CELEX: 51987PC0577
Language: en
Date: 1987-11-26
Title: Proposal for a COUNCIL DIRECTIVE amending Directives 75/362/EEC, 77/452/EEC, 78/686/EEC, 78/1026/EEC and 80/154/EEC relating to the mutual recognition of diplomas, certificates and other evidence of formal qualifications as doctor, nurse responsible for general care, dental practitioner, veterinary surgeon and midwife, together with Directives 75/363/EEC, 78/1027/EEC and 80/155/EEC concerning the coordination of provisions laid down by law, regulation or administrative action relating to the activities of doctors, veterinary surgeons and midwives (submitted by the Commission)

ARCHIVES HISTORIQUES
DE LA COMMISSION
COLLECTION RELIEE DES
DOCUMENTS "COM"
COM (87) 577
Vol. 1987/0283
 ---pagebreak--- Disclaimer
Conformément au règlement (CEE, Euratom) n° 354/83 du Conseil du 1er février 1983 concernant
l'ouverture au public des archives historiques de la Communauté économique européenne et de
la Communauté européenne de l'énergie atomique (JO L 43 du 15.2.1983, p. 1) modifié en dernier
lieu par le règlement (UE) 2015/496 du Conseil du 17 mars 2015 (JO L79 du 25. 3.2015, p. 1), ce
dossier est ouvert au public. Le cas échéant, les documents classifiés présents dans ce dossier
ont été déclassifiés conformément à l'article 5 dudit règlement ou sont considérés déclassifiés
conformément aux articles 26(3) et 59(2) de la décision (UE, Euratom) 2015/444 de la
Commission du 13 mars 2015 concernant les règles de sécurité aux fins de la protection des
informations classifiées de l'Union européenne.
In accordance with Council Regulation (EEC, Euratom) No 354/83 of 1 February 1983 concerning
the opening to the public of the historical archives of the European Economic Community and the
European Atomic Energy Community (OJ L 43, 15.2.1983, p. 1), as last amended by Council
Regulation (EU) 2015/496 of 17 March 2015 (OJ L 79, 27.3.2015, p. 1), this file is open to the
public. Where necessary, classified documents in this file have been declassified in conformity
with Article 5 of the aforementioned regulation or are considered declassified in conformity with
Articles (26.3) and 59(2) of the Commission Decision (EU, Euratom) 2015/444 of 13 March 2015
on the security rules for protecting EU classified information.
In Übereinstimmung mit der Verordnung (EWG, Euratom) Nr. 354/83 des Rates vom 1. Februar
1983 über die Freigabe der historischen Archive der Europäischen Wirtschaftsgemeinschaft und
der Europäischen Atomgemeinschaft (ABI. L 43 vom 15.2.1983, S. 1), zuletzt geändert durch die
Verordnung (EU) Nr. 2015/496 vom 17. März 2015 (ABI. L 79 vom 25.3.2015, S. 1), ist dieser Akt
der Öffentlichkeit zugänglich. Soweit erforderlich, wurden die Verschlusssachen in diesem Akt in
Übereinstimmung mit Artikel 5 der genannten Verordnung freigegeben; beziehungsweise werden
sie auf Grundlage von Artikel 26(3) und 59(2) der Entscheidung der Kommission (EU, Euratom)
2015/444 vom      13.   März 2015     über die   Sicherheitsvorschriften für den Schutz von  EU-
Verschlusssachen als herabgestuft angesehen.
 ---pagebreak---      COMMISSION OF THE EUROPEAN COMMUNITIES
                                                              COM(87 ) 577 final
                                                              Brussels, 26 November 1987
                                              Proposai for a
                                            COUNCIL DIRECTIVE
amending Directives 75 /362 / EEC , 77 /452 / EEC , 78 /686 / EEC , 78 / 1026 / EEC and 80 / 154 / EEC
 relating to the mutual recognition of diplomas , certificates and other evidence
  of formal qualifications as doctor , nurse responsible for general care , dental
      practitioner , veterinary surgeon and midwife , together with Directives
      75 /363 / EEC , 78 / 1027 / EEC and 80/ 155 / EEC concerning the coordination of
          provisions laid down by law , regulation or administrative action
           relating to the activities of doctors , veterinary surgeons and
                                                 midwives
                                   ( submitted by the Commission )
                II 0 4 DEC. ISS7 fl
                                Secrétariat
                             Général
   C0M(87 ) 577 final
 ---pagebreak---                                    Explanatory memorandum
1 . Origin , aims and Legal basis of the proposal
1.1    The proposal          for a Directive relates to the following Directives
       adopted by the Council :
       - Council Directive of 16 June 1975 on the mutual recognition of
         diplomas , certificates and other evidence of formal qualifications in
         medicine , including measures to facilitate the effective exercise of
         the right of establishment and freedom to provide services ( Directive
         75 / 362 / EEC ) ( 1 );
       - Council Directive of 16 June 1975 concerning the coordination of
         provisions laid down by law , regulation or administrative action in
         respect of the activities of doctors ( Directive 75 / 363 / EEC ) ( 1 );
       - Council Directive of 27 June 1977 concerning the mutual recognition
         of diplomas , certificates and other evidence of 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 ( Directive 77 / 452 / EEC ) ( 2 );
       - Council Directive of 25 July 1978 concerning the mutual recognition
         of diplomas , certificates and other evidence of formal qualifications
         of dental practitioner , including measures to facilitate the
         effective exercise of the right of establishment and freedom to
         provide services ( Directive 78 / 686 / EEC ) ( 3 );
       - Council Directive of 18 December 1978 concerning the mutual recogni ¬
         tion of diplomas , certificates and other evidence of formal quali ¬
         fications in veterinary medecine , including measures to facilitate
         the effective exercise of the right of establishment and freedom to
         provide services ( Directive 78 / 1026 / EEC ) ( 4 );
       - Council Directive of 18 December 1978 concerning the coordination of
         provisions laid down by law, regulation or administrative action in
         respect of the activities of veterinary surgeons ( Directive
         78 / 1027 / EEC ) ( 4 );
       - Council Directive of 21 January 1980 concerning the            mutual recogni ¬
         tion of diplomas , certificates and other evidence of           formal qualifi ¬
         cations in midwifery and including measures to                  facilitate the
         effective exercise of the right of establishment                and freedom to
         provide services ( Directive 80 / 154 / EEC ) ( 5 );
       - Council Directive of 21 January 1980 concerning the coordination of
         provisions laid down by law, regulation or administrative action
         relating to the taking up and pursuit of the activities of midwives
         ( Directive 80 / 155 / EEC ) ( 5 );
( 1 ) OJ L 167 of 30 June 1975 .
( 2 ) OJ L 176 of 15 July 1977 .
( 3 ) OJ L 233 of 24 August 1978 .
( 4 ) OJ L 362 of 23 December 1978 .
( 5 ) OJ L 33 of 11 February 1980 .
 ---pagebreak---                                          - 2 -
 1.2    The purpose of the proposal is to make technical amendments to these
        eight Directives , which have become necessary as a result of changes in
        the Member States' legislation . A series of amendments of the same kind
        has already been made to the 1975 " Doctors " Directives by Directive
        82 / 76 / EEC ( 1 ).
 1.3    The legal basis for the proposal is the Treaty establishing the
        European Economic Community, and in particular Articles 49, 57 and 66
        thereof .
        The Commission considers , moreover, that the qualified majority rule
        should be applied when the Council adopts this proposal for a Directive
        in accordance with the new wording of Article 57(2 ) of the EEC Treaty
        pursuant to Article 16(2 ) of the Single Act .
        The Commission takes the view that none of the provisions of this
        proposal for a Directive involve in a Member State " amendment of the
        existing principles laid down by law governing the professions with
        respect to training and conditions of access for natural persons ".
2 . Purpose of the proposed amendments
2.1     Amendments to the wording of the diploma or formal qualification
Article 1
This article amends the names of the diplomas in medicine in Article 3 of
Directive 75 / 362 / EEC with respect to Italy , Greece and Spain .
As regards Italy , it is proposed to include both the " laurea " in medicine
and surgery which is awarded by the university and the diploma conferring
the right to practise medicine and surgery awarded following the relevant
State examination . Under Italian law , as it already stood at the time the
" Doctors " Directives were adopted , the profession cannot be pursued in Italy
on the basis of the " laurea " without the State examination and vice versa ;
the holding of a degree is a prerequisite for admission to the State
examination . The proposed addition is intended to remove any misunder¬
standing about the need to hold both qualifications .
