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Brian Edwards CBE
Emeritus Professor
Healthcare Development,
University of Sheffield, UK
Former President
HOPE (European Hospital and Healthcare Federation),
Brussels, Belgium
Both the European Parliament and the Commission have been busy working out how to update the 2005 Directive on the recognition of professional qualifications.
It is vital, claimed Bernadette Vergnaud, the rapporteur on this subject for the Parliamentary Committee on the Internal Market, that professional mobility was made easier as a stimulus to competitiveness and employment within the EU.(1)
Despite the fact that a legal framework has been in place since the 1970s, mobility remains low and many of the complaints to ‘EU Solvit Centres’ relate to problems in securing recognition of professional qualifications that will allow a professional to work in another country within the EU.
The planned European Professional Card will help, but will not remove, all the blockages. New problems will be generated as planning progresses to update the training requirements for pharmacists, nurses, midwives and architects and the number of professions covered by the automatic recognition scheme is expanded.
A recent study in Spain uncovered some of the hidden barriers generated by professional colleges that have made membership a mandatory requirement for practice, sometimes without an adequate legal foundation. In some cases, autonomous communities in Spain have their own rules that place a geographic boundary on approvals and that make transfer difficult, even within a national territory. Some colleges have discriminatory or excessive entry charges or demand deposit bonds prior to approval to practice. Setting mandatory scale fees is seen as anti-competitive, as are unreasonable rules about the advertising of professional services.
The authors of this report want the Spanish government to monitor colleges to ensure that they adhere to EU competition rules. They want a single register for the entire country for those professions that are subject to mandatory college membership. Mandatory membership itself, they argue, has to be justified rigorously and argued on the basis of over-riding public interest.
The Spanish barriers are not very different from those that exist in other countries, which is why it is proving so difficult to get this Directive to work.
Other problems relate to the grounds for removing an individual from practice in cases of misconduct or incompetence. Some countries and some professions take a stronger line than others in upholding agreed standards. At least the regulatory bodies across Europe are now telling each other when a professional is barred from practice.
This is tough policy territory, which is proving difficult to fix with a Directive.
Many of the barriers have been built up and consolidated over many years. Sometimes the barriers have been simple protectionism, but it cannot be denied that this has often had the effect of protecting patients from poor or unscrupulous practice.
One must wonder whether the economic benefit from this political energy is worthwhile. The number of professionals who want to practice outside the country in which they qualified must be very small. In any case, some countries want to keep the health professionals that they have trained to treat their own populations.
It is not going to be an easy nut to crack but it will keep the politicians busy.
Reference
- Draft report on a proposal for a Directive on the recognition of professional regulation.2011/0435. www.europarl.europa.eu/oeil/popups/ficheprocedure.do?lang=en&reference=2011/0226%28COD%29 (accessed 15 November 2012).
