European directives & Dutch practice

European directives &

Dutch practice

Committee Foreign Degree Holders Health Care Advice Committee to the Minister of Health in the Netherlands

Central Agency for Information on Health Care Professions Warsaw, Poland, April 15th 2004, Mr. Niels P. Wijkhuijs, secretary

Process of RecognitionForeign Degree Holders Health Care

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Content

Sectoral Directives & General System

Dutch numbers in 2002

Dutch infrastructure

Dutch actors

Cases (after break, with Mrs. d’Artillac Brill)

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Sectoral Directives & General System (I)

European Union (EU): agreements on the

recognition of qualifications

General System

Sectoral Directives

Applications from outside the EU

decision on application important to other member states

European Economic Area (EEA)

EU + Norway, Liechtenstein, Iceland + Switzerland

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Sectoral Directives & General System (II)

General System:

First Directive (89/48/EU)

Second Directive (92/51/EU) GeneralSystem

Third Directive (99/42/EU)

not Sectoral Directives-professions mutual trust of EEA-member states in their training and

diploma but in case of ESSENTIAL DIFFERENCES:

adaptation period aptitude test

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Sectoral Directives & General System (III)

Sectoral Directives Health Care:

Doctor (93/16/EU) Pharmacist (85/432/EU and 85/433/EU) Dentist (78/686/EU and 78/687/EU) Midwife (80/154/EU and 80/155/EU) Nurse (77/452/EU and 77/453/EU)

diploma automatically recognized by member states specific diploma mentioned in Sectoral Directive training’s structure and content is (roughly) harmonized

within EEA-member states

ACQUIRED RIGHTS possible in case not all conditions are fulfilled for automatic recognition

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Sectoral Directives & General System (IV)Acquired Rights

‘3 years out of 5 years’-experience

“in the case diplomas (…) do not satisfy all the minimum training requirements,

each member state shall recognize these diplomas as sufficient proof (…) when

accompanied by a certificate stating that [a national] 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.”

Doctor section 9, par. 1 (93/16/EU)

Pharmacist section 6, par. 1 (85/433/EU)

Dentist section 7, par. 1 (78/686/EU)

Midwife section 5, par. 1 (80/154/EU)

Nurse section 4, par. 1 (77/452/EU)

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Sectoral Directives & General System (V)Acquired Rights

‘declaration from competent authorities’

“in the case diplomas (…) do not confirm with qualifications or designations (…),

each member state shall recognize as sufficient proof the diplomas (…),

accompanied by a certificate issues by the competent authorities of bodies,

stating that diplomas (…) were awarded following training in accordance with

(summarized) ‘training requirements’ (…).”

Doctor section 9, par. 5 (see also 42b) (93/16/EU)

Pharmacist section 6, par. 2 (see also 18b) (85/433/EU)

Dentist section 7, par. 3 (see also 23b) (78/686/EU)

Midwife section 5, par. 3 (see also 19b) (80/154/EU)

Nurse section 4, par. 2 (see also 18b) (77/452/EU)

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Sectoral Directives & General System (VI)‘Third Countries’

“member states shall examine diplomas (…) in the field covered by

the Directive, obtained by the holder outside the EU in cases where

those diplomas (…) have been recognised in a member state, as well

as of training undergone and/or professional experience gained in a

member state.”

Doctor section 42c (93/16/EU)

Pharmacist section 18c (85/432/EU)

Dentist section 23c (78/686/EU)

Midwife section 19c (80/154/EU)

Nurse section 18c (77/452/EU)

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Sectoral Directives & General System (VII)Challenge for the accession countries:

Implementation of General System & Sectoral

Directives in own law

Infrastructure for decision making on

applications and registration: e.g. decision within terms!

e.g. motivation of decision and appeal

e.g. costs, documents, information et cetera

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(Numbers I)

Sectoral Directives (number of registered

practitioners in the “BIG-register” with a Sectoral

Directive-diploma)

doctor 531pharmacist 22dentist 170midwife 69nurse 371

Total 1163

Dutch numbers in the year 2002

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(Numbers II)

