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					Concise Report from the Kick-off Meeting of the Phare Twinning Project “The
Mutual Recognition of Qualifications of Medical Professions”, 8 October 2003,
Warsaw, Poland

General Information

About 130 invitations were sent to Polish representatives of Main and Regional Chambers of
Physicians and Dentists; Nurses and Midwives and Pharmacists and other officials. There
were around ninety people present at the start of the meeting, including the Presidents of the
three Main Chambers, Ministry of Health employees and the Dutch delegation of experts.

The meeting was opened by the Polish Project Leader Mr. Roman Danielewicz and Mr. Fred
Lafeber from the Dutch Ministry of Health, Welfare and Sport who expressed their mutual
interests in the exchange of expertise and further cooperation. Mr. Lafeber stressed the
assisting role that the Dutch side can play in helping Poland find its way to the acquis

Mr. Frits Tjadens, Project Leader Member State, continued by introducing Pre-Accession
Advisor Mr. Thijs Van Ormondt as the most important Dutch project member. He thanked
the Polish partners for organizing the conference in such a short notice (one month), and also
stressed the importance of the Dutch as providers of assistance, not as the sole leaders of the
project. Then, Mr. Danielewicz elaborated on the aim of the project, ensuring the
qualifications, and the results such as a data system for the central register and the upgrading
of professional knowledge. The name of the web-site was given on which all the current
developments as well as the background documents will be placed. The web-site which is
under construction now will be available at the following address:

Representatives of three Main Chambers gave their presentations on their assumptions and
expectations of the Twinning project. The first speaker was Mr. Konstanty Radziwiłł,
President of the Polish Chamber of Physicians and Dentists. He expressed his concerns about
the progress of the implementation of the new directives and pointed to the responsibility of
the Ministry of Health to act adequately in this respect. A manual with technical rules and
procedures was said to be needed for an easy identification and recognition of qualifications.
Also, the need for more information to be provided to the Chambers was signaled, e.g. by
organizing seminars on the practical aspects of recognition. According to Mr. Radziwiłł, it is
still unclear what the consequences of the European free movement will be for the self-
employed people with their private practices.

The President of the Main Chamber of Nurses and Midwives Mrs. Ilona Tułodziecka
elaborated on the secondary position that nurses and midwives had been in up until now in
Poland and welcomed the project that may further the emancipation of these professions. The
President further stressed the importance of the central register, and acknowledged the fear of
the possible prospect of many highly qualified nurses and midwives emigrating to the other
EU member states.

The President of the Main Pharmaceutical Chamber Mr. Roman Hechmann did not believe
that much migration would follow. A problem for Polish pharmacists is that they cannot
emigrate as easily as foreign pharmacists may immigrate to Poland, but this matter can be
still regarded as unclear. In fact, much is still unclear for the pharmacists, who expressed the
need for national standards of certification. Official recognition processes need to be clarified
and the Twinning project can assist in the changes that need to be made.

Two general questions were raised about the level on which qualifications are to be
recognized (regional or national) and about the international differences in specializations.

Afternoon Session and Workshops

Before the workshops started, Mr. Theo von Berkestijn (CBGV) briefly explained what
experiences the Netherlands had with Europe and stated that the Dutch had made many
mistakes in the process of integration, which Poland can avoid. This was followed by Mr.
Dirk Haaksman’s presentation which provided a short outline of the professional recognition
directives in the EU, the general directives, basic principles and the conditions for
recognition. About ninety percent of professional recognition in the EU is automatic. Mr. Jos
van den Heuvel was the last speaker, who again stressed the role of assistance of the Dutch
experts in this project. Mutual trust, transparency and frankness are needed to make this
project a success he stated. There is a tension between markets and regulations, but the
safeguards that are developed to control for any serious disruptions, have as of yet never been

Workshop for Nurses and Midwives
Mrs. Ria von Bönninghausen (president of the NU’91 and PCN), Mrs. Marian Adriaansen
(University of Nijmegen) and Mrs. Maria de Boer (Chief Inspector of Health Care) were
present to answer questions that were raised by the audience. Mrs. Von Bönninghausen gave
a brief historic outline of the Dutch experience, which firstly meant resisting European
interference, but then was changed by a more pragmatic approach of taking the opportunity to
further develop the European recognition system, which does not at present guarantee the
level of competences. Mrs. Von Bönninghausen formulated the upcoming transformation as a
process of making nurses and midwives more professional which would lead to further
recognition. Mrs. De Boer provided basic figures on the Dutch Midwifery and stressed the
importance of cooperation in this project. After this, questions were answered. Mr. Van
Ormondt concluded the workshop. He said that some issues had been clarified, but that other
dilemmas should be dealt with, not only by the Dutch experts, but also by the Ministry of
Health and the European Commission.

Workshop for Pharmacists
The workshop attracted 15 persons, including representatives of the Polish Ministry of
Health. Stimulated by the presentation of Mr. Jan de Smidt who gave more of a background
picture on the role of the pharmacists rather than a general outlook on the EU accession
issues, the audience asked many questions about pharmacy in the Netherlands and explained
the situation in Poland, not directly related to the recognition and mobility of pharmacists in
the EU.

Workshop for Doctors and Dentists
During the workshop on doctors and dentists the professional bodies concerned strongly
asked for a manual with all relevant medical diplomas to be obtained within the enlarged EU
as one of the tools needed for a proper application of the sectoral directive. It was explained
that such a manual would be outdated at the moment when it is finalized. It was advised to
make use of the experiences of the Polish Bureau for Academic Recognition and
International Exchange in the process of diploma verification.

Concluding Session

First, the chairpersons of the three workshops reported shortly on the content and conclusions
of discussions that took place in the framework of the workshops.

Mr. Van Ormondt characterized the workshop for nurses and midwives as a long and fruitful
discussion with many detailed questions about qualifications, central register, bridging
courses, and working experience. Mr. Van den Heuvel stated that there was a difference in
view on the recognition of doctors and dentists, whether this should be done on the basis of
the diploma or full professional qualifications. This depends on the difference between the
general and the sectoral directives of the EU. As an instrument for recognition, a manual with
procedures and guidelines was discussed about. Lastly, Mr. De Graaf asserted that much of
the discussion was about finding common ground, which was very relevant. The tension
between being a businessman and a healthcare worker was debated on, which brought about
questions on the academic level of pharmacists and company management.

Mr. Von Berkestijn presented his final remarks and concluded the meeting. He expressed his
gratitude for the active participation of the audience.

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