The shift intends to move care from a hospital-centred system to one where GPs coordinate their patients' healthcare journey.

The Luxembourgish healthcare system faces big challenges. The Covid pandemic brought our strengths and weaknesses into stark relief. Now politicians must lay the groundwork to ensure patients will get the best possible care in the future. In light of this, the CSV had requested an orientation debate in the Chamber of Deputies.

"Ambulatory shift" is the hot topic of the day. It describes a transition from a system which centres around hospitals to one where GPs coordinate the patient's journey. Local medical establishmens such as group practices or medical centres will be favoured. This means care moves closer to the patient, while hospitals are relieved, said DP MP Carole Hartmann. "This is made possible by medical progress. Many interventions are less invasive than they used to be. Supervision and control after surgery is reduced."

This frees up beds and shortens wait times for emergencies, because less urgent issues can be dealt with in other ways.

This raises not only logistical, but also legal questions. And, of course, money is an issue. Old debates around so-called pluridisciplinary centres with high performance equipment rear their heads. For Claude Wiseler from the CSV, it is clear that "the list of devices that can be authorised outside of hospitals and privately financed is much longer and must be adapted to today's reality. This includes MRIs."

Health Minister Paulette Lenert stresses that these decisions must not be rushed. "Is there a need? Thinking of MRIs alone, the situation when those processes were started was different than it is now. We got additional MRIs. The question must be asked. We are working on it."
MPs from all parties agree that a two-tier medical system, where more money buys you faster access, must be avoided. Déi Lénk and LSAP in particular stress that financial interests have no place in the healthcare system in Luxembourg. "If new establishments are to be developed, this cannot be about individual interests or about mini clinics working on their own. Actual needs must be prioritised, with regional distribution and not centred around where it is most lucrative," says Mars di Bartolomeo.

Still, there will be a move to more care being offered outside of hospitals. The healthcare sector, with its many actors and stakeholders, should be modernised in the interest of patients, above all.