( 1 ) Council       Directive of 26 January 1982 amending Directive 75 / 362 / EEC
      concerning the mutual recognition of diplomas , certificates and other
      evidence of formal qualifications in medicine , including measures to
      facilitate effective exercise of the right of establishment and freedom
      to provide services and Directive 75 / 363 / EEC concerning the coordination
      of provisions laid down by law, regulation or administrative action in
      respect of activities of doctors ( 82 / 75 / EEC ), OJ L 43 of 15 February
      1982 .
 ---pagebreak---                                           - 3 -
It is also proposed to amend the entry under "( j ) in Greece" in Article 3 of
the " Doctors " Directive 75 / 362 / EEC , as inserted by the Act of Accession of
Greece ( 1 ), by deleting the reference to the certificate of practical
training issued by the Ministry for Social Services . This certificate was
included together with the degree awarded by the university faculties of
medicine in Greece . The training certificate was included in the technical
adjustments contained in the Act of Accession because at the time of the
accession negotiations the Greek authorities intended to introduce require¬
ment of this certificate into Greek law and accordingly notified it to the
Community . However, they did not in fact do so, so the practical training
certificate has never existed        in Greek law . Account must also be taken of
the change which has occurred meantime in the name of the authorities
awarding the diploma .
Where Spain is concerned , account must be taken of a change in Spanish law
since entry into force of the Act of Accession of Spain and Portugal ( 2 ),
whereby the rector awards the diplomas of those universities for which the
procedure culminating in autonomous status has been completed; this was
previously the responsibility of the Ministry of Education and Science .
Since both arrangements may persist for some time , it is proposed to mention
the two authorities in the Directive .
Article 2
This provision , which amends Article 5(2 ) of the " Doctors " Directive
75 / 362 / EEC , adds to the Dutch version of the Belgian diplomas of medical
specialist the word " geneesheer ", which had previously been omitted .
Where Greece is concerned , account is taken of the fact that Greek
specialist medical qualifications are issued by the prefectures and no
longer by the Ministry for Social Services .
With respect to Spain , it is necessary to make the amendment to Article 1 of
this proposal concerning diplomas in medicine also where diplomas in
specialized medicine are concerned .
( 1 ) Act concerning the conditions of accession of the Hellenic Republic and
      the adjustments to the Treaties , OJ L 291 of 19 November 1979, page 90
      et seq .
( 2) Act concerning the conditions of accession of the Kingdom of Spain and
      the Portuguese Republic and the adjustments to the Treaties , OJ L 302 of
      15 November 1985 , page 158 et seq .
 ---pagebreak---                                        - 4 -
 Articles 10 and 11
 These provisions modify Articles 1 and 3 of the " Nurses " Directive
 77/ 452/ EEC as regards Italian , United Kingdom, Greek and Spanish qualific¬
 ations .
 The amendment to the section covering the United Kingdom qualifications is a
 result of the amalgamation of the bodies responsible for nurses and midwives
 in England and Wales with those in Scotland and Northern Ireland to form a
 single body, known as the " United Kingdom ‘Central Council for Nursing,
 Midwifery and Health Visiting " responsible for the United Kingdom as a
whole .
The amendment to the wording of the Greek qualifications is similarly
 intended to bring the Directive into line with changes which have taken
place since the entry into force of the Act of Accession . Jn addition , the
 reference to the certificate of practical training has been deleted for the
same reasons as those given for deleting it from Article 1 of this proposal
concerning diplomas in medicine .
As for Italy , the proposal is designed to correct an error in the previous
wording . The Italian nurses' diploma is not the "abi litazione "; such a
qualification is awarded following a State examination and there is no such
examination for nursing .
The reasons for the amendment concerning the Spanish nurses' diploma are the
same as those given in relation to Article 1 of this proposal concerning
diplomas in medicine .
It should be pointed out that the amendments introduced by Article 10 of the
proposal to the United Kingdom and Greek qualifications are simply changes
in name ; the field of activities of the profession is not affected .
Articles 13
This article is intended to amend Article 1 of the " Dental Practitioners "
Directive 78/ 686/ EEC by adding the            Italian professional title ,
"odontoiatra ". The present text of Article 1 of the said Directive refers in
relation to Italy to " the diploma , the title of which will be notified by
Italy to the Member States and the Commission within the time limit laid
down in Article 24(1 )". This formula is explained by the fact that Italy was
allowed a period of 6 years to create the profession of "dental
practitioner " which at the date of adoption of the " Dental practitioner "
Directives did not exist in Italy . The diploma notified by Italy is that of
" odontoiatra ".
As regards the diplomas , certificates and other qualifications of Italian
dental practitioners, see point 4 " Additional remarks " which is to be found
at the end of this explanatory memorandum .
 ---pagebreak---                                           - 5 -
 Article 16
 This provision amends Article 3 of the " Veterinary Surgeons " Directive
 78/ 1026/ EEC as regards Greek and Spanish diplomas .
The proposed text takes account of the change in the name of the Greek
authority awarding the diploma and of the fact that Spanish diplomas may now
be awarded by university rectors .
Articles 20 and 21
These articles amend Articles 1 and 3 of the " Midwives " Directive 80/ 154/ EEC
to take account of changes which have taken place in the designation of
German , United Kingdom and Greek qualifications . As already indicated in
relation to Articles 10 and 11 , the changes relating to the United Kingdom
result from the establishment of the single " United Kingdom Central Council
for Nursing, Midwifery and Health Visiting". Following changes in
terminology in Germany and Greece , the purpose of the amendments concerning
qualifications and diplomas in these Member States is to add to the feminine
form of the qualification or diploma the corresponding masculine form . Since
the amendments concerning Greece relate to all the diplomas set out there.
Directive 80/ 1273/ EEC of 22 December 1980 amending , consequent to the
accession of Greece, Directive 80/ 154/ EEC ( 1 ) becomes null and void . As
regards the Netherlands , it is necessary to correct an error which found its
way into all the language versions other than the Dutch . The proper title of
the Dutch midwife 's diploma , i.e. the "diploma van verloskundige " appears
only in the Dutch version while the other versions use the term " vroedvrouw-
diploma ", a title formerly used in the Netherlands . The amendment relating
to the Spanish diploma takes account of the fact that this diploma may now
be awarded by university rectors .
As regards the amendments introduced in Article 20, it should be pointed
out , as already mentioned under Article 10 above , that these are no more
than changes in titles of qualifications .
( 1 ) Council Directive of 22 December 1980 amending , consequent on the
      accession of Greece , Directive 80/ 154/ EEC concerning the mutual recog¬
      nition of diplomas , certificates and other evidence of formal qualifi ¬
      cations in midwifery and including measures to facilitate the effective
      exercise of the right of establishment and freedom to provide services
      ( 80/ 1273/ EEC ), 0J L 375 of 31 December 1980 .
 ---pagebreak---                                       - 6 -
2.2    Amendments to the titles of certain medical specialties
Articles 3 and 4
These amendments appearing in Articles 3 and 4 relating to Article 5(3 ) and
Article 7(2 ) of the " Doctors " Directive 75 / 362 / EEC , which range from simple
spelling changes to actual changes in title , relate to Belgium ( for
ophthalmology ), France ( for pathological anatomy and radiology ), Italy ( for
vascular surgery ), the Netherlands ( for anaesthetics , respiratory medicine ,
gastro-enterology and dermato-venereology ) and Greece ( for pathological
anatomy , gastro-enterology , physiotherapy and allergology ).
2.3 Amendments relating to the insertion or the deletion of certain medical
      specialties and of certain headings
Articles 3, 4, 7 and 8
             Like those referred to at 2.2 above , such amendments are set out
in Articles 3 and 4 of this Directive . They amend certain provisions of
Article 5(3 )    and Article  7(2 ) of the " Doctors " Directive 75 / 362 / EEC . To
retain consistency with some of these amendments , amendments are also
required to Articles 4 and 5 of the " Doctors " Directive . That is the purpose
of Articles 7 and 8 of this Directive .
2.3.1           As regards the specialties already listed in the " Doctors "
Directives , Belgium recently introduced a specialty in pathological anatomy,
in neurology and in psychiatry, France in endocrinology , Ireland in child
psychiatry, Luxembourg in renal diseases and the Netherlands in geriatrics
( Articles 3 and 4 of the proposal ).
2.3.2         It is also necessary to delete under "biological haematology" in
all the language versions other than the French and Portuguese the
subheading relating to Spain " hematologia y hemoterapia ". An error found its
way into the various language versions of the Act of Accession of Spain and
Portugal . The Spanish specialty in question should in fact appear only under
"general haematology" as in the French and Portuguese versions ( Article 4 of
the proposal ).
