Nursing Personnel Convention, 1977 (No. 149) - Norway (Ratification: 1989)

Replies received to the issues raised in a direct request which do not give rise to further comments (CEACR) - adopted 2024, published 113rd ILC session (2025)

The Committee notes the information provided by the Government, which answers the points raised in its previous direct request and has no further matters to raise in this regard.

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

Article 2 of the Convention. National policy concerning nursing services and nursing personnel. Further to its previous comment, the Committee understands that the National Health Plan 2007–10 suggests a series of policy measures in partnership with county and municipal authorities with a view to improving the training and continued education, distribution, recruitment and working environment of health-care personnel. In particular, the Committee notes activities such as the “Aksjon Helsefagarbeider” project initiated in 2006, or the “recruitment patrols” initiative started in 2007, with a view to attracting young people to become health-care workers and ensuring that the communities, hospitals and private institutions offer sufficient numbers of places of apprenticeship. It also understands that, as a result of these programmes, the number of young persons who indicated their interest in starting health-care education rose by 7 per cent in 2009. The Committee requests the Government to provide in its next report full particulars concerning these campaigns and the results obtained.

In addition, the Committee notes the Government’s indication that nursing-care programmes are administered at the municipality (for primary health and care services) and the individual hospital and clinic (for specialist health services) levels. In this connection, it understands that the National Health Plan provides for policies and programmes to achieve even distribution of the nursing personnel for these services at different geographical locations and to improve skills and competencies of these workers, but it does not specifically provide for other conditions of service of the nursing personnel. While noting the Government’s indication that the Government does not intervene in the negotiations between the social partners concerning specific conditions of employment, it understands that the National Health Plan 2007–10 was developed and adopted through broad consultations with various bodies including professional organizations. In particular, it understands that the National Health Plan contains an action plan referred to as “Competence Lift 2015”, which aims at increasing the number of health professionals, promoting their continuous education, improving management, providing better working environment and reducing involuntary part-time work. The Committee would be grateful if the Government would elaborate on the implementation of the “Competence Lift 2015” action plan or any other similar programme seeking to improve the quantity and quality of nursing services.

Moreover, the Committee notes the Government’s statement that at present there is no shortage of nurses and that, according to data from Statistics Norway, the employment of nurses is nearly 90 per cent. Available data also indicate that the total number of nurses stands at approximately 70,500 persons and there are no reports about nurses prematurely leaving the profession. The Committee notes, however, that according to an OECD study “Tackling nurse shortages in OECD countries”, published in 2005, there is an estimated shortage of 3,300 nurses in Norway representing 5.4 per cent of practising nurses, and Norway regulates international recruitment of nurses through government-to-government agreements having assigned responsibility for attracting a limited number of foreign nurses to a single government agency. The Committee would appreciate receiving additional explanations in this respect. In this connection, the Committee also notes the Government’s indication that two working groups have been established to analyse future challenges and needs in terms of the health-care workforce, including nurses, and that the reports from these working groups would be delivered in January 2009. The Committee requests the Government to provide more detailed information on the findings and recommendations of the working groups, with special reference to nursing personnel.

Article 5, paragraphs 2 and 3. Settlement of disputes. The Committee understands that the health-care sector has been particularly affected by industrial action over the past few years, initially over pay issues but also in relation to the revision of the Working Environment Act. The Committee also understands that an expert committee was established in November 2007 to examine certain aspects of the organization of working time, such as shift and rotation work, which may have important consequences for female-dominated groups in the health and social care sector. Recalling that the Convention requires that the settlement of disputes arising in connection with the determination of working conditions of nursing personnel should be sought through negotiations or through mediation, conciliation and voluntary arbitration with a view to making it unnecessary for the workers’ organizations to have recourse to other disruptive forms of protest action, the Committee requests the Government to provide an updated account of the industrial relations situation in the nursing sector and the measures taken or envisaged for the settlement of any outstanding disputes.

Article 7. Occupational safety and health of nursing personnel. The Committee notes the Government’s indication that no new measures have been taken in order to adapt existing laws and regulations on occupational safety and health to the special nature of nursing work, as provided for in this Article of the Convention. In this connection, the Committee draws the Government’s attention to the Joint ILO/WHO guidelines on health services and HIV/AIDS, published in 2005, with a view to assisting health services in building their capacities to provide their workers with a safe, healthy and decent working environment as the most effective way both to reduce transmission of HIV and to improve the delivery of care to patients. The Committee wishes also to refer to the International Labour Conference discussion held in June 2009 on “HIV/AIDS and the world of work” with a view to adopting an international labour Recommendation, and in particular to paragraph 37 of the proposed conclusions (see ILC, 98th Session, 2009, Report IV(2), page 310) which provides 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 measures that might be taken or envisaged with a view to further reinforcing the protection of nursing personnel against infectious diseases, including HIV/AIDS.

