Direct Request (CEACR) - adopted 2004, published 93rd ILC session (2005)

The Committee notes the Government’s detailed report and attached documentation.

Article 2, paragraph 1, of the Convention. The Committee notes the information that a new sectoral development programme for nursing (2001-05) has been drawn up by the Ministry of Health in consultation with the Inter-Regional Nursing Association. The programme, which is part of the plan for the development of health and medical science approved by the Government in 1997, aims at improving all aspects (legislative, material, technical) of the organization of the work of nursing personnel, refining systems for training and management of nursing staff, raising the professional and social status of nurses, guaranteeing social protection for nursing specialists and assisting the development of professional nursing associations. The Committee would be grateful if the Government would provide in its next report full information on the practical implementation of the programme, its concrete results and any follow-up action.

Article 2, paragraph 2(a). As regards education and training, the Committee notes the Government’s indication that the second sectoral employment assistance programme for medical and pharmaceutical workers (2001-03) has now been completed. The programme, which was drawn up by the Ministry of Health in consultation with the Health Workers’ Union, aimed at promoting employment opportunities for nursing personnel by refining training courses, study programmes and curriculum, improving professional mobility and developing educational standards for specific fields or institutions. While noting with interest the general description of the scope and aims of the programme, the Committee would appreciate receiving documented information on the practical results achieved, including for instance statistics on the number of training courses delivered and health workers trained.

Article 2, paragraph 2(b). The Committee notes the Government’s indication that the nurses’ current system of pay, which is based on the unified wage scale, offers little incentive and therefore consideration is given to the possibility of introducing flexible pay incentive systems which would allow health-care institutions to reward good performance, retain high-quality specialists and stimulate personnel to achieve specific targets. The Committee would be interested in receiving additional information on the evolution of the system and level of remuneration of nursing personnel in light of the difficulty and special characteristics of their profession.

Article 5. The Committee notes from the Government’s report that the participation of nursing personnel in the planning of nursing services is ensured through nurses’ councils traditionally functioning within medical institutions, the institute of nursing specialists which coordinates the work with representatives of the Ministry of Health and health authorities in all federal districts and regions, and the Nursing Council which has been set up within the Ministry of Health. These are all public bodies playing a consultative role in drawing up recommendations on training and employment issues, and in making proposals for laws and regulations relating to the organization of nursing and the introduction of new nursing technology. The Committee would be grateful if the Government would transmit a copy of the text establishing the Nursing Council and regulating its composition and mandate.

Article 7. The Committee notes the Government’s reference to a new programme for the improvement of working conditions and safety and health of health workers (2002-05) set up by the Ministry of Health in consultation with the Health Workers’ Union. The programme is designed to safeguard the occupational safety and health of health workers through legal, organizational, technical and scientific means, assess working conditions in workplaces, provide training, and help to reduce occupational injuries and diseases among health workers. The Committee would welcome all additional information that the Government could provide on the specific steps taken for the realization of the programme and the progress made in this respect.

Moreover, the Committee notes that according to the Government’s report 39 new documents relating to the occupational safety and health of health-care personnel currently exist in draft form. The Committee requests the Government to give a detailed account in its next report of any new legislative or administrative instruments which may have entered into effect in these matters, including provisions or measures relating to the protection of nursing personnel against HIV infection.

Part V of the report form. The Committee notes the statistical information provided by the Government according to which in 2003 there were 1,388,349 medical personnel, including 923,560 nurses, while 150,000 to 200,000 of those health-care workers (or 13 to 15 per cent) leave the nursing profession every year. The Committee would be grateful if the Government could continue supplying information on the application of the Convention in practice, including for instance statistics on the number of students attending nursing schools and the number of nurses leaving the profession, copies of official reports or research studies examining the evolution of the socio-economic status of nursing personnel, as well as any practical difficulties encountered in the implementation of the Convention (e.g. delays in paying wages in the health sector, increase of occupational diseases among medical workers, etc.).