4 31,6 31,7 31,8 32 32,3 32,3 32,5 33 33,1 33,6
Life expectancy at 65 - males BE 14,8 15 15,2 15,3 15,5 15,6 15,9 15,8 15,9 16,4 16,6 17
Healthy Life Years at birth - males BE 63,3 64,1 66,5 63,3 66 65,7 66,6 66.9 (e) 67.4 (e) 58.4 (b) 61,7 62,8
Life expectancy at birth - females BE 80,4 80,7 80,7 80,7 81 81 81, 2 81,2 81,1 81,8 81,9 82,3
Life expectancy at 45 - females BE 37 37,2 37,2 37,2 37,4 37,5 37,7 37,5 37,3 38 38 38,5
Life expectancy at 65 - females BE 19,3 19,4 19,5 19,6 19,6 19,7 19,9 19,7 19,6 20,2 20,2 20,6
Healthy Life Years at birth - females BE 66,4 68.5 (e) 68,3 65.4 (e) 68,4 69,1 68, 8 69.0 (e) 69.2 (e) 58.1 (b) 61,9 62,8
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males BG 67,4 67,4 67 67,4 68,2 68,4 68,6 68,8 68,9 68,9 69 69,2
Life expectancy at 45 - males BG 26,6 26,6 26,3 26,4 27,2 27 27, 2 27,3 27,3 27,3 27,2 27,3
Life expectancy at 65 - males BG 12,7 12,5 12,3 12,5 12,9 12,7 13 13 13 13 13,1 13,2
Healthy Life Years at birth - males BG ::::::::::::
Life expectancy at birth - females BG 74,9 74,5 73,8 74,6 75 75 75, 4 75,5 75,9 75,8 76,2 76,3
Life expectancy at 45 - females BG 32,4 32,2 31,7 32,2 32,5 32,4 32,8 32,9 33,1 33 33,3 33,5
Life expectancy at 65 - females BG 15,3 15 14,7 15 15,4 15,3 15, 6 15,7 15,8 15,8 16,1 16,3
Healthy Life Years at birth - females BG ::::::::::::
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males CZ 69,7 70,4 70,5 71,2 71,5 71,7 72,1 72,1 72 72,6 72,9 73,5
Life expectancy at 45 - males CZ 27,6 27,9 28,1 28,6 28,8 29 29, 3 29,3 29,2 29,7 29,9 30,4
Life expectancy at 65 - males CZ 12,7 13,1 13,2 13,5 13,7 13,8 1 4 13,9 13,8 14,2 14,4 14,8
Healthy Life Years at birth - males CZ ::::::: 6 2 . 8  ( p ) :: 5 7 . 9  ( b ) 5 7 , 8
Life expectancy at birth - females CZ 76,8 77,5 77,6 78,2 78,3 78,5 78,6 78,7 78,6 79,2 79,2 79,9
Life expectancy at 45 - females CZ 33,4 33,9 34,1 34,5 34,5 34,8 34,8 34,9 34,7 35,3 35,3 36
Life expectancy at 65 - females CZ 16,2 16,6 16,7 17 17 17,3 17, 3 17,3 17,2 17,6 17,7 18,3
Healthy Life Years at birth - females CZ ::::::: 6 3 . 3   ( p ) :: 5 9 . 9  ( b ) 5 9 , 8
 
EN 163   EN 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males DK 72,7 73,1 73,6 74 74,2 74,5 74,7 74,8 75 75,4 76 76,1
Life expectancy at 45 - males DK 30,2 30,5 30,9 31,1 31,3 31,6 31,7 31,8 32 32,4 32,8 32,8
Life expectancy at 65 - males DK 14,1 14,4 14,6 14,9 15 15,2 15, 2 15,4 15,6 15,9 16,1 16,2
Healthy Life Years at birth - males DK 61,6 61,7 61,6 62,4 62,5 62,9 62,2 62. 8 (e) 63 (e) 68.3 (b) 68,4 67,7
Life expectancy at birth - females DK 77,9 78,3 78,6 79 79 79,2 79, 3 79,4 79,8 80,2 80,5 80,7
Life expectancy at 45 - females DK 34,4 34,9 35 35,4 35,2 35,5 35, 6 35,6 35,9 36,4 36,6 36,8
Life expectancy at 65 - females DK 17,6 17,9 18 18,3 18,1 18,3 18,3 18,2 18,5 19 19,1 19,2
Healthy Life Years at birth - females DK 60,7 61,1 60.7 (e) 61.3 (e) 60,8 61,9 60, 4 61.0 (e) 60.9 (e) 68.8 (b) 68,2 67,1
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males DE 73,3 73,6 74,1 74,5 74,8 75,1 75,6 75,7 75,8 76,5 76,7 77,2
Life expectancy at 45 - males DE 30,7 31 31,4 31,7 32 32,2 32, 5 32,6 32,7 33,3 33,4 33,8
Life expectancy at 65 - males DE 14,8 14,9 15,2 15,4 15,6 15,8 16,1 16,2 16,2 16,7 16,9 17,2
Healthy Life Years at birth - males DE 60 60,8 61.9 (e) 62.1 (e) 62.3 (e) 63.2 (e ) 64.1 (e) 64.4 (e) 65 (e) : 55 (b) 58,5
Life expectancy at birth - females DE 79,9 80,1 80,5 80,8 81 81,2 81,4 81,3 81,3 81,9 82 82,4
Life expectancy at 45 - females DE 36,4 36,5 36,9 37,1 37,3 37,5 37,6 37,5 37,5 38 38,1 38,5
Life expectancy at 65 - females DE 18,7 18,8 19,1 19,3 19,4 19,6 19,8 19,6 19,5 20,1 20,1 20,5
Healthy Life Years at birth - females DE 64,3 64,5 64.3 (e) 64.3 (e) 64.3 (e) 64.6 (e ) 64.5 (e) 64.5 (e) 64.7 (e) : 55.1 (b) 58
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males EE 61,5 64,3 64,3 64,1 64,9 65,5 64,9 65,3 66,1 66,4 67,3 67,4
Life expectancy at 45 - males EE 23,4 24,5 24,9 24,3 25,2 25,3 24,9 25,3 25,6 25,8 26,2 26,3
Life expectancy at 65 - males EE 12 12,2 12,5 12,2 12,6 12,8 12,7 12,8 12,7 13 13,1 13,2
Healthy Life Years at birth - males EE ::::::::: 4 9 . 8  ( b ) 4 8 4 9 , 4
Life expectancy at birth - females EE 74,3 75,6 75,9 75,4 76 76,2 76,4 77 77,1 77,8 78,2 78,6
Life expectancy at 45 - females EE 32,4 33 33,3 32,9 33,5 33,6 33,7 34 34,1 34,6 35 35,1
Life expectancy at 65 - females EE 16,1 16,4 16,8 16,5 17 17 17,3 17,3 17,4 17,8 18 18,3
Healthy Life Years at birth - females EE ::::::::: 5 3 . 3  ( b )  5 2 , 2 5 3 , 7
 
EN 164   EN 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males IE 72,8 73,1 73,4 73,4 73,4 74 74, 5 75,2 75,9 76,4 77,3 77,3
Life expectancy at 45 - males IE 30,1 30,5 30,7 30,9 30,8 31,5 31,9 32,4 33 33,4 34,1 34,1
Life expectancy at 65 - males IE 13,5 13,9 14 14,2 14,1 14,6 1 5 15,4 15,9 16,2 16,8 16,8
Healthy Life Years at birth - males IE 63,2 64 63,2 64 63,9 63,3 63,3 63.5 (e) 63.4 (e) 62.5 (b) 62,9 63,3
Life expectancy at birth - females IE 78,3 78,7 78,7 79,1 78,9 79,2 79,9 80,5 80,8 81,4 81,7 82,1
Life expectancy at 45 - females IE 34,8 35,1 35,2 35,5 35,3 35,7 36,4 36,9 37 37,6 37,9 38,2
Life expectancy at 65 - females IE 17,2 17,4 17,6 17,8 17,6 18 18,5 18,9 19,2 19,7 20 20,2
Healthy Life Years at birth - females IE :::: 6 7 , 6 6 6 , 9 6 6 , 5 6 5 . 9  ( e )  6 5 . 4  ( e )  6 4 . 3  ( b ) 6 4 , 1 6 5
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males EL 75 75,1 75,4 75,4 75,5 75,5 75, 9 76,2 76,5 76,6 76,8 77,2
Life expectancy at 45 - males EL 32,6 32,6 32,9 32,8 32,9 32,8 33,2 33,4 33,5 33,7 33,9 34,3
Life expectancy at 65 - males EL 15,9 16 16,2 16,1 16,2 16,1 16, 5 16,6 16,7 16,9 17,1 17,5
Healthy Life Years at birth - males EL 65,8 66,9 66,4 66,5 66,7 66,3 66,7 66. 7 (e) 66.7 (e) 63.7 (b) 65.7 66,3
Life expectancy at birth - females EL 80,1 80,2 80,4 80,3 80,5 80,6 8 1 81,1 81,2 81,3 81,6 81,9
Life expectancy at 45 - females EL 36,5 36,6 36,8 36,7 36,8 36,8 37,2 37,2 37,2 37,5 37,8 37,9
Life expectancy at 65 - females EL 18,2 18,3 18,4 18,3 18,4 18,4 18,7 18,7 18,7 18,9 19,2 19,4
Healthy Life Years at birth - females EL 69.2 (e) 69,6 68,7 68,3 69,4 68,2 68,8 68.5 (e) 68.4 (e) 65.2 (b) 67,2 67,9
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males ES 74,4 74,5 75,2 75,3 75,3 75,8 76,2 76,3 76,3 76,9 77 77,7
Life expectancy at 45 - males ES 32,5 32,6 32,8 32,8 32,7 33,2 33,4 33,5 33,5 34 33,9 34,6
Life expectancy at 65 - males ES 16,2 16,2 16,3 16,2 16,2 16,7 16,9 16,9 16,8 17,3 17,3 17,9
Healthy Life Years at birth - males ES 64,2 65,1 65,5 65,2 65,6 66,5 66 66.6 (e) 66.8 (e) 62.5 (b) 63,2 63,7
Life expectancy at birth - females ES 81,8 82 82,3 82,4 82,4 82,9 83,2 83,2 83 83,7 83,7 84,4
Life expectancy at 45 - females ES 38,4 38,5 38,8 38,7 38,7 39,2 39,4 39,4 39,2 39,9 39,7 40,4
Life expectancy at 65 - females ES 20,2 20,3 20,5 20,4 20,3 20,8 21 21 20,8 21,5 21,3 22
Healthy Life Years at birth - females ES 67,7 68,4 68,2 68,2 69,5 69,3 69.2 (e) 69.9 (e) 70.2 (e) 62.5 (b) 63,1 63,3
 
EN 165   EN 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males FR : : : 74,8 75 75,3 75,5 75,7 75,8 76,7 76,7 77,3
Life expectancy at 45 - males FR : : : 32,4 32,6 32,9 33 33,1 33,1 33,9 33,9 34,4
Life expectancy at 65 - males FR : : : 16,5 16,6 16,8 17 17 17 17,7 17,7 18,2
Healthy Life Years at birth - males FR 60 59,6 60,2 59,2 60,1 60,1 60,5 60. 4 (e) 60.6 (e) 61.2 (b) 62 62,7
Life expectancy at birth - females FR : : : 82,6 82,7 83 83 83 82,7 83,8 83,7 84,4
Life expectancy at 45 - females FR : : : 39,1 39,2 39,4 39,4 39,3 39 40,1 40 40,6
Life expectancy at 65 - females FR : : : 21,2 21,2 21,4 21,5 21,3 21 22,1 22 22,6
Healthy Life Years at birth - females FR 62,4 62,5 63,1 62,8 63,3 63.2 (e) 63,3 63.7 (e) 63.9 (e) 64.1 (b) 64,3 64,1
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males IT 75,1 75,5 75,9 76,1 76,6 77 77,2 77,4 77,1 77,9 : :
Life expectancy at 45 - males IT 32,6 32,9 33,1 33,1 33,5 33,8 34,1 34,2 34 34,7 : :
Life expectancy at 65 - males IT 15,8 16 16,1 16,1 16,4 16,7 16,9 17 16,8 17,5 : :
Healthy Life Years at birth - males IT 66,7 67,4 68 67,9 68,7 69,7 69,8 70. 4 (e) 70.9 (e) 67.9 (b) 65,8 :
Life expectancy at birth - females IT 81,6 81,8 82,1 82,2 82,7 82, 9 83,2 83,2 82,8 83,8 : :
Life expectancy at 45 - females IT 38 38,3 38,4 38,5 38,8 39 39,3 39,3 38,8 39,8 : :
Life expectancy at 65 - females IT 19,9 20,1 20,2 20,3 20,5 20,7 21 21 20,6 21,5 : :
Healthy Life Years at birth - females IT 70 70.5 (e) 71,3 71,3 72,1 72,9 73.0 (e) 73.9 (e) 74.4 (e) 70.2 (b) 67 :
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males CY ::::::: 7 6 , 4 7 7 , 4 7 6 , 8 7 6 , 8 7 8 , 8
Life expectancy at 45 - males CY ::::::: 3 3 , 7 3 4 , 2 3 3 , 9 3 4 , 2 3 5 , 4
Life expectancy at 65 - males CY ::::::: 1 6 , 3 1 6 , 8 1 6 , 7 1 6 , 8 1 7 , 7
Healthy Life Years at birth - males CY :::::::: 6 8 , 4 : 5 9 . 5  ( b ) 6 4 , 3
Life expectancy at birth - females CY ::::::: 8 1 8 1 , 6 8 2 , 1 8 1 , 1 8 2 , 4
Life expectancy at 45 - females CY ::::::: 3 7 , 4 3 7 , 7 3 8 3 7 , 6 3 8 , 3
Life expectancy at 65 - females CY ::::::: 1 9 1 9 , 3 1 9 , 5 1 9 , 1 1 9 , 7
Healthy Life Years at birth - females CY :::::::: 6 9 , 6 : 5 7 . 9  ( b ) 6 3 , 2
 
EN 166   EN 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males LV ::::::: 6 4 , 7 6 5 , 6 6 5 , 9 6 5 , 4 6 5 , 4
Life expectancy at 45 - males LV ::::::: 2 4 , 9 2 5 , 3 2 5 , 4 2 5 2 4 , 9
Life expectancy at 65 - males LV ::::::: 1 2 , 5 1 2 , 6 1 2 , 6 1 2 , 5 1 2 , 7
Healthy Life Years at birth - males LV :::::::::: 5 0 . 6  ( b ) 5 0 , 5
Life expectancy at birth - females LV ::::::: 7 6 7 5 , 9 7 6 , 2 7 6 , 5 7 6 , 3
Life expectancy at 45 - females LV ::::::: 3 3 , 5 3 3 , 2 3 3 , 7 3 3 , 8 3 3 , 5
Life expectancy at 65 - females LV ::::::: 1 7 1 6 , 8 1 7 , 1 1 7 , 2 1 7 , 3
Healthy Life Years at birth - females LV :::::::::: 5 3 . 1  ( b ) 5 2 , 1
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males LT 63,3 64,6 65,5 66 66,3 66,8 65, 9 66,2 66,4 66,3 65,3 65,3
Life expectancy at 45 - males LT 24,5 25,2 26 26,2 26,4 26,7 26, 2 26,1 26,1 26,1 25,3 25,1
Life expectancy at 65 - males LT 12,9 13 13,2 13,3 13,4 13,7 13,5 13,3 13,3 13,4 13 13
Healthy Life Years at birth - males LT :::::::::: 5 1 . 2  ( b ) 5 2 , 4
Life expectancy at birth - females LT 75,1 75,9 76,6 76,6 77 77,5 77,6 77,5 77,8 77,7 77,3 77
Life expectancy at 45 - females LT 33 33,6 34,1 34,1 34,5 34,8 34, 7 34,6 34,8 34,7 34,3 34,2
Life expectancy at 65 - females LT 16,9 17,2 17,3 17,4 17,6 17,9 17,9 17,8 18,1 17,9 17,6 17,6
Healthy Life Years at birth - females LT :::::::::: 5 4 . 3  ( b ) 5 6 , 1
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males LU 73 73,3 74 73,7 74,4 74,6 75, 1 74,6 74,8 75,9 76,7 76,8
Life expectancy at 45 - males LU 30,5 30,7 31,2 31,2 31,8 32 32, 5 32,3 31,9 33,1 33,3 33,5
Life expectancy at 65 - males LU 14,7 14,8 14,8 15,2 15,3 15, 5 16 15,9 15,3 16,5 16,7 17
Healthy Life Years at birth - males LU ::::::::: 5 9 . 1  ( b ) 6 2 , 2 6 1
Life expectancy at birth - females LU 80,6 80,2 80 80,8 81,4 81,3 80, 7 81,5 80,8 82,3 82,3 81,9
Life expectancy at 45 - females LU 37,3 37,1 36,7 37,3 37,5 37, 7 37,4 37,7 37 38,5 38,4 38
Life expectancy at 65 - females LU 19,7 19,5 19,2 19,5 19,8 20,1 19,7 20 18,9 20,5 20,4 20,3
Healthy Life Years at birth - females LU ::::::::: 6 0 . 2  ( b ) 6 2 , 1 6 1 , 8
 
EN 167   EN 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males HU 65,4 66,3 66,7 66,5 66,7 67,6 68,2 68,3 68,4 68,7 68,7 69,2
Life expectancy at 45 - males HU 24,7 25,1 25,4 25,3 25,3 26 26, 4 26,4 26,3 26,6 26,4 26,8
Life expectancy at 65 - males HU 12,2 12,3 12,5 12,5 12,5 13 13,2 13,2 13 13,4 13,3 13,6
Healthy Life Years at birth - males HU :::::::: 5 3 . 5   ( p ) : 5 2  ( b ) 5 4 , 2
Life expectancy at birth - females HU 74,8 75 75,5 75,6 75,6 76,2 76, 7 76,7 76,7 77,2 77,2 77,8
Life expectancy at 45 - females HU 32,2 32,4 32,7 32,8 32,6 33,2 33,5 33,6 33,5 33,8 33,8 34,3
Life expectancy at 65 - females HU 16 15,9 16,3 16,4 16,2 16,7 17 17 16,9 17,3 17,2 17,7
Healthy Life Years at birth - females HU :::::::: 5 7 . 8   ( p ) : 5 3 . 9  ( b ) 5 7
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males MT 74,8 74,8 75,2 74,9 75,3 76,2 76,6 76,3 76,4 77,4 77,3 77
Life expectancy at 45 - males MT 32,5 32,3 32,1 32 32,1 32,7 33,4 33 33,2 34,1 33,8 33,6
Life expectancy at 65 - males MT 15,5 14,8 14,6 14,6 15 15,1 15, 7 15,3 15,6 16,3 16,2 16,1
Healthy Life Years at birth - males MT ::::::: 6 5 . 1   ( p ) :: 6 8 . 5  ( b ) 6 8 , 1
Life expectancy at birth - females MT 79,6 79,6 80,1 80 79,4 80,3 81, 2 81,3 80,8 81,2 81,4 81,9
Life expectancy at 45 - females MT 35,7 36,5 36,6 36,3 35,9 36,5 36,9 37,3 36,9 37,4 37,5 37,7
Life expectancy at 65 - females MT 17,6 18,3 18,4 18,1 17,8 18,5 18,7 19,1 18,6 19,1 19,4 19,5
Healthy Life Years at birth - females MT ::::::: 6 5 . 7   ( p ) :: 7 0 . 1  ( b ) 6 9 , 2
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males NL 74,6 74,7 75,2 75,2 75,3 : 75, 8 76 76,3 76,9 77,2 77,7
Life expectancy at 45 - males NL 31,6 31,6 32 32 32,1 : 32,6 32,7 32,9 33,5 33,8 34,2
Life expectancy at 65 - males NL 14,7 14,8 15,1 15,1 15,2 : 15, 6 15,6 15,8 16,3 16,4 16,8
Healthy Life Years at birth - males NL 61,1 62,1 62,5 61,9 61,6 61,4 61,9 61.7 (e) 61.7 (e) : 65 (b) 65
Life expectancy at birth - females NL 80,5 80,5 80,7 80,8 80,5 : 80,8 80,7 81 81,5 81,7 82
Life expectancy at 45 - females NL 36,9 36,9 37 37,1 36,9 : 37,1 37 37,2 37,7 37,9 38,1
Life expectancy at 65 - females NL 19,2 19,2 19,3 19,4 19,2 : 19, 4 19,3 19,5 19,9 20,1 20,3
Healthy Life Years at birth - females NL 62.1 (e) 61,5 61,4 61.1 (e) 61,4 60,2 59, 4 59.3 (e) 58.8 (e) : 63.1 (b) 63,2
 
