ministry of social security and labour of the republic...

LIETUVOS RESPUBLIKOS SOCIALINĖS APSAUGOS IR DARBO MINISTERIJA

MINISTRY OF SOCIAL SECURITY AND LABOUR

OF THE REPUBLIC OF LITHUANIA

International Labour Standards Department 2013-10-30

International Labour Office

4, route des Morillons

CH-1211 GENEVE 22

No. (29.5-61)-SD-7320

REF.ILO: ACD 8-0 (2013)

Article 22 of the Constitution of the ILO

Report for the period ending June 2013

made by the Government of the Republic of Lithuania

on the

NURSING PERSONNEL CONVENTION, 1977 (No. 149)

(ratification registered on 12 June 2007)

I. The list of laws and other legal acts that implement provisions of the Convention in

the Republic of Lithuania:

1. Labour Code of the Republic of Lithuania (OG, 2002, No 64-2569);

2. Law on Nursing Practice and Obstetrics (OG, 2001, No 62-2224; 2009, No 89-

3801) and legal acts that implement it:

3. Specialised List of Nursing Fields, approved by 17 December 2009 Order No V-

1037 of the Minister of Healthcare of the Republic of Lithuania (OG, 2009, No 152-

6842);

4. Descriptions of Informal Education Programme Requirements for Specialised

Nursing Fields, approved by 21 January 2010 Order No V-51 of the Minister of

Healthcare of the Republic of Lithuania (OG, 2010, No 13-659);

5. Rules on Equation of Professional Qualifications that were Gained Before the Law

on Nursing Practice and Obstetrics Practice Came into Force to the General Practice

Nurse Professional Qualification, approved by 17 December 2009 Order No V-1038

of the Minister of Healthcare of the Republic of Lithuania (OG, 2009, No 152-

6843).

6. Licensing Rules for Nursing Practice, approved by 30 December 2009 Order No V-

1088 of the Minister of Healthcare of the Republic of Lithuania (OG, 2010, No 1-

48).

7. Licensing Rules for Obstetrics Practice, approved by 30 December 2009 Order No

V-1089 of the Minister of Healthcare of the Republic of Lithuania (OG, 2010, No

1-49).

8. List of Diseases that Prevent Persons from Provision of Nursing or Obstetrics

Services, approved by 12 August 2010 Order No V-720 of the Minister of

Healthcare of the Republic of Lithuania (OG, 2010, No 99-5157).

9. Law on Recognition of Regulated Professional Qualifications (OG, 2008, No 47-

1747).

10. Law on Social Insurance of Occupational Accidents and Occupational Diseases

(OG, 1999, No 110-3207; OG, 2003, No 114-5114).

11. 23 December 2009 Resolution of the Government of the Republic of Lithuania No

1749 ‘On the Approval of the List of Study Courses and Fields, Pursuant to Which

the Studies in Higher Education Institutions are Carried on and the List of

Qualification Degrees’ (OG, 2009, No 158-7135).

12. 7 May 1999 Resolution of the Government of the Republic of Lithuania No 544

‘On the Approval of the List of Jobs and Fields of Activities Where Only Those

Employees are Allowed to Work, Who Get a Prior Health Check and Later

Periodical Checks for Infectious Diseases and the Procedure on Health Check of

These Employees (OG, 1999, No 41-1294; 2002, No 73-3127). This Resolution

defines the groups of workers (including nursing personnel) that are allowed to

work only after they get checked and periodically get checked afterwards for

infectious diseases.

13. 31 May 2000 Order of the Minister of Healthcare of the Republic of Lithuania No

301 ‘On Preventive Health Examinations in Health Care Institutions’ (OG, 2000,

No 47-1365), that establishes that the health of nursing personnel must be examined

once a year.

14. According to the Law on Safety and Health of Employees of the Republic of

Lithuania (OG, 2003, No 70-3170), it is employer’s duty to provide employees with

safe and not hazardous working conditions in respect of all the work-related aspects.

15. Hygiene Standard of Lithuania No HN 47-2012 ‘Healthcare Institutions.

Requirements for Infection Control’, approved by 19 October 2012 Order of the

Minister of Healthcare of the Republic of Lithuania No V-946, that lays down the

requirements for the control of infections.

16. 18 March 2002 Order of the Minister of Healthcare of the Republic of Lithuania No

132 ‘On the Improvement of Professional Qualification of Healthcare Institution

Specialists and Pharmaceutics and the Funding Procedure Thereof’ (OG, 2002, No

31-1180).

17. 11 January 2007 Order of the Minister of Healthcare of the Republic of Lithuania

No V-14 ‘On the Approval of Description of Requirements for the Provision of

Palliative Help Services for Adults and Children’ (OG, 2007, No 7-290).

18. 16 May 2008 Order of the Minister of Healthcare of the Republic of Lithuania No

V-470 ‘On the Approval of the List of Base Prices of Palliative Help Services for

Adults and Children’ (OG 2008, No 59-2247).

19. 5 December 2005 Order of the Minister of Healthcare of the Republic of Lithuania

No V-943 ‘On the Approval of Description of the Procedure on Organisation of

Initial Out-patient Healthcare Services and Payment Thereof, as well as of the List

of Base Prices for the Initial Out-patient Healthcare Services’ (OG, 2005, No 143-

5205).


No V-1026 ‘On the Approval of Requirements for the Provision of Nursing

Services in Out-patient Healthcare Institutions and at Home’ (OG, 2007, No 137-

5626).

21. 11 April 2003 Order of the Minister of Healthcare of the Republic of Lithuania No

ISAK-480/V-210 ‘On the Minimum Requirements for Preparation of Doctors,

Doctors Deontologists, General Practice Nurses, Obstetrics and Pharmacists’ (OG,

2003, 41-1896).

22. Standard for Preparation of General Practice Nurses, approved by 10 July 2002

Order of the Minister of Healthcare of the Republic of Lithuania No 1302 ‘On the

Approval of the Standard for Preparation of General Practice Nurses’ (OG, 2004,

No 61-2208).

23. Description on the Procedure for Establishing the Workload for Nursing Personnel,

approved by 9 May 2012 Order of the Minister of Healthcare of the Republic of

Lithuania No V-400 (OG, 2012, No 55-2751).

24. Description on the Procedure for Establishing the Workload for Obstetrics,

approved by 9 May 2012 Order of the Minister of Healthcare of the Republic of

Lithuania No V-399 (OG, 2012, No 55-2750).

Medical standards establish the fields of activity, rights, duties, competence and

responsibility of nurses of different nursing fields:

25. 14 June 2004 Order of the Minister of Healthcare of the Republic of Lithuania No

V-437 ‘On the Approval of Lithuanian Medical Standard MN 28: 2011 ‘General

Practice Nurse. Rights, Duties, Competence and Responsibility’ (OG, 2011, No 72-

3490);

26. 4 August 2006 Order of the Minister of Healthcare of the Republic of Lithuania No

629 ‘On the Approval of Lithuanian Medical Standard MN 22: 2006 ‘Mental Health

Nurse. Rights, Duties, Competence and Responsibility’ (OG, 2006, No 95-3746);


No V-437 ‘On the Approval of Lithuanian Medical Standard MN 91: 2001

‘Children’s Nurse. Rights, Duties, Competence and Responsibility’ (OG, 2001, No

105-3769);


V-245 ‘On the Approval of Lithuanian Medical Standard MN 40: 2006

‘Obstetrician. Rights, Duties, Competence and Responsibility’ (OG, 2006, No 40-

1446);


No 628 ‘On the Approval of Lithuanian Medical Standard MN 93: 2001 ‘Operating

Room Nurse. Rights, Duties, Competence and Responsibility’ (OG, 2001, No 104-

3731);



‘Community Nurse. Rights, Duties, Competence and Responsibility’ (OG, 2011, No

82-4015).


