A/HRC/28/59/Add.1 C. Right to health 57. Iceland has a high-standard universal health-care system, and hospital services are free of charge. Since 2009, all children have access to free primary health care. On the other hand, user fees for private health care increased from about 16.4 per cent in 2000 to 19.1 per cent in 2010 and adult dental care is also payable. The number of people who reported having skipped a dental visit because it was too expensive increased from 6 per cent in 2007 to 11 per cent in 2013. Access to affordable dental care is a concern, in particular to people in the lowest income quintile, 18 per cent of whom said that they had skipped a necessary service because they could not afford it.34 The Government should be commended for gradually introducing a scheme to provide free dental health care for children. Expanding such a scheme to individuals in situations of poverty, irrespective of their age, should be considered. 58. Research conducted so far indicates that the banking collapse had only limited impact on the health of the population. Studies have identified slightly higher stress levels among women, in particular unemployed women, and students with middle levels of income or education. However, the crisis seems to have reduced smoking, heavy drinking, consumption of sugared soft drinks and fast food, and resulted in better sleeping behaviour.35 59. The number of people reporting that they were in good or very good health dropped only slightly from 79.0 per cent in 2007 to 76.8 per cent in 2013. Self-reported good health decreased more among the more affluent, but remained largely unchanged among those with lower incomes. In 2014, the Euro Health Consumer Index ranked Iceland seventh in Europe, with particular good scores on patient rights, prevention and health system outcomes, including the lowest number of infant deaths and the lowest number of potential years of life lost.36 While the Icelandic health system maintained its impressive services, job satisfaction of doctors and nurses probably suffered most owing to cost-containment policies.37 The health sector is starting to encounter difficulties in keeping highly qualified staff, who can easily find more attractive jobs abroad. D. Right to education 60. Independent research suggests that teaching and learning — the core functions of schools — were, to a large extent, protected. The reduction in expenditure on education did not cause a school crisis as access to education of a suitable quality was not threatened. However, that may not apply to all primary schools, which were harder hit by the cutbacks than other schools. Various cuts were made at all school levels; some administrative positions were eliminated; class size was increased; teachers were not paid for overtime and principals served as substitute teachers. A number of schools at the preschool and primary 34 35 36 37 Statistics Iceland, Health services, available from www.statice.is/Statistics/Health,-social-affairs-andjusti/Health-services. See Christopher B. MacClure, “Mental health and health behaviours following an economic collapse. The case of Iceland”, PhD dissertation, University of Iceland, 2014; also Tinna Laufrey Ásgeirdóttir and others. “Was the economic crisis of 2008 good for Icelanders? Impact on health behaviours”, Economics and Human Biology, Vol. 13 (2014), pp. 1-19. Health Consumer Powerhouse, Euro Health Consumer Index 2014 Report, 2015, available from www.healthpowerhouse.com/files/EHCI_2014/EHCI_2014_report.pdf. I.B. Solberg and others, “Cross-national comparison of job satisfaction in doctors during economic recession”, Occupational Medicine, vol. 64, No. 8 (December 2014), pp. 595-600. 19