Nursing Personnel Convention, 1977 (No. 149) - Venezuela (Bolivarian Republic of) (Ratification: 1983)

Observation (CEACR) - adopted 2018, published 108th ILC session (2019)

The Committee notes the observations of the National Union of Workers of Venezuela (UNETE), the Confederation of Workers of Venezuela (CTV), the General Confederation of Labour (CGT) and the Confederation of Autonomous Trade Unions (CODESA), received on 26 September 2018. The Committee also notes the observations of the Independent Trade Union Alliance Confederation of Workers (CTASI), received on 29 August 2018. The Committee requests the Government to provide its comments in this respect.

Articles 2(2)(b) and 5(2) of the Convention. Determination of conditions of employment by negotiation between the employers’ and workers’ organizations concerned. In response to the Committee’s previous comments, the Government indicates that the following are applicable to nursing personnel: the Basic Labour Act on men and women workers (LOTTT); the Third Collective Agreement of 2002 between the Ministry of Health and Social Development and its autonomous institutes and the Federation of Nurses of Venezuela; the Collective Labour Agreements agreed in the Labour Standards Meetings held from the 2013 and 2015 Labour Policy Meetings; and the 2018 Health Sector Agreement. The Committee notes that the Government has provided a copy of the Third Collective Agreement of 2002 between the Ministry of Health and Social Development and its autonomous institutes and the Federation of Nurses of Venezuela and the 2018 Health Sector Agreement, which regulate conditions such as hours of work, weekly rest and paid annual holidays, and the payment of special bonuses and compensation, respectively. However, the Committee notes that the workers’ organizations UNETE, CTV, CGT and CODESA assert that, following the approval of the Executive Resolution implementing the single wage scale for all public administration workers from September 2018, more than 90 per cent of the collective agreements concluded in the health sector have fallen into abeyance, as these include more advantageous wage scales. They also indicate that the enforcement of the single wage scale eliminates the payment of bonuses and other labour benefits set out in the collective agreements. The Committee also notes the CTASI’s indication that the number of nursing staff emigrating to other countries in search of better working conditions has increased. The Committee requests the Government to indicate the measures adopted or envisaged to provide nursing personnel with employment and working conditions, including career prospects and remuneration, which are likely to attract persons to the profession and retain them in it (Article 2(2)(b)). It also requests the Government to indicate the measures taken or envisaged with a view to holding negotiations with workers’ and employers’ organizations to determine the conditions of work and employment of nursing personnel (Article 5).

Articles 2 and 7. Employment and occupational safety and health of nursing personnel. In its previous comments, the Committee requested the Government to provide its response to the observations of the CTV, in which the CTV indicated that the working conditions of nursing personnel have deteriorated along with the whole infrastructure of the public health system in the country, in particular in large urban hospitals, including in maternity units and children’s hospitals. The CTV also indicated that murders, harassment and dismissals on the grounds of protests had occurred among nursing personnel and in the emergency services, which are regularly victims of crime and violence. In this regard, the Committee notes the Government’s indication in its report that article 68 of the Constitution of the Bolivarian Republic of Venezuela and section 487 of the LOTTT recognize the right of men and women workers to demonstrate, in accordance with the law, which has been respected by the competent authorities. The Government adds that, despite the fact that discussions are ongoing regarding an agreement to improve the living conditions of workers in the health sector, a group of nursing professionals, including the Executive Board of the Nursing College of the Capital District, failed to comply with the agreements established in round tables in which legitimately representative trade unions and the competent authorities had participated. The Government adds that, through the Neighbourhood Mission (Barrio Adentro), progress has been made regarding the establishment of a comprehensive and efficient Public National Health System. The Government reports that 24 hospitals were built and 200 operating theatres were renovated between 2000 and 2014. However, the Committee notes the CTASI’s allegations in its observations regarding a lack of medical supplies in the country’s health centres, precarious working conditions in hospitals (where there is allegedly a shortage of water and food), threats to nursing personnel and a lack of fair wages. Furthermore, the CTASI affirms that, as a result of the above-mentioned precarious conditions, on 25 June 2018, there was a work stoppage by nursing personnel in the public sector. Lastly, the Committee notes that, in its concluding observations of 7 July 2015, the Committee on Economic, Social and Cultural Rights (CESCR) noted with concern “the reports regarding the critical situation of the healthcare system …, due to the severe shortage and irregular supply of medicines and surgical and medical equipment. It is further concerned at the poor state of repair of some hospitals and the reported lack of medical personnel” (E/C.12/VEN/CO/3, paragraph 27). The Committee therefore requests the Government to adopt the necessary measures, in consultation with the social partners, with a view to developing and implementing a policy concerning nursing services and nursing personnel designed, within the framework of a general health programme and within the resources available for healthcare as a whole, to provide the quantity and quality of nursing care necessary for attaining the highest possible level of health for the population (Article 2). Furthermore, observing that the Government has not responded to the comments of the CTV regarding the alleged cases of murder, harassment and dismissals as a result of protests by nursing personnel and the emergency services, the Committee reiterates its request to the Government to send its comments in this respect (Article 7).

