WRITTEN QUESTION E-2534/99 by Neil MacCormick (Verts/ALE) to the Commission. Free movement of doctors and patient safety.
Date: 2000-01-04
Institutions: European Parliament, Provisional data
Subjects: European social policy, physician, recognition of vocational training qualifications

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enhance safety at sea. The Parliament, with its resolution of 11 March 1994 on a common policy on safe
seas (2), approved the analysis contained in the Commission communication and called for a careful and
speedy execution of the action programme contained therein.

In its green paper on sea ports and maritime infrastructure (3), the Commission further highlighted the
importance of the role of Community ports in implementing and enforcing the Community(cid:146)s maritime
safety legislation and in ensuring a high level of port services that are intrinsically related to the safety of
ships.

2.
The Commission addressed the safety of ferry passengers at sea by proposing a series of Community
measures in the aftermath of the Estonia accident in September 1994, and following the requests from
Parliament and Council to provide for a coherent and stringent ferry safety regime in the Community.
These measures are Council Regulation (EC) No 3051/95 of 8 December 1995, on the safety management
of ro-ro ferries (4), Council Directive 98/18/EC of 17 March 1998 on safety rules for passenger ships (5),
Council Directive 98/41/EC of 18 June 1998 on the registration of persons sailing on board passenger
ships, operating to or from parts of the Member States of the Communities (6), and Council Directive
1999/35/EC of 29 April 1999 on a system of mandatory surveys for the safe operation of regular ro-ro
ferry and high-speed passenger craft services (7).

The safety of workers in ports is covered by a number of directives adopted in the social field in particular
covering issues related to safety and health at work. A listing of this legislation is forwarded direct to the
Honourable Member and to Parliament(cid:146)s Secretariat.

3.
The control of lorries to be loaded on board is governed by the international conventions on
maritime safety and marine pollution prevention, which include special requirements for the carriage of
dangerous goods in packaged form or in solid form in bulk. These international requirements have been
complemented by Community legislation which imposes reporting obligations on vessels bound for or
leaving Community ports and carrying dangerous or polluting goods (8).

4.
The Commission has no intention to table, in the framework of the follow-up to its green paper on
seaports and maritime infrastructure, proposals for mandatory minimum standards in the Community with
regard to the safety and hygiene of passengers. However, the Commission intends to issue a general
communication on safety at sea, and responsibilities of flag states, port states and industry related more
specifically to ship safety.

(1) COM(93) 66 final.
(2) OJ C 91, 28.3.1994.
(3) COM(97) 678 final.
(4) OJ L 320, 30.12.1995.
(5) OJ L 144, 15.5.1998.
(6) OJ L 188, 2.7.1998.
(7) OJ L 138, 1.6.1999.
(8) Council Directive 93/75/EEC, of 13 September 1993 concerning minimum requirements for vessels bound for or

leaving Community ports and carrying dangerous or polluting goods, OJ L 247, 5.10.1993.

(2000/C 280 E/066)

WRITTEN QUESTION E-2534/99

by Neil MacCormick (Verts/ALE) to the Commission

(4 January 2000)

Subject: Free movement of doctors and patient safety

In its Explanatory Memorandum attached to the proposed (cid:145)SLIM Directive(cid:146) simplifying and updating the
EU sectoral Directives on the mutual recognition of professional qualifications (COM(97) 638 final) (1) the

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Commission signalled its intention to ask the Council to abrogate the existing advisory committees on the
training of certain health professionals (doctors, nurses, dentists, midwives and pharmacists). Should the
Council comply with this request, the Commission intends to reconstitute these advisory committees by
Commission decision, giving them a simplified structure and a much narrower remit. Specifically, the
advisory committees would no longer have a mandate to promote free movement of health professionals
by proactively updating the minimum standards of competence in the professions concerned. Rather, the
advisory committee would only advise on free movement problems referred to them by the Commission.

Is the Commission aware that, in anticipation of a Council Decision to abrogate the existing Advisory
Committee on Medical Training (ACMT), the Commission(cid:146)s services have informed doctors(cid:146) representatives
that the Commission plans to initiate no new work in this committee?

Is the Commission aware that on 12 November 1999 the umbrella organisation representing Member
State Medical Associations, the Standing Committee of European Doctors, unanimously condemned the
Commission(cid:146)s cancellation of the 30 November 1999 plenary of the ACMT and its refusal to initiate work
in the ACMT?

Is the Commission aware that Europe(cid:146)s doctors regard the Commission(cid:146)s plans for a new ACMT with no
mandate to update EU minimum standards for general and specialist medical training as a threat to the
welfare of patients around the EU?

In light of these criticisms from EU doctors, is the Commission satisfied that its current policy on the
ACMT and its proposals concerning the future remit of the ACMT comply with the Commission(cid:146)s
obligation under Article 152 of the EC Treaty to ensure (cid:145)a high level of human health protection(cid:146) in the
definition and implementation of all Community policies and activities?

