Proposition 54K3526

Projet de loi portant modification de la loi coordonnée du 10 mai 2015 relative à l'exercice de professions des soins de santé.

General information ¶

Authors

CD&V Nathalie Muylle
MR Damien Thiéry
Open Vld Ine Somers

Submission date

Feb. 6, 2019

Official page

Visit

Status

Adopted

Requirement

Simple

Subjects

pharmacist health care profession occupational migration mental health health policy paramedical profession psychiatry psychology nursing staff public health

Voting ¶

Voted to adopt

Groen CD&V Vooruit Ecolo Open Vld N-VA MR PP

Abstained from voting

LE PS | SP DéFI ∉ PVDA | PTB VB

Party dissidents ¶

• Olivier Maingain (MR) abstained from voting.

Contact form ¶

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Discussion ¶

March 28, 2019 | Plenary session (Chamber of representatives)

Full source

The rapporteur, Mr Dirk Janssens, refers to the written report.

Mr. Speaker, dear colleagues, I will address very quickly three points of the bill under consideration: the Federal Council of Pharmacists, the new concept of advanced practice nurse and the provisions relating to foreign doctors.

The creation of a Federal Council of Pharmacists concrete a measure of the pact with pharmacists. It has long been expected by the industry. Today, we take into account the demands of pharmacists.

In the end, the profession of pharmacist was the only health care profession that did not have its own advisory body. Therefore, it was quite logical to create this Council. It will be his responsibility to decide on all aspects relating to the profession of pharmacist and the development of pharmaceutical care.

The concept of advanced practice nurse is a novelty. A new category relating to complex nursing care will be specified in a royal decree to be followed. The Federal Council of Nursing Art has already issued an opinion on this in May last year.

Let me quote a short passage of the text to illustrate the concept as such: “The advanced practice nurse is expert in a specific field or in responding to the needs of a specific group of people as well as in managing complex situations. The Advanced Practice Nurse acts in all areas where complex situations are encountered and where additional skills are needed to provide quality care, based on evidence and with a systemic view of care."

The measure will, of course, be implemented in perfect coordination with the Federal Council of Nursing Arts, but also with the Higher Council of Specialist Doctors and General Doctors. This concertation is important.

Furthermore, the proposal provides for stricter rules for foreign physicians who have completed their training outside the European Union and who wish to exercise their profession in Belgium.

This amendment aims to ensure that care providers who have graduated outside the European Union have the level required to ensure the best quality of care possible. The proposal includes the possibility to set a quota for doctors and dentists who have graduated outside the European Union.

The proposal also allows foreign doctors who are highly specialized in a particular field, due to their perfect expertise in this field, to exercise their profession for a limited period in our country. Thanks to this arrangement, a specialized surgeon will be able to come to practice in our country a very complex operation on a patient suffering, for example, of a rare cancer.

Finally, the law aims to clarify the conditions that a physician from a non-EU country must meet in order to be able to receive training in Belgium on a particular medical technique or expertise.

These were the three elements that I wanted to highlight, today, in the framework of this bill that has been long debated in the committee.

Mr. Speaker, Mrs. Minister, dear colleagues, as we pointed out in the committee, several elements of this text, which brings a series of amendments to the law on health professions, question us.

Among them, the establishment of a visa quota for doctors from a non-member country of the European Union in a context of shortage – we are constantly reminding it – to which there is never a comprehensive response and this at the expense of patients but also of our hospitals.

I will also mention the changes in access to clinical training for foreign doctors who are not members of the European Union which, in our opinion, have only one objective, namely to restrict access to these training.

Finally, if we fully support the creation of the advanced practice nurse profession, it should have been part of a more comprehensive reform of the practice of nursing art.

The questions and concerns of the sector, in particular with regard to delegation of acts and training, are increasing and it is unfortunate not being able to clarify this situation.

In view of these elements and as we have done in committee, we will abstain from this bill.

Mr. Speaker, we had supported several articles of this bill, in particular the one concerning the access to the practice of the medical art in Belgium for doctors from non-member countries of the European Union. Remember that in this matter, it is a very small number that is concerned since the majority of the hundreds of doctors and dentists who settle each year and who automatically obtain an INAMI number are from the European Union – not from neighboring countries but from beyond. In this regard, Madame Minister, it will be your responsibility, or that of your successor, to make a royal decree based on the law that I introduced a few weeks ago and that we voted for.

On the other hand, and know that I will mainly focus my speech on this topic, one point really raises a concern in this bill. As much as I have pledged, for a very long time, for the nurse of advanced practice, so much the way you present it is really problematic. The reason for this is that you are passing by a comprehensive reform in particular concerning the nurse in general care.

Furthermore, Mrs. Minister, I must find that while I had asked you about the famous royal decree on the basis of which you transfer nursing acts to the caregivers, you had made us a great mystery in commission by telling us that you did not know where this royal decree was. I can repeat your terms, they are as you said in the report. It was big anything! There was a lot of amateurism and contempt towards Parliament. But the truth is that this royal decree is now out.

You managed to put all the nurses on your back. Honestly, I understand them. Bringing things small as you do, without having a concerted approach with the first concerned (the nurses) and without taking into account the entire aspect of nurses in general care, is totally unacceptable.

You terminerai par les promises que vous aviez pourtant faites à l'ensemble des représentants de la profession infirmière. You have absolutely not tenu ces promises de concertation, singulièrement par rapport à ces réformes. Franchement, you find that it is particulièrement regrettable et irrespectueux pour ces infirmières et infirmiers qui, vous le rappelle, que ce soit au domicile ou dans les hôpitaux, travaillent aujourd'hui dans un cadre largement insufficient. It is sufficient to examine the European averages. It is a great weakness and a great failure of your ministry in the last five years.