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

Nursing Personnel Convention, 1977 (No. 149) - Portugal (Ratification: 1985)

Article 2, paragraphs 1–3, of the Convention. Formulation and implementation of a policy for nursing services and nursing personnel. The Committee notes the detailed information supplied in the Government’s report and also the attached documentation. Further to its previous comments concerning nursing personnel employed under precarious conditions, the Committee notes the information supplied by the Government indicating positive developments in the number of professionals working in the health sector. It notes that, under section 1 of Legislative Decree No. 276-A/2007 of 31 July 2007 amending the status of the national health service, services within establishments governed by the national health service may, in order to satisfy urgent staff requirements and on an exceptional basis, award fixed-term contracts for a maximum of one year, according to a simplified selection procedure. The Committee recalls that on a number of occasions it underlined the need to take steps to stabilize the situation of contracted personnel who had been admitted to the public service in an irregular, precarious and inappropriate manner, in order to satisfy the ongoing requirements of the services. It therefore requests the Government to indicate: (i) the number of persons still in a precarious situation in the health sector; and (ii) the steps taken or contemplated to stabilize the employment situation of contracted personnel.

Furthermore, with regard to the technical committees for training of nursing personnel and training in medical technologies, to which the Government referred in its previous report, the Committee notes the statement to the effect that these committees do not exist at present but that the Ministry of Science, Technology and Higher Education is continuing to cooperate with the Ministry of Health with regard to nursing personnel. It also notes the establishment in the context of the Bologna Accord of a joint commission for the supervision of nursing personnel and the definition of the education to be provided for them. The Committee requests the Government to supply further information on the work undertaken by this commission and also on any new measure adopted, in consultation with the employers’ and workers’ organizations concerned, with regard to education and training for nursing personnel.

Moreover, the Committee understands that a project was established between 2005 and 2007 to assist immigrant nurses, particularly by permitting the validation of the knowledge of these nurses, who at present work in a number of public health institutions. The Committee requests the Government to supply more detailed information on the implementation of this project and the results achieved, particularly its impact on the conditions of work of foreign nursing personnel. The Committee also requests the Government to provide information, especially statistical data, on the number of foreign nursing personnel currently working in the country and the conditions in which they are recruited.

Finally, the Committee notes the study published in October 2004 concerning the conditions of work of Portuguese nursing personnel. This study, conducted by the Faculty of Human Sciences of the Portuguese Catholic University, at the request of the nursing association, analyses the various elements which have a positive or negative impact on the well-being of nursing personnel. It reveals that the areas posing the most problems for nursing personnel are: occupational safety and health conditions, deficient equipment, working hours and workload, and internal staff movements. The analysis of the situation of nursing personnel also shows that there is a desire to see improvements in conditions of work, particularly with regard to further training, human relations, technical conditions, hours of work and pay. The Committee requests the Government to provide information on any action contemplated in the light of the conclusions of this study.

Article 2, paragraph 4. Consultation with employers’ and workers’ organizations. Further to its previous comments concerning the operation of regional health administrations, the Committee notes that the Government has not supplied any information in this respect. It previously noted the Government’s indication that information was being collected and would be sent to the Office as soon as possible. The Committee once again requests the Government to supply detailed information concerning (i) the working of regional health administrations and (ii) the coordination of health policies.

Article 5, paragraph 2. Determination of conditions of employment and work through collective bargaining. The Committee notes the copies of the collective agreement and enterprise agreements sent by the Government in its report. It also notes the statement that, with regard to the public sector, the rights to collective bargaining and participation provided for by Act No. 23/98 of 26 May 1998 regulating collective bargaining and the participation of employees in public administration, are not expressed in the conclusion of collective labour agreements but in effective bargaining and participation by workers in establishing and amending their staff regulations and also in implementing these amendments. The Committee requests the Government to continue to supply up to date information on the working of collective bargaining in the nursing sector.

Article 7. Occupational safety and health. The Committee notes Resolution No. 105/2004 of the Council of Ministers establishing a national action plan for the prevention of occupational risks, which appears to restrict action by the Ministry of Health to matters relating to protection against ionizing radiation. It emphasizes the fact that nursing personnel also face the risk of contamination by HIV/AIDS in the course of their duties. In this regard, the Committee wishes to draw the Government’s attention to the Joint ILO/WHO guidelines on health services and HIV/AIDS, published in 2005, with a view to helping health services to strengthen their capacity for providing workers with a healthy and decent working environment, this being the most effective means of reducing the transmission of HIV and improving the provision of care for patients. The Committee would also like to refer to the discussion held at the June 2009 session of the International Labour Conference on “HIV/AIDS and the world of work”, with a view to the adoption of an international labour Recommendation, in particular paragraph 37 of the draft conclusions (see ILC, 98th Session, 2009, Report IV(2), page 310), which states that public health systems should be strengthened, where appropriate, in order to ensure greater access to prevention, treatment, care and support and to reduce the additional strain on public services, particularly on health workers, caused by HIV/AIDS. The Committee requests the Government to keep the Office informed of any new measure taken or contemplated in order to improve the protection of nursing personnel against infectious diseases, including HIV/AIDS.

Part V of the report form. Application in practice. The Committee notes the statistics provided by the nursing association for the 2000–07 period. The Committee requests the Government to continue to supply information on the application of the Convention in practice, including, for example, statistics on the numbers of nursing personnel – by sectors of activity and by levels of training and functions, if possible – the number of persons entering and leaving the profession each year, copies of official reports or studies on nursing services, and information on any practical difficulties encountered in the implementation of the Convention.