Midwifery and the enlarged European Union

The freedom of movement of midwives within the European Union has been guaranteed by the application of midwives' sectoral directives signed in 1980 and applied in 1983. Since then the size of the European Union has grown from 9 to 15 members and is due for a next wave of enlargement of another 10 member states in 2004. The rules and regulations that govern the European Union are being revisited to accommodate this change. Midwifery will be affected and some changes are potentially worrying, in particular the proposed loss of the Advisory Committee on the Training of Midwives. Six other professions regulated in a very similar way are also to lose their own advisory committees. The European Commission has proposed the adoption of a single directive for all professions, together with the setting up of an expert group whose function would be to deal principally with health professions. However, neither its remit nor its membership has been determined. Whereas previous movement of midwives within Europe has been minimal, it is anticipated that this may well be changed at the next enlargement stage. Without clear directives and some form of controlling power at European level, public health may be threatened. In this paper the developments to date and the concerns that have emerged from the recent proposals are outlined.