COMMISSION OF THE EUROPEAN COMMUNITIES 
COM(91) 552 final - SYN 278 
Brussels, 2D December 1991 
Re-examined proposal for a 
COUNCIL DIRECTIVE 
ON THE MINIMUM SAFETY AND HEALTH REQUIREMENTS 
FOR IMPROVED MEDICAL TREATMENT 
ON BOARD VESSELS 
(presented by the Commission pursuant to Article 149.2(d) 
of the EEC treaty) 
The initial proposal for this Directive was forwarded to the Council by the 
Commission on 20 July 1990(1). 
Th,is proposal for a Council Directive, based on Articje 118a of the EEC 
Treaty, seeks to improve medical treatment on board vessels by laying down 
minimum requirements in respect of the medical supplies appropriate to 
various categories of vessel. These minimum requirements apply particularly 
to the presence of antidotes on vessels carrying dangerous substances and to 
medical training for the captain and other crew members. The proposal also 
provides for inspection arrangements. 
The European Parliament (first reading) and the Economic and Social Committee 
gave their opinions on 24 January 1991 and 20 September 1990 respectively. 
The Commission forwarded an amended proposal to the Council on 
28 February 1991<2>. 
The Council common position of 1 October 1991 was examined by the European 
Parliament (second reading) on 20 November 1991 and adopted subject to 20 
amendments. 
Of these 20 amendments, the Commission has agreed to incorporate seven, in 
full or in part, into its re-examined proposal. As regards amendments No 3 
and No 8, only the part corresponding to the proposal put forward in 
amendment No 2 has been adopted, with the rest of the text being rejected. 
It has rejected 13 amendments, namely Nos 1, 4, 9, 10, 11, 12, 13, 14, 17, 
18, 19, 20 and 21 . 
The Commission's comments on the amendments which it has not adopted are as 
fol lows: 
(1) COM(90) 272 final 
(The numbering corresponds to that adopted for the plenary sitting of 
20 November) 
Amendment No 1 : (Fifth recital a) 
This makes provision for the Member States to be asked to ratify ILO 
Convent ion No 164. 
Comments: This form of recital cannot be justified, since the present 
proposal for a Directive is not a suitable instrument for calling for 
ratification of an ILO Convention. This amendment had already been rejected 
at the first reading. 
Amendment No 3: (Article 2 (1) (a)) 
The part of this amendment embracing the concept of "vessels registered in a 
Member State" has been accepted (same purpose as amendment No 2). This 
amendment also cat's for revision of the lists of medical supplies following 
harmonisation of various elements, particularly pharmaceutical standards. 
Comments : The procedures for adapting the annexes of the Directive are 
covered in overall terms and more satisfactorily by the provisions of 
Art icle 8. 
Amendment No 4: (Article 2 (1) (b)) 
This calls for quantities of medical supplies to be determined on the basis 
of data supplied by the competent national authorities. 
Comments: The competent authorities cannot possibly take account of the 
various parameters specified in paragraph 1 (b) of this Article. 
Amendment No 8: (Article 3 (1)) 
The part of this amendment embracing the concept of "vessels registered in a 
Member State" has been accepted (same purpose as amendment No 2). The other 
part of this amendment requires the captain to be kept informed of dangerous 
substances loaded on board the vessel. 
Comments: This general requirement is excessive and difficult to apply, 
particularly where ferries are concerned. 
Amendment No 9: (Article 3 (2a)) 
This sets out requirements in respect of the transport of dangerous 
substances. 
Comments: The checks envisaged by this provision are excessive, largely 
impractical and entail too much red tape. 
Amendment No 10-, (Art icle 4 (2a) ) 
This gives seafarers the right to medical examination at ports of call. 
Comments: This provision would be of little practical value and would, in 
many cases, be unfeasible. Moreover, the emergency factor is already taken 
into account in other provisions of the Directive, particularly 
Art icle 4 (3). 
Amendment No 11 : (Article 5 (3)) 
This relates to information and training programmes for the captain and other 
persons as regards both the provision of medical treatment and preventive 
aspects. 
Comments : These elements are already covered by the wording of Article 5 (3) 
of the common position, the content of Annex V and the principles laid down 
in Council Directive 89/391/EEC (0J No L 183 Of 29 June 1989, p. 1). 
Amendment No 12: (Article 7 (2)) 
This makes reference to ILO Convention No 164 and reinforces the checks to be 
carried out on medical supplies on life-rafts. 
Comments: Firstly, the ILO Convention in question does not cover life-rafts 
in the terms of the present Directive-, secondly, checks of medical supplies 
on life-rafts as envisaged by the amendment are inappropriate. 
Amendment No 13: (Article 8 (3)) 
This modifies the procedure involving the committee responsible for 
adaptation of the annexes of the Directive. 
