Midwifery, Nursing, Physiotherapy and Paramedical Services under the Economic Partnership Agreement

For those engaged in providing the following services; Midwifery, Nursing, Physiotherapy and Paramedical, the Barbados Private Sector Trade Team has provided a series of questions and answers designed to address many of the issues you may have regarding access to the EC for your business.

May 08 2012 | Research

What provisions are made under the EPA for the Independent Midwife, Nurse, Physiotherapist or Paramedical Practitioner from Barbados who wishes to provide services to a European client from Barbados without travelling to the EU?

A Barbadian service provider can supply midwifery, nursing, physiotherapy & paramedical personnel services from Barbados to a European consumer.  These opportunities are subject to conditions in the following European countries:

Finally, there are no restrictions on Barbadian service providers in these sectors wishing to provide services to European clients in Barbados.

Midwifery, Nursing, Physiotherapy and Paramedical

My question deals with Independent Service Providers from Barbados working in the EU. Does the EPA allow for independent midwives, nurses, physiotherapists or paramedical personnel to enter into contracts and provide services to clients in Europe?

Yes, Independent midwives, nurses, physiotherapists or paramedical personnel who have a contract with a consumer in an EU member state may travel to these states to provide their services, but there are some conditions – both general – and country specific.

Generally, the person applying to supply the service from Barbados must be a self-employed person established in the Barbados, and must have obtained a service contract for a period not more than 12 months.

The Barbadian professional must possess at least 6 years professional experience in the relevant sector and must have a university degree or equivalent qualification and professional qualifications where required by law.

The temporary entry will be for a cumulative period not exceeding 6 months (or 25 weeks in Luxembourg) during a 12-month period or for the duration of the contract (whichever is less) and the visa will permit the Barbadian to work only on the contracted service activity – no other business activities will be permitted.

The following conditions are country and sector specific.  The chart explains the conditions for each country as applicable by sector:

Midwifery, Nursing, Physiotherapy and Paramedical

Do Barbadian service providers in the Midwifery, Nursing, Physiotherapy or Paramedical Sectors have to be licensed or meet certain qualifications to practice in the EU?

The Economic Partnership Agreement (EPA) requires that in order for Barbadians to provide Midwifery, Nursing, Physiotherapy or Paramedical services in Europe, the service provider’s qualifications or business license needs to be recognised in the European country.  The EPA establishes a process for the private sector, through the relevant professional bodies, to negotiate the terms for mutual recognition of qualifications and licensing requirements.

The Agreement requires the relevant professional bodies in CARIFORUM to engage in negotiations with their counterparts in the EU.  The professional bodies will then make recommendations to the CARIFORUM-EC Trade and Development Committee, which will finalise the mutual recognition agreements.

Midwifery, Nursing, Physiotherapy and Paramedical

Once granted permission to operate a business in the EU under the terms of the EPA, what types of personnel would be allowed to work at the EU-located business? And how long would they be permitted to live and work in Europe?

Subject, of course, to the normal visa and immigration requirements, the following categories of personnel are allowed for the designated lengths of time:
Generally, the senior Barbadian staff responsible for establishing a commercial presence in Europe may stay for 90 days in any 12-month period. Key personnel will be allowed to work in Europe for a period of up to 3 years, and graduate trainees may stay for one year.

There are, though, some conditions imposed on these general entry terms based on 1) the country and 2) the sector involved.

Midwifery, Nursing, Physiotherapy and Paramedical

What provisions are included in the Economic Partnership Agreement (EPA) between the countries of CARIFORUM (Including Barbados) and the European Union for persons engaged in Midwifery, Nursing, Physiotherapy and Para-Medical Services?

In general, market access has been granted to Barbadian entities in the EU in the service categories of Midwifery, Nursing, Physiotherapy and Paramedical service.  This means that they are able to invest in or establish a legal operation in these areas in European countries that are members of the Union. There are general conditions applicable across these categories in some countries.

Austria, Bulgaria, Cyprus, Czech Republic, Denmark, Estonia, Spain, Greece, Finland, Hungary, Ireland, Italy, Lithuania, Latvia, Malta, Poland, Romania, Slovak Republic, and Slovenia all place limitations on the acquisition of land and real estate.
Estonia, Finland, Italy, Romania and Sweden have requirements of local citizenship or residency of senior management or Board of Directors.
In Poland, there are limitations on the type of business that Barbadian service providers may operate or own.
Bulgaria, France, Finland and Italy place limitations on the type of investment that Barbadian firms may make, e.g. putting a limit on the maximum percentage for foreign shareholding or voting rights, and the EU in general has limitations on the treatment that is extended to branches and agencies.

The EPA treats Midwifery, Nursing, Physiotherapy and Paramedical services generally as belonging to a single category.  There are, however, some differences in how each one of the services is treated in some European countries.
This access is subject to the following conditions:

MIDWIVES
For midwives, Bulgaria, Finland, Malta & Slovenia have made no commitment to permit the provision of this service. In France, while other types of legal form are available for EC investors, foreign investors only have access to the legal forms of "société d'exercice liberal" and "société civile professionnelle.” In Lithuania, an economics needs test may be applied prior to a Barbadian company being allowed access with the employment situation among midwives in Lithuania being the primary criterion in the determination.

NURSES, PHYSIOTHERAPISTS & PARAMEDICAL PERSONNEL SERVICES
Following are the market access restrictions in specific countries for Barbadian Nursing, Physiotherapy and Paramedical service providers interested in investment or operating in Europe under the Economic Partnership Agreement:

Midwifery, Nursing, Physiotherapy and Paramedical