Doctors, dentists, psychologists, speech therapists, midwives and physiotherapists have all come to an agreement with health insurance associations on patient fees and rates. This will see healthcare become more accessible to everyone in Belgium.
The agreement has been reached in recent weeks between representatives of the profession and of the National Institute for Health and Disability Insurance (NIHDI).
This means that patients will no longer have to pay a co-payment for consultations with psychologists and psychiatrists, and there will be a gradual ban on fee supplements for people with an increased allowance from 2025. The age limit for reimbursement of a preventive periodontal oral examination and plaque removal at the dentist will also rise to 65 years (up from 60).
"We are improving in terms of accessibility and affordability of care. Those who are struggling financially are better protected," said Luc Van Gorp, chairperson of CM Health Fund. "More resources are also going to people with a mental illness or vulnerability."
Federal Health Minister Frank Vandenbroucke also stated that the healthcare agreements would provide "better protection" and clarity for some 2.3 million people. "Agreements between doctors and mutual insurers will also lead to greater transparency in the extra fees charged. It is clear that doctors, dentists and mutual insurers have demonstrated their responsibility in this area."
Improving health across the board
The gradual ban on fee supplements in outpatient care (without hospitalisation) for patients with an increased allowance will be introduced gradually from 2025, for all doctors, general practitioners and specialists.
The agreement also focuses on improving the health status and quality of life of vulnerable patients, both young and old. Specifically, this means improving the health offered for people struggling with mental health problems and strengthening care for hospitalised people with mental vulnerability.
More focus will also be put on eye screening in young children as well as on the cooperation of different doctors in elderly care, home dialysis and end-of-life care.
Credit: Belga / Nicolas Maeterlinck
For dental care, investments are also being made in removable dentures – totalling €26.2 million – to reduce the cost for patients who need them. Investments will also be made to make early orthodontics more accessible, as it prevents the need for other more complex treatments later on.
Some of these measures require an amendment to the law, however, and will therefore only come into force in 2024.
'Opting for the future'
In terms of psychological care, the committee for psychologists is dedicated to strengthening the mental resilience of citizens by rolling out group programmes aimed at local communities.
A sum of €25 million will be invested in strengthening work outside psychologists' practices: in schools, at Public Centres for Social Welfare, in GP practices, among others. The aim is to reach the target groups that are currently not benefitting from mental healthcare.
Additionally, the co-payment for children and young people under 24 has been dropped. "With this, we are resolutely opting for the future of our country," declared Van Gorp.
For physiotherapists, honorarium fees will rise but the price paid by the patient will not increase. The same applies to speech therapists.
In the midwives committee, a premium of €975 was approved for 'conventioned' midwives. There will also be additional funding (€11.4 million) for a perinatal care trajectory for vulnerable women.
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"We were able to take important steps forward in accessibility and affordability, such as by removing financial barriers for children and young people in psychological care and dental care," said Van Gorp. "Those who are struggling financially will also be better protected."
Additionally, The Belgian Association of Medical Unions stated that the agreement anticipates higher on-call rates during weekends and public holidays for general practitioners. The availability fee will double from €7.60 to €15.20 per hour, and late-shift allowances for doctors working past 18:00 will also increase.
The agreements will be ratified on Wednesday by the NIHDI Insurance Committee, with representatives from health insurance funds, healthcare providers and healthcare facilities. They will then be ratified by the General Council, which includes representatives of the unions and the government.