2.3.3         In the Dutch language version , the title of the heading "vascular
surgery " should be amended to make it consistent with the other language
versions . To retain consistency the same amendment must be made to Article 5
of   the   Dutch version of   Directive 75 / 362 / EEC  ( Articles 4 and 8 of the
proposal ) .
 ---pagebreak---                                                 _ 7 _
 2.3.4      To give effect to a recommendation ( 1 ) by the Advisory Committee on
 Medical Training ( 2 ), the list of countries where there is a specialty in
 occupational medicine listed in Article 7(2 ) of Directive 75 /362 / EEC , so
 far Ireland and the United Kingdom only, is to be extended to Germany,
 Denmark , Italy , Greece, Spain and Portugal . It is proposed to retain the
 minimum four years' training period as at present . Since occupational
 medicine can no longer be considered a specialty peculiar to Ireland and the
 United Kingdom the term " occupational medicine " in the various language
 versions other than English should be replaced by an appropriate translation
 of this term ( Articles 4 and 8 of the proposal ).
 2.3.5        Since pathological anatomy is now a specialty common to all the
Member States , the related heading ( j ) should be transferred from Article
7(2 ) of Directive 75 / 362 / EEC where it comes unter Chapter IV " Diplomas ,
 certificates and other evidence of formal qualifications in specialized
medicine peculiar to two or more Member States " to Article 5(3) of the
 Directive under Chapter III " Diplomas , certificates and other evidence of
formal qualifications in specialized medicine common to all Member States ".
Pathological anatomy is also recognized as a specialty in Spain and
Portugal . The Annexes to the Act of Accession also provide for inclusion of
appropriate headings in Article 7(2 ) of Directive 75 / 362 / EEC . As the
proposal transfers the heading " pathological anatomy " to Article 5(3 ) of the
Directive it also consequently amends this provision in the Annexes to the
Act of Accession . In addition, since pathological anatomy has now become a
specialty recognized in all the Member States it should accordingly also be
transferred from Article 5 to Article 4 of Directive 75 / 363 / EEC without any
change in the minimum length ( see Articles 3 and 4 and 7 and 8 of the
proposal ) .
2.3.6      A new heading " nuclear medicine " should also be included in Article
7(2 )   of   the   " Doctors "        Directive    75 /362 / EEC . Here the Commission is
supporting a proposal by the Advisory Committee on Medical Training
recommending ( 2 ) that this new specialty should be inserted in the
Directives, since it existed in seven Member States at the time ( and also in
Spain and Portugal ) and that the minimum training period should be set at
four years ( 3 ). This new specialty should be included in the Second group in
Article 5 of Directive 75 / 363/ EEC among those specialties requiring a
minimum four years' training period ( Articles 4 and 8 of the proposal ).
( 1 ) Document III / D / 1640 / 6 / 83 .
( 2) Set up by Council Directive 75 / 364 / EEC of 16 June 1975, OJ L 167 of
      30 June 1975 .
( 3 ) Document III / D / 107 / 5 / 82 .
 ---pagebreak--- 2.3.7        The Advisory Committee on Medical Training also recommended in its
 report ( 1 ) that in respect of Germany , France and Italy , maxi llo-facial
surgery should be included in the " Doctors " Directives as a new specialty .
However, it has emerged that in Germany it is necessary to hold both a
diploma in medicine and a qualification as dental practitioner to follow
such training , while in the other Member States where the specialty exists ,
it is a purely medical specialty . Where France is concerned it has emerged
that maxi llo-facial surgery is not a specialty as such , but a skill based on
a recognized specialty ( general surgery ). On scrutiny it has turned out that
maxi llo-facial surgery exists as a specialty with a comparable structure in
Italy and Spain only . It should accordingly appear in the Directives as a
specialty only in respect of those two Member States with a minimum five
years' training period ( Articles 4 and 8 of the proposal ).
2.3.8       Article 4(12 ) of the proposal for a Directive deletes the reference
to Belgium in Article 7(2 ) of the " Doctors " Directive 75 / 362 / EEC under
" tropical medicine ". This deletion has been made at the request of Belgium,
since tropical medicine there is a skill based on a specialty acquired
previously ( Article 4 of the proposal ).
2.4    Amendments relating to acquired rights
Article 5
This article is intended to extend the provisions of Article 9(3 ) of the
" Doctors " Directive 75 / 362 / EEC ( which so far relate only to specialist
diplomas ) to cover diplomas awarded in respect of basic medical training .
The purpose is to take account of changes which have taken place, or which
could yet take place , in the titles of these diplomas . The rule so far has
been that when a mutual recognition directive is adopted , reference is made
in it only to the titles of diplomas awarded at the time of its adoption .
The various titles used in the past are not mentioned , so where they are
concerned an appropriate attestation by the competent authorities is
required if the holder of such a diploma wishes to move to another country .
The amendment is also intended to dispel the somewhat ambigious nature of
the words " certificate of equivalence ".
( 1 ) Document III / D / 107 / 5 / 82 .
 ---pagebreak---                                     - 9 -
Article 9
 This article incorporates , thus permitting their repeal , the similar
provisions already provided for in Article 9(A) of the " Doctors" Directive
75 /362 / EEC and Article 15 of Directive 82 /76/ EEC . In addition, the text has
been amended in such a way as to bring it into line with changes in
 legislation in some Member States . The addition of an Annex is intended to
define more precisely the rights of those migrants coming under these
provisions .
The situation dealt with in Article 9 is different from that referred to in
Article 5 , which determines for the Member States other than the Member
State issuing the certificate the acquired rights of the holders of former
qualifications where a change takes place in the title of these qualific¬
ations in their Member State of origin or Member State from which they come .
In the case referred to in Article 9 the qualification ceases to be awarded
at a given moment and the corresponding training is no longer given on the
understanding that , under the national rules of the Member State concerned,
the holders of the former qualification retain the perogatives attached to
this qualification . The purpose is to protect for the future in the Member
State to which they wish to migrate the rights of the holders of diplomas in
the specialty concerned awarded by other Member States before the date the
specialty concerned was abolished and before the award of the qualification
was discontinued .      This latter category are therefore put on the same
footing as the holders of the former qualification issued by the host Member
State .
To ensure that the holders of these former specialist qualifications - who
maintain their prerogatives in their Member State of origin or the Member
State under whose national rules they come - can also migrate in future , the
specialties concerned will be retained in the Directives for all the Member
States in question . Article 9 gives Community migrants who find themselves
in a situation analogous to the nationals of these Member States the same
acquired rights as those enjoyed by the latter under their national law .
Accordingly, a migrant Community doctor holding a qualification from another
Member State where a given specialty exists , awarded prior to the date the
specialty was abolished in the host Member State, will enjoy in that Member
State the same acquired rights as the holders of the former qualification
issued by that Member State .
 ---pagebreak---                                          10 -
 Articles 12, 14, 17 and 22
 In respect of nurses responsible for general care , dental practitioners ,
 veterinary surgeons and midwives , these articles pursue the same aim as that
 set out in Article 5 of this proposal as regards doctors .
 In regard to the amendment to Article 5 of the " Midwives " Directive
 80 / 154 / EEC set out in Article 22 of this proposal , it should be noted that
 in    accordance   with  Article 2 of  that  Directive     the  Member States are
 required to recognize certain categories of midwives * diplomas issued by
other Member States ( i.e. diplomas awarded following full-time training in
midwifery lasting at least three years , admittance to which was not subject
to possession of a diploma providing for university entrance and diplomas
awarded following training lasting at least 18 months , but no more than two
years , open to nurses ) only where the holders of such diplomas can also
provide evidence of professional experience lasting two years or at least
one year as referred to in Article 4 of that Directive . It goes without
saying that the holders of the certificate referred to in Article 22 of this
proposal will have to satisfy the same requirements , as appropriate . To
avoid any risk of misunderstanding here , it seemed useftl to state this in
the proposed text .
  2.5    Amendments relating to some types of training as veterinary surgeon
         not complying fully with Directive 78 / 1026 / EEC
Articles 15 and 17
The purpose of these articles is to specify in the second paragraph of
Article 2 and Article 4 of the " Veterinary Surgeons " Directive 78 / 1026 / EEC
( as amended , the present text of Article 4 will become the new paragraph 1
of that Article ) that the provisions therein apply also to diplomas in
veterinary medicine awarded following training commenced before implement ¬
ation of the " Veterinary Surgeons " Directive 78 / 1027 / EEC but completed
subsequent ly .
The proposed amendment to the second paragraph of Directive 78 / 1027 / EEC is
intended to fill a technical gap left , where veterinary surgeons are
concerned , by the " Acquired Rights " Directive 81 / 1057 / EEC ( 1 ).
( 1 ) OJ L 385 of 31 December 1981 , p. 25 .