EN 168   EN 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males AT 73,4 73,7 74,1 74,5 74,9 75,2 75,7 75,8 75,9 76,4 76,7 77,2
Life expectancy at 45 - males AT 31 31,2 31,4 31,7 32 32,4 32,8 32,9 32,9 33,4 33,6 34
Life expectancy at 65 - males AT 15 15,1 15,2 15,4 15,7 16 16,3 16,3 16,4 16,9 17 17,3
Healthy Life Years at birth - males AT 60 62,3 62,2 63,4 63,6 64,6 64,2 65.6 (e) 66.2 (e) 58.1 (b) 57,8 58,4
Life expectancy at birth - females AT 80,1 80,2 80,7 81 81 81,2 81, 7 81,7 81,5 82,1 82,3 82,8
Life expectancy at 45 - females AT 36,5 36,6 37 37,3 37,3 37,5 37, 9 37,8 37,7 38,3 38,4 38,9
Life expectancy at 65 - females AT 18,8 18,9 19,1 19,4 19,4 19,6 2 0 19,8 19,8 20,2 20,4 20,7
Healthy Life Years at birth - females AT ::::: 6 8 6 8 , 5 6 9 . 0  ( e )  6 9 . 6  ( e )  6 0 . 2  ( b ) 5 9 , 6 6 0 , 8
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males PL 67,7 68,1 68,5 68,9 68,8 69,6 7 0 70,3 70,5 70,6 70,8 70,9
Life expectancy at 45 - males PL 26,7 26,9 27,1 27,4 27,3 27,9 28,1 28,3 28,4 28,5 28,6 28,8
Life expectancy at 65 - males PL 12,9 12,9 13,1 13,4 13,3 13,6 13,7 13,9 13,9 14,2 14,3 14,5
Healthy Life Years at birth - males PL : 5 9 , 9 ::::: 6 2 , 5 :: 6 1 5 8 , 2
Life expectancy at birth - females PL 76,4 76,6 77 77,4 77,5 78 78, 4 78,8 78,8 79,2 79,3 79,7
Life expectancy at 45 - females PL 33,6 33,7 33,9 34,2 34,3 34,7 3 5 35,3 35,3 35,6 35,8 36,1
Life expectancy at 65 - females PL 16,5 16,5 16,8 17,1 17,1 17, 5 17,7 18 18 18,3 18,5 18,8
Healthy Life Years at birth - females PL : 6 6 , 8 ::::: 6 8 , 9 :: 6 6 . 6  ( b ) 6 2 , 5
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males PT 71,7 71,6 72,2 72,4 72,6 73,2 73,5 73,8 74,2 75 74,9 75,5
Life expectancy at 45 - males PT 30,7 30,6 31 31,1 31,3 31,6 31,9 31,9 32 32,6 32,4 32,9
Life expectancy at 65 - males PT 14,7 14,6 14,9 14,9 15 15,4 15, 7 15,7 15,7 16,3 16,1 16,6
Healthy Life Years at birth - males PT 59,6 58,2 59,3 59,1 58,8 60,2 59,5 59. 7 (e) 59.8 (e) 55.1 (b) 58,4 59,6
Life expectancy at birth - females PT 79 79 79,3 79,5 79,7 80,2 80, 5 80,6 80,6 81,5 81,3 82,3
Life expectancy at 45 - females PT 35,9 35,9 36,3 36,4 36,4 36,9 37,1 37,2 37 37,9 37,6 38,5
Life expectancy at 65 - females PT 18,1 18,1 18,4 18,5 18,5 18,9 19,1 19,2 19 19,7 19,4 20,2
Healthy Life Years at birth - females PT 63,1 60,5 60,4 61,1 60,7 62,2 62,7 61. 8 (e) 61.8 (e) 52 (b) 56,7 57,6
 
EN 169   EN 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males RO 65,5 65,1 65,2 66,3 67,1 67,7 67,5 67,3 67,7 68,2 68,7 69,2
Life expectancy at 45 - males RO 26 25,6 25,8 26,4 26,9 27,3 2 7 26,7 26,8 27,3 27,4 27,7
Life expectancy at 65 - males RO 12,8 12,4 12,7 13 13 13,4 13,3 12,9 13 13,3 13,4 13,6
Healthy Life Years at birth - males RO :
Life expectancy at birth - females RO 73,5 72,8 73,3 73,8 74,2 74,8 74,9 74,7 75 75,5 75,7 76,2
Life expectancy at 45 - females RO 31,8 31,4 31,8 32,1 32,3 32,7 32,7 32,4 32,7 33,1 33,1 33,5
Life expectancy at 65 - females RO 15,3 14,9 15,3 15,5 15,5 15,9 1 6 15,7 15,8 16,2 16,1 16,5
Healthy Life Years at birth - females RO :
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males SI 70,8 71,1 71,1 71,3 71,8 72,2 72,3 72,6 72,5 73,5 73,9 74,5
Life expectancy at 45 - males SI 28,6 29 29 29,1 29,3 29,7 29,8 30 29,8 30,7 31,1 31,6
Life expectancy at 65 - males SI 13,6 13,8 14 13,9 14,1 14,2 14,5 14,5 14,3 15 15,2 15,8
Healthy Life Years at birth - males SI :::::::::: 5 6 . 3  ( b ) 5 7 , 6
Life expectancy at birth - females SI 78,5 79 79,1 79,2 79,5 79,9 80,4 80,5 80,3 80,8 80,9 82
Life expectancy at 45 - females SI 35 35,4 35,5 35,6 35,8 36,2 36,5 36,6 36,5 37 37,1 37,9
Life expectancy at 65 - females SI 17,6 18,1 18 18,1 18,3 18,7 19 19 18,7 19,4 19,3 20
Healthy Life Years at birth - females SI :::::::::: 5 9 . 9  ( b ) 6 1
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males SK 68,4 68,8 68,9 68,6 69 69,2 69, 5 69,8 69,8 70,3 70,2 70,4
Life expectancy at 45 - males SK 26,7 27 27 26,9 27,1 27,2 27,3 27,5 27,6 28 27,8 28
Life expectancy at 65 - males SK 12,7 12,8 12,9 12,8 13 12,9 1 3 13,2 13,2 13,3 13,3 13,3
Healthy Life Years at birth - males SK :::::::::: 5 4 . 9  ( b ) 5 4 , 3
Life expectancy at birth - females SK 76,5 77 76,9 77 77,4 77,5 77,7 77,7 77,7 78 78,1 78,4
Life expectancy at 45 - females SK 33,3 33,8 33,7 33,8 34 34,1 34, 1 34,3 34,3 34,5 34,5 34,8
Life expectancy at 65 - females SK 16,2 16,6 16,5 16,6 16,8 16,7 16,8 16,9 16,9 17,1 17,1 17,3
Healthy Life Years at birth - females SK :::::::::: 5 6 . 4  ( b ) 5 4 , 4
 
EN 170   EN 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males FI 72,8 73,1 73,5 73,6 73,8 74,2 74,6 74,9 75,1 75,4 75,6 75,9
Life expectancy at 45 - males FI 30,4 30,7 31 31 31,2 31,6 32 32,1 32,3 32,6 32,8 33,1
Life expectancy at 65 - males FI 14,6 14,7 15 15 15,2 15,5 15, 7 15,8 16,2 16,5 16,8 16,9
Healthy Life Years at birth - males FI : 54,6 55,5 55,9 55,8 56,3 56,7 57.0 (e) 57.3 (e) 53.1 (b) 51,7 52,9
Life expectancy at birth - females FI 80,4 80,7 80,7 81 81,2 81,2 81, 7 81,6 81,9 82,5 82,5 83,1
Life expectancy at 45 - females FI 36,7 37 37 37,3 37,5 37,5 37,8 37,8 38 38,6 38,8 39,2
Life expectancy at 65 - females FI 18,7 18,9 19,1 19,3 19,5 19, 5 19,8 19,8 20 20,7 21 21,2
Healthy Life Years at birth - females FI : 57,7 57,6 58,3 57,4 56.8 (e) 56,9 56. 8 (e) 56.5 (e) 52.9 (b) 52,4 52,7
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males SE 76,2 76,6 76,8 76,9 77,1 77,4 77,6 77,7 78 78,4 78,5 78,8
Life expectancy at 45 - males SE 33 33,2 33,4 33,6 33,8 34,1 34, 2 34,3 34,5 34,9 34,9 35,2
Life expectancy at 65 - males SE 16 16,1 16,3 16,4 16,5 16,7 16, 9 16,9 17,1 17,5 17,4 17,7
Healthy Life Years at birth - males SE : : 62,1 61,7 62 63,1 61,9 62.4 (e) 62.5 (e) 62 (b) 64,2 67,1
Life expectancy at birth - females SE 81,7 81,7 82 82,1 82 82 82,2 82,1 82,5 82,8 82,9 83,1
Life expectancy at 45 - females SE 37,8 37,8 38,1 38,2 38 38 38,1 38,1 38,5 38,8 38,8 39
Life expectancy at 65 - females SE 19,9 19,9 20,1 20,2 20 20,2 20, 2 20,1 20,4 20,7 20,7 20,9
Healthy Life Years at birth - females SE : : 60 61.3 (e) 61,8 61,9 61 61.9 (e) 62.2 (e) 60.9 (b) 63,1 67
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Life expectancy at birth - males UK 74 74,3 74,6 74,8 75 75,5 75,8 76 76,2 76,8 77,1 :
Life expectancy at 45 - males UK 31,2 31,5 31,8 32 32,1 32,6 32,9 33,1 33,2 33,8 34 :
Life expectancy at 65 - males UK 14,6 14,9 15,1 15,3 15,4 15, 8 16,1 16,2 16,3 16,8 17 :
Healthy Life Years at birth - males UK 60,6 60,8 60.9 (e) 60.8 (e) 61.2 (e) 61.3 (e) 61.1 (e) 61.4 (e) 61.5 (e) : 63.2 (b) :
Life expectancy at birth - females UK 79,3 79,5 79,7 79,8 79,9 80, 3 80,5 80,6 80,5 81 81,1 :
Life expectancy at 45 - females UK 35,7 35,9 36,1 36,2 36,2 36, 7 36,9 36,9 36,8 37,2 37,4 :
Life expectancy at 65 - females UK 18,2 18,4 18,5 18,6 18,6 19 19,2 19,2 19,1 19,4 19,5 :
Healthy Life Years at birth - females UK 61.2 (e) 61.8 (e) 61.2 (e) 62.2 (e) 61.3 (e) 61.2 (e) 60.8 (e) 60.9 (e) 60.9 (e) : 65 (b) :
 
EN 171   EN 4. Early school-leavers  (% of the total population aged 18-24 who have at most lower secondary education and not in further education or training)
EU27 EU25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SL SK FI SE UK
2000 total 17,6e 17,3e 12,5 : : 11,6 14,9 14,2 : 18,2 29,1 13,3 25,3 18,5 : 16,7 16,8 13,8 54,2 15,5 10,2 : 42,6 22,3 : : 8,9b 7,7 18,4
female 15,6e 15,2e 10,2 : : 9,9 15,2 12,1u : 13,6 23,4 11,9 21,9 13,9 : 14,9 17,6 13,2 56,1 14,8 10,7 : 35,1 21,3 : : 6,5b 6,2 17,9male 19,7e 19,5e 14,8 : : 13,4 14,6 16,3 : 22,9 34,7 14,8 28,8 25 : 18,5 15,9 14,3 52,5 16,2 9,6 : 50,1 23,3 : : 11,3b 9,2 19
2004 total 16,1 15,6 11,9b 21,4 6,1 8,5 12,1 13,7 12,9p 14,9 31,7 14,2 22,3 20,6 15,6 9,5b 12,7 12,6 42b 14 8,7i 5,7b 39,4b 23,6b 4,2u 7,1 8,7 8,6 14,9i
female 13,7 13,1 8,3b 20,7 6,5 6,7 11,9 : 9,7p 11,6 24,6 12,3 18,4 14,9 10,7 7,4u 12,7 11,4 39,5b 11,9 7,9i 3,7b 30,6b 22,4b 2,6u 6,4 6,9 7,9 14,2imale 18,5 18 15,6b 22,1 5,8 10,4 12,2 20,5 16,1p 18,3 38,5 16,1 26,2 27,2 20,5 11,6u 12,6 13,7 44,2b 16,1 9,5i 7,7b 47,9b 24,9b 5,8u 7,8 10,6 9,3 15,7i
2005 total 15,6 15,2 13 20 6,4 8,5 13,8 14 12,3p 13,3 30,8b 12,6 21,9 18,1 11,9 9,2 13,3 12,3 41,2 13,6 9 5,5 38,6 20,8 4,3u 5,8 9,3 11,7b 14
female 13,6 13,1 10,6 20,6 6,6 7,5 14,1 10,7u 9,6p 9,2 25b 10,7 17,8 10,6 8,2 6,2u 9,6 11,1 39,3 11,2 8,5 4 30,1 20,1 2,8u 5,7 7,3 10,9b 13,2male 17,6 17,3 15,3 19,5 6,2 9,4 13,5 17,4u 14,9p 17,5 36,4b 14,6 25,9 26,6 15,5 12,2u 17 13,5 43 15,8 9,4 6,9 46,7 21,4 5,7u 6 11,3 12,4b 14,7
2006 total 15,3 15,1 12,6 18 5,5 10,9 13,8 13,2 12,3 15,9 29,9 13,1 20,8 16 19p 10,3 17,4 12,4 41,7 12,9 9,6 5,6 39,2p 19 5,2u 6,4 8,3p 12 13
female 13,2 12,8 10,2 17,9 5,4 9,1 13,6 : 9 11 23,8 11,2 17,3 9,2 16.1p 7u 14 10,7 38,8 10,7 9,8 3,8 31,8p 18,9 3,3u 5,5 6,4p 10,7 11,4male 17,5 17,4 14,9 18,2 5,7 12,8 13,9 19,6u 15,6 20,7 35,8 15,1 24,3 23,5 21.6p 13,3u 20,9 14 44,6 15,1 9,3 7,2 46,4p 19,1 6,9u 7,3 10,4p 13,3 14,6
2007 total 14,8 14,5 12,3 16,6 : 12.4b 12,7 14,3 11,5 14,7 31 12,7 19,3 12,6 16p 8,7 15,1 10,9 37,3 12 10,9 5 36.3p 19,2 4.3u 7,2 7,9 8,6b 17,0b
female 12,7 12,3 10,7 16,9 : 8.9b 11,9 : 8,7 10,7 25,6 10,9 15,9 6,8 12.3p 5.9u 11.1u 9,3 32,9 9,6 10,2 3,6 30.4p 19,1 2.7u 6,3 6,3 7,0b 15,8bmale 16,9 16,7 13,9 16,3 : 15.7b 13,4 21,0 14,2 18,6 36,1 14,6 22,6 19,5 19.7p 11,4 19,2 12,5 41,1 14,4 11,6 6,4 42.0p 19,2 5.7u 8,1 9,7 10,2b 18,2b
u = data lack reliability due to low sample size / : = not available or unreliable data / b = break / p = provisional
In DK, LU, IS, NO, EE, LV, LT, CY, MT and SI, the high degree of variation of results over time is partly influenced by a low s ample size. 
In CY, the reference population (denominator) excludes students abroad. In DE (2004), participation to personnel interest cours es is excluded
Source : Eurostat, Labour Force Survey - Quarter 2 results
 
EN 172   EN 5. People living in jobless households: children (0-17 years) and prime-age adults (18-59 years), selected years (% of population in the relevant age group)
EU27 EU25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SI SK FI SE UK
2001 Children 9.5e 12,9 19 8 : 8,9 11,2 10,4 5,3 6,4 9,2 7 3,9 10,7 : 3,4 13,5 7,9 6 4,1 : 3,6 6,8 3,8 9.3u : : 16,9
Adults (18-59)
Total 10.1e 13,8 17.3b 7,9 : 9,7 11 8,8 8,8 7,4 10,3 10,8 4,9 12,8 10 6,7 13,2 7,8 6,9 7,9 13,8 4,3 8,7 8,2 10 : : 11,2
Men 8.8e 11,5 16.8b 6,2 : 8,9 10,9 7,4 6,4 6,6 8,9 9,1 3,4 12,3 10,1 5,3 12 5,7 5,4 6,2 12,9 3,7 7,7 7,1 9,6 : : 9,1
Women 11.4e 16,2 17.8b 9,5 : 10,5 11,1 10,2 11,2 8,3 11,6 12,4 6,3 13,2 10 8,1 14,3 9,9 8,5 9,6 14,7 4,9 9,6 9,4 10,5 : : 13,2
2002 Children 9.8e 13,8 18,7 7,6 5,6 9,3 10,1 10,8 5,1 6,6 9,6 7,2 3,9 10.6b 8,4 2,8 14,3 7,6 6 4,4 : 4,2 9.8b 3,8 12,1 : : 17,4
Adults (18-59)
Total 10.2e 14,2 16,6 7,3 7,6 10 10,8 8,5 8,9 7,3 10,4 10,2 5,3 10.5b 9.1b 6,3 13 7,2 6,7 7,5 15,1 4,6 11.3b 8 10,9 : : 11,3
Men 8.9e 11,9 16,1 5,6 7,2 9,4 10,6 7,3 6,5 6,6 9,1 8,6 3,9 10.7b 8.5b 5,6 12 5,8 5,3 6,2 14,1 3,9 10.1b 7 10,4 : : 9,2
Women 11.4e 16,6 17 9,1 8 10,7 10,9 9,7 11,2 8 11,8 11,8 6,5 10.3b 9.7b 7 14 8,6 8,1 8,8 16,1 5,2 12.5b 8,9 11,4 : : 13,3
2003 Children 9.8e 13,9 16,6 8,4 5,7 10,3 9 11,8 4,6 6 9,5 7 3,4 7,2 6,1 3.9i 12.6b 8 7 4,3 : 5 10,2 4 11,8 5,7 : 17
Adults (18-59)
Total 10.2e 14,4 15,3 7,7 8,6 10,6 10,9 8,9 8,5 7,2 10,6 9,7 5,2 8,7 7,4 7.5i 11.6b 7,9 8 7,4 14,8 5,5 11,1 8,7 10,1 10,9 : 10,9
Men 9e 12,7 14,7 5,8 7,8 10 11,3 7,6 6,2 6,5 9,5 8,1 4,3 8,9 7,4 6i 10.9b 6,2 6,7 6,1 13,7 4,8 9,8 7,8 9,3 11,6 : 8,9
Women 11.3e 16,2 15,8 9,7 9,3 11,2 10,5 10,2 10,8 7,8 11,8 11,3 6,1 8,6 7,4 9i 12.2b 9,7 9,3 8,6 15,9 6,1 12,4 9,6 10,9 10,3 : 12,9
2004 Children 9.8i 13,2 15,6 9 6 10,9 9,6 11,8 4,5 6,3 9,6 5,7 2,6 7,2 6,5 3,4 13,2 9,2 7 5.6i : 4,3 11,1 3,8 12,8 5,7 : 16,8
Adults (18-59)
Total 10.3i 13,7 13,7 8 8,5 11,1 9,5 8,6 8,5 7,3 10,8 9,1 5 7,8 8,1 7,1 11,9 8,6 8 8.8i 15,8 5,3 11,1 7,5 10,8 11 : 11
Men 9.3i 11,3 13,2 6,4 8,3 10,8 10,2 7,2 6,2 6,7 9,5 7,9 3,8 7,1 8,3 5,7 11,1 6,8 6,7 7.6i 14,8 5 10,4 7 10 11,2 : 9
Women 11.4i 16 14,2 9,6 8,8 11,4 8,7 10,1 10,7 7,9 12,1 10,4 6,1 8,4 8 8,5 12,7 10,4 9,3 10i 16,8 5,7 11,7 8 11,6 10,9 : 13
2005 Children 9,7e 9.6e 12,9 14,5 8,1 5,7 10.7p 9,1 12 4,1 5,4 9,5 5,6 3,5 8,3 6,2 2,7 14,2 8,9 7 6,3 : 4,3 10,4 2.7u 13,8 6,6 : 16,5
Adults (18-59)
Total 10,3e 10.2e 13,5 13 7,4 7,7 11p 8,5 8,4 8,5 6,7 10,7 9,5 5,2 8,1 6,6 6,7 12,3 8,2 8 8,7 15,3 5,5 10,4 6,7 10,2 10,5 : 11
Men 9,3e 9.2e 11,6 12,6 5,8 7,7 10.9p 10,2 7,2 6,4 6,2 9,6 8,3 4,2 8,7 6,9 5,4 11,6 6,5 6,9 7,7 14 5,1 9,4 6,3 9,5 11 : 9,2
Women 11,2e 11.2e 15,4 13,5 9 7,8 11.2p 7 9,8 10,7 7,2 11,8 10,8 6,2 7,6 6,4 8,1 13,1 9,9 9 9,6 16,6 5,8 11,3 7,1 10,9 10 : 12,8
2006 Children 9,7e 9.6e 13,5 14,5 8,2 5 10.3p 8,2 11,3 3,6 5,1 9.5p 5,4 3,9 7,1 5,3 3,7 13,3 8,2 6,2 7,2 12,8 4,7 10 3,6 11,8 4,9 : 16,2
Adults (18-59)
Total 9,9e 9.9e 14,3 11,6 7,3 6,9 10.5p 6 7,9 8,1 6,3 10.9p 9,2 4,9 6,8 7 7,1 11,6 6,7 7,4 8,8 14,4 5,8 9,7 7,2 9,6 9,5 : 10,7
Men 8,9e 8.9e 12,3 11,1 5,8 6,4 10.3p 6,1 6,5 6,1 5,8 9.9p 7,8 3,7 7,5 7,2 5,4 10,6 5,2 6,2 7,8 13,2 5,3 8,8 6,6 9 10,1 : 8,8
Women 10,9e 10.9e 16,4 12 8,8 7,3 10.7p 5,8 9,3 10,1 6,8 12p 10,6 5,9 6,2 6,9 8,9 12,6 8,2 8,6 9,8 15,6 6,4 10,6 7,8 10,2 9 : 12,5
2007 Children 9.4e 9.3e 12 12,8 8 : 9,6 7,2 11,5 3,9 5,3 8,7 5,8 3,9 8,3 8,3 3,4 13,9 9,2 5,9 5,3 9,5 5,1 10 2,2 10,6 4,4 : 16,7
Adults (18-59)
Total 9.3e 9.2e 12,3 10,2 6,5 : 9,5 6 7,9 8 6,2 10 9,2 4,7 6,6 7 7 11,9 7,7 6,5 7,1 11,6 5,7 10,4 6,5 8,9 9,1 : 10,7
Men 8,2e 8.2e 10,6 10,1 4,9 : 9,1 6,1 6,7 6 5,8 9 7,9 4,2 6,7 7,3 6 10,8 6,2 5,3 5,9 10,4 5,3 9,3 5,5 8,1 9,6 : 8,8
Women 10.3e 10.2e 13,9 10,3 8,1 : 9,9 5,9 9,3 10 6,7 11,1 10,6 5,2 6,6 6,8 7,9 12,9 9,3 7,6 8,4 12,7 6,1 11,5 7,5 9,6 8,6 : 12,7
u = data lack reliability due to low sample size / : = not available or unreliable data / b = break / p = provisional / e: esti mate
In DK, LU, IS, NO, EE, LV, LT, CY, MT and SI, the high degree of variation of results over time is partly influenced by a low s ample size. 
In CY, the reference population (denominator) excludes students abroad. In DE (2003 and 2004), participation to personnel inter est courses is excluded
Source : Eurostat, Labour Force Survey - Quarter 2 results
 
