The National Health Fund (CNS) is projected to spend significantly more this year than it will receive in contributions, with a deficit of €126 million expected. This ongoing trend has raised concerns that, as early as next year, the CNS’s reserves could fall below the legally required minimum of ten percent.
To avoid this scenario, government officials are seeking ways to curb expenditure, with sick leave identified as one area for potential savings.
It is important to note, however, that sick leave represents only a fraction of the CNS’s total outlays. Of the more than €5 billion spent annually, roughly €1.5 billion goes to hospitals, making them the system’s biggest expense by far. Hospital costs increased by 6.5 percent, closely mirroring the overall rise in spending.
While the €365 million spent on sick leave only ranks fifth, it saw the sharpest annual jump at 10.8 percent. In light of this, Democratic Party (DP) MP Gérard Schockmel proposed on Wednesday that doctors who issue an above-average number of sick notes should be made more aware of their prescribing patterns.
Schockmel cited a cost-neutral approach used for years in the United Kingdom: each year, every doctor receives a brief letter informing them of the average number of sick notes issued by general practitioners, and showing where they stand in comparison. "If you are far above the average, you are kindly asked to make an effort to bring your numbers closer to the norm", he explained. According to Schockmel, such feedback often leads to an initial drop in sick notes, which typically stabilises over time.
Health Minister Martine Deprez clarified that the €365 million figure only represents sick leave costs covered by the CNS. The fund only starts paying once an employee is absent for more than seventy-seven days. Before that, costs are borne by the employer and mutual insurance. José Balanzategui, President of the CNS, added that targeted awareness campaigns have already been carried out.
Balanzategui said he had already contacted medical professionals, for example, regarding prescriptions, laboratory analyses, or thyroid medication, to remind them of best practices. "Doctors also receive statistics showing how their prescription rates compare to the national average."
The immediate impact was visible, with prescriptions for thyroid issues falling sharply. The Left (Déi Lénk) MP Marc Baum then enquired whether long-term sick leave cases were increasingly associated with specific health conditions.
Minister Deprez responded that the most frequent causes of prolonged sick leave are mental health issues and musculoskeletal disorders, "which suggests that our population is ageing, and that our environment is contributing to more people being diagnosed with depression."
The increase in sick leave due to musculoskeletal problems is mirrored by a 10.6 percent rise in physiotherapy costs, making it the second fastest-growing expenditure after sick leave. According to Minister Deprez, the ministry is currently working with doctors to review how many physiotherapy sessions are truly necessary in individual cases.
At the same time, Deprez also emphasised that, despite the need to control costs, everyone should continue to have access to the medical care they need at an affordable price.
