1977L0452 — EN — 12.12.1990 — 005.001 — 1
This document is meant purely as a documentation tool and the institutions do not assume any liability for its contents
►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
►M2Council Directive 89/594/EEC of 30 October 1989 L 341 19 23.11.1989
►M3Council Directive 90/658/EEC of 4 December 1990 L 353 73 17.12.1990
Amended by:
►A1Act of Accession of Greece L 291 17 19.11.1979
►A2Act of Accession of Spain and Portugal L 302 23 15.11.1985
▼B
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 withregard to establish ment and provision of services is
prohibited as from the end of the transitional period; whereas the prin-
ciple of suchtreatment based on nationality applies in particular to th egrant 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 in several 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 possession of 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, 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 — 12.12.1990 — 005.001 — 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, in the case of the provision of services, the requirement of
registration withor membersh ip 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 person wishing to provide the service, by reason of 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 application of 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 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 char-
acter or good repute, professional discipline or use of title for theprofessions covered; whereas, depending on the individual MemberState, suchrules are or may be applicable bothto 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 — 12.12.1990 — 005.001 — 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:
►
M2‘State Registered Nurse or Registered General Nurse’; ◄
Scotland:
Registered General Nurse;
in Greece:
►M2‘∆ιπλωµατούχος ή πτυχιούχος νοσοκόµος, νοσηλευτής ή
νοσηλεύτρια ;’◄;
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 in accordance 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 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);
(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 — 12.12.1990 — 005.001 — 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:
—t he‘diploma di infermiere professionale’ awarded by State-
recognized 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:
— a statement of registration as a Registered General Nurse in Part
I of the register maintained by the United Kingdom Central
Council for Nursing, Midwifery and HealthVisiting;
(j)in Greece:
—‘Το δίπλωµα Αδελφής Νοσοκόµας της Ανωτέρας Σχολής
Αδελφών Νοσοκόµων ’ (diploma of general nurse from the
advanced school of general nursing), authenticated by theMinistry of Social Services or by the Ministry of Health andSocial Welfare, or
—‘Το πτυχίο Νοσοκόµον του Τµήµατος Αδελφών Νοσο-
κόµων των Παραϊατρικών Σχολών των ΚέντρωνΑνωτέρας Τεχνικής και Επαγγελµατικής Εκπαίδευσης ’
(degree in nursing from the nursing sections of the paramedicalschools at the advanced centres of technical and vocationaltraining) awarded by the Ministry of Education and Religious
Affairs, or
—‘ΤοπτυχίονοσηλευτήήνοσηλεύτριαςτωνΤεχνολογικών
ΕκπαιδευτικώνΙδρυµάτων(ΤΕΙ) ’ (degree in nursing from the
technological training establishments) run by the Ministry ofEducation and Religious Affairs, or
—‘Το πτυχίο της Ανωτάτης Νοσηλευτικής της Σχολής
Επαγγελµάτων Υγείας, Τµήµα Νοσηλευτικής του Πανεπ-τιστηµίου Αθηνών ’ (degree in nursing from the faculty of
health sciences, nursing section, University of Athens);
(k)in Spain:
— ‘Título de Diplomado en Enfermería’ (university diploma in
nursing) awarded by the Ministry for Education and Science orthe rector of a university;1977L0452 — EN — 12.12.1990 — 005.001 — 5
▼M2
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▼A2
(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.
CHAPTER III
EXISTINGCIRCUMSTANCES
Article 4
►M21.◄In the case of nationals of Member States whose
diplomas, certificates and other evidence of formal qualifications donot satisfy all the minimum training requirements laid down in Article1 of Directive 77/453/EEC, eachMember State sh all recognize, asbeing sufficient proof, the diplomas, certificates and other evidence of
the formal qualifications of nurses responsible for general care awarded
by those Member States before the implementation of Directive 77/453/ EEC, accompanied by a certificate stating that: those nationalshave effectively and lawfully been engaged in the activities of nursesresponsible for general care for at least three years during the fiveyears 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.
2. In the case of nationals of Member States whose diplomas, certi-
ficates and other evidence of formal qualifications as nurse responsible
for general care do not conform withth e qualifications or designationsset out in Article 3, eachMember State sh all recognize as being suffi-cient proof the diplomas, certificates and other evidence of formalqualifications awarded by those Member States, accompanied by a
certificate issued by the competent authorities or bodies. The certificate
shall state that the diplomas, certificates and other evidence of formalqualifications as nurse responsible for general care were awardedfollowing training in accordance withth e provisions of Directive 77/453/EEC, referred to in Article 2 of the present Directive, and aretreated by the Member State which awarded them as the qualifications
or designations set out in Article 3 of the present Directive.
