Cross-border mobility of specialized nurses - two Dutch hospitals in borderregions

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The cross-border mobility of specialized nurses (gespecialiseerde verpleegkundigen) is a particular one. Access to that profession in the Netherlands is not subject to the recognition of qualifications because the profession is not regulated by law, meaning the European directive on recognition does not apply. In theory, this would mean that one could start working immediately. However, Dutch health care actors have set quality standards which only foresee one national qualification as meeting the standard. The Dutch Ministry of the Interior and Kingdom relations has asked ITEM to research the cross-border mobility of specialized nurses in some Dutch health care institutions.

The issue arose from practice. A Dutch hospital located in the border region is facing shortages of specialized nurses. Cross-border employment is often suggested as a way to remedy such shortages. Nevertheless, quality standards may form obstacles to the employment of other EU Member State professionals.

ITEM’s research delves into this issue by focusing on two Dutch hospitals located in the Zeeland and Limburg border regions. The goal of the research is to find out about the status and influence of quality standards and the actors involved, as well as to provide solutions to facilitate the cross-border mobility of specialized nurses while maintaining high quality health care.

Directive 2005/36/EC is the EU-instrument for the recognition of qualifications. Nurses are guaranteed automatic recognition when the directive’s criteria are fulfilled. However, not all nurses are covered by the directive. Centred on the term “regulated profession”, Directive 2005/36/EC only applies to professions for which qualification requirements are set by law. Specialized nurses first obtain a basic nursing qualification that falls under the directive’s system for automatic recognition. They subsequently follow additional education and training to qualify as specialized nurses. This latter profession is not regulated by law in the Netherlands.

 

The fact that the profession of specialized nurse is not regulated by law means that recognition is not required and equally Directive 2005/36/EC is not applicable. Nevertheless, specialized nurses and their potential employers are confronted with quality standards set by various actors in the Dutch health care sector. Only one particular Dutch qualification is foreseen as fulfilling the Dutch quality standards. What consequences does this have for the cross-border mobility of specialized nurses? This question is central to ITEM’s research carried out on behalf of the Dutch Ministry of the Interior and Kingdom relations.