Paulette Lenert’s replies to the AMMD attacks

paper jam : You currently appear somewhat at the heart of the cyclone, with on one side the charge of the Association of Physicians and Dentists (AMMD) and, on the other, that of the CSV. Both based more or less on the same themes (shortage of doctors, ambulatory care, waiting times, etc.). Do you understand the reviews?

Paulette Lenert: “Hardly when they come from the AMMD. Less when they come from an opposition party. As far as ambulatory care is concerned, I recently heard Alain Schmit, president of the AMMD, say that there needs to be a link between the extra-hospital and the hospital or even a new mode of financing. The bill (called “outpatient shift”, editor’s note) that we are defending does not say anything else. I would like to discuss the subject more precisely with the AMMD, to see where our differences lie. But when I hear that it’s me who lacks dialogue, I don’t agree…

paper jam : Why?

Paulette Lenert: “In July, when we presented the outline of the national health plan, we launched an appeal to the players in the sector, so that they could send us their observations, but also to see what they needed.

That’s how I like to move forward, by talking. However, we are still waiting for an answer from the AMMD… In the same vein, we organized a Gesondheetsdesch (a health round table, editor’s note) on October 12th. Everyone responded with one exception…

paper jam : AMDD?

Paulette Lenert: “It held its general meeting the same day. We then offered them different time slots so that they could still come and talk, without success… So you understand that when people say that it’s me who doesn’t want to talk… I notice, for against, that they like to do it, but outward.

paper jam : Is the problem facing public health policy structural?

Paulette Lenert: “Nope. The health system is a continuous process, which must be updated and reviewed regularly. We must keep in mind that our country has grown very quickly. Not so long ago, the population was still under 500,000 people. And it is not always easy to adapt everything to the same rhythm, when the latter is high.

“The shortage that affects us in terms of human resources is not unique to Luxembourg, or even to the health sector”.

Paulette Lenert, Deputy Prime Minister, Minister of Health, Minister of Consumer Protection and Minister Delegate for Social Security, LSAP

But we should not see everything in black. The recent OECD report shows how resilient Luxembourg has been in managing the Covid-19 crisis. If our healthcare system was bad, it certainly wouldn’t have been so positive. We simply face the same challenges as our neighbours. The shortage that affects us in terms of human resources is not unique to Luxembourg, nor even to the health sector. When I meet my European counterparts, it is always THE subject that causes concern. The lack of manpower is widespread.

paper jam : What are the solutions?

Paulette Lenert: “We had this lack linked to the training of doctors and, beyond that, to all the functions of the health sector. Not having a university was problematic. Because students tend to get hooked instead of their studies. From now on, at Belval, we therefore have a Bachelor’s degree in medicine (the possibility of a Master’s degree is under discussion, editor’s note). It takes time to set up. We do not thus open a complete course overnight. But we are moving forward. Just as we do by also listening to students. These can provide good leads. We were told, for example, that in Switzerland, the last year of study is covered. Financially, it is necessarily interesting for future doctors. And suddenly, it attracts a lot of students.

“By pronouncing this kind of sentence, the AMMD is not in the criticism, but in the controversy” Paulette Lenert, Deputy Prime Minister, Minister of Health, Minister of Consumer Protection and Minister Delegate for Social Security , LSAP

Society has evolved. We have to be able to put in place incentives like that. It is also in this sense that another bill, providing for the extension of the right of association between doctors and/or health professionals, was born. This had been a claim of the AMMD for years. It resurfaced during a health round table and was translated into a bill now tabled. The Association of Physicians and Dentists can therefore hardly say that I am not listening to it…

paper jam : During the general assembly of the latter, we could hear that “the patients have been abandoned by the health policy of the last 15 years.” Which is an indirect criticism of your party, the LSAP, which has held this ministry since 2004. Wouldn’t a certain alternation sometimes be necessary?

Paulette Lenert: “In view of the OECD report I was telling you about, Luxembourg can be proud to have had the LSAP at work for all these years! This made it possible not to have an underfunded health system, like what we have seen in other countries, where different political colors have held these positions.

You know, at the OECD, they are not really altar boys. They are even rather dry in their evaluations.

So, if they say that we did well, it is difficult to say afterwards that our patients were abandoned. At the height of the health crisis, we did not see long lines outside the front doors of hospitals or patients treated in makeshift premises. By pronouncing this kind of sentence, the AMMD is not in the criticism, but in the controversy. Or that they clearly give examples of what they believe to be patient abandonment.

“The LSAP has made it possible not to have an underfunded health system, like what we have seen in other countries, where different political colors have held these positions. Paulette Lenert, Deputy Prime Minister, Minister of Health, Minister of Consumer Protection and Minister Delegate for Social Security, LSAP

paper jam We often point to particularly long waiting times…

Paulette Lenert: “It is a concern that has actually appeared with the increase in population. But we are working to solve it. What’s more, the bill on the ambulatory shift will open up a lot of possibilities.

If I take the case of radiological examinations, for example, we realized the problem and we increased capacity by more than 50%, with the appearance of four new centers (from 7 to 11, editor’s note) set up at the start of the health crisis. A lot of delay has been accumulated during this one. If we wanted to be intellectually honest, we would have to let a year pass after the pandemic to see how it reduced the delays.

Afterwards, at the level of doctors, we try to objectify things with, in particular, a tool like Doctena. The delays seem to vary from one specialty to another. But we lack data. I do not deny that a problem exists, but there too, we should discuss it with the AMMD. In order to go into detail to assess where the concerns lie. Is this also, we should discuss it with the AMMD. Is it a price issue? Difficulty in studies? Or related to other factors? a question of prices? Difficulty in studies? Or related to other factors?

“The resignation of the six cardiologists? The AMMD used it to proclaim that doctors were fleeing Luxembourg. Whereas they did not leave the country and just set up on their own”.

Paulette Lenert”, Deputy Prime Minister, Minister of Health, Minister of Consumer Protection and Minister Delegate for Social Security LSAP

paper jam At the level of doctors, what marked was the simultaneous resignation of six cardiologists from the Center hospitalier du Nord (CHDN) in Ettelbruck…

Paulette Lenert “It gave me a bit of a shock too. Even if, with hindsight, I have the impression that it was dramatized and instrumentalized. The AMMD, for example, used it to proclaim that doctors were fleeing Luxembourg.

While they did not leave the country and just set up on their own, outside the hospital. A way to have a better quality of life no doubt… According to my information, less than 15 days after the publication of job offers, three candidates have already presented themselves. There will be a concern if, in December, the CHDN is really in a problematic position. But that does not take the direction of it.

paper jam We often point to the low compensation of doctors during legally imposed on-call and on-call duty…

Paulette Lenert : “The negotiations were not easy but an envelope of 44 million euros was released. 24-hour care represents an amount of around 2,300 euros. Which is added to what the doctor bills for the acts he performs on those days. Or 96 euros per additional hour. While the on-call hour is set at 40 euros. This last amount is therefore what a doctor receives to simply be reachable if necessary. I confess that I find it difficult to understand when we talk about low compensation. You have to realize that some people work a month to earn the equivalent of two days of care.

Paulette Lenert’s replies to the AMMD attacks