V-644 ‘On the Approval of Lithuanian Medical Standard MN 60: 2011 ‘Nurse-

Anaesthetist and Intensive Therapy Nurse. Rights, Duties, Competence and

Responsibility’ (OG, 2011, No 79-3882).

32. The Law on State Social Insurance (OG, 1991, No 17-447; 2004, No 171-6295).

33. The Law on State Social Insurance Pensions (OG, 1994, No 59-1153, 2005, No 71-

2555).

34. The Law on Sickness and Maternity Social Insurance (OG, 2000, No 111-3574).

35. The Law on Unemployment Social Insurance (OG, 2004, No 4-26).

36. The Law on Social Insurance of Occupational Accidents and Occupational Diseases

(OG, 1999, No 110-3207; 2003, No 114-5114).

37. The Law on Health Social Insurance (OG, 1996, No 55-1287; 2002, No 123-5512).

II.

Article 1

One of the basic principles of legal regulation of employment relationships is laid

down in Paragraph 4 of Article 2 of the Labour Code of the Republic of Lithuania

(hereinafter – the Labour Code) – equality of subjects of labour law irrespective of their

gender, sexual orientation, race, nationality, language, origin, citizenship and social status,

religion, intention to have a child (children), marital and family status, age, beliefs or

views, membership in political parties and public organisations, factors that are not related

to the employee's professional qualities.

Article 11 of the Labour Code establishes the duty of the employer to ensure safety

and health of workers in all work-related aspects. The duties of workers when protecting

their own and other workers’ health and safety, do not release the employer from the

mentioned duty. Measures of safety and health at work are financed from the employer’s

resources. In seeking to implement the employer’s duty, a person representing the employer

organises the implementation of preventive measures (technical, medical, legal,

organisational, and others) intended for the prevention of accidents at work and

occupational diseases, by laying down the procedure for implementing and controlling such

measures in an undertaking, appointing the persons authorised by the employer and setting

for them concrete assignments on the implementation of the preventive measures.

According to Article 25 of the Labour Code, when implementing the duty of the

employer to ensure safe and healthy working conditions for workers in all aspects related to

work, an employer’s representative takes all measures to ensure the conformity of the

buildings of the undertaking where workstations are located, the workstations themselves,

work equipment, and the working environment with the requirements established in

regulatory acts on safety and health at work; organises or instructs the person authorised by

the employer to organise the evaluation of occupational risk, and, on the basis thereof,

evaluates (establishes) the actual status of occupational safety and health in the

undertaking, its subdivisions and individual work stations. Upon having established that the

status of safety and health at work does not meet the requirements laid down in regulatory

acts on safety and health at work, the employer’s representative must organise the

preparation and implementation of necessary measures. According to the status of

occupational safety and health in the undertaking, the employer’s representative decides on

the choice of collective protective equipment, organises the installation of the said

equipment, and, in the event such equipment does not adequately protect workers from

risks, provides the workers with personal protective equipment, organises the verification

thereof, provides workers with safe work equipment, introduces safe work and technology

processes, installs safety signs and equips ancillary facilities in the workplaces where there

is a possibility of risks; ensures that the workers, upon their recruitment and in the course of

employment in the undertaking, receive comprehensive information concerning the

organisation of safety and health at work in the undertaking, the existing or possible

occupational hazards, the existing measures for elimination and (or) reduction of risk, the

appointed workers responsible for providing the first aid, organisation of rescue works,

evacuation of workers in cases of possible natural disasters or fires, measures for fire-

fighting and evacuation as well as information on the findings of the inspections of the

undertaking carried put by the State Labour Inspectorate; approves instructions on safety

and health at work, job descriptions, fulfils obligations undertaken under collective

agreements concerning improvement in safety and health at work; organises or instructs the

person authorised by the employer to organise instruction of workers by ensuring that the

workers are instructed on recruitment, transfer to another job, change in the organisation of

work, introduction of new or modernised work equipment, introduction of new

technologies, upon amendment or adoption of new regulations on safety and health at work.

Establishes the procedure for training of workers and examination of their knowledge in the

field of safety and health at work; provides conditions for proper functioning of the

occupational safety and health service, the occupational safety and health committee of the

undertaking; ensures the compliance of working time and rest periods of employees with

the requirements of legal acts, organises filling of records on the actual employee working

time; organises or instructs the person authorised by the employer to organise compulsory

health examination of workers. Creates conditions for workers to have their health

examined during the working hours; transfers workers (with their consent) to another job

upon the conclusions of the Disability and Capacity for Work Establishment Office under

the Ministry of the Social Security and Labour or the healthcare institution which has

examined the worker’s health; ensures that specialists in health and safety at work, an

occupational safety and health service, a person authorised by the employer and exercising

the functions of the occupational safety and health service, natural or legal persons

exercising the functions of the occupational safety and health or a part thereof are provided

with information on the recruitment of workers, which is necessary for them to be able to

properly carry out preventive measures of occupational safety and health intended for all

the workers; in accordance with the Regulations on the Investigation and Record of

Accidents at Work and the Regulations on the Investigation and Record of Occupational

Diseases approved by the Government, reports or instructs the person authorised by the

employer to report accidents at work and occupational diseases to relevant State

institutions, provide conditions for the investigation of accidents at work and occupational

diseases; controls how workers fulfil the requirements of regulatory acts on safety and

health at work, suspend from work in an undertaking those workers who do not follow the

requirements for health and safety at work; in accordance with the procedure established

the Regulations on the Investigation and Record of Accidents at Work and the Regulations

on the Investigation and Record of Occupational Diseases organises or instructs the person

authorised by the employer to organise the registration of accidents at work and

occupational diseases; draws up or instructs the person authorised by the employer to draw

up the lists of occupational accidents or occupational diseases when an employee has lost

capacity for work for more than 3 working days, registers the incidents; performs other

duties and implements necessary measures by creating safe and healthy working

conditions for workers.

Article 34 of the Labour Code establishes the following rights of employees:

1) to demand that the employer should ensure safety and health at work, install

collective protective equipment, supply with personal protective equipment when

collective protective equipment does not protect from the impact of risk factors;

2) to receive information from the workers' representative for the safety and health,

head of the subdivision or another person authorised by the employer, or employer’s

representative about hazardous and (or) dangerous factors in working environment;

3) to have access to the conclusions of the initial and periodical compulsory health

examinations and upon disagreement with the examination results, to repeat health

examination; to demand to be transferred to another work if, according to the conclusions

of the Disability and Capacity for Work Establishment Office under the Ministry of the

Social Security and Labour or a healthcare institution concerning his health condition,

he/she cannot carry out the work or hold the office specified in the employment contract;

4) to negotiate the improvements of safety and health of workers with the head of a

subdivision or employer’s representative directly or via an authorised workers'

representative for safety and health, workers’ representative;

5) to refuse to work in the event of danger to safety and health of workers. If the

employer violates the requirements for safety and health of workers laid down by laws, the

worker has the right to terminate a non-term or fixed-term employment contract in the

manner prescribed by the Labour Code;

6) to require, in accordance with the procedure established by law, to be

compensated for the damage to health caused by unsafe working conditions;

7) to address the workers' representative for safety and health, head of the

subdivision, undertaking’s occupational safety and health service, occupational safety and

health committee, workers’ representatives, worker’s representative, State Labour

Inspectorate or other state institutions and agencies on the issues of the state of safety and

health at a workstation or in an enterprise.

