Direct Request (CEACR) - adopted 2005, published 95th ILC session (2006)

Nursing Personnel Convention, 1977 (No. 149) - Latvia (Ratification: 1993)

The Committee notes the Government’s report and wishes to draw its attention to the following points.

Article 2, paragraph 2(b), of the Convention. Further to its previous comments concerning the poor pay conditions in the nursing care sector which are mainly responsible for the sharp decrease of the nursing workforce in recent years, the Committee notes that the Government envisaged to increase the monthly average earnings of medical nurses from 125 to 178 lats (US$335) by December 2003. The Committee would be grateful if the Government would provide up-to-date information on the remuneration levels currently practised both in the public and the private sectors and to indicate any additional incentives, financial or other, designed to retain qualified nurses in the profession. In this connection, the Committee notes with concern recent press reports according to which nursing personnel consider joining the strike movement for higher pay and shorter working hours launched by anaesthetists in September 2004. According to some accounts, the current monthly wage for a nurse working a full shift is 173 euros before tax, while some 50 to 60 per cent of nurses perform extra work outside the normal working hours without receiving 100 per cent pay premium for overtime as laid down in section 68(1) of the new Labour Law. Moreover, the non-competitive working conditions in the Latvian health-care sector seem to promote the migration of medical specialists to Western Europe and concerns are being expressed that workers in poorly funded public service sectors, such as health care, education and science, might be particularly affected by this "brain drain". The Committee wishes to receive the Government’s views on the situation and the measures it intends to take in the short term to reverse this trend.

Articles 3 and 4. The Committee notes the information on the basic requirements of nursing education, the number of medical schools offering secondary medical education, the functions of the coordinating agency at the Ministry of Health and the procedures for registration and certification of medical practitioners. In this respect, the Committee would appreciate receiving copies of Cabinet Regulation No. 337 of 6 August 2002 and Ministry of Health Order No. 150 of 10 June 2003 which were not appended to the Government’s report and are not available at the Office. In addition, the Committee notes that the Government intends to reorganize public medical schools into higher vocational educational institutions in an effort to render the programmes of higher nursing education more attractive and consequently improve the status and reputation of the nursing profession as a whole. The Committee asks the Government to keep it informed of any concrete steps taken to this end in consultation with the Latvian Nurses Association, the Latvian Midwives Association and other interested professional organizations.

Article 5, paragraph 2, and Article 6. The Committee notes the Government’s statement to the effect that nursing personnel enjoy the same protection as other workers covered by the Labour Law of 20 June 2001 in matters of hours of work (sections 130 to 140), weekly rest (sections 141 to 144), paid holidays (sections 149 to 152), educational leave (section 157), maternity leave (section 154), sick leave and social security. The Committee also notes that a general agreement was concluded on 6 March 2002 between the Ministry of Welfare and the Health and Social Care Workers’ Trade Union in respect of the working conditions of nursing personnel employed in social care institutions under the supervision of the Ministry of Welfare. The Committee requests the Government to provide a copy of the above agreement and to report on any progress made with regard to collective bargaining in all other public health-care establishments as well as in private medical centres.

Article 7. The Committee notes the Government’s reference to Cabinet Regulation No. 328 of 23 September 1997 which prescribes measures to limit HIV-infection risk among medical practitioners. As this text is unavailable at the Office, the Committee requests the Government to forward a copy.

Part V of the report form. The Committee notes the statistical information provided by the Government in its report concerning the number of medical practitioners, including nurses and midwives, in the period 2000-01. It also notes the Government’s statement that within the last ten years the nursing workforce has decreased almost by half due to low pay, difficult socio-economic conditions and the depreciation of the nursing profession. The Committee would be grateful to the Government for supplying additional information on any concrete efforts to address the problem of the shortage of nurses. Moreover, the Committee would appreciate receiving all available information on the practical application of the Convention, including, for instance, statistics on the nurse-to-population ratio, the number of students attending nursing schools and the number of nurses leaving or joining the profession, copies of official reports or research studies examining the employment and working conditions of nursing personnel, etc.