1977L0452 — EN — 13.10.1989 — 003.001 — 1
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►B COUNCILDIRECTIVE
of27June1977
concerningthemutualrecognitionofdiplomas,certificatesandotherevidenceoftheformalquali-
fications of nurses responsible for general care, including measures to facilitate the effective
exercise oftherightofestablishmentandfreedom toprovideservices
(77/452/EEC)
(OJ L 176, 15.7.1977, p. 1)
Amended by:
Official Journal
No page date
►M1Council Directive 89/595/EEC of 10 October 1989 L 341 30 23.11.1989
Amended by:
►A1Act of Accessionof Greece L 291 17 19.11.1979
►A2Act of Accessionof Spainan d Portugal L 302 23 15.11.1985
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COUNCILDIRECTIVE
of27June1977
concerning the mutual recognition of diplomas, certificates and
other evidence of the formal qualifications of nurses responsibleforgeneralcare,includingmeasurestofacilitate theeffective exer-
ciseoftherightofestablishmentandfreedom toprovideservices
(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 is
prohibited as from the end of the transitional period; whereas the prin-
ciple of such treatment based on nationality applies in particular to thegrant of any authorization required to practise as a nurse responsiblefor general care and also to the registration with or membership ofprofessional 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 ofnurses 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 for coordi-nating the conditions governing the training of nurses responsibles forgeneral care; whereas such coordination is the subject of Directive 77/453/EEC(
3);
Whereas inseveral Member States the law makes the right to take up
and pursue the activities of a nurse responsible for general care depen-
dent upon the possession of a nursing diploma; whereas in certain otherMember States where this requirement does not exist, the right to usethe title of nurse responsible for general care is nevertheless governedby law;
Whereas, with regard to the possessionof a formal certificate of
training, since a Directive on the mutual recognition of diplomas does
not necessarily imply equivalence in the training covered by suchdiplomas; the use of such qualifications should be authorized only inthe language of the Member State of origin or of the Member Statefrom which the foreign national comes;
Whereas, to facilitate the application of this Directive by the national
authorities, Member States may prescribe that, inadditionto 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 — 13.10.1989 — 003.001 — 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.
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Whereas, with regard to the requirements relating to good character
and good repute, a distinction should be drawn between the require-ments to be satisfied on first taking up the profession and those to be
satisfied to practise it;
Whereas, inthe case of the provisionof services, the requiremen t of
registration with or membership of professional organizations or
bodies, since it is related to the fixed and permanent nature of theactivity pursued in the host country, would undoubtedly constitute anobstacle to the personwishin g to provide the service, by reasonof thetemporary nature of his activity; whereas this requirement should there-fore be abolished; 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, itshould be provided, subject to the applicationof Article 62 of theTreaty, that the person concerned may be required to submit to thecompetent authority of the host Member State particulars relating to
the provisionof 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 onfreedom of movemen t for workers withinthe
Community(
1) lays down no specific provisions relating to good char-
acter 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 a
diploma, certificate or other evidence of formal qualification innursing; whereas such activities are pursued by both employed andself-employed persons, or by the same persons in both capacities inthe course of their professional 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 thisDirective 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:1977L0452 — EN — 13.10.1989 — 003.001 — 3
(1) OJ No L 257, 19. 10. 1968, p. 2.
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‘infermiere professionale’;
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 ’;
in Spain:
‘Enfermero/a diplomado/a;’in Portugal:‘Enfermeiro’.
CHAPTER II
DIPLOMAS; CERTIFICATES AND OTHER EVIDENCE OF
FORMAL QUALIFICATIONS OF NURSES RESPONSIBLE
FORGENERALCARE
Article 2
Each Member State shall recognize the diplomas, certificates and other
evidence of formal qualifications awarded to nationals of Member
States by other Member States inaccordan ce with Article 1 of Direc-
tive 77/453/EEC and which are listed in Article 3, by giving suchqualifications, as far as the right to take up and pursue the activitiesof a nurse responsible for general care in a self-employed capacity isconcerned, the same effect in its territory as those which the MemberState itself awards.