Article 4a
In the case of nationals of Member States whose diplomas, certificates
and other evidence of formal qualifications as nurses responsible forgeneral care attest to training received on the territory of the former
German Democratic Republic which does not satisfy all the minimum
training requirements laid down in Article 1 of Directive 77/453/EEC,Member States other than Germany shall recognize those diplomas,certificates and other evidence of former qualifications as being suffi-cient proof if:
— they attest to training commenced before German unification,
— they entitle the holder to pursue the activities of a nurse responsible
for general care throughout the territory of Germany under the sameconditions as the qualifications awarded by the competent Germanauthorities and referred to in Article 3 (a), and
— they are accompanied by a certificate issued by the competent
German authorities stating that those nationals have effectively and
lawfully been engaged in the activities of nurse responsible forgeneral care in Germany for at least three years during the fiveyears prior to the date of issue of the certificate. These activitiesmust have included taking full responsibility for the planning, orga-nization and carrying-out of the nursing care of the patient.1977L0452 — EN — 12.12.1990 — 005.001 — 6
▼B
▼M2
▼M3
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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 abbreviation thereof of their Member State of originor of the Member State from which they come, in the language 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 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 sucha person to use th e title employed in
the Member State of origin or 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 when they 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 acompetent authority in the Member State of origin or in the MemberState from which the foreign national comes attesting that the require-
ments of the Member State as to good character or good repute for
taking up the activity 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 good char-
acter or good repute of persons wishing to take up the activity in
question for the first time, the host Member State may require ofnationals of the Member State of origin or of the Member State fromwhich the foreign national comes an extract from the ‘judicial record’or, failing this, an equivalent document issued by a competent authorityin the Member State of origin or 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 personconcerned 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 from
which the foreign national comes.
The Member State of origin or 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 consequential
action which they take with regard to the certificates or documentsthey have issued.
Member States shall ensure the confidentiality of the information made
available.1977L0452 — EN — 12.12.1990 — 005.001 — 7
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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 orconviction for criminal offences and relating to the pursuit of any ofthe activities referred to in Article 1, the Member State of origin orthe Member State from which the foreign national comes shall forward
to the host Member State all necessary information regarding measures
or disciplinary action of a professional or administrative nature taken inrespect of the person concerned, or criminal penalties imposed on himwhen 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, prior to the establishment of the personconcerned in that State, outside its territory and which is likely to
affect the pursuit within its territory of the activity concerned, it may
inform the Member State of origin or the Member State from whichthe foreign national comes.
The Member State of origin or, 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 consequentialaction which they take with regard to the information they haveforwarded in accordance withparagraph1.
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 sufficientevidence thereof the presentation of the document required in theMember State of origin or in the Member State from which the foreignnational 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 hostMember State shall accept from such national a certificate issued by acompetent authority in that State corresponding to the certificatesissued in the host Member State.
Article 9
Documents issued in accordance withArticles 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 monthsafter 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. 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 — 12.12.1990 — 005.001 — 8
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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 solemn declaration and where the form of such an oath or
declaration cannot be used by nationals of other Member States, the
host Member State shall ensure that an appropriate and equivalentform of oathor declaration is offered to th e 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 an
authorization, or membership of or registration with a professional
organization or body, that Member State shall in the case of the provi-sion 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 or administra-
tive nature which apply in that Member State.
For this purpose and in addition to the declaration provided for in para-
graph2 relating to th e services to be provided, Member States may, soas to permit the implementation of the provisions relating to profes-sional conduct in force in their territory, require either automatictemporary registration or pro forma membership of a professional orga-nization or body or, as an alternative, registration, provided that such
registration or membership does not delay or in any way complicate
the provision of services or impose any additional costs on the personproviding the services.
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
provision of 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 documentscontaining 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 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 provision of the services in question and referred
to 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 activ-ities referred to in Article 1, it shall, as appropriate, ensure thetemporary or permanent withdrawal of the certificate referred to in thesecond indent of paragraph3.1977L0452 — EN — 12.12.1990 — 005.001 — 9
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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 of
provision 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 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 Member
State 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 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 designate
within 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, the
linguistic knowledge necessary for the exercise of their profession in
the host Member State.
CHAPTER VI
FINALPROVISIONS
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 inChapters II and III, and also confirmation of the fact that the person
concerned has fulfilled all the training requirements laid down in
Directive 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 aswell as the documents and information referred to in this Directive,and shall forthwith inform the other Member States and the Commis-sion thereof.1977L0452 — EN — 12.12.1990 — 005.001 — 10
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Article 18
This Directive shall also apply to nationals of Member States who, in
accordance withRegulation (EEC) No 1612/68, are pursuing or will
pursue 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.
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 — 12.12.1990 — 005.001 — 11
(1) OJ No L 167, 30. 6. 1975, p. 19.
(2) See page 13 of this Official Journal.