1977L0452 — EN — 01.01.1981 — 001.001 — 1
This document is meant purely as a documentation tool and the institutions do not assume any liability for its contents
►B COUNCIL DIRECTIVE
of 27June 197 7
concerning the mutual recognition of diplomas, certificates and other evidence of the formal
qualifications of nurses responsible for general care, including measures to facilitate the effective
exercise of the right of establishment and freedom to provide services
(77/452/EEC)
(OJ L 176, 15.7.1977, p. 1)
Amended by:
Official Journal
No page date
►A1 Act of Accession of Greece L 291 17 19.11.1979
▼B
COUNCIL DIRECTIVE
of 27June 197 7
concerning the mutual recognition of diplomas, certificates and
other evidence of the formal qualifications of nurses responsible forgeneral care, including measures to facilitate the effective exercise of
the right of establishment and freedom to provide services
(77/452/EEC)
THE COUNCIL OF THE EUROPEAN COMMUNITIES,
Having regard to the Treaty establishing the European Economic
Community, and in particular Articles 49, 57, 66 and 235 thereof,
Having regard to the proposal from the Commission,
Having regard to the opinion of the European Parliament (1),
Having regard to the opinion of the Economic and Social Committee (2),
Whereas, pursuant to the Treaty, all discriminatory treatment based on
nationality with regard to establishment and provision of services isprohibited as from the end of the transitional period; whereas theprinciple of such treatment based on nationality applies in particular tothe grant of any authorization required to practise as a nurse responsible
for general care and also to the registration with or membership of
professional organizations or bodies;
Whereas it nevertheless seems desirable that certain provisions be
introduced to facilitate the effective exercise of the right of establish-
ment and freedom to provide services in respect of the activities of
nurses responsible for general care;
Whereas, pursuant to the Treaty, the Member States are required not to
grant any form of aid likely to distort the conditions of establishment;
Whereas Article 57 (1) of the Treaty provides that Directives be issued
for mutual recognition of diplomas, certificates and other evidence of
formal qualifications;
Whereas it would appear advisable that, contemporaneously with the
mutual recognition of diplomas, provision should be made forcoordinating the conditions governing the training of nurses responsibles
for general care; whereas such coordination is the subject of Directive
77/453/EEC (
3);
Whereas in several Member States the law makes the right to take up
and pursue the activities of a nurse responsible for general care
dependent upon the possession of a nursing diploma; whereas in certainother Member States where this requirement does not exist, the right touse the title of nurse responsible for general care is neverthelessgoverned by law;
Whereas, with regard to the possession of a formal certificate of
training, since a Directive on the mutual recognition of diplomas doesnot necessarily imply equivalence in the training covered by suchdiplomas; the use of such qualifications should be authorized only in the
language of the Member State of origin or of the Member State from
which the foreign national comes;
Whereas, to facilitate the application of this Directive by the national
authorities, Member States may prescribe that, in addition to formal
certificates of training, the person who satisfies the conditions oftraining required by this Directive must provide a certificate from thecompetent authorities of his country of origin or of the country fromwhich he comes stating that these certificates of training are thosecovered by the Directive;1977L0452 — EN — 01.01.1981 — 001.001 — 2
(1) OJ No C 65, 5. 6. 1970, p. 12.
(2) OJ No C 108, 26. 8.1970, p. 23.
(3) See page 8 of this Official Journal.
▼B
Whereas, with regard to the requirements relating to good character and
good repute, a distinction should be drawn between the requirements tobe satisfied on first taking up the profession and those to be satisfied to
practise it;
Whereas, in the case of the provision of services, the requirement of
registration with or membership of professional organizations or bodies,
since it is related to the fixed and permanent nature of the activitypursued in the host country, would undoubtedly constitute an obstacle tothe person wishing to provide the service, by reason of the temporarynature of his activity; whereas this requirement should therefore beabolished; whereas, however, in this event, control over professional
discipline, which is the responsibility of these professional organizations
or bodies, should be guaranteed; whereas, to this end, it should beprovided, subject to the application of Article 62 of the Treaty, that theperson concerned may be required to submit to the competent authorityof the host Member State particulars relating to the provision of
services;
Whereas, as far as the activities of employed nurses responsible for
general care are concerned, Council Regulation (EEC) No 1612/68 of 15
October 1968 on freedom of movement for workers within the
Community (
1) lays down no specific provisions relating to good
character or good repute, professional discipline or use of title for theprofessions covered; whereas, depending on the individual MemberState, such rules are or may be applicable both to employed and self-
employed persons; whereas the activities of a nurse responsible for
general care are subject in several Member States to possession of adiploma, certificate or other evidence of formal qualification in nursing;whereas such activities are pursued by both employed and self-employedpersons, or by the same persons in both capacities in the course of theirprofessional career; whereas, in order to encourage as far as possible the
free movement of those professional persons within the Community, it
therefore appears necessary to extend this Directive to employed nurses,
HAS ADOPTED THIS DIRECTIVE:
CHAPTER I
SCOPE
Article 1
1. This Directive shall apply to the activities of nurses responsible for
general care.