Article 4. Legislation on the requirements for the practice of nursing. In its previous comments, the Committee requested the Government to indicate whether the implementing regulations of the Act concerning the provision of professional nursing care (Official Gazette No. 38263 of 1 September 2005) and the regulations relating to the minimum remuneration received by nursing personnel in the private sector had been adopted. In this regard, the Government indicates that the fixing of minimum wages for nursing personnel is currently being discussed by the Federation of Professional Nursing Colleges of the Bolivarian Republic of Venezuela and the body responsible for health with a view to updating and adapting wages to the current situation in the country. However, the Committee observes that the Government has not indicated in its report whether the implementing regulations of the Act concerning the provision of professional nursing care have been adopted. The Committee requests the Government to provide information on the outcome of the negotiations held with a view to fixing the minimum wages of nursing personnel. Furthermore, the Committee once again requests the Government to indicate whether the implementing regulations of the Act concerning the provision of professional nursing care have been adopted and, if so, to provide a copy.

Part V of the report form. Application in practice. The Committee requests the Government to provide detailed and updated information on how the Convention is applied in practice, including statistical information on the numbers of nursing personnel, disaggregated by sex, area of activity, training level and function , the ratio of nursing personnel to population, the number of persons who enrol in nursing schools and leave the profession each year, copies of official reports or studies on nursing services and information on any practical difficulties experienced in the application of the Convention, such as the lack or migration of nursing personnel.

Direct Request (CEACR) - adopted 2013, published 103rd ILC session (2014)

Article 2, paragraph 2(b) and Article 5(2) of the Convention. Determination of conditions of employment by negotiation between employers’ and workers’ organizations concerned. The Committee understands that a new collective agreement applicable to public health workers, including nursing personnel, was signed in August 2013. However, the Committee notes that the Office has not received a copy of this collective agreement. The Committee therefore requests the Government to supply a copy of the collective agreement currently in force for nursing personnel.

Article 4. Legislation concerning the requirements for the provision of nursing care and nursing services. The Committee recalls that the Act concerning the provision of professional nursing care (Official Gazette No. 38263 of 1 September 2005) mentions implementing regulations and, in section 22, regulations relating to the minimum remuneration received by nursing personnel in the private sector. The Committee requests the Government to indicate whether these regulations have been adopted and, if so, to provide copies.

Article 7. Occupational safety and health. The Committee notes the comments by the Confederation of Workers of Venezuela (CTV) received on 30 August 2013 and forwarded to the Government on 16 September 2013. In expressing its deep concern, the CTV indicates that working conditions of nursing personnel have deteriorated in the same way as the whole infrastructure of the public health system in the country, in particular in large urban hospitals. The CTV also specifies that maternity units, hospitals for children and working conditions of their personnel have deteriorated significantly. Murders, harassment and dismissals on the grounds of protests have been registered among nursing personnel and in the emergency services, which are regularly victims of crime and violence. The Committee requests the Government to forward any comments it wishes to make in response to the observations of the CTV.

