Proposition 51K1014

Projet de loi modifiant l'arrêté royal n° 143 du 30 décembre 1982 fixant les conditions auxquelles les laboratoires doivent répondre en vue de l'intervention de l'assurance maladie pour les prestations de biologie clinique.

General information ¶

Submitted by

PS | SP MR Open Vld Vooruit Purple Ⅰ

Submission date

April 8, 2004

Official page

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Status

Adopted

Requirement

Simple

Subjects

medical diagnosis paramedical profession health insurance

Voting ¶

Voted to adopt

Vooruit Ecolo PS | SP Open Vld MR

Abstained from voting

CD&V LE N-VA FN VB

Party dissidents ¶

• Josy Arens (LE) voted to adopt.

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Discussion ¶

April 28, 2005 | Plenary session (Chamber of representatives)

Full source

Mr. Speaker, dear colleagues, following the referral to the committee decided by the plenary session of 13 May 2004, your committee of Public Health reviewed the bill at the meetings of 9 November 2004 and 12 and 26 April 2005.

Mr. Speaker, I suggest that you suspend the meeting.

Why Mr Annemans?

There is no Minister present.

I must say that it is so little noticeable that I had not seen it.

Mr. Speaker, you are talking about a party member.

I am talking about his absence.

I understand it, Mr. President.

I will call Minister Tobback.

This is not an alternative, Mr. Speaker.

By definition, the ministry is a temporary function.

You can suspend the meeting for a short time.

No, I am looking for someone.

When I was minister for the first time, one had to fill out a file with his status. I had completed BTK, Special Temporary Framework as Minister.

Minister Tobback has entered.

In his speech, the Minister

Recalls that the draft law under consideration originates in a reasoned opinion of the European Commission in which Belgium is asked to adapt its legislation. This reasoned opinion emphasises that the provision that only specialists in clinical biology may operate a laboratory or be associated with or managed by a company operating a laboratory should be repealed.

In order to guarantee professional independence as well as the quality of care, the draft law, in its initial drafting, provided for a number of obligations that could guarantee this independence as well as the provision of sufficient resources.

The working conditions must be included in an agreement concluded between the operator and the dispenser, which will be subject to inspection by the Clinical Biology Commission.

Following the adoption of the bill by the commission, the association of physicians specialists in bio-pathologies expressed concern about the dangers of what the sector calls mercantilism. It was therefore prudent not to proceed immediately to the approval of the bill, but rather to organize hearings and, thus, to get acquainted with possible problems and solutions that could remedy them.

The hearings, organized by the Commission on 9 November 2004, brought together numerous bodies, namely representatives of the 4 professional organisations concerned, the administrator of INAMI and the head of the Directorate for European Foreign Affairs Law.

Here is what can be concluded from these hearings.

First, Belgium has no choice as to whether or not to comply with the request of the European Commission. by

Both the experts and the minister present at the hearings confirmed that there was little chance for Belgium to escape a conviction by the Court of Justice.

Then, from a structural point of view, the expenses of compulsory health care insurance for clinical biology benefits are under control. by

It should be noted that this situation, however, is not a consequence of the legislation relating to the operation of laboratories but rather of various measures taken in the 1990s. These include the announcement effect relating to the registration and evaluation of prescribing behavior, closed budgets, mechanisms for claiming for excesses and the fact that deficits are deducted from subsequent budgets.

As regards the professional independence of specialists in clinical biology, it can be guaranteed more effectively if it is no longer the operator of the laboratory but the said specialists who are creditor of fees and packages for their services.

These montants shall be then perçus de façon centrale by the director of the laboratory which is specialist in clinical biology. The Committee on Public Health has adopted the draft law amending the Royal Decree no. Regulation (EC) No 143 of 30 December 1982 laying down the conditions which laboratories must meet in order to meet the health insurance for clinical biology provision, as the European Commission has requested Belgium to modify its legislation in this regard.

