© René Pfeiffer
Luxembourg’s Association of Doctors and Dentists (AMMD) voted almost unanimously on Wednesday evening to end its convention with the national health insurance fund (CNS), warning the government it must act quickly to address longstanding concerns.
The doctors have had enough. On Wednesday evening, the Association of Doctors and Dentists (AMMD) gathered its members to discuss the future of the profession, and to vote on whether to terminate the convention with Luxembourg’s national health insurance fund (CNS). The result was unambiguous: among roughly 300 members present, only five voted against leaving the convention, and two abstained.
This gives the AMMD a strong mandate to exit the convention. The move has not yet taken effect – and the government could still step in – but it would need to act quickly to show that it takes doctors’ concerns seriously, said AMMD president Chris Roller.
"If we get signals from the government saying, ‘Okay, we made these proposals, and now we’ll actually act on them’, that’s fine. But then Mrs Deprez says, ‘Oh, I’m sorry, I don’t have the resources.’ She has no staff. She’s the minister – are we supposed to do her job for her? Hopefully, the state still has enough money to hire people to get things done."
Anything less, Roller added, would be "a cheap excuse to avoid keeping promises."
The AMMD also voiced frustration that Health Minister Martine Deprez – after nearly two years in office – is only now asking doctors what they would like to do outside hospital structures.
"Mrs Deprez has been in power for two years, and now she suddenly asks us to give her a list of what we want to do in extra-hospital care. We’ll provide that list – she’s already heard it all from us – but it’s strange that she’s only asking for it now."
Another major issue for the doctors and dentists is the governance of the CNS.
"There are 34 members, nearly half of them alternates, and not one has a medical background, yet they decide how healthcare is run", Roller said. “Looking at the numbers is fine, but the way this tripartite model works makes you wonder if it really serves patients’ best interests."
The AMMD regrets that patients and healthcare professionals currently have no voice within this tripartite system.
If no clear signal comes from the government soon, the AMMD will terminate the convention as decided at the extraordinary general assembly, after which it will present its own proposals to the government.
For now, patients do not need to worry – nothing will be changing immediately. The doctors’ stated goal is to improve the system in the long term, particularly for outpatient care.
“At the moment, patients – even those in good health – have to go to hospitals for every imaging exam", Roller said. "There, they’re surrounded by sick people and emergencies, and may even feel worse afterwards. Waiting times are extremely long, and the current offer doesn’t meet real needs."
Ultimately, the AMMD wants to make healthcare more efficient and comfortable for patients, ensuring that minor procedures and diagnostics no longer require a hospital visit. Roller estimated that around 80% of medical care could be provided on an outpatient basis.
Watch the full report in Luxembourgish
