The obligation for doctors to provide out-of-hours service and on-call duty was introduced through the 2018 Hospital Bill. Subsequently, the Association of Doctors and Dentists (AMMD) sought payment for these services. Due to unresolved points of contention, a convention was signed in 2022 by former Minister of Health Paulette Lenert and the Federation of Luxembourg Hospitals (FHL), excluding the AMMD from the agreement.
While assurances were made at the time that doctors would be compensated for their out-of-hours service and on-call duty, this did not fully materialise. A notable example from earlier this year highlights that, of the 42 doctors providing such services daily at Kirchberg Hospital and the Zitha Clinic, 16 received no compensation, raising criticism that the convention was overly restrictive.
According to Dr Alain Schmit, President of the AMMD, there has been a “shift in perspective” over the past year, which he welcomes. However, dissatisfaction persists as on-call duty is only compensated from 6pm to 7am on weekdays. Dr Schmit stresses, “Every doctor is on duty 24 hours a day, not just 13.”
Further concerns arise from the indirect payment mechanism, where doctors are not compensated directly by the Ministry of Health. Instead, funds are allocated to hospitals, which then distribute the payments. Minister of Health Martine Deprez asserts that the responsibility for organising out-of-hours services lies with the hospital, and funds are transferred based on fulfilment of obligations, “which hospitals usually pass on to doctors in a 1:1 manner.”
The new Minister of Health and Social Security presented the amendments to the 2018 Hospital Bill to the relevant parliamentary committee on Wednesday morning. The changes still have to be approved by the Chamber of Deputies before the end of the year. Up to €60.5 million have been earmarked for out-of-hours service and on-call duty compensation in hospitals in 2024.
The AMMD now expects to reconvene with the ministry and the hospital federation to draw up the new convention. “I have to get them on board anyway when we work on the hospital law,” the minister affirmed, adding, “And I think that they will then take the opportunity to present me with the points that they think need to be changed.”
Full report by RTL Télé (in Luxembourgish)
