Proposition 51K2090

Projet de loi fixant des dispositions spécifiques relatives au statut des officiers du corps technique médical du service médical.

General information ¶

Authors

MR Philippe Monfils
Open Vld Hilde Vautmans
PS | SP Bruno Van Grootenbrulle
Vooruit David Geerts

Submission date

Nov. 18, 2005

Official page

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Status

Adopted

Requirement

Simple

Subjects

medicine armed forces

Contact form ¶

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Discussion ¶

Jan. 26, 2006 | Plenary session (Chamber of representatives)

Full source

Mr. Speaker, Mr. Minister, dear colleagues, our committee examined this bill at its meetings of 7 December 2005 and 11 January 2006. The State Council’s opinion was also requested; it was delivered on 14 December 2005.

In his introductory speech, Mr. Geerts first mentioned the context in which this bill enters. by

The medical component of the Belgian Armed Forces is facing a decrease in its personnel, and more ⁇ a decrease in its healthcare providers. However, it is necessary that the staff involved in operational and humanitarian missions, which are constantly increasing, have access to quality medical support. This is why a revaluation of the function of the officers of the medical technical body of the medical service is necessary.

The aim of the bill is therefore to make the status of Medical Technical Corps officers attractive enough for potential candidates and also to offer new career prospects and motivation to officers currently in service.

by Mr. Geerts subsequently presented an overview of the force lines of the bill. by

Finally, the main author of the proposal highlighted the fruitful collaboration of the departments of the Department of Defense in the preparation of the text.

As for the general discussion, we remember the following few points.

by Mr. Denis supported the bill, however calling for a deeper reform, focused on recruiting and ⁇ ining a sufficient number of qualified military doctors. He also addressed the problem of the cumulative activities of military doctors and called for strict and clear regulation in this area. According to him, the intention to align the incomes of military doctors with those of civil doctors, according to the arrangement provided by the law, will not be easy to implement. by

Ms. Wiaux, on the other hand, questioned the definition and concretization of the concept of medical authority. She proposed to entrust this task to a committee rather than to a single person. by

by Mr. Monfils, as a co-author, replied that the authors had been attentive to this aspect and that the medical authority is carefully framed. by

According to M. From Crem, the means to ⁇ the objective of the bill to be examined are lacking. According to him, not only is lateral recruitment not an attractive enough solution to attract doctors, but it also does not adequately take into account skills. by Mr. De Crem also regrets that officers who have reduced their commitments to a minimum will now be able to become Major or Lieutenant Colonel, grades allowing access to the position of head of service or to lead a medical unit in operation, while these officers have not received additional training preparing for the functions of operational command. by

According to M. Sevenhans, the bill proposal is a missed opportunity. According to him, a wider opening of the debate would have given the reform a greater scope.

by Mr. Kelchtermans requested clarifications regarding the fixing of the number of students likely to perform a specific medical function in the reserve at the end of their university studies, by engaging immediately and receiving an annual premium.

According to Mr. Kelchtermans, French-speaking candidates could be advantageous because there is no admission examination for medical studies in the French Community, while there is one in the Flemish Community.

by Mr. The Minister stressed that the objective of this proposal should be pursued in parallel with a series of ongoing initiatives concerning a new organization of structures and associations within and outside the Department of Defense. The Minister then gave a brief comment on the various measures provided for in the bill under consideration. In this regard, I refer to my written report.

Regarding the cumulative activities of military doctors, the minister stressed that it is absolutely not opposed to it, provided that their complementary activity does not become their main activity.

In response to Mr. Geerts, this specified that in any case, the medical authority must be able to control the cumulative activities. He also added that it was precisely trying to increase the attractiveness of the financial aspect and to allow the development of expertise through the cumulative to remedy the current problem, to provide vacancies.

by Mr. Geerts clarified that a reasoned opinion from the medical authority and the necessary experience were required for obtaining a leadership position. He also mentioned that the premium to students who immediately commit to performing a specific medical function in the reserve at the end of their university studies depended on the year from which the student used the system.

by Mr. Monfils, as a co-author, added that the number of candidates will be determined according to the needs. It also stipulated that if the student failed or decided not to engage again at the end of his studies, he should refund it. A royal decree must specify this basic rule as well as the amount of the premium. For further clarification of the general discussion, I refer to my written report.

In order to take into account the opinion of the State Council on the draft law under consideration, Mr. Geerts, Mrs. Vautmans, Mr. Meanwhile, I and Monfils submitted nine amendments. For further clarification, I will also refer you to my written report.