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

Article 2, paragraph 2(b), in conjunction with Article 5, paragraph 2, of the Convention. Determination of conditions of employment by negotiation between employers’ and workers’ organizations concerned. The Committee notes the Government’s indication that public sector nursing personnel were covered by a collective agreement discussed at the meeting concerning labour standards in the health sector of the national public service. It notes that this agreement regulated employment in this sector during the 2006–08 period. The Committee requests the Government to supply a copy of the collective agreement currently in force for nursing personnel in the public sector and also of any similar collective agreement applicable to nursing personnel in the private sector.

Article 4. Legislation concerning the requirements for the provision of nursing care and nursing services. Further to its previous comment, the Committee notes the adoption of the Act of 26 July 2005 concerning the provision of professional nursing care (Official Gazette No. 38263 of 1 September 2005), which regulates, inter alia, the requirements for the provision of nursing care and nursing services – following the decision taken between 1985 and 1990 to professionalize and gradually raise the required level of study – remuneration, penalties for infringements and also the powers of the Federation of Professional Nursing Associations (FCPEV) and its bodies. It also notes that this Act mentions implementing regulations (to be adopted 180 days after the entry into force of the Act) and also regulations relating to minimum remuneration received by nursing personnel in the private sector drawn up by the FCPEV and the health ministry. Since these regulations are not available to the Office, the Committee requests the Government to supply a copy. The Committee would also be grateful to receive more detailed information on requirements for the teaching and training of nursing personnel and also on any teaching or training programme drawn up further to the adoption of the new Act. Finally, the Committee requests the Government to indicate whether – and, if so, how – competent professional bodies have been involved in the formulation and implementation of the new policy and the general principles applicable to the nursing profession in the fields of teaching, training and the exercise of the profession.

Part V of the report form. Practical application. The Committee requests the Government to provide a general description of the manner in which the Convention is applied 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 – and the nurse-to-population ratio, the number of persons entering and leaving the profession each year, copies of official reports or studies relating to nursing services, information concerning any practical difficulties encountered in the implementation of the Convention, such as understaffing or migration of nursing personnel, etc.

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

The Committee notes the information contained in the Government’s last report and the attached documentation.

Article 2, paragraph 2(b), in conjunction with Article 5, paragraph 2, of the Convention. Further to its previous comment regarding the establishment of wage scales for nursing personnel, the Committee notes the Government’s indication that wage scales are provided for in section 24 of the collective agreement concluded in 2002 between the Ministry of Health and Social Development (MSDS) and the Federation of Nurses Associations (FCEV). Noting that, as provided for in section 92, the 2002 collective agreement was to remain effective for a period of two years, the Committee would be grateful to the Government for forwarding a copy of any new agreement which may have replaced it in the meantime. It would also appreciate receiving copies of any similar collective agreement currently in force for nursing staff employed in the private sector.

Article 4. The Committee notes the Government’s indication that the Bill on Nursing Personnel is currently before the Permanent Commission for Social Development, for discussion and approval. Considering the importance of such legislation for the development of the nursing profession and the improvement of nursing care services in the country, the Committee hopes that the Government will adopt the said Bill shortly and will attach a copy to its next report.

Article 7. The Committee notes the Government’s statement that Decision No. 439 of the Ministry of Health and Social Development is still in force. Additionally, the Committee notes with interest the legal opinion No. 71 of the Legal Department of the Ministry of Labour, which complements Decision No. 439 and specifies the constitutional and other guarantees concerning the employment protection of HIV-infected persons. The Committee would thank the Government for continuing to provide information on any new measures taken or envisaged in order to improve the occupational safety and health conditions of nursing personnel.

Part V of the report form. The Committee notes with interest the study provided by the Government giving an estimate of the budgetary implications of the increase of the various wage supplements and benefits provided for in the 2002 collective agreement for nursing personnel. The Committee would be grateful if the Government would supply in its next report all available information on the practical application of the Convention, including, for instance, statistics on the nurses/population ratio, the evolution of the nursing workforce both in rural and urban areas, the number of students enrolled in nursing schools and the number of persons leaving the nursing profession every year, copies of official reports or recent studies examining the employment and working conditions of nursing personnel, etc. The Committee would particularly appreciate receiving general information on any broader difficulties affecting the health sector (e.g. redundancies, internal or international migration of nursing personnel, shortage of qualified nurses, salary reductions, delayed payment of wages, loss of purchasing power of wages).