Article 3
The diplomas, certificates and other evidence of formal qualifications
referred to inArticle 2 are the followin g:
(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 8
May 1945 by the competent authorities of the German Demo-
cratic Republic are recognized as equivalent to those listed inthe first indent;
(b)in Belgium:
— the certificate of ‘hospitalier(ère)/verpleegassistent(e)’ awarded
by the State or by schools established or recognized by theState,
— the certificate of ‘infirmier(ère) hospitalier(ère)/ziekenhuisver-
pleger (-verpleegster)’ awarded by the State or by schools
established or recognized by the State,
— the diploma of ‘infirmier(ère) gradué(e) hospitalier(ère)/gegra-
dueerd ziekenhuisverpleger (-verpleegster)’ awarded by theState or by higher paramedical colleges established or recog-nized by the State;1977L0452 — EN — 13.10.1989 — 003.001 — 4
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(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;
(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 profes-
sionale’ 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 admissionto the gen eral part of the Register,
awarded in England and Wales by the General Nursing Council
for England and Wales, in Scotland by the General Nursing
Council 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 diplomaofτων παραϊατρικών σχολών των Κέντρων Ανωτέρας
Τεχνικής και Επαγγελµατικής Εκπαιδεύσεως ( paramedical
schools of the Higher Technical and Vocational Education
Centres) 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;
(k)in Spain:
— ‘Título de Diplomado universitario en Enfermería’ (university
diploma in nursing) awarded by the Ministry for Educationand Science;
(l)in Portugal:
— ‘Diploma do curso de enfermagem geral’ (diploma in general
nursing) awarded by State recognized educational establish-ments and registered by the competent authority.1977L0452 — EN — 13.10.1989 — 003.001 — 5
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CHAPTER III
EXISTINGCIRCUMSTANCES
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 Directive77/453/EEC, each Member State shall recognize, as being sufficient
proof, the diplomas, certificates and other evidence of the formal quali-
fications of nurses responsible for general care awarded by thoseMember States before the implementation of Directive 77/453/ EEC,accompanied by a certificate stating that: those nationals have effec-tively and lawfully been 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.
CHAPTER IV
USEOFACADEMICTITLE
Article 5
1. Without prejudice to Article 13, host Member States shall ensure
that nationals of Member States who fulfil the conditions laid down inArticles 2 and 4 have the right to use the lawful academic title, inas-much as it is not identical to the professional title, or, where
appropriate, the abbreviationthereof of their Member State of origin
or of the Member State from which they come, inthe lan guage orlanguages of that State. Host Member States may require this title tobe followed by the name and location of the establishment or exam-ining board which awarded it.
2. If the academic title used inthe Member State of origin , or inthe
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 hostMember State may require such a personto use the title employed in
the Member State of originor the Memer State from which he comes.
in suitable wording to be indicated by the host Member State.
CHAPTER V
PROVISIONS TO FACILITATE THE EFFECTIVE EXERCISEOF THE RIGHT OF ESTABLISHMENT ANDFREED OM TOPROVIDE SERVICES IN RESPECT OF THE ACTIVITIES OF
NURSESRESPONSIBLEFORGENERALCARE
A.Provisionsspecifically relatingtotherightofestablishment
Article 6
1. A host Member State which requires of its nationals proof of
good character or good repute whenthey take up for the first timeany activity referred to in Article 1 shall accept as sufficient evidence,
in respect of nationals of other Member States, a certificate issued by a
competen t authority inthe Member State of originor inthe MemberState from which the foreign national comes attesting that the require-ments of the Member State as to good character or good repute fortaking up the activity in question have been met.
2. Where the Member State of originor the Member State from
which the foreign national comes does not require proof of good char-acter or good repute of persons wishing to take up the activity inquestionfor the first time, the host Member State may require ofnationals of the Member State of origin or of the Member State from1977L0452 — EN — 13.10.1989 — 003.001 — 6
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which the foreign national comes an extract from the ‘judicial record’
or, failing this, an equivalent document issued by a competent authorityinthe Member State of originor the Member State from which the
foreign national comes.
3. If the host Member State has detailed knowledge of a serious
matter which has occurred, prior to the establishment of the person
concerned in that State, outside its territory and which is likely toaffect the taking up within its territory of the activity concerned, itmay inform the Member State of origin or the Member State fromwhich the foreign national comes.
The Member State of originor the Member State from which the
foreign national comes shall verify the accuracy of the facts. Its autho-
rities shall decide on the nature and extent of the investigation to be
made and shall inform the host Member State of any consequentialactionwhich they take with regard to the certificates or documen tsthey have issued.
Member States shall ensure the confidentiality of the information made
available.
Article 7
1. Where, ina host Member State, provision s laid downby 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 orconviction for criminal offences and relating to the pursuit of any ofthe activities referred to inArticle 1, the Member State of originor
the Member State from which the foreign national comes shall forward
to the host Member State all necessary information regarding measuresor disciplinary action of a professional or administrative nature taken inrespect of the person concerned, or criminal penalties imposed on himwhenpursuin g his professioninthe Member State of originor intheMember State from which he came.
2. If the host Member State has detailed knowledge of a serious
matter which has occurred, prior to the establishment of the person
concerned in that State, outside its territory and which is likely to
affect the pursuit within its territory of the activity concerned, it mayinform the Member State of origin or the Member State from whichthe foreign national comes.