2. For the purposes of this Directive ‘activities of nurses responsible
for general care’ shall mean activities pursued by persons holding the
following titles:
in Germany:
‘Krankenschwester’, ‘Krankenpfleger’;in Belgium:
‘hospitalier(ère)/verpleegassistent(e)’, ‘infirmier(ère) hospitalier(ère)/
ziekenhuisverpleger (-verpleegster)’;
in Denmark:‘sygeplejerske’;in France:‘infirmier(ère)’;in Ireland:Registered General Nurse;in Italy:‘infermiere professionale’;1977L0452 — EN — 01.01.1981 — 001.001 — 3
(1) OJ No L 257, 19. 10. 1968, p. 2.
▼B
in Luxembourg:
‘infirmier’;in the Netherlands:‘verpleegkundige’;in the united Kingdom:
England,Wales and Northern Ireland:
State Registered Nurse;Scotland:
Registered General Nurse;
in Greece:
‘διπλωµατούχος αδελφή νοσοκόµος ’.
CHAPTER II
DIPLOMAS; CERTIFICATES AND OTHER EVIDENCE OF
FORMAL QUALIFICATIONS OF NURSES RESPONSIBLE
FOR GENERAL CARE
Article 2
Each Member State shall recognize the diplomas, certificates and other
evidence of formal qualifications awarded to nationals of Member Statesby other Member States in accordance with Article 1 of Directive 77/
453/EEC and which are listed in Article 3, by giving such qualifications,
as far as the right to take up and pursue the activities of a nurseresponsible for general care in a self-employed capacity is concerned,the same effect in its territory as those which the Member State itselfawards.
Article 3
The diplomas, certificates and other evidence of formal qualifications
referred to in Article 2 are the following:
(a)in Germany:
— the certificates awarded by the competent authorities as a result
of the ‘staatliche Prufung in der Krankenpflege’ (State nursing.examintion),
— the certificates from the competent authorities of the Federal
Republic of Germany stating that the diplomas awarded after 8May 1945 by the competent authorities of the GermanDemocratic Republic are recognized as equivalent to those
listed in the first indent;
(b)in Belgium:
— the certificate of ‘hospitalier(ère)/verpleegassistent(e)’ awarded
by the State or by schools established or recognized by the State,
— the certificate of ‘infirmier(ère) hospitalier(ère)/ziekenhuisver-
pleger (-verpleegster)’ awarded by the State or by schoolsestablished or recognized by the State,
— the diploma of ‘infirmier(ère) gradué(e) hospitalier(ère)/gegra-
dueerd ziekenhuisverpleger (-verpleegster)’ awarded by the Stateor by higher paramedical colleges established or recognized bythe State;
(c)in Denmark:
— the diploma of ‘sygeplejerske’ awarded by nursing schools
recognized by the ‘Sundhedsstyrelsen’ (State board of health)
(d)in France:
— the State diploma of ‘infirmier(ère)’. awarded by the Ministry of
Health;1977L0452 — EN — 01.01.1981 — 001.001 — 4
▼A1
▼B
▼B
(e)in Ireland:
— the certificate of ‘Registered General Nurse’. awarded by ‘An
Bord Altranais’ (the Nursing Board);
(f)in Italy:
— the ‘diploma di abilitazione professionale per infermiere
professionale’ awarded by Staterecognized schools;
(g)in Luxembourg:
— the State diploma of ‘infirmier’
— the State diploma of ‘infirmier hospitalier gradué’
awarded by the Ministry of Public Health on the strength of an
examining board decision;
(h)in the Netherlands:
— the diplomas of ‘verpleger A’, ‘verpleegster A’ or ‘verpleeg-
kundige A’,
— the diploma of ‘verpleegkundige MBOV (Middelbare Beroepso-
pleiding Verpleegkundige)’ (intermediate nursing training),
— the diploma of ‘verpleegkundige HBOV (Hogere Beroepso-
pleiding Verpleegkundige)’ (higher nursing training),
awarded by one of the examining boards appointed by the public
authorities;
(i)in the United Kingdom:
— the certificate of admission to the general part of the Register,
awarded in England and Wales by the General Nursing Councilfor England and Wales, in Scotland by the General NursingCouncil for Scotland and in Northern Ireland by the NorthernIreland Council for Nurses and Midwives;
(j)in Greece:
— either the diploma of Ανωτέρας Σχολής Αδελφών Νοσο-
