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

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

Article 2, paragraphs 1 and 3, of the Convention. Further to its previous comment on this point, the Committee notes that the Government admits that the employers’ and workers’ organizations were not involved in the formulation of the National Health Policy but undertakes to consult the social partners in any future policy formulation. The Committee recalls that the Convention places particular importance on the requirement for full consultations with the employers’ and workers’ organizations concerned not only in the design and implementation of a specific policy for nursing services and nursing personnel but also in the coordination of this policy with broader policies relating to health-care planning. The Committee hopes that the Government will take concrete steps to ensure that the social partners have some influence on the policy decisions affecting nursing services and asks the Government to keep it informed of any practical developments in this regard.

Article 2, paragraph 2. The Committee notes the Government’s indication that no regulations have as yet been issued under section 15(c) of the Nurses and Midwives Act (Revised 1991) concerning the vocational training, examinations and the conduct of examinations in nursing and midwifery. The Government adds, however, that the Seychelles Nurses and Midwives Council (SNMC), which is a statutory body established under section 3(1) of the Nurses and Midwives Act, has recently proposed some new regulations relating to the minimum education and training requirements for registration of nurses and midwives. The Committee would appreciate receiving additional information on any follow-up action in respect of the proposed regulations and requests the Government to transmit a copy of any relevant text as soon as it is adopted. As regards the revised Scheme of Service for the Nursing Cadre, which sets out the classification of nursing posts and outlines the corresponding job summary, minimum entry requirements, salary scales and allowances, the Committee notes that this Scheme applies exclusively to nursing staff employed in the public sector. Recalling that the Convention applies to all nursing personnel, wherever they work, the Committee requests the Government to specify the measures taken or envisaged to ensure that the nursing personnel engaged in the private sector enjoy employment and working conditions including career prospects and remuneration which are likely to attract persons to the profession and retain them in it.

Article 2, paragraph 4. The Committee once again requests the Government to describe how the policy on nursing profession is integrated into a coherent policy framework on health care in general and to specify whether provision is made for consultations with employers’ and workers’ organizations to this effect.

Articles 3 and 4. The Committee notes the information provided by the Government concerning the National Institute of Health and Social Studies and the various programmes it offers in paramedical, biomedical, dental, environmental health, and pharmaceutical sciences, including a three-year course on nursing and an 18-month course on midwifery. The Committee would appreciate receiving additional information on the functioning of the National Institute of Health and Social Studies and the organization of nursing and midwifery studies, including the number of students enrolled to each course and the rate of graduates who are offered salaried employment at the end of their studies.

Article 5, paragraph 1. The Committee notes that according to the information provided by the Government with respect to the composition and mandate of the 13-member Central Management Committee of the Ministry of Health, no representative of the nursing personnel appears to participate in the Committee’s discussions relating to the planning of nursing services. Noting, however, that the Government had previously indicated that the nurses are represented to the Central Management Committee by the Director of Nurses, the Committee requests the Government to provide further clarifications on this point.

Article 5, paragraph 2. The Committee notes the Government’s indication that there have been to date no collective agreements concluded in either the public or private sector in respect of nursing personnel. The Committee would be grateful if the Government could continue to provide in future reports information concerning any collective bargaining effort with a view to determining higher employment and working standards for nursing personnel especially in the private sector.

Article 5, paragraph 3. The Committee notes the Government’s explanations concerning the internal dispute settlement procedure provided for under the Public Service Orders in respect of disciplinary offences. However, the Committee is bound to recall that this Article of the Convention does not refer to disciplinary matters or other individual labour disputes involving nursing staff but to collective disputes arising in connection with the determination of terms and conditions of employment of the nursing profession as such. The Committee requests therefore the Government to provide in its next report more precise information regarding any institutionalized arrangements, as may be available, for the purpose of settling collective disputes through independent and impartial proceedings in a manner that makes it unnecessary for the organizations representing nursing personnel to resort to such other forms of industrial action which may be disruptive to the health services system.

Article 7. Further to its previous comment on this point, the Committee notes the document entitled "Management of health-care worker exposures to HIV and recommendations for post-exposure prophylaxis" which establishes a protocol for effective risk assessment and preventive action with respect to occupational transmission of HIV. The Committee requests the Government to report on the measures taken or contemplated with respect to health-care workers who are infected or considered to be infected by HIV, for instance regarding the confidentiality of test results, the arrangement of working conditions, etc.

Part V of the report form. The Committee notes with interest the statistical information concerning the total number of registered nurses and midwives as at September 2003 as well as the number of persons who have left the profession in the course of that year. It asks the Government to continue to supply the information requested under this point, particularly as regards the number of nursing personnel, by sectors of activity and by levels of training and functions, and their relation to population, to the number of patients and to other manpower in the health field, and also to indicate any practical difficulties encountered in the implementation of the Convention.