The organisation of the health system in times of the COVID-19 crisis

The COVID-19 health crisis has required a reorganisation of our healthcare system so that patients can continue to benefit from medical care adapted to their needs and circumstances. For healthcare professionals, too, the epidemic has brought about many changes. For example, the activities carried out in private physicians' practices have been reduced to the most severe and/or urgent medical conditions.

The Minister of Health, Paulette Lenert, and the President of the Association of Physicians and Dentists (Association des médecins et médecins-dentistes, AMMD), Dr. Alain Schmit, today presented to the press the main elements of this reorganisation, from the perspective of both patients and physicians.

1. The patient at the time of COVID-19: Who is my medical interlocutor?

Minister Paulette Lenert emphasised that in this time of crisis, when many points of reference have been turned upside down, it is more important than ever that patients are clearly informed of the structures they can turn to in the event of a medical condition.

Together with the medical professionals, the Ministry of Health has set up several channels in the primary care sector according to a well-structured organisational model aimed at protecting both the patient and the healthcare professionals.

General physicians can be reached by teleconsultation (preferably via the eConsult system). This option is to be preferred by people at risk, i.e. people over 65 years of age as well as people suffering from certain chronic diseases such as diabetes, a cardiovascular condition, a chronic illness of the respiratory tract, or who have an immune system weakened by a condition or treatment, or cancer. The general physician will, if necessary and depending on the patient's state of health, refer the patient to the most suitable structure (advanced care centres, emergency departments).

General physicians will also provide home visits for the duration of the COVID crisis, both to patients with COVID-19 symptoms and to people with non-COVID-19 related conditions. These visits will be carried out by different medical teams in order to avoid the risk of contagion.

Patients can also visit advanced care centres (Centres de soins avancés - CSA) on their own initiative for a medical examination in case of symptoms related to COVID-19. Patients do not need a prescription and can also go there for health problems unrelated to COVID-19. The four CSAs are open daily from 8 a.m. to 8 p.m. and are located at the following locations:

in Luxembourg-Kirchberg in the halls of Luxexpo;

in Esch/Belval in the Rockhal;

in Ettelbruck in the Däichhal;

in Grevenmacher at the Cultural centre.

Medical centres (Maisons médicales) will remain closed for the duration of the epidemic.

Residents of nursing homes and residential facilities for the elderly will benefit from a planning that ensures a continuous 24/7 medical presence to follow up COVID-19 and non-COVID-19 patients.

Hospital emergency departments continue to operate for people with serious medical conditions or for patients with COVID-19 symptomatology with a need for hospital treatment.

For a dental problem, the patient can call the Hotline 8002 8080 which will put him in contact with the on-call dental practice in his area. This service is reserved for dental emergencies, with the exception of routine maintenance or check-up dental procedures.

2. A new form of medical organisation

Minister Paulette Lenert welcomed the good cooperation with doctors and healthcare professions during the crisis. She praised their commitment and the flexibility they have shown since the beginning of the epidemic. "We are preparing for an epidemiological peak that will require all our professional resources to be mobilised effectively at the right time."

General physicians, medical specialists and dentists are invited to register by e-mail to reserve.prof-de-sante@ms.etat.lu until 31 March at the latest by 2 p.m. in one of the following groups:

Group 1: Medical care in advanced care centres (centres de soins avancés - CSA) and home visits to COVID patients;

Group 2: Medical care by teleconsultation and home visits home visits to non-Covid patients;

Group 3: Medical care and visits to assistance and care facilities for COVID and non-COVID patients;

Group 4: Medical care by teleconsultation by medical specialists;

Group 5: Dental care

The management of the medical contingent that is available is ensured, according to an organisational model developed by a national coordinator who is appointed by the Minister of Health, in consultation with the heads of the structures concerned.

A new uniform hourly tariff of 236.40 euros was adopted on 30 March 2020 to pay for consultations and treatment in the context of the COVID-19 epidemic to be applied by any doctor, general physician or specialist, regardless of the care structure (hospital or out-of-hospital).

3. The possibility of signing a government employee contract for doctors and healthcare professions

Doctors and regulated healthcare professions covered by the Law of 26 March 1992and exercising their profession on an independent basis may opt, under certain conditions, for a government engagement in the form of a fixed-term employment contract as a government private employee. These are the following healthcare professions: nursing auxiliary, senior assistant, medical technical assistant, nurse, anaesthetist nurse, paediatric nurse, psychiatric nurse, orderly nurse, midwife, social hygiene assistant, chiropodist, social worker, dietician, occupational therapist, laboratory technician, masseur, masseur-physiotherapist, osteopath, speech therapist, orthoptist, curative teacher and psychomotricity reeducator. The same applies to psychotherapists.

Further information can be requested by telephone on 247-73210 or by e-mail: ressources.covid-19@ms.etat.lu.

Press release by the Ministry of Health and the Ministry of Social Security