There are no special rules for the nursing personnel voluntarily providing care and

nursing services; however, requirements of legal acts also apply to the nursing personnel

voluntarily providing care and nursing services – under Item 2 of the Regulations on

Prevention of Injures Made by Sharp Instruments at Healthcare Institutions, the

requirements of these regulations apply to any activity carried out by the employees of

healthcare institutions as well as all persons who are managed and supervised by employers

or their representatives, where the risk of injuries made by sharp instruments arises or may

arise. Employers or their representatives must seek to ensure that persons, who provide

healthcare services directly or participate in providing the healthcare services according to

contractual relationships established with the employer, follow the requirements of these

regulations.

One of the defined fields is for volunteers who help patients that are in need of

palliative help services. Heads of the healthcare institutions are allowed to hire volunteers

according to the procedure laid down by the head of this institution (11 January 2007 Order

of the Minister of Healthcare of the Republic of Lithuania No V-14 ‘On the Approval of

Description of Requirements for the Provision of Palliative Help Services for Adults and

Children’). Discussions and coordination procedures concerning various provisions were

being carried out with the employee and employer organisations during the preparation of

the mentioned document.

The draft of the Regulations on Prevention of Injures Made by Sharp Instruments

at Healthcare Institutions was prepared by a working group attended by the specialists from

the Ministry of Social Security and Labour, the Ministry of Healthcare and State Labour

Inspectorate, as well as representatives of the Union of Managing Doctors of Lithuania,

Labour Union of Healthcare Employees of Lithuania, the National Association of

Healthcare Institution Managers of Lithuania, Lithuanian Dental Chamber, Organisation of

Nursing Specialists of Lithuania. Society was consulted regarding this draft by publishing

the Draft Order in the information system of drafted legal acts of the Parliament of the

Republic of Lithuania. The draft was coordinated with the Lithuanian Confederation of

Business Employers, Lithuanian Confederation of Labour Unions, the Lithuanian Labour

Union ‘Solidarumas’, Lithuanian Labour Federation, Lithuanian Confederation of

Industrialists.

Article 2

The national policy is applied to nursing services and nursing personnel by these

legal acts: the Law on Nursing Practice and Obstetrics that establishes gaining the

professional qualification of common practice nurses and obstetrics, practice conditions,

rights, duties and responsibility, and the legal acts that implement this law:

1. Specialised List of Nursing Fields, approved by 17 December 2009 Order No V-

1037 of the Minister of Healthcare of the Republic of Lithuania (OG, 2009, No

152-6842);

2. Descriptions of Informal Education Programme Requirements for Specialised

Nursing Fields, approved by 21 January 2010 Order No V-51 of the Minister of

Healthcare of the Republic of Lithuania (OG, 2010, No 13-659);

3. Rules on Equation of Professional Qualifications that were Gained Before the Law

on Nursing Practice and Obstetrics Practice Came into Force to the General

Practice Nurse Professional Qualification, approved by 17 December 2009 Order

No V-1038 of the Minister of Healthcare of the Republic of Lithuania (OG, 2009,

No 152-6843).

4. Licensing Rules for Nursing Practice, approved by 30 December 2009 Order No


1-48).

5. Licensing Rules for Obstetrics Practice, approved by 30 December 2009 Order No


1-49).

6. List of Diseases that Prevent Persons from Providing Nursing or Obstetrics

Services, approved by 12 August 2010 Order No V-720 of the Minister of

Healthcare of the Republic of Lithuania (OG, 2010, No 99-5157).

Other legal acts:

1. Obstetrics who have been integrated into the initial healthcare are provided with such

conditions that their services are paid for by the resources from the National Health

Insurance Fund resources (17 January 2008 Order of the Minister of Healthcare of the

Republic of Lithuania No V-48 ‘On the Amendment of the 5 December 2005 Order

of the Minister of Healthcare of the Republic of Lithuania No V-943 ‘On the

Approval of the Description of the Procedure for Organising the Initial Out-patient

Healthcare Services and Payment Thereof, as well as the List of the Base Prices for

the Initial Out-patient Healthcare Services’);

2. Home nursing services are being expanded. 14 December 2007 Order of the Minister

of Healthcare of the Republic of Lithuania No V-1026 ‘On the Approval of

Requirements for the Provision of Nursing Services in Out-patient Healthcare

Institutions and at Home’ is designed to expand the provision of nursing services at

patients’ homes by improving the quality of patients’ lives, preserving their

independence in their domestic environment, encouraging their self-care;

3. The palliative help is being expanded. By 11 January 2007 Order of the Minister of

Healthcare of the Republic of Lithuania No V-14 ‘On the Approval of Description of

Requirements for the Provision of Palliative Help Services for Adults and Children’

the arrangement and provision of palliative help was legitimised in Lithuania. This

Order regulates the provision of palliative help services in out-patient and in-patient

healthcare institutions, by organising the provision of these services in in-patient, day

in-patient and out-patient conditions;

4. Bed facilities of nursing and maintenance treatment are being expanded. Decision on

the expansion of these services and the number of nursing beds in healthcare

institutions is adopted by their founders, i.e. municipal institutions upon taking into

account the needs of residents.

5. Description on Establishment of Workload for Nursing Personnel, approved by 9

May 2012 Order of the Minister of Healthcare of the Republic of Lithuania No V-400

(OG, 2012, No 55-2751).

6. Description on establishment of Workload for Obstetrics, approved by 9 May 2012

Order of the Minister of Healthcare of the Republic of Lithuania No V-399 (OG,

2012, No 55-2750).

Measures that are essential in order to ensure the nursing personnel:

With respect to education and training:

1) Mandatory improvement of professional qualification of nurses has been

established (18 March 2002 Order of the Minister of Healthcare of the Republic

of Lithuania No 132 ‘On the Improvement of Professional Qualification of the

Specialists of Healthcare Institutions and Pharmaceutics and the Funding Order

Thereof’ (OG, 2002, No 31-1180);

2) The minimum requirements for preparation of general practice nurses has been

established and approved by 11 April 2003 Order of the Minister of Healthcare of

the Republic of Lithuania No ISAK-480/V-210 ‘On the Minimum Requirements

for Preparation of Doctors, Doctors Deontologists, General Practice Nurses,

Obstetrics and Pharmacists’ (OG, 2003, 41-1896).

With respect to the occupation and working conditions, remuneration:

1) Occupation of nursing personnel, working conditions and remuneration is

established by local legal acts (job description, work regulations of the institution)

that are approved by the head of the healthcare institution where the nurse is

working and must be coordinated with labour unions.

Consultations with the employee and employer organisations are carried out by

asking for the opinion of professional organisations (Lithuanian Organisation of Nursing

Specialists, Lithuanian Union of Managers of Nurses and other associations) on relevant

matters and providing them with the drafts of legal acts for harmonisation and by taking

into account the received proposals.

Standing working group has been established for dealing with proposals provided by

Lithuanian Organisation of Nursing Specialists in respect of nursing problems (draft of the

Law on Nursing Practice, licensing problems of nursing personnel, improvement problems,

unsafe working environment, workload and representation of labour group, etc.); this group

was established by 6 February 2009 Order of the Minister of Healthcare No V-88.

On 3 August 2007 The Ministry of Healthcare has concluded a Cooperation

agreement No S-248 with the Lithuanian Organisation of Nursing Specialists, under which

the ministry undertakes constant and constructive cooperation. Consultations with other

nurse unions and associations are still carried out, their representatives are invited to the

working groups when legal acts are drafted, and their proposals are taken into

consideration. Trade union and union representatives are also included into working

groups, commissions that are dealing with issues, under the approved orders of the minister

of healthcare.

