Working across the border as a specialised IC nurse is not a matter of course. For this reason, the Dutch Ministry of the Interior and Kingdom Relations requested Expertise Centre ITEM to study the cross-border mobility of specialised Intensive Care (IC) nurses; more specifically the recognition of diploma's.
In conclusion of its study, ITEM proposed a number of possible solutions related to the formulation of the quality standard, the comparison of training programmes in The Netherlands and Belgium, increased cross-border cooperation in healthcare and a follow-up study.
On Wednesday 7 March, ITEM researcher Lavinia Kortese presented the results of the report, and Prof. dr. Anouk Bollen, Director of ITEM, handed the report to State Secretary of the Interior and Kingdom Relations Raymond Knops during his work visit to the Scheldemond Euregion. During the same visit, Secretary of State Knops accredited Ghent University Hospital as a training location for specialised nurses1.
In the event of shortages in the labour market, the natural solution is to hire staff from across the border. This is no different for IC nurses. The case recently studied by ITEM was practical in nature: a Dutch hospital in the border region was facing a shortage of IC nurses similar to the shortage of Dutch applicants. The logical solution would have been to recruit IC nurses across the border. While Belgian candidates indeed applied for the positions, their appointment did not appear to be evident.
In response to this situation, the Institute for Transnational and Euregional cross-border cooperation and Mobility / ITEM received a request from the Dutch Ministry of the Interior and Kingdom Relations to study the issue of specialized IC nurses, whose mobility seemed to be hindered by the existing quality standard. Quality standards are necessary and common in Dutch healthcare, mainly to ensure a high quality of medical care. For IC nurses, quality is mainly guaranteed by making requirements regarding their qualifications, i.e. demanding a diploma that is recognised by the College Zorgopleidingen (CZO), the Dutch quality supervisor for healthcare education. Such a diploma can currently only be obtained in the Netherlands, meaning that Belgian IC nurses a priori will not meet the standard. How is this handled in practice? How is this regulated by European law? What possible solutions can be proposed? These questions were the focus of the study carried out by ITEM.
The study found that, in practice, it was often decided to have IC nurses with a foreign diploma follow a full or partial CZO-recognized training programme. Such decisions are due to differences between the practical components of the training programmes and the potential consequences of not complying with the applicable quality standard.
The quality standard, which demands a CZO-recognised diploma, was reviewed as to its application of European Law, particularly regarding the recognition of professional qualifications and the free movement of persons. Although the recognition of professional qualifications at European level has been laid down in the Professional Qualifications Directive, the profession of ‘specialised IC nurse’ is not considered a regulated profession. ITEM has found that the quality standard can be considered an impediment to the free movement of workers and an infringement on the right to non-discrimination on the basis of nationality.