 ---pagebreak---                                        - 11 -
 This Directive extends the provisions relating to acquired rights provided
 for in Article 4 of Directive 78 / 1026 / EEC ( which initially applied only to
 diplomas attesting to training not complying with the Directive awarded
 before implementation of Directive 78/ 1027 / EEC ) to diplomas attesting to
 training not complying with the Directive commenced before that date and
 completed subsequently . No account was taken of the fact that under the
 second paragraph of Article 2 of Directive 78 / 1026 / EEC ( the article
 concerning the recognition of diplomas attesting to training complying with
the Directive ), to qualify for recognition pursuant to the said article
diplomas issued before implementation of Directive 78 / 1027 / EEC must be
accompanied by a certificate stating that they comply with the Directive ;
this additional requirement is not included in the corresponding provisions
of the other Directives . To ensure consistency of the texts from the time
that Article 4 was extended to training under way , it is therefore essential
to make a suitable addition to the second paragraph of Article 2 , which was
overlooked at that time . The Commission also wanted to take the opportunity
to incorporate the amendment made by Directive 81 / 1057 / EEC into the text of
Article 4 of Directive 78 / 1026 / EEC . Directive 81 / 1057 / EEC will accordingly
lapse in respect of veterinary surgeons .
More generally , the proposed amendment to Article 2 of Directive 78 / 1026 / EEC
will also solve a practical problem which could arise in respect of diplomas
awarded by certain Spanish schools of veterinary medicine . According to
information from the Spanish authorities , the training in some of these
schools of veterinary medicine is , and before Spanish accession already was ,
in line with Article 1 of Directive 78 / 1027 / EEC , while in other schools it
is not . Where the latter are concerned , Spain intends to make use of the
option open to it under Directive 81 / 1057 / EEC to continue with the training
commenced under the old programmes before Directive 78 / 1027 / EEC applied to
Spain , i.e. 1 January 1986, the date of accession . Generally speaking ,
therefore , until 1991 some diplomas awarded in Spain will comply with
Directive 78 / 1027 / EEC , while others will not . By virtue of the new wording
of the second paragraph of Article 2 of Directive 78 / 1026 / EEC set out in
Article 16 it will be possible to distinguish between the two .
 ---pagebreak---                                          - 12 -
Artide 18
This article provides for a transitional measure in respect of Italian
veterinary surgeons whose training does not comply fully with the minimum
training programme laid down by the " Veterinary Surgeons " Directive
 78 / 1027 / 87 . By its judgment of 18 September 1984 in Case 221 / 83 Commission v
 Italy ( 1 ) the Court ruled against Italy for failing to provide for
 compulsory instruction in the subjects referred to as " animal ethology and
protection " and " food hygiene and technology " as part of its curriculum for
veterinary surgeons .
Decree No 947 of the President of the Italian Republic of 29 August 1986,
published in the Gazzetta Ufficiale of 12 January 1987 , introduced a new
training programme whereby , inter alia , the two subjects referred to in the
Court 's      decision   were  made  compulsory . However , under  the   Decree  the
universities have two academic years from the date of its signature to apply
the new programme and students having commenced their studies before then
are given the option of continuing their studies in accordance with the new
programme ( with the necessary adjustments to the part of the studies already
completed ) or continuing their studies in accordance with the old programme
( which does not include the subjects in question ). For some time yet ,
therefore , the diplomas issued in Italy may attest to training both
complying and not complying with the Directive . It should be noted , however,
that even prior to Decree No 947 and prior to the Court judgment , the two
subjects were optional in some Italian faculties .
The last students having commenced their studies before implementation of
Directive 78 / 1027 / EEC , who accordingly qualify under the provisions relating
to acquired rights , obtained their diploma in veterinary medicine in 1986
( at least as a rule and on the basis of five years' study ). It is therefore
proposed to take special transitional measures to deal with the situation of
Italian veterinary surgeons who commenced their training after the deadline
for implementation of Directive 78 / 1027 / EEC and have followed a training
programme that does not necessarily include the two subjects at issue so
that they are not excluded from the benefit of the " Veterinary Surgeons "
Directive . The proposed text is thus based on that of Article 7 of the
" Doctors " Directive 75 / 363 / EEC , as amended by Article 12 of Directive
82 / 76 / EEC which dealt with a similar problem .
( 1 ) | 1984 | ECR 3249 .
 ---pagebreak---                                         - 13
 The first paragraph of the proposed text clarifies the problem of those
 concerned taking up the practice of veterinary medicine on Italian territory
and the second paragraph provides for other Member States to recognize their
diplomas by means of proof of at least three years' professional experience
as in relation to acquired rights , unless they have a certificate from the
 Italian authorities stating that the training they followed complied with
Directive 78 / 1027 / EEC and therefore included the two subjects in question .
It is proposed to restrict the benefit of these special measures to students
having commenced their training before 1 January 1985 . Given that the
Court 's decision was dated 18 September 1984 , the proposed deadline leaves
Italy a reasonable period to bring itself into line with Community law .
Moreover, it would be difficult to require supplementary training of
veterinary surgeons who had already obtained their diploma or were
approaching the end of their studies . These technical difficulties do not
apply to students commencing their studies after 31 December 1984, for their
training may easily be supplemented as required by instruction in the
subjects omitted, as appropriate during the course of their studies .
  2.6   Other amendments
Article 6
This Article is intended to correct an error which found its way into
Article 2(3 ) of Directive 75 / 363 / EEC . The time the Member States are allowed
to designate the authorities competent to issue diplomas in specialized
medicine , i.e. within 18 months of its notification, is not laid down in
Article 7 , but in Article 9 of that Directive .
Article 19
This article is intended to correct an error which found its way into the
Greek version of the Annex to the " Veterinary Surgeons" Directive
78 / 1026 / EEC . In the first indent of Group 2 under B in the Annex , the term
" surgery" should be replaced by the term " obstetrics" to bring the Greek
version into line with the other language versions .
 ---pagebreak---                                          - 14
Artide 23
 This    article   sets   out  to add to   Article 1  of  the " Midwives "  Directive
 80 / 155 / EEC a new paragraph 5 stipulating that the Directive      in question in
no way prejudices the rights of the Member States to                 allow on their
territory and in accordance with their own rules , holders of        diplomas issued
by non-member countries to take up and pursue the activities         of midwife .
Such a clause is included in Article 1 ( final paragraph ) of the Coordination
Directives relating to doctors ( Directive 75 / 363 / EEC ), dental practitioners
 ( Directive 78 / 687 / EEC ) and veterinary surgeons ( Directive 78 / 1027 / EEC ).
However , these provisions ( see in each case the first sentence of
paragraph 1 ) require either for taking up and pursuing the profession
concerned ( in the case of doctors and veterinary surgeons ) or for taking up
and pursuing the profession under the title concerned ( in the case of dental
practitioners ) possession of one of the diplomas specified in the
Directives , which are obviously all diplomas awarded by the Member States .
It thus appeared appropriate to include a suitable derogation so as not to
exclude diploma-holders from non-member countries from taking up and
pursuing the profession concerned .
However , the first subparagraph of Article 1(1 ) of the " Midwives " Directive
80 / 155 / EEC which does not contain such a clause uses the same wording as the
first subparagraph of Article 1(1 ) of the " Dental practitioners " Directive
78 / 687 / EEC , which in its Article 1(4 ) does contain a clause relating to
diplomas issued in non-member countries . Accordingly , the Member States are
not strictly speaking entitled in law to allow holders of diplomas from
non-member countries to take up and pursue the profession of midwife under
the professional title of midwife . Since this was certainly not what the
Community legislator intended , Directive 80 / 155 / EEC should be supplemented
as proposed .
Article 24
This     article    is   intended  to  bring   the   Spanish  language    version  of
Article 4(6 ) of the " Midwives " Directive 80 / 155 / CEE into line with the text
of the other language versions . While in the language versions other than
Spanish the midwife must be entitled to conduct spontaneous deliveries and
in urgent cases a breech delivery , the Spanish language version wrongly
provided for the midwife to be entitled merely to assist at such deliveries .
Article 25
This article sets out to rectify a point which was overlooked only in the
German version of Article 8 of the " Midwives " Directive 80 / 155 / CEE . While in
all the language versions other than German provision is made for compulsory
consultation of the Advisory Committee on the Training of Midwives before
the adoption of the measure referred to therein, this point is missing in
the German text .