The provision that a laboratory must be operated by a person recognised as a clinical biologist or by a company in which the associates and managers are exclusively clinical biologists should be deleted.

The draft law originally provided for a number of obligations and instruments to safeguard the professional independence and the quality of the services. The working conditions shall be determined in an agreement between the operator and the provider, under the supervision of the Commission for Clinical Biology. The Belgian professional association of doctors-specialists in medical biopathology was concerned that profit-bejag would become a major driving force in the sector, and therefore it was decided not to immediately approve the bill, but first to organize hearings to look for solutions.

Uit die hoorzittingen kon worden opgemaakt dat Belgium gehouden is op het verzoek van de Europese Commission in te gaan, dat of uitgaven van de verplichte verzekering voor geneeskundige verzorging voor verstrekkingen van klinische biologie onder control zijn in dat de professionele onafhankelijkheid the operator and the specialist in clinical biology would be governed by the agreement between the two parties and under the control of the Commission of clinical biology. In this way, we obtain a regulation similar to that which applies to hospitals and hospital doctors. It is in this perspective that the government has drafted amendments that also include a number of technical and legal improvements.

Finally, there is a delegation of competence to the King in order to make, by decree deliberated in the Council of Ministers, changes to the categories of companies that can operate a laboratory outside a hospital. Similarly, other changes could be made in time, such as reserving the operation of these laboratories to non-profit legal entities, with the advantage of providing an additional guarantee against commercialization feared by clinical biologists.

In any case, the Minister is convinced that the government’s amendments will allow to preserve the balance between Belgium’s obligations to the European Commission and a health policy in which the criterion of affordable quality care prevails over other purely commercial objectives.

During the general discussion, several commissioners highlighted that some amendments submitted by the government raise some fundamental problems, including the remuneration due to the dispenser, which is collected centrally by the laboratory director. Indeed, they argue that the preferred logic in the bill concerning measures in health care or sanctions in the area of heavy appliances strikes the dispensers while the decision belongs to the hospital manager and is not the one held by this bill. However, if the central perception is preferred, it is important to guarantee the security of service providers. Furthermore, amendment 14 could be a source of conflict in so far as this security is less, which could jeopardize the autonomy of the provider.

It can also be noted other interventions regarding Amendment No. 22, which empowers the King to determine the categories of legal persons who may operate a laboratory. Some thus question the conformity of this delegation and a too vague power, which means that this power delegated to the King allows him to authorize commercial companies to conduct clinical research as well as to prohibit them. Another speaker asks whether, in the European context, health care should still be regarded as an ethical matter. If necessary, it is necessary to verify whether the application of the law of supply and demand should not be corrected from a social point of view.

The amendment 24 tends to modify the article 5 and the article 3, 1° of the Royal Decree no. 143, for the following reasons. The author emphasizes that the costs of analysis are, for the moment, at the expense of the sector of health care, financed by the denier public. This cannot give rise to a search for profit. The remunerations relating to the sector of clinical biology have been fixed. This involves the risk that it intends to increase the number of lucrative analyses or increase the global number of analyses, which could cause a derapage in this sub-sector of health care. of the specialists in clinical biology will be better secured in a system in which the fees are paid to the specialists and no longer to the operator of the laboratory. The Government has therefore drawn up amendments that improve the draft from a technical and legal point of view and give the King a certain power. The Minister believes that the Government’s amendments will ensure that the balance is ⁇ ined between, on the one hand, Belgium’s obligations to the European Commission and, on the other hand, a health policy that prioritizes an accessible and high-quality health care.

During the general discussion, several committee members pointed out the fundamental problems raised by some government amendments, in particular with regard to amendment no. 22 which empowers the King to determine the categories of legal entities that may operate a laboratory. In response to the various comments, the Minister emphasizes that the figures have evolved significantly and notes that between 2002 and 2004 the budget has not been exceeded once. The companies were transformed into BVBAs and if we can believe some, the doctors would not be able to establish BVBA anymore.