Part V of the report form. Application in practice. The Committee notes the statistical information provided by the Government concerning the nursing workforce. It would be grateful if the Government would continue supplying up to date information concerning the application of the Convention in practice, including, in particular, the number of students currently enrolled in nursing schools, the nurse-to-population ratio, copies of official reports or studies analysing the situation in the nursing-care sector, etc.

Direct Request (CEACR) - adopted 2008, published 98th ILC session (2009)

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 matters raised in its previous direct request, which reads as follows:

Article 2, paragraphs 1 and 3, of the Convention. In its previous comment, the Committee had asked the Government to indicate the measures taken or contemplated to render the nursing profession more attractive, to slow down the rate of nurses leaving prematurely the profession and to improve the quality of nursing care. In its reply, the Government limited itself to stating that the Directorate of Labour Inspection was not aware of any special measures taken to attract persons to the profession and to retain them in it. The Committee wishes to recall once again the clear requirements of this Article of the Convention and hopes that the Government will take steps to supply in its next report substantive information on these matters. In the light of current challenges facing health-care systems in general, such as rising costs and restructuring of health services, advances in medical technology and work reorganization, or growing workload and stress, the Committee requests the Government to outline the objectives and priorities of its policy concerning nursing services and to elaborate on any time-bound action plan, programme or initiative, designed in consultation with the employers’ and workers’ organizations concerned, with a view to improving the quality of nursing care, promoting knowledge and skill enhancement for nursing personnel and ensuring sufficiently rewarding working conditions for the practice of the nursing profession.

Article 5, paragraph 2. Further to the point raised in its previous comments, the Committee is obliged to reiterate its request for copies of all collective agreements in force regulating remuneration and working conditions of nursing personnel employed in public or private hospitals, nursing homes and medical centres.

Article 5, paragraph 3. In the absence of any reply on this point, the Committee renews its previous request for specific information on dispute settlement procedures applicable to labour conflicts involving nursing personnel.

Article 6. The Committee notes that, according to observations made by the Norwegian Confederation of Trade Unions (LO), the amendment of section 50 of the 1977 Working Environment Act regarding the length of overtime work was proposed to the Parliament without prior consultations with the social partners. In the view of the workers’ organization, the Government has acted in violation of the Convention as it did not offer LO any real possibility to exert influence on the proposal. The Committee would appreciate receiving any comments the Government might wish to make in reply to these observations.

Article 7. The Committee notes the information concerning regulations No. 1322 of 19 December 1997 on protection against exposure to biological factors at work, as amended through to 2003. The Committee requests the Government to provide information of any new measures or initiatives regarding the adaptation of existing laws and regulations on occupational safety and health to the special nature of nursing work.

Part V of the report form. The Committee notes the Government’s statement that there are no statistics available on the number of persons leaving the nursing profession. The Committee trusts that the Government will make every effort to collect and transmit in its next report full particulars on the number of nurses currently employed in public and private health-care institutions, the nurse-to-population ratio, and the number of students attending nursing schools. The Committee would also be grateful to the Government for supplying detailed information on the practical application of the Convention, including for instance copies of official reports or studies addressing labour and employment issues concerning nursing services and nursing personnel, as well as any practical difficulties encountered in the implementation of the Convention.

Direct Request (CEACR) - adopted 2004, published 93rd ILC session (2005)

The Committee notes the information provided in the Government’s report and the attached documentation, in particular the latest amendments to the Working Environment Act No. 4 of 4 February 1977, as well as the observations made by the Norwegian Confederation of Trade Unions (LO).

Article 2, paragraphs 1 and 3, of the Convention. The Committee has been asking the Government to indicate the measures taken or contemplated to render the nursing profession more attractive, to slow down the rate of nurses leaving prematurely the profession and to improve the quality of nursing care. In its reply, the Government limits itself to stating that the Directorate of Labour Inspection is not aware of any special measures taken to attract persons to the profession and to retain them in it. The Committee wishes to remind the Government once again of the clear requirements of this Article of the Convention and hopes that the Government will take steps to supply in its next report substantive information on these matters. In the light of current challenges facing health-care systems in general, such as rising costs and restructuring of health services, advances in medical technology and work reorganization, or growing workload and stress, the Committee requests the Government to outline the objectives and priorities of its policy concerning nursing services and to elaborate on any time-bound action plan, programme or initiative, designed in consultation with the employers’ and workers’ organizations concerned, with a view to improving the quality of nursing care, promoting knowledge and skill enhancement for nursing personnel and ensuring sufficiently rewarding working conditions for the practice of the nursing profession.

