Direct Request (CEACR) - adopted 2009, published 99th ILC session (2010)

Nursing Personnel Convention, 1977 (No. 149) - Poland (Ratification: 1980)

Article 2, paragraph 1, of the Convention. National policy concerning nursing services and nursing personnel. The Committee notes the Government’s indication that the National Parliament is currently working on a package of acts regulating health-care issues and that these acts are expected to operate a reform of the health-care system and produce positive impact on all persons employed within the system, including nurses and midwives. While remaining concerned about the unresolved crisis experienced by the public health-care sector in recent years, the Committee requests the Government to provide in its next report full particulars on all legislative developments regarding the announced reform of the health-care system and to transmit copies of all relevant texts.

Article 2, paragraph 2. Employment and working conditions of nursing personnel. The Committee understands that there is an important migration flow of nurses towards other European countries such as Italy and the United Kingdom, the flow which is primarily connected with low wages, poor working conditions and the threat of unemployment. It also understands that some thought appears to be given to policies to encourage the return of emigrants, in particular medical professionals, as reflected for instance in the policy recommendations on this issue presented by the Institute of Public Affairs in September 2006. The Committee therefore requests the Government to provide specific information on the extent of the migration phenomenon in the health sector and on any programmes, campaigns or other measures taken or envisaged to address this issue.

Article 4. Requirements for practice of nursing profession. The Committee notes the Government’s reference to the Ordinance of the Minister of Science and Higher Education of 12 April 2007, concerning education standards for individual fields of study and levels of education. In particular, it notes the Government’s indication that each graduate of higher nursing and midwifery school must now be approved by the Minister of Science and Higher Education based on an opinion of the State Commission for Accreditation, and be accredited by the Minister of Heath, on the basis of an opinion of the National Council for Accreditation of Medical Education. Recalling that under section 12.2 of the Act of 5 July 1996 concerning the professions of nurse and midwife, the authorization to practise is to be granted by the district board of nurses and midwives, the Committee requests the Government to clarify whether the Ordinance of the Minister of Science and Higher Education of 12 April 2007 repealed or otherwise modified the provisions of the Act of 5 July 1996.

Article 5. Collective bargaining and dispute settlement. Further to its previous comments on the serious wage dispute which has been affecting the Polish health-care system for many years, the Committee notes the Government’s reference to the Act of 22 April 2006 on transfer of funds, which allocated the necessary resources to finance salary increases to health-care service providers that took place in 2006 and 2007. It also notes the Government’s indication that with respect to claims arising from the so-called “Act 203”, as of 31 January 2008, liabilities to employees had been satisfied in 99.99 per cent of the cases. While noting the Government’s explanations, the Committee understands that, since its last comment in 2005, the situation in the health sector has remained tense and occasionally escalated to protracted and even radical protest action (for instance, warning strikes in April–May 2006, the four-week strike movement of June 2007 known as the “white village protest”, etc.). In this connection, the Committee wishes to recall that Article 5(2) of the Convention calls for negotiations between employers’ and workers organizations for the determination of conditions of employment and work of nursing personnel while Article 5(3) requires recourse to negotiations or to independent and impartial machinery for the settlement of disputes with a view to making it unnecessary for the organizations representing nursing personnel to resort to such other protest action which might be potentially harmful to the well-being of patients and the operation of medical centres. While reiterating the importance of constant and open social dialogue, as required by this Article of the Convention, the Committee requests the Government to continue supplying detailed information on the evolution of the situation, particularly as regards any direct negotiations or recourse to such third-party settlement procedure as mediation, conciliation or arbitration and the results obtained.

Part V of the report form. Application in practice. The Committee notes the statistical information provided by the Government showing the yearly evolution of the number of nursing training places and of the amount of subsidy per training place. The Committee requests the Government to continue supplying up to date information concerning the application of the Convention in practice, including, in particular, the number of students currently enrolled in nursing schools, the nurse-to-population ratio, copies of official reports or studies analysing the situation in the nursing care sector, etc.