κόµων ( college of nurses responsible for general care),
recognized by the Ministry for Social Services or the diploma
ofτων παραϊατρικών σχολών των Κέντρων Ανωτέρας
Τεχνικής και Επαγγελµατικής Εκπαιδεύσεως ( paramedical
schools of the Higher Technical and Vocational EducationCentres) awarded by the Ministry for National Education andReligious Affairs,
— theπιστοποιητικό πρακτικής ασκήσεως του επαγγέλµατος
της αδελφής νοσοκόµου ( certificate of practical training for
the nursing profession) awarded by the Ministry for SocialServices.
CHAPTER III
EXISTING CIRCUMSTANCES
Article 4
In the case of nationals of Member States whose diplomas, certificates
and other evidence of formal qualifications do not satisfy all theminimum training requirements laid down in Article 1 of Directive 77/
453/EEC, each Member State shall recognize, as being sufficient proof,
the diplomas, certificates and other evidence of the formal qualificationsof nurses responsible for general care awarded by those Member Statesbefore the implementation of Directive 77/453/ EEC, accompanied by acertificate stating that: those nationals have effectively and lawfullybeen engaged in the activities of nurses responsible for general care for
at least three years during the five years prior to the date of issue of the
certificate.
These activities must have included taking full responsibility for the
planning, organization and carrying out of the nursing care of thepatient.1977L0452 — EN — 01.01.1981 — 001.001 — 5
▼A1
▼B
▼B
CHAPTER IV
USE OF ACADEMIC TITLE
Article 5
1. Without prejudice to Article 13, host Member States shall ensure
that nationals of Member States who fulfil the conditions laid down in
Articles 2 and 4 have the right to use the lawful academic title, inasmuch
as it is not identical to the professional title, or, where appropriate, theabbreviation thereof of their Member State of origin or of the MemberState from which they come, in the language or languages of that State.Host Member States may require this title to be followed by the nameand location of the establishment or examining board which awarded it.
2. If the academic title used in the Member State of origin, or in the
Member State from which a foreign national comes, can be confused inthe host Member State with a title requiring, in that State, additionaltraining which the person concerned has not undergone, the host
Member State may require such a person to use the title employed in the
Member State of origin or the Memer State from which he comes. insuitable wording to be indicated by the host Member State.
CHAPTER V
PROVISIONS TO FACILITATE THE EFFECTIVE EXERCISEOF THE RIGHT OF ESTABLISHMENT AND FREEDOM TOPROVIDE SERVICES IN RESPECT OF THE ACTIVITIES OF
NURSES RESPONSIBLE FOR GENERAL CARE
A.Provisions specifically relating to the right of establishment
Article 6
1. A host Member State which requires of its nationals proof of good
character or good repute when they take up for the first time any activity
referred to in Article 1 shall accept as sufficient evidence, in respect of
nationals of other Member States, a certificate issued by a competentauthority in the Member State of origin or in the Member State fromwhich the foreign national comes attesting that the requirements of theMember State as to good character or good repute for taking up theactivity in question have been met.
2. Where the Member State of origin or the Member State from
which the foreign national comes does not require proof of goodcharacter or good repute of persons wishing to take up the activity inquestion for the first time, the host Member State may require of
nationals of the Member State of origin or of the Member State from
which the foreign national comes an extract from the ‘judicial record’ or,failing this, an equivalent document issued by a competent authority inthe Member State of origin or the Member State from which the foreignnational comes.
