Direct Request (CEACR) - adopted 2023, published 112nd ILC session (2024)

Nursing Personnel Convention, 1977 (No. 149) - Belgium (Ratification: 1988)

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Article 2 of the Convention. Adoption and application of a policy concerning nursing services and nursing personnel. With regard to the impact of the new job classification and pay scale model developed by the Institute of Job Classification (IFIC), the Government indicates in its 2022 report that, when the new pay scale was implemented in the private federal sector in 2018, it proved advantageous for over 90 per cent of nurses in service. The Government states that procedures put in place by the social partners ensure that no worker in service suffers a pay cut, and that anyone can choose whether or not to opt for the new model. The Government adds that the focus has been on raising starting salaries and salaries during the first part of the nursing career, as several studies have shown that many nurses leave the sector after less than 15 years. The Government also considers that the IFIC scale offers greater career development prospects, as it is primarily based on the duties performed and not solely on the level of training or hierarchical function. Moreover, the IFIC scale goes up to 35 years of experience, instead of 27 years (31 years for hospital assistants) under the old scale, thus offering longer-term career prospects. As to the public federal sector, the Government indicates that the implementation of the IFIC classification is under way and that it does not have any data on its impact in this sector. Concerning the healthcare sectors under the jurisdiction of the federated entities, the Government reports that Flanders and the French Community Commission of the Brussels-Capital Region adopted the FIDIC model in 2021. Regarding other measures relating to the policy concerning nursing services and nursing personnel, the Government indicates that in early 2022, the Minister of Social Affairs and Public Health announced his intention to reintroduce a reward for nursing specializations through the introduction of annual bonuses for holders of particular professional titles (TPP) or particular professional qualifications (QPP). The Committee notes that, in view of the growing challenges faced by many societies, such as the ageing population due to longer life expectancies, the explosion in chronic diseases and the emergence of challenges such as pandemics and summer heatwaves, the national policy concerning nursing services and nursing personnel required by the Convention is a crucial aspect of the system that needs to be put in place in order to meet these challenges and guarantee accessibility to care. The Committee therefore requests the Government to continue to provide detailed and up-to-date information on the impact of the IFIC model on the remuneration and career prospects for nursing personnel in the private and public sectors, at the federal and federated level. The Government is also asked to provide an evaluation of the reform and to indicate whether it has enabled the necessary (human and financial) reinvestment in the qualification (students applying to the profession) but also, and above all, in the retention of qualified nursing personnel, by improving career prospects, making the profession more attractive, and ensuring a better work–life balance. The Committee also requests the Government to indicate how nursing personnel representatives are involved in the implementation and evaluation of the policy concerning them, and how the policy is coordinated with the policy concerning other aspects of health, including through the evaluation of attractiveness, talent retention, quality of working life and quality of care. The Government is also asked to provide information on any new measures aimed at improving working conditions, career prospects and remuneration for nursing personnel, including the announced reintroduction of a bonus rewarding nursing specializations.

Articles 3 and 4. Right to exercise the profession. With regard to the impact of Institutional Agreement for the Sixth State Reform of 11 October 2011, which transferred the issue of care provider accreditation to the federated entities, the Committee notes that 7,056 nursing visas were issued in 2018, compared to 5,828 in 2021. Based on the information provided by the Government, the Committee also notes that in 2021, 64 per cent of nursing visas were issued in the Flemish Community, compared to 35 per cent in the French Community and 0.2 percent in the German-speaking Community. The Committee requests the Government to continue to provide information, including statistical data, disaggregated, if possible, by federated entity and sex, on the number of people joining the profession each year.

Part V of the report form. The Committee asks the Government to continue to provide further information on the application of the Convention in practice and to specify the nurse-to-population ratio in the federated entities, as well as the number of nursing personnel in the public and private sectors respectively.