The Directive on the Recognition of Professional Qualifications aims to facilitate the free movement of EU citizens by making it easier for professionals qualified in one Member State to practise their profession in another. The Directive covers all professions, for example vets and architects, and not just healthcare.
Download the NHS European Office's briefing on the new proposals for the recognition of professional qualifications
The European Commission published new proposals to revise the EU Directive on the mutual recognition of professional qualifications on Monday 19 December 2011.
The proposals followed months of extensive discussions with stakeholders about the existing Directive, which governs the movement of professionals - including doctors and nurses - across the EU.
The new proposals are intended to make it easier for people to practise in other European countries, though they do recognise that more stringent measures need to apply to health professionals to protect patients.
Draft Directive
The draft Directive introduces:
• a warning system so that regulatory bodies across Europe must warn each other if (for example) a doctor or nurse has been struck off or suspended from the register. If the individual then turns up and tries to register in another country, the authorities in that country will be forewarned.
• a right for regulatory bodies to check the language skills of health care professionals – something for which UK health organisations have been pressing.
• new procedures for updating the list of qualifications which will be recognised in future, aimed at ensuring they meet the minimum training requirements needed to deliver safe, modern services.
The proposals also seeks to introduce a voluntary professional card, which is an electronic certificate which regulatory authorities could exchange securely over the internet. The European Office continues to have concerns about how realistic and workable the proposals for such a card will be.
The full EU proposal can be read here.
The NHS European Office has been heavily involved in this Directive throughout its review and has published a briefing outlining the key issues for NHS organisations. Download it here or email kate.ling@nhsconfed.org if you want a hard copy.
The Health Service Journal has also published an article by the European Office on the proposed changes to the Directive. You can read the article here.
Next steps
These proposals will now pass through the usual EU legislative procedure, being scrutinised by the European Parliament and the Council of Ministers throughout 2012. The NHS European Office will continue to engage throughout this process to ensure the agreed Directive takes account of the particular nature of the health sector.
Our earlier influencing work on professional mobility
The House of Lords' Inquiry
The House of Lords' Social Policies and Consumer Protection EU Sub-Committee has reported on its Inquiry into the mobility of health professionals, which will heavily influence the UK government's position on the review of the EU Directive. The NHS European Office submitted evidence to the Inquiry on 17 June, restating its call for stricter standards for healthcare workers compared with other professionals covered by the EU Directive. The Inquiry report cites the European Office's submission on several occasions.
The evidence submitted was based on the recent consultation exercise the NHS European Office ran with the NHS to inform its response to the European Commission consultation in January 2011.
The Inquiry recommended that:
• regulatory bodies should be allowed to test the language skills of ALL non-UK applicants
• an alert mechanism should be implemented so that authorities can share fitness to practise information and warn each other about practitioners who have been subject to disciplinary proceedings
• the list of qualifications and skills recognised by the EU Directive must be updated.
Influencing both sides of the Channel on the review of this Directive is particularly important for the NHS and the European Office will continue to lobby on behalf of the NHS in the coming months.
Read our submission to the Lords Sub-Committee here.
The European Commission Green Paper
The NHS European Office responded to the European Commission's Green Paper on a revised Recognition of Professional Qualifications Directive, calling for stricter checks on the movement of European healthcare workers.
The main proposals outlined in the Green Paper included a professional card, partial access, reviewing the scope of regulated professions and making information and applications procedures available online. In addition, the Commission proposed to further facilitate temporary mobility, to change the education levels and provisions for compensation measures, expand IMI and modernise the system for automatic recognition a three-phase process.
The NHS European Office responded to the Green Paper on behalf of the NHS, calling for:
• the minimum qualifications standards required for professionals to practice across Europe to be updated
• regulatory bodies across Europe to have access to a shared electronic system to exchange information about professionals and their qualifications
• the introduction of a more rigorous warning system that requires regulatory bodies across Europe to alert their counterparts if they take action against fraudulent or incompetent doctors or healthcare professionals
• all EU countries to ensure they require health professionals to keep their skills up to date, rather than being admitted to a professional register for life
• the avoidance of any relaxation on checks for migrating professionals, for example by allowing those who are qualified in one specialised area to practice in general areas of medicine.
The full response can be found here.
For more information on this Directive please contact: Kate.ling@nhsconfed.org.
The summary document the European Office produced on the earlier EU consultation provides helpful background to the issues proposed.
A recent history
For five healthcare professions - doctors, dentists, nurses, midwives and pharmacists - there is a system of automatic recognition whereby certain qualifications (listed in an Annex to the Directive) are deemed to satisfy a minimum level of equivalence. Professionals holding one of these qualifications and currently registered with a "competent authority" (i.e. regulatory body, such as the General Medical Council) in one EU country can register to practise in any other EU country, without having to satisfy further tests or formalities.
Automatic recognition of qualifications under the Directive is about granting access to professional registration, not about suitability to undertake a particular job. It is up to employers to ensure, as part of the recruitment process, that the applicant has the necessary skills and competences to perform the role for which they are applying.
Concerns have been expressed for some time about the competence of some European health professionals - both their clinical competence and their communication (English language) skills. Indeed, the House of Commons Health Select Committee recommended in April 2010 that "as a matter of extreme urgency, the Government seek to make necessary changes to Directive 2005/36/EC before it is due to be revised in 2012, to enable the GMC to test the clinical competence of doctors and undertake systematic testing of language skills". The UK Government has publicly committed to ensuring that foreign healthcare professionals are not allowed to work in the NHS unless they have proven their competence and language. The European Commission recognises that there have been problems implementing the Directive and that parts of the Directive need to be changed or updated.