3. If the host Member State has detailed knowledge of a serious
matter which has occurred outside its territory and which is likely toaffect the taking up within its territory of the activity concerned, it mayinform the Member State of origin or the Member State from which theforeign national comes.
The Member State of origin or the Member State from which the foreign
national comes shall verify the accuracy of the facts if they are likely toaffect in that Member State the taking up of the activity in question. Theauthorities in that State shall decide on the nature and extent of the
investigation to be made and shall inform the host Member State of any
consequential action which they take with regard to the certificates ordocuments they have issued.
Member States shall ensure the confidentiality of the information which
is forwarded.1977L0452 — EN — 01.01.1981 — 001.001 — 6
▼B
Article 7
1. Where, in a host Member State, provisions laid down by law,
regulation or administrative action are in force laying down require-ments as to good character or good repute, including provisions fordisciplinary action in respect of serious professional misconduct or
conviction for criminal offences and relating to the pursuit of any of the
activities referred to in Article 1, the Member State of origin or theMember State from which the foreign national comes shall forward tothe host Member State all necessary information regarding measures ordisciplinary action of a professional or administrative nature taken in
respect of the person concerned, or criminal penalties imposed on him
when pursuing his profession in the Member State of origin or in theMember State from which he came.
2. If the host Member State has detailed knowledge of a serious
matter which has occurred outside its territory and which is likely toaffect the pursuit within its territory of the activity concerned, it mayinform the Member State of origin or the Member State from which theforeign national comes.
The Member State of origin or the Member State from which the foreign
national comes shall verify the accuracy of the facts if they are likely to
affect in that Member State the pursuit of the activity in question. The
authorities in that State shall decide on the nature and extent of theinvestigation to be made and shall inform the host Member State of anyconsequential action which they take with regard to the information theyhave forwarded in accordance with paragraph 1.
3. Member States shall ensure the confidentiality of the information
which is forwarded.
Article 8
Where a host Member State requires of its own nationals wishing to take
up or pursue any of the activities referred to in Article 1 a certificate ofphysical or mental health, that State shall accept as sufficient evidencethereof the presentation of the document required in the Member Stateof origin or in the Member State from which the foreign national comes.
Where the Member State of origin or the Member State from which the
foreign national comes does not impose any requirements of this natureon those wishing to take up or pursue the activity in question, the host
Member State shall accept from such national a certificate issued by a
competent authority in that State corresponding to the certificates issuedin the host Member State.
Article 9
Documents issued in accordance with Articles 6, 7 and 8 may not be
presented more than three months after their date of issue.
Article 10
1. The procedure for authorizing the person concerned to take up any
activity referred to in Article 1, pursuant to Articles 6, 7 and 8, must becompleted as soon as possible and not later than three months afterpresentation of all the documents relating to such person, without
prejudice to delays resulting from any appeal that may be made upon the
termination of this procedure.
2. In the cases referred to in Articles 6 (3) and 7 (2), a request for re-
examination shall suspend the period stipulated in paragraph 1.
The Member State consulted shall give its reply within three months.
On receipt of the reply or at the end of the period the host Member State
shall continue with the procedure referred to in paragraph 1.1977L0452 — EN — 01.01.1981 — 001.001 — 7
▼B
B.Special provisions relating to the provision of services
Article 11
1. Where a Member State requires of its own nationals wishing to
take up or pursue any of the activities referred to in Article 1 anauthorization, or membership of or registration with a professional
organization or body, that Member State shall in the case of the
provision of services exempt the nationals of Member States from thatrequirement.
The person concerned shall provide services with the same rights and
obligations as the nationals of the host Member State; in particular heshall be subject to the rules of conduct of a professional oradministrative nature which apply in that Member State.
Where a host Member State adopts a measure pursuant to the second
subparagraph or becomes aware of facts which run counter to theseprovisions, it shall forthwith inform the Member State where the personconcerned is established.
2. The host Member State may require the person concerned to make
a prior declaration to the competent authorities concerning the provisionof his services where they involve a temporary stay in its territory.
In urgent cases this declaration may be made as soon as possible after
the services have been provided.