What steps, if any, has the Commission taken to reassure itself that its policy and proposals in relation to
medical training will have no negative health effects?

(1) OJ C 28, 26.1.1998, p. 1.

Answer given by Mr Bolkestein on behalf of the Commission

(8 February 2000)

It should first be pointed out that the situation faced by the Advisory Committee on Medical Training
(ACMT) is no different to that faced by similar committees. There are in fact six advisory committees on
the training of certain health professionals (doctors, pharmacists, dentists, veterinary surgeons, nurses and
midwives). These six committees were set up by the Council under the sectoral directives facilitating
freedom of movement for the categories of health professionals in question. These committees have the
same operating rules.

The first question concerning the work of the ACMT should be examined in light of the reform of the six
advisory committees concerned. In fact, in response to the initiative entitled Simpler Legislation for the
Internal Market (SLIM), the Commission announced in its Communication to the Council and Parliament
on the SLIM initiative (1) dated 6 November 1996 that it intended to rationalise the way in which the
advisory committees on training operated. The measures planned were in fact enlarged upon in the
explanatory memorandum attached to the proposed directive to which the Honourable Member refers.
Parliament adopted the proposal for a directive at first reading on 2 July 1998. The measures planned
should come into force on 1 January 2001 and new committees should be set up on that date.

The current period is therefore a transitional period during which the committees will be able to finish
ongoing work without undertaking any new work which they cannot complete by 1 January 2001. The

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Commission was therefore justified in informing all the committees concerned (cid:129) in the case of the ACMT,
at its meeting on 5 February 1999 (cid:129) about this transitional situation and how it would affect the way in
which work was organised. As a result, the ACMT decided to set up informal working parties which would
operate independently without financial assistance from the Commission. In this context, the committee
agreed that the decision whether or not to hold a meeting provisionally scheduled for 30 November 1999
would depend on how much progress had been made with this informal work.

With regard to the second question on the cancellation of the meeting of 30 November 1999, the
Commission would point out that, in general, owing to material and budgetary constraints, a rigorous
selection must be made of the requests received from the numerous committees that exist for permission
to hold meetings. The meeting of 30 November 1999 was cancelled because no adequate agenda had been
drawn up. In fact, the meeting could not be held on that date owing to the state of progress with the
informal work mentioned above. The decision to cancel the meeting was therefore justified and in keeping
with what the ACMT had itself agreed in this regard.

As to the third question on the protection of patients(cid:146) interests, it should be noted that the main objective
of the training criteria set out in Council Directive 93/16/EEC of 5 April 1993, designed to facilitate the
free movement of doctors and the mutual recognition of their diplomas (2), is to establish the minimum
training requirements which are considered necessary and sufficient for the mutual recognition of medical
diplomas. In fact, as the title indicates, the directive seeks to facilitate the free movement of doctors. To
this end, the directive provides for a system of mutual recognition of diplomas based on the observance of
training is largely the
minimum training requirements. Otherwise,
responsibility of the Member States, in keeping with Articles 149 and 150 (ex Articles 126 and 127) of
the EC Treaty. Both these articles expressly rule out any harmonisation of training at Community level.
Finally, the protection of human health and patients(cid:146)
interests also falls mainly within the scope of
competence of the Member States.

the organisation and content of

With regard to the fourth question concerning policy on the ACMT and future measures, the Commission
would point out that the situation faced by this committee is no different from that faced by other similar
committees. Moreover, the Commission wishes to draw the Honourable Member(cid:146)s attention to the fact that
the ACMT seeks to ensure a comparably demanding standard of training for doctors in keeping with
Council Decision 75/364/EEC of 16 June 1975 setting up this committee (3). The standard of training
implemented in each Member State depends on the rules adopted by each Member State,
it being
understood that each Member State is obliged to observe the minimum training requirements provided
for in Directive 93/16/EEC.

In this context, the Commission will continue to organise meetings between the representatives of the
competent authorities from each Member State. The appropriate instrument to this end is the Committee
of Senior Officials on Public Health established by Council Decision 75/365/EEC of 16 June 1975 (3).

Finally, although the purpose of the new advisory committee will be to give opinions on the main subject
of Directive 93/16/EEC (cid:129) i.e. the mutual recognition of doctors(cid:146) diplomas to allow the free movement of
doctors (cid:129) this does not prevent the committee from taking account of subjects relating to doctors(cid:146) training
within the framework of the mutual recognition of their diplomas and in keeping with the obligations
which the Commission must meet under Article 152 ( ex Article 129) of the EC Treaty.

With regard to the fifth question on the measures taken by the Commission to ensure that its policy and
proposals concerning medical training do not have an adverse effect on health, the Commission would
point out that, within the limits of its jurisdiction, it is cooperating closely with the Member States and the
professionals concerned in order to ensure that all interests are taken into account. The measures planned
by the Commission to reform some of the advisory committees including the ACMT are not likely to
change this situation.

(1) COM(96) 559 final.
(2) OJ L 165, 7.7.1993.
(3) OJ L 167, 30.6.1975.