Demande directe (CEACR) - adoptée 2004, publiée 93ème session CIT (2005)

The Committee takes note of the information provided in the Government’s detailed report and the attached documentation, in particular the adoption of Legislative Decree No. 229 of 19 June 1999 on the rationalization of the National Health Service pursuant to section 1 of Act No. 419 of 30 November 1998, and of Act No. 251 of 10 August 2000 on nursing and related professions.

Article 2, paragraphs 1 and 2, of the Convention. The Committee notes that following the reorganization of the health system, health care planning is assured through the National Health Plan covering a three-year span which specifies the aims and objectives of integrated local authority health and social welfare services, the basic training needs of nursing staff, as well as the development of human resources. According to the Government’s indications, various institutional changes have taken place redefining the responsibilities of the State and the regions in respect of health matters with a view to furthering decentralization and recognizing the fundamental role of the regions in the programming, organization and management of health services. More concretely, under Constitutional Act No. 3/2001 of 8 March 2001 on amendments to Title V of Part Two of the Constitution and the Agreement of 8 August 2001 between the State and the regions on transfer of resources to the regions and local authorities responsible for human health, the State formulates the principles and objectives in matters of public health but their implementation is the exclusive responsibility of the regions. The Committee requests the Government to continue to supply information on the operation of the new decentralized health structures and its practical implications for nursing personnel, especially in terms of work reorganization, workload and stress, career prospects and remuneration.

Article 3. The Committee notes that the National Health Plan 2003-05 places particular emphasis on promoting and intensifying continuous training activities for nursing personnel, while the National Commission on Continuing Training, established in 2000 and extended on 1 February 2002, introduced lifelong training schemes for the health sector paying particular attention to the harmonization of the national training system with European training standards and requirements. The Government reports that university nursing education has been reformed and that the Ministerial Decree of 2 April 2001 on health professions sets out the specific requirements and academic qualifications for the practice of nursing. The Committee would be grateful if the Government would forward a copy of the National Health Plan 2003-05 and elaborate on its practical implementation and the results obtained in terms of improving the quality of nursing care, promoting knowledge and skill enhancement for nursing personnel and ensuring sufficiently rewarding working conditions for the practice of the nursing profession, especially in the light of the Munich Declaration of the European Health Ministers of June 2000 regarding nursing and midwifery and the WHO European Strategy for Nursing and Midwifery Education.

Articles 5 and 6. The Committee notes the terms of the Integrated National Collective Agreement for the health sector of 20 September 2001, and the National Collective Agreement for the health sector for the financial biennium 2000-01, also dated 20 September 2001. The Committee requests the Government to continue supplying concrete information on special arrangements or benefits, as may be provided for in national laws and regulations or collective agreements, especially in relation to remuneration, working time and social security, which are commensurate to the socio-economic needs and responsibilities of nursing personnel and which take account of the constraints and hazards inherent in the profession.

Article 7. The Committee notes that the Government refers to Legislative Decree No. 626 of 24 September 1994 on workers’ safety and health which identifies specific risks related to exposure to chemical, physical or biological agents and further indicates that the Higher Institute for Prevention and Safety in the Workplace (ISPESL) has produced risk assessment guidelines for the health sector. The Committee also notes the Government’s indication that by a Ministry of Health Decree of 31 December 2002, the National Commission for the Prevention of AIDS and Emerging and Re-emerging Infectious Diseases was reconstituted for one year, among other things, to monitor epidemiological trends particularly with regard to the spread of infections among risk groups. The Committee would appreciate being kept informed of any new measures or initiatives regarding the adaptation of existing laws and regulations on occupational safety and health to the special nature of nursing work.

Part V of the report form. The Committee would be grateful to the Government for supplying detailed information on the practical application of the Convention, including for instance up-to-date statistics on the number of nurses employed in the public and private sectors, the nurse-to-population ratio, the number of students attending nursing schools, the number of nurses prematurely leaving the profession, copies of official publications or studies (e.g. reports of regional health service agencies (ASSR)) addressing labour and employment issues concerning nursing services and nursing personnel, as well as any practical difficulties encountered in the implementation of the Convention.