CELEX: 51987PC0649
Language: en
Date: 1987-12-17
Title: PROPOSAL FOR A COUNCIL DIRECTIVE AMENDING DIRECTIVE 77/452/EEC CONCERNING THE MUTUAL RECOGNITION OF DIPLOMAS, CERTIFICATES AND OTHER EVIDENCE OF THE FORMAL QUALIFICATIONS OF NURSES RESPONSIBLE FOR GENERAL CARE, INCLUDING MEASURES TO FACILITATE THE EFFECTIVE EXERCISE OF THE RIGHT OF ESTABLISHMENT AND FREEDOM TO PROVIDE SERVICES, AND DIRECTIVE 77/453/EEC CONCERNING THE COORDINATION OF PROVISIONS LAID DOWN BY LAW, REGULATION OR ADMINISTRATIVE ACTION IN RESPECT OF THE ACTIVITIES OF NURSES RESPONSIBLE FOR GENERAL CARE

No C 20/10                               Official Journal of the European Communities                                     26. 1. 88
               Proposal for a Council Directive amending Directive 77/452/EEC concerning the mutual
               recognition of diplomas, certificates and other evidence of the formal qualifications of nurses
               responsible for general care, including measures to facilitate the effective exercise of the right of
               establishment and freedom to provide services, and Directive 77/453/EEC concerning the
               coordination of provisions laid down by law, regulation or administrative action in respect of the
                                         activities of nurses responsible for general care
                                                         COM(87) 649 final
                               (Submitted by the Commission to the Council on 28 December 1987)
                                                           (88/C 20/08)
THE COUNCIL OF THE EUROPEAN COMMUNITIES,                              77/452/EEC (2), as last amended by the Act of
                                                                     Accession of Spain and Portugal, with that of similar
                                                                      provisions of Council Directive 75/362/EEC of 16 June
Having regard to the Treaty establishing the European                 1975 concerning the mutual recognition of diplomas,
Economic Community, and in particular Articles 49, 57                 certificates and other evidence of formal qualifications in
and 66 thereof,                                                       medicine, including measures to facilitate the effective
                                                                      exercise of the right of establishment and freedom to
                                                                      provide services (3), as amended by Directive 82/76/
Having regard to the proposal from the Commission,                    EEC (4),
Having regard to cooperation with the European Par-                   HAS ADOPTED THIS DIRECTIVE:
liament,
                                                                                                   Article 1
Having regard to the opinion of the Economic and                      Directive 77/452/EEC is hereby amended as follows:
Social Committee,
                                                                      1. Article 6 (3) is replaced by the following:
Whereas the second subparagraph of Article 1 (3) of                       '3.     If the host Member State has detailed
Council Directive 77/453/EEC (') sets out the principle                   knowledge of a serious matter which has occurred,
that theoretical and technical training shall be                          prior to the establishment of the person concerned in
coordinated and balanced with clinical training, although                 that State, outside its territory and which is likely to
no specific ratio is laid down; whereas Article 1 (4) states              affect the taking up within its territory of the activity
that the Council, acting on a proposal from the                           concerned in that State, it may inform the Member
Commission, shall decide whether these provisions                         State of origin or the Member State from which the
should be retained or amended;                                            foreign national comes.
                                                                          The Member State of origin or the Member State
                                                                          from which the foreign national comes shall verify the
Whereas, in the light of this review and given in
                                                                          accuracy of the facts. Its authorities shall decide on
particular the increased demands as regards the level of
                                                                          the nature and extent of the investigation to be made
knowledge of nurses responsible for general care, it is
                                                                           and shall inform the host Member State of any
appropriate to amend Article 1 (4) of Directive
                                                                           consequential action which they take with regard to
77/453/EEC in such a way as to set the length of the
                                                                           the certificates or documents they have issued.
theoretical instruction at at least one third, and that of
the clinical instruction at at least one half, of the                      Member States shall ensure the confidentiality of the
minimum length of the training referred to in Article 1                    information made available.'