EN 173   EN 6. Projected total public social expenditures
Total age-related public spending: pension, health care, long-term care, education and unemployment transfers (% of GDP) – base line scenario
http://ec.europa.eu/economy_finance/epc/documents/2006/ageingannex_en.pdf p.7
http://ec.europa.eu/economy_finance/epc/documents/2006/ageingreport_en.pdf p.11
EU25 BE CZ DK DE EE IE EL* ES FR IT CY LT LV LU HU MT NL AT PL PT SI SK FI SE UK
2004 23,4 25,4 19,3 26,8 23,7 17,1 15,5 8,9 20,1 26,7 26,2 16,4 16 17,5 19,5 20,7 18,2 20,9 25,2 23,7 23,8 24,2 16,2 25,4 29,6 19,6
Change 2004-2010 -0,7 -0,3 -0,5 0,2 -1,2 -0,6 -0,1 -0,2 -0,4 0 -0,5 0,1 -0,7 -2,9 -0,1 0,3 0,9 -0,3 -1 -3,5 0,4 -0,2 -0,8 0,2 -1,4 -0,2
Change 2004-2020 -0,2 1,2 -0,1 1,8 -0,8 -2 1,6 -0,2 0,3 0,9 -0,3 1,2 -0,9 -2,9 2,1 1,6 2,2 1,5 -1 -5,8 2,5 1,3 -0,9 2,3 -1 0,3
Change 2004-2030 1,5 4,5 1,7 4 1 -2,3 3,3 0,2 3,3 1,9 1,1 4,1 0,3 -1,5 5,5 2,8 1,8 3,8 0,8 -6,1 4,2 4,4 0,3 4,7 1,3 2,2
Change 2004-2040 3 6,2 4,8 5,3 2 -2,8 5,2 0,8 7,2 2,9 2,5 7 0,8 -1,3 7,9 5,7 1 5,3 0,9 -6,4 7,3 7,5 1,5 5,3 2,3 3,3
Change 2004-2050 3,4 6,3 7,1 4,8 2,7 -2,7 7,8 1,3 8,5 2,9 1,8 11,8 1,4 -1,3 8,3 7 0,3 4,9 0,1 -6,7 9,8 9,6 2,9 5,2 2,2 4
1) Total expenditure for GR does not include pension expenditure. The Greek authorities have agreed to provide the pension proj ections in 2006. In the context of the most recent assessment
 of the sustainability of public finances based on the Greek stability programme, public spending on pensions was projected to increase by 10.3% of GDP between 2004 and 2050.
2) Total expenditure for: GR, FR, PT, CY, EE, HU does not include long-term care
3) The projection results for public spending on long-term care for Germany does not reflect current legislation where benefit levels are fixed. A scenario which comes closer to the current setting
 of legislation projects that public spending would remain constant as a share of GDP over the projection period.
Note: these figures refer to the baseline projections for social security spending on pensions, education and unemployment tran sfers.
For health care and long-term care, the projections refer to “AWG reference scenarios”
7a. Relative median income ratio of people aged 65+ (relative to the complementary age group 0-64) (%), 2007
EU27 EU25 BE BG(1)CZ DK DK(2)DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO(1)SI SK FI SE UK
Relative median 
income ratio (65+/0 -
64)Total
0.84ps 0.84p 0,74 0.83i 0,81 0,7 0.62p 0.86p 0.65p 0.69p 0.83p 0,76 0.9p 0,86 0,57 0,65 0,69 0,96 0,97 0,79 0.83p 0,93 1,04 0.79p 0.89p 0,86 0,81 0,74 0,78 0,72
Notes: i See explanatory text (Eurostat website) p = provisional value  s = Eurostat estimate  u = unreliable or uncertain data   (:) = data not available 
EU Aggregates: Eurostat estimates are obtained as a population size weighted average of national data.
7b. Aggregate replacement ratio (%), 2007
EU27 EU25 BE BG(1)CZ DK DK(2)DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO(1)SI SK FI SE UK
Total: 0,49 0,44 0.6i 0,51 0,39 0.37p 0,45 0,47 0,47 0,4 0,47 0,61 0,49 0,29 0,38 0,4 0,61 0,58 0,5 0,42 0,61 0,58 0,47 : 0,44 0,54 0,46 0,61 0,41
Men : 0,52 0,46 0.62i 0,51 0,38 : 0,47 0,4 0,41 0,46 0,52 0,61 0,56 0,34 0,33 0,38 0,59 0,6 0,52 0,49 0,62 0,64 0,5 : 0,51 0,53 0,46 0,63 0,42
Women : 0,49 0,45 0.58i 0,56 0,43 : 0,48 0,57 0,53 0,42 0,48 0,54 0,37 0,34 0,43 0,44 0,58 0,57 0,48 0,54 0,68 0,57 0,48 : 0,39 0,57 0,48 0,54 0,44
Notes: i See explanatory text (Eurostat website) p = provisional value  s = Eurostat estimate  u = unreliable or uncertain data   (:) = data not available 
EU Aggregates: Eurostat estimates are obtained as a population size weighted average of national data.
8a. Inequalities in access to health care (unmet need for care by income quintile for 3 reasons: too expensive, too long waitin g time, too far to travel), SILC 2006
EU-27 EU-25 BE CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT SI SK FI SE UK
1st quintile : : 1,8 1,4 0,2 : 14,4 2,7 7,9 0,9 4,3 9,2 6,6 28,9 13,6 0,8 3,9 3,4 0,9 1 13,3 9,6 0,3 6,4 4,7 4,1 2,6
2nd quintile : : 0,4 0,7 0,3 : 7 2,1 7,8 0,9 1,4 5,1 4,7 20,5 10,5 0,1 3,2 1,9 0,3 0,5 11 6,8 0,2 3,4 3,3 3,9 1,7
3rd quintile : : 0,2 0,5 0,2 : 5,9 2,4 7,3 0,5 1,2 4 2,6 10,2 7,9 0,2 2,4 1,6 0,3 0,2 8,9 4,9 0,1 2,2 2,1 3,3 1,5
4th quintile : : : 0,5 0,2 : 6,3 1,9 4,1 0,4 0,3 3,1 1,5 9,8 5,2 0,2 1,7 1,2 0,3 0,3 7,2 2,7 0,1 1,5 1,7 2 2,4
5th quintile : : 0,1 0,2 0,2 : 3,1 0,7 2 0,2 0,6 2,1 0,5 5,9 3,9 0,4 0,8 0,8 0,3 0,3 6,4 1,1 0,2 0,8 0,9 1,1 1,5
* This data should be interpreted with care when comparing levels of across countries due to a problem in the translation of th e questionnaire.
8b. Doctor's consultations
EU-27 EU-25 BE CZ DK EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT SI SK FI SE UK
: : 7,5 12,9 7,5 6,9 : : 8,1 6,4 7,0 2,0 5,2 6,8 6,0 12,9 1,9 5,6 6,7 6,6 3,9 7,2 10,4 4,3 2,8 5,1
Notes:  (:) = data not available
Source:  OECD Health Data. Calculated as the number of contacts with an ambulatory care physician divided by the population. Includes c ontacts in out-patient wards.Source: SILC(2006)  Source: SILC 2007,  Income data 2006; except for UK, income year 2006 and for IE moving income reference period (2005-2006);  (1)BG National HBS 2006, income data 2006; (2) with imputed rent data 2006 (see methodological note).
Source: SILC 2007,  Income data 2006; except for UK, income year 2006 and for IE moving income reference period (2005-2006);  (1) BG National HBS 2006, income data 2006; (2) with imputed rent data 2006 (see methodological note).Aggregate 
replacement ratio  
(Pensions 65-74 
/Earnings 50-59)
 
EN 174   EN 9. At-risk of poverty rate anchored at a fixed moment in time (poverty threshold of 2005),  2007
EU27 EU25 BE BG(1)CZ DK DK(2)DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO(1)SI SK FI SE UK
Total population Total : 14p 14 : 7 11 14p 8 12 20 17 13 20 10 10 8 14 10 11 9 13 13 18 : 10 5 11 9 16
Men : 14p 14 : 7 10 13p 8 11 19 16 12 18 9 10 7 13 10 10 9 12 13 17 : 8 5 10 9 15
Women : 15p 15 : 8 11 15p 8 12 20 18 14 21 12 10 8 15 10 11 10 15 12 19 : 11 5 11 9 17
Children aged 0-17 Total : 1 7 p 1 6 : 1 3 9 1 3 p9 1 42 32 01 62 5 7 1 11 12 11 61 41 31 71 82 1 : 9 9 9 1 01 9
People aged 18-64 Total 13p 12 7 10 14p 8 11 18 14 12 17 6 10 7 13 10 9 8 11 12 15 : 8 5 10 9 13
Men : 12p 11 : 6 11 13p 9 10 18 13 11 16 5 10 7 13 10 8 7 10 13 14 : 8 5 10 10 12
Women : 14p 13 : 7 10 15p 8 11 19 15 13 19 8 10 7 14 10 10 9 13 12 16 : 8 5 9 8 13
People aged 65+ Total : 17p 22 : 3 16 15p 6 13 22 23 13 22 39 9 5 8 4 13 8 16 4 26 : 17 3 18 8 24
Men : 14p 19 : 1 13 12p 4 11 20 22 12 18 35 5 1 7 2 16 7 11 3 24 : 9 2 14 5 21
Women : 18p 24 : 4 17 17p 7 15 24 25 14 25 42 10 6 8 6 11 9 19 5 27 : 22 4 20 11 27
Source: SILC 2007,  Income data 2006; except for UK, income year 2007 and for IE moving income reference period (2006-2007);  (1) BG, RO (:) data not available; (2) with imputed rent (see methodological note).
Notes: i See explanatory text (Eurostat website) p = provisional value  s = Eurostat estimate  u = unreliable or uncertain data   (:) = data not available n.a.=forthcomimg
EU Aggregates: Eurostat estimates are obtained as a population size weighted average of national data.
10. Employment rate of older workers (% of people aged 55-64)
EU27 EU25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SL SK FI SE UK
1998 total : 35,8 22,9 : 37,1 52 37,7 50,2 41,7 39 35,1 28,3 27,7 : 36,3 39,5 25,1 17,3 : 33,9 28,4 32,1 49.6b 51,5 23,9 22,8 36,2 63 49
male : 46,6 32,1 : 53,2 61,3 47,2 62 60,2 56 52,6 32,5 41,4 : 48,1 54,4 35,2 27 : 47,5 40,5 41,5 62.9b 59,5 31,8 39,1 38,4 66,1 59,1female : 25,5 14 : 22,9 42 28,3 41,6 23,1 23,5 18,8 24,4 15 : 27,5 28,3 15,5 9,6 : 20,3 17,1 24,1 38b 44,5 16,1 9,4 34,1 60 39,2
2000 total 36,9 36,6 26,3 20,8 36,3 55,7 37,6 46,3 45,3 39 37 29,9 27,7 49,4 36 40,4 26,7 22,2 28,5 38,2 28,8 28,4 50,7 49,5 22,7 21,3 41,6 64,9 50.7b
male 47,1 46,9 36,4 33,2 51,7 64,1 46,4 55,9 63,2 55,2 54,9 33,6 40,9 67,3 48,4 50,6 37,2 33,2 50,8 50,2 41,2 36,7 62,1 56 32,3 35,4 42,9 67,8 60.1b
female 27,4 26,9 16,6 10,3 22,4 46,6 29 39 27,2 24,3 20,2 26,3 15,3 32,1 26,7 32,6 16,4 13,3 8,4 26,1 17,2 21,4 40,6 43,8 13,8 9,8 40,4 62,1 41.7b
2002 total 38,5 38,7 26,6 27 40,8 57,9 38,9 51,6 48 39,2 39,6 34,7 28,9 49,4 41,7 41,6 28,1 25,6 30,1 42,3 29,1 26,1 51,4 37.3b 24,5 22,8 47,8 68 53,4
male 48,4 48,8 36 37 57,2 64,5 47,3 58,4 65 55,9 58,4 38,7 41,3 67,3 50,5 51,5 37,7 35,5 50,8 54,6 39,6 34,5 61,9 42.7b 35,4 39,1 48,5 70,4 62,6
female 29,1 29,2 17,5 18,2 25,9 50,4 30,6 46,5 30,8 24 21,9 30,8 17,3 32,2 35,2 34,1 18,4 17,6 10,9 29,9 19,3 18,9 42,2 32.6b 14,2 9,5 47,2 65,6 44,5
2004 total 40,6 41 30 32,5 42,7 60,3 41,8 52,4 49,5 39,4 41,3 37,3 30.5b 49,9 47,9 47,1 30,4 31,1 31,5 45,2 28.8b 26,2 50,3 36,9 29 26,8 50,9 69,1 56,2
male 50,3 50,7 39,1 42,2 57,2 67,3 50,7 56,4 65 56,4 58,9 41 42.2b 70,8 55,8 57,6 38,3 38,4 53,4 56,9 38.9b 34,1 59,1 43,1 40,9 43,8 51,4 71,2 65,7
female 31,6 31,7 21,1 24,2 29,4 53,3 33 49,4 33,7 24 24,6 33,8 19.6b 30 41,9 39,3 22,2 25 11,5 33,4 19.3b 19,4 42,5 31,4 17,8 12,6 50,4 67 47
2005 total 42.3p 42.5p 31,8 34,7 44,5 59,5 45.4p 56,1 51,6 41,6 43.1b 37,9 31,4 50,6 49,5 49,2 31,7 33 30,8 46,1 31,8 27,2 50,5 39,4 30,7 30,3 52,7 69.4b 56, 9
male 51.5p 51.8p 41,7 45,5 59,3 65,6 53.5p 59,3 65,7 58,8 59.7b 40,7 42,7 70,8 55,2 59,1 38,3 40,6 50,8 56,9 41,3 35,9 58,1 46,7 43,1 47,8 52,8 72b 66
female 33.5p 33.7p 22,1 25,5 30,9 53,5 37.5p 53,7 37,3 25,8 27.4b 35,2 20,8 31,5 45,3 41,7 24,9 26,7 12,4 35,2 22,9 19,7 43,7 33,1 18,5 15,6 52,7 66.7b 48,1
2006 total 43.5p 43.6p 32 39,6 45,2 60,7 48.4p 58,5 53,1 42,3 44,1 37.6p 32,5 53,6 53,3 49,6 33,2 33,6 30 47,7 35,5 28,1 50,1 41,7 32,6 33,1 54,5 69,6 57,4
male 52.6p 52.8p 40,9 49,5 59,5 67,1 56.4p 57,5 67 59,2 60,4 40.1p 43,7 71,6 59,5 55,7 38,7 41,4 50,4 58 45,3 38,4 58,2 50 44,5 49,8 54,8 72,3 66
female 34.8p 34.9p 23,2 31,1 32,1 54,3 40.6p 59,2 39,1 26,6 28,7 35.2p 21,9 36,6 48,7 45,1 27,8 27,1 11,2 37,2 26,3 19 42,8 34,5 21 18,9 54,3 66,9 49,1
2007 total 44,7 44,9 34,4 42,6 46 58,6 51,5 60 53,8 42,4 44,6 38,3 33,8 55,9 57,7 53,4 32 33,1 28,5 50,9 38,6 29,7 50,9 41,4 33,5 35,6 55 70 57,4
male 53,9 54,1 42,9 51,8 59,6 64,9 59,7 59,4 67,9 59,1 60 40,5 45,1 72,5 64,6 60,8 35,6 41,7 45,9 61,5 49,8 41,4 58,6 50,3 45,3 52,5 55,1 72,9 66,3
female 36 36,1 26 34,5 33,5 52,4 43,6 60,5 39,6 26,9 30 36,2 23 40,3 52,4 47,9 28,6 26,2 11,6 40,1 28 19,4 44 33,6 22,2 21,2 55 67 48,9
b= break in data series u= unreliable or uncertain data
Source : Eurostat - Labour Force Survey, Annual averages.
 
