Luxembourg's healthcare system was the focus of a conversation at RTL Radio on Tuesday, featuring Sylvain Vitali, director of the Luxembourg Hospital Federation (FHL).
With the upcoming quadripartite meeting in Dudelange on Wednesday, which will bring together healthcare stakeholders, concerns are mounting over the financial situation of the National Health Fund (CNS), which is expected to post a deficit of around €161 million this year.
Vitali said hospitals are calling for available resources to be used as efficiently as possible, stressing that continued investment in quality and patient safety remains essential. According to him, maintaining high standards of care ultimately helps contain costs while ensuring patients receive appropriate treatment.
Hospitals operate under a capped budget system, unlike other healthcare providers. For 2026, a total envelope of around €1.5 billion has been allocated to Luxembourg's eleven hospitals, Vitali said.
He explained that personnel costs account for the largest share of spending, representing between 60% and 70% of total expenditure, with around 10,000 staff working in the sector. Vitali added that a further 20% is linked to variable costs such as medical supplies, prostheses, and medication.
Vitali acknowledged that the capped system limits hospitals' ability to meet all needs, particularly when it comes to investing in innovation. While mechanisms such as quality premiums help finance advanced equipment, Vitali said budget constraints can make it difficult to adopt the latest technologies.
Despite financial pressures, Vitali argued that hospitals have already demonstrated their ability to control costs. He pointed out that hospital spending as a share of total CNS expenditure has decreased over time.
According to Vitali, efforts to improve efficiency include joint procurement of medicines, allowing hospitals to benefit from economies of scale, and plans to centralise certain services. One example is the proposed centralisation of sterilisation processes, which could reduce duplication and generate savings, he explained.
Similar approaches are being considered for laboratory services, with the aim of organising analyses more efficiently and concentrating them where resources are best available, he said.
Vitali also highlighted the need for better coordination across the healthcare system. He argued that structured patient pathways, from diagnosis to treatment and follow-up care, could improve efficiency and reduce unnecessary costs.
He noted that closer cooperation between hospitals, general practitioners, and post-hospital care providers would be key to achieving this. Digital tools such as the shared patient record (DSP) are expected to play an important role in facilitating information exchange between healthcare actors, according to Vitali.
Among the ideas to ease financial pressure on the CNS, Vitali expressed support for transferring maternity leave costs to the state budget.
He also suggested that investments in hospital infrastructure should be fully funded by the state, rather than partially by the CNS, which currently covers 20% of such costs. This, he argued, would free up resources for patient care.
Addressing concerns following the case of suspended surgeon Philippe Wilmes, Vitali stressed that hospitals already operate under structured quality programmes based on international accreditation standards.
He said there is a need to further develop systems that not only assess how care is delivered, but also evaluate outcomes, including when and why treatments are carried out, and their results.
While acknowledging that improvements are always possible, Vitali emphasised that continuous evaluation and cooperation between hospital management and medical councils are essential to maintaining and improving standards of care.
