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16 October 2012 – Health First Europe attended a roundtable event jointly organised by the European Federation of Nurses (EFN) and the European Parliament to discuss professional qualifications for nurses.  This issue is currently being debated in the European Parliament as part of the Directive 36 (known as the Professional Qualifications Directive).  The event brought together a variety of stakeholders, including Members of the European Parliament, representatives of Member State health ministries and permanent representations as well as nurses and EU health organisations to present the diverse positions of stakeholders and to better understand the impact of this directive on the nursing profession and patients.

The roundtable was opened by MEP Mario Pirillo (S&D, Italy) who is a Shadow Rapporteur on Directive 36, in conjunction with his colleague, MEP Bernadette Vergnaud (S&D, France) who is the Rapporteur for Directive 36.  The MEPs outlined the key issue at stake in the debate which centres on the number of years of general education which would be required for a person to be recognised as a nurse in the EU. The Commission proposal sets out a minimum requirement of 12 years of general education.  However, some Member States currently have in place systems which only require 10 years of general education to go into the nursing profession. The assistant to Ms. Vergnaud explained that in order to remedy this dispute, she suggests that Member States are given a transition period to implement the new regulation, or, as proposed by MEPs Andreas Schwab (EPP, Germany) and Ana Weisgerber (EPP, Germany), to allow for two possible routes of education for nurses – one level of competencies for a nurse with 10 years of general education, and another level of competencies for a nurse with 12 years of general education.

Following this introduction, multiple stakeholders were given three minutes each to provide their opinion regarding Directive 36.  Thierry Lothaire, from the Belgian Nurses Association, argued for one level of education to support the efficiency of structural reform.  While Ms. Reka Kovacs from the Hungarian Permanent Representation, declared that Hungary could not support the proposal of the Commission for 12 years of education because Hungary believed the proposal to be based on years of education rather than competencies.  The representative from the Dutch government, Ms. Leon Van Berkel, argued that two types of nurses are needed (vocational and those with Bachelor’s degrees) and that the definition of general education is extremely important in this Directive in order to clearly understand the overall education nurses are receiving (not based on years).

Speaking on behalf of the nurses, President of EFN Unni Hembre, described the supporting evidence for ensuring the higher level of education of nurses.  She presented RN4Cast, a Commission project, which looked at several nursing variables that can have an impact on quality of care.  In the study, which involved 12 Member States and more than 300 hospitals, the higher education of nurses correlated to lower mortality: for every 10% increase in nurses with Bachelor’s degrees, there was a 7% reduction in patient deaths. She expressed that “the cost of lower patient outcomes is sure to be more costly for Member States than implementing Directive 36.”

Additionally, Monica Kosinska, Secretary General for the European Public Health Alliance, also spoke in favour of the 12 years of education by highlighting the importance of nurses’ education for patient safety.  She declared that we do not want “a race to the bottom” for healthcare professionals especially during times of economic austerity when healthcare budgets are shrinking.  Supporting her statement, MEP Antonyia Parvanova, (ALDE, Bulgaria) considered that if a child begins his/her general education at the age of 4, and has only 10 years of general education before going into nursing, is this person old enough to have this type of responsibility?  She asked the participants, “Is this person ready to take a decision about someone’s life?”

Overall, the debate provided very interesting perspectives not only on the importance of education for nurses, but also the overwhelming importance of nurses for health systems and particularly the safety of patients.  As nurses are typically the primary carer for a patient in a healthcare setting, it is clear that their knowledge, experience and education play a vital role in how that care is delivered and the level of care that is received.