Elderly Pensioners' Rights for Healthcare in Shirak Region in the Frame of the State Benefit Package

'The Republic of Armenia is a sovereign, democratic state,
based on social justice and the rule of law.'
Article 1, Constitution of RoA

Each person has the right of receiving healthcare and services as well as of free healthcare stipulated by the law. In addition to this, the UN International Covenant on Economic, Social and Cultural Rights specifies the following in Article 12 of Part II: "The State Parties to the Present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. The steps to be taken by the State Parties to the Present Covenant to achieve the full realization of this right shall include those necessary for the creation of conditions which would assure to all medical service and medical attention in the event of sickness". The 'Law of RoA on State Pensions" adopted on November 19, 2002, specifies a number of types of state pensions, particularly the one that provides for life old-age pensions for citizens who are 65 years old.
On November 23, 2006 the Government adopted Decree N17171 which specified the list of social groups of population and diseases that are eligible for obtaining medicine free of charge or by discount. Single, not working pensioners and families consisting of only not working pensioners (including those that have dependent minors) are entitled to 50% discount for medicines in case of illness, while not working pensioners receive medicines with 30% of discount. If the old-age pensioner suffers a disease which is on the list specified in Decree N 1717, then the State provides those medicines free of charge. Decree of the Government N 318 of March 4, 2004, specifies the list of socially vulnerable and special groups of population whom the Government guarantees free health care and services. Old-age pensioners are not included on the list as a separate category.
Observations
The following healthcare facilities were furnished with ramps: Abajyan Center for Family Healthcare, G. Gulbenkian Surgical Hospital, and Akhuryan Medical Center. The other five institutions did not have ramps and the examination rooms were located on the second floor. This creates difficulties for old people as there are no elevators to go upstairs. The monitoring group witnessed in Artik Medical Center how several elderly persons were struggling to get up to the second floor with the help of crutches to see the general practitioner. To our question whether it was not difficult for them to climb up the stairs, the pensioners answered that even if they reach the second floor there is a chance that the doctor is not there. "Maybe he will be there but will not have time for us and in that case we will have to make this way for the second or even third or fourth time." From all observed medical institutions only the Gulbenkian Surgical Hospital and the Akhuryan Medical Center had located information boards notifying visitors about benefits and provision of free healthcare services and medicines to old-age pensioners. These information boards were well legible. One or two boards were found in other observed institutions too, but they were located in dark corridors while the script was too small to be read. Examination rooms in all facilities were lit well but the same cannot be said about the passages that led to the rooms. There was little light in all observed facilities. At the moment when the group was carrying out monitoring at the "Samaritan" hospital, the ambulance brought in an old patient on a stretcher and put the stretcher in the lobby waiting for someone to come and take the patient to the third floor. This shows that the service of old-age patients is not carried out at due level.
 
Conclusions
Monitoring showed that in Guimri, Artik, Akhurian communities of Shirak region the rights of old-age pensioners of healthcare within state basic benefit package are not protected fully.

• The list of conditions in the benefit package does not fully coincide with the needs of old- age pensioners.
• The quality and quantity of medicine provided to the pensioners are not satisfactory, their expiry dates are short.
• Physical conditions of the buildings are not easily accessible for people above 65 years of age who are the main visitors of such facilities.
• Healthcare facilities are not well equipped which is one of the reasons why the service to the old age pensioners is not of good quality.
• Because of poor professional level, old age pensioners often do not trust the healthcare practitioners.
• The attitude of healthcare practitioners towards visitors is not caring; the quality of services is low.
• The cases of unofficial payments are many, while the pensions are hardly enough only for most basic needs.
• The level of awareness of the population is low, often people are not aware of their rights when it comes to receiving healthcare service.


Sergey Gabrielyan
“Guarantee” Center of Civil Society NGO