1. “Implementing EU Acquis, Procedures and Challenges” Poland, Warsaw 22 nd –23 rd September 2004 Dr Annita Anastassiadou Co-ordinator EU Integration Sector Ministry of Health Cyprus

2. CYPRUS Cyprus is the third largest Mediterranean Island (area: 9250 sq km) Population: 793.100 (data 2001)

3. Health System in Cyprus Cyprus has a dual System on health Care Delivery Public Sector ( funded by taxation and some user charges) Private Sector (funded by user charges, private health insurance and foreign investments) Total expenditure on health as a percentage to GDP increased from 4.5% in 1999 to 6.4% in 2002

4. Statistical Data 2002 Birth Rate 11.6 Death Rate 6.9 Infant Mortality Rate 4.9 Expectation of life at birth: Men 76.1, Women 81

5. Statistical Data 2002 (2) Doctors per 1000 of population: 2,6 Persons per dentist 1.092 Persons per nurse/midwife: 237

6. Implementation of EU Acquis into National Law The following harmonized amended Laws were approved by the Cyprus House of Representatives before 1 st of May 2004: Doctors’ Registration Law and Regulations (Specialties) 2004 Dentists’ Registration Law and Regulations (Specialties) 2004 Nursing and Midwifery Law 2004 Pharmacy and Poison Law 2002 and 2003

7. Contacts with other MS Competent Authorities and the EU Commission The Cyprus Competent Authorities have contacts with the CA of the other member states (mainly UK and Greece) Contacts with the European Commission are established (Senior Officials of Public Health Committee) Useful and fruitful cooperation

8. Recognition of EEA qualifications (including third country qualifications recognized in other EEA countries), the national system The EEA qualifications (stated in the relevant Directives) are automatically recognized by the Cyprus Competent authorities In the cases of third country qualifications, these are assessed by the Cyprus CA according to certain criteria, like curriculum and training period. In addition,KYSATS (Cyprus Council for the Recognition of University Diplomas), has a counselling role to the CA on these issues by examining the equivalency of third country qualifications.

9. Registration and Licensing Cyprus’ competent authorities Cyprus Medical Council Cyprus Dental council Cyprus Nursing and Midwifery Council Cyprus Pharmacy Council The Councils are legally regulated bodies, with autonomous status, supervised by the Ministry of Health The members of these Councils are appointed by the Cyprus Council of Ministers. The members are private and public sector professionals.

10. Minimum requirements for first time registration Proof of identity Proof of qualification (diploma or certificate) Certificate of good standing Proof of previous diploma or certificate which gives the right to exercise the profession These requirements are common for doctors, dentists, pharmacists, nurses and midwives. The pharmacists require certificate of physical and mental health, as well.No language requirement exists, except for nurses and midwives and operators of pharmacies.

11. Responsibilities of the Competent Authorities Recognize the qualifications and issue license to practice Safeguard the quality of the execution of the professions Supervise the professions Serve as information centres for health care professionals wishing to work abroad/for foreign professionals wishing to work in Cyprus Continuing Education in collaboration with the professional associations

12. Other Issues Language Requirements Not regulated in the National legislation Prerequisite for employment in the Public Sector

13. Problems encountered by the Councils: MEDICAL COUNCIL From May the 1 st until 31 st August 2004, twelve(12) doctors applied for registration with the Cyprus Medical Council. Another six (6) applied for registration to provide services Applicants’ Citizenship (for establishment): Greek, Hungarian and English Applicants’ Citizenship (temporary): Greek, English Many requests for information have been received. Confusion on the issue of temporary provision of services

14. DENTAL COUNCIL From May the 1 st until 31 st August 2004, fifteen (15) dentists applied for registration with the Cyprus Dental Council. Ten were approved for registration. Applicants’ Citizenship: 8 Cypriots, 5 Greeks and 2 from third countries - Applicants’ diplomas:8 from EU countries, 7 from third countries

15. DENTAL COUNCIL (2): Applicants having a diploma from former CEE (Central East European Countries, like Czech Republic and Slovakia) applied for registration with the Cyprus Dental Council. Their diplomas are not compatible with the Dental Training Directive. In the country of origin of the diploma, a dentist is eligible for registration after having completed 3 years of vocational training. Nevertheless, they are registered in Cyprus due to the article on transitional period of the Dentists’ Registration Law, that covers the Cypriot citizens, their children and spouses. This clause is valid until April 2009 (5 years after the accession).

16. PHARMACY COUNCIL: From May the 1 st until 31 st August 2004, Five (5) pharmacists (4 Cypiots with EU Diplomas and one EU citizen with third country diploma) applied for registration with the Cyprus Pharmaceutical Council. By way of comparison, there has been no significant increase in the number of the applicants.

17. Cyprus Nursing and Midwifery Council: From May the 1 st until 31 st August 2004, Eighty-five (85) nurses applied for registration with the Cyprus Nursing and Midwifery Council. Thirty-two (32) were approved for registration -46 EU Citizens and 39 from third countries -34 with EU Diplomas and 51 with third countries diplomas Fourteen (14) midwives applied for Registration with the Cyprus Nursing and Midwifery Council. Ten (10) were approved for registration 5 EU Citizens and 9 from third countries-6 with EU Diplomas and 8 with third countries diplomas

18. Problems encountered by the Councils: 3.Cyprus Nursing and Midwifery Council: Since the 1 st of May 2004, by way of comparison, there has been an increase in the number of the nurses and midwives applicants from Greece and CEE countries. 4. Problems deriving from the acquired rights of the nurses/midwives from CEE (Czech Republic, Slovakia, Poland) According to the Nursing and Midwifery Law, which was harmonised and amended in 2003 (the relevant Articles for nationals of member states applied after 1 st May 2004) some nationals from the above mentioned countries were registered with the Cyprus Nursing and Midwifery Council as 2 nd level nurses (working under the supervision of 1 st level nurses). After Cyprus accession into the EU, these professionals applied for registration with the council as General Nurses (previously named 1 st level). According to current legislation, the prerequisites for registration as a General Nurse include the provision of a certificate from their country of origin that the interested persons were practicing the profession for three consecutive years over the last five years and that their diploma complies with the directives 77/452/EEC (General care nurses) and 80/154/EEC (Midwives). Nevertheless, these persons can not obtain such a certificate because they have been residing in Cyprus for some years prior to accession.

19. After Accession: Certification of nationally acquired professional qualifications, the national system Acquired rights: the certificates issued The Cyprus Competent Authorities certify that a professional registered in Cyprus has lawfully practiced the profession in question for at least three consecutive years during the last five years prior to the issue of the certificate. This certificate is required for nationals of member states in case their diplomas do not comply with the relevant Directives.

20. After Accession: Certification of nationally acquired professional qualifications, the national system Numbers (estimates) of migrating professionals Only four (4) registered dentists applied to the Cyprus Dental Council for a Certificate of Good Standing