Direct Request (CEACR) - adopted 2013, published 103rd ILC session (2014)

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

Article 2 of the Convention. National policy concerning nursing services and nursing personnel. Further to its previous comment, the Committee notes the Government’s reference to the Act of 15 April 2011 on medical activity (Dz. U. No. 112, Text 654) which introduces a major reorganization of the health care system and the functioning of medical institutions. The Government also refers to the Act of 15 July 2011 on nurse and midwife professions (Dz. U. No. 174, Text 1039) which sets out updated standards for nursing education and training and to new postgraduate courses curricula for nurses scheduled to be developed by August 2015. As regards the problem of nursing migration, the Government indicates that in the absence of a mechanism to monitor this phenomenon on the EU scale, the only statistical information available is the number of nurses who have requested and received a certificate of recognition of their qualifications enabling them to practise their profession in any EU Member State, or 806 nurses in 2010, 939 in 2011 and 1,154 in 2012.

In this connection, the Committee notes the comments of the Independent and Self-Governing Trade Union NSZZ “Solidarnosc” dated 19 August 2013, according to which the nurse-to-population ratio in Poland (47 nurses per 10,000 inhabitants) is almost two times lower than the European average while the number of nurses who graduated from nursing schools in 2013 is ten times lower than the number of persons who used to enter the profession several years ago. The NSZZ “Solidarnosc” adds that nurses are overtired, their work is poorly paid, and as a result, migration decisions are dictated mainly by low salaries. In its reply, the Government indicates that efforts are made to render nursing studies more attractive and refers to promotional steps taken under the Human Capital Development Strategy – Health Care 2020 such as publicizing the nursing profession among secondary school students and including the faculties of nursing in the list of government-sponsored fields of studies. While noting the Government’s explanations, the Committee understands that a relatively small number of nurses continue to seek employment abroad – mainly in the United Kingdom, Ireland, Germany, Sweden and Denmark – and that the push factors for such migration are associated not only with wage differentials but also with low job satisfaction caused by limited prospects for professional development and poor working atmosphere in hospitals (see Health systems in transition – Poland health system review, European Observatory on health systems and policies, 2011, page 111). The Committee therefore requests the Government to continue to provide information on any concrete measures aimed at addressing shortages and outward migration of nurses, notably through improving employment conditions and levels of remuneration.

Article 5(3). Collective bargaining and dispute settlement. Further to its previous comments, the Committee understands that the tensions in the health care sector remain high and have resulted in several protest actions in the last two years. The main concerns seem to be the chronic low wages of nurses, increase of workload, restructuring policies and the commercialization of hospitals. Recalling that the settlement of disputes in connection with the terms and conditions of employment of nursing personnel should be sought through negotiation between the parties or through independent and impartial machinery, such as mediation, conciliation and voluntary arbitration, the Committee requests the Government to indicate any measures taken to improve the quality of social dialogue in the particularly sensitive area of public health.