Ten slotte wil de regering het probleem van de definition van de rechtspersonen die een laboratorium kunnen uitbaten met een technische ingreep oplossen; they will say aan de hand van reeds bestaande formules doen. This speaker also recalls that the Royal Decree of 30 December 1982 sets out the conditions which laboratories must meet for the intervention of the health insurance for clinical biology benefits and also tends to control the expenses related to clinical biology. On the one hand, it emphasizes that this law clearly violates European law. On the other hand, it recalls that by subjecting the refund of clinical biology in Belgium to the criterion of the non-commercial character of the operator, it would be possible to comply with European law on freedom of establishment. He adds that this criterion is justified by the goal of controlling healthcare spending.

Another member mentions that the bill under consideration should enable Belgian clinical biology laboratories to safeguard their competitiveness on the European market. Following the various interventions, the Minister insists on the importance of the evolution of the figures and notes that between 2002 and 2004, no budget exceeding was observed. Societies are, from now on, SPRLs and if we follow the reasoning of some, doctors would no longer be able to constitute themselves in SPRLs.

As a conclusion, the minister recalls that the government wants to provide a technical solution to the problem of defining legal persons who can operate a laboratory, and decided to use the same formulas already used in the past. Also, it wants to reassure itself since there is no real danger of exceeding the budget even if there is a need to remain vigilant.

The Minister adds that the Hospital Act also, in the same way, gives the King the power to define which legal persons can operate a hospital. Therefore, the proposed system is the same as the one applied to hospitals.

Votre commission a procédé au vote du projet de loi, dont l'ensemble a été adopté par neuf voix pour et deux abstentions. There is no risk that the budget will be exceeded. He believes that the hospital law gives the King the possibility to determine which legal entities are allowed to operate a hospital. The proposed system is identical to that applied to hospitals.

The draft law was adopted in its entirety by the committee with nine votes for and two abstentions.

Madame Lejeune, it is important to have a report searched when it is purely oral, since the committee has appointed you and authorized you to make an oral report to the plenary assembly.

On 17 July 2002, Commissioner Bolkestein issued an opinion following a complaint two years earlier. The result was that the Belgian legislation had to be adjusted on a number of points. In fact, Frits Bolkestein spoke about a matter from European Commissioner David Byrne.

In short, the scope, health care, should be moved from the Directive on services in the free market economy to health and consumer protection. After all, for us, clinical biology is still a specialized discipline and not a commodity.

On 27 April 2003, the draft law was discussed in the Public Health Committee and a year, less one day later it came back into the committee. It seems like old wine in new bags. Why Why ? Because the government amended its own bill, not once but ten times. 10 amendments, some of which are substantial and

On 17 July 2002, following a complaint filed two years earlier, the former European Commissioner Bolkenstein issued an opinion that forced us to amend some points of our legislation. Thus, the scope of clinical biology has been removed from the Services in a Market Economy Directive to be included in the component on health and consumer protection.

On 27 April 2003, le projet de loi a été débattu en commission. Un an klepper of course—the minister cannot let it; the VLD has yet said to be against it — amendment 22 is. There is a new delegation of powers to the King.

As a result, with the access of commercial companies, it can go all directions. The State Council also considers that delegation of powers “too indefinite”. This is what the State Council has formulated. But apparently the words of that court have very little impact on this government. The proof of this is the Health Act.

In the field, the minister has the hands free. He can go all directions. He can tighten — as, I must admit, amendment 22 proposes — but he can also soften. It can also provide access to commercial companies. He would never be able to make a royal decision. We add questions to this, knowing that Minister Demotte has made clear in the committee several times that it is not important for him that Belgium must adhere to the European regulation that health care should be liberalized.

The other government party then says again: liberalization is not going far enough for us. Questions arise about the consistency of this government when a majority party abstains from the government’s main amendment, or when an amendment of a party fellow is simply voted out. Talking about collegiality with colleague Avontroodt! If any other majority party is silent like death... The government is not only divided into two camps but also within the government parties there is clearly great division.