EN 175   EN 11. In work at-risk-of-poverty rate after social transfers by gender  (Age 18+), 2007
EU27 EU25 BE BG(1)CZ DK DK(2)DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO(1)SI SK FI SE UK
Total 8 p s  8 p  4 : 34 : 7 p  86 1 4 1 1 6 1 0 6 1 0 896456 1 2 1 0 4 p  55578
Men 8 p s  9 p  4 : 35 : 7 p  66 1 5 1 2 7 1 2 69897556 1 3 1 0 5 p  55578
Women 7 p s  7 p  4 : 33 : 8 p  96 1 2 9677 1 0 895256 1 0 9 3 p  45668
Notes: i See explanatory text (Eurostat website) p = provisional value  s = Eurostat estimate  u = unreliable or uncertain data   (:) = data not available 
EU Aggregates: Eurostat estimates are obtained as a population size weighted average of national data.
12. Activit y rates  (% of population aged 15-64)
EU27 EU25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SL SK FI SE UK
1998 Total : 68,0 63,5 : 72,0 79,7 70,8 72,2 65,6 63,2 63,0 68,4 59,0 : 69,8 72,1 62,1 58,7 : 73,0 71,0 65,7 70.6b 68,9 68,2 69,3 72,3 76,2 75,4
Male : 77,4 72,8 : 80,0 83,8 79,2 79,0 78,2 77,6 77,3 75,2 73,6 : 76,4 78,2 75,9 66,6 : 82,6 80,3 72,8 79.3b 75,7 72,6 77,2 75,6 79,0 83,2Female : 58,7 54,0 : 64,0 75,6 62,2 66,4 52,9 49,0 48,9 61,9 44,6 : 63,9 66,5 48,1 51,2 : 63,2 61,7 58,8 62.3b 62,3 63,6 61,7 69,1 73,5 67,4
2 0 0 0 T o t a l 6 8 , 6 6 8 , 7 6 5 , 1 6 0 , 77 1 , 38 0 , 07 1 , 17 0 , 26 8 , 26 3 , 86 5 , 46 8 , 76 0 , 16 9 , 16 7 , 27 0 , 86 4 , 16 0 , 15 8 , 07 5 , 27 1 , 06 5 , 87 1 , 46 8 , 46 7 , 56 9 , 97 4 , 57 7 , 3 7 5 . 4 b
Male 77,1 77,4 73,7 66,2 79,1 84,2 78,9 75,6 79,9 77,4 78,8 75,2 74,1 81,4 72,7 74,5 76,3 67,9 80,5 84,1 80,1 71,7 79,2 75,0 71,9 76,8 77,2 79,8 82.8bFemale 60,1 60,0 56,4 55,6 63,6 75,6 63,3 65,3 56,3 50,5 52,0 62,4 46,3 57,7 62,1 67,3 51,6 52,7 35,2 66,0 62,0 59,9 63,9 61,9 62,9 63,2 71,9 74,8 68.2b
2002 Total 68,6 69,0 64,8 61,9 70,6 79,6 71,7 69,3 68,6 64,2 66,2 69,1 61,1 71,2 68,8 69,6 65,2 59,7 58,5 76,5 71,6 64,6 72,7 63.4b 67,8 69,9 74,9 77,6 75,2
Male 76,8 77,3 73,2 66,4 78,6 83,6 78,8 74,6 79,2 77,6 79,1 75,5 74,3 81,3 74,1 73,6 76,7 67,1 80,1 84,5 79,6 70,6 80,0 70.4b 72,5 76,7 77,0 79,4 82,3Female 60,5 60,7 56,3 57,5 62,7 75,5 64,4 64,4 57,8 51,0 53,1 63,0 47,9 61,8 63,9 65,8 53,6 52,7 36,7 68,3 63,7 58,7 65,6 56.6b 63,0 63,2 72,8 75,8 68,3
2004 Total 69,3 69,7 65,9 61,8 70,0 80,1 72,6 70,0 69,5 66,5 68,7 69,5 62.7b 72,6 69,7 69,1 65,8 60,5 58,2 76,6 71.3b 64,0 73,0 63,0 69,8 69,7 74,2 77,2 75,2
Male 77,0 77,5 73,4 66,4 77,9 84,0 79,2 74,4 79,9 79,0 80,4 75,3 74.9b 83,0 74,3 72,8 75,6 67,2 80,2 83,9 78.5b 70,1 79,1 70,0 74,5 76,5 76,4 79,1 82,0Female 61,6 62,0 58,2 57,2 62,2 76,2 65,8 66,0 59,0 54,1 56,8 63,9 50.6b 62,8 65,3 65,6 55,8 54,0 36,0 69,2 64.2b 57,9 67,0 56,2 65,0 63,0 72,0 75,2 68,6
2005 Total 69.8p 70.3p 66,7 62,1 70,4 79,8 74.3p 70,1 70,8 66,8 69.7b 69,5 62,5 72,4 69,6 68,4 66,6 61,3 58,1 76,9 72,4 64,4 73,4 62,3 70,7 68,9 74,7 78.7b 7 5,3
Male 77.3p 77.8p 73,9 67,0 78,4 83,6 80.6p 73,6 80,6 79,2 80.9b 75,1 74,6 82,9 74,4 72,1 76,0 67,9 79,1 83,7 79,3 70,8 79,0 69,4 75,1 76,5 76,6 80.9b 81,9
Female 62.3p 62.7p 59,5 57,3 62,4 75,9 68p 66,9 60,8 54,5 58.3b 64,1 50,4 62,5 65,1 64,9 57,0 55,1 36,9 70,0 65,6 58,1 67,9 55,3 66,1 61,5 72,8 76.3b 68,8
2006 Total 70.2p 70.6p 66,5 64,5 70,3 80,6 75.3p 72,4 71,8 67,0 70,8 69.4p 62,7 73,0 71,3 67,4 66,7 62,0 59,2 77,4 73,7 63,4 73,9 63,6 70,9 68,6 75,2 78,8 75 ,5
Male 77.5p 78p 73,4 68,8 78,3 84,1 81.3p 75,8 81,5 79,1 81,3 74.8p 74,6 82,7 76,2 70,5 75,3 68,7 79,7 83,9 80,5 70,1 79,5 70,7 74,9 76,4 77,1 81,2 82,1
Female 62.9p 63.2p 59,5 60,2 62,3 77,0 69.2p 69,3 61,9 55,0 60,2 64.1p 50,8 63,8 66,7 64,6 58,2 55,5 38,3 70,7 67,0 56,8 68,4 56,6 66,7 60,9 73,3 76,3 69,2
2 0 0 7 T o t a l 7 0 , 5 7 0 , 9 6 7 , 1 6 6 , 36 9 , 98 0 , 27 6 , 07 2 , 97 2 , 46 7 , 07 1 , 67 0 , 26 2 , 57 3 , 97 2 , 86 7 , 96 6 , 96 1 , 95 8 , 47 8 , 57 4 , 76 3 , 27 4 , 16 3 , 07 1 , 36 8 , 37 5 , 67 9 , 17 5 , 5
Male 77,7 78,2 73,6 70,6 78,1 83,9 81,8 77,5 81,4 79,1 81,4 74,9 74,4 82,9 77,6 71,0 75,0 69,0 77,6 84,6 81,7 70,0 79,4 70,1 75,8 75,9 77,2 81,4 82,2
Female 63,4 63,7 60,4 62,1 61,5 76,4 70,1 68,7 63,3 54,9 61,4 65,6 50,7 65,4 68,3 65,0 58,9 55,1 38,6 72,2 67,8 56,5 68,8 56,0 66,6 60,8 73,8 76,8 69,0
Source : Eurostat - Labour Force Survey, Annual averages.
(b) break in series
13. Dispersion of regional employment rates*, selected years (%)
EU27 EU25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SL SK FI SE UK
2000 1 3 . 4 7 . 9 1 0 . 3 5 . 8 - 5 . 7 -- 5 . 1 1 0 . 7 6 . 9 1 7 . 5 ---- 9 . 0 - 2 . 2 2 . 5 6 . 9 4 . 3 4 . 6 - 9 . 1 6 . 8 4 . 5 7 . 1
2004 1 2 . 2 8 . 7 7 . 0 5 . 6 - 6 . 2 -- 4 . 1 8 . 7 7 . 1 1 5 . 6 ---- 9 . 4 - 2 . 3 3 . 5 6 . 4 3 . 5 4 . 9 - 9 . 0 5 . 5 4 . 4 5 . 8
2005 1 1 . 9 8 . 4 7 . 1 5 . 5 - 5 . 6 -- 4 . 3 8 . 3 7 . 3 1 6 . 0 ---- 9 . 9 - 2 . 0 4 . 1 5 . 6 3 . 3 4 . 5 - 9 . 8 5 . 5 3 . 0 5 . 7
2006 1 1 , 4 : 8 , 7 7 , 3 5 , 2 : 5 , 2 -: 3 , 7 7 , 8 7 , 5 1 6 , 3 ---- 9 , 1 - 2 , 2 3 , 4 5 , 1 3 , 1 3 , 6 : 8 , 6 5 , 4 2 , 9 5 , 5
2007 11,1 : 8,6 7,1 4,6 : 4,8 - : 3,5 7,5 6,6 16,3 - - - - 9,7 - 2,2 3,8 4,5 3,3 4,6 : 8,3 5,6 2,4 5,4
* Coefficient of variation of employme nt rates across regions at NUTS2 level
e = estimate; p = provisional figure
Source : Eurostat - Labour Force Survey, Annual averagesSource: SILC 2007, Income data 2006; except for UK, income year 2007 and for IE moving income reference period (2006-2007);  (1) BG National HBS 2007, income data 2007; (2) with imputed rent data 2006 (see methodological In work
 
EN 176   EN 14. Total health expenditure per capita
EU BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SI SK FI SE UK
1990 1358 244 560 1544 1769 ... 792 853 873 1449 1359 ... 161 162 1532 ... ... 1416 1631 290 636 81 311 ... 1367 1592 965
1991 1488 541 1591 887 874 952 1553 1471 1630 578 1518 1728 346 754 1503 1576 1052
1992 1576 568 1666 1977 1009 974 1030 1649 1522 1757 615 1604 1870 366 805 1507 1617 1153
1993 1616 768 1772 1993 1040 1086 1086 1752 1534 1870 629 1673 2014 372 842 1393 1660 1209
1994 1654 817 1857 2129 1120 1227 1114 1813 1540 1904 709 1719 2183 375 872 1373 1665 1299
1995 1854 899 1871 2275 1204 1264 1193 1997 1538 1911 660 1799 2259 411 1036 1440 1746 1350
1996 1923 917 1979 2399 1280 1301 1249 2050 1613 1990 659 1862 2351 478 1117 1509 1861 1436
1997 1969 922 2060 2413 1395 1354 1298 2107 1728 1972 679 1916 2439 498 1186 564 1562 1886 1499
1998 1637 2042 289 926 2176 2483 474 1499 1382 1383 2190 1829 947 439 489 2083 763 1058 2054 2598 559 1210 246 1226 584 1622 1982 1569
1999 1717 2176 343 938 2281 2592 522 1626 1468 1450 2279 1879 984 473 498 2384 810 1103 2178 2726 573 1329 253 1303 599 1700 2129 1690
2000 1823 2377 386 980 2379 2671 513 1801 1429 1536 2421 2053 1074 482 559 2554 852 1247 2337 2859 583 1509 275 1447 603 1794 2284 1847
2001 1960 2484 484 1082 2521 2809 519 2128 1669 1636 2590 2215 1140 541 598 2738 971 1294 2556 2890 642 1569 312 1581 665 1913 2511 2021
2002 2087 2685 552 1195 2696 2937 561 2360 1792 1745 2780 2223 1228 611 681 3081 1114 1492 2833 3068 733 1657 368 1693 730 2089 2707 2165
2003 2226 3153 609 1340 2824 3090 646 2515 1928 2019 2988 2272 1335 653 793 3582 1302 1586 2988 3206 749 1824 415 1767 792 2210 2841 2259
2004 2347 3311 655 1388 3030 3162 740 2724 1991 2128 3117 2401 1335 796 756 4083 1327 1608 3156 3397 808 1913 427 1863 1058 2412 2964 2509
2005 2454 3421 734 1447 3169 3251 846 3126 2283 2260 3306 2496 1550 860 862 4153 1440 1733 3192 3507 843 2029 507 1959 1130 2523 3012 2580
2006 3488 1490 3349 3371 3082 2483 2458 3449 2614 4303 1504 3391 3606 910 2120 2668 3202 2760
Source: OECD health data 2008 for OECD Member States and WHO health for all database for the others
 
EN 177   EN Context 1: Growth rate of GDP at constant prices (2000)  - percentage change over previous yea r
EU27 EU25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SL SK FI SE UK
2000 3,9 3,9 3,7 5,4 3,6 3,5 3,2 9,6 9,2 4,5 5,0 3,9 3,7 5,0 6,9 4,2 8,4 5,2 : 3,9 3,7 4,3 3,9 2,1 4,4 1,4 5,0 4,4 3,92005 2,0 2,0 1,8 6,2 6,3 2,4 0,8 9,2 6,4 2,9 3,6 1,9 0,6 3,9 10,6 7,8 5,2 4,0 3,5 2,0 2,9 3,6 0,9 4,2 4,3 6,5 2,8 3,3 2,1
2006 3,1 3,1 3,0 6,3 6,8 3,3 3,0 10,4 5,7 4,5 3,9 2,2 1,8 4,1 11,9 7,8 6,4 4,1 3,2 3,4 3,4 6,2 1,4 7,9 5,9 8,5 4,9 4,2 2,8
2007 2,9 2,9 2,8 6,2 6,0 1,6 2,5 6,3 6,0 4,0 3,7 2,2 1,5 4,4 10,2 8,9 5,2 1,1 3,9 3,5 3,1 6,6 1,9 6,2 6,8 10,4 4,5 2,5 3,0
2008f 1,0 1,0 1,3 6,4 4,2 -0,6 1,3 -2,4 -2,0 2,9 1,2 0,7 -0,6 3,6 -2,3 3,4 1,0 0,9 2,1 1,9 1,7 5,0 0,2 7,8 4,0 7,1 1,5 0,5 0,7
Source : Eurostat, Structural indicators database
f = forecast
Context 1: GDP per capita in Purchasing Power Standards (PPS),  (EU-27 = 100)
EU27 EU25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SL SK FI SE UK
2000 100,0 105,0 125,9 27,8 68,5 131,6 118,5 44,6 131,0 84,1 97,3 115,3 116,9 88,8 36,7 39,3 243,7 56,1 83,6 134,3 131,4 48,2 78,0 25,9 79,8 1,7 117,3 126, 7 119,0
2005 100,0 104,1 119,4 34,5 75,9 123,6 116,9 61,1 144,1 92,8 102,0 110,8 104,7 90, 9 48,6 52,9 254,1 63,2 78,2 130,8 124,8 51,3 76,9 35,0 87,4 2,0 114,3 120 ,3 121,8
2006 100,0 103,9 118,5 36,5 77,4 122,9 115,8 65,3 147,4 94,1 104,1 109,5 103,5 90, 3 52,6 55,5 267,1 63,6 76,9 130,9 124,3 52,3 76,4 38,4 87,7 2,1 114,9 121 ,5 120,4
2007 100,0 103,7 118,2 37,3 80,2 120,1 114,8 68,0 150,4 94,9 105,5 109,2 101,5 90, 7 54,7 59,5 266,5 62,6 77,8 131,0 124,0 53,4 76,2 42,2 89,3 2,2 115,9 122 ,2 119,2
2008f 100 103,6 114,7 38,5 80,6 116,3 112,4 64,8 140,1 94,1 101,7 105,7 97,6 89,3 52, 6 59,9 261,1 61,5 76,4 129 121,5 54,3 73,7 44,3 89,3 69,1 114,1 118,1 1 15,5
f = forecast
Source : Eurostat, Structural indicators database
Context 2a: Employment rate  (% of population aged 15-64)
EU27 EU25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SL SK FI SE UK
1998 total : 61,2 57,4 : 67,3 75,1 63,9 64,6 60,6 56,0 51,3 60,2 51,9 : 59,9 62,3 60,5 53,7 : 70,2 67,9 59,0 66.8b 64,2 62,9 60,6 64,6 70,3 70,5
male : 70,6 67,1 : 76,0 79,9 71,9 69,6 72,1 71,7 66,8 67,4 66,8 : 65,1 66,2 74,5 60,5 : 80,2 77,0 66,5 75.9b 70,4 67,2 67,8 67,8 72,8 77,3
female : 51,8 47,6 : 58,7 70,2 55,8 60,3 49,0 40,5 35,8 53,1 37,3 : 55,1 58,6 46,2 47,2 : 60,1 58,8 51,7 58.2b 58,2 58,6 53,5 61,2 67,9 63,6
2000 total 62,2 62,4 60,5 50,4 65,0 76,3 65,6 60,4 65,2 56,5 56,3 62,1 53,7 65, 7 57,5 59,1 62,7 56,3 54,2 72,9 68,5 55,0 68,4 63,0 62,8 56,8 67,2 73,0 71.2b
male 70,8 71,2 69,5 54,7 73,2 80,8 72,9 64,3 76,3 71,5 71,2 69,2 68,0 78,7 61,5 60,5 75,0 63,1 75,0 82,1 77,3 61,2 76,5 68,6 67,2 62,2 70,1 75,1 77.8b
female 53,7 53,6 51,5 46,3 56,9 71,6 58,1 56,9 53,9 41,7 41,3 55,2 39,6 53,5 53,8 57,7 50,1 49,7 33,1 63,5 59,6 48,9 60,5 57,5 58,4 51,5 64,2 70,9 64.7b
2002 total 62,3 62,8 59,9 50,6 65,4 75,9 65,4 62,0 65,5 57,5 58,5 63,0 55,5 68, 6 60,4 59,9 63,4 56,2 54,4 74,4 68,7 51,5 68,8 57.6b 63,4 56,8 68,1 73,6 71,3
male 70,3 71,0 68,3 53,7 73,9 80,0 71,8 66,5 75,4 72,2 72,6 69,5 69,1 78,9 64,3 62,7 75,1 62,9 74,7 82,4 76,4 56,9 76,5 63.6b 68,2 62,4 70,0 74,9 77,6
female 54,4 54,7 51,4 47,5 57,0 71,7 58,9 57,9 55,4 42,9 44,4 56,7 42,0 59,1 56,8 57,2 51,6 49,8 33,9 66,2 61,3 46,2 61,4 51.8b 58,6 51,4 66,2 72,2 65,2
2004 total 62,9 63,3 60,3 54,2 64,2 75,7 65,0 63,0 66,3 59,4 61,1 63,1 57.6b 68,9 62,3 61,2 62,5 56,8 54,0 73,1 67.8b 51,7 67,8 57,7 65,3 57,0 67,6 72,1 71,6
male 70,3 70,9 67,9 57,9 72,3 79,7 70,8 66,4 75,9 73,7 73,8 69,0 70.1b 79,8 66,4 64,7 72,8 63,1 75,1 80,2 74.9b 57,2 74,2 63,4 70,0 63,2 69,7 73,6 77,8
female 55,4 55,7 52,6 50,6 56,0 71,6 59,2 60,0 56,5 45,2 48,3 57,4 45.2b 58,7 58,5 57,8 51,9 50,7 32,7 65,8 60.7b 46,2 61,7 52,1 60,5 50,9 65,6 70,5 65,6
2005 total 63.4p 63.9p 61,1 55,8 64,8 75,9 66p 64,4 67,6 60,1 63.3b 63,1 57,6 68, 5 63,3 62,6 63,6 56,9 53,9 73,2 68,6 52,8 67,5 57,6 66,0 57,7 68,4 72.5b 71, 7
male 70.8p 71.3p 68,3 60,0 73,3 79,8 71.3p 67,0 76,9 74,2 75.2b 68,8 69,9 79,2 67,6 66,1 73,3 63,1 73,8 79,9 75,4 58,9 73,4 63,7 70,4 64,6 70,3 74.4b 77,6
female 56.2p 56.5p 53,8 51,7 56,3 71,9 60.6p 62,1 58,3 46,1 51.2b 57,6 45,3 58,4 59,3 59,4 53,7 51,0 33,7 66,4 62,0 46,8 61,7 51,5 61,3 50,9 66,5 70.4b 65,9
2006 total 64.4p 64.7p 61,0 58,6 65,3 77,4 67.5p 68,1 68,6 61,0 64,8 63p 58,4 69, 6 66,3 63,6 63,6 57,3 54,8 74,3 70,2 54,5 67,9 58,8 66,6 59,4 69,3 73,1 71,5
male 71.6p 72p 67,9 62,8 73,7 81,2 72.8p 71,0 77,7 74,6 76,1 68.5p 70,5 79,4 70, 4 6 6 , 3 7 2 , 6 6 3 , 8 7 4 , 58 0 , 97 6 , 96 0 , 97 3 , 96 4 , 67 1 , 16 7 , 07 1 , 47 5 , 57 7 , 3
female 57.2p 57.4p 54,0 54,6 56,8 73,4 62.2p 65,3 59,3 47,4 53,2 57.7p 46,3 60,3 62,4 61,0 54,6 51,1 34,9 67,7 63,5 48,2 62,0 53,0 61,8 51,9 67,3 70,7 65,8
2007 total 65,4 65,8 62,0 61,7 66,1 77,1 69,4 69,4 69,1 61,4 65,6 64,6 58,7 71, 0 68,3 64,9 64,2 57,3 54,6 76,0 71,4 57,0 67,8 58,8 67,8 60,7 70,3 74,2 71,5
male 72,5 73,0 68,7 66,0 74,8 81,0 74,7 73,2 77,4 74,9 76,2 69,3 70,7 80,0 72,5 67,9 72,3 64,0 72,9 82,2 78,4 63,6 73,8 64,8 72,7 68,4 72,1 76,5 77,5
female 58,3 58,6 55,3 57,6 57,3 73,2 64,0 65,9 60,6 47,9 54,7 60,0 46,6 62,4 64,4 62,2 56,1 50,9 35,7 69,6 64,4 50,6 61,9 52,8 62,6 53,0 68,5 71,8 65,5
Source : Eurostat - Labour Force Survey, Annual averages.
b= break in data series
 
