NoC98/6 OfficialJournaloftheEuropeanCommunities 21.4.92
occupationarenowsubjecttothelegislationofthe
countryofresidence.Thisconditionappliestoallnon­
employedpersons,andremovesapreviousanomaly.
ARTICLE 3codifiedandupdated,incorporating allthechanges
sincethistaskwaspreviouslycompletedin1983[Regu­
lation(EEC)No201/83].Followingtheproductionof
thenewofficialtext,itisimportantthatanupdated
'CompendiumofCommunityprovisiononsocialsecur­
ity'ismadeavailableatanearlydate,asthecurrent
publicationissooutofdate,astobevirtuallyunusable
andthereforedangerous .
5.2.TheCommitteenotesandapprovesthatthis
Regulationshallenterintoforceonthedayofits
publicationintheOfficialJournaloftheEuropean
Communities ,andthatitshallbebindinginitsentirety
anddirectlyapplicableinallMemberStates.5.Conclusion
5.1.Thisproposalisessentialinthatitrepresents
thenextnecessarysteptowardsaPeople'sEurope,and
itshouldhelptoprovideforasingleofficialtext,
DoneatBrussels,26February1992.
TheChairman
oftheEconomicandSocialCommittee
MichaelGEUENICH
OpinionontheproposalforaCouncilDirectivetofacilitatethefreemovementofdoctors
andthemutualrecognitionoftheirdiplomas,certificatesandotherevidenceofformal
qualification
(92/C98/04)
On27January1992,theCouncildecidedtoconsulttheEconomicandSocialCommittee,
underArticle198oftheTreatyestablishingtheEuropeanEconomicCommunity ,onthe
abovementioned proposal.
TheSectionforSocial,Family,EducationalandCulturalAffairs,whichwasresponsiblefor
preparingtheCommittee'sworkonthesubject,adopteditsOpinionon14February1992.
TheRapporteurwasMrPearson.
Atits294thPlenarySession(meetingof26February1992)theEconomicandSocialCom­
mitteeadoptedthefollowingOpinionunanimously .
1.Introduction legislativeconsolidation isachievedbytheproposed
newDirectivewhichembracesalmostalltheprovisions
alreadyinoperationinthepreviousDirectives.
1.3.Thecoordinateddocumentwillbemorereadily
understoodbythosedoctorswishingtoengageinpro­
fessionalactivitiesinotherMemberStatesandbyother
interestedparties.
1.4.TheCommitteeendorsestheCommissionpro­
posalsasitbelievesthatacomprehensive document
containingfullinformationconcerningthenecessary
qualifications ineachareaofthemedicalprofessionis
necessary.Thefollowingcomments,includingamend­
mentstothetext,arehoweverimportantinthecontext
oftheproposedconsolidatedlegislationanditseffects.1.1.TheCommitteenotesthattheproposedDirec­
tiveisaconsolidation ofthoseDirectives,asamended,
alreadyinoperationconcerningthemutualrecognition
ofmedicaldoctors'diplomas,certificatesandother
formalspecialistqualificationsandincludingmeasures
tofacilitatetheeffectiveexerciseoftherightofestab­
lishmentandfreedomtoprovideservices.TheCom­
mitteewelcomesthisinitiativeasacoordinateddocu­
ment.
1.2.Theproposalwillsimplifyandclarifytheregu­
lationsenablingboththedoctorsandtheirpatientsto
benefitfromthefreedomofmovementofdoctors.The

21.4.92 OfficialJournaloftheEuropeanCommunitiesNoC98/7
professionhasalreadycalledfortheminimumtraining
periodoftwoyears(Art.31)tobeincreasedtothree
years,theCommitteeurgestheCommissiontocom­
mencetheevaluationassoonaspossiblesothatthere
willbenodelayinpresentingproposals.Anextension
tothreeyearswouldnotonlyachievefurthertimefor
thetrainingofgeneralpractitionersbutwouldmeet
thequalityconcernsexpressedbythecallforlonger
training.
2.7.Medicalprogressandprofessionalexpertiseis
evolvingatsucharateatpresentthattheCommission
hasanobligationtocontinuallykeepunderreview
currentmedicalmatters.Itisimportantthattheexpert
committee (theAdvisoryCommitteeonMedicalTrain­
ing)isprovidedwiththesufficientbackuptoenableit
tocarryoutitsvitaladvisor'sroletoitsfullestextent.
2.8.1.WithregardtoArticle20ofthecurrentpro­
posaltheCommitteereferstotherecommendation in
itsOpiniondated29January1970(2)thatthereshould
beaperiodofadaptationduringwhichthedoctor
wishingtopractiseinanotherMemberStatecould
increasehislinguisticcompetenceandfamiliaritywith
socialsecuritysystemsinthehostcountry(see
Appendix1below).2.Generalcomments
2.1.TheCommitteerecognisesthatthisproposalis
strictlylimitedtothecoordinationoflegaltextsof
existingDirectivesandthatanyminortextualchanges
madeare,ofnecessity,editorialinordertoclarifythe
intentofthelegislation :suchclarificationofthetext
isuseful.
2.2.AssomeoftheDirectivesinvolvedhavenow
beeninoperationformorethansixteenyearstheCom­
mitteewelcomestheopportunitytocommentonsome
ofthestrengthsandweaknessesofthelegislationinthe
lightofexperienceofdoctorsexercisingtherightof
establishmentandprovisionofservicesinotherMem­
berStates.