How is it possible that a decision discussed in the Council of Ministers will look like this?

That leaves the worst suspicion. With regard to amendment 22 I have only one concrete question, Mr. Minister. A decision must be taken in the Council of Ministers. The amendment gives a number of special powers to the government, in this case the minister. Our group wants to know what the minister wants to do with that power. Will he make the competition play more, or will he, on the contrary, tighten the law? This is what we would like to know about the government: what is going to happen with the extra power that will be assigned to the government. This is crucial because it is the fundamental question of the draft law. I would like to have an answer and then I can go on. I don’t know what direction the minister is going to take with the powers that he or the government is given. Can you answer this, Mr. Minister? This is crucial for me: knowing which direction we are going with the bill. There are clearly two camps. plus tard, jour pour jour, il figure à nouveau à l'ordre du jour because the government has amended until ten times its own project of law. Amendment No. 22 tends to grant a new delegation the competences that the Council of State has judged too imprecise. The government does not, however, take account of this newspaper.

This amendment allows the Minister to do what he wants. He may at his own discretion strengthen or soften the law and even decide never to promulgate a royal decree. We ask ourselves about this because Minister Demotte suggested that he did not welcome the idea of a European legislation providing for a liberalization of healthcare. He is opposed to another party of the majority. If a majority party abstains from the most important amendment of another party of the same majority or even rejects it, there is no longer any collegiality. We can then speak of a profound fracture within the government.

I wonder what a deliberate decision in the Council of Ministers would look like. Amendment No. 22 assigns special powers to the Government and the Minister. What position will the Minister take in this case? by

Will it allow more competition to play or will it further strengthen the law? by

Is Minister Tobback, who represents the government here, able to answer the question?

Mr. Verhaegen, I assume that in the beginning this discussion will also be discussed in the committee discussions and that Minister Demotte will have very clearly formulated his position there. When you ask whether it can be the intention to tighten the law by decision, I must only point out that the law and the Constitution determine what can and can not be by decision, whether or not discussed in the Council of Ministers, and that therefore much further.

This was discussed during the committee debates. Minister Demotte has clearly expressed his point of view in the committee. The law and the Constitution define the gaan dat wat in de wet staat, per definition niet kan. possibilities and impossibilities by means of a decision possibly deliberated in the Council of Ministers. The provisions of the law cannot be violated.

My question is concrete: will we ease or tighten access for commercial companies? What is the government’s view on this?

Specifically, I want to know whether access is enhanced or relaxed for commercial ⁇ . What is the government’s position?

If this has been discussed in the discussions of the committees, it will undoubtedly be agreed there, as it should be in the distribution between the executive and the legislative powers, that the law is the law and the decisions the decisions. As far as I know, the decisions here are not in question.

If this point has already been addressed, it has ⁇ been established that the law is the law and that the arrested are the arrested. These arrests are not in question here.

This is clearly not an answer. It is almost a political response. In the end, we are not a step further. I find it regrettable that we do not get an answer to that.

This is not an answer.

Is it too much asked that, when the minister refers to Minister Demotte, Minister Demotte would come here to answer the pertinent question of our colleague?

Minister Demotte should come to answer before this assembly.

Minister Demotte is not apologized!

Minister Demotte is not apologized.

Has he resigned?

I actually only have one question.

There are reasons for the absence of the Minister. The resignation of the government may be a valid reason, of course. When he is replaced, it seems to me normal that the substitute is able to answer an essential question such as this, which is not technically or difficult. Is this too much requested?

The minister can ⁇ explain his absence, but the one who replaces him must still be able to answer the essential questions.

As far as I know, I have answered the question. If it is not a clear answer or an insufficient answer for you, it is a matter of appreciation. Nothing more. Your appreciation and mine are different.

If my answer is not clear to some, then I think it is a matter of personal appreciation.