Article 27 of the Law on Safety and Health of Employees of the Republic of

Lithuania regulates the instructing and training of employees. According to the law, the

employer may not demand that the employee should start working for the enterprise if

he/she has not been instructed on the safe work performance. The employees are instructed

when employer’s representative or a person authorised by the employer decides that it is

required in order to protect the employees from traumas or occupational diseases. When

professional knowledge or the knowledge gained during the instruction is not sufficient for

the safe work of an employee so that his/her health would not be affected, the employer’s

representative or a person authorised by the employer arranges the training of the employee

at his/her workplace, enterprise or training institutions that carry out training, according to

the General Regulations on Training and Qualification Testing of Employees in

Occupational Safety and Health Matters prescribed by the Law. The employer’s

representative establishes procedure on training and instruction of employees in the

enterprise.

An employee who has been temporarily sent to work for an enterprise from another

enterprise, may not start working until he/she is instructed on safe work in the particular

workstation despite the fact that he/or she has been instructed and trained to work safely

under the established procedure in the enterprise he/she constantly works for. Employees

who have been sent to work for another enterprise must also be provided with the

information on the appointed employees of the enterprise who are responsible for the

provision of the first aid, organising the rescue and evacuation of employees in the event of

possible accidents, natural disasters or fires as well as on the measures of evacuation and

for putting out fires; they must also get acquaintained with the employee evacuation plans.

Employees who carry out work or provide services in other enterprises as well as

employees, who carry out control functions stipulated by the laws or other regulatory acts,

are instructed by their employers.

Procedure on drafting occupational safety and health instructions and instructing of

employees, working for enterprises carrying out any type of economic activities, is

established by the State Labour Inspectorate.

Only those employees who have gained special knowledge and passed the exam

testing that knowledge under the General Regulations on Training and Qualification

Testing of Employees in Occupational Safety and Health Matters, are allowed to use the

potentially dangerous equipment, the list of categories whereof is approved by the

Government, as well as to carry out the compulsory continuous maintenance during the

exploitation of this equipment. Employer establishes the procedure for training and

knowledge testing of employees who use the potentially dangerous equipment, which is not

the subject of compulsory inspections of the authorised institutions for the inspection of the

technical condition of dangerous equipment.

Employer establishes the procedure for training and examination of knowledge on

employee safety and health as well as on safe performance of this work of employees

performing dangerous work, the list whereof is approved by the Government, except for

cases when the laws or other regulatory acts establish a different procedure of training,

knowledge examination and safe performance of work of these employees.

According to the peculiarities of types of economic activities carried out by

enterprises and professional risk, employers may prepare and approve, upon coordination

with the State Labour Inspectorate, regulations on training and qualification testing of

employees of these enterprises on the base of the General Regulations on Training and

Qualification Testing of Employees in Occupational Safety and Health Matters. For

different types of economic activities the laws may establish a different procedure on

training and testing the knowledge of safety and health of employees than the one

established by the General Regulations on Training and Qualification Testing of Employees

in Occupational Safety and Health Matters. In this case the employees shall be trained and

their knowledge on employee safety and health shall be examined under the procedure laid

down by those laws.

The Regulations on Prevention of Injures Made by Sharp Instruments at Healthcare

Institutions establish the following:

The employer or employer’s representative organises the proper training of

employees, according to the procedures and strategy on the prevention of injuries made by

sharp instruments, including the training on:

1. the proper use of equipment with the mechanisms protecting from injuries and

(or) pricks;

2. introductory training for all new or temporary employees;

3. the risk related to the impact of blood or other body liquids;

4. preventive measures, including standard means of precaution, safe working

systems, the importance of proper use of sharp instruments as well as disposal

procedures and immunization thereof;

5. the importance of providing information about the accidents of incidents related

to sharp instruments, reacting and health monitoring procedures;

6. the measures that must be taken in case of injury.

Employers or their representatives must release from work those employees who

have to attend the training. This training is carried out on a regular basis under the

procedure established by the employer, according to the results of monitoring the

effectiveness of applied preventive measures.

Article 3

The key requirements for the education and training of nursing personnel are laid

down in these legal acts:

1. The Law on Nursing Practice and Obstetrics (OG, 2001, No 62-2224; 2009, No

89-3801), that establishes gaining the professional qualification of general

practice nurse and obstetrics, practice conditions, rights, duties and

responsibility.

2. The Law on Recognition of Regulated Professional Qualifications (OG, 2008,

No 47-1747), that establishes the principles and procedures for the recognition

of professional qualifications of nationals of Member States of the European

Union, nationals of countries of the European Economic Area and nationals of

the Swiss Confederation obtained in the European Union, European Economic

Area and Swiss Confederation, and administrative cooperation, safeguards that

persons who obtained professional qualifications in another Member State shall

have the same rights as nationals of the Republic of Lithuania to pursue, on

either a self-employed or employed basis, a regulated profession in the

Republic of Lithuania. This Law does not hinder the recognition of professional

qualifications of third country nationals obtained outside the European Union,

European Economic Area and Swiss Confederation by the Republic of

Lithuania in accordance with the procedure laid down by other legal acts. When

recognising professional qualifications, the minimum training conditions for the

respective professions must be complied with in all cases.

3. 23 December 2009 Resolution of the Government of the Republic of Lithuania

No 1749 ‘On the Approval of the List of Areas and Fields of Studies, Pursuant

to Which the Studies are Carried on in Higher Education Institutions and the

List of Qualification Degrees’ (OG, 2009, No 158-7135).

4. 18 March 2002 Order of the Minister of Healthcare of the Republic of Lithuania

No 132 ‘On the Improvement of Professional Qualification of the Specialists of

Healthcare Institutions and Pharmaceutics and the Funding Order Thereof’ (OG,

2002, No 31-1180).

5. Standard for Preparation of Nurses of General Practice, approved by 10 July

2002 Order of the Minister of Healthcare of the Republic of Lithuania No 1302

‘On the Approval of the Standard for Preparation of General Practice Nurses’

(OG, 2004, No 61-2208).

6. 11 April 2003 Order of the Minister of Healthcare of the Republic of Lithuania

No ISAK-480/V-210 ‘On the Minimum Requirements for Preparation of

Doctors, Doctors Deontologists, General Practice Nurses, Obstetrics and

Pharmacists’ (OG, 2003, 41-1896).

Coordination of education and training in nursing field is ensured by mutual

cooperation of the Ministry of Healthcare, the Ministry of Education and Science,

institutions that prepare the nursing personnel (colleges and universities) and labour unions.

Article 4

Requirements for the nursing practice are established in these legal acts:

The Law on Nursing Practice and Obstetrics (OG, 2001, No 62-2224; 2009, No 89-

3801) and the legal acts that implement it:

1. The Specialised List of Nursing Fields, approved by 17 December 2009 Order No


152-6842);

2. Descriptions of Requirements for Informal Education programmes of the

Specialised Nursing Fields, approved by 21 January 2010 Order No V-51 of the

Minister of Healthcare of the Republic of Lithuania (OG, 2010, No 13-659);

3. The Rules on Equation of Professional Qualifications Gained Before the Law on

Nursing Practice and Obstetrics Practice Came into Force and the General Practice

Nurse Professional Qualification approved by 17 December 2009 Order No V-1038

of the Minister of Healthcare of the Republic of Lithuania (OG, 2009, No 152-

6843);

4. The Licensing Rules for Nursing Practice, approved by 30 December 2009 Order


No 1-48);

5. The Licensing Rules for Obstetrics Practice, approved by 30 December 2009 Order


No 1-49);

6. The List of Diseases that Prevent Persons from the Provision of Nursing or

Obstetrics Services, approved by 12 August 2010 Order No V-720 of the Minister

of Healthcare of the Republic of Lithuania (OG, 2010, No 99-5157).

