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

Nursing Personnel Convention, 1977 (No. 149) - France (Ratification: 1984)

With reference to the previous comments concerning the observations of the French Confederation of Christian Workers (CFTC), the General Confederation of Labour Force ouvrière (CGT-FO) and the French Democratic Confederation of Labour Health and Social Federation (CFDT), the Committee notes the information supplied by the Government.

1. The Committee notes with interest circular No. 20 of 4 May 1994 which changes the methods for taking account of former service and also allows service on humanitarian missions abroad to be taken into account. It asks the Government to indicate whether the principles laid down in this circular also apply to the private sector.

2. The Committee notes the Government's statement that the application of Protocol No. 1 concerning the reduction of working hours in the event of night work has required an increase in periods and funds. It notes that the application of the working hours established for nursing personnel in the public sector (39 hours per week reduced to 35 hours in the event of night work) is ensured in 51.55 per cent of public health establishments, covering 43.48 per cent of such staff in hospital establishments. It also notes that additional funds were allocated early in May 1994 by the Regional Directorates for Health and Social Matters (DRASS) so as to complete implementation of the system. The Committee asks the Government to continue to provide information on the application of the adjusted working hours to all hospital centres.

3. The Committee notes that Act No. 91-748 to reform hospitals establishes, in addition to advisory committees with trade union representation: (i) procedures for direct consultation with the service councils made up, depending on the size of the service or department, either of medical and non-medical staff of the service or department, or of representatives from the "functional units", in accordance with requirements established in regulations; (ii) procedures for specific consultation with nursing care committees composed of all personnel participating in the provision of nursing care, such as nurses and auxiliaries. It also notes that under section R.714-26-1 of the Public Health Code, members of the nursing care service committee are appointed by drawing lots among volunteers who must let the director of the establishment know that they are willing to stand. The nursing care service committee is consulted on the general organization of the service as part of a nursing care project, on monitoring and research in nursing care, on the preparation of a training policy and the establishment project. According to the survey on the nursing care service committees carried out in September 1993, of the 722 hospital establishments consulted, 25 indicated that they had no nursing care service committee.

The Committee notes that no mention is made of any participation by organizations representing the staff in the survey of September 1993 on nursing care committees, conducted by the Ministry of Social Affairs.

The Committee notes that the method for appointing members of the nursing care service committee is to draw lots among a set of volunteers. It understands that, although it is not unknown in French law, this method of appointment is exceptional in the area of staff representation. In the hospital sector, for example, section L.714-17 of the above-mentioned Code provides for the election of the members of the establishment's technical committee and recalls the requirements regarding representativeness for submitting the lists of candidates.

The Committee notes that Article 5, paragraph 1, of the Convention does not specify the role to be played by the representatives of nursing personnel in implementing the measures that must be taken, in accordance with methods appropriate to national conditions, to encourage consultation of such personnel in decisions concerning them. Even less does it specify how staff representatives should be appointed. The Committee none the less recalls the indications in Paragraphs 19(2) and 20 of the Nursing Personnel Recommendation (No. 157), which refer expressly to representatives of personnel within the meaning of Article 3 of the Workers' Representatives Convention, 1971 (No. 135), which sets out specific procedures for the appointment of representatives.

The Committee asks the Government to indicate why the drawing of lots was adopted as the procedure for appointing members of nursing care service committees, and to provide information on the participation of representative organizations in nursing care service committees.

The Committee is also addressing a direct request to the Government concerning certain other points.