OPINION OF THE ECONOMIC AND SOCIAL COMMITTEE on the Proposal for a European Parliament and Council Directive amending Directive 93/16/EEC which facilitates the free movement of doctors and provides for the mutual recognition of their diplomas, certificates and other evidence of formal qualifications, and conferring implementing powers on the Commission for the updating of certain Articles thereof
Date: 1995-03-29
Institutions: European Economic and Social Committee
Subjects: advisory committee (EU), free movement of workers, medical specialisation, physician, recognition of diplomas













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51995AC0316

OPINION OF THE ECONOMIC AND SOCIAL COMMITTEE on the Proposal for a European Parliament and Council Directive amending Directive 93/16/EEC which facilitates the free movement of doctors and provides for the mutual recognition of their diplomas, certificates and other evidence of formal qualifications, and conferring implementing powers on the Commission for the updating of certain Articles thereof  


Official Journal C 133 , 31/05/1995 P. 0010 





Opinion on the proposal for a European Parliament and Council Directive  amending Directive 93/16/EEC which facilitates the free movement of doctors and provides for the  mutual recognition of their diplomas, certificates and other evidence of formal qualifications, and  conferring implementing powers on the Commission for the updating of certain Articles thereof  ()(95/C 133/06)On 18  January 1995 the Council decided to consult the Economic and Social  Committee, under Article 198 of the Treaty establishing the European 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 9  March 1995. The Rapporteur  was Mr Fuchs. At its 324th Plenary Session (meeting of 29  March 1995), the Economic and Social Committee adopted  the following Opinion unanimously. 1. General comments 1.1. The Economic and Social Committee notes that the purpose of the  proposed company directive is to bring about more efficient updating of certain articles of  Directive 93/16/EEC, which relates to doctors. 1.2. It acknowledges that the present situation as regards specialists' qualifications in the  Member States is not reflected in the consolidated text of the Directive. 1.3. The Committee welcomes the intention of incorporating in Directive 93/16/EEC adaptations of  descriptions of specialists which have been introduced or amended in the Member States in the  meantime. 2. Specific comments 2.1. Legal procedure2.1.1. The Committee notes that the intention is to introduce a legal procedure for  amending Article  5 (3) and Article  7 (2) of Directive 93/16/EEC concerning the rules on the  mutual recognition of specialists diplomas, certificates and other qualifications, and Articles 26  and 27 concerning the minimum duration of further training in the specialist areas described  therein. 2.1.2. The basis for the introduction of this procedure is the Council decision laying down the  procedures for the exercise of the implementing powers conferred on the Commission (Decision  87/373/EEC) (). A new Article  44 A will empower the Commission to amend the above provisions. For the amendment of Article  5 (3) and Article  7 (2) the advisory committee procedure under the  above Directive is to be used, whereas for amendment of Articles 26 and 27 the management committee  procedure is to be used. In the first case the Commission has the final decision even if the advisory committee should  disagree. In the last case, should the management committee disagree, the Council would still have  the possibility, by a qualified majority, to 'take a different decision within the time limit  referred to in the previous paragraph'. 2.1.3. The Committee of Senior Officials on Public Health set up by Council Decision 75/365/EEC,  which is the ESC's view should as far as possible be composed of experts, is to function both as  advisory committee (Article  5 (3) and Article  7 (2)) and as management committee (Articles 26 and  27). It should be pointed out here that this committee is composed of senior officials in the field  of public health appointed by the Member States, and concerned not only with doctors but also with  nurses, dentists and midwives. 2.2. The aims of the authorization must be clarified2.2.1. The Committee notes that the authorization  for the Commission to amend the said Articles is more extensive than the aim of the draft - namely  a more efficient updating of certain Articles - warrants. 2.2.1.1. The Committee doubts, first of all, the basis in Community law for this authorization to  amend, since under Article  145 of the EC Treaty 'the Council shall confer on the Commission, in  the acts which the Council adopts, powers for the implementation of the rules which the Council  lays down'. However, when using such powers, the Commission may neither amend nor supplement the  legal acts of the Council to be implemented. 2.2.1.2. Such a far reaching authorization is unnecessary, given that it is only a question of the  adoption of new specialist descriptions, the amendment of existing specialist descriptions and the  amendment of the minimum duration of further training for specialists. 2.2.1.3. The Committee takes note of the justification for the planned amendment procedure for  Article  26 and 27, which includes the statement: 'The question of the length of training for medical specialists is one which involves financial  considerations and many Member States national care delivery systems are dependent on trainee  specialists.'However, in the Committee's view, costs are not important for the duration of further  training, the sole decisive issue is whether the planned duration of further training suffices for  a doctor to be recognized as having thorough knowledge and experience, i.e. as a specialist. For  the same reason the Committee has doubts about the general powers of the Commission to amend these  provisions. 2.2.1.4. The Committee points out that the 'updating' of specialist qualifications is not only a  technical or drafting question of inclusion in the catalogue; in individual cases it entails an  evaluation of qualitative and substantive conformity with the relevant specializations. 