Medical standards that establish areas of activities of nurses of different nursing

fields, their rights, duties, competence and responsibility:


V-437 ‘On the Approval of Lithuanian Medical Standard MN 28: 2011 ‘General

Practice Nurse. Rights, Duties, Competence and Responsibility’ (OG, 2011, No 72-

3490);

2. 4 August 2006 Order of the Minister of Healthcare of the Republic of Lithuania No

629 ‘On the Approval of Lithuanian Medical Standard MN 22: 2006 ‘Mental Health

Nurse. Rights, Duties, Competence and Responsibility’ (OG, 2006, No 95-3746);


No V-437 ‘On the Approval of Lithuanian Medical Standard MN 91: 2001

‘Children’s Nurse. Rights, Duties, Competence and Responsibility’ (OG, 2001, No

105-3769);



‘Obstetrician. Rights, Duties, Competence and Responsibility’ (OG, 2006, No 40-

1446);


No 628 ‘On the Approval of Lithuanian Medical Standard MN 93: 2001 ‘Operating

Room Nurse. Rights, Duties, Competence and Responsibility’ (OG, 2001, No 104-

3731);



‘Community Nurse. Rights, Duties, Competence and Responsibility’ (OG, 2011, No

82-4015);


V-644 ‘On the Approval of Lithuanian Medical Standard MN 60: 2011 ‘Nurse-

Anaesthetist and Intensive Therapy Nurse. Rights, Duties, Competence and

Responsibility’ (OG, 2011, No 79-3882).

Article 5

According to Article 41 of the Labour Code, representatives of employees and

employers and their organisations are considered to be the parties of social partnership –

social partners. In case of a tripartite social partnership the Government and municipal

institutions participate in the partnership on an equal basis with representatives of

employees and employers and their organisations.

Social partnership may be developed on the following levels: national; sector

(production, services, professional); territorial (municipality, county) and enterprises,

establishments or organisations and their structural divisions. Social partnership may be

implemented through participation in the activities of bipartite or tripartite

councils (commissions, committees) through the exercise by employees’ representatives of

information and consultation rights and other rights of participation in the employer's

decision-making processes, by conducting collective bargaining and concluding collective

agreements. The system of social partnership is comprised of the Tripartite Council of the

Republic of Lithuania and other tripartite and bipartite councils (commissions, committees)

formed in accordance with the procedure established by laws or collective agreements.

One of the key and, it is true to say, the most effective form of the nationally carried

out social partnership is the formation of Tripartite Council of the Republic of Lithuania

and the activity of social partners that comprise it and the State, when solving issues

directly related to the legal status of employees, employers and legal subjects that represent

them; by initiating the drafting of legal acts that regulate labour relations. Social dialog

carried out by this institution plays an important role in coordinating the interests of

participants of legal labour relations. The Tripartite Council of the Republic of Lithuania

has been granted enough rights to regulate labour relations on the national basis.

By agreement between social partners, the Tripartite Council is formed from the

equal number of members enjoying equal rights: representatives of central (national) trade

unions, employers' organisations and the Government. The functions, rights, procedure of

formation, organisation of work of the Tripartite Council are established in the Regulations

of the Tripartite Council. Representatives of trade unions, employers' organisations and the

Government must provide the Tripartite Council with the necessary information on the

issues under consideration. The Tripartite Council may conclude trilateral agreements on

employment relationships and associated social and economic conditions, also on the

regulation of mutual relationships between the parties to the agreement. The Tripartite

Council's agreements are published in "Valstybės žinios" by the orders of the Prime

Minister and come into force in the manner prescribed for the Government resolutions.

Other trilateral or bilateral councils (commissions, committees) may be established

in accordance with the procedure prescribed by laws or collective agreements for

addressing and solving issues of work, employment, employee safety and health and social

policy implementation on the ground of trilateral and bilateral co-operation based on equal

rights. The procedure for the formation of such trilateral or bilateral councils (commissions,

committees) and their functions is established in the regulations of relevant councils

(commissions, committees). The regulations shall be approved by the subjects specified by

laws or the subjects of collective agreements in cases established by laws.

13 June 2005 the Government of the Republic of Lithuania, labour union and

employer organisations signed the “Agreement on Trilateral Cooperation of the

Government of the Republic of Lithuania, the Labour Unions and Employer Organisations”

in order to continue and improve the trilateral cooperation in various labour fields of

general interest and social security, that was initiated under 5 May 1995 agreement and

further developed by 11 February 1999 agreement.

The interests of the State, employers and employees, related to safety and health are

coordinated in the Commission of Employee Safety and Health of the Republic of

Lithuania, that is established by the principle of trilateral cooperation of social partners (the

parties) and working according to the Regulations of the Commission of Employee Safety

and Health of the Republic of Lithuania, approved by 9 January 2002 Resolution of the

Government of the Republic of Lithuania No 13 (OG, 2002, No 4-97). The Commission

analyses draft legal acts, provides comments and proposals to the Ministry of Social

Security and Labour, the Ministry of Healthcare, other state institutions and agencies, when

needed, provides the respective state institutions with proposals on the expedience of

drafting new legal acts on employee safety and health, the change or amendment of valid

legal acts, discusses the report on work safety conditions and implementation of labour

laws published by the State Labour Inspectorate, analyses the state of employee safety and

health, proposes measures and ways for improving the employee safety and health

conditions to the Ministry of Social Security and Labour, the Ministry of Healthcare, other

state institutions and agencies, employer organizations, labour unions and enterprises,

discusses plans of the programs and measures for improving the safety and health of

employees as well as results of implementation thereof. The issues on prevention of

infringement of employee safety and health requirements are dealt with by the territorial

and municipal commissions of employee safety and health, established according to the

principal of trilateral cooperation of social partners.

According to Article 47 of the Labour Code, the employees’ representatives have

the right to information and consultation. Information means the transfer of information

(data) to the employees’ representatives for the purpose of introducing them to the

substance of the matter. Consultation means the exchange of views and the establishment

and development of dialogue between the employees’ representatives and the employer.

The employer must regularly, at least once a year, inform the employees' representatives

and hold consultations with them about the current and future activities of the enterprise

(structural division), its economic situation and the status of employment relationships.

Prior to taking a decision on collective redundancies, the employer must inform the

employees’ representatives and hold consultations with them. Information must cover the

reasons for the planned redundancies, the total number of employees and the number of

employees to be made redundant by category, the period over which employment contracts

are to be terminated, the criteria for the selection of employees to be made redundant, the

conditions for the termination of employment contracts and other relevant information.

Consultations must be held with a view to avoiding collective redundancies or reducing the

number thereof, or mitigating the consequences of such redundancies. Prior to taking a

decision on the reorganisation of the enterprise, transfer of business or a part thereof and

other decisions that are likely to have substantial effects on the organisation of work in the

enterprise and the legal status of the employees, the employer must inform the employees’

representatives and hold consultations with them about the reasons for such a decision, the

legal, economic and social implications for the employees, as well as about any measures

envisaged to avoid or mitigate the expected consequences. Other cases, conditions and

procedure of information and consultation is established by laws, collective agreements and

agreements between the employer and the employees’ representatives. In the case of

information provision, the employer must provide the employees and their representatives

with information in writing in a timely manner free of charge and is responsible for the

correctness of such information. Upon submitting a written obligation not to reveal any

commercial (industrial) or professional secret, the employees or their representatives have

the right of access to information, which constitutes a commercial (industrial) or

professional secret but is necessary for the performance of their duties. The employees and

their representatives, irrespective of where they are and regardless of the termination of

employment relationships or powers of representation, are prohibited from using for any

other purpose or disclosing to the third persons any information, which has been

communicated to them as a commercial (industrial) or professional secret. Access to State,

official secrets and liability for the disclosure or unlawful use thereof is regulated by

special laws.