Comments: The regulatory committee procedure should be retained in accordance 
with established practice. 
Amendment No 14: (Article 8 (3) new) 
This provides for consultation of the Joint Committee on Maritime Transport. 
Comments: Such consultation is already provided for in Commission 
Decision 87/467/EEC of 31 July 1987 (OJ L 253 of 4 September 1987, p. 20). 
Amendment No 17: (Annex II, Section I (2) (c)) 
This extends the availability of laxatives to category B vessels. 
Comments : Little medical justification for this amendment. 
Amendment No 18: (Annex II, Section II (1)) 
This extends the availability of oxygen to category C vessels. 
Comments : There is little medical justification for this amendment; moreover, 
many vessels in category C do not have industrial oxygen on board. 
Amendment No 19: (Annex Ilia) 
This amendment introduces a list of dangerous wastes. 
Comments : Annex III refers to a version of the International Maritime 
Dangerous Goods Code which contains all the necessary details. 
Amendments No 20 and 21 : (Annex IV) 
These amend the content of the captain's training and make reference to the 
guidance document published by the ILO and IMO. 
Comments: These aspects of training are already mentioned in the text of the 
common position-, moreover, it is inappropriate to make a direct reference to 
the IM0/IL0 guide, since the Community has no control over its content. 
DIRECTIVE ON MEDICAL TREATMENT 
Common position adopted by the Counc 
1/10/91 on J* 
Revised Commission proposal in 
accordance with Article 149(2)(d) 
THE COUNCIL OF THE EUROPEAN COMMUNITIES, 
Having regard to the Treaty establishing 
the European Economic Community and in 
particular Article 118a thereof, (Where there is no entry in this 
ppl|i(T)n, the common position 
remains unchanged.) 
Having regard to the proposal from the 
Commission^1), drawn up after 
consultation with the Advisory Committee 
on Safety, Hygiene and Health Protection 
at Work, 
In co-operation with the European 
Par I iament^2), 
Having regard to the Opinion of the 
Economic and Social Committee^), 
Whereas the Commission communication on 
its programme concerning safety, hygiene 
and health at work^4) envisages measures 
to ensure medical treatment at sea; 
Whereas the safety and health of workers 
on board a vessel, which constitutes a 
workplace involving a wide range of risks, 
bearing in mind, inter alia, its 
geographical isolation, where appropriate, 
require special attention; 
Whereas vessels should have adequate 
medical supplies, kept in good order and 
checked at regular intervals, so that 
workers can obtain the necessary medical 
treatment at sea-, 
Whereas, in order to ensure appropriate 
medical treatment at sea, training and 
information of seafarers should be 
encouraged as regards the use of medical 
suppl ies-, 
Whereas the use of long-distance medical-
consultation methods constitutes an 
efficient way of contributing to the 
protection of the safety and health of 
workers, 
HAS ADOPTED THIS DIRECTIVE: 
(1) OJ No C 183, 24.7.1990, p.6 and 0J 
No C 74, 20.3.1991, p. 11. 
(2) OJ No C 48, 25.2.1991, p.154 and 
Decision of (not yet published in 
the Off icial Journal). 
Art icle 1 
Def ini t ions 
For the purposes of this Directive the 
following terms shall have the following 
meanings: 
a) vessel: any vessel flying the flag of a a) vessel: any vessel flying the 
Member State, seagoing or estuary-
fishing, publicly or privately owned, 
excluding: 
inland navigation vessels; 
- warships; 
- pleasure boats used for non­
commercial purposes and not manned 
by professional crews; 
- tugs operating in harbour areas. 
Vessels shall be classed in three 
categories in accordance with Annex I; 
b) worker: any person carrying out an 
occupation on board a vessel, including 
trainees and apprentices, but excluding 
port pilots and shore personnel 
carrying out work on board a vessel at 
the quayside. 
c) owner: the registered owner of a vessel 
unless that vessel has been chartered 
by demise or is managed, either wholly 
or in part, by a natural or legal 
person other than the registered owner 
under the terms of a management 
agreement; in that case the owner shall 
be construed as the demise charterer or 
natural or legal person managing the 
vessel as appropriate; 
d) medical supplies: medicines, medical 
equipment and antidotes, a non-
exhaustive list of which is given in 
Annex I I . flag of a Member State or 
registered in a Member State, 
seagoing or estuary-fishing, 
publicly or privately owned, 
excluding: 
e) antidote: a substance used to prevent 
or treat a harmful effect or effects, 
direct or indirect, of one or more 
substances on the list of dangerous 
substances in Annex Ml. 
