Belgium’s Health Minister, Frank Vandenbroucke, has revised his proposed healthcare reform amid ongoing criticism from medical trade unions.
Vandenbroucke is moving cautiously with plans that include a cap on fee supplements, which would only be implemented from 1 January 2028, contingent on reforms in hospital financing and tariffs. “I aim to address many grievances and criticisms,” he stated.
Doctors’ unions have been vocally opposed to the minister’s framework law for reforming the conventions system, especially the planned cap on fee supplements and the timeline. They demand hospital financing and tariffs reforms first, as supported by coalition parties N-VA, MR, and Les Engagés.
Vandenbroucke has met several times with medical organisations, making adjustments ahead of a doctors’ strike on 7 July, which the main union, BVAS, dismissed as “cosmetic changes.” The minister presented further amendments last Friday.
Addressing parliament, he promised to finalise the law by year’s end but opened the possibility for the new convention model, including fee caps, to be postponed to 2028 and only if hospital financing reform takes effect as planned. If not, the cap start might be delayed by another year. He also suggested adjusting the fee supplement limit percentage, considering 25% for outpatient care and 125% for hospitalised patients. If sectors can prove that hospitals cannot be funded under these limits by mid-September, the caps could change.
On the index mass issue, currently adjusted annually, Vandenbroucke proposed ensuring indexed fees are released even without an agreement between doctors and health insurers, potentially providing year-end payouts.
He aims to ensure new hospital financing covers all costs, reducing hospitals’ dependency on contributions from doctors. “I am presenting very substantial changes to address many concerns and criticisms,” Vandenbroucke asserted. “I will take these proposals to the government.”
For MPs Dominiek Sneppe (Vlaams Belang) and Irina De Knop (Open VLD), the plans remain insufficient, with De Knop fearing a move towards “state medicine.” She urged the N-VA to block the proposals.
N-VA MP Frieda Gijbels welcomed the adjustments as positive but insisted on seeing nomenclature and financing reforms before agreeing to percentage caps on fee supplements.
Despite ongoing tensions over unresolved issues such as fee caps and hospital financing, doctors’ union BVAS opted against a strike, choosing to continue negotiations. “We give dialogue every chance,” said BVAS spokesperson Jos Vanhoof.
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