Direct Request (CEACR) - adopted 1999, published 88th ILC session (2000)

The Committee notes the information provided by the Government in its report, in particular with regard to the application of Article 5 of the Convention.

Article 2, paragraph 2(b). In its earlier comment the Committee asked the Government to supply information on the establishment of wage scales for nursing personnel, provided for in Clause No. 33 of the collective agreement between the Venezuelan Social Insurance Institute (IVSS) and the National Federation of Health Workers (FETRA SALUD). It notes that the Government supplies no information in this regard in its last report. The Committee trusts that the Government will be able to indicate in its next report the progress achieved in respect of this question.

Article 4. The Committee notes the Government's indication that the Bill on nursing has been partly amended by the Executive and is at present under discussion before the Congress of the Republic. It hopes that the Government will state in its next report that this Bill has been adopted.

Article 7. The Committee notes with interest the publications sent by the Government in its last report on the measures regarding care of patients suffering from sexually transmitted diseases, and HIV/AIDS. It also notes the information supplied in the document submitted by the Nursing Association of Venezuela, on the adoption of Decision No. 439 of the Ministry of Health and Social Assistance, which prohibits the obligation to present proof of HIV antibodies, unless it is clinically or epidemiologically justified, or without the express, clear and free agreement of the person concerned. The Committee trusts that the Government will indicate in its next report the measures adopted or envisaged, regarding the maintenance of employment relations of nursing personnel infected or possibly infected with HIV, for example adoption of conditions of work, confidentiality of test results, recognition that the cause of infection was occupational, etc.

Part V of the report form. The Committee notes the information supplied in respect of the number of nursing personnel. It trusts that the Government will continue to supply further indications regarding the application of the Convention in practice.

Direct Request (CEACR) - adopted 1995, published 82nd ILC session (1995)

The Committee notes the information supplied by the Government during a direct contacts mission organized in September 1994.

Article 2, paragraph 2(b), of the Convention. The Committee notes Decree No. 193 of 27 May 1994 to supplement Decree No. 3245 of 26 January 1994 and to establish a new classification for the majority of nursing personnel. It hopes, as the Government has proposed, that the wage scales to be established by the joint committee provided for in clause 33 of the collective agreement between the Venezuelan Social Insurance Institute (IVSS) and the National Federation of Health Workers (FETRA SALUD), will be communicated shortly.

Article 4. The Committee notes that the Bill on nursing has not yet been published. It asks the Government to provide a copy of it as soon as it has been adopted. Please also provide information on any developments with regard to university qualification requirements for nursing personnel.

Article 5, paragraph 1. The Committee notes that there have been no developments in nursing service planning by the Health Steering Committee (Comisión Rectora de Salud). It hopes that the Government will shortly be able to report on progress in this respect.

Article 5, paragraph 3. The Committee notes that the disputes with nursing personnel were settled by means of conciliation with intervention by the Directorate of Health Sector Disputes and the Office of the Public Prosecutor. Please state whether the parties concerned were consulted on the matter, in both the public and the private sectors.

Article 7. The Committee asks the Government to indicate the measures taken or contemplated to improve existing legislation on occupational health and safety by adapting it to the special nature of nursing work and of the environment in which it is carried out. In addition, with reference to its general observation of 1990, which it repeated in 1994, the Committee asks the Government to indicate the measures taken or contemplated, in consultation with the employers' and workers' organizations concerned, to take into account the particular risk of accidental exposure to the human immunodeficiency virus (HIV) among nursing personnel: for example, conditions of work, confidentiality of test results, recognition that the cause of infection was occupational, etc.

Point V of the report form. The Committee requests the Government to continue to provide the statistics and other information required under this point.

Direct Request (CEACR) - adopted 1994, published 81st ILC session (1994)

The Committee notes the Government's detailed report, in particular on Article 1, paragraph 3; Article 3, paragraph 4 and Article 3, paragraphs 1 and 2. It would be grateful if the Government would provide additional information on the following points.