 ---pagebreak---                                        - 15 -
3 . Date of entry into force and addressees
Articles 26 and 27
The appropriate provisions regarding the date of entry into force and the
addressees are included in Articles 26 and 27 of the proposal for a
Directive . As regards the date of entry into force , it is proposed that the
Member States should take measures to incorporate the Directive into
national law within six months of its notification . Since it involves merely
technical amendments , incorporation of which should not give rise to any
particular problems , a six-month time limit appears sufficient and
appropriate . This is all the more so since migrants who hold a recent
qualification are obviously keen to see the provisions that bring it under
the Directives enter into force as rapidly as possible .
4 . Additional remarks
It was thought desirable that the present proposal for a Directive should
also bring up-to-date the text of Articles 1 and 3 of the " Dental
practitioners " Directive 78 / 686 / EEC following the creation in Italy of a
profession of dental practitioners with a separate training .
However , Italy has introduced two types of training :
- one specifically in dentistry which takes five years , and leads to a
   diploma in dental practice ;
- the other, training as a doctor^ which takes seven years and is accompanied
   by a diploma in medicine^, followed by 3 years' additional training leading
   to a diploma of specialization in orthodontics , in total 10 years .
Allegations that this second type of training does not comply with the
criteria laid down in the coordination Directive 78/ 687 / EEC have been made
by several Member States as well as in the Advisory Committee on the
Training of Dental Practitioners and in the Committee of Senior Officials on
Public Health .
These allegations are currently being investigated .
In the circumstances , it seemed premature for the Commission to include in
the Directive the diplomas awarded on completion of both types of training
and consequently preferable to leave untouched the present text of
Articles 1 and 3 of Directive 78 / 686 / EEC , insofar as they concern Italy .
 ---pagebreak---                                                   Proposai for a
                                                COUNCIL DIRECTIVE
    amending Directives 75 / 362 / EEC , 77 / 452 / EEC , 78 / 686 / EEC , 78 / 1026 / EEC and 80 / 154 / EEC
      relating to the mutual recognition of diplomas , certificates and other evidence
       of formal qualifications as doctor , nurse responsible for general care , dental
           practitioner , veterinary surgeon and midwife , together with Directives
            75 / 363 / EEC , 78 / 1027 / EEC and 80 / 155 / EEC concerning the coordination of
               provisions laid down by law , regulation or administrative action
                  relating to the activities of doctors , veterinary surgeons and
                                                      midwives
    THE COUNCIL OF THE EUROPEAN COMMUNITIES ,
    Having regard to the Treaty establishing the European Economic Community , and in
    particular Articles 49 , 57 and 66 thereof ,
    Having regard to the proposal from the Commission ( 1 ),
    In cooperation with the European Parliament ( 2),
    Having regard to the Opinion of the Economic and Social Committee ( 3 ),
    Whereas certain technical amendments should be made to Council Directives 75 / 362 / EEC ( 4 ),
    77 /452 / EEC ( 5 ), 78 / 686 / EEC < 6 ), 78 / 1026 / EEC ( 7 ) and 80/ 154 / EEC (8 ), as last amended by
    the Act of Accession of Spain and Portugal , concerning the mutual recognition of
    diplomas , certificates and other evidence of formal qualifications of doctors , nurses
    responsible for general care , dental practitioners , veterinary surgeons and midwives ,
    and to Council Directive 75 /363 / EEC ( 9), as last amended by Directive 82 /76 / EEC ( 10 ),
    and Council Directives 78 / 1027 / EEC ( 11 ) and 80 / 155 / EEC ( 12 ) concerning the coordination
    of provisions laid down by law, regulation or administrative action in respect of the
    activities of doctors , veterinary surgeons and midwives in order to take account
    in particular           of changes in the titles of diplomas , certificates and
  ( 1 ) 0J No C _
  ( 2 ) 0J No C _
  ( 3 ) 0J No C _
  (4 )  0J  No   L  167,   30.6.1975 , p. 1 .
  (5)   0J  No   L  176 ,  15.7.1977, p. 1 .
  (6)   0J  No   L  233,   24.8.1978, p. 1 .
  (7)   0J  No   L 362 ,   23.12.1978, p. 1 .
  ( 8)  0J  No   L   33,   11.2.1980, p. 1 .
  (9)   0J  No   L  167 , 30.6.1975, p. 14 .
( 10 )  0J  No  L    43,   15.2.1982 , p. 21 .
( 11 )  0J  No  L  362 ,  23.12.1978, p. 7 .
( 12 )  0K  No  L    33,  11.2.1980, p. 8 .
 ---pagebreak---                                 - 2 -
other evidence of formal qualifications in these professions or in the
designation of     certain medical       specialties,  as well as of     the
establishment of certain new medical specialties of the discontinuing
of certain former specialties which have taken place in some Member
States ;
Whereas it is necessary to protect at Community level the acquired
rights of the holders of former qualifications which are no longer
awarded as a result of the above changes which have taken place in the
rules of the Member State which awarded the qualification to them and
to supplement where necessary in this connection the abovementioned
Directives by appropriate provisions ;
Whereas it is advisable to provide , for reasons of equity and in the light of
the special situation in one Member State , for certain transitional
measures for the holders of diplomas , certificates and other evidence
of formal qualifications in veterinary medicine awarded in that Member
State , following training commenced after entry into force of
Directives 78 / 1026 / EEC and 78 / 1027 / EEC and not complying fully with
Article 1 of Directive 78 / 1027 / EEC ; whereas , however , it is advisable
to restrict these measures to persons . who commenced their training
before 1 January 1985 , the necessary supplementary training being
provided in the case of training commenced at a later date, where
necessary during the course of studies ,
HAS ADOPTED THIS DIRECTIVE ;
 ---pagebreak---                                            - 3 -
 CHAPTER 1
 Amendments relating to Directives 75 / 362 / EEC and 75 / 363 / EEC ( mutual recogni ¬
tion of diplomas , certificates and other evidence of formal qualifications in
medicine and coordination of the provisions Laid down by Law / regulation or
administrative action in respect of activities of doctors )
                                         Article 1
Article 3 of Directive 75 / 362 / EEC is hereby amended as follows :
            1 . Under the heading "( f ) in Italy " the text is replaced by
                 the following :
                ■
                   'diploma di laurea in medicina e chirurgia' ( diploma of
                 graduate in medicine and surgery ) awarded by a university,
                accompanied by a
                 'diploma di abilitazione al l ' esercizio della medicina e chirur ¬
                gia' ( diploma conferring the right to practise medicine and
                surgery ) awarded by the State Examining Commission ."
            2 . Under the heading "( j ) in Greece " the text is replaced by
                the following :
                "· Πτυχίο Ιατρυκη ^ ,
                 ( degree in medicine ) awarded by :
                - the faculty of medicine of a university , or
                - the faculty of health sciences , department of medicine , of a
                university ."
           3 . Under the heading "( k ) in Spain " the text is       replaced    by
                the following :
                N
                   'Título de licenciado en Medicina y Cirugía'
                ( university degree in medicine and surgery ) awarded by the
                Ministry of Education and Science or the rector of a univer¬
                sity ."
                                        Article 2
Article 5(2 ) of Directive 75 / 362 / EEC is hereby amended as follows :
           1 . Under the heading " in Belgium" the text      is   replaced    by    the
                following :
                N
                   'le titre d' agrégation en qualité de médecin spécialiste / erken-
                ningstitel van geneesheer specialist'
                ( formal evidence of having qualified as a medical specialist )
                issued by the Minister for Public Health ."
 ---pagebreak---                                          - 4 -
           2 . Under the heading " in Greece " the text is       replaced   by   the
                following :
               ■                  ...
                  • Τίτλος Ιατρικής ειδικότητας χορηγούμενος απο τις Νομαρχίες ·
                ( ΐϊΐΐε οί πιβάτεοί ερθεΐοΐΐγ ) δμοτςίθϋ βχ ΐΗβ ρΓ6·ίβεΐυΓεδ ."
          3 . Under the heading " in Spain" the text is         replaced   by the
               following :
                  'Título de Especialista *
                ( professional qualification of specialist ) awarded by the
               Ministry of Education and Science or the rector of a univer¬
               sity ."
                                       Article 3
Article 5(3 ) of Directive 75 / 362 / EEC is hereby amended as follows :
          1 . Under " anaesthetics " the subheading relating to the Netherlands
               is replaced by the following :
               " Netherlands : anesthesiologie ".
          2 . Under " ophthalmology " the subheading relating to Belgium
               is replaced by the following :
               " Belgium : ophtalmologie-oftalmologie ".
          3 . Under " respiratory medicine " the subheading relating to the
               Netherlands is replaced by the following :
               " Netherlands : longziekten en tuberculose ".