Article 5, paragraph 2. Further to the point raised in its previous comments, the Committee is obliged to reiterate its request for copies of all collective agreements in force regulating remuneration and working conditions of nursing personnel employed in public or private hospitals, nursing homes and medical centres.

Article 5, paragraph 3. In the absence of any reply on this point, the Committee renews its previous request for specific information on dispute settlement procedures applicable to labour conflicts involving nursing personnel.

Article 6. The Committee notes that, according to the Norwegian Confederation of Trade Unions (LO), the amendment of section 50 of the 1977 Working Environment Act regarding the length of overtime work was proposed to the Parliament without prior consultations with the social partners. In the view of the workers’ organization, the Government has acted in violation of the Convention as it did not offer LO any real possibility to exert influence on the proposal. The Committee would appreciate receiving any comments the Government might wish to make in reply to these observations.

Article 7. The Committee notes the information concerning regulations No. 1322 of 19 December 1997 on protection against exposure to biological factors at work, as amended through to 2003. The Committee requests the Government to keep it informed of any new measures or initiatives regarding the adaptation of existing laws and regulations on occupational safety and health to the special nature of nursing work.

Part V of the report form. The Committee notes the Government’s statement that no statistics are available on the number of persons leaving the nursing profession. The Committee trusts that the Government will make every effort to collect and transmit in its next report full particulars on the number of nurses currently employed in public and private health-care institutions, the nurse-to-population ratio, and the number of students attending nursing schools. The Committee would also be grateful to the Government for supplying detailed information on the practical application of the Convention, including for instance copies of official reports or studies addressing labour and employment issues concerning nursing services and nursing personnel, as well as any practical difficulties encountered in the implementation of the Convention.

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

The Committee notes the information supplied by the Government in its report.

Article 1 of the Convention. The Committee requested the Government in its previous report to inform whether there are categories of nursing personnel that are not covered by the law in either the public or private sectors, such as uncertified nursing personnel or nursing personnel who give nursing care and services on a voluntary basis. The Committee takes note of the information supplied by the Government in its last report that "no categories of nurses or auxiliary nurses lack protection under the health legislation in the sense of not being subject to public certification/authorization schemes" and that "requirements as to public certification apply regardless of whether the nurses are employed in the public or private sector". However, the Committee notes the information of the Government that "nursing assistants/untrained personnel are a composite group for whom the health authorities have not established public certification schemes". The Committee recalls that according to this provision "for the purposes of this Convention, the term 'nursing personnel' includes all categories of persons providing nursing care and nursing services". The Committee requests the Government to communicate information whether "nursing assistants/untrained personnel" provide nursing care and nursing services, and if so, to indicate the measures adopted or envisaged to apply the provisions of the Convention to these personnel.

Article 2, paragraph 2(b). The Committee notes with concern the information supplied by the Government that both a report from a researcher at the Institute for Social Research called "Women in care occupations" from 1997 and a report "Labour reserves among trained nurses" based on figures for 1996, conclude that:

-- 68 per cent of auxiliary nurses leave the profession five years after taking their first job in the profession;

-- the rate is highest in the first year;

-- the corresponding figure for nurses after five years is 30 per cent;

-- out of 72,000 certified nurses below the age of 65, about 3,000 were not occupationally active and 15,000 were working outside the health service.

In its previous comments the Committee requested the Government to indicate the particular measures which have been a matter of negotiation or other adoption procedures with a view to ensuring conditions of employment and work of nursing personnel in the public and private sectors, including career prospects and remuneration, which are in accordance with these provisions of the Convention and are likely to attract persons to the profession and retain them in it. It notes that the report does not contain any information in this respect. The Committee once again requests the Government to provide information on the abovementioned measures with its next report.

In addition, the Committee has also requested the Government in its previous comments to supply copies of some examples of collective agreements covering nursing personnel. It notes that the report does not contain any copy. The Committee cannot but reiterate the Government to supply the mentioned examples of collective agreements with its next report.

Article 3, paragraph 2. In its previous comments the Committee has noted the information of the Government that the admission requirements for nursing education and training are coordinated and that the Ministry of Health encourages coordination between the training programmes provided by the health and the social service colleges. The Committee has requested the Government to indicate the means used to ensure coordination with the education and training of other workers in the field of health. The Committee notes that the Government's report does not contain this information. It hopes that the Government will communicate the requested information with its next report.

Article 5, paragraph 3. The Committee notes that the Government's report has no information on its previous request as regards the procedure for the settlement of conflicts of nursing personnel. The Committee trusts that the Government will supply this information with its next report.