3. Pursuant to paragraphs 1 and 2, the host Member State may require
the person concerned to supply one or more documents containing the
following particulars:
— the declaration referred to in paragraph 2,
— a certificate stating that the person concerned is lawfully pursuing
the activities in question in the Member State where he isestablished,
— a certificate that the person concerned holds one or other of the
diplomas, certificates or other evidence of formal qualificationappropriate for the provision of the services in question and referredto in this Directive.
4. The document or documents specified in paragraph 3 may not be
produced more than 12 months after their date of issue.
5. Where a Member State temporarily or permanently deprives, in
whole or in part, one of its nationals or a national of another MemberState established in its territory of the right to pursue one of the activitiesreferred to in Article 1, it shall, as appropriate, ensure the temporary orpermanent withdrawal of the certificate referred to in the second indent
of paragraph 3.
Article 12
Where registration with a public social security body is required in a
host Member State for the settlement with insurance bodies of accountsrelating to services rendered to persons insured under social securityschemes, that Member State shall exempt nationals of Member Statesestablished in another Member State from this requirement in cases ofprovision of services entailing travel on the part of the person concerned.
However, the persons concerned shall supply information to this body in
advance or, in urgent cases, subsequently, concerning the servicesprovided.
C.Provisions common to the right of establishment and freedom to
provide services
Article 13
Where in, a host Member State the use of the professional title relating
to one of the activities referred to in Article 1 is subject to rules,nationals of other Member States who fulfil the conditions laid down inArticles 2 and 4 shall use the professional title of the host Member State1977L0452 — EN — 01.01.1981 — 001.001 — 8
▼B
which, in that State, corresponds to those conditions of qualification, and
shall use the abbreviated title.
Article 14
Where a host Member State requires its own nationals wishing to take
up or pursue one of the activities referred to in Article 1 to take an oathor make a solemn declaration and where the form of such oath ordeclaration cannot be used by nationals of other Member States, thatMember State shall ensure that an appropriate and equivalent form ofoath or declaration is offered to the person concerned.
Article 15
1. Member States shall take the necessary measures to enable the
persons concerned to obtain information on the health and socialsecurity laws and, where applicable, on the professional ethics of thehost Member State.
For this purpose, Member States may set up information centres from
which such persons may obtain the necessary information. In the case of
establishment, the host Member States may require the personsconcerned to contact these centres.
2. Member States may set up the centres referred to in paragraph 1
within the competent authorities and bodies which they must designatewithin the period laid down in Article 19 (1).
3. Member States shall see to it that, where appropriate, the persons
concerned acquire, in their own interest and in that of their patients, thelinguistic knowledge necessary for the exercise of their profession in thehost Member State.
CHAPTER VI
FINAL PROVISIONS
Article 16
In the event of justified doubts, the host Member State may require of
the competent authorities of another Member State confirmation of theauthenticity of the diplomas, certificates and other evidence of formalqualifications issued in that other Member State and referred to in
Chapters II and III, and also confirmation of the fact that the person
concerned has fulfilled all the training requirements laid down inDirective 77/453/EEC.
Article 17
Within the time limit laid down in Article 19 (1), Member States shall
designate the authorities and bodies competent to issue or receive thediplomas, certificates and other.evidence of formal qualifications as well
as the documents and information referred to in this Directive, and shall
forthwith inform the other Member States and the Commission thereof.
Article 18
This Directive shall also apply to nationals of Member States who, in
accordance with Regulation (EEC) No 1612/68, are pursuing or willpursue as employed persons one of the activities referred to in Article 1.
Article 19
1. Member States shall bring into force the measures necessary to
comply with this Directive within two years of its notification and shallforthwith inform the Commission thereof.
2. Member States shall communicate to the Commission the texts of
the main provisions of national law which they adopt in the fieldcovered by this Directive.1977L0452 — EN — 01.01.1981 — 001.001 — 9
▼B
Article 20
Where a Member State encounters major difficulties in certain fields
when applying this Directive, the Commission shall examine these
difficulties in conjunction with that State and' shall request the opinion
of the Committee of Senior Officials on Public Health set up underDecision 75/365/EEC (
1), as amended by Decision 77/455/EEC (2).
Where necessary, the Commission shall submit appropriate proposals to
the Council.
Article 21
This Directive is addressed to the Member States.1977L0452 — EN — 01.01.1981 — 001.001 — 10
(1) OJ No L 167, 30. 6. 1975, p. 19.
(2) See page 13 of this Official Journal.