Currently the government is working on two Grand Ducal regulations which will enter into force when the agreement ends later this month. The termination was announced on 30 October last year, with a year's notice.
No agreement was reached in negotiations between the CNS and the AMMD, therefore the mandatory provisions of the two conventions will now be regulated by Grand Ducal regulations. Last week, the Council of State published its opinion on the regulations. As a result, the texts adopted by the government on 17 August are now being revised once again.
The Minister of Health and Social Security Martine Deprez emphasised that the concerns of the Council of State can be addressed, but the texts have to be reviewed again.
She cited an example of using the 'tacte et mesure' approach, or the legal and ethical obligation to set fair medical fees. As the term is somewhat imprecise and subject to different interpretations, she said they either needed to clarify it in the texts, or remove it completely.
She mentioned a specific example of the CPs, or personal allowances – supplements that doctors can add to invoices in selected cases. Deprez said that any CPs that exist within the AMMD-CNS agreement also exist within the framework of the Grand Ducal regulation, and therefore can be invoiced according to the principles that have existed in the convention until now.
The Left's Marc Baum warned of potential risks on this issue: "This could effectively be the back door to being able to charge pretty much anything, and then the door would really be wide open to freedom of tariffs, which I don't think anyone here wants. "
LSAP MP and former Minister of Health Mars di Bartolomeo expressed surprise when he read the opinion of the Council of State, as they did not question the supplement for single rooms. Doctors can charge up to 66% more for these.
"Now it's not up to us to tell the Council of State, look at this again, you forgot to analyse something that may not be very constitutional. I'm not convinced that if patients were to complain about it now, when it's in a Grand Ducal Regulation, that it would simply go through like a letter in the post. "
The minister did not want to respond to that point, other than to say that the government did not have to comment on an opinion from the Council of State.