 (2) (b) of that Directive; whereas that ratio makes it
 necessary to define more precisely theoretical instruction           2. Article 7 (2) is replaced by the following:
 and clinical instruction;
                                                                           '2.    If the host Member State has detailed
                                                                           knowledge of a serious matter which has occurred,
 Whereas it is also necessary to specify, as in the case of                prior to the establishment of the person concerned in
 similar provisions in other directives relating to the                    that State, outside its territory and which is likely to
 health professions, that the list of subjects in the Annex                affect the pursuit within its territory of the activity
 to Directive 77/453/EEC is not restrictive and to use as                  concerned, it may inform the Member State of origin
 standard terms 'theoretical instruction' and 'clinical in-                or the Member State from which the foreign national
 struction' in Directive 77/453/EEC and in the headings                    comes.
 in its Annex; whereas it is likewise necessary to align the
 wording of certain provisions of Council Directive                    (2) O J N o L 176, 15. 7. 1977, p. 1.
                                                                       (3) O J N o L 167, 30.6. 1975, p. 1.
 (') O J N o L 176, 15.7. 1977, p. 8.                                  (4) O J N o L 43, 15.2. 1982, p. 21.
 ---pagebreak--- 26.1.88                                  Official Journal of the European Communities                                 No C 20/11
   The Member State of origin or the Member State                        "Theoretical instruction"shall be defined as:
    from which the foreign national comes shall verify the
    accuracy of the facts. Its authorities shall decide on
    the nature and extent of the investigation to be made               that part of nursing training whereby student nurses
    and shall inform the host Member State of any                       acquire the knowledge, understanding and pro-
    consequential action which they take with regard to                 fessional skills needed to plan, provide and assess total
    the information they have forwarded in accordance                   nursing care. This teaching is provided in nursing
    with paragraph 1'.                                                  schools and other teaching environments chosen by
                                                                        the educational institution, and is given by a staff of
                                                                        nursing teachers and other competent persons.
3. The following Article 10a is inserted:
                                                                         "Clinical instruction"shall be defined as:
     'Article 10a
    Where a host Member State requires its own nationals                that part of nursing training whereby student nurses
    wishing to take up or pursue one of the activities                  as part of a team and in direct contact with a healthy
    referred to in Article 1 to take an oath or make a                  or sick individual and/or a community learn to plan,
    solemn declaration and where the form of such an                    provide and assess the required total nursing care on
    oath or declaration cannot be used by nationals of                  the basis of their acquired knowledge and skills. The
    other Member States, the host Member State shall                    student nurse learns not only to be a member of the
    ensure that an appropriate and equivalent form of                   team, but to be a team leader organizing total nursing
    oath or declaration is offered to the persons                       care, including health education, for individuals and
    concerned'.                                                         small groups in the health institution or the
                                                                        community.
4. The following is inserted after the second subpara-
    graph of Article 11 (1):                                            This instruction takes place in hospitals and other
                                                                        health institutions and in the community, under the
    'For this purpose and in addition to the declaration                responsibility of teachers who are nurses and with the
    provided for in paragraph 2 relating to the services to             cooperation and assistance of other qualified nurses.
    be provided, Member States may, so as to permit the                  Other qualified personnel may be involved in this
     implementation of the provisions relating to pro-                  teaching process.
     fessional conduct in force in their territory, require
     either automatic temporary registration or pro forma
                                                                         Student nurses shall participate in the activities of the
     membership of a professional organization or body
                                                                         departments concerned in so far as those activities
     or, as an alternative, registration, provided that such
                                                                         contribute to their training, enabling them to learn to
     registration or membership does not delay or in any
                                                                         undertake the responsibilities inherent in nursing care.
     way complicate the provision of services or impose
     any additional costs on the person providing the
     services'.                                                          4.    The theoretical instruction referred to in part A
                                                                         of the Annex shall be balanced and coordinated with
 5. Article 14 is deleted.                                               the clinical instruction of nurses referred to in part B
                                                                         of the same Annex in such a way that the knowledge
                                                                         and experience listed in paragraph 1 may be acquired
                            Article 2                                    in an adequate manner. The length of the theoretical
                                                                         instruction shall amount to no less than one third and
 Directive 77/453/EEC is hereby amended as follows:                      that of the clinical instruction to no less than one half
                                                                         of the minimum length of training referred to in
                                                                         paragraph 2 (b).'
