24. 5. 88 Official Journal of the European Communities No C 134/27 
Opinion on the proposal for a Council Directive amending Directives 75/362/EEC, 
77/452/EEC, 78/686/EEC, 78/1026/EEC and 80/154/EEC relating to the mutual recognition 
of diplomas, certificates and other evidence of formal qualifications as doctor, nurse respon­
sible for general care, dental practitioner, veterinary surgeon and midwife, together with 
Directives 75/363/EEC, 78/1027/EEC and 80/155/EEC concerning the coordination of pro­
visions laid down by law, regulation or administrative action relating to the activities of 
doctors, veterinary surgeons and midwives(1) 
(88/C 134/10) 
On 16 December 1987 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 
adopted the following Opinion by 50 votes to 0, with 4 abstentions. 
The Committee approved the proposal for this amend­
ing Directive, and made the following general com­
ments. 
1. Introduction 
1.1. The primary aim of this Directive is to update 
the initial sectoral Directives relating to the professions 
mentioned in the title to take into account the changes 
in national legislation, largely of a technical nature, 
affecting the provisions for coordination and mutual 
recognition of qualifications for the professions men­
tioned above. 
1.2. In addition, certain omissions to individual sec­
toral Directives which are common to the other pro­
fessions have been corrected and finally, proposals are 
made for recognizing new developments within the 
professions concerned. 
1.3. The availability of services provided by the 
health professions to citizens within the Community, 
and the importance of ensuring the freedom of move­
ment of health professionals in the Community has 
been recognized by the Committee previously on a 
number of occasions. 
2. Sectoral Directives 
2.1. Whilst the adoption of sectoral Directives for 
doctors, dentists, midwives, veterinary surgeons and 
nurses represents a substantial achievement towards 
achieving the aims of the completion of the internal 
market (particularly related to the freedom of move­
ment of professionals to provide services and establish 
themselves in other Member States), the provisions of 
services by all categories of health-care professionals is 
of such importance that the Committee reaffirms its 
concern that sectoral Directives for the paramedical 
professions, physiotherapists for example, have not 
been adopted, in common with a number of other 
vocations outside the health field. 
(!) OJ No C 353, 30. 12. 1987, p. 17. 2.2. The Committee noted that relatively little move­
ment had taken place since the adoption of these Direc­
tives and demographic problems in these professions 
were causing particular difficulties tending to limit the 
possibilities oi establishment and could lead to distor­
tion of circulation. 
3. General qualification recognition Directive 
3.1. Whilst the Committee recognizes the logistic 
problems inherent in continuing a sectoral approach 
and the value of the initiative relating to a general 
qualification recognition Directive (doc. COM(85) 355 
final), it notes that adoption of this Directive has been 
subject to substantial delay and indeed to some funda­
mental amendments. 
3.2. With regard to the latter, the Committee feels 
that it should be consulted as a result of the substantial 
change in the original proposal. 
3.3. With regard to the other paramedical health 
professions, it remains convinced of the importance of 
adopting sectoral Directives as soon as possible, and 
requests the Commission to reconsider its attitude. 
4. Advisory Training Committees 
4.1. Many of the amendments are concerned with 
technical problems relating to mutual recognition of 
basic and specialist qualifications held by national 
Member States and which, for technical reasons, did 
not conform exactly with the Directives in their present 
form. Whilst the Committee accepts the formule pro­
posed for dealing with this anomaly, it feels most 
strongly that, where matters concerning the recognition 
of qualifications are concerned, such proposed amend­
ments should be reported to and considered by the 
No C 134/28 Official Journal of the European Communities 24. 5. 88 
Advisory Committees on Training established to advise 
the Commission in relation to each profession on such 
subjects. It regrets that this process has not been carried 
out and urges that the Commission consult its advisory 
bodies on the proposed changes in the Directive relative 
to changes in recognized or certified training. The Com­
mittee recognizes that the Committee of Senior Public 
Health Officials was consulted but still feels it impor­
tant that the bodies specifically established to advise 
the Commission on matters of training and standards 
relating to the individual professions concerned should 
be consulted. 
4.2. The Committee considers in particular that new 
qualifications awarded by an appropriate institution in 
a Member State for the first time after the coming 
into force of the relevant sectoral Directive should be 
referred to the Advisory Training Committee con­
cerned, for scrutiny and (if necessary) comment. 
5. Recognition of qualifications and coordination 
5.1. The Committee noted that in relation to stu­
dents who obtain their university degrees in Member 
States other than their state of origin, such persons 
would, in most Member States, be required to take 
the state examination or complete the period of post-
graduation training in their state of origin if they wished 
to establish themselves in their country of origin. This 
question was raised in relation to students completing 
their university degrees outside their country of origin 
and returning to their own State, without having 
acquired the right to practice in the State in which they 
trained. The position of EC Member States nationals 
who have obtained qualifications in a non-EC Member 
State must also be mentioned. The logic of the Com­
mission's new approach in the general system of recog­
nition of diplomas should mean that if their qualifi­
cations are recognized by one Member State and they 
have acquired the right to practise in that State, they 
must clearly also be accepted for work in other Member 
States (as if they had obtained their qualifications in 
the country where they are in practice). 
5.2. In considering the proposal relating to rights of 
establishment and mutual recognition, the question of 
Done at Brussels, 24 March 1988. nationals of non-Member States with whom agreements 
of association have been concluded was considered. It 
was noted that the provisions of the Directives were not 
directly applicable to nationals of associated Member 
States, although the Committee is concerned in the 
present situation which may ultimately need testing in 
the European Court. 
5.3. As some of the proposed Articles are concerned 
with certification that the criteria relating to standards 
of training affirmed by the certificate issued by a Mem­
ber State were not detailed in the same degree for 
different professions, the Committe noted the initiative 
of the Advisory Committee on Veterinary Training in 
organizing visits by members of that body to university 
training institutions and welcomed this initiative. 
Whilst the Committee recognized that certain other 
professions, for example doctors and nurses, would be 
unable to carry out such a detailed visitation pro­
gramme, simply from the point of view of logistics, it 
felt that even on a limited scale such action would assist 
the process of ensuring that standards of training in the 
health professions subject to sectoral Directives should 
be as uniform as possible. 
6. Occupational health 
6.1. The Committee noted with pleasure that the 
speciality of 'occupational medicine' was now more 
widely recognized throughout the Community. This 
further realizes the wishes, expressed by the Committee 
over a long period, that adequate occupational health 
services should be available in all Member States and 
that those so qualified should be free to move within the 
Community and provide their services. The Committee 
hopes that those few remaining Member States will 
provide adequate specialist training in occupational 
health to achieve the minimum standards throughout 
the Community. 
7. Nuclear medicine 
7.1. It was noted that the speciality of nuclear medi­
cine was now recognized in all countries. It is noticed 
that Ireland is not included in the listing of Article 4.18. 
It should appear as: 
'Ireland: nuclear medicine.' 
The Chairman 
of the Economic and Social Committee 
Alfons MARGOT