EN 178   EN Context 2b: Unemployment rate (% of labour force aged 15+)
EU27 EU25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SL SK FI SE UK
1998 Total : 9,3 9,3 : 6,4 4,9 8,8 9,2 7,5 10,8 15,0 11,1 11,3 : 14,3 13,2 2,7 8,4 : 3,8 4,5 10,2 5,1 5,4 7,4 12,6 11,4 8,2 6,1
Males : 8,0 7,7 : 5,0 3,9 7,1 9,9 7,7 7,0 11,2 9,5 8,8 : 15,1 14,6 1,9 9,0 : 3,0 3,8 8,5 4,1 5,5 7,3 12,2 10,9 8,4 6,8Females : 11,2 11,6 : 8,1 6,0 11,1 8,3 7,3 16,7 21,1 12,9 15,4 : 13,6 11,7 4,0 7,8 : 5,0 5,4 12,2 6,3 5,3 7,5 13,1 12,0 8,0 5,3
2000 Total 8,7 8,6 6,9 16,4 8,7 4,3 7,2 12,8 4,2 11,2 11,1 9,1 10,1 4,9 13,7 16,4 2,3 6,4 6,7 2,8 3,6 16,1 4,0 7,2 6,7 18,8 9,8 5,6 5,5
Males 7,5 7,4 5,6 16,7 7,3 3,9 6,0 13,8 4,3 7,4 7,9 7,6 7,8 3,2 14,4 18,6 1,8 7,0 6,4 2,2 3,1 14,4 3,2 7,8 6,5 18,9 9,1 5,9 6,0Females 10,1 10,2 8,5 16,2 10,3 4,8 8,7 11,8 4,2 17,1 16,0 10,9 13,6 7,2 12,9 14,1 3,1 5,6 7,4 3,6 4,3 18,1 4,9 6,4 7,0 18,6 10,6 5,3 4,9
2002 Total 8,9 8,7 7,5 18,1 7,3 4,6 8,2 10,3 4,5 10,3 11,1 8,7 8,6 3,6 12,2 13,5 2,7 5,8 7,5 2,8 4,2 19,9 5,0 8,4 6,3 18,7 9,1 4,9 5,1
Males 8,0 7,8 6,7 18,9 5,9 4,3 7,1 10,8 4,7 6,8 8,1 7,8 6,7 2,9 13,3 14,2 2,0 6,2 6,6 2,5 4,0 19,1 4,1 9,1 5,9 18,6 9,1 5,3 5,6Females 10,0 10,0 8,6 17,3 9,0 5,0 9,4 9,7 4,1 15,6 15,7 9,8 11,5 4,5 11,0 12,8 3,7 5,4 9,3 3,1 4,4 20,9 6,0 7,7 6,8 18,7 9,1 4,6 4,5
2004 Total 9,1 9,1 8,4 12,0 8,3 5,5 9,5 9,7 4,5 10,5 10,6 9,6 8b 4,6 10,4 11,4 5,1 6,1 7,4 4,6 4.8b 19,0 6,7 8,1 6,3 18,2 8,8 6,3 4,7
Males 8,2 8,1 7,5 12,5 7,1 5,1 8,7 10,4 4,9 6,6 8,0 8,7 6.4b 3,6 10,6 11,0 3,7 6,1 6,6 4,3 4.4b 18,2 5,8 9,1 5,8 17,4 8,7 6,5 5,0Females 10,1 10,2 9,5 11,5 9,9 6,0 10,5 8,9 4,1 16,2 14,3 10,6 10.5b 6,0 10,2 11,8 7,1 6,1 9,0 4,8 5.3b 19,9 7,6 6,9 6,8 19,2 8,9 6,1 4,2
2005 Total 8,7 8,7 8,4 10,1 7,9 4,8 9.4p 7,9 4,3 9,8 9,2 9.7p 7,7 5,2 8,9 8,3 4,5 7,2 7,3 4,7 5,2 17,7 7,6 7,2 6,5 16,3 8,4 7.4b 4,8
Males 7,9 7,9 7,6 10,3 6,5 4,4 8.7p 8,8 4,6 6,1 7,0 8.8p 6,2 4,3 9,1 8,2 3,5 7,0 6,5 4,4 4,9 16,6 6,7 7,8 6,1 15,5 8,2 7.5b 5,1Females 9,7 9,8 9,5 9,8 9,8 5,3 10.3p 7,1 4,0 15,3 12,2 10.7p 10,1 6,5 8,7 8,3 5,8 7,4 9,0 5,1 5,5 19,1 8,7 6,4 7,0 17,2 8,6 7.3b 4,3
2006 Total 7,9 7,9 8,2 9,0 7,1 3,9 8.4p 5,9 4,4 8,9 8,5 9.5p 6,8 4,6 6,8 5,6 4,7 7,5 7,3 3,9 4,7 13,8 7,7 7,3 6,0 13,4 7,7 7,1 5,3
Males 7,2 7,1 7,4 8,6 5,8 3,3 7.7p 6,2 4,6 5,6 6,3 8.8p 5,4 4,0 7,4 5,8 3,5 7,2 6,5 3,5 4,4 13,0 6,5 8,2 4,9 12,3 7,4 6,9 5,7
Females 8,9 9,0 9,3 9,3 8,8 4,5 9.2p 5,6 4,1 13,6 11,6 10.4p 8,8 5,4 6,2 5,4 6,2 7,8 8,9 4,4 5,2 14,9 9,0 6,1 7,2 14,7 8,1 7,2 4,9
2007 Total 7,1 7,1 7,5 6,9 5,3 3,8 8,6 4,7 4,6 8,3 8,3 7,9 6,1 3,9 6,0 4,3 4,1 7,4 6,5 3,2 4,4 9,6 8,0 6,4 4,8 6,9 6,2 5,3 5,3
Males 6,5 6,5 6,7 6,5 4,2 3,5 8,5 5,4 4,9 5,2 6,4 7,4 4,9 3,4 6,4 4,3 3,6 7,1 6,0 2,8 3,9 9,0 6,6 7,2 4,0 6,5 5,9 5,6 5,6
Females 7,8 7,9 8,4 7,3 6,7 4,2 8,7 3.9u 4,2 12,8 10,9 8,5 7,9 4,6 5,6 4,3 4,7 7,7 7,6 3,6 5,0 10,3 9,6 5,4 5,8 7,2 6,5 4,9 5,0
Source:  Eurostat - Harmonised unemployment series, Annual average
p = provisional value u = unreliable or uncertain data  b= break in data series
EU27 EU25 BE BG CZ DK DE EE IE EL ES F R IT CY LV LT LU HU MT NL AT PL PT RO SL SK FI SE UK
1998 Total : 19,5 22,1 : 12,8 7,3 15 15,2 11,3 29,9 33,1 25,6 29,9 : 26,8 25,5 6,9 15 : 7,6 6,4 22,5 10,7 15,8 17,8 25,1 23,5 16,1 13,1
Males : 17,7 20,2 : 11,5 7,1 12,3 16,7 11,6 21,3 25,9 23,3 25,4 : 27,4 30,1 6,5 16,6 : 7,4 5 20,2 8,5 15,6 16,9 26,6 22,8 16,4 14,8
Females : 21,6 24,5 : 14,4 7,4 17,9 13,1 11 40,2 42,4 28,3 35,5 : 26 18,4 7,3 13 : 7,9 7,9 25,1 13,2 16,1 18,8 23,4 24,3 15,8 11,3
2000 Total 17,9 17,6 16,7 33,7 17,8 6,2 10,6 23,9 6,8 29,1 24,3 20,1 27 10,1 21,4 30,6 7,1 12,4 13,7 5,7 5,3 35,1 8,8 20 16,3 36,9 21,4 10,5 12,6
Males 16,7 16,2 14,5 36,1 18,5 6,6 9,4 23,8 6,8 21,5 18,1 18 23,1 6,9 21,2 32,3 6,5 13,6 14,9 4,9 4,7 33,3 6,6 22,2 14,6 39,7 21,1 11 13,7
Females 19,3 19,3 19,5 30,7 17 5,7 11,9 24,1 7 38,1 32,5 22,5 31,9 13 21,6 28,3 7,9 10,8 12,3 6,5 6 37,2 11,5 17,2 18,3 33,8 21,6 9,9 11,4
2002 Total 18,9 18,5 17,7 37 16,9 7,4 14,2 17,6 8,5 26,8 24,2 19,7 23,1 8,1 22 22,5 7,7 12,7 17,1 5 6,7 42,5 11,6 23,2 16,5 37,7 21 11,9 12
Males 18,1 17,5 17,2 40,1 16,6 7,3 13 14,3 9,3 19,9 19,2 18,2 19,4 7,9 20,4 22,6 6,1 13,2 17,6 5,2 6,4 41,9 9,8 24,3 15 39,5 21,2 12 13,7
Females 19,8 19,6 18,3 33,2 17,2 7,5 15,4 22,5 7,6 35,3 31,1 21,7 27,8 8,3 24,3 22,2 9,6 11,9 16,7 4,8 7,1 43,3 13,9 21,8 18,6 35,5 20,9 11,8 10,2
2004 Total 19,2 19 21,2 25,8 21 8,2 15 21,7 8,9 26,9 23,9 21,8 23,5b 10,5 18,1 22,7 16,8 15,5 16,8 8 9,4b 39,6 15,3 21,9 16,1 33,1 20,7 16,3 12,1
Males 18,7 18,4 20,2 27 22,2 8,9 15,2 21,2 9,3 19,1 19,4 20,8 20,6b 9,4 16 22,5 12 16,2 16,3 7,9 9b 37,7 13,5 24,2 13,9 34,7 22 15,7 13,4
Females 19,8 19,7 22,4 24,3 19,5 7,4 14,8 22,4 8,5 36,3 30,1 23 27,2b 11,6 21,3 22,9 22,3 14,4 17,4 8,1 9,8b 41,9 17,6 18,9 19,2 31 19,4 16,9 10,7
2005 Total 18,4 18,3 21,5 22,3 19,2 8,6 14,1p 15,9 8,6 26 19,7 22,7p 24 13 13,6 15,7 13,7 19,4 16,4 8,2 10,3 36,9 16,1 20,2 15,9 30,1 20,1 21,1b 12,9
Males 18,1 17,9 21 23,4 19,3 8,6 14,4p 16,6 9,1 18,7 16,7 21,3p 21,5 11,9 11,8 15,9 11,7 19,6 16,8 8 10,5 35,7 13,6 21,6 14,5 31 20,6 21,1b 14,5
Females 18,7 18,7 22,1 21 19,1 8,6 13,8p 14,9 8 34,8 23,4 24,4p 27,4 14,2 16,2 15,3 16,2 19 16 8,4 10,1 38,3 19,1 18,4 17,8 28,8 19,5 21,1b 11,1
2006 Total 17,3 17,1 20,5 19,5 17,5 7,7 13,7 12u 8,6 25,2 17,9 21,3 21,6 10 12,2 9,8 16,2 19,1 15,9 6,6 9,1 29,8 16,3 21,4 13,9 26,6 18,7 21,5 14
Males 16,9 16,7 18,8 18,9 16,6 7,9 14,8 10 9,1 17,7 15 20,1 19,1 8,9 10,5 10u 17u 18,6 17,2u 6,1 8,9 28,3 14,5 22,3 11,6u 26,4 19 21 15,7
Females 17,7 17,5 22,6 20,3 18,7 7,5 12,5 14,7 8 34,7 21,6 22,9 25,3 11,1 14,7 9,6 15,2 19,8 14,3u 7,1 9,3 31,6 18,4 20,2 16,8u 27 18,4 22 12
2007 Total 15,4 15,3 18,8 15,1 10,7 7,9 11,9 10u 9,1 22,9 18,2 18,7 20,3 10,2 10,7 8.2u 15.2u 18 13,9 5,9 8,7 21,7 16,6 20,1 10,1 20,3 16,5 19,3 14,4
Males 15,1 14,9 17,1 14,5 10,6 8,2 12,6 : 10 15,7 15,2 18 18,2 11 11,2 7u 13.5u 17,6 15,8u 5,6 8,3 20 13,5 21,1 9.4u 20,4 16,4 18,8 15,8
Females 15,8 15,7 20,9 15,9 11 7,5 11,1 : 8,1 32,1 21,9 19,6 23,3 9,4 10u 10u 17.5u 18,6 11,6u 6,2 9,1 23,8 20,3 18,7 11.2u 20,2 16,6 19,8 12,5
Source:  Eurostat - Harmonised unemployment series, Annual average
p = provisional value u = unreliable or uncertain data  b= break in data seriesContext 2c: Youth unemployment rate (% of labour force aged 15-24)
 
EN 179   EN Context 2d: Long-term unemployment rate by gender, selected years (% of the labour force 15+)
EU27 EU25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SL SK FI SE UK
1998 Total : 4,4 5,6 : 2 1,3 4,5 4,2 3,9 5,8 7,5 4,5 6,8 : 7,9 7,5 0,9 4,2 : 1,5 1,3 4,7 2,2 2,3 3,3 6,5 4,1 2,6 1,9
Males : 3,6 4,5 : 1,5 0,9 3,4 4,4 4,7 3,1 4,9 3,8 5,3 : 8,3 7,9 0,7 4,5 : 1,3 1 3,5 1,7 2,2 3,3 6 4,3 3,2 2,4
Females : 5,5 7,1 : 2,6 1,7 6 4,1 2,8 10 11,6 5,3 9,1 : 7,5 7 1,1 3,8 : 1,8 1,8 6,3 2,8 2,5 3,3 7,1 3,9 1,8 1,2
2000 Total 4,1 3,9 3,7 9,4 4,2 0,9 3,7 5,9 1,6 6,2 4,6 3,5 6,3 1,2 7,9 8 0,6 3,1 4,4 0,8 1 7,4 1,7 3,5 4,1 10,3 2,8 1,4 1,4
Males 4,2 3,3 3 9,6 3,5 0,8 3 6,7 2 3,6 2,8 2,9 4,8 0,5 8,3 9,4 0,5 3,5 4,5 0,6 0,9 6 1,4 3,6 4,1 10,3 2,8 1,7 1,9
Females 4 4,8 4,6 9,2 5,2 1,1 4,6 5 1 10,2 7,4 4,3 8,4 2,2 7,5 6,5 0,6 2,5 4,2 1 1,2 9,1 2 3,4 4,2 10,2 2,7 1 0,9
2002 Total 4,6 3,9 3,7 12 3,7 0,9 3,9 5,4 1,4 5,3 3,7 3,1 5,1 0,8 5,5 7,2 0,7 2,5 3,3 0,7 1,1 10,9 1,7 4 3,5 12,2 2,3 1 1,1
Males 4,6 3,3 3,2 12,5 3 0,7 3,3 6,3 1,8 3,1 2,3 2,6 4 0,5 6,4 7,6 0,6 2,8 3,5 0,6 1 9,7 1,4 4,1 3,4 11,9 2,5 1,2 1,4
Females 4,5 4,6 4,3 11,4 4,6 1 4,8 4,4 0,8 8,6 5,9 3,5 6,9 1 4,6 6,8 0,9 2,2 2,4 0,9 1,2 12,3 2,1 4 3,6 12,5 2 0,8 0,7
2004 Total 4,2 4,1 4,1 7,2 4,2 1,2 5,4 5 1,6 5,6 3,4 3,9 4b 1,2 4,6 5,8 1,1 2,7 3,4 1,6 1,3b 10,3 3 4,5 3,2 11,8 2,1 1,2 1
Males 3,7 3,6 3,7 7,3 3,4 1,1 4,8 5,6 2 3 2,2 3,5 2,9b 0,9 4,8 5,5 0,8 2,8 3,7 1,5 1,3b 9,6 2,6 5,2 3,1 11,3 2,3 1,4 1,2
Females 4,7 4,7 4,7 7 5,3 1,3 6,1 4,4 1 9,4 5,1 4,3 5,5b 1,6 4,3 6,2 1,4 2,6 3 1,6 1,4b 11 3,4 3,6 3,4 12,4 2 1 0,6
2005 Total 4p 3,9p 4,4 6 4,2 1,1 5p 4,2 1,5 5,1 2,2b 4 3,9 1,2 4,1 4,3 1,2p 3,2 3,4 1,9 1,3 10,2 3,7 4 3,1 11,7 2,2 1,2p 1
Males 3,6p 3,5p 3,8 6,1 3,4 1,1 4,7p 4,2 1,9 2,6 1,4b 3,5 2,9 0,8 4,4 4,2 1,2p 3,3 3,4 1,9 1,2 9,3 3,2 4,6 2,9 11,2 2,4 1,4p 1,3
Females 4,5p 4,5p 5 6 5,3 1,2 5,5p 4,2 0,8 8,9 3,4b 4,5 5,2 1,7 3,7 4,5 1,2p 3,2 3,2 1,9 1,4 11,4 4,2 3,4 3,3 12,3 1,9 1p 0,7
2006 Total 3,6p 3,6p 4,2 5 3,9 0,8 4,7p 2,8 1,4 4,8 1,8 4p 3,4 0,9 2,5 2,5 1,4p 3,4 2,9 1,7 1,3 7,8 3,8 4,2 2,9 10,2 1,9 1,1 1,2
Males 3,3p 3,2p 3,7 4,8 3,1 0,7 4,4p 3,1 1,8 2,6 1,2 3,7p 2,6 0,7 3 2,5 1,2p 3,3 3,1 1,6 1,3 7,1 3,3 4,7 2,4 9,4 2,1 1,2 1,5
Females 4p 4p 4,9 5,2 4,9 0,9 5,2p 2,6 0,9 8 2,8 4,3p 4,5 1,2 1,9 2,4 1,6p 3,4 2,5 1,8 1,3 8,6 4,4 3,6 3,5 11,2 1,8 0,9 0,8
2007 Total 3.1 3.0 3.8 4.1 2.8 0.6 4.7 2.3 1.4 4.1 1.7 3.3 2.9 0.7 1.6 1.4 1.2 3.4 2.7 1.3 1.2 4.9 3.8 3.2 2.2 8.3 1.6 0.9 1.3
Males 2.8 2.8 3.3 3.7 2.1 0.5 4.8 2.9 1.8 2.2 1.1 3.1 2.2 0.8 1.9 1.4 1.2 3.3 2.8 1.2 1.0 4.6 3.2 3.6 1.8 7.4 1.7 0.9 1.6Females 3.3 3.3 4.3 4.5 3.6 0.7 4.7 1.7 0.9 7.0 2.5 3.6 3.9 0.7 1.2 1.3 1.1 3.6 2.4 1.4 1.4 5.4 4.5 2.7 2.7 9.3 1.4 0.8 0.9
Source : Eurostat - Labour Force Survey, Annual averages
p = provisional value u = unreliable or uncertain data  b= break in data series
Context 4: Old age dependency ratio (current and projected) - ratio between the total number of people aged 65 and over and the  number of persons of working age (from 15 to 64)
EU27 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SI SK FI SE UK
2010 25,9 26,1 25,3 21,8 25,0 31,2 25,0 16,7 28,2 24,4 25,8 31,0 18,0 25,2 23,2 21,1 24,2 21,2 22,8 26,0 19,0 26,6 21,3 23,9 17,0 25,7 27,8 24,7
2020 31,1 30,6 31,1 31,1 31,9 35,3 29,2 20,2 32,8 27,4 32,8 35,5 22,3 28,1 26,0 24,2 30,3 31,3 30,7 29,2 27,2 30,7 25,7 31,2 23,9 36,8 33,7 28,6
2030 38,0 37,6 36,3 35,7 37,9 46,2 34,4 24,6 38,5 34,3 39,0 42,5 27,4 34,6 34,7 30,8 34,1 39,1 40,0 38,1 36,0 36,6 30,3 40,8 32,3 43,9 37,4 33,2
2040 45,4 42,3 43,6 42,7 42,7 54,7 39,0 30,6 48,3 46,4 44,0 54,1 30,8 40,7 42,8 36,3 40,1 41,7 46,8 46,0 41,3 44,6 40,8 49,4 40,0 45,1 40,8 36,9
2050 50,4 43,9 55,4 54,8 41,3 56,4 47,2 40,4 57,0 58,7 44,7 59,2 37,7 51,2 51,1 37,8 50,8 49,8 45,6 48,3 55,7 53,0 54,0 59,4 55,5 46,6 41,9 38,0
2060 53,5 45,8 63,5 61,4 42,7 59,1 55,6 43,6 57,1 59,1 45,2 59,3 44,5 64,5 65,7 39,1 57,6 59,1 47,2 50,7 69,0 54,8 65,3 62,2 68,5 49,3 46,7 42,1
Source : Eurostat - EUROPOP2008 Trend scenario - baseline variant
 