The Member State of originor, the Member State from which the
foreign national comes shall verify the accuracy of the facts. Its autho-rities shall decide on the nature and extent of the investigation to bemade and shall inform the host Member State of any consequential
actionwhich they take with regard to the in formationthey have
forwarded inaccordan ce 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 certifi-
cate of physical or mental health, that State shall accept as sufficient
evidence thereof the presentation of the document required in theMember State of originor inthe Member State from which the foreignnational comes.
Where the Member State of originor 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 hostMember State shall accept from such national a certificate issued by a1977L0452 — EN — 13.10.1989 — 003.001 — 7
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competent authority in that State corresponding to the certificates
issued inthe 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 be completed as soon as possible and not later than three months
after presentation of all the documents relating to such person, withoutprejudice to delays resulting from any appeal that may be made uponthe termination of this procedure.
2. Inthe cases referred to inArticles 6 (3) an d 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.Onreceipt of the reply or at the en d of the period the host Member
State shall continue with the procedure referred to in paragraph 1.
Article 10a
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 solemndeclarationan d where the form of such anoath or
declaration cannot be used by nationals of other Member States, the
host Member State shall ensure that an appropriate and equivalentform of oath or declaration is offered to the persons concerned.
B.Specialprovisionsrelatingtotheprovisionofservices
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 professionalorganization or body, that Member State shall in the case of the provi-
sion of services exempt the nationals of Member States from that
requirement.
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 or administra-
tive nature which apply in that Member State.
For this purpose and in addition to the declaration provided for in para-
graph 2 relating to the services to be provided, Member States may, so
as to permit the implementation of the provisions relating to profes-
sional conduct in force in their territory, require either automatictemporary registrationor pro forma membership of a profession al orga-nization or body or, as an alternative, registration, provided that suchregistration or membership does not delay or in any way complicate
the provision of services or impose any additional costs on the person
providing the services.
Where a host Member State adopts a measure pursuant to the second
subparagraph or becomes aware of facts which runcoun ter to these
provisions, 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 the1977L0452 — EN — 13.10.1989 — 003.001 — 8
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provisionof his services where they in volve a temporary stay inits
territory.
Inurgen t cases this declarationmay be made as soonas possible after
the services have beenprovided.
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 declarationreferred to inparagraph 2,
— a certificate stating that the person concerned is lawfully pursuing
the activities inquestioninthe Member State where he is estab-lished,
— a certificate that the person concerned holds one or other of the
diplomas, certificates or other evidence of formal qualificationappropriate for the provisionof the services inquestionan d referredto inthis Directive.
4. The document or documents specified in paragraph 3 may not be
produced more than12 mon ths 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 inits territory of the right to pursue on e of the activ-ities referred to inArticle 1, it shall, as appropriate, en sure thetemporary or permanent withdrawal of the certificate referred to in thesecond indent of paragraph 3.
Article 12
Where registrationwith a public social security body is required ina
host Member State for the settlement with insurance bodies of accounts
relating to services rendered to persons insured under social security
schemes, that Member State shall exempt nationals of Member Statesestablished inan other Member State from this requiremen t incases ofprovision of services entailing travel on the part of the personconcerned.
However, the persons concerned shall supply information to this body
in advance or, in urgent cases, subsequently, concerning the services
provided.
C.Provisionscommontotherightofestablishmentandfreedomto
provideservices
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 downin Articles 2 and 4 shall use the professional title of the host MemberState which, in that State, corresponds to those conditions of qualifica-tion, and shall use the abbreviated title.
Article 15
1. Member States shall take the necessary measures to enable the
persons concerned to obtain information on the health and social
security 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 caseof establishment, the host Member States may require the personsconcerned to contact these centres.1977L0452 — EN — 13.10.1989 — 003.001 — 9
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2. Member States may set up the centres referred to in paragraph 1
within the competent authorities and bodies which they must designatewithinthe period laid downinArticle 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 inthe host Member State.
CHAPTER VI
FINALPROVISIONS
Article 16
Inthe even t 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 formal
qualifications issued in that other Member State and referred to in
Chapters II and III, and also confirmation of the fact that the personconcerned has fulfilled all the training requirements laid down inDirective 77/453/EEC.
Article 17
Withinthe time limit laid downinArticle 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 Commis-sionthereof.
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 Article1.
Article 19
1. Member States shall bring into force the measures necessary to
comply with this Directive within two years of its notification and shall
forthwith 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.
Article 20
Where a Member State encounters major difficulties in certain fields
when applying this Directive, the Commission shall examine thesedifficulties in conjunction with that State and' shall request the opinionof the Committee of Senior Officials on Public Health set up under
Decision75/365/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 — 13.10.1989 — 003.001 — 10
(1) OJ No L 167, 30. 6. 1975, p. 19.
(2) See page 13 of this Official Journal.