Consultations concerning the information (data) communicated by the employer and

the opinion expressed by the employees' representatives must be held in a timely manner,

enabling employees' representatives to meet the competent decision-making representatives

of the employer and obtain reasoned responses. Consultations must be held with a view to

reaching a decision satisfactory to both the parties. The results of consultations shall be

recorded in the minutes. The employer may refuse in writing to provide any information,

which constitutes a commercial (industrial) or professional secret, or to have discussions

with the employees' representatives when the nature of that information or discussion

might, according to objective criteria, seriously harm the functioning of the undertaking

concerned or would be prejudicial to it. The employees' representative, disagreeing with the

decision of the employer, may, within one month, apply to the court. After the court’s

ruling that the refusal to provide information or have discussions is unjustified, the

employer in question is obligated to provide such information or carry out the discussion

within a reasonable period of time. The peculiarities of information and consultation

procedures in Community-scale undertakings, Community-scale groups of undertakings,

European companies and European cooperative societies are established by special laws.

According to Article 6 of the Law on Safety and Health at Work, the interests of the

State, the employers and employees related to occupational safety and health, shall be

coordinated by the Commission of Employee Safety and Health of the Republic of

Lithuania, established upon the principle of trilateral cooperation of social partners (the

parties). Procedure on establishment and functions of this Commission is stipulated by the

Regulations of the Commission of Employee Safety and Health approved by the

Government. According to the principle of trilateral cooperation of social partners,

Territorial district commissions of employee safety and health may be established,

municipal commissions of employee safety and health may be also established in order to

deal with issues on the prevention of infringements of occupational safety and health

requirements. The Minister of social security and labour lays down the procedure for

establishment and composition of the territorial district and municipal commissions of

employee safety and health. According to the principle of bilateral cooperation between the

employer organisations and the labour unions of respective branch, commissions of safety

and health of employees of different fields of economic activities may be established.

Founders of these commissions lay down the procedures for establishment and composition

thereof.

Under Article 13 of Law on Safety and Health at Work, the employer’s

representative, or authorised persons must inform and consult employees on all the issues

related to the state of their safety and health, plans for improvement thereof, arrangement of

measures, their implementation and control. The employer’s representative or heads of the

subdivisions provide conditions for employees and their representatives for safety and

health to take part in discussions concerning occupational safety and health matters. To this

end, occupational safety and health committees are established in an enterprise or

representatives for safety and health of employees are elected.

Occupational safety and health committee is established in an enterprise where there

are more than 50 employees. In case less that 50 employees work for the enterprise,

occupational safety and health committee may be established by the initiative of the

employer or the employee representatives, or upon the proposal of more than a half of

employee staff of the enterprise. In some enterprises that carry out particular economic

activities, where the professional risk is higher, the occupational safety and health

committee may be established even when there are less than 50 employees in the enterprise.

The types of economic activities that qualify for the establishment of committees in

enterprises having more than 50 employees and the types of economic activities in respect

of which the establishment of committees in enterprises having more than 50 employees is

recommended, are defined in the General Regulations of Occupational Safety and Health

Committees. The Commission of Employee Safety and Health approves these regulations.

The Committee is formed by the bilateral principle – from the equal number of employer’s

representatives appointed by employer’s representative (management officers of the

enterprise) and the elected employee representatives for safety and health. Activity of the

Committee is carried out and it is managed by the chairman of the committee – employer’s

representative or an employee representative appointed by him/her. The chairman organises

the work of the committee. The employee representative for occupational safety and help is

elected the secretary of the committee. Employer provides members of the committee with

equipment and information required for carrying out their duties. Under the periods defined

by the collective agreement, members of the committee are periodically trained at

educational institutions that provide education services related to occupational safety and

health, according to the General Regulations on Training and Qualification Testing of

Employees of Occupational Safety and Health Matters; in seminars or the enterprise using

employer’s financial resources. Issues on education of committee members are dealt with

by concluding collective agreements. The time that the committee member spends carrying

out duties delegated to him related to occupational safety and health or studying, is

remunerated with his average wage. According to the General Regulations on Occupational

Safety and Health of Enterprise Employees, enterprises draft the Regulations of the

Committee of Employee Safety and Health. Employer’s representative approves these

regulations upon their coordination with employee representatives. Following regulations

of the committee of employee safety and health, the labour union of the enterprise and in

case there is no labour union – other employee representatives elected at the staff meeting,

organises the election of the employee representative for safety and health and the election

of members of the committee of employee safety and health. Employee representatives

establish the number of enterprise subdivisions and employees that are represented by the

employee representative for safety and health. In case there is more than one employee

representative for safety and health, one of them is elected the senior employee

representative, who coordinates the activities of all employee representatives for safety and

health in the enterprise. There must be at least one employee representative for safety and

health during every shift.

Employee representatives for safety and health perform the following functions:

1) represent the employees of the enterprise in committee, participate in all

measures for the improvement of occupational safety and health of employees in enterprise

or at workstations carried out by the employer, including evaluation of professional risk

and taking measures to eliminate and (or) mitigate the risk;

2) participate when the employer’s representative or an authorised person selects

and appoints employees responsible for first aid, organisation of rescue measures,

evacuation in the event of accidents, natural disasters or fires (prior to the appointment of

such workers, the employer consults the employee representatives for safety and health,

upon their appointment employer informs employee representatives about the duties and

workstations of these employees);

3) participate in providing the employees with necessary and appropriate personal

protective equipment and controls the use thereof;

4) upon delegation of employee representative participate in investigation of

occupational accidents, occupational diseases and incidents;

5) upon the instruction of the employer or head of the subdivision immediately

inform the employees about the existing or possible danger and inform on emergency

actions that should be taken in order to avoid the danger and help to transfer the employees

to safe locations in case of danger.

The representative of employees for safety and health is entitled to:

1) propose and demand that head of the subdivision, employer’s representative

should take necessary measures to ensure safety and health of employees;

2) take part in the assessment of professional risk and planning preventive

measures;

3) inform employer’s representative if the head of the subdivision does not take

necessary measures to ensure safety and health of employees. In case employer’s

representative does not take measures to remove or mitigate risk factors, to inform the State

Labour Inspectorate;

4) receive information on all issues related to occupational safety and health of

employees from the head of the subdivision, safety and health service and committee of

the undertaking.

The employer or employer’s representative provides the employee representatives

for safety and health with the relative information, required equipment and gives enough

time during their working hours to carry out their delegated functions and implement their

rights. Particular number of working hours required for carrying out their functions and

rights is established by employment contracts or collective agreements. They are paid the

salary that may not be less than the average salary for this time.

When carrying out their duties, employee representatives for safety and health may

not incur any financial loss, they are not subject to administrative or other liability, they

may not feel animosity from employer’s representative or the persons authorised by the

employer or employees, if they are following the regulatory acts on occupational safety and

health when carrying out their activities. Representatives of employees are trained in the

enterprise using employer’s resources, in training seminars, at educational institutions that

provide education services related to occupational safety and health according to the

General Regulations on Training and Qualification Testing of Employees in Occupational

Safety and Health Matters. They are paid their average wage during the time of training.

Issues related to training of employee representatives for occupational safety and health are

dealt with in the enterprise by solving them in the committee by concluding collective

agreements. The representatives of employees for safety and health must not reveal the

commercial and industrial secrets, which they learn when carrying out their functions.

Provisions of the Labour Code apply to the nursing personnel in the same manner as

they apply to other employees working under employment contracts. Article 47 of the

Labour Code establishes information and consultation: the employees’ representatives have

the right to information and consultation. Information means the transfer of information

(data) to the employees’ representatives for the purpose of introducing them to the

substance of the matter. Consultation means the exchange of views and the establishment

and development of dialogue between the employees’ representatives and the employer.