          4 . The following heading is added at the end of Article 5 :
               " pathological anatomy :
       Germany             Pathologie
       Belgium             anatomie pathologique / pathologische anatomie
       Denmark             patologisk anatomi og histologi eller
                           vaevsundersògelse
       France              anatomie et cythologie pathologique
       Ireland             morbid anatomy and histopathology
       Italy               anatomia patologica
       Luxembourg          anatomie pathologique
       Netherlands         pathologische anatomie
       United Kingdom morbid anatomy and histopathology
       Greece              TraSoXoyiKn avaTopiKri
       Spain               anatomia patològica
       Portugal            anatomia patològica ".
                                                                               •■•/•• •
 ---pagebreak---                                           - 5 -
                                        Article 4
Article 7(2 ) of Directive 75 / 362 / EEC is hereby amended as follows :
           1 . In all the language versions other than the French and the
                Portuguese, under " biological haematology " the subheading
                relating to Spain is deleted .
           2 . The heading " pathological anatomy " is deleted .
           3 . Under " vascular surgery " :
               - in the Dutch language version the title of the heading is
                  replaced by " chirurgie van bloedvaten " ;
               - the subheading relating to Italy is            replaced   by  the
                  following :
                  " Italy : chirurgia vascolare ".
           4 . Under " gastro-enterology " :
               - the subheading relating to the Netherlands is replaced
                  by the following :
                  " Netherlands : gastro-enterologie ";
               - the subheading relating to Greece is replaced by the
                  following :
                    " 6ΓΘΘΟΘ : ’γαστρεντερολογ ία    ",
          5 . Under " endocrinology " the following subheading is           added
               relating to France :
               " France : endocrinologie - maladies métaboliques ".
          6 . Under " physiotherapy " the subheading relating to Greece is
               replaced by the following :
               " βτββΰβ : φυσική ιατρική και αποκατάσταση
          7 . Under "neurology " the following subheading              is  added
               relating to Belgium :
               " Belgium : neurologie - neurologie ".
          8 . Under      " psychiatry " the following subheading is        added
               relating to Belgium :
               " Belgium : psychiatrie - psychiatrie ".
          9 . Under " neuro-psychi at ry " the subheading relating to Greece
               is replaced by the following :
               " βΓβθΰε : νευρολογια - ψυχιατρική ·> _
         10 . Under      " dermato-venereology "  the   subheading   relating   to the
               Netherlands is replaced by the following :
               " Netherlands : dermatologie en venerologie ".
         11 . Under " radiology " the subheading relating to France            is
               replaced by the following :
               " France : électro-radiologie ".
 ---pagebreak---                                 - 6 -
12 . Under " tropical medicine" the following subheading is
     deleted :
     " Belgium : médecine tropicale /tropische geneeskunde ".
13 . Under " child psychiatry" the following subheading is
     added relating to Ireland :
     " Ireland : child and adolescent psychiatry ".
14 . Under " geriatrics "/ the following subheading is added
     relating to the Netherlands :
     " Netherlands : klinische gériatrie ".
15 . Under " renal diseases " the following subheading           is added
     relating to Luxembourg :
     " Luxembourg : néphrologie ".
16 . Under " allergology" the subheading relating to Greece            is
     replaced by the following :
     " Greece : . aXXepYioXoYia
17 . The     heading   " occupational- medicine "     is  amended   as
     follows :
     ( a ) The title of the heading is replaced , except in the English
           language version, by the following :
           - Danish language version           " arbe jdsmedicin "
           - German language version           " Arbeitsmedizin "
           - Greek language version            " laTpiKñ THC epYaoíaq "
           - Spanish language version          " medicina del trabajo "
           - French language version           " médecine du travail "
           - Italian language version          " medicina del lavoro "
           - Dutch language version            " arbeidsgeneeskunde "
           - Portuguese language version " medicina do trabalho ".
     ( b ) Under    this   heading the following subheadings         are
           added :
           " Germany          Arbeitsmedizin "
           " Denmark          samfundsmedicin "
           " Italy            medicina del lavoro "
           " Greece           idTptKn  TH <; epYaoiac;"
           " Spain            medicina del trabajo "
           " Portugal         medicina do trabalho".
                                                                       •■•/•• •
 ---pagebreak---                                              7
            18 . The following two new subheadings            are added at the end of
                  paragraph 2 :
                       " nuclear medicine :
                         - Germany             Nuklearmedizin
                         - Belgium             médecine       nue léai re / nuc leai re genees-
                                               kunde
                         - Italy               medicina nucleare
                         - Netherlands         nucleaire geneeskunde
                         - United Kingdom      nuclear medicine
                         - Greece              TT'JpHV IK n  IdTpIKH
                         - Spain               medicina nuclear
                         - Portugal            medicina nuclear ."
                       " maxillo-facial surgery :
                         - Italy            : chirurgia maxi Ilo-facciale
                         - Spain            : cirugia       oral y maxi lofacial ."
                                        Article 5
Article 9(3 ) of Directive 75 / 362 / EEC is hereby replaced by the following :
       " 3 . In the case of nationals of the Member States whose diplomas ,
              certificates and other evidence of formal qualifications in
              medicine or in specialized medicine do not conform with the
              qualifications or designations set out in Articles 3 , 5 and 7 ,
              each Member State shall recognize as being sufficient proof the
              diplomas , certificates and other evidence of formal qualifications
              awarded by those Member States , accompanied by a certificate
              issued by the competent authorities or bodies . The certificate
              shall state that these diplomas , certificates and other evidence
              of formal qualifications in medicine or in specialized medicine
              were awarded following training in accordance with the provisions
              of Directive 75 / 363 / EEC , referred to , as appropriate , in
              Articles 2 , 4 or 6 of Directive 75 / 362 / EEC , and are treated by the
              Member State which awarded them as the qualifications or designations
              set out , as appropriate , in Articles 3 , 5 or 7 ."
                                        Article 6
Article 2(3 ) of Directive 75 / 363 / EEC is hereby amended as follows :
            " 3 . Within the time limit laid down in Article 9 , Member States
                  shall designate the authorities or bodies competent to issue
                  the diplomas , certificates and other evidence of formal
                  qualifications referred to in paragraph 1 ".
 ---pagebreak---                                          - 8 -
                                       Artide 7
The following entry is hereby added to Article 4 of Directive 75 / 363 / EEC at
the end of the heading " Second group " :
                "- pathological anatomy ".
                                       Artide 8
Article 5 of Directive 75 / 363 / EEC is hereby amended as -follows :
           1 . Under " First group " :
                - in the Dutch language version the entry " chirurgie van hart ¬
                  en bloedvaten" is replaced by " chirurgie van bloedvaten";
                  the following entry is added at the end :
                  "- maxillo-facial surgery ".
           2 . Under " Second group " :
               - the entry " pathological anatomy " is deleted ;
               - except in the English language version the entry "occupational
                  medicine" is replaced as follows :
                    Danish language version       "a rbe jdsmedicin "
                    German language version       " Arbeitsmedicin "
                    Greek language version        " laTpiKrí THC epYaoíac "
                    Spanish language version      " medicina del trabajo"
                    French language version       " médecine du travail "
                    Italian language version      " medicina del lavoro "
                    Dutch language version        " arbeidsgeneeskunde "
                    Portuguese language version " medicina do trabalho".
               - the following entry is added at the end of the list :
               "- nuclear medicine ".
                                      Article 9
 1 . Those Member States which have repealed the provisions laid down by law,
     regulation or administrative action relating to the award of diplomas ,
     certificates and other evidence of formal qualification in neuro-psy¬
     chiatry , radiology , thoracic surgery , vascular surgery , gastro-entero-
     logical surgery , biological haematology or physiotherapy , and have taken
     measures relating to acquired rights on behalf of their own nationals ,
     shall recognize the right of nationals of the Member States to benefit
     from those same measures , provided their diplomas , certificates and
     other evidence of formal qualifications in neuropsychiatry , radiology ,
 ---pagebreak---                                                       - 9 -
      thoracic surgery , vascular surgery , gastro-enterological surgery ,
      biological haematology or physiotherapy fulfil the relevant conditions
      set out either in Article 9(2 ) of Directive 75 / 362 / EEC or in Articles 2 ,
      3 and 5 of Directive 75 / 363 / EEC and in so far as the said diplomas ,
      certificates and other evidence of formal qualification were awarded
      before the date on which the host Member State stopped awarding such
      diplomas , certificates and other evidence of formal qualification in the
      specialty concerned .
  2 . The dates on which the Member States concerned repealed the provisions
      laid down by law , regulation or administrative action in respect of the
      diplomas , certificates and other evidence of formal qualifications
      referred to in paragraph 1 are set out in the Annex .
