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

The Committee notes the Government’s first report on the application of the Convention and wishes to draw its attention to the following points.

Article 2, paragraph 1, of the Convention. National policy concerning nursing services and nursing personnel. The Committee notes that under sections 67 and 68 of the Law amending the Law on the health system (Act No. VIII-946 of 1 December 1998), the formulation of national health policies is carried out primarily by two bodies, namely, the National Health Board, which acts as an advisory body for the Parliament and the Government, and the State Health Commission, which acts as a coordinating body among government entities for the formulation of policy measures and the implementation of relevant legislation. It understands that the Parliament has adopted the Lithuanian Health Programme 1997–2010 while the Government has adopted the Implementation Strategy of Health Care Reform’s Aims and Objectives. This strategy, however, does not appear to contain any policies, programmes or activities specifically targeted to nursing personnel. The Committee therefore requests the Government to provide a copy of the Health Programme 1997–2010 and to elaborate on its implementation and the results achieved with respect to nursing personnel. It also asks the Government to explain how the ongoing health-care reform is expected to affect the quality and quantity of nursing care.

Article 2, paragraph 2. Employment and working conditions of nursing personnel. The Committee notes the Government’s indication that working hours, working conditions, remuneration levels, job descriptions and internal procedures for nurses are regulated by internal rules approved by the heads of health-care institutions in consultation with the employers’ and workers’ organizations concerned, such as the Union of Lithuanian Nursing Managers (ULNM) and the Lithuanian Nursing Specialists Organization (LNSO). Recalling that the Convention calls for measures designed to render the nursing profession attractive, including reasonable career prospects and levels of remuneration that take account of the constraints and hazards inherent in the profession, the Committee would appreciate receiving the Government’s views as to whether nursing personnel is currently offered employment and working conditions (including possibilities of professional advancement and financial benefits) that are likely to incite young persons to join the profession or retain qualified nurses in it. It would also request the Government to provide sample copies of internal rules regulating the working conditions in health establishments.

Article 2, paragraph 3. Consultations with social partners. The Committee notes the Government’s indication that representatives of the ULNM and the LNSO are included in the panel of the Ministry of Health and a standing working group on nursing issues, both set up in 2009, for the examination of questions such as the draft Law on nursing practice, licensing, skill development, safe working environment, workload and trade union representation. It would be grateful if the Government would provide more detailed information on the organization and activities of the panel as well as on the operation of the standing working group and any practical results obtained so far.

Article 5, paragraph 1. Participation of nursing personnel in planning. The Committee notes the Government’s reference to section 47 of the Labour Code (Act No. IX-926 of 4 June 2002) generally providing for the employee’s right to information and consultation. According to the Government’s explanations, the information and consultation processes deal with issues related to the internal administration of an enterprise, including, for instance, its current and future activities and important decisions concerning financial and labour matters. Recalling that the Convention requires that nursing personnel be not merely kept informed but rather actively involved in the elaboration and application of policies and general principles regarding the nursing profession, the Committee requests the Government to provide additional information on any specific measures to this effect.

Part V of the report form. Application in practice. The Committee understands that the country experiences a serious problem of nurse migration with 45 per cent of all licensed nurses being reportedly registered in other countries, mainly in Western Europe. The Committee would be grateful if the Government would provide in its next report up to date information on the manner in which the Convention is applied in practice, including for instance statistics on the number of students entering or graduating from nursing schools, the number of nurses registered with the State Health-care Accreditation Agency (VASPVT), the nurse–population ratio, copies of any relevant collective agreements, measures or initiatives to contain or reverse the nurse migration trend, etc.