Mr. Minister, I have actually not received a response. My question is whether the government is planning to act more tightly with these additional powers or is it going to act more calmly? There are also two camps within the government. My question is what the government is going to do with the powers. After all, how can we grant a power if we do not know what to begin with it? That is my question.

For the completeness of the discussion, I refer to the answer.

That is not enough for me, Mr. Minister.

I consider this answer insufficient.

If you cannot give the answer, Mr. Minister, you may be able to get it from the documentation you are reading on this issue. That can hardly be a problem. It may even be in the form of dialogue.

Even if it is pure formalism, but I do not think it is possible for the minister to come here to read a book. It looks like a novel. It may be ⁇ intriguing, but you will not completely ridicule the Parliament by just sitting here and referring to the committee’s report, Mr. Minister. If you replace a minister here on whose subject it is concerned, make sure you are able to answer the most crucial questions. Otherwise, stay away and let someone else come, preferably without the same book.

Parliament is ridiculous. When a relevant question is asked, the Minister can absolutely not merely refer to the report.

We have also experienced this once with the Elia tax and Mrs. Van Brempt was so galant to have the session suspended and Minister Vande Lanotte pushed. But that was of a different kind of socialism than that of Mr. Tobback.

One day, Secretary of State Van Brempt, who was in office at the time, brought back to the House the Minister Vande Lanotte, whom she replaced in that homicide, to answer a question.

Mr. Minister, the least you can do is not openly show that this does not interest you.

Mr. Tante, just as little as I judge about what you read or do during a day of parliamentary discussions, I think it’s up to you to discuss serious things in a serious way. I told you that I heard the question of Mr. Verhaegen and gave the answer that I had to give. There is no other answer. If that is not enough, then it is your good right to find that it does not meet your expectations and to reflect that in your voice behavior. The point.

If my answer does not meet your expectations, you just have to let it know through your way of voting.

Mr. Minister, you simply do not answer anything. You didn’t say which side you want to go. Will it be strengthened or relaxed? Which direction does the government go? That is my question.

I would like to suggest that you again put the question briefly and clearly. If the Minister does not know the answer, I am prepared to ask for a suspension to allow him to seek the answer. However, we want an answer.

Mr. Tante, I propose to repeat the question before the vote and then to give an answer. In this way, we can complete the agenda.

I will put this question before the vote. I will make sure that a response is ready by then.

( ... ...

It is the same debate.

No, this is not the same debate. The further progress of Mr. Verhaegen’s speech will depend on the Minister’s response.

Following the presentation of Mr. Verhaegen depends on the response he will receive.

Mr. Speaker, I am prepared to make every effort to answer. It must be a concrete question. What does Mr. Verhaegen understand between tightening and relaxing?

Mr. Verhaegen, you asked a very general question to which I gave a very general answer. More is not possible under these circumstances.

If you want to overtake the full discussion in the committee in this plenary session, that is your right after the report of the rapporteur.

You want an answer. I wish a question.

by Mr. Verhaegen be clear: what is meant by reinforcing and what is meant by “softening”? I gave a general answer to a general question.

Mr. Verhaegen, I let Minister Demotte call.

I will call Mr. and Demoth.

The Minister reads a book all the time. He should at least listen to Mr. Verhaegen’s speech. If he had listened, he would have heard the question.

Mr. Tante, I have called Minister Demotte.

I suggest that you continue your argument. I will make sure you get an answer.

Mr. Speaker, I would like to emphasize that this is a very important matter. In addition, the debate has an ideological value. It is about the fundamental question whether welfare and health care issues, including in the context of European integration, should still be considered as ethical issues. If yes, what social corrections are then required to correct the law of supply and demand?

