Don’t look for any urgently needed discussions on reforming the financing of the National Health Fund (CNS); there won’t be any before the autumn. “Current expenditure will continue to grow strongly in 2025. Their recent increase is too great in relation to the level of revenue. The latest forecasts show a deficit of around €132.6m (or 16.5% of current expenditure) for 2025 on current operations [compared with €160m in the forecast budget for 2025 with parameters that may vary significantly, editor’s note]. Multi-year projections therefore indicate continued consumption of the reserve, with a risk of reaching the minimum legal threshold of 10% as early as 2027,” concluded the ministry of health and social security, following a progress update on 21 May in Dudelange.
“The so-called ‘structural’ deficit continues to grow,” says the Association of Doctors and Dentists (AMMD), in a statement issued Thursday afternoon. “It was therefore with amazement that we recently learned of the content of the interim memorandum of understanding signed between the OGBL and LCGB unions, and the Luxembourg Hospital Federation (FHL), as part of the renewal of the collective labour agreement applicable to hospital staff.”
According to them, this text provides for “a linear increase in salaries, accompanied by retroactive bonuses, which represents a significant financial burden for hospitals--and therefore, indirectly, for health insurance. This additional expenditure significantly worsens the ‘structural’ deficit of the CNS, without providing any tangible improvements for patients: neither better access to necessary examinations or treatments, nor a reduction in waiting times, particularly in emergency departments.”
Worse still, the AMMD denounces the way in which this memorandum of understanding was concluded. This “highlights serious conflicts of interest within the CNS board, which compromise its proper functioning and its public interest mission. The representatives of the Chamber of Employees--also members of the signatory unions--validated, without any apparent reservation, and probably with the at least tacit consent of the state representative, a substantial salary increase in the hospital sector. This decision, taken despite the alarming state of the CNS’s finances and without any benefit to patients, illustrates a dangerous drift. The unions are obtaining direct economic benefits for their members, while at the same time doctors and dentists are being categorically refused any serious discussion about the future of their profession, on the pretext of the ‘structural’ deficit.”
While not questioning the right of unions to negotiate in their sectors, the association regrets “the obvious and assumed conflict of interest [which] is unacceptable, as is the double-speak and double allegiance of certain members of the CNS board ofdDirectors,” and believes that it has been duped by the board into calling into question the balance of negotiations. An extraordinary general meeting will be called in October to decide on the follow-up to this agreement.
A week ago, the two unions presented the main points of the agreement: a one-off bonus of 1.38% of 2023 income and a one-off bonus of 2.37% of 2024 income will be paid retrospectively, together with interest on arrears; a linear increase of 1.5% in the value of the index point, applicable retrospectively from 1 January 2025; the temporary award of a 30-point monthly bonus for medical physics experts, applicable retrospectively from 1 January 2025. As well as organisational measures: extension of the deadline for publication of the initial work plan to 20 calendar days; definition of occasional teleworking as carrying out professional activity at home for up to 20% of working time; commitment to negotiate within establishments access to medical and paramedical visits during working time and clarification of rights in disciplinary procedures, particularly on the involvement of staff representatives.
If the agreement is only provisional, it is because the two unions and the FHL are still negotiating around the analysis of all careers, long-term solutions for professions requiring training above master’s level, as well as levers for improving the quality of life at work.
The AMMD is consistent on one point: it has never hesitated to put its foot down about what it felt was dangerous for patient health, having lashed out against three of the last four health ministers (
This article was originally published in French.