Article 6(c), (d), (e), (f) and (g). The Committee notes the information of the Government that the Working Environment Act (WEA) provides for working time and weekly rest of nursing personnel. The Committee takes note of the information provided by the Government and requests it to send specific information on to what degree nursing personnel enjoy conditions at least equivalent to those of other workers in respect of each of the fields mentioned in this provision of the Convention.

Article 7. In its previous report, the Committee requested the Government to provide information on the measures taken or envisaged to improve existing laws and regulations on occupational health and safety by adapting them to the special nature of nursing work and the environment in which it is carried out. The Committee notes the response of the Government according to which:

-- no special measures have been taken to adapt the body of rules to the particular environment in which nursing personnel work;

-- regulations do not make a distinction between nursing personnel and other employees, and apply to all employees who may become exposed to biological factors;

-- article 13 of the National Insurance Act provides that certain diseases are regarded as equal with occupational injury when contracted in an occupational context, and that AIDS and HIV-infection are included in the list;

-- the Act of 5 August 1994 was adopted concerning protection against infectious diseases; separate regulations of 5 July 1996 were adopted concerning protection against infection in health institutions; and regulations concerning protection of employees against hazards when working with biological factors were laid down by Royal Decree of 19 December 1999, the text of which is enclosed as Annex 1 of the report.

The Committee notes that paragraph 4 of section 1 of the Royal Decree of 19 December 1999 provides that persons who were exposed to AIDS among other infections should be recorded in a list. It also notes that employers should keep this list for ten years and for 40 years in the circumstances determined in paragraph 15 of section 2. The Committee requests the Government to inform in relation to the persons who are entitled to request information on the data contained in that list and under which conditions information is provided. The Committee also requests the Government to provide copies of the rest of the mentioned legislation in order to examine to what extent they ensure the application of the Convention on this matter.

Part V of the report form. The Committee notes the statistics and data supplied by the Government. It requests the Government to continue supplying statistics and data on the number of persons who are leaving the profession.

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

The Committee notes the information supplied by the Government in its first report. It requests the Government to supply further information on the following points.

Article 1 of the Convention. The Committee notes that the practice of nursing is not an activity protected by law. However, the law regulates the use of the title "public certified nurse" or "public certified auxiliary nurse". The Committee requests the Government to indicate whether there are categories of nursing personnel which are not covered by the law in either the public or private sectors, such as uncertified nursing personnel or nursing personnel who give nursing care and services on a voluntary basis.

Article 2, paragraph 2(b). The Government states that the conditions of work and employment of nursing personnel are a matter for negotiation between the social partners at both the central and local levels. The Committee requests the Government to indicate the particular measures which have been a matter of negotiation or other adoption procedures with a view to ensuring conditions of employment and work of nursing personnel in the public and private sectors, including career prospects and remuneration, which are in accordance with these provisions of the Convention and are likely to attract persons to the profession and retain them in it. Please also supply copies of some examples of collective agreements covering nursing personnel.

Article 3, paragraph 2. The Committee notes from the Government's report that the admission requirements for nursing education and training are coordinated and that the Ministry of Health encourages coordination between the training programmes provided by the health and the social service colleges. Please indicate the means used (the institutional framework, legislation, etc.) to ensure the coordination envisaged in this paragraph.

Article 5, paragraph 3. According to the Government, nursing personnel are subject to the same procedure for the settlement of conflicts as other workers in the country. It requests the Government to provide information on this procedure.

Article 6(a), (b), (c), (d), (e), (f) and (g). The Committee notes from the Government's report that the conditions of work of nursing personnel are regulated by law or collective agreements and that they are equal to those of other workers in the country. It requests the Government to indicate, taking into account the nature and specific constraints of the profession, the measures which have been taken in respect of (a) hours of work, (b) weekly rest, (c) paid annual holidays, (d) educational leave, (e) maternity leave, (f) sick leave and (g) social security, to ensure that nursing personnel in the public and private sectors enjoy conditions of work that are at least equivalent to those of other workers in the country.

Article 7. The Committee notes that in the field of occupational health and safety nursing personnel are governed by the legislation which is generally applicable and that the representatives of local elected trade union organizations are responsible for ensuring that conditions of work comply with the relevant provisions. The Committee requests the Government to indicate the measures which have been taken or are envisaged to improve existing laws and regulations on occupational health and safety by adapting them to the special nature of nursing work and the environment in which it is carried out. Furthermore, with reference to its general observation of 1990, which was repeated in 1994, the Committee requests the Government to indicate the measures which have been taken or are envisaged, 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, the arrangement of working conditions, the confidentiality of test results, recognition that the cause of infection was occupational, etc.

Point V of the report form. The Committee notes the statistics supplied by the Government. It requests the Government to continue supplying such statistics and to provide data on the number of persons who are leaving the profession.