  3 . Article 9(4 )          of       Directive    75 / 362 / EEC  and  Article 15  of  Directive
      82 / 76 / EEC are hereby repealed .
CHAPTER 2
Amendments relating to Directive 77 / 452 / EEC ( mutual recognition of diplomas ,
certificates and other evidence of formal qualifications as nurse responsible
for general care )
                                                  Article 10
Article 1(2 ) of Directive 77 / 452 / EEC is hereby amended as follows :
             1 . Under " in the United Kingdom " the text is replaced by the
                  following :
                  " State Registered Nurse or Registered General Nurse ".
             2 . Under " in Greece " the text is replaced by the following :
                  "Διπλωματούχος ύ ιττυνιούχυ ^ νοσοκόμος , νοοιιλευτίϊς
                             . .„ ,^
                    νϋυ ί( / ν ^     ΤΟ     ·
                                                  Article 11
Article 3 of Directive 77 / 452 / EEC is hereby amended as follows :
             1 . Under         "( f )    in   Italy "   the    text is replaced by the
                  following :
                  " the ’diploma di infermiere professiona le ’                awarded by State -
                  recognized schools ."
 ---pagebreak---                                    - 10 -
 2 . Under "( i ) in the      United Kingdom" the text is replaced by
      the following :
          a Statement of      Registration as a Registered General Nurse in
          Part I of the        register maintained by the United Kingdom
          Central Council     for Nursing , Midwifery and Health Visiting".
3 . Under "( j )       in  Greece "    the   text    is replaced by the
      following :
          . · Το δίπλωμα, Αδελφής Ιίοσυκυμας της Α,νωτέρας Σχολής
               Αδελφών Ποσο /ίόμων'
             ( diploma of general nurse from the advanced school of
            general nursing ), certified by the Ministry of Social
            Services or by the Ministry of Health and Social Welfare ,
            or
             ■ Το πτυχίο Νοοοπομου του Τμήματος Αδελφών Νοσοκομων
               των Παραϊ τρ ικών Σχολών των Κέντρων Ανωτέρας
               Τεχνικής και Ετταγγελματ ικής Εκπαίδευσης 1
            ( degree    in   nursing    from   the   nursing   sections  of  the
            paramedical schools at the advanced centres of technical
            and vocational training ) awarded by the Ministry of
            Education and Religious Affairs , or
            ιΤο πτυχίο νοσηλευτή ή νοση?\£ ύτρ ιας των Τεχνολογ ΐπω’
               Επιζα ιδέ υ τ ικών Ιδρυμάτων ( ΐ.Ε.Ι .)
            (degree in nursing from the technological                   training
            establishments )     run    by   the   Ministry  of   Education  and
            Religious Affairs , or
            § Το πτυχίο τ.ης Ανώτατης Νοσηλε υτ ικής - -της' Σχολής.
               Επαγγελμάτων γ ^ε ίας , Τμήμα ϊτοσηλε υτ ικής του
               Πανεπιστημίου Αθηνών
            ( degree in nursing from the faculty of health sciences ,
            nursing section, University of Athens )."
4 . Under "( k )       in  Spain "   the   text is replaced by the
     following :
     M
       'Titulo de Diplomado universitario en Enfermería'
     ( university diploma in nursing ) awarded by the Ministry for
     Education and Science or the rector of a university ."
 ---pagebreak---                                              - 11
                                           Artide 12
Article 4 of Directive 77 / 452 / EEC is hereby amended as follows :
      - the two existing paragraphs become paragraph 1 and are preceded
         by the figure " I ".
     - The following new paragraph 2 is added :
         " 2 . In the case of nationals of Member States whose diplomas ,
                certificates and other evidence of formal qualifications as nurse
                responsible for general care do not conform with the qualific ¬
                ations or designations set out in Article 3 , each Member State
                shall recognize as being sufficient proof the diplomas , certifi¬
                cates and other evidence of formal qualifications awarded by those
                Member States , accompanied by a certificate issued by the
                competent authorities or bodies . The certificate shall state that
                the diplomas , certificates and other evidence of formal qualific ¬
                ations as nurse responsible for general care were awarded
                following training in accordance with the provisions of Directive
                77 / 453 / EEC, referred to in Article 2 of Directive 77 / 452 / EEC, and
                are treated by the Member State which awarded them as                 the
                qualifications or désignations set out in Article 3 ".
CHAPTER 3
Amendments relating to Directive 78 / 686 / EEC ( mutual recognition of diplomas ,
certificates and other formal evidence of qualifications as dental practi -
tioner )
                                           Article 13
In Article 1 of Directive 78 / 686 / EEC the text under the heading "- in Italy "
is replaced by the following :
              " odontoiatra ".
 ---pagebreak---                                        - 12 -
                                     Artide 14
The following paragraph 3 is hereby inserted in Article 7 of Directive
78 / 686 / EEC :
" 3 . In the case of nationals of Member States whose diplomas , certificates
       and other evidence of formal qualifications in dentistry or in
       specialist dentistry ( orthodontics and oral surgery ) do not conform with
       the qualifications or designations set out in Articles 3 and 5 , each
       Member State shall recognize as being sufficient proof the diplomas ,
       certificates and other evidence of formal qualifications awarded by
       these Member States , accompanied by a certificate issued by the
       competent authorities or bodies . The certificate shall state that the
       diplomas , certificates and other evidence of formal qualifications as
       dental practitioner or as specialist dental practitioner ( orthodontics
       and oral surgery ) were awarded following training in accordance with the
       provisions of Directive 78/ 687/ EEC , referred to , as appropriate , in
       Articles 2 or 4 of Directive 78 / 686 / EEC , and are treated by the Member
       State which awarded them as the qualifications or designations set out ,
       as appropriate , in Articles 3 or 5 ."
 ---pagebreak---                                           - 13 -
CHAPTER A
Amendments relating to Directives 78 / 1026 / EEC and 78 / 1027 / EEC ( mutual
recognition of diplomas , certificates and other evidence of format qualific ¬
ations as veterinary surgeon and coordination of provisions Laid down by Law,
regulation or administrative action in respect of the activities of
veterinary surgeons )
                                        Article 15
The second paragraph of Article . 2 of Directive 78 / 1026 / EEC is hereby replaced
by the following :
          " Where a diploma , certificate or other evidence of formal
            qualifications as listed in Article 3 was awarded before the
            implementation of this Directive , or was awarded after that date
            but following training commenced before that date , it shall be
            accompanied by a certificate from the competent authorities of the
            issuing country stating that it complies with Article 1 of
            Directive 78 / 1027 / EEC ."
                                        Article 16
Article 3 of Directive 78 / 1026 / EEC is hereby amended as follows :
          1 . Under "( j )   in    Greece "   the    text is replaced by the
              following :
              "l IÎTUXLO KTTlVLaTpLKrie I
              ( diploma of veterinary surgeon from the faculty of geotechnical
              sciences of the Aristotle University of Saloniki or the School
              of    veterinary     medicine      of    the  Aristotle  University of
              Saloniki )".
          2 . Under "( k )   in    Spain "   the    text is replaced by the
              following :
              m
                'Título de Licenciado en Veterinaria'
              ( university degree in veterinary medicine ) awarded by the
              Ministry for Education and Science or by the rector of a
              university ."
 ---pagebreak---                                                    - 14 -
                                                Article 17
Article 4 of Directive 78 / 1026 / EEC is hereby replaced by the following :
                                              " Article 4
                1 . In the case of nationals of Member States whose diplomas ,
                    certificates and other evidence of formal qualifications do not
                    satisfy all the minimum training requirements laid down in
                    Article 1 of Directive 78 / 1027 / EEC , each Member State shall
                    recognize as being sufficient proof the diplomas , certificates
                    and    other      evidence of       formal  qualifications  in veterinary
                    medicine awarded by those Member States before the implement ¬
                    ation of Directive 78 / 1027 / EEC or awarded after that date but
                    following training commenced before that date, accompanied by a
                    certificate stating that those nationals have effectively and
                    lawfully been engaged in the activities in question for at
                    least three consecutive years during the five years prior to
                    the date of issue of the certificate .
                2 . In the case of nationals of Member States whose diplomas ,
                    certificates and other evidence of formal qualifications as
                    veterinary surgeon do not conform with the qualifications or
                    designations set out in Article 3, each Member State shall
                    recognize as being sufficient proof the diplomas , certificates
                    and other evidence of formal qualifications awarded by those
                    Member States , accompanied by a certificate issued by the
                    competent authorities or bodies . The certificate shall certify
                    that the diplomas , certificates and other evidence of formal
                    qualifications as veterinary surgeon were awarded following
                    training in accordance with the provisions of Directive
                    78 / 1027 / EEC , .       referred to in Article 2 of Directive
                    78 / 1026 / EEC , and are treated by the Member State which awarded
                    them as the qualifications or designations set out in
                    Article 3 ".
