24. 5. 88 Official Journal of the European Communities No C 134/29 
Opinion on the proposal for a Council Directive amending Directive 77/452/EEC concerning 
the mutual recognition of diplomas, certificates andother 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, and Directive 77/453/EEC 
concerning the coordination of provisions laid down by law, regulation or administrative 
action in respect of the activities of nurses responsible for general care 
(88/C 134/11) 
On 21 January 1988 the Council decided to consult the Economic and Social Committee, 
under Article 49 of the Treaty establishing the European Economic Community, on the 
abovementioned proposal. 
The Section for Social, Family, Educational and Cultural Affairs, which was responsible for 
preparing the Committee's work on the subject, adopted its Opinion on 10 March 1988 in 
the light of the report by Dr Storie-Pugh. 
At its 254th plenary session (meeting of 24 March 1988), the Economic and Social Committee 
unanimously adopted the following Opinion. 
The Commmittee approves the proposal to amend the 
Directives 77/452/EEC and 77/453/EEC. 
1. The Committee makes the following general com­
ments: 
1.1. The Directive provides for amendments to 
Directive 77/452/EEC to incorporate certain provisions 
common to the other health professional sectoral Direc­
tives but omitted from the nurses' Directive. 
1.2. The substantial purpose of the present proposal 
is, however, to amend 77/453/EEC in order to deal with 
the minimum balance between theoretical and clinical 
instruction in accordance with the requirements of 
Article 1.4 of that Directive. 
1.3. The Advisory Committee on Training in Nurs­
ing adopted a report on the training of nurses in hospital 
general care, in particular on the balance between clini­
cal and theoretical instruction for this category of nurse. 
1.4. The Advisory Committee made two main rec­
ommendations. The first was concerned with training, 
recommending that training should be under two head­
ings: theoretical and clinical, and that the word «techni-
cal» be abandoned throughout the Directive. It rec­
ommended that the number of hours of theoretical 
training should amount to no less than one third, and 
of clinical training to no less than one half of the total 
hours of instruction in a complete training programme, 
the remaining period to be apportioned according to 
the needs of programmes approved by the competent 
authorities in the Member States. It further set out clear definitions of theoretical instruction and clinical 
instruction. These have all been incorporated in the 
proposed Directive. 
1.5. The second main recommendation referred to 
the need for the programme of instruction to be the 
responsibility of, and be under the direction of, the 
nurses in the school of nursing or educational institution 
approved by the competent authority within the frame­
work of the laws enforced. The Commission's proposal 
for amending Article 1 of Directive 77/453/EEC, subsec­
tion 3, does not fulfill the totality of the recommen­
dation of the Advisory Committee on nurses' training. 
No other Directives refer to the management of training 
institution, and to incorporate this in the nurses' direc­
tive would create a precedent. Nevertheless, the pro­
posal from the Commission makes it clear that instruc­
tion shall be under the responsibility of teachers who 
are nurses and with the cooperation and assistance of 
other qualified nurses. A provision is also made for 
appropriate clinically qualified personnel also to be 
involved in the teaching process. 
1.6. The Committee took note of the fact that in 
certain Member States the direction of the training 
institutions of nurses was subject to domestic legis­
lation, and therefore the Commission felt unable to 
pursue this recommendation. 
1.7. The implementation of this Directive should be 
carried out as quickly as is practicable. 
2. Textual distortion 
2.1. The Committee noted that in the various linguis­
tic texts there were discrepancies between those refer-
No C 134/30 Official Journal of the European Communities 24. 5. 88 
ring only to male or only to female nurses and other 
texts which referred to male and female nurses. 
2.2. The Committee recommends that this discrimi­
nation problem be resolved by inserting an additional 
Article at the beginning of the Directive, as follows: 
'The provisions of this Directive and of the Direc­
tives 77/452/EEC and 77/453/EEC shall apply 
equally to all nurses regardless of sex.' 3. Other sectoral Directives 
The Committee draws to the attention of the Com­
mission that the considerations rehearsed above in 2.1 
apply equally to other professions which have been the 
subject of Directives. It recommends that the Com­
mission consider the incorporation of the amendment 
at 2.2 above, appropriately modified in all the other 
Directives. 
Done at Brussels, 24 March 1988. 
The Chairman 
of the Economic and Social Committee 
Alfons MARGOT