Art icle 2 
Medicines and medical equipment 
Sick-bay - Doctor 
Each Member State shall take the measures 
necessary to ensure that: 
1)(a) every vessel flying its flag always 
carries on board medical supplies 
which meet at least, in terms of 
quality, the specifications of Annex 
II sections I and II for the 
category of vessel to which it 
belongs; 
(b) the quantities of medicinal products 
and medical equipment to be carried 
depend on the nature of the voyage -
in particular ports of call, 
destination, duration - the type or 
types of work to be carried out 
during the voyage, the nature of the 
cargo and the number of workers; 
(c) th* content of the medicines and 
medical equipment included in the 
medical supplies shall be detailed 
on a checklist corresponding at 
least to the general framework laid 
down in Annex IV, sections A, B and 
C II 1 and II 2; 1)(a) every vessel flying its 
flag or registered under 
its jurisdiction always 
carries on board medical 
supplies which meet, at 
least in terms of quality, 
the specifications of Annex 
I I sect ions I and I I for 
the category of vessel to 
which it belongs; 
2)(a) for each of its life-rafts and life­
boats, every vessel flying its flag 
carries a watertight medicine chest 
at least containing the medical 
supplies specified in Annex II, 
sections I and II, for category C 
vessels; 
(b) the content of these chests is also 
detailed on the checklist referred 
to in paragraph 1(c); 
3) every vessel flying its flag of more 
than 500 gross registered tonnes, with 
a crew of 15 or more workers, engaged 
on a voyage of more than three days, 
has a sick-bay in which medical 3) every vessel flying its flag 
or registered under its 
jurisdiction of more than 500 
gross registered tonnes, with 
a crew of 15 or more workers, 
engaged on a voyage of more 
than three days, 
treatment can be administered under 
satisfactory material and hygienic 
cond i t ions-, has a sick-bay in which 
medical treatment can be 
administered under 
satisfactory material and 
hygienic condi t ions; 
4) every vessel flying its flag with a 
crew of 100 or more workers, engaged on 
an international voyage of more than 
three days, has a doctor on board. 4) every vessel flying its flag 
or registered under its 
jurisdiction with a crew of 
100 or more workers, engaged 
on an international voyage of 
more than three days, has a 
doctor on board responsible 
for the medical care of the 
workers; 
Art icle 3 
Ant idotes 
Each Member State shall take the measures 
necessary to ensure that: 5) when, in accordance with Annex 
I, category B is extended to 
cover longer trips, the 
helicopter rescue services 
provided for are available and 
operational and the captains 
of the vessels concerned are 
informed regularly of their 
ava i lab i I i ty. 
1) any vessel flying its flag and carrying 1) any vessel flying its flag or 
any of the dangerous substances listed 
in Annex III carries on board medical 
supplies including at least the 
antidotes listed in Section I I I of 
Annex I I ; registered under its 
jurisdiction and carrying any 
of the dangerous substances 
listed in Annex III carries on 
board medical supplies 
including at least the 
antidotes listed in Section II 
of Annex I I ; 
2) any ferry-type vessels flying its flag 
whose conditions of operation do not 
always allow them to know well enough 
in advance the nature of the dangerous 
substances being transported has on 
board medical supplies including at 
least the antidotes listed in Section 
I I I of Annex I I . 
However, on a regular route where the 
crossing is due to last less than two 
hours, the antidotes may be limited to 
those which have to be administered in 
cases of extreme emergency within a 
period of time not exceeding the normal 
duration of the crossing; 
3) the contents of the medical supplies, 
as regards antidotes, shall be detailed 
on a check list corresponding at least 
to the general framework laid down in 
Annex IV, sections A, B and C, 113. 
Art icle 4 
Allocation of responsibilities 
Each Member State shall take the measures 
necessary to ensure that: 
1)(a) the provision and replenishment of 
the medical supplies of any vessel 
flying its flag are undertaken on 
the exclusive responsibility of the 
owner, without any expense to the 
workers; 
(b) the management of the medical 
supplies is placed under the 
responsibility of the captain of the 
vessel; he may, without prejudice to 
this responsibility, delegate the 
use and maintenance of the medical 
supplies to one or more workers 
specially designated by reason of 
their competence-, 
2) the medical supplies are maintained in 
good condition and replenished and/or 
replaced as soon as possible, and in 
every case as a priority part of normal 
revictualI ing procedures; 
3) in an emergency established by the 
captain as far as possible after having 
obtained a medical opinion, the 
required medicines, medical equipment 
and antidotes which are not available 
on board are made available as soon as 
possible. 
