Doc. 8578

11 October 1999

Demographic trends and human potential in the countries of central and eastern Europe

Opinion1
Social, Health and Family Affairs Committee

Rapporteur: Mr Andreas Gross, Switzerland, Socialist Group

1.       For a number of years, the Council of Europe as a whole, and the Parliamentary Assembly in particular, have been engaged in an appreciable number of co-operation projects with the countries of central and eastern Europe in fields as varied as social cohesion, health care, education and the remoulding of political and economic institutions. The demographic situation is a fundamental constituent of the backdrop to these reforms and programmes. The converse is also true: population developments are influenced by the changes and reforms introduced. The report by the Committee on Migration, Refugees and Demography therefore comes at an opportune time and contains some very enlightening information on the situation in these countries.

2.       Before we consider the specific matters raised in the report, it is important to make one observation. It is generally accepted — both by the media, which relay what they hear, and in political circles, where it is a matter of conviction — that the negative demographic trends in eastern Europe can be explained more or less exclusively by reference to the political, economic and social upheaval experienced by the region since the end of the 1980s. Mr Chyzh’s report is no exception to this point of view. Yet the social sciences teach that, although institutional changes may come about, or be imposed from above, relatively swiftly, social behaviour patterns and attitudes evolve rather more slowly. Consequently, the causes of deep-seated change must sometimes be sought in the legacy of a more distant past and in entrenched social structures and cultural patterns, although change will naturally be accentuated at times of political reform and economic difficulty.

Mortality and health policies

3.       The report quite rightly describes the high mortality rate as the main challenge for a great number of eastern European countries. The causes given include cardiovascular diseases, drinking and smoking, pollution, the ineffectiveness of medical services and an increase in violent deaths. With the exception of the last two, these factors can hardly be attributed directly to political change. On the contrary, drinking, smoking and pollution are symptomatic of the inadequacies of the former system.

4.       The present state of affairs owes more to the legacy of health policies over-concerned with immediate results and statistics and insufficiently attuned to prevention and chronic illness. During the Soviet era, especially the 1950s and 1960s, the Plan was ruthless in declaring war on infectious diseases. Thanks to considerable effort this goal was achieved, but triumph led to over-confidence and a certain amount of inertia. There were delays in redeploying structural resources, and too little account was taken of prevention.

5.       The incidence of cardiovascular diseases, which as early as 1965 were already an overwhelming cause of mortality (accounting for 50% of all deaths among males and 62% among females), was still rising in 1993 (54% and 68% respectively). In contrast to infectious diseases, vascular conditions entail not only expensive treatment, but also the introduction of prevention policies to reduce the risk factors (such as smoking and alcohol abuse, high blood pressure and high cholesterol). Such policies can only succeed if government runs public awareness and information campaigns to encourage people to care for their own health.

6.       Without a doubt, one extremely disturbing statistic is the rise in the death rate among young people, whether infants, small children or adolescents, in certain countries of eastern Europe. The trend should not be over-generalised, however, since the rate in several central European countries has dropped significantly during the last ten years and now compares favourably with that in the West. In the remaining countries, especially those of the former Soviet Union, the rise is attributable to poor sanitation, food shortages, the poor state of health and nutrition of pregnant women, inadequate access to health services, growing poverty, an increase in the number children abandoned to their fate by destitute families, and above all to the renewed prevalence of infectious diseases such as tuberculosis2 and diphtheria. Where adolescents are concerned, the causes are to be found in the doubling or even tripling of the suicide rate among 15-19-year-olds during the past six years and in the spread of hard drugs. In Slovenia, 15% of intravenous drug users were under 14 years of age, and 72% were between 15 and 19.

Social policies and demographic change

7.       Fertility is another important element of population change. The main issue here is family policy and the attitude of the state towards the “family” in the widest sense of the term. In family matters there is obviously no equivalent to public health structures, and state influence would therefore appear to be more limited — notwithstanding the exaggerated fertility policy of Ceaucescu’s Romania. Within any given country, variations in fertility depend on a great many different factors.

8.       In this regard, the behaviour of central and eastern European women has been noticeably converging with that of their peers in the West for many years, in a process which began well before any political changes. There is nothing unusual in this: several previous Assembly texts have insisted that a country’s social development must include recognition of the role of women and their emancipation. The worries and uncertainties of daily life are now adding to this general trend as the welfare state declines and is replaced by the market economy. In line with the experience of western Europe, the initial fall in fertility will doubtless be followed by gradual recovery over the years, and equilibrium will be reached as the period of socio-economic transition comes to an end.

9.       One thorny issue barely touched on by the Chyzh report is the inconsistency between the ageing of the population and the retirement age. This matter, which has extremely serious social and economic implications, goes to the very heart of welfare provision and thus affects social cohesion within the community.

10.       As the Chyzh report points out, with a few exceptions, central and eastern European countries share the Europe-wide trend towards an older population. Yet the average retirement age (57 for men and 53 for women) is well below that of the OECD countries (around 65). A quick glance at the relatively large proportion of the national budget allocated to funding pensions in these countries (15% of GDP in Poland and Slovenia, and 10% in Bulgaria, Hungary and Slovakia) reveals the extent of the problem. There is no way that this kind of vicious circle can continue without causing an unbearable drain on the system. It would be politically delicate to raise the retirement age beyond a certain level, since the generation which suffered most under the former regime is understandably unwilling to make any further sacrifices. None the less, there must be open and in-depth discussion of specific elements of this problem.