EN 180   EN Context 5a: Distribution of households by age and household type (private/institutional)
EU25 BE BG CZ DK DE EE EL ES FR IE IT CY LV LT LU HU MT NL AT PL PT RO SI SK FI SE UK
Total Total ('000) 441467 10296 7904 10230 5349 82277 1370 10628 40847 58514 3852 56996 690 2377 3484 440 10198 0 15986 8033 38230 10356 21681 1964 5379 5181 0 58789
Private households (%) 98,7       98,6    99,3    99,3       98,7         99,0          98,8       96,6         99,4           97,8         98,4           99,3       99,4       99,0         99,3         98,3       97,5           -         98,6    98,9    98,9    99,0    98,5    99,3    98,4    98,1    -       98,2    
Institutional household ( % 1,3         1,4      0,7      0,7        1,3           1,0            0,9         3,4           0,6             2,2           1,6             0,7         0,6         1,0           0,7           1,7         2,4             -         1,4      1,1      1,1      1,0      1,5      0,7      0,8      0,7      -       1,8      
Total ('000) 90525 2162 1531 2057 1161 15251 312 2011 7341 13426 1009 9833 180 541 846 98 2087 0 3532 1639 8851 2053 4847 376 1277 1135 0 13346
Private households (%) 99,4       99,9    97,9    99,8       99,4         99,7          99,2       97,8         99,9           99,2         99,6           99,9       99,9       99,4         99,3         99,0       96,9           -         99,7    99,7    99,2    99,5    98,3    : 98,3    99,1    -       99,3    
Institutional household ( % 0,6         0,1      2,1      0,2        0,6           : 0,6         2,2           0,1             0,8           0,4             0,1         0,1         0,6           0,7           1,0         3,1             -         0,3      0,3      0,8      0,5      1,7      : 0,4      0,4      -       0,7      
18-64 Total ('000) 279593 6390 5586 6759 3396 52516 852 6824 26547 35788 2420 36517 428 1485 2148 281 6565 0 10279 5152 24522 6610 15420 1299 3444 3269 0 36103
Private households (%) 99,0       99,5    99,4    99,5       98,9         99,6          98,9       96,0         99,7           98,2         98,9           99,5       99,7       99,0         99,4         99,0       97,7           -         99,4    99,4    98,8    99,6    98,0    : 98,7    98,4    -       98,5    
Institutional household ( % 1,0         0,5      0,6      0,5        1,1           : 0,9         4,0           0,3             1,8           1,1             0,5         0,3         1,0           0,6           1,0         2,2             -         0,6      0,6      1,2      0,4      2,0      : 0,6      0,3      -       1,5      
65+ Total ('000) 71306 1744 1322 1411 792 14510 205 1792 6974 9299 423 10646 80 352 489 61 1546 0 2174 1242 4853 1693 3050 289 611 777 0 9341
Private households (%) 96,4       93,9    99,6    97,7       96,7         96,3          98,1       97,5         97,7           94,3         92,8           97,9       96,4       98,7         98,9         93,7       97,5           -         93,5    95,8    98,8    96,4    99,6    : 97,0    95,1    -       95,4    
Institutional household ( % 3,6         6,1      0,4      2,3        3,3           : 1,7         2,5           2,3             5,7           7,2             2,1         3,6         1,3           1,1           6,3         2,5             -         6,5      4,2      1,2      3,6      0,4      : 2,7      3,1      -       4,6      
75+ Total ('000) 30917 774 481 570 379 6191 75 642 3036 4133 184 4762 34 126 178 25 619 0 972 582 1841 701 1063 110 238 340 0 4405
Private households (%) 93,3       88,4    99,3    95,7       94,2         92,5          96,9       96,7         96,1           89,5         87,6           96,5       92,7       98,1         98,3         87,0       95,8           -         87,2    92,4    98,1    93,1    99,4    88,4    95,4    90,8    -       91,5    
Institutional household ( % 6,7         11,5    0,7      4,3        5,8           7,5            2,9         3,3           3,9             10,5         12,4           3,5         7,3         1,9           1,7           13,0       4,2             -         12,8    7,6      1,9      6,9      0,6      5,3      4,2      6,0      -       8,5      
   Hospitals (%) 19,9       5,3      14,0    4,9        : : 3,6         20,4         12,5           13,8         27,8           1,5         5,8         2,0           5,2           9,8         11,8           -         20,8    19,4    18,5    3,3      30,7    : 13,3    27,9    -       44,6    
   Old people's homes (%) 68,0       85,1    83,8    86,3       : : 95,4       34,3         56,6           79,5         56,4           73,2       91,0       97,7         89,1         69,2       83,4           -         75,9    76,3    65,8    85,8    59,4    : 75,1    58,5    -       46,0    
Source: Eurostat Census data collection 2000-01
Context 5b: Population living in private households by household type, 2007 (percentage of total population)
EU25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT SI SK FI SE UK
13 15 9 22 18 14 8 7 6 15 12 5 10 11 12 9 7 16 15 9 6 7 8 18 20 14
of which: :
-  S i n g l e  m e n 5 7 4 1 0 7 5 4 2 2 6 5 2 3 3 5 3 3 763222896
- Single women 8 8 6 11 11 9 4 5 4 9 7 3 7 8 7 7 4 9 9 6 4 5 7 11 10 7
:
- Under 65 7 9 5 15 12 8 4 4 3 8 6 3 5 6 8 5 3 11 9 4 2 3 3 12 12 8
-  6 5  a n d  o v e r 5 6 4 7 6 6 4 4 3 6 6 2 5 5 4 5 4 565445676
5 6 4 7 6 7 8 2 2 5 3 2 5 6 4 5 2 443333588
13 15 14 18 16 11 10 9 10 16 9 8 10 9 12 11 9 17 13 8 9 8 7 19 16 17
1 1 1 0 9 1 0 1 3 9 7 1 2 9 1 1 1 2 9 9 9 9 9 8 1 09 71 18 71 0 1 0 1 1
12 9 15 3 7 10 12 23 23 5 18 13 13 10 11 14 20 7 13 13 18 19 17 5 2 1112 11 12 10 12 15 10 10 13 13 13 10 14 16 13 12 11 11 11 12 17 11 9 12 11 10
18 16 21 19 15 14 15 25 20 24 19 26 13 17 25 16 17 20 15 15 16 19 17 16 19 16
7 11 5 10 6 6 14 3 3 7 5 10 5 7 7 9 8 12 8 7 4 5 8 12 10 8
10 7 11 2 6 14 17 10 14 4 11 16 21 16 8 15 18 5 12 25 17 19 24 3 4 7
EU aggregates based on available country data
Source : Eurostat - European Labour Force Survey
Context 6a: General government debt - General government consolidated gross debt as a percentage of GDP
E U - 2 7 B EB G C Z D K D E E E I E E L E S F R I T C Y L V L T L U H U M TN LA TP LP TR O S I S K F I S EU K
2000 61,7 107,8 74,3 18,5 51,7 59,7 5,2 37,7 101,8 59,2 56,7 109,2 58,8 12,3 23,7 6,4 54,2 55,9 53,8 66,4 36,8 50,4 24,7 26,8 50,3 43,8 53,6 41,0
2001 60,8 106,5 67,3 25,1 47,4 58,8 4,8 35,5 102,9 55,5 56,2 108,8 60,7 14,0 23,1 6,5 52,1 62,1 50,7 67,0 37,6 52,9 26,0 27,4 48,9 42,3 54,4 37,7
2002 60,2 103,4 53,6 28,5 46,8 60,3 5,6 32,2 101,5 52,5 58,2 105,7 64,6 13,5 22,3 6,5 55,8 60,1 50,5 66,4 42,2 55,5 25,0 28,1 43,4 41,3 52,6 37,5
2003 61,8 98,6 45,9 30,1 45,8 63,8 5,5 31,1 97,8 48,7 62,9 104,4 68,9 14,6 21,1 6,2 58,1 69,3 52 65,4 47,1 56,9 21,5 27,5 42,4 44,3 52,3 38,7
2004 62,2 94,3 37,9 30,4 43,8 65,6 5 29,4 98,6 46,2 64,9 103,8 70,2 14,9 19,4 6,3 59,4 72,1 52,4 64,8 45,7 58,3 18,8 27,2 41,4 44,1 51,2 40,6
2005 62,7 92,1 29,2 29,8 36,4 67,8 4,5 27,3 98,8 43,0 66,4 105,9 69,1 12,4 18,4 6,1 61,7 69,9 51,8 63,7 47,1 63,6 15,8 27 34,2 41,3 50,9 42,3
2006 61,3 87,8 22,7 29,6 30,5 67,6 4,3 24,7 95,9 39,6 63,6 106,9 64,6 10,7 18 6,6 65,6 63,9 47,4 62 47,7 64,7 12,4 26,7 30,4 39,2 45,9 43,4
2007 58,7 83,9 18,2 28,9 26,2 65,1 3,5 24,8 94,8 36,2 63,9 104,1 59,5 9,5 17 7 65,8 62,2 45,7 59,5 44,9 63,6 12,9 23,4 29,4 35,1 40,4 44,2
2008 59,8 86,5 13,8 26,6 21,1 64,3 4,2 31,6 93,4 37,5 65,4 104,1 48,2 12,3 17,5 14,1 65,4 63,1 48,2 57,4 43,7 64,3 13,4 21,8 28,8 31,6 34,7 50,1
2009 60,9 86,1 10,6 26,4 21,1 63,2 5 39,2 92,2 41,1 67,7 104,3 44,7 17, 7 20 14,6 66 63,2 47 57,1 43,4 65,2 15,4 21,1 29 30,2 33,8 55,1
2010 61,8 85,6 7,9 26,3 20,1 61,9 6,1 46,2 91,9 44,4 69,9 103,8 41,3 23 23, 3 14,5 66,2 63,1 45,9 56,9 42,9 66,6 17,1 20,1 29,3 29,8 32,4 60,3
Source: Eurostat - General Government data (2000 to 2007) and ECFIN forecasts (2008-2009)- 2 adults, at least one aged 65+, no children
- 3 or more adults, with children- 3 or more adults, no children
- 2 adults, 1 child- 2 adults, 2 children- 2 adults, 3 or more childrenChildren (0-17)
- Single adults, no children
- Single parents
- 2 adults below 65, no children
 
EN 181   EN Context 6b: Projected evolution of debt levels up to 2050 (in % of GDP)
Programme scenario
EU-25* *BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SI SK FI SE UK
2005 63 93,3 : 30,5 35,8 67,7 4,8 27,6 107,5 43,2 66,8 106,4 70,3 11,9 18,7 6,2 58,4 74,7 52,9 62,9 42.5 63,9 : 29,1 34,5 41,1 50,3 42,8
2010 61 72 : 30 18 64 0 17 90 30 60 97 57 9 16 10 61 65 46 54 45 65 : 27 31 25 34 42
2030 79 31 : 43 23 37 -25 37 18 33 41 32 42 26 22 74 51 16 70 23 -33 64 : 65 16 26 -3 44
2050 180 83 : 188 98 65 -82 157 -56 198 66 1 172 92 76 240 155 -58 176 18 -163 208 : 270 66 96 -1 114
2005 budget scenario
2010 55 74 : 43,2 14,4 73,6 0,9 13,6 96,9 25,7 69,2 108,9 64,3 13 22,4 11,5 76,1 80,2 44,2 58,9 53,2 76,3 : 25,1 38,7 23,7 30,3 472030 33 52 : 95,7 -61,2 116,2 -39,3 7,9 165,2 -13,5 132,8 127,6 116,3 14,9 46,7 56,1 143,6 92,9 67,8 54,9 20 195,4 : 68,5 66,8 7,9 8 90,1
2050 76 129 : 320,3 -135,5 232,4 -117 100,4 451,3 42,6 269,9 208,9 269,9 49,6 135,7 179,1 247,6 79,6 177,7 67,5 -42,5 517,4 : 287,2 176,9 61,6 58,8 186,7
* Adjusted gross debt.
** aggregates exclude Greece
Source: Commission services, 2005/06 updated stability and convergence programmes.
Context 7a: Social protection benefits by group of functions (as a percentage of total benefits) - 2006
EU-27 EU-25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SL SK FI SE UK
Sickness, health care 29.2p 29.2p 25,7 26 34,4 21,6 29.1p 31,2 41,1 28,7 31.2p 29.9p 26.8p 25,7 29.1p 32.1p 25,4 29 28,4 31.8p 25,5 20,4 29,2 34,8 32.1p 31.0p 26,2 26.0p 31.8p
Disability 7.5p 7.5p 6,4 9,1 8,6 14,9 6.2p 9,5 5,4 4,7 7.3p 6.1p 5.9p 3,9 7.3p 10.7p 13,2 9,6 6,3 8.5p 8,2 9,3 10 7,4 8.5p 8.7p 12,7 14.9p 8.7p
Family and children 8.0p 8.0p 7,1 7,4 7,6 13,1 11.1p 12,1 14,7 6,2 5.7p 8.6p 4.5p 10,8 10. 2p 9.0p 16,9 13 6,3 5.8p 10,4 4,4 5,1 8,9 8.6p 7.8p 11,6 9.8p 6.1p
Unemployment 5.6p 5.6p 11,9 2,2 3,2 7,2 6.3p 0,9 7,6 4,6 12.5p 6.9p 2.0p 6,1 3.7p 1.9p 4,9 3,1 3,4 5.0p 5,8 3 5,5 2,7 3.0p 3.5p 8,5 5.5p 2.4p
Old age and survivors benefits 46.2p 46.2p 47 52,9 43,1 37,9 44.3p 45,2 27,4 51,3 41.3p 44.3p 60.5p 46,1 48.3p 44.8p 36,7 42,2 52,8 41.4p 48,6 61,2 49,1 45 45.4p 45.3p 37,8 40.2p 44.7p
Housing and social exclusion 3.6p 3.6p 2 2,5 3,1 5,3 3.0p 1 3,8 4,5 2.0p 4.3p 0.3p 7,4 1.4p 1.6p 2,9 3,1 2,8 7.5p 1,5 1,8 1,2 1,2 2.5p 3.6p 3,2 3.6p 6.3p
e: Eurostat estimate; p: provisional
Context 7b: Social protection benefits by group of functions (as a percentage of GDP) - 2006
EU-27 EU-25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SL SK FI SE UK
Total expenditure* 26,9p 27,0p 30,1 15,0 18,7 29,1 28,7p 12,4 18,2 24,2 20,9p 31,1p 26,6p 18,4 12,2p 13,2p 20,4 22,3 18,1 29,3p 28,5 19,2 25,4 14,0 22,8p 15,9p 26,2 30,7p 26, 4p
Social protection benefits 25,8p 26,0p 28,7 14,5 18,1 28,3 27,6p 12,2 16,9 23,6 20,4p 29,2p 25,7p 18,1 11,9p 12,8p 20,0 21,8 17,9 27,5p 27,6 18,8 23,8 13,7 22,2p 15,3p 25,4 30,0p 25, 9p
Sickness/Health care 7,5p 7,6p 7,4 3,8 6,2 6,1 8,0p 3,8 7,0 6,8 6,4p 8,7p 6,9p 4,6 3,5p 4,1p 5,1 6,3 5,1 8,7p 7,1 3,8 6,9 4,8 7,1p 4,7p 6,6 7,8p 8,2p
Disability 1,9p 1,9p 1,8 1,3 1,5 4,2 1,7p 1,2 0,9 1,1 1,5p 1,8p 1,5p 0,7 0,9p 1,4p 2,6 2,1 1,1 2,3p 2,3 1,7 2,4 1,0 1,9p 1,3p 3,2 4,5p 2,2p
Family/Children 2,1p 2,1p 2,0 1,1 1,4 3,7 3,1p 1,5 2,5 1,5 1,2p 2,5p 1,2p 1,9 1,2p 1,1p 3,4 2,8 1,1 1,6p 2,9 0,8 1,2 1,2 1,9p 1,2p 2,9 2,9p 1,6p
Unemployment 1,4p 1,5p 3,4 0,3 0,6 2,0 1,7p 0,1 1,3 1,1 2,6p 2,0p 0,5p 1,1 0,4p 0,2p 1,0 0,7 0,6 1,4p 1,6 0,6 1,3 0,4 0,7p 0,5p 2,2 1,6p 0,6p
Old age and survivors 11,9p 12,0p 13,5 7,7 7,8 10,7 12,2p 5,5 4,6 12,1 8,4p 12,9p 15,5p 8,3 5,7p 5,7p 7,3 9,2 9,5 11,4p 13,4 11,5 11,7 6,2 10,1p 6,9p 9,6 12,1p 11,6p
Housing and Social exclusion n.e.c. 0,9p 0,9p 0,6 0,4 0,6 1,5 0,8p 0,1 0,6 1,1 0,4p 1,2p 0,1p 1,3 0,2p 0,2p 0,6 0,7 0,5 2,0p 0,4 0,3 0,3 0,2 0,6p 0,6p 0,8 1,1p 1,6p
Administration costs 0,8p 0,8p 1,0 0,4 0,6 0,8 1,0p 0,2 1,3 0,6 0,5p 1,3p 0,7p 0,3 0,3p 0,4p 0,3 0,5 0,2 1,5p 0,5 0,4 0,5 0,2 0,5p 0,6p 0,8 0,7p 0,5p
Other expenditure 0,2p 0,2p 0,4 0,1 0,0 : 0,1p : 0,0 0,0 0,0p 0,6p 0,2p 0,1 0,1p 0,0p 0,1 : : 0,4p 0,4 0,0 1,0 0,0 0,0p 0,0p : 0,0p 0,0p
* including administrative costs; e: Eurostat estimate; p: provisional
 