CD&V clearly wishes to narrow the scope of the Bolkestein Directive in this matter. Healthcare has so many specific characteristics that it cannot be included in the Services Directive with a horizontal approach. In other words, the health sector, including the rules on reimbursability by the social security system, needs its own approach. I would say it a little more illustrative. Given the condition in which he/she is, the patient has no choice but to resort to health care. Consequently, for ideological reasons, CD&V opposes the increasing importance of the principle of freedom in certain aspects of the service sector. Their

CD&V principally agrees that European citizens should be free in their choice. We also agree in principle that the liberalization of services is conducive to economic growth. Similarly

This debate also has an ideological dimension. Should issues related to well-being and health care be considered as ethical matters and what corrections should then be made to the law of supply and demand? The CD&V wants to reduce the scope of the Bolkestein Directive. The healthcare sector is so specific that it does not fit into the horizontal approach of the Services Directive. The patient can only receive health care. CD&V opposes increased freedom in certain aspects of the service sector. Citizens must remain free in their choices. The liberalization of services can promote growth in principle vindt CD&V dat de Europese eenheidsmarkt niet ten koste van sociale bescherming in social verworvenheden op de arbeidsmarkt in in de gezondheidszorg mag gaan, ook al worden deze diensten op commerciële basis geleverd.

In other words, clinical biology is a specialized discipline, not a commodity. Therefore, we also oppose any sale of the Belgian health care. We will not reject the Directive on the free movement of services, i.e. the Bolkenstein Directive. and economic. But the single European market must nevertheless not be realized at the expense of the social acquis. Clinical biology is not a commercial product.

Mr. Verhaegen, I do not like to interrupt you, but do you want to ask the exact question to the Minister now? I thought the room should be informed. Can I ask you to repeat them? Mr. Demotte is there now and it was a crucial question you wanted to ask.

by Mr. Demotte has arrived. I invite you to rest your question.

I may be better to repeat the concrete question again at the end of my discussion, because the minister has heard our vision again.

Of course, we will not simply reject the Directive on the free movement of services, i.e. the Bolkenstein Directive, but CD&V is in favour of helping to fundamentally improve it. This is done through amendments, including in the European Parliament, including for the sensitive sectors we have listed. Just as the Bolkenstein Directive is subject to improvement, I have also submitted an amendment to this draft in the committee, out of concern to set limits to the marketing of healthcare, to put in a number of barriers against the unrestricted commercialization of our publicly funded healthcare, to counter disportion and to safeguard the financial manageability. I thought it was a noble amendment, although I say it myself. Their

Furthermore, the same concern was also expressed in the existing legislation of 1982, in which the case was adapted to the concrete Belgian situation also through the system of prior authorization, of prior diploma requirements. Apparently, this was difficult to answer in European law. We then proposed a solution by making a link between the refund for clinical biology in Belgium and the required non-commercial character of the exploitant, a solution compatible with the European right to freedom of establishment, to the extent that the requirement is to be satisfied from the objective that the safeguarding of the financial balance of the health insurance in this case is ⁇ an absolute necessity. Their

I also referred at that time in the committee to the judgment-Sodemare of June 1997 in the resting house sector, in which it is expressly stated that “the European Treaty does not preclude a Member State from allowing only private non-profit providers to participate in the implementation of its system of social assistance”.

We reached a reasonable and feasible compromise. Suddenly, however, your servant got all the banblicks over him. Suddenly your servant was accused of the pot and the boiler, from both corners. A divided majority suddenly shrugged hands. I am glad that you can hear it again. You also fell out of your role by blaming me for Stalinist practices. That is of course

I will conclude with my speech. We do not simply reject the Bolkestein Directive. We want to improve it through amendments in the European Parliament. In the House, I submitted an amendment to this bill to impose limits on the “commercialization” of health care, a concern that is also inserted in the 1982 legislation. We proposed to link the refund of clinical biology in Belgium to the non-commercial character of the operator. This provision is compatible with European law because it is absolutely indispensable to preserve the financial balance of the insurance company. However, the divided majority has complained to me. The minister went so far as to blame me for Stalinist practices.

The last thing you can say about me.

The Minister wants to interrupt you.