The employer must regularly, at least once a year, inform the employees' representatives

and hold consultations with them about the current and future activities of the enterprise

(structural division), its economic situation and the status of employment relationships.

Prior to taking a decision on collective redundancies, the employer must inform the

employees’ representatives and consult them. Information must cover the reasons for the

planned redundancies, the total number of employees and the number of employees to be

made redundant by category, the period over which employment contracts are to be

terminated, the criteria for the selection of employees to be made redundant, the conditions

for the termination of employment contracts and other relevant information. Consultations

must be held with a view to avoiding collective redundancies or reducing the number

thereof, or mitigating the consequences of such redundancies. Prior to taking a decision on

the reorganisation of the enterprise, transfer of business or a part thereof and other

decisions that are likely to have substantial effects on the organisation of work in the

enterprise and the legal status of the employees, the employer must inform the employees’

representatives and hold consultations with them about the reasons for such a decision, the

legal, economic and social implications for the employees, as well as about any measures

envisaged to avoid or mitigate the expected consequences. Other cases, conditions and

procedure of information and consultation is established by laws, collective agreements and

agreements between the employer and the employees’ representatives. In the case of

information provision, the employer must provide the employees and their representatives

with information in writing in a timely manner free of charge and is responsible for the

correctness of such information. Upon submitting a written obligation not to reveal any

commercial (industrial) or professional secret, the employees or their representatives have

the right of access to information, which constitutes a commercial (industrial) or

professional secret but is necessary for the performance of their duties. The employees and

their representatives, irrespective of where they are and regardless of the termination of

employment relationships or powers of representation, are prohibited from using for any

other purpose or disclosing to the third persons any information, which has been

communicated to them as a commercial (industrial) or professional secret. Special laws

regulate the access to State, official secrets and liability for the disclosure or unlawful use

thereof. Consultations concerning the information (data) communicated by the employer

and the opinion expressed by the employees' representatives must be held in a timely

manner, enabling employees' representatives to meet the competent decision-making

representatives of the employer and obtain reasoned responses. Consultations must be held

with a view to reaching a decision satisfactory to both the parties. The results of

consultations shall be recorded in the minutes. The employer may refuse in writing to

provide any information, which constitutes a commercial (industrial) or professional secret,

or to have discussions with the employees' representatives when the nature of that

information or discussion might, according to objective criteria, seriously harm the

functioning of the undertaking concerned or would be prejudicial to it. The employees'

representative, disagreeing with the decision of the employer, may, within one month,

apply to the court. After the court’s ruling that the refusal to provide information or have

discussions is unjustified, the employer in question is obligated to provide such information

or carry out the discussion within a reasonable period of time. Special laws establish the

peculiarities of information and consultation procedures in Community-scale undertakings,

Community-scale groups of undertakings, European companies and European cooperative

societies. In case there are no representatives of employees in the enterprise, the employer

must, directly or at the general meeting of employees, inform the employees in advance on

the execution date, reasons, legal, economical and social consequences of adopted

decisions as well as on the established measures related to employees.

The supervisory boards (advisory body) are formed in public establishments in

order to ensure the publicity of activities thereof that should also involve one representative

appointed by labour unions of healthcare specialists of the establishment. Nursing councils

are formed this way in establishments as well. They are comprised of nursing specialists of

establishment subdivisions and branches. Nursing council deals with issues on organisation

and improvement of patient nursing and provides recommendatory proposals to the

administration of establishment. Articles of Association of public establishments define the

formation of nursing council, rights and duties thereof, working procedure, rights and

duties of members, terms of their appointment and revocation, remuneration and

responsibility.

By 6 February 2009 Order of the Minister of Healthcare No V-88 the standing

working group has been established for discussing proposals made by Lithuanian

Organisation of Nursing Specialists in respect of nursing problems (draft of the Law on

Nursing Practice, licensing problems of nursing personnel, improvement problems, unsafe

working environment, workloads and representation of labour group, etc.).

3 August 2007 the Ministry of Healthcare has concluded a Cooperation agreement

No S-248 with the Lithuanian Organisation of Nursing Specialists, under which the

ministry undertook constant and constructive cooperation. Consultations with other nurse

unions and associations are also carried out, their representatives are invited to the working

groups when legal acts are drafted, and their proposals are taken into consideration.

Representatives of labour unions or unions also comprise working groups and commissions

of pending issues approved by the order of the Minister of healthcare

According to Article 39 of the Labour Code, safety and health of workers is

assessed on the basis of the degree of compliance of working conditions and work

equipment in the enterprise, its subdivisions with the requirements of regulatory acts on

employee safety and health at work and on evaluation of professional risk at workspaces or

other areas of enterprise where the employee may be during the working hours. The

compliance of working equipment, working conditions including work environment with

requirements of regulatory acts on safety and health of employees is assessed upon carrying

out the investigation on professional risk and evaluating the results of this investigation.

Employer’s representative or a person authorised by employer organises the evaluation of

professional risk in the enterprise. In case there are no personnel qualified to identify the

workstations or objects where the risk should be evaluated, to examine the risk and

establish the results, the enterprise hires outside agencies or specialists to provide these

services. Labour inspector may indicate the workstations and objects where the risk should

be evaluated. The Minister of Social Security and Labour and the Minister of Healthcare

approve the general regulations on the assessment of professional risk. The Minister of

Social Security and Labour and the Minister of Healthcare also establish qualification

requirements for agencies that carry out investigation of risk factors.

Enterprises provide information on occupational safety of employees and

compliance of workstations with the requirements of regulatory acts on occupational safety

and health to the State Labour Inspectorate under the procedure established by the senior

state labour inspector.

The requirements for working environment are laid down in Article 40 of the

Labour Code. Workers must be provided with the working environment, which excludes

dangerous and (or) hazardous factors posing a risk of injury or any damage to health, and if

such risk exists, it must be as small as possible and measures must be foreseen to eliminate

such risk. Permitted limit values of factors in the working environment are laid down in

health protection regulations (hygiene norms) and other regulations on safety and health at

work

The working time must not exceed 36 hours for the workers who perform work in

the working environment in which the proportions of hazardous factors exceed the

permitted limit values and it is technically or otherwise impossible to reduce them to the

permitted limit values as established in regulations on safety and health at work. The

concrete daily or weekly working time of the workers who perform work in the working

environment in which the proportions of hazardous factors exceed the permitted limit

values (amounts) and it is technically or otherwise impossible to reduce them to the

permitted limit values (amounts) as established in regulations on safety and health at work,

is set by evaluating the results of working environment investigations, complying with the

criteria and procedure for setting shorter working time taking into account the working

environment, approved by the Minister of Health Care.

The employment of nursing personnel is regulated by the Labour Code of the

Republic of Lithuania (OG, 2002, No 64-2569), the Law on Healthcare Institutions (OG,

1996, No 66-1572; 1997, No 62-1462; 1998, No 109-2995) and other accompanying legal

acts.

Disputes between the nursing personnel and employer are heard in accordance with

the procedure laid down in the chapter on individual labour disputes of the Labour Code.

Individual labour disputes may be heard by the labour dispute commission, which is

formed in an enterprise, and the court.

Article 6

Nursing personnel shall enjoy conditions at least equivalent to those of other

workers in the country concerned in the following fields: hours of work, including

regulation and compensation of overtime, inconvenient hours and shift work; weekly rest;

paid annual holidays; educational leave; maternity leave; sick leave; social security.

Hours of work, weekly rest and paid annual holidays of nursing personnel, as well

as of all healthcare employees is regulated by Resolutions of the Government of the

Republic of Lithuania. The number of working hours was unified for all healthcare

employees (working week of 38 hours) and prolonged annual holidays of 36 calendar days

were established. The Organisation of Healthcare Specialists has approved this unification

of working conditions. It should be noted that provisions of the Labour Code apply to all

healthcare personnel, including the nursing personnel.

