In the context of discussions around the Arizona note, health negotiations are encountering numerous blockages. Doctors and nurses denounce the absence of representatives from the field to address sensitive subjects such as the flat rate of care or the reduction of fee supplements. Meanwhile, the attractiveness of the nursing profession remains without a concrete plan.
While health professionals are rare around the negotiating table, experts are looking at the sticking points. Within the health sector, many doctors and nurses draw our attention to this subject: “Is it not worrying to see technicians thinking about the future of our profession when they are never in the offices medical, nor in hospitals on a daily basis, in contact with patients and illnesses? » If a doctor or nurse does not necessarily make a good negotiator, it is still urgent to ask the question of the people who represent them, according to our speakers. “Health is not just about numbers. Sometimes, budget cuts lead to higher costs on the ground,” adds this fatalistic medical unionist: “This note, as far as I know, is not part of a long-term vision of health. However, this is really what we need today. »
A package under debate
We have already spoken to you about the issues that are tense: mutual funds and the growth standard. We will not return to these two points, which are part of the current arbitrations. Another subject is debated: the flat-rate system. Indeed, the Federal Minister of Health, Frank Vandenbroucke, is satisfied with the first months of the New Deal and the partial flat rate of health care. He would like to extend this approach to other sectors. According to supporters of this approach, flat rate pricing would ensure better long-term financial sustainability for health care. Needless to say, not all parties around the table share this vision…
A reduction in supplements
The question of fee supplements is also on the table, as is the BIM status and the maximum to be invoiced, which are part of the socio-economic note. The elimination of fee supplements, or their reduction, raises questions. If we can understand the symbolic aspect of such a measure (which would, moreover, reduce the weight of mutual societies in this debate), some point out the immediate impact that such a decision would have on the finances of hospitals.
Hospital finances
The question of contributions (basic and accountability) resurfaces, and it is not trivial for hospitals. The federal government could intervene in this problem, which mainly affects Brussels and Walloon hospitals, but whose repercussions go well beyond the health sector, since it also concerns CPAS and municipalities. As a reminder, Santhea looked into this complex issue and emphasized that “the costs relating to the pensions of local statutory staff are increasingly high for healthcare institutions, in particular because of the unsustainable increase in growing contractualization of the civil service, with the consequence of reducing the payroll from which to deduct contributions from appointed staff, de facto reducing the contribution to the Pension Fund…”
Even more worrying: currently, there is still no real attractiveness or investment plan for the nursing sector.