Art icle 5 
Information and training 
Each Member State shall take the measures 
necessary to ensure that: 
1) medical supplies are accompanied by one 
or more guides to their use, including 
instructions for use of at least the 
antidotes required in Annex II section 
I I I ; 
2) all persons receiving professional 
maritime training and intending to work 
on board ship have been given basic 
training in the medical and emergency 
measures to be taken immediately in the 
event of an accident or serious medical 
emergency; 
3) the captain and any worker or workers 
to whom he delegates the use of the 
medical supplies under Article 4(1)(b) 
have received special training updated 
periodically, at least every five 
years, taking into account the specific 
risks and needs connected with the 
different categories of vessel and in 
accordance with the general guidelines 
set out in Annex V. 
Art icle 6 
Medical consultations by radio 
1) To ensure better emergency treatment 
for workers, each Member State shall 
take the measures necessary to ensure 
that: 
(a) one or more centres are designated 
to provide workers with free medical 
advice by radio-, 
(b) some of the doctors providing their 
services for the radio consultation 
centres have been trained in the 
special conditions prevailing on 
board ship. 
2) In order to optimise the advice given, 
the radio consultation centres may keep 
personal medical records, with the 
agreement of the workers concerned. 
Such records shall remain confidential. 
Art icle 7 
Inspect ion 
1) Each Member State shall take the 
measures necessary to ensure that 
competent person or a competent 
authority carries out an annual 
inspection to check that on board 
vessels flying its flag: /lo 
- the medical supplies meet the '"J 
minimum requirements of this 
Di rect ive; 
- the checklist provided for in 
Article 2(1)(c) confirms that the 
medical supplies comply with those 
minimum requirements; 
- the medical supplies are correctly 
stored; 
- any expiry dates have been 
respected. 
2) Inspections of the medical supplies 
stored on life-rafts shall be carried 
out in the course of those life-rafts' 
annual maintenance. 
Those inspections may exceptionally be 
postponed for up to five months. 
Art icle 8 
Commi ttee 
With a view to the strictly technical 
adaptation of the Annexes to this 
Directive in the light of technical 
progress or changes in international 
regulations or specifications and new 
findings in this field, the Commission 
shall be assisted by a committee 
composed of the representatives of the 
Member States and chaired by the 
representative of the Commission. 
The representative of the Commission 
shall submit to the committee a draft 
of the measures to be taken. The 
committee shall deliver its opinion on 
the draft, within a time limit which 
the chairman may lay down according to 
the urgency of the matter. The opinion 
shall be delivered by the majority laid 
down in Article 148(2) of the Treaty in 
the case of decisions which the Council 
is required to adopt on a proposal from 
the Commission. The votes of the 
representatives of the Member States 
within the committee shall be weighted 
in the mannner set out in that Article. 
The Chairman shall not vote. 
^ 
3) The Commission shall adopt the measures 
envisaged if they are in accordance 
with the opinion of the committee. 
If the measures envisaged are not in 
accordance with the opinion of the 
committee, or if no opinion is 
delivered, the Commission shall, 
without delay, submit to the Council a 
proposal relating to the measures to be 
taken. The Council shall act by a 
quaii f ied major ity. 
If, on the expiry of a period of three 
months from the date of referral to the 
Council, the Council has not acted, 
the proposed measures shall be adopted 
by the Commission. 
Art icle 9 
Final provisions 
1) Member States shall bring into force 
the laws, regulations and 
administrative provisions necessary to 
comply with this Directive by 31 
December 1995. They shall forthwith 
inform the Commission thereof. 
When Member States adopt these 
measures, such measures shall contain a 
reference to this Directive or shall be 
accompanied by such reference on the 
occasion of their official publication. 
The methods of making such a reference 
shall be laid down by the Member 
States. 1) Member States shall bring into 
force the laws, regulations 
and administrative provisions 
necessary to comply with this 
directive by 31 December 1992. 
They shall forthwith inform 
the Commission thereof. 
2) Member States shall communicate to the 
Commission the texts of the provisions 
of national law which they have already 
adopted or which they adopt in the 
field governed by this Directive. 
3) Member States shall report to 
the Commission every four 
years on the implementation of 
the provisions of this 
Directive, and in particular 
of Article 2(5), giving the 
views of the two sides of 
industry. 
The Commission shall inform 
the European Parliament, the 
Counci I, the Economic and 
Social Committee and the 
Advisory Committee for Safety, 
Hygiene and Health at Work. 
Art icle 10 
This Directive is addressed to the Member 
States. 
Done at Brussels, 
For the Counci 
The President "fa 
4) The Commission shall report 
periodically to the European 
Parliament, the Council and 
the Economic and Social 
Commi ttee on the 
implementation of this 
Directive, taking into account 
paragraphs i, % and 3. 
Annexes: (unchanged) 
IV 
ISSN 0254-1475 
COM(91) 552 final 
DOCUMENTS 
EN 05 04 
Catalogue number : CB-CO-91-603-EN-C 
ISBN 92-77-79126-8 
Office for Official Publications of the European Communities 
D-2985 Luxembourg