11.       According to the World Bank, an alternative way of overcoming financial difficulties and guaranteeing retirement income would be to supplement the state pension with two private systems, a funded scheme based on compulsory contributions and a voluntary "top-up" scheme. Needless to say, this proposal raises questions with strong ideological and cultural ramifications, and they can be resolved only on a country by country basis. The Council of Europe’s treaties in this field (the European Social Charter and the European Code of Social Security) and its related experience could possibly provide some guidance for the difficult choices which lie ahead.

12.       Whatever choices are made, in certain countries (Russia and Ukraine) the situation regarding pensions and pensioners themselves is tragic, to say the least. The Social Affairs Committee is examining this particular case with a good deal of interest.3

The exodus that never was

13.       The final factor of demographic change is migration. In the early 1990s the western media confidently proclaimed an exodus from central and eastern Europe which never happened. In his report, Mr Chyzh generously explains this as being “partly because the receiving countries set up effective controls”. A more honest analysis might add that western Europe chose, at the historic moment of transition in the East to democracy and market economics, to erect barriers and restrict immigration to selected individuals such as scientists, sports stars and performing artists. Yet, contrary to the assertion in the report’s paragraph 38, there has not been a real brain-drain, because the countries concerned initially had little to offer in the way of manufacturing expertise, information technology and financial or management skills. On the other hand, people qualified in sectors such as eye surgery, space technology, laser science and mathematics are in enormous demand.

14.       As for internal migration, the Chyzh report does not sufficiently emphasise the impact which this can have on the fabric of society and on the balance of power between the capital and the regions. To take Russia as an example, migration to urban areas is slowing, populations from the Far East are returning home, Siberia is emptying and people fleeing the Caucasian conflicts are largely responsible for increased settlement in the northern Caucasus (Krasnodar and Stavropol districts). Ultimately, no doubt, these displacements will have an effect on human and economic resources, and a new balance will be created.

15.       Similarly, in recent years there has been a return flow of Russian speakers whose parents or grandparents settled in central Asia. This wave of migration is currently stronger than ever. Having gained their independence at the break-up of the USSR, many republics now operate discriminatory policies which are impelling Russian speakers back to the Federation.

16.       Demographic trends in eastern Europe are relevant to the issue of nationalities, not to mention that of nationalistic movements, especially in view of their potential for causing ethnic imbalance. For this reason they can also lead to political repercussions, which it would be as well not to ignore.

Conclusions

17.       The report of the Committee on Migration, Refugees and Demography sheds some interesting light on a new set of facts which merit closer attention. It raises several issues which could in turn be studied in greater depth, such as the potential of social policies to influence life expectancy, mortality rates and public health. It is precisely these issues that the Social, Health and Family Affairs Committee plans to examine at a conference to be held in Moscow this October on “Social reforms in Russia: towards a better protection for vulnerable groups”.

18.       We do not share the pessimism of the report in its description of current demographic trends as a “crisis situation” (paragraph 45) which is “likely to become a […] catastrophe” (paragraph 49). Firstly, the countries in question cannot be considered on an equal, necessarily over-simplistic footing, because analysis shows that their situations differ widely. Demographic change is part and parcel of the life of nations. Secondly, we do not believe the demographic situation in the central and eastern European countries at this moment of their development to have reached a critical stage. These countries are going through a period of uncertainty and socio-economic conflict, yet individual rights and freedoms are flourishing. Although citizens now enjoy a greater variety of activities and more scope for personal achievement, it is understandable that a certain lack of confidence in the future should affect birth rates. The uncertainty of what lies ahead is compelling couples to alter their plans, which may mean delaying starting a family.

19.       However, in some areas the introduction of State measures is a matter of urgency. This is particularly so in the health field, where high overall and infant mortality rates need to be tackled.

20.       In the final analysis, the development of new forms of contact between individuals and government bodies will prove crucial to achieving demographic balance in the countries of central and eastern Europe. As political systems change and social and economic progress is made, a new form of citizenship, with corresponding norms of social behaviour, will become noticeable. In the case of geographically large countries like Russia, relations between the federal state and local authorities will also have an influence, both on citizens’ decisions and on the implementation of government measures.i

Proposed amendments

21.       The Committee on Social, Health and Family Affairs would like to propose some amendments to the draft recommendation:

Amendment No. 1:

Amendment No. 2:

Amendment No. 3:

Amendment No. 4:

Amendment No. 5:

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Reporting committee: Committee on Migration, Refugees and Demography (Doc. 8463)

Committee for opinion: Social, Health and Family Affairs Committee

Reference to committee: Doc. 7498 and Reference N° 2059 of 20 March 1996 and modified by Reference N° 2157 of 27 January 1997

Opinion approved by the committee on 23 September 1999

Secretaries to the committee: Mr Perin, Mrs Meunier, Mrs Clamer

1 Doc. 8463 — report and draft recommendation adopted by the Committee on Migration, Refugees and Demography on 24 June 1999.

2        In 1999 a total of 42 000 TB cases were recorded in Poland, most of them in prisons.

3 See Doc. AS/Inf (1998) 8 on the non-payment of wages in Russia.