 1. Paragraphs 2 (b), 3 and 4 of Article 1 are replaced by
     the following:
                                                                     2. The Annex is amended as follows:
      '2 (b) full-time training, of a specifically vocational
              nature, which must cover the subjects of the
              programme set out in the Annex to this                      (a) The introductory sentence is replaced by the
              Directive and comprise a three-year course or                   following:
              4 600 hours of theoretical and clinical in-                     'The training programme leading to the award of
              struction.                                                      a diploma, certificate or other evidence of formal
                                                                              qualifications as nurses responsible for general
      3.    Member States shall ensure that the institution                   care shall consist of the two parts and at least the
      training nurses is responsible for the coordination of                  subjects listed below. Instruction in one or more
      theoretical and clinical instruction throughout the                     of these subjects may be given as part of, or in
      training.                                                               association with, other courses:'
 ---pagebreak--- No C 20/12                             Official Journal of the European Communities                                 26. 1. 88
  (b) The headings of parts A and B are amended as                       — Italian version: the heading 'A. Insegnamento
      follows:                                                              teorico e tecnico' is replaced by 'A.
      — English version: the heading 'A. Theoretical                        Insegnamento teorico' and the heading 'B.
          and technical instruction' is replaced by 'A.                     Insegnamento       infermieristico clinico' is
          Theoretical instruction';                                         replaced by 'B. Insegnamento clinico'.
      — Danish version: the heading 'A. Teoretisk og                     — Dutch version: the heading 'A. Theoretisch en
          teknisk undervisning' is replaced by CA.                          technisch onderwijs' is replaced by 'A.
          Teoretisk undervisning';                                          Theoretisch onderwijs';
      — German version: the heading 'A. Theo-                            — Portuguese version: the heading 'A. Ensino
          retischer und technischer Unterricht' is re-                      teorico e tecnico' is replaced by 'A. Ensino
          placed by 'A. Theoretischer Unterricht' and                       teorico' and the heading 'B. Ensino clinico da
          the heading 'B. Klinisch-praktische Kranken-                      enfermagem' is replaced by 'B. Ensino clinico'.
          pflege-Ausbildung' is replaced by 'B. Klinische
          Unterweisung';                                                                   Article 3
      — Greek version: the heading A. '0EO)pr|TiK:f| Kai          Training courses for nurses responsible for general care
          7tpaKTiKf) 5i5aaKcdta' is replaced by 'A.               commenced before 1 March 1991 pursuant to Article 1
          3£CopT)TiKf] 8i5aaKaAia' and the heading 'B.            of Directive 77/453/EEC may be concluded in
          K-JIIVIKT] 5i5aoKaXia tou VOOOKUUOI)' is replaced       accordance with that Article.
          by 'B. KXIVIKT] 5i5aoKa>ia'.
      — Spanish version: the heading 'A. Ensenanza
                                                                                           Article 4
          teorica y tecnica' is replaced by 'A. Ensenanza
          teorica' and the heading 'B. Ensenanzas de              Member States shall bring into force the measures
          enfermeria clinica' is replaced by 'B.                  necessary to comply with this Directive no later than
          Ensenanza clinica';                                      1 March 1991. They shall forthwith inform the
      — French version: the heading 'A. Enseignement              Commission thereof.
          theorique et technique' is replaced by 'A.
          Enseignement theorique' and the heading 'B.                                      Article                ")
          Enseignement infirmier clinique' is replaced by
          'B. Enseignement clinique';                             This Directive is addressed to the Member States.