Sectoral Directives (number of “not-regular-

cases”)

doctor 13pharmacist 2dentist 10midwife 2nurse 23

Total 50

Acquired Rights (possibility)


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(Numbers III)

General System (number of applications for

a training title)

physiotherapist 16psychotherapist/psychologist health care 6assistant nurse 2occupational therapist 9speech therapist 2radiographic laboratory worker 2podiatrist 1dental hygienist 1assistent pharmacist 5

Total 44


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(Numbers IV)

Number of applications from outside EEA

doctor 303pharmacist 15dentist 134midwife 14nurse 147physiotherapist 15psychotherapist/psychologist health care 4assistant nurse 11occupational therapist 6speech therapist 2radiographic laboratory worker 10dental hygienist 2assistent pharmacist 5

Total 668


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(Numbers V)

Applications from outside EEA - accession countries

Doctor (303) 31 eq. 114 a.e. 158 n.e.Poland (28) 7 eq. 19 a.e. 2 n.e. Hungary (6) 6 a.e.Czech Rep. (1) 1 a.e.Slovakia (3) 1 a.e. 2 n.e.

Pharmacist (15) 2 eq. 13 n.e.Poland (1) 1 eq.Lithuania (1) 1 eq.

Dentist (134) 18 eq. 54 a.e. 62 n.e.Poland (6) 1 a.e. 5 n.e.Hungary (1) 1 a.e.Czech Rep. (1) 1 n.e.Lithuania (2) 2 n.e.Latvia (1) 1 n.e.


eq. =

equivalent

a.e. =

almost

equivalent

n.e. =

not

equivalent

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(Numbers VI)


Midwife (14) 14 n.e.Poland (5) 5 n.e.Hungary (1) 1 n.e.

Nurse (147) 28 eq. 29 a.e. 90 n.e.Poland (14) 3 eq. 2 a.e. 9 n.e.Hungary (3) 3 n.e.Czech Rep. (4) 2 a.e. 2 n.e.Slovakia (4) 3 eq. 1 n.e.Lithuania (3) 3 n.e.Estonia (2) 2 n.e.

Physiotherapist (15) 3 eq. 3 a.e. 9 n.e.Poland (1) 1 n.e.Hungary (2) 1 a.e. 3 n.e.


eq. =

equivalent

a.e. =

almost

equivalent

n.e. =

not

equivalent

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(Numbers VII)


Psychotherapist/psychologist health care (4) 1 eq. 1 a.e. 2 n.e.

Czech Rep. (1) 1 a.e.

Assistant nurse (11) 1 eq. 10 n.e.Poland (1) 1 n.e.

Radiographic laboratory worker (10) 2 eq. 8 n.e.Poland (1) 1 n.e.Czech Rep. (1) 1 n.e.

Assistent pharmacist (5) 2 eq. 3 n.e.

Poland (1) 1 eq.


eq. =

equivalent

a.e. =

almost

equivalent

n.e. =

not

equivalent

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Infrastructure (I)

Individual Health Care Act (“BIG-act”)

regulation of quality in Dutch health care

Aim “BIG-act” promote and safeguard the quality of

professional practice in individual health care protect patients from unprofessional treatment

Two categories of regulated professions in “BIG-act”:

Professions with ‘registered titles’ Professions with ‘training titles’

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Infrastructure (II)

doctorpharmacistdentist Sectoral Directives-professionsmidwifenursephysiotherapistpsychotherapist General Systempsychologist health care

registration in legal “BIG-register”

Numbers in “BIG-register”

Professions (8) with ‘registered title’

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Infrastructure (III)

Registrations February 1st 2004 “BIG-register”

doctor 56.690 pharmacists 4.970 dentists 9.842 midwife 2.836 nurse 226.517 physiotherapist 33.924 psychotherapist 6.020 psychologist health care9.709

350.508

Professions (8) with ‘registered title’

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Infrastructure (IV)

assistant nursedental prothesis makerskin therapistoccupational therapistspeech therapistpodiatristorthoptistoptometristMensendieck therapistCesar therapistradiographic laboratory worker (therapeutic/diagnostic)dental hygienistdieticianassistent pharmacist

no legal register no legal disciplinary rules

Professions (14) with ‘training title’

