[Passage of the Nursing Act] ① Medical System Changing After 70 Years... What and How Will It Change?

Separate Law for Nursing and Care Sectors
Explicit Provision for Improving Nursing Staff Treatment
President Yoon's Veto Power as a Variable

The long-awaited Nursing Act, a longstanding wish in the nursing community, passed the National Assembly plenary session on the 27th, marking a significant change in the healthcare system after more than 70 years. Previously, all medical activities, including nursing and caregiving, were regulated under the Medical Service Act, but now they will be governed separately through the Nursing Act. Since the Nursing Act also includes the duties, treatment, and qualification requirements of nursing personnel such as nurses and nursing assistants, the fields of nursing and caregiving will be legally completely separated.

A Major Transformation in the Healthcare System After 72 Years

The foundation of Korea’s current Medical Service Act is the ‘National Medical Service Act’ enacted in 1951. Although it has been amended several times and evolved into the current Medical Service Act, its basic structure has been maintained. The Medical Service Act covers fundamental aspects such as licensing and qualification requirements for ‘medical personnel’ including doctors, dentists, oriental medicine doctors, and nurses, as well as regulating overall medical activities. It was primarily focused on effectively regulating traditional medical practices centered on doctors’ diagnosis and treatment in ‘medical institutions.’

The enactment of the Nursing Act signifies a departure from this perspective by separating the fields of nursing and caregiving from traditional medical care. The reality of an aging society and the increase in chronic diseases are shifting the paradigm of health management from hospital-centered to community- and prevention-centered care. Reflecting the increased demand for nursing and caregiving services and the growing professional value of the nursing field, the Nursing Act embodies the view that these roles should be newly defined as independent and professional.

Demand for the Enactment of the Nursing Act. / Photo by Jinhyung Kang aymsdream@

Specific Contents of the Nursing Act

The Nursing Act first separates matters related to nursing personnel such as nurses and nursing assistants, which were previously included in the Medical Service Act, into an independent law. The purpose of enacting the Nursing Act is explicitly stated as ‘to regulate necessary matters so that all citizens can receive high-quality nursing benefits at medical institutions and in the community.’ To this end, it stipulates licenses and qualifications, scope of work, rights and treatment improvements, and workforce development plans for nurses, specialized nurses, and nursing assistants (nursing personnel).

In particular, the Nursing Act includes provisions for the rights and treatment improvements of nurses, which were not present in the Medical Service Act. The state and local governments must establish and support policies necessary to induce long-term service and secure skilled nursing personnel. Additionally, legal grounds are established for the state and local governments to provide financial support to medical institutions to secure nursing personnel, and institutions and facilities employing nursing personnel are also obligated to support improvements in working conditions and treatment.

Measures for workforce development are also specifically included. Hospital-level medical institutions are required to appoint ‘education-dedicated nurses’ to transfer the knowledge, skills, and competencies necessary for job performance and support adaptation. Education-dedicated nurses will oversee the education of new nurses, plan, operate, and evaluate educational programs, and secure and develop resources needed for education. The costs required to operate education-dedicated nurses will be fully or partially supported by the state.

Many Controversial Parts Excluded... The Variable is the ‘Veto Power’

The Nursing Act passed this time is a bill approved as an alternative by the National Assembly’s Health and Welfare Committee. The original bill defined nurses’ duties under the supervision of doctors, dentists, and oriental medicine doctors as ‘tasks necessary for patient care,’ but this was maintained as ‘assistance in medical treatment,’ the same as the current Medical Service Act. The government’s role in establishing a comprehensive nursing plan every five years was also downgraded to merely requiring the formulation of necessary policies. Since the bill was effectively reduced to separating the nursing and nursing assistant parts from the Medical Service Act, there are forecasts that even if the Nursing Act is enacted, the immediate changes felt by medical sites or the public will not be significant.

However, variables remain. Since the bill passed the plenary session of the National Assembly with the strong will of the ruling party, the Democratic Party of Korea, opposition from the ruling party is expected. Earlier, Yoon Jae-ok, floor leader of the People Power Party, stated, “If the Nursing Act is forcibly passed alone, the ruling party cannot just watch this situation without special measures,” and added, “We think we have no choice but to recommend the president exercise the right of reconsideration (veto).” If President Yoon Suk-yeol exercises the veto, the Nursing Act will effectively be on the path to repeal. Previously, the Grain Management Act, which President Yoon vetoed, was discarded after failing to pass the two-thirds majority in the National Assembly. However, in this case, repeated vetoes could face criticism for undermining the legislative power of the National Assembly, and since President Yoon promised to improve nurses’ treatment during his candidacy, it is also expected that exercising the veto will not be easy.