A/HRC/25/50/Add.1 the European Social Charter.58 As the Committee noted, ultimately, the pension cuts are likely to occasion “a significant degradation of the standard of living and the living conditions of many of the pensioners concerned”.59 It is therefore critical that the Government make efforts to ensure a sufficient level of protection for the most vulnerable sectors of the population. 56. In 2011 and 2012, several family benefits were abolished and replaced by a single means-tested family benefit provided according to family income.60 The new benefit amounts to €40 per month per child (with slightly higher benefits per child for families with three or more children). However, only families with an annual income under €18,000 are eligible. 57. While the changes to the family benefit system ensure that support is provided in a more targeted fashion to those in need, the Independent Expert is concerned that eligibility criteria are very strict and require (since February 2011) 10 years of permanent and continuous residence in Greece. This has the effect of excluding large numbers of immigrants, and needs to be addressed. 58. It is notable that, to date, Greece is the only euro zone member State without a comprehensive social assistance scheme serving as a social safety net of last resort. The Independent Expert is concerned that, rather than maintain or expand social security spending to mitigate the negative social impact of the adjustment programme, the initial mid-term fiscal strategy envisioned that social programmes (excluding pensions and health) would contribute 1.5 per cent of GDP to fiscal consolidation. 59. The Independent Expert welcomes the steps taken by the Government to enhance social protection, including, inter alia, a health voucher programme, which will provide 100,000 long-term uninsured citizens with access to primary health-care services, and a review of the effectiveness of its income support programmes.61 Nonetheless, he urges the Government to extend coverage to all, including immigrants, in accordance with the human rights obligation of non-discrimination. He also urges the Government to ensure participation of affected individuals and communities, as well as civil society organizations, in the review, design and implementation of any proposed social protection measures. C. Health 60. A combination of cuts to health-care spending to below 6 per cent of GDP (approximately €12.4 billion in 2012) from around 10 per cent in recent years, job cuts in the public health sector, increased fees and co-payments,62 the closure/merger of hospitals 58 59 60 61 62 16 See Federation of Employed Pensioners of Greece (IKA-ETAM) v. Greece, Complaint No. 76/2012, Decision on Merits, 7 December 2012; Panhellenic Federation of Public Service Pensioners (POPS) v Greece, Complaint No. 77/2012; Pensioners’ Union of the Athens-Piraeus Electric Railways (I.S.A.P.) v Greece, Complaint No. 78/2012; Panhellenic Federation of Pensioners of the Public Electricity Corporation (POS-DEI) v Greece, Complaint No. 79/2012; and Pensioners’ Union of the Agricultural Bank of Greece (ATE) v Greece, Complaint No. 80/2012. See for example Federation of Employed Pensioners of Greece (IKA-ETAM) v. Greece, Complaint No. 76/2012, Decision on merits, 7 December 2012, para. 78. Overall spending on insurance and assistance-based family benefits fell dramatically from around €1.6 billion in 2009 to €900 million by 2011. See OECD, Greece: Reform of Social Welfare Programmes (see footnote 55), pp. 52-53. IMF Country Report No. 13/241(see footnote 32), pp. 83-84. In October 2010, additional user fees were imposed, ranging from €3 to €5 in outpatient departments of public hospitals and health centres. In January 2012, a 15 per cent co-payment for clinical tests was