General

System

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Infrastructure (V)Individual Health Care Act (“BIG-act”)

(besides the regulation of Dutch health care professions)

Implementation of

the Sectoral Directives and

the General System

“BIG-act”-chapter foreign degree holders

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Infrastructure (VI)“BIG-act”-chapter foreign degree holders

1. ‘Regulation on the Registration of Foreign

Health Care Qualifications’

(contains list of Sectoral Directive-diplomas

and possible bilateral agreements)

direct application for

registration in “BIG-register”

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Infrastructure (VII)Registration in “BIG-register”:

Dutch diploma completed and signed application form original diploma or certified copy payment of registration fee (€ 59,-)

EEA diploma (sectoral directives) completed and signed application form original diploma/certificate letter of good conduct copy of passport payment of registration fee (€ 59,-)

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Infrastructure (VIII)“BIG-act”-chapter foreign degreeholders

2. ‘Application for a Declaration of Professional

Competence’

‘Not-regular-case’ Sectoral Directive

General System-cases

Applications from outside the EEA

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Infrastructure (IX)Declaration of Professional Competence: request to Minister of Health

optional:

advice Committee Foreign Degree Holders with

evaluation of the diploma - information on the foreign

educational system - by Nuffic or Colo (Naric)

final decision by Minister of Health

possible appeal:

General Administrative Act

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Infrastructure (X)Declaration of Professional Competence

list of documents for file (compulsory): application form

certified copy of passport

certified copy of the qualification

grades, etcetera

professional course program (hours)

proof of registration (if available)

proof of permit to practice

proof of professional experience, etcetera

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Infrastructure (XI)Declaration of Professional Competence

possible results: ‘Not-regular-cases’ Sectoral Directive:

registration in “BIG-register” or other

General System:

equivalent or essential differences:

adaptation period

aptitude test

Applications from outside EEA:

equivalent, almost equivalent or not equivalent

(conditional) registration “BIG-register” add. training

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Actors (I)- Ministry of Health

recognition of qualifications of medical professions

regulation of ‘Training requirements and Areas of Competency’

of the “BIG-act”-professions

- Ministry of Education (+ training institutes) training/education

In case of adjustments in ‘training requirements’:

negotiations between these two ministries

- Ministry of Social Affairs

work permit (not for EEA)

- Ministry of Justice residence status (not for EEA)

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Actors (II)

“assignment of executive power”

Ministry of Health in the Netherlands

Information and Referral Desk Foreign Degree Holders

Department Declarations of Professional Competence

“BIG-register”

Other departments

Central agency: Centre for Information on Health Care Professions

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Actors (III)

4 Members (+ 4 deputy-members), appointed by the Minister of Health: 2 (+ 2) members from the training/educational institutes 2 (+ 2) members from the professional organizations

Department Declarations of Professional Competence

Bureau of Foreign Degree Holders: “decision on application”

Secretariate Committee Foreign Degree Holders: “advice”

Chairman Committee Foreign Degree Holders

Members of the Committee Foreign Degree Holders

(176 members)

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Actors (IV) Information and Referral Desk Foreign Degree Holders

“BIG-register”

Help desk Staff Registration desk

General information on the application of a foreign degree

holder (telephone and personal) Referral to “BIG-register” in case of Sectoral Directive-

diploma

Registration of Dutch diplomas (8 professions) Registration (automatically) of Sectoral Directive-diploma Registration in case of positive decision on application of

professional competence

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Public information restricted to the following information:

whether a person is registered whether a person is recognised as a specialist and for

which specialism whether the registration is suspended and for how long whether part of the competence is revoked whether conditions apply and for how long

Actors (V) “BIG-register”

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Information & questions:

Mr. N. (Niels) P. Wijkhuijs, secretary

Committee Foreign Degree Holders Health Care

PO Box 16114

2500 BC The Hague

The Netherlands

Telephone: 0031-70-3406156

Fax: 0031-70-3405105

E-mail: [email protected]

Website: www.buitenlandsediplomahouders.nl

(English pages under construction)

CCCBBBGGGVVV

European directives & Dutch practice

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