Mr. Speaker, in general, I’m someone – who doesn’t get upset when he hears nonsense but, here, it goes beyond all acceptable limits!

What I said was that we could not accept to enter into a logic where, at a given moment, one goes to settle the form of all the structures of society, as was the case in the “Stalinist” order regimes.

Rest assured, Mr. Verhaegen, I did not call the CD&V a “Stalinist” party! There are other qualifications that colleagues on these benches will find, but “Stalinist” please!

Now you are really talking about writing. I never said that the CD&V is a Stalinist party. I only said that we cannot accept that all aspects of society are regulated as in Stalinist regimes.

Mr. Minister, I am pleased that you apologize and that you say that you did not say those words. These were clearly the words I heard. It is far from me to get the mustard there. I thought, by the way, that socialism also grew out of a sort of ideology called Marxism. I stop with this. I will not go further into that. I hope we can end the incident here. However, I found it worth mentioning that you have caught me a little.

I am pleased that the minister apologizes and says he has not accused me of Stalinist practices.

(...) That is the reason.

Mr. Tant, (...) are good for the Catholics.

I am always ready to put up another tree with you on this.

Ladies and gentlemen, stay on the subject.

I conclude, Mr President. I only advocated for a free market economy that is corrected, to establish guarantees for the affordability of our solidarity system. That was all. It was indeed a discourse in the desert, but I did not expect otherwise. Our group naturally abstained in the vote on this bill.

I have a concrete question, Mr. Minister. With amendment 22, the government amendment that grants the special powers to the minister or to a decision consulted in the Council of Ministers, one can go all the way. Our question is in which direction do you want to go? Do you want to strengthen the design with this, for example? It could be. When I read the explanation of the amendment, I have the impression that certain points will tighten, but they could soften equally. You could provide additional access to commercial companies or you could also get to no KB. However, that will not be the intention. In what direction do you want to go with that power, if the Parliament grants it to you?

As a committee, I advocated for a corrected liberal economy, in order to establish guarantees regarding the financing of the solidarity system. But, as planned, I preached in the desert. CD&V abstained from voting on the bill.

My question now is: what position will the minister take? Will it soften the law or strengthen it?

I will be very short on this. We have taken the same decision as for the hospitals. What does this mean? We do not yet have a precise idea of the form that will be accepted.

We have taken the same decisions that in the case of becoming for the various companies that will be recognized. This needs to be discussed in consultation with the industry. If we find that in the current situation, with the current form of companies operating in the field of clinical biology, we have no major problems... I have the figures for the first months of this year and they prove that there is no exceeding. I repeat that the system provides that if there is an excess, there is also a mechanism that guarantees that the excess must be reimbursed. So I think we do not take any risks.

In clinical biology, a system is provided that allows recovery next year. We have no problem in this area. The problem is more about the statute of the companies. It is feared that such a small Bolkestein Directive will be created. I do not share this opinion because the form of those different companies so far allows for private users, who are now, of course, clinical biologists. The European Directive stipulates that the responsibility for these laboratories should not be left to clinical biologists alone.

Do we take a risk? I think not. If we are in a few months of years to determine that there is a risk there is a risk there is a risk there is a risk there is a risk there is a risk there is a risk there is a risk there is a risk there is a risk there is a risk there is. Tot no toe is er volgens us geen nood aan preciezere bepalingen. and hospitals. The exact form of the different companies that will be licensed is not yet known. I will discuss this with the industry. The current clinical biology scheme does not experience major problems of exceeding and the system provides mechanisms for reimbursement in case of exceeding. Some fear, a bit prematurely, a new Bolkenstein directive. The current form of companies already allows the presence of private operators, but all are clinical biologists. Europe wants to expand this aspect, but it is now unnecessary to change the shape of societies.

I am very pleased with the Minister’s response. We expect to be kept informed of the budgetary situation so that we can exercise control over it.

This answer satisfies me. We hope to be kept informed of the budget situation so that we can exercise our control in this regard.