                                                Article 18
The following new paragraph 5 is hereby added to Article 1 of Directive
78 / 1027 / EEC :
              " 5 . As a transitional measure and notwithstanding paragraph 2 ,
                    Italy , whose provisions laid down by law, regulation or
                    administrative action provided for a training programme which
                    did not comply fully with that set out in the Annex when
                    Directive        78 / 1026 / EEC and    this Directive took effect , may
                    continue to apply those provisions to persons who commenced
                    their veterinary training not later than 31 December 1984 .
                                                                                        ■ ■ • /• • •
 ---pagebreak---                                               15
                      Each host Member State shall be authorized to require of
                      holders of diplomas , certificates or other evidence of formal
                      qualifications as veterinary surgeon awarded by Italy following
                      training commenced before 1 January 1985 that their diplomas ,
                      certificates and other evidence of formal qualifications be
                      accompanied by a certificate stating that they have effectively
                      and lawfully been engaged in the activities of veterinary
                      surgeon for at least three consecutive years during the five
                      years prior to the date of the issue of the certificate , unless
                      the said diploma,' certificate or other evidence of formal
                      qualifications is accompanied by a certificate issued by the
                      competent Italian authorities stating that it attests to
                      training in full compliance with this Article and with the
                      Annex ."
                                          Article 19
In   the Annex to Directive 78 / 1027 / EEC in the Greek language version under
" B.  Specific subjects " the first indent of " Group 2 : Clinical sciences "
         XeipoupTiirfi    " is hereby replaced by n
                                                          pCU tUT)K *\
CHAPTER 5
Amendments relating to Directives 80 / 154 / EEC and 80 / 155 / EEC ( mutual recogni ¬
tion of diplomas , certificates and other evidence of formal qualifications as
midwife and coordination of the provisions laid down by law , regulation or
administrative action in respect of the activities and exercise of the
profession of midwife )
                                          Article 20
Article 1 of Directive 80 / 154 / EEC is hereby amended as follows :
               1 . Under " in the Federal Republic of Germany " the text is
                    replaced by the following :
                 " 'Hebamme' or ' Entbindungspf léger "
               2 . Under " in Greece " the    text is replaced by the following :
                 " * Μαία      ' ΟΓ ' Μαιευτής · _ "
 ---pagebreak---                                         - 16 -
                                      Article 21
Article 3 of Directive 80 / 154 / EEC is hereby amended as follows :
          1 . Under "( a ) in the Federal Republic of Germany " the first indent
              is replaced, by the following :
                 the 'Zeugnis über die staatliche Prüfung für Hebammen und
                 Entbindungspf leger' , awarded by the State examining board ".
          2 . Under "( h ) in the Netherlands " in all the language versions
              other than the Dutch language version, the term 'vroedvrouw-
              diploma' is replaced by "diploma van ver loskundige ' .
          3 . Under "( i ) in the United Kingdom " the text is replaced by
              the following :
                 a statement of Registration as a Midwife in Part 10 of the
                 register maintained by the United Kingdom Central Council for
                 Nursing , Midwifery and Health Visiting ".
          4 . Under "( j ) in   Greece "   the   text is replaced by the
              following :
            " - Ιήβ ' Πτυχίο Μαίας ή Μαιευτή'
                authenticated by the Ministry of Health and Welfare ,
              - ΐήθ ' Πτυχίο Ανωτέρας Σχολής Στελεχών Υγείας και Κοινωνικής
                  Πρόνοιας , Τμήματος Μαιευτικής »
                issued by the faculty of health and social welfare workers ,
                obstetrics section , of the advanced technical and vocational
                education centres or by the technological training establish ¬
                ments run by the Ministry of Education and Religious Affairs ".
          5 . Under   "( k ) in  Spain "  the    text is replaced by the
              following :
                 the diploma of " asistente obstetrico (matrona) o matrona ",
                 awarded by the Ministry for Education and Science or by the
                 rector of a university ".
                                                                         •• •/* ••
 ---pagebreak---                                                     17 -
                                               Artide 22
 The    following new paragraph 3 is hereby added to Article 5 of Directive
 80 / 154 / EEC :
                " 3 . Without prejudice to Article 4 , in the case of nationals of
                      Member States whose diplomas , certificates and other evidence
                      of formal qualifications as midwife do not conform with the
                      qualifications or designations set out in Article 3 , each
                      Member State shall recognize as being sufficient proof
                      diplomas , certificates and other evidence of formal qualific¬
                      ations awarded by those Member States , accompanied by a
                      certificate issued by the competent authorities or bodies . The
                      certificate shall state that the diplomas , certificates and
                      other evidence of formal qualifications as midwife were awarded
                      following      training    in    accordance   with  the provisions  of
                      Directive 80 / 155 / EEC , referred to in Article 2 of Directive
                      80 / 154 / EEC and are treated by the Member State which awarded
                      them as the qualifications or designations set out in
                      Article 3 ".
                                              Article 23
The following new paragraph 5 is hereby                     added to Article 1 of Directive
80 / 155 / EEC :
               " 5 . Nothing in this Directive shall prejudice any facility which
                      may be granted in accordance with their own rules by Member
                      States in respect of their own territory to authorize holders
                      of diplomas , certificates or other evidence of formal qualific¬
                      ations which have not been obtained in a Member State to take
                      up and pursue the activities of midwife ".
                                              Article 24
In Article 4(6 ) of Directive 80 / 155 / EEC in the Spanish language version the
text is hereby replaced by the following :
               " 6 . llevar       a  cabo  el    parto     normal  cuando  se trate  de  una
                      presentación de vértice , incluyendo , si es necesario , la
                      episiotomia , y , en caso de urgencia , realizar el parto en
                      presentación de nalgas ."
                                              Arti c le 25
In Article 8 of Directive 80 / 155 / EEC in the German language version the text
is replaced by the following :
                                            " Article 8
                 Spätestens sechs Jahre nach Bekanntgabe dieser Richtlinie be-
                 schliesst der Rat auf Vorschlag der Kommission und nach Stellung¬
                nahme des Beratenden Ausschusses , ob die Ausnahme
                 nach Teil B Nummer 3 des Anhangs geändert oder aufgehoben werden
                 so II ".
 ---pagebreak---                                   - 18 -
CHAPTER 6
Final provisions
                                Article 26
Member States shall take the necessary measures to comply with this Directive
by 1 April 1989 .  They shall forthwith inform the Commission thereof .
                                Article 27
This Directive is addressed to the Member States .
Done at Brussels ,                                        For the Council
                                                           The President
 ---pagebreak---                                                                           ANNEX
 Dates from which some Member States abolished the provisions laid down by
 law , regulation or administrative action concerning the issue of the
 diplomas , certificates and other evidence of formal qualifications referred
 to in Article 9 .
BELGIUM
Thoracic surgery                                                 1 January 1983
Vascular surgery                                                 1 January 1983
Neuro-psychiatry                                                 1 August 1987 ,
                                             save for persons having commenced
                                                    training before that date .
Gastro-enterological surgery                                     1 January 1983
DENMARK
Biological haematology                                          1 January 1983 ,
Physiotherapy                                save for persons having commenced
                                             training before that date and who
                                          will complete it by the end of 1988 .
FRANCE
Radiology                                                      5 September 1972
Neuropsychiatry                                                31 December 1971
LUXEMBOURG
Radiology                                 The diplomas , certificates and other
Neuropsychiatry                              evidence of formal qualifications
                                            are no longer issued in respect of
                                        training commenced after 5 March 1982 .
NETHERLANDS
Radiology                                                           9 July 1984
Neuropsychiatry                                                     9 July 1984
 ---pagebreak---                                         w
                           SMALL BUSINESS IMPACT NOTE
1 . ADMINISTRATIVE OBLIGATIONS ON FIRMS RESULTING FROM
    APPLICATION OF THE LEGISLATION                     not applicable
2 . ADVANTAGES TO FIRMS                                not applicable
    - YES /NO
    - SPECIFY
3 . DISADVANTAGES TO FIRMS                              not applicable
    ( additional costs )
    - YES/NO
    - CONSEQUENCES
4 . EFFECTS ON EMPLOYMENT                              not applicable
5 . WERE BOTH SIDES OF INDUSTRY CONSULTED ?            not applicable
    - YES/NO
    - OPINION OF BOTH SIDES OF INDUSTRY
6 . IS THERE AN ALTERNATIVE APPROACH WHICH ENTAILS
    FEWER CONSTRAINTS ?                                not applicable