Under the Law on State Social Insurance the insured persons mean the natural

persons who, in accordance with the procedure laid down by this Law, pay state social

insurance contributions themselves and (or) insurers pay these contributions for them.

Thus, the nursing personnel, as well as other persons working under employment contracts,

is covered by the types of social insurance stipulated in the Law on State Social Insurance:

1. Pension social insurance, where a person is insured to receive the basic or the

basic and supplementary parts of a pension as provided for in the Law on State Social

Insurance Pensions;

2. Sickness and maternity social insurance, where a person is insured to receive the

sickness and maternity, paternity and maternity (paternity) and vocational rehabilitation

benefits provided for in the Law on Sickness and Maternity Social Insurance. In the cases

provided for by this Law, persons shall be covered by sickness and maternity social

insurance, where a person is insured to receive only the maternity, paternity and maternity

(paternity) benefits provided for in the Law on Sickness and Maternity Social Insurance;

2.1. According to the Law on Sickness and Maternity Social Insurance the insured

persons are entitled to sickness allowance if:

a) they become temporarily incapacitated for work and due to this lose their income

from work and also if during that period they are not in receipt of a sickness allowance on

the basis of the Law on Social Insurance of Occupational Accidents and Occupational

Diseases;

b) they had the sickness and maternity social insurance record of not less than 3

months during the last 12 months or not less than 6 months during the last 24 months

before the day of establishment of temporary incapacity for work.

The sickness allowance is granted to the persons entitled to it:

a) the insured persons who became temporarily incapacitated for work due to illness

or trauma and therefore lost income from work, except for the cases of granting and

payment of sickness allowances provided for by the Occupational Accidents and

Occupational Diseases Social Insurance Law;

b) for nursing sick family members (if on the doctor’s instruction it is necessary to

nurse a sick family member);

c) the insured removed from the job due to the outbreak of infectious diseases or

epidemics;

d) the insured undergoing treatment at the health care institutions providing

orthopaedic and (or) prosthetic services;

e) for childcare if the regime for containing the spread of infection has been

introduced in childcare institutions;

f) for childcare if the person who has been granted a maternity leave or a childcare

leave is unable to take care of the child due to her/his own sickness or trauma;

g) the insured persons who have become temporarily incapable for work because of

taking of the tissues, cells or organs for transplantation with the purpose of donation.

2.2. The following persons are entitled to maternity allowance during the pregnancy

and childcare leave:

a) covered by the sickness and maternity insurance;

b) who were granted a maternity under procedure laid down by laws;

c) who have the sickness and maternity social insurance record of not less than 12

months during the last 24 months by the first day of pregnancy and childbirth leave.

2.3. A father is entitled to paternity allowance, who:

1) is covered by the sickness and maternity insurance;

2) has been granted paternity leave until the child reaches the age of 1 month in

accordance with the procedure laid down by the laws;

3) over the last 24 months before the first day of a paternity leave had not less than

12 months of the sickness and maternity social insurance record during the last 24 months.

2.4. Entitled to a maternity (paternity) allowance is one of the parents (adopted

parents) or a guardian who:

a) has been ensured by the sickness and maternity insurance;

b) has been granted a childcare leave according to the procedure established by

laws;

c) over the last 24 months before the first day of a childcare leave has got not less

than 12 months of the sickness and maternity social insurance record during the last 24

months.

3. Unemployment social insurance, where a person is insured to receive the benefits

provided for in the Law on Unemployment Social Insurance.

4. Social insurance of occupational accidents and occupational diseases, where a

person is insured to receive the benefits provided for in the Law on Social Insurance of

Occupational Accidents and Occupational Diseases. The benefits of social insurance of

occupational accidents are the following:

4.1. Benefit for illness resulting from an occupational accident, an accident on the

way to/from work or an occupational disease.

4.2. Lump-sum compensation for loss of capacity for work.

4.3. Periodic compensation for loss of capacity for work.

4.4. A lump-sum insurance benefit upon the death of an insured as a result of an

insured event, paid in equal parts to his family members.

4.5. A periodic insurance benefit upon the death of an insured as a result of an

insured event, paid monthly in equal parts to his family members.

5. Health insurance, where an insurer insures for the health care services and

compensations provided for in the Law on Health Insurance.

Article 7

Improvement of existing laws and other legal acts on occupational health and safety

by adapting them to the special nature of nursing work and the environment where it is

carried out:

1. 7 May 1999 Resolution of the Government of the Republic of Lithuania No 544

‘On the Approval of the List of Jobs and Areas of Activities Where Only Those Employees

are Permitted to Work, Who Get an Early Check and Later Periodical Checks for Infectious

Diseases and the Order for the Health Check of These Employees’ defines the groups of

workers (including nursing personnel) that are permitted to work only after they get

checked and later on periodically get checked for infectious diseases.

2. 31 May 2000 Order of the Minister of Healthcare of the Republic of Lithuania

No 301 ‘On the Preventive Health Checks in Healthcare Institutions’ that establishes that

the nursing personnel must get their health checked once a year.

3. The Law on Safety and Health of Employees establishes that it is employer’s

duty to ensure safe and healthy working conditions in all the work-related aspects. The

safety and health equipment of employees are financed from employer’s resources.

4. Description on Establishment of Workload for Nursing Personnel, approved by 9

May 2012 Order of the Minister of Healthcare of the Republic of Lithuania No V-400.

5. Description on Establishment of Workload for Obstetrics, approved by 9 May

2012 Order of the Minister of Healthcare of the Republic of Lithuania No V-399.

6. Hygiene Standard of Lithuania No HN 47-2012 ‘Health Care Institutions.

Requirements on Infection Control’, approved by 19 October 2012 Order of the Minister of

Healthcare of the Republic of Lithuania No V-946, that lays down the requirements for the

control of infections.

7. 16 March 2012 Order of the Minister of Social Security and Labour of the

Republic of Lithuania and the Minister of Health Care of the Republic of Lithuania No A1-

157/V-210/V-501 on the Approval of Regulations on Prevention of the Injures Made by

Sharp Instruments at Healthcare Institutions. The purpose of the Regulations on Prevention

of the Injures Made by Sharp Instruments at Healthcare Institutions – to establish the key

requirements for employee protection where the risk of injuries made by various sharp

instruments (as well as pricks) arises or may arise. The requirements of these regulations

apply to any activities carried out by the employees of healthcare institutions as well as all

persons who are managed and supervised by employers or their representatives where the

risk of injuries made by sharp instruments arises or may arise. Employers or their

representatives must seek to ensure that the persons who provide the healthcare services

directly or participate in providing the healthcare services according to the contractual

relationship established with employer, follow the requirements of these regulations.

Article 8

In order to consolidate social partnership and following the Labour Code of the

Republic of Lithuania, some health care institutions have concluded Collective agreements.

III. The policy applied to nursing services and nursing personnel is implemented by

the Ministry of Social Security and Labour, The State Social Insurance Fund Board under

the Ministry of Social Security and Labour.

IV. There were no court rulings related to application of Convention provisions

during the period of the report.

VI. According to the provisions of Paragraph 2 of Article 23 of the Constitution of

ILO, the copies of this report have been presented to the following organizations:

Lithuanian Trade Union ‘Solidarumas’;

Lithuanian Confederation of Trade Unions;

Lithuanian Labour Federation;

Lithuanian Confederation of Industrialists;

Lithuanian Confederation of Business Employers.

No comments related to this report have been received from the mentioned

organizations.

Vice-minister Laisvūnas Bartkevičius

Neringa Dulkinaitė, tel: +370 706 68231, email: [email protected]

ministry of social security and labour of the republic...

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