After the Luxembourg Association of Doctors and Dentists (AMMD) announced that it will not sign a new agreement with the National Health Fund (CNS), RTL spoke to AMMD president Chris Roller about the failed negotiations. Throughout the mediation, Roller said, the CNS had made it very clear that it had no interest in adapting the legal framework.
For Roller, it seemed as though the current arrangement had worked well for the Fund according to its own assessment, and the CNS therefore had no intention of changing anything. In those circumstances, Roller argued, the AMMD could hardly sign on again in good conscience.
The current agreement was terminated in October 2025 and is due to expire this October. The main condition for the doctors' association is that the legal framework must be adapted.
The CNS, however, has consistently referred back to the current law as it stands during the negotiations, criticised the AMMD president.
According to Roller, there is also a lack of political appetite to change things. Talks had been held with Health Minister Martine Deprez, and in June Prime Minister Luc Frieden had also made the file a priority.
Even so, it had become clear that no changes were coming, Roller noted.
Politicians in particular, Roller argued, had made a whole set of promises when the Christian Social People's Party (CSV) was still in opposition, in the run-up to the election, including modernising and adapting medicine in Luxembourg. "These things are also included in the coalition agreement. But ultimately there is no will to implement it politically", Roller explained.
The doctors' association's demands are not new. Smaller or lower-risk procedures should, in the AMMD's view, be able to be carried out outside the hospital setting more often, and adjustments are also needed when it comes to negotiating tariffs.
Those, Roller pointed out, are currently set solely by the CNS. The AMMD had asked for at least a bit more automation in those revaluations, as is already provided for in collective agreements for hospitals and hospital staff. That, however, was a point where politicians had not been willing to move.
Just over two months are now left before the current agreement expires. After that, a Grand Ducal regulation will take over.
Nothing will change for the patient, Roller underscored, with tariffs and reimbursements remaining the same. However, this will equally mean that the management of the system will no longer be as efficient and will not reduce waiting times.
In the eyes of the AMMD, which is the only representative doctors' association in the country, a reform could, for instance, help take some of the pressure off clinics, MRI machines, and operating theatres. That would benefit patients and could also ease the strain on the CNS budget, at a time when a rise in contributions cannot be ruled out as part of the quadripartite talks in the autumn.
The AMMD rejects the trade unions' accusation that the doctors' association is heading towards a two-tier health system. This, Roller argued, was purely about drumming up fear. The fact that the unions sit on the CNS board via the Chamber of Employees created, in the AMMD's view, a conflict of interest.
Last year, Roller recalled, the pension reforms had turned into a huge mess when politicians took on the unions, and he assumed the government did not want to repeat the experience this time round. Politicians could also see, he suggested, that there are only 3,000 doctors in Luxembourg, roughly half of whom are foreign nationals without voting rights in Luxembourg anyway.
Minister Deprez, he added, tends to underplay the situation. However, nothing would work without the country's doctors, Roller noted, and if Luxembourg wanted to attract good doctors, the system had to be made attractive in some way.
In the president of the AMMD's view, the file is not being debated objectively.