EN 182   EN Context 8a: Adults aged 18-59 living in jobless households by household types , 2006, in % of total number of adults living in jobless households
EU27 EU25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SI SK FI SE UK
Alone without children 23,1 24,1 32,2 15,3 23,2 : 38,5 31,8 : 19,0 11,5 30,3 18,2 15,2 19,0 26,7 33,3 15,9 12,1 41,9 36,0 14,3 14,3 11,5 29,4 11,8 48,5 : 27,2
Alone with child(ren) 10,3 10,9 14,9 3,9 12,9 : 12,1 12,0 : 3,6 5,6 10,7 3,4 11,8 5,4 10,7 6,1 6,2 10,6 11,7 5,6 7,9 6,2 3,8 5,5 4,0 3,1 : 23,5
Couple without children 22,0 22,1 25,2 19,5 24,0 : 22,5 15,5 : 28,1 14,4 28,9 19,4 30,3 13,6 6,9 31,4 21, 9 17,9 24,4 24,4 21,9 22,3 21,0 27,6 19,1 25,3 : 16,6
Couple with child(ren) 15,6 15,0 9,6 19,6 14,5 : 17,4 13,5 : 10,2 20,3 15,3 15,0 18,3 15,8 12,0 12,2 19,4 26,7 14,0 16,3 14,9 14,1 24,3 9,6 16,8 11,2 : 15,4
Other households without children - total 20,0 19,8 11,5 22,0 19,4 : 6,9 19,0 : 33,7 37,7 10,8 34,5 20,9 30,0 30,2 12,7 23,8 28,4 7,6 13,2 25,2 33,5 21,5 23,6 26,2 11,0 : 12,0
    - without elderly (65+) 9,5 9,5 6,3 8,9 8,3 : 3,6 4,1 : 13,3 13,8 5,4 16,1 10,4 8,6 9,0 7,1 10,6 11,6 4,8 5,9 12,2 12,7 11,0 11,6 12,4 3,5 : 7,1
    - with at least 1 elderly (65+) 10,4 10,4 5,2 13,1 11,2 : 3,3 14,9 : 20,4 23,9 5,4 18,4 10,5 21,4 21,2 5,6 13,2 16,8 2,8 7,3 13,0 20,8 10,5 12,0 13,8 7,5 : 4,9
Other households with child(ren) - total 8,9 8,1 6,5 19,7 5,9 : 2,6 8,2 : 5,5 10,6 4,1 9,4 3,5 16,2 13,4 4,3 12,8 4,4 0,4 4,5 15,8 9,7 17,9 4,3 22,1 0,9 : 5,3
    - without elderly (65+) 6,9 6,4 5,6 13,6 4,6 : 2,3 3,6 : 3,6 7,3 3,5 7,8 2,3 12,6 6,0 3,5 10,7 3,0 0,2 3,5 11,6 7,1 11,3 3,7 18,7 0,7 : 4,6
    - with at least 1 elderly (65+) 2,1 1,7 0,9 6,1 1,2 : 0,2 4,6 : 1,9 3,3 0,6 1,6 1,2 3,6 7,4 0,8 2,2 1,4 0,2 1,0 4,1 2,6 6,6 0,5 3,5 0,2 : 0,7
Total number in 1000 19386,3 17763 799,9 482,1 437,256 581,56 44, 4749 467,909 233,7121 3486,4 2912,8 20,3 106 87,6593 126,44 17,52665 640,3 15,38 217,5 406,1 2835 337,8 1142 84,94 305,3 276,7 3427,1
Source : Eurostat - European Labour Force Survey 2006, Spring results. Annual averages for FI.
Context 8b: Children aged 0-17 living in jobless households by household types , 2006, in % of total number of children living in jobless households
EU27 EU25 BE BG CZ DK DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO SI SK FI SE UK
Alone with child(ren) - no elderly 44,6 47,5 61,6 15,8 50,8 : 45,0 48,3 : 30,0 26,8 47,2 21,8 56,8 26,8 38,9 49,7 23,2 41,9 57,8 28,2 34,7 33,2 12,9 40,5 12,4 23,2 : 66,5
Alone with child(ren) - at least 1 elderly 0,4 0,3 0,0 1,2 0,3 : 0,2 10,7 : 1,2 0,8 0,3 0,2 1,1 0,0 1,1 0,7 0,1 1,2 0,0 0,2 0,2 1,4 0,6 0,0 0,0 0,0 : 0,3
Couple with child(ren) - total 39,9 38,4 25,4 50,1 35,9 : 48,4 25,6 : 52,5 49,5 44,8 59,2 38,7 41,8 24,6 41, 1 52,5 46,4 40,9 58,1 35,7 39,3 58,2 47,8 51,8 73,4 : 26,1
    - without elderly (65+) 38,8 37,3 24,8 47,9 35,7 : 48,0 25,6 : 46,2 45,5 43,3 57,5 37,6 36,7 23,0 35,9 51,9 45,5 39,8 56,4 34,7 36,9 57,2 47,3 51,3 72,8 : 25,4
    - with at least 1 elderly (65+) 1,1 1,1 0,6 2,2 0,2 : 0,4 0,0 : 6,3 4,0 1,5 1,7 1,1 5,2 1,6 5,2 0,6 0,9 1,0 1,7 0,9 2,4 1,1 0,5 0,5 0,5 : 0,7
Other households with child(ren) - no elderly 15,1 13,7 13,1 32,9 13,1 : 6,4 15,4 : 16,2 22,8 7,7 18,9 3,4 31,3 35,5 8,6 24,2 10,5 1,3 13,5 29,3 26,1 28,2 11,7 35,8 3,4 : 7,0
    - without elderly (65+) 10,5 9,9 11,5 19,9 10,2 : 5,8 5,0 : 7,2 15,5 6,0 13,0 1,1 25,8 11,7 6,0 19,3 6,0 0,6 9,2 18,7 15,9 15,8 5,7 28,9 2,3 : 5,7
    - with at least 1 elderly (65+) 4,6 3,9 1,5 13,0 2,9 : 0,7 10,3 : 9,0 7,3 1,7 5,8 2,3 5,5 23,7 2,6 5,0 4,5 0,7 4,2 10,7 10,2 12,5 6,0 7,0 1,1 : 1,3
Total number in 1000 7036,67 6438 289,6 189,76 148,0428 59,58677 203,751 18,92742 117,92024 67,10845 63,63202 1261,13 523, 48 7,01462 27,52685 36,5547 3,60966 247,037 8,075 69,681 112,5 2 854,32 85,391 409,05 12,074 129,1 53,446 0 2038,4
Source : Eurostat - European Labour Force Survey 2006, Spring results. Annual averages for  FI.
 
EN 183   EN moving to % of AW 50 67 50 67 50 67 50 67 % of gross earnings in new job
BE 86% 83% 75% 77% 72% 73% 76% 75% BE 74 76 49 56
CZ 66% 63% 62% 62% 84% 69% 74% 73% CZ 69 84 36 51
DK 94% 91% 85% 91% 73% 89% 97% 94% DK 85 94 54 67
DE 79% 76% 97% 87% 97% 85% 91% 90% DE 84 90 52 65
EE 64% 64% 64% 64% 61% 61% 64% 64% IE 57 123 23 90
IE 93% 77% -13% 12% 97% 88% 61% 53% EL 16 20 16 26
EL 68% 57% 83% 66% 86% 69% 57% 49% FR 93 100 29 51
ES 78% 80% 75% 80% 75% 79% 79% 82% LU 71 77 24 37
FR 80% 81% 89% 86% 89% 85% 81% 79% HU 45 45 50 63
IT 64% 72% 59% 63% 59% 61% 78% 71% NL 79 81 37 58
CY 63% 61% 35% 72% 91% 82% 77% 72% AT 73 81 54 83
LV 86% 88% 100% 100% 100% 100% 83% 85% PL 64 72 43 51
LT 82% 79% 78% 76% 92% 77% 82% 79% PT 66 68 23 32
LU 86% 88% 92% 86% 104% 102% 80% 86% SK 56 73 64 81
HU 77% 78% 74% 79% 88% 78% 74% 78% FI 70 75 50 63
MT 70% 61% 80% 64% 85% 68% 35% 34% SE 64 69 30 41
NL 96% 86% 77% 83% 92% 87% 72% 76% UK 70 85 23 88
AT 70% 67% 78% 72% 93% 81% 76% 76%
PL 98% 82% 81% 99% 100% 89% 81% 71%PT 79% 82% 86% 87% 94% 85% 83% 85%SI 87% 94% 84% 83% 100% 86% 92% 84%
SK 40% 44% 29% 35% 39% 30% 47% 49%
FI 84% 76% 84% 85% 89% 92% 77% 74%
SE 92% 87% 91% 91% 100% 95% 87% 87%
UK 78% 68% 66% 72% 74% 78% 44% 41%
Source:  Joint Commission -OECD project using tax-benefit Models
Notes:
AETR = 1 - (change in net income / change in gross income). AETRx% is that part of additional gross earnings that is "taxed awa y" when moving from unemployment (full-time with previous earnings of x% AW) to 
full time employent (with current earnings of x% AW). AETRs are measure at the household level and take into account increasing  taxes and contributions as well as reduced benefits.
Weekly working hours are 0/40 for the out-of-work/in-work situations.
For one earner couple households the first spouse is inactive with 0 earnings. The 'x%' therefore relate to the second spouse o nly.
For two-earners couple households the first spouse's earnings are held fixed at 67% of AW. The 'x%' therefore relate to the sec ond spouse only.Results do not take into account national minimum wage legislation. As a result, the "33%" and "50%" scenarios may in fact not be relevant for employees covered by minimum wage rules.Context 9b. Inactivity Trap at 67% of AW,  2005
Total increase in effective tax burden with and without childcare costs, 
Lone parents and two-earner couples with two children
Lone Parents 
with two 
children, no 
childcareLone Parents    
with two 
children, with 
childcareTwo-earner 
Couple with 2 
children, no 
childcareTwo-earner Couple 
with 2 children, 
with childcareContext 9a. Unemployment traps, 2006
For unemployed persons (previous work at 67% of Average Wage, full-time) returning to full-time 
work at 2 different wage levels. Incl uding social assistance where applicable. 
Single person, no 
childrenLone parentOne-earner couple, 
2 childrenTwo-earner couple, 
2 children
Transitions from labour-market inactivity to a full-time low-wage job (67% of AW). 
Person assumed to be aged 40 with 22 years of employment, children  aged two and three. For couples the % of AW relates to 1 spouse only. Assumes full-time centre based care while in work and no childcare costs while out of work. Benefits available only on a temporary basis immediately following the transition into work are not taken into account. 
 
EN 184   EN For inactive persons entering work at 2 different wage levels1,  2006
moving to % of AW 50 67 50 67 50 67 50 67
BE 66% 65% 75% 71% 68% 65% 42% 47%
CZ 62% 53% 62% 62% 84% 69% 49% 48%
DK 104% 88% 90% 84% 90% 92% 65% 63%
DE 73% 68% 97% 87% 97% 85% 50% 50%
EE 46% 40% 46% 40% 61% 52% 25% 25%
IE 93% 77% -13% 12% 97% 88% 33% 32%
EL 16% 18% 16% 16% 16% 16% 16% 18%
ES 48% 44% 62% 54% 62% 52% 18% 20%
FR 66% 62% 79% 73% 89% 81% 21% 25%
IT 14% 22% -10% -1% -17% -8% 40% 42%
CY 68% 52% 56% 75% 126% 96% 6% 6%
LV 61% 54% 100% 100% 100% 100% 45% 41%
LT 39% 37% 64% 55% 85% 71% 19% 22%LU 80% 67% 88% 69% 82% 89% 16% 20%
HU 44% 43% 51% 49% 69% 61% 5% 13%
MT 71% 62% 81% 64% 86% 69% 35% 34%
NL 98% 85% 77% 74% 93% 88% 41% 44%
AT 70% 64% 78% 70% 93% 81% 25% 30%
PL 67% 59% 50% 75% 68% 66% 52% 50%
PT 41% 37% 58% 55% 58% 57% 18% 20%
SI 71% 73% 84% 75% 100% 86% 68% 63%
SK 28% 29% 35% 34% 47% 38% 22% 24%
FI 84% 72% 62% 64% 89% 92% 31% 32%
SE 92% 77% 65% 63% 100% 95% 29% 30%
UK 78% 68% 66% 72% 74% 78% 40% 38%
Notes:
AETR = 1 - (change in net income / change in gross income). AETRx% is that part of additional gross earnings that is "taxed awa y" when moving from inactivity (without entitlements to unemeployment benefits) to 
full time employent (with current earnings of x% AW). AETRs are measure at the household level and take into account increasing  taxes and contributions as well as reduced benefits.
Weekly working hours are 0/40 for the out-of-work/in-work situations.Two-earner couple, 
2 children
Results do not take into account national minimum wage legislation. As a result, the "33%" and "50%" scenarios may in fact not be relevant for employees covered by minimum wage rules.
For one earner couple households the first spouse is inactive with 0 earnings. The 'x%' therefore relate to the second spouse o nly.
For two-earners couple households the first spouse's earnings are held fixed at 67% of AW. The 'x%' therefore relate to the sec ond spouse only.9c. Inactivity traps, 2006
Single person, no 
childrenLone parentOne-earner couple, 
2 children
 
EN 185   EN Context 9d. Low wage traps - 2006
Income ranges:Single 
person, 
no 
childrenLone 
parentOne-
earner 
couple, 2 
childrenTwo-
earner 
couple, 2 
childrenSingle 
person, 
no 
childrenLone 
parentOne-
earner 
couple, 2 
childrenTwo-
earner 
couple, 2 
children
BE 58% 52% 47% 58% 56% 56% 50% 55%
CZ 31% 43% 53% 24% 29% 55% 50% 29%
DK 82% 74% 92% 49% 51% 61% 59% 43%
DE 50% 66% 65% 51% 55% 54% 51% 54%EE 25% 25% 19% 25% 25% 25% 25% 25%IE 54% -34% 77% 23% 30% 84% 57% 30%
EL 20% 16% 16% 20% 41% 41% 41% 41%
ES 26% 19% 17% 26% 29% 27% 25% 29%FR 64% 96% 111% 37% 35% 25% 23% 33%
IT 34% -2% -11% 40% 38% 52% 49% 38%
CY 6% 93% 91% 6% 15% 15% 15% 15%LV 32% 100% 100% 32% 32% 40% 65% 32%
LT 30% 30% 52% 30% 30% 30% 30% 30%
LU 50% 58% 110% 29% 42% 30% 18% 36%HU 32% 35% 32% 32% 59% 64% 67% 59%MT 24% 60% 30% 33% 43% 39% 39% 32%
NL 71% 49% 77% 41% 46% 56% 58% 46%
AT 37% 41% 62% 37% 45% 45% 45% 45%PL 66% 94% 79% 35% 35% 57% 58% 35%
PT 22% 54% 56% 25% 35% 35% 55% 35%
SI 67% 50% 73% 34% 58% 89% 54% 43%
SK 24% 24% 28% 35% 30% 30% 18% 30%
FI 61% 62% 100% 33% 43% 55% 60% 43%
SE 55% 53% 89% 34% 36% 50% 39% 36%
UK 58% 85% 85% 33% 33% 56% 60% 33%
Notes:
For one earner couple households the second spouse's earnings are varied while the first spouse's earnings are held fixed at 0%  AW (inactive).
For two earner couple households the second spouse's earnings are varied while the first spouse's earnings are held fixed at 67 % AW.
1 In computing METRs, weekly working hours are increased by the same fraction as earnings, i.e., it is assumed that hourly earnin gs remain at weekly AW / 40.
2 In computing METRs, working hours are held constant at 40, i.e., earnings above 100% AW are a result of increasing hourly earni ngs rather than working hours.METR as wage increases by 33% of the AW wage level from two starting low wages
from 33 to 67% of AW from 67 to 100% of AW
 
EN 186   EN Context 10: Net income of social assistance recipients as % of the at-risk of poverty rate threshold for 3 jobless households t ypes, 2006
LT SK PT MT EE HU ES LV CZ BE PL LU CY FR SI AT DE FI SE DK UK IE NL
single 0,3         0,5      0,5      0,5        0,5           0,5            0,6         0,6           0,6             0,7           0,7             0,8         0,8         0,8           0,8           0,8         0,9             1,0        1,1      1,1      1,2      1,2      1,3      
lone parent, 2 children 0,7         0,6      0,7      0,4        0,6           0,9            0,6         1,3           0,8             0,9           0,9             0,8         0,8         0,8           1,0           0,9         1,2             0,9        0,9      1,0      1,2      1,0      1,1      
couple with two children 0,7         0,5      0,8      0,3        0,5           0,9            0,4         1,1           0,8             0,6           0,7             0,7         0,7         0,7           0,9           0,8         1,1             0,9        0,8      0,9      1,0      1,0      0,9      
Source : Joint EC-OECD project using OECD tax-benefit models, and Eurostat.
Context 11: At-risk-of-poverty rate before social transfers by gender and selected age groups
Before all social transfers except old-age and survivors' benefits
EU27 EU25 BE BG(1)CZ DK DK(2)DE EE IE EL ES FR IT CY LV LT LU HU MT NL AT PL PT RO(1)SI SK FI SE UK
Total population Total 25ps 26p 28 17i 20 27 28p 25p 25 33 24 24 26 24 21 27 26 23 29 22 21 25 27 24 24p 23 18 29 28 30
Men 24ps 24p 26 15i 19 26 27p 24p 23 31 23 23 25 23 19 25 24 23 30 21 20 23 27 24 24p 21 18 27 26 28
Women 26ps 27p 29 19i 21 29 29p 26p 27 35 25 25 27 25 23 29 27 24 29 22 22 26 26 25 24p 25 19 31 30 32
Children aged 0-17 years 33ps 33p 31 21i 31 24 24p 30p 28 39 27 29 36 32 20 30 29 33 44 29 25 36 35 27 34p 25 27 31 33 40
People aged 18-64 ye aTotal 24ps 24p 26 15i 19 27 27p 25p 21 29 22 21 24 22 15 24 22 23 29 19 20 23 27 22 21p 21 17 28 27 25
Men 23ps 23p 25 15i 18 25 26p 24p 21 27 21 20 23 21 13 23 22 22 29 17 18 22 28 21 22p 20 17 27 26 23
Women 25ps 25p 28 15i 20 28 29p 27p 22 31 22 22 26 23 18 25 23 24 28 21 22 24 26 23 20p 22 17 29 28 27
People aged 65 years aTotal 23ps 24p 27 20i 12 34 37p 18p 36 42 28 31 18 24 55 37 34 10 11 23 17 17 12 29 21p 30 13 31 23 38
Men 20ps 20p 24 10i 9 34 34p 15p 23 37 24 29 17 20 50 25 18 9 7 26 15 12 9 27 15p 23 6 26 12 34
Women 26ps 26p 29 27i 14 35 39p 21p 42 47 31 33 19 27 59 43 41 10 13 21 19 21 13 31 25p 35 17 35 31 41
Notes: i See explanatory text (Eurostat website) p = provisional value  s = Eurostat estimate  u = unreliable or uncertain data   (:) = data not available 
EU Aggregates: Eurostat estimates are obtained as a population size weighted average of national data.Source: SILC 2007,  Income data 2006; except for UK, income year 2007 and for IE moving income reference period (2006-2007);  (1) BG National HBS 2006, income data 2006 and RO National HBS 2007, income data 2007; (2) with imputed rent data 2006 (see methodological note).
 