2.2.1.5. The Committee therefore proposes that given the aims of the Draft Directive (2.2.1.2), the  new Article  5(4) and Article  7(3) and the new sections of Articles 26 and 27 should make it clear  that the Commission's powers are based on the standard rules laid down in these provisions. In  other words, the Commission's powers should be confined to the adoption and amendment of  specialization descriptions on the basis of Member States' data, and to the amendment of the  minimum duration of specialist further training. 2.2.1.6. The Committee therefore proposes that Articles 1 and 2 of the Draft Directive be reworded  as follows: 'Article  1In Article  5 of Directive 93/16/EEC, the following new paragraph shall be added: "4. Paragraph 3 of this Article shall be modified in accordance with the procedure set out in  Article  44A(2), only as regards the adoption of new or amendment of existing descriptions of  specializations as proposed by the Member States." In Article  7 of Directive 93/16/EEC, the following new paragraph shall be added: "3. Paragraph 2 of this Article shall be modified in accordance with the procedure set out in  Article  44A(2), only as regards the adoption of new or amendment of existing descriptions of  specializations as proposed by the Member States." Article  2In each of Articles 26 and 27 of Directive 93/16/EEC, there shall be added the following  new sentence: "The provisions of this Article shall be modified in accordance with the procedure set in Article   44A(3), only as regards modifying the minimum period of specialist training as proposed by the  Member States."'2.3. Involvement of the advisory committees for further medical training2.3.1. The Committee points out  that the Advisory Committee for further medical training (Council Decision 75/364/EEC of 16  June  1975) has been set up in connection with the original adoption of the 'doctors' Directive'. Taking  account in particular of the reasons set out above (2.2.1.3 and 2.2.1.4) the Committee therefore  regards it as necessary to involve the afore-mentioned Advisory Committee in the procedure. The  Committee regards it as inadequate for the matter to be left to the Committee of Senior Officials  for Public Health. 2.4. Involvement of European doctors' organizations2.4.1. The Committee stresses that the proposed  amendment procedure for medical further training raises questions for the medical profession which  must be discussed by experts. This applies to the question of which new specialization descriptions  should be included and to the conformity evaluation of new specialization descriptions. It applies  equally to the modification of minimum requirements, e.g. the duration of further training and to  determination of the category of minimum duration which is to be laid down at EU level for  individual new specialists careers. 2.4.2. The Committee therefore regards it as necessary for the Standing Committee of European  Doctors, as the federation of national organizations at European level, to be asked for its opinion  in all procedures. 2.4.3. The Committee therefore proposes that the above principle be enshrined in the new text of  Article  44 A as follows: '4. The Commission shall make its proposals after consulting the Advisory Committee for further  medical adjudication (75/364 EEC of 16  June 1975). It should also give the Standing Committee of  European Doctors the opportunity to express an opinion. Before submitting proposals for amendment,  the Commission shall ask the Standing Committee of European Doctors for proposals.'2.4.4. The  Committee points out that in its Opinion of 26  February 1992 () on the drawing up of the  codification Directive, it called for EU bodies to be assisted by medical expertise: 'The Committee is aware that the medical profession and the Advisory Committee on Medical Training  is already reexamining the qualitative aspects of specialist training and urges the Commission to  make proposals to effect any recommended changes as soon as possible, in the interest of both  doctors and their patients. Medical progress and professional expertise is evolving at such a rate at present that the  Commission has an obligation to continually keep under review current medical matters. It is  important that the expert committee (the Advisory Committee on Medical Training) is provided with  sufficient backup to enable it to carry out its vital Advisor's role to its full extent.'The  Committee is convinced that this 'backup' must and can come from the representatives of the  European medical profession, namely the Standing Committee. This backup should therefore be  'institutionalized' through the provision proposed above (2.4.3). 2.5. Member States to consult the national medical professionsThe Committee proposes that the  Commission be urged to ensure, when a draft Directive is being drawn up, that the Member States'  authorities responsible for further training take account of the views of the national medical  profession. 2.6. Further development of the system of recognition of doctors' diplomas with the support of the  Standing Committee of European Doctors2.6.1 The Committee suggests examination of the question of  whether the present system of individual references to the extremely varied descriptions of  specializations used in the individual Member States, could not be replaced by a more simple system  of mutual recognition of main specializations and associated 'sub-specializations'. 2.6.2. To this end the Committee proposes that when it takes a decision on the Draft Directive  under review, the Council should instruct the Commission to request the Standing Committee of  European Doctors to produce a proposal on the further development of the mutual recognition  arrangements for specialist medical qualifications, with the aim of improving freedom of  establishment and freedom to provide services. Done at Brussels, 29  March 1995. The Presidentof the Economic and Social CommitteeCarlos FERRER() OJ No C  389, 31. 12. 1994, p. 19.  () OJ No L 197, 18. 7. 1987, p. 33.  () OJ No C 98, 21. 4. 1992.