2.3.1.TheCommitteehasinallofitsexaminations
ofDirectivesconcerningprofessionalsplacedparticular
importanceonthequalityandsafetyoftheservices
providedasaresultofthemutualrecognitionofqualifi­
cationsforthepurposeoffreedomofmovement.
2.3.2.ItisamatterofgraveconcerntotheCom­
mitteethattheapprehensionexpressedinitsOpinions,
bothontheoriginaldraftDirectiveandonsubsequent
occasions,stillremainsvalidin1992.
2.3.3.Inparticularitsrecommendations concerning
linguisticcompetenceandfamiliaritywiththesystem
ofhealthcare(socialsecurity)inindividualMember
Stateshavenotbeenrealisedbythevagueandlegally
ineffectiveprovisionsofArticle20.
2.4.InthesixteenyearssincetheinitialDirective
wasadopted,patient'sexpectationshavechangedand
theprofessionrecognisesthatthequalitativecriteriaof
1975arenolongeradequate.
2.5.TheCommitteerecognisesthatinthecaseof
nursesandmidwivesand,toalimitedextent,general
practice(Directive86/457/EEC)(*)moredetailofthe
contentoftraininghasbeenincluded.However,in
relationtothebasicandthespecialisttrainingofdoc­
torstheminimalcriteriaremainunchanged .
2.6.1.TheCommitteeisawarethatthemedicalpro­
fessionandtheAdvisoryCommitteeonMedicalTrain­
ingisalreadyre-examiningthequalitativeaspectsof
specialisttrainingandurgestheCommissiontomake
proposalstoeffectanyrecommendedchangesassoon
aspossible,intheinterestofbothdoctorsandtheir
patients.
2.6.2.NotingthatArticle33callsforareviewofthe
chapteronSpecificTraininginGeneralPracticeby
1January1966(atthelatest)andthatthemedical2.8.2.TheCommitteeisawarethattheimposition
ofsuchaperiodorofatestoflinguisticcompetenceis
heldtoconstituteabarriertofreemovement .Itis
thereforeillegalandMemberStateshavehadtomodify
theirnationallegislationtoconformtothisview.
Equallyitisreportedthatsignificantproblemshave
ariseninsomeMemberStateswhenlackofappropriate
linguisticabilitythreatensthesafetyofpatientsand
remainsaseriouscauseforconcern.
2.8.3.Abilitytocommunicatewithouttheriskof
misunderstanding issoessentialtothepracticeofmedi­
cineandthedoctor-patient relationship ,thatitispart
ofthebasiccommunication skillsnecessaryforthe
practiceofmedicine.Thusastrictrequirementfor
appropriatelinguisticcompetence isjustifiedand
shouldnotbeconsideredasdiscriminatory .
2.8.4.WithfurtherenlargementoftheCommunity
thepotentialformovementofdoctorsisincreasedand
thereforethislinguisticproblemmaybecomemore
acute.ThustheCommitteeurgestheCommissionto
re-examinethisproblem,notonlyreconsideringthe
originalrecommendation oftheCommittee,butif
necessaryusingtheprovisionsofArticles235and
100(a)(3)oftheTreatyofRometoresolvetheproblem.
(»)OJNoL267,19.9.1986,p.26. (2)OJNoC36,28.3.1970,p.18.

NoC98/8 OfficialJournaloftheEuropeanCommunities 21.4.92
3.Specificcommentsinthetextoftheproposal 3.2.Article11
3.1.Preamble
TheCommitteenotesthatthereferenceinthefirst
paragraphtoArticle235oftheTreatyestablishingthe
EEChasbeenomitted.Inviewoftheconcernofthe
CommitteerelatingtoArticle20setoutat2.3.3above,
theCommittee considersthatthereferenceto
Article235shouldbereinstated .TheEnglishtextrefersto'activityofadoctor'whereas
Article12usesthephrase'activitiesofadoctor'.The
Committeerecommendsthatthelatterphraseshould
beusedconsistenlythroughoutthedocument (Art.11,
12,13,15,16,17,19).Othertranslationsshouldbe
consultedtoensureuniformityoftext.
DoneatBrussels,26February1992.
TheChairman
oftheEconomicandSocialCommittee
MichaelGEUENICH
APPENDIX
totheOpinionoftheEconomicandSocialCommittee
ExtractfromESCOpinionof29January1970:
NewArticle
TheCommitteeregretstheabsenceofaprovisionstronglyadvocatedbythedoctors'representatives ofthe
(then)sixMemberStates.Ittakestheviewthatthereshouldbeacompulsoryadaptationperiodofsix
monthsforanydoctoremigratingtoanotherMemberState,anditthereforeproposestheinclusionofan
Articlewhichisself-explanatory :
'ThehostcountriesshallrequireofthenationalsoftheotherMemberStatesatotaladaptationperiodofsix
monthsbeforeauthorizingthemtoexerciseoneoftheactivitieslistedinArticle2oftheCouncilDirective
of...concerningtheimplementation offreedomofestablishmentandfreedomtoprovideservicesasregards
thedoctor'snon-salariedactivities,toenablethemtofamiliarizethemselveswiththelanguage,health
legislationandsocialsecuritysystemofthehostcountry.Theadaptationperiodmustbespentworkingina
hospitalorwithanotherdoctorspecificallyallocatedtothetask.'