Article 2, paragraph 2(b) of the Convention. The Committee notes Presidential Decree No. 2039 of 26.12.1991 to implement a new salary scale for administrative staff and technical assistants, applicable also to nursing personnel. It further notes that on 28.02.1992 the Nursing Association of Venezuela (Colegio de Enfermeras) was registered as a trade union organization, to represent its members in discussions with the Ministry of Health and Social Assistance to conclude collective agreements, and that a study was being undertaken to determine the classification of nursing personnel. The Committee would be grateful if the Government would send the new classification, once established.

As far as remuneration of nursing personnel who are not public employees is concerned, the Committee notes the collective agreement between the Venezuelan Institute for Social Security (IVSS) and the National Federation of Health Workers (FETRASALUD). The Committee requests the Government to communicate a table of salaries, to be established by the bipartite committee under clause No. 33 of the collective agreement.

Article 4. The Committee notes that the draft Act on the Practice of Nursing is still under consideration. It hopes that it will soon be enacted and asks the Government to keep it informed about any progress in this respect. The Committee also notes the information on academic qualifications of nursing personnel and asks the Government to inform it about future developments.

Article 5, paragraph 1. The Committee notes the information on the composition and functioning of the Health Board (Comisión Rectora de Salud) and the participation of representatives of nursing personnel in this body. It would be grateful if the Government would continue to communicate information about any developments in the planning of nursing services which are taking place in this Board.

Article 5, paragraph 3. The Committee notes from the Government's report that conflicts with nursing personnel have been resolved through methods of negotiation juridically based on the Law of the National Health System, the Labour Law and the present Convention, which together have allowed the settlement of the conflicts in a manner which was positive for the nursing personnel. The Committee asks the Government to indicate what machinery has been used in practice for the settlement of disputes, what bodies were involved and to which methods, such as negotiations, mediation, conciliation and voluntary arbitration they had recourse in the individual case.

The Committee takes note of the information supplied by the Government under point V of the report form. It asks the Government to continue to supply in the future reports on statistics and other information as required by this point of the report form.

Direct Request (CEACR) - adopted 1993, published 80th ILC session (1993)

The Committee notes that the Government's report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the following matters raised in its previous request:

Article 2, paragraph 2(b), of the Convention. Further to its previous comments, the Committee notes the repeal of Resolution No. G-74 of 11 December 1979, and the adoption of a number of other legal texts concerning the levels of remuneration of public service employees and nursing personnel in the public sector, which appear to be comparable. It also notes the information on the classification of nursing personnel and the new measures envisaged in this respect. The Committee hopes that the Government will continue to indicate in future reports any progress achieved in this connection. The Committee recalls that in its previous comments it asked for information of the remuneration of nursing personnel who are not public employees. As no such information has been provided in the report, the Committee again requests the Government to provide it in the next report.

Article 4. The Committee notes that the draft Act on the Practice of Nursing has not been adopted. Please indicate whether it is still under consideration. The Committee notes the information supplied on academic qualifications for the practice of nursing.

Article 5, paragraph 1. The Committee notes the information supplied by the Government on the Health Board (Comisión Rectora de Salud) and on the participation of the Nursing Association (El Colegio de Profesionales de Enfermería) as representatives of nursing personnel on the Board. Please indicate how this ensures their participation in the planning of nursing services.

Article 5, paragraph 3. The Government's report appears to indicate that the settlement of disputes in the public sector is achieved through informal methods based on dialogue with the professional association of nurses and, in other cases, in conformity with the relevant provisions of the Labour Act. The Committee requests the Government to supply additional information on the application in practice of the Convention on this point.

Article 1, paragraph 3, Article 2, paragraph 4, and Article 3, paragraphs 1 and 2. The Committee notes the Government's reply to its previous comments which appears to indicate that there are no nurses in Venezuela who give nursing care and services on a voluntary basis, though the "Damas Voluntarias" (Volunteer Ladies) keep sick persons company and ensure that they follow their treatment. The Committee would appreciate receiving confirmation that these groups are not used to provide nursing care and nursing services.