EN 187   EN Context 12 already in 2.1
 
EN 188   EN 1. Employment rate gap by country of birth, 2005, 2006, 2007 annual averages
2005 2006 2007Born in 
the 
countryBorn in 
another 
EU25 
countryBorn 
outside 
the 
EU25Born in 
the 
countryBorn in 
another 
EU25 
countryBorn 
outside 
the 
EU25Born in 
the 
countryBorn in 
another 
EU25 
countryBorn 
outside 
the 
EU25Born in 
the 
countryBorn in 
another 
EU25 
countryBorn 
outside 
the 
EU25Born in 
the 
countryBorn in 
another 
EU25 
countryBorn 
outside 
the 
EU25Born in 
the 
countryBorn in 
another 
EU25 
countryBorn 
outside 
the 
EU25
BE 12,5 12,5 12,7 62,7 57,5 44,2 62,7 56,2 45,2 63,5 57,9 45,2 87,1 5,8 7,1 86,5 6,1 7,5 88,4 5,2 6,5
B G: - 2 , 4 2 , 1 ::: 5 8 , 6 : 6 1 , 8 6 1 , 7 : 6 1 , 0 :::::::::CZ 3,4 4,8 -2,3 64,9 59,0 67,2 65,4 58,3 65,2 66,1 61,2 71,4 98,1 1,4 0,6 98,1 1,3 0,6 99,1 0,3 0,6D K 1 3 , 61 4 , 51 6 , 07 6 , 97 2 , 26 0 , 17 8 , 47 0 , 86 1 , 57 8 , 8 74,8 59,6 93,1 1,8 5,1 93,2 1,8 5,0 90,6 1,9 7,5
D E  *1 4 , 41 4 , 91 4 , 86 7 , 56 5 , 54 7 , 06 9 , 16 6 , 34 8 , 17 0,9 68,2 49,6 89,5 3,4 7,0 89,7 3,5 6,8 89,7 3,6 6,7
EE -5,3 -4,7 -5,9 63,7 64,1 69,3 67,4 64,9 72,6 68,6 75,4 74,4 85,6 0,9 13,5 85,7 0,9 13,5 86,2 0,6 13,1I E :::::: 6 8 , 2 :: 6 8 , 4 :::::::::::
EL -6,4 -6,6 -5,1 59,6 55,0 67,9 60,5 55,5 68,8 60,9 58,2 67,5 92,0 1,2 6,9 92,5 1,0 6,5 92,3 1,2 6,4
ES -6,8 -6,9 -4,6 62,5 64,2 70,2 63,8 65,7 71,6 64,9 69,9 69,4 88,0 1,9 10,1 86,4 2,0 11,7 84,9 4,0 11,1FR 7,9 7,5 7,3 64,1 63,5 53,5 64,7 65,4 54,0 65,5 64,6 55,8 88,4 3,1 8,5 89,0 3,0 8,0 88,5 3,1 8,3IT : -7,3 -7,8 : : : 57,9 58,9 66,4 58,0 64,9 66,2 : : : 92,4 1,3 6,3 92,0 2,1 5,9CY -2,2 -1,6 -0,6 68,1 57,4 75,8 69,3 62,1 75,3 70,8 64,8 75,2 82,9 5,1 12,0 82,7 5,6 11,7 82,3 6,4 11,2LV -4,2 -6,0 -5,0 62,8 56,1 68,4 65,7 (62,1) 72,7 67,7 (69,4) 73,1 88,0 1,4 10,7 89,4 1,0 9,6 87,8 1,3 10,9LT -5,1 -6,7 -6,4 62,4 : 68,7 63,3 73,2 69,7 64,7 72,3 70,9 (96,3) (0,2) (3,5) 95,9 0,4 3,8 95,9 0,4 3,8
LU -9,4 -8,9 -11,9 59,8 70,7 60,0 60,0 71,2 55,3 59,2 72,9 60,0 59,7 34,6 5,8 59,6 34,4 6,0 58,3 35,6 6,0
HU -5,8 -3,4 -7,6 56,8 53,1 64,5 57,3 (53,5) 62,4 57,2 (65,7) 62,6 98,2 0,3 1,5 98,3 0,3 1,3 98,5 1,1 0,4MT -4,1 -0,5 -3,4 53,7 (48,9) 61,9 54,8 56,1 54,9 55, 5 55,8 60,2 95,3 1,5 3,2 95,4 1,7 3,0 95,5 1,4 3,1
NL 14,5 14,2 13,2 75,2 70,2 58,5 76,2 72,5 59,5 77,7 73,1 62,2 86,9 2,5 10,7 87,0 2,5 10,5 87,1 2,7 10,3AT 7,7 8,2 7,7 69,9 65,3 61,0 71,6 67,8 61,6 72,7 (69,4) 63,0 83,7 4,7 11,5 83,0 4,9 12,1 82,8 5,4 11,7PL 22,9 19,1 21,7 52,9 29,8 30,1 54,6 36,2 35,0 57,1 30,7 38,7 99,4 0,3 0,4 99,5 0,2 0,3 99,6 0,2 0,2PT -5,4 -4,3 -5,8 67,1 65,1 74,5 67,6 : 72,9 67,3 : 73,7 92,9 1,5 5,6 92,6 1,6 5,8 92,3 1,6 6,1
RO (-1.9) : (-4.3) 57,6 : : 58,8 51,9 : 58,8 67,7 (62,4) : : : : : : : : :
SI -1,3 -0,2 -0,2 65,9 59,4 67,9 66,6 51,3 68,4 67,8 64,1 68,2 92,1 0,6 7,2 92,5 0,7 6,7 91,9 0,5 7,6SK 6,4 4,3 -5,6 57,8 49,0 61,6 59,5 54,8 (57,5) 60,7 67,7 (60,9) 99,1 0,7 0,2 99,3 0,6 0,1 99,5 0,4 0,1FI 11,7 9,2 6,8 68,8 65,4 50,8 69,7 69,4 53,7 70,5 74,8 55,8 96,9 1,3 1,8 96,7 1,4 1,9 96,6 1,4 2,0SE 13,8 13,5 13,1 74,3 71,8 54,8 75,1 72,5 56,9 76,2 72,7 58,9 86,4 4,6 9,0 85,1 4,6 10,3 84,7 4,7 10,6UK 7,7 5,9 5,6 72,5 72,1 62,2 72,2 75,1 63,1 72,0 75,4 62,8 88,9 3,0 8,2 88,2 3,1 8,7 87,4 3,7 9,0
EU-27 4,6 2,7 2,6 64,8 65,6 58,2 64,7 66,6 60,4 65,6 68,6 60,8 91,1 2,4 6,4 91,3 2,2 6,4 91,0 2,6 6,4
EU-25 5,1 3,1 3,0 65,2 65,6 58,2 65,1 66,6 60,4 66,1 68,6 60,8 90,6 2,6 6,8 90,8 2,4 6,9 90,4 2,8 6,8
EU-15 7,2 4,7 4,5 67,4 66,2 57,9 66,7 67,1 60,2 67,4 68,8 60,5 88,9 3,1 8,0 89,3 2,7 7,9 88,8 3,2 7,9
Source: EU labour Force Survey, quarter 2. Data marked 'u' lack reliabilty due to small sample size. Empty cells correspond to data not avaialble or not reliable due to smal sample size
(1) In case "born in another EU25 country" is not reliable due to small sample size, the cell "Born outside the EU25" refers to  "Born outside the country".
(2) Country of birth is not available for BG, DE and RO. Nationality is used instead. Employment rate gap 
between persons born 
inside and outside the 
country2005 2006 2005Employment rates by country of birth
2006 2007 2007Distribution of the population aged 15-64 by country of birth
 
EN 189   EN 2. Distrbution of the population by age and country of birth
15-24 25-49 50-64 15-24 25-49 50-64 15-24 25-49 50-64 15-24 25-49 50- 64 15-24 25-49 50-64 15-24 25-49 50-64 15-24 25-49 50-64 15-24 25-49 50-6415-
2425-49 50-64
BE 19,4 53,3 27,3 8,3 54,1 37,6 14,2 67,4 18,4 19,4 52,8 27,8 10,3 53,1 36,6 13,5 67,0 19,5 19,0 52,5 28,5 11,4 52,8 35,8 14,6 66,1 19,2
BG 19,8 52,1 28,1 : : : : : : : : : : : : : : : : : :
CZ 18,9 51,8 29,3 6,7 50,7 42,6 13,3 71,0 15,7 18,6 51,8 29,6 8,4 49,5 42,1 13,8 70,5 15,7 18,4 51,8 29,8 11,1 49,7 39,1 12,2 71,9 15,8
DK 16,7 52,6 30,6 12,1 55,7 32,3 16,8 68,9 14,3 17,1 52,2 30,7 12,3 56, 1 31,6 20,0 64,1 16,0 17,0 51,6 31,4 13,8 55,0 31,2 19,2 63,6 17,2
DE 17,7 53,7 28,7 13,3 59,4 27,3 19,5 61,2 19,3 18,4 53,8 27,8 : : : : : : 18,4 53,2 28,4 : : : : : :
EE 25,6 52,0 22,4 3,4 47,8 48,8 26,0 51,6 22,3 : 49,1 41,5 2,9 46,7 50,5 25,8 52,3 21,9 : 51,1 42,8 2,5 43,8 53,7
IE 23,3 52,8 23,9 16,5 68,8 14,7 22,5 53,1 24,4 : : : : : : 21,9 53,3 24,7 : : : : : :
EL 17,1 55,0 27,9 19,2 66,9 13,9 18,4 67,4 14,2 16,8 55,1 28,0 15,8 70, 3 13,9 18,5 68,7 12,7 16,2 55,1 28,7 15,3 68,6 16,2 17,5 69,4 13,1
ES 17,6 56,8 25,7 7,8 69,4 22,8 19,6 71,3 9,1 16,9 56,6 26,6 13,7 69,0 17,3 18,3 72,9 8,8 16,5 56,1 27,4 13,3 72,6 14,1 17,6 72,0 10,4
FR 20,5 53,0 26,5 6,4 50,2 43,4 10,7 56,6 32,8 20,5 52,5 27,0 5,5 51,2 43,3 10,6 56,7 32,7 20,4 52,0 27,6 7,2 48,5 44,3 10,1 58,5 31,5
IT 15,7 55,2 29,0 11,8 73,3 14,9 15,1 74,0 10,9 15,7 55,0 29,3 10,5 75,1 14,4 14,5 73,6 11,9
CY 19,5 53,4 27,1 14,2 61,1 24,8 16,9 72,0 11,1 19,6 53,3 27,1 15,4 62, 1 22,5 14,6 74,6 10,8 18,7 53,5 27,8 15,3 60,6 24,2 15,4 74,2 10,4
LV 25,2 52,6 22,2 11,3 38,7 50,0 3,4 45,3 51,3 25,0 52,3 22,7 : 42,3 52,4 4,1 46,1 49,9 25,3 52,5 22,2 (6.1) 40,7 53,2 4,2 46,3 49,5
LT 23,2 53,2 23,5 5,7 u 55,4 39,0 23,5 53,0 23,5 : (72.4) : (6.8) 51,5 41,7 23,7 52,8 23,5 : (59.3) : (5.9) 52,2 42,0
LU 21,5 52,2 26,4 9,7 64,9 25,3 14,8 70,4 14,7 21,7 51,0 27,3 9,4 64,8 25,8 15,6 64,9 19,5 21,7 51,7 26,5 9,6 65,9 24,5 16,1 66,3 17,6
HU 18,8 52,1 29,2 12,2 u 40,9 46,9 12,0 63,9 24,1 18,5 51,6 29,9 11,9 61, 1 27,0 16,2 59,4 24,5 18,4 51,7 29,9 10,4 62,3 27,3 20,0 58,7 21,3
MT 22,5 50,4 27,1 22,6 50,3 27,1 : (58.5) : (22.1) 67,6 : 22,8 49,8 27,4 : (57.5) : (22.2 )66,7 :
NL 18,4 52,7 28,9 8,9 60,8 30,3 13,1 66,2 20,7 18,6 52,2 29,2 10,2 60,7 29,2 13,2 65,3 21,5 18,7 51,6 29,7 11,2 59,7 29,2 12,4 65,0 22,6
AT 18,4 55,0 26,6 12,0 55,9 32,1 16,2 62,5 21,3 18,6 54,9 26,6 10,4 59, 6 30,0 16,2 62,2 21,6 18,6 54,5 26,8 11,0 61,7 27,2 15,6 62,2 22,2
PL 22,6 51,7 25,7 5,8 u 27,6 66,6 22,2 51,3 26,5 : (25.0) 71,4 (10.6) 33,0 56,5 21,5 51,0 27,5 : (18.5) 74,3 : 35,1 57,9
PT 18,6 54,3 27,2 22,3 70,5 7,2 15,4 72,2 12,3 18,1 54,3 27,6 18,2 76,6 5,2 15,4 70,6 14,0 17,6 54,3 28,1 16,5 79,1 4,4 14,1 70,6 15,3
RO 21,6 53,2 25,2 : : : : : : 21,3 53,0 25,7 : : : : (77.2) :
SI 20,2 54,0 25,8 6,3 u 53,1 40,6 u 5,0 58,0 37,0 19,6 53,9 26,5 (6.7) 53,9 (39.4) 6,1 55,2 38,7 19,3 53,8 26,9 : 61,6 (34.3) 5,1 53,3 41,5
SK 23,0 53,2 23,8 22,3 53,0 24,7 (9.2) 46,8 43,9 : : : 22,0 52,9 25,1 : 39,7 55,2 : 68,6 :
FI 18,1 50,0 32,0 24,1 61,0 14,8 22,1 64,6 13,3 18,0 49,4 32,5 17,8 70, 9 11,4 23,9 61,7 14,4 18,3 48,8 33,0 13,4 73,7 12,9 23,0 60,6 16,3
SE 19,7 49,8 30,5 4,8 48,3 46,9 18,7 63,6 17,7 20,0 49,5 30,5 4,6 48,8 46,6 18,5 62,0 19,6 20,5 49,2 30,3 5,1 47,7 47,2 18,8 61,0 20,2
UK 19,4 52,3 28,3 15,8 59,5 24,7 14,4 64,8 20,8 19,4 51,9 28,7 18,2 60, 9 21,0 14,1 64,9 21,0 19,6 51,2 29,2 19,0 61,9 19,1 14,0 65,6 20,3
:::::::::::: : : : : : :
EU-27 19,3 53,2 27,5 11,2 57,4 31,4 15,6 63,4 21,0 19,1 53,2 27,7 11,7 61, 0 27,3 14,4 65,5 20,0 18,9 52,8 28,2 12,3 61,7 26,0 14,1 65,8 20,2
EU-25 19,3 53,3 27,5 11,2 57,4 31,4 15,6 63,4 21,0 18,9 53,2 27,9 11,7 61, 0 27,3 14,4 65,5 20,0 18,8 52,8 28,4 12,3 61,7 26,0 14,1 65,8 20,2
EU-15 18,7 53,6 27,8 11,3 58,1 30,5 16,0 63,9 20,1 18,2 53,6 28,2 11,8 61, 6 26,6 14,8 66,1 19,1 18,2 53,2 28,7 12,4 62,3 25,3 14,4 66,3 19,3
Source: EU labour Force Survey, quarter 2. Data marked 'u' lack reliabilty due to small sample size. Empty cells correspond to data not avaialble or not reliable due to smal sample size
(1) In case "born in another EU25 country" is not reliable due to small sample size, the cell "Born outside the EU25" refers to  "Born outside the country".
(2) Country of birth is not available for BG, DE and RO. Nationality is used instead. Born in the countryBorn in another EU27 
countryBorn in another country 
outside the EU25Born in the countryBorn in another EU25 
countryBorn in another country 
outside the EU252005 2006 2007
Born in the countryBorn in another EU27 
countryBorn in another 
country outside the 
EU25
 
EN 190   EN 3. Distribution of the 15-64 by sex and country of birth
MenWo
menMenWo
menMenWo
menMenWo
menMenWo
menMenWo
menMenWo
menMenWo
menMenWo
men
BE 49,5 50,5 51,6 48,4 50,8 49,2 49,2 50,8 46,1 5 3,9 48,2 51,8 49,1 50,9 47,2 52,8 47,4 52,6
BG 50,5 49,5 55,4 u 44,6 u 48,4 51,6 41,7 58, 3 37,8 62,2 48,4 51,6 41,8 58,2 46,6 53,4
CZ 49,9 50,1 49,6 50,4 45,8 54,2 48,9 51,1 45,8 5 4,2 47,4 52,6 48,9 51,1 44,4 55,6 48,5 51,5
DK 49,3 50,7 45,2 54,8 55,7 44,3 49,8 50,2 50,4 4 9,6 44,3 55,7 49,8 50,2 43,3 56,7 46,9 53,1
DE 49,8 50,2 47,5 52,5 49,1 50,9 48,8 51,2 52,7 4 7,3 51,2 48,8 48,8 51,2 52,6 47,4 51,1 48,9
EE 51,6 48,4 52,7 47,3 57,1 42,9 47,4 52,6 35,8 6 4,2 38,0 62,0 47,4 52,6 33,4 66,6 38,5 61,5
IE 49,8 50,2 48,1 51,9 48,3 51,7 49,7 50,3 : : : : 49,8 50,2 : : : :
EL 50,1 49,9 62,0 38,0 49,2 50,8 49,1 50,9 35,0 6 5,0 50,1 49,9 49,2 50,8 39,9 60,1 51,4 48,6
ES 49,4 50,6 53,2 46,8 50,1 49,9 49,4 50,6 48,5 5 1,5 49,4 50,6 49,5 50,5 49,7 50,3 49,0 51,0
FR 50,5 49,5 53,2 46,8 51,0 49,0 48,7 51,3 46,3 5 3,7 48,6 51,4 48,7 51,3 45,4 54,6 49,3 50,7
IT 48,7 51,3 36,4 63,6 49,6 50,4 48,7 51,3 40,4 59,6 49,8 50,2
CY 50,1 49,9 53,3 46,7 60,6 39,4 50,0 50,0 45,9 5 4,1 39,3 60,7 50,1 49,9 43,7 56,3 39,8 60,2
LV 51,2 48,8 57,2 42,8 56,5 43,5 46,8 53,2 46,5 5 3,5 40,5 59,5 47,1 52,9 43,0 57,0 39,5 60,5
LT 51,7 48,3 53,9 46,1 46,8 53,2 54,9 45,1 42,7 57,3 46,7 53,3 49,1 50,9 42,7 57,3
LU 49,2 50,8 49,6 50,4 53,4 46,6 51,2 48,8 50,4 4 9,6 46,3 53,7 50,5 49,5 51,2 48,8 44,9 55,1
HU 51,1 48,9 56,3 43,7 53,3 46,7 47,4 52,6 41,6 5 8,4 44,3 55,7 47,4 52,6 44,0 56,0 42,8 57,2
MT 49,7 50,3 53,0 u 47,0 u 47,7 52,3 49,7 50,3 51, 8 48,2 44,9 55,1 49,7 50,3 43,2 56,8 48,9 51,1
NL 49,3 50,7 56,1 43,9 50,1 49,9 49,8 50,2 41,9 5 8,1 49,3 50,7 49,8 50,2 44,1 55,9 48,5 51,5
AT 49,8 50,2 57,5 42,5 50,5 49,5 48,8 51,2 43,0 5 7,0 49,5 50,5 48,9 51,1 43,2 56,8 49,6 50,4
PL 50,5 49,5 46,8 53,2 53,8 46,2 48,3 51,7 43,8 5 6,2 37,6 62,4 48,2 51,8 46,4 53,6 37,1 62,9
PT 50,5 49,5 52,1 47,9 52,4 47,6 48,4 51,6 48,0 5 2,0 48,1 51,9 48,5 51,5 47,5 52,5 47,6 52,4
RO 48,7 51,3 58,0 42,0 65,7 34,3 48,7 51,3 63,4 36,6 54,8 45,2
SI 49,2 50,8 54,9 45,1 49,0 51,0 48,9 51,1 45,1 5 4,9 51,8 48,2 49,0 51,0 38,3 61,7 53,2 46,8
SK 50,3 49,7 53,3 46,7 53,9 46,1 48,6 51,4 46,4 5 3,6 37,2 62,8 48,6 51,4 43,1 56,9 53,2 46,8
FI 49,7 50,3 48,3 51,7 53,8 46,2 48,8 51,2 51,2 4 8,8 43,9 56,1 48,8 51,2 53,2 46,8 46,3 53,7
SE 48,9 51,1 53,0 47,0 50,5 49,5 50,9 49,1 44,7 5 5,3 49,4 50,6 51,0 49,0 45,5 54,5 48,8 51,2
UK 50,6 49,4 53,1 46,9 51,6 48,4 48,9 51,1 46,4 5 3,6 48,4 51,6 48,8 51,2 47,4 52,6 48,5 51,5
EU-27 50,1 49,9 51,6 48,4 50,6 49,4 48,8 51,2 47,0 5 3,0 49,0 51,0 48,8 51,2 47,4 52,6 49,0 51,0
EU-25 50,1 49,9 51,6 48,4 50,6 49,4 48,8 51,2 47,0 5 3,0 49,0 51,0 48,8 51,2 47,4 52,6 49,0 51,0
EU-15 50,0 50,0 51,6 48,4 50,5 49,5 48,9 51,1 47,1 5 2,9 49,4 50,6 49,0 51,0 47,5 52,5 49,4 50,6
Source: EU labour Force Survey, quarter 2. Data marked 'u' lack reliabilty due to small sample size. Empty cells correspond to data not avaialble or not reliable due to smal sample size
(1) In case "born in another EU25 country" is not reliable due to small sample size, the cell "Born outside the EU25" refers to  "Born outside the country".
(2) Country of birth is not available for BG, DE and RO. Nationality is used instead. Born outside the 
EU25Born in the countryBorn in another 
EU25 country2006 2005
Born in the countryBorn in another 
EU25 countryBorn outside the 
EU25Born in the countryBorn in another 
EU25 countryBorn outside the 
EU252007