The Committee takes note of the information supplied by the Government under point V of the report form. It requests the Government to continue to supply in its future reports the statistics and other information as required by point V of the report form.

Direct Request (CEACR) - adopted 1991, published 78th ILC session (1991)

Article 2, paragraph 2(b), of the Convention. Further to its previous comments, the Committee notes the repeal of Resolution No. G-74 of 11 December 1979, and the adoption of a number of other legal texts concerning the levels of remuneration of public service employees and nursing personnel in the public sector, which appear to be comparable. It also notes the information on the classification of nursing personnel and the new measures envisaged in this respect. The Committee hopes that the Government will continue to indicate in future reports any progress achieved in this connection. The Committee recalls that in its previous comments it asked for information of the remuneration of nursing personnel who are not public employees. As no such information has been provided in the report, the Committee again requests the Government to provide it in the next report.

Article 4. The Committee notes that the draft Act on the Practice of Nursing has not been adopted. Please indicate whether it is still under consideration. The Committee notes the information supplied on academic qualifications for the practice of nursing.

Article 5, paragraph 1. The Committee notes the information supplied by the Government on the Health Board (Comisión Rectora de Salud) and on the participation of the Nursing Association (El Colegio de Profesionales de Enfermería) as respresentatives of nursing personnel on the Board. Please indicate how this ensures their participation in the planning of nursing services.

Article 5, paragraph 3. The Government's report appears to indicate that the settlement of disputes in the public sector is achieved through informal methods based on dialogue with the professional association of nurses and, in other cases, in conformity with the relevant provisions of the Labour Act. The Committee requests the Government to supply additional information on the application in practice of the Convention on this point.

Article 1, paragraph 3, Article 2, paragraph 4, and Article 3, paragraphs 1 and 2. The Committee notes the Government's reply to its previous comments which appears to indicate that there are no nurses in Venezuela who give nursing care and services on a voluntary basis, though the "Damas Voluntarias" (Volunteer Ladies) keep sick persons company and ensure that they follow their treatment. The Committee would appreciate receiving confirmation that these groups are not used to provide nursing care and nursing services.

The Committee takes note of the information supplied by the Government under point V of the report form. It requests the Government to continue to supply in its future reports the statistics and other information as required by point V of the report form.

Direct Request (CEACR) - adopted 1990, published 77th ILC session (1990)

The Committee notes with regret that the Government's report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the following matters raised in its previous direct request:

Article 2, paragraph 2(b), of the Convention. 1. Please indicate the measures that have been taken concerning classification under sections 1 (single paragraph) and 3 of Resolution No. G-74 of 11 December 1979 and supply the most recent information on the classification of nursing personnel.

2. Please indicate the manner in which the remuneration of nursing personnel covered by Resolution No. G-74 has developed since 1979 as compared to the remuneration of other public service employees.

3. Please provide detailed and up-to-date information on the remuneration of nursing personnel who are not public employees, since the collective agreement between the Ministry of Health and the Health Workers' Federation dates from 1979 and makes no specific provision as to the basic wage payable to nursing personnel.

Article 4. Please state whether the draft Act on the practice of nursing, drawn up by the Venezuelan College of Nursing Service Professionals, has been adopted and, if so, please provide a copy of the text. If not, please indicate the statutory academic qualifications required in practice by the public administration and private hospitals for the practice of the profession.

Article 5, paragraph 1. Please indicate the attributions of the Health Board which, according to the previous report, ensures the participation of nursing personnel in the planning of nursing services. Please indicate also the responsibilities and membership of the College of Nursing Service Professionals.

Article 5, paragraph 3. The Committee has noted from the previous report that the settlement of disputes involving nursing personnel was sought through discussions with the professional associations and unions. Please indicate whether any other procedures are followed in settling disputes arising in connection with the determination of the conditions of employment of nursing personnel, the manner in which they were established and whether the representative organisations of nursing personnel were consulted on the establishment of these procedures.

Article 1, paragraph 3, Article 2, paragraph 4, and Article 3, paragraphs 1 and 2, of the Convention, and point V of the report form. Please supply the information requested under the above provisions of the Convention in the report form.