At the level of discussion of articles, most articles have not been the subject of additional discussions and questions. As mentioned earlier, 9 amendments aimed at taking into account the State Council’s opinion on the draft law under consideration have been submitted and adopted by our committee. The amendment was approved by 9 votes and 3 abstentions. Consequently, the annexed bill becomes unobjective.

I have finished with my report, Mr. President.

Mr. Speaker, Mr. Minister, Mr. Geerts – the main author of this proposal – Dear colleagues, the CDH group will abstain when voting on this bill.

It is true that the transformation of the Armed Forces has changed the structure of staff and the need for medical support. It is true that currently there is a shortage of candidates in the recruitment of doctor candidates and it is true that there is a decrease in the number of military doctors available, both in Belgium and as part of external operations.

It is of course necessary to guarantee the continuity and quality of the medical care and medical support provided to staff, both during operational engagements abroad and during the normal service in Belgium and during training. This is also what the bill wants to meet since it wants to set very specific provisions for officers of the Medical Technical Corps, so that their status is attractive enough for potential candidates and that it opens new career prospects and motivation for officers of the Medical Technical Corps currently in active service. However, we find it regrettable that not all trade unions have been consulted on the entire text. Some are surprised to be placed in the face of the accomplished fact, especially since this bill seeks to regulate the status of officers of the medical technical body only.

While it is true that this bill allows positive advances such as the new system of complementary activities that allows more flexibility, many enforcement orders will be decisive for the orientation of this status. We can regret this unknown even if, I admit, Mr. Minister, you have been reassuring in the committee when you talked about a thorough consultation with the trade union delegations. The future definition of a royal decree of execution of the higher medical authority interpels us in particular.

Here, Mr. President, Mr. Minister, Mr. Geerts, are the reasons for our abstention.

I can also submit my comments on the articles.

You can do it. Your amendment can also be defended.

Mr. Speaker, colleagues, you may know that there is a problem in the medical corps in general and with the military doctors in particular. I will leave for a moment in the middle who is the cause, but I can assure you that Minister Flahaut has definitely put his money in the pocket. Their

Colleagues, something had to happen, but I fear, like the previous speaker, that this is a missed opportunity. It is believed that in this case one can solve the problem by simply giving a little more money. If I were a doctor — maybe there are a few doctors in the room — I would be insulted, for apparently it is stated here that a doctor is simply for sale. I have spoken to a lot of doctors, but I have never heard complaints about money. Their

I suppose you know the difference between a bill and a bill. You may be surprised at the speed with which this bill was passed. Between the first draft and approval are only three months. Their

Colleagues, in fact, it is a bill inspired by Chamber member Flahaut. Mr. Minister, I would like to welcome you back as a member of the Chamber. This could solve a number of problems. All madness on a stick, the submitters of this so-called bill were chosen very carefully. There is one per majority party, with Mrs. Vautmans of course at the head, ladies first I hear always say. Apparently she dropped Mr. Goris definitively from the throne. No problem for me. Mr Monfils is the chairman of our committee. He is also a specialist in this area. There is also the charming Mr. Geerts. It was also signed by a certain Mr. Van Grootenbrulle. I have never seen him. I do not know who it is. He is also a specialist in this area. Colleagues, the bill translates a rather old concept that was developed in the General Directorate of Human Resources, under the leadership of a colonel. It was further written under the leadership of a Lieutenant Colonel by the Policy Preparation Division. It was subsequently signed by the four aforementioned members of the Chamber. Their

By letting a bill be submitted instead of a bill, the minister saves himself some effort, among other things, he originally did not have to ask for advice from the Council of State, but that has, fortunately, still changed during the course. He avoids, of course, also the trade unions, the inspector of Finance and so on. Their

He is also, and this is important, the Minister of Pension. I think this has a clear impact. Particularly the latter seems to me, however, important because of Article 29, § 1, of the proposal which stipulates: "the officer who has received a positive assessment of his competences receives an allowance the amount of which is in accordance with his specialty."

No concrete figures have been given on these subsidies to date, but the responsible persons in charge of the file at the ADHR speak of a substantial amount. This should ⁇ not surprise us, it responds to a necessity. However, I think you can predict amounts of 3,000 to 4,000 euros per month. With regard to the draft law-Flahaut, it is intended to open the way for quasi-arbitrary recruitment and promotion of certain medical personnel. The State Council was then asked for advice and was given only five days. So they have done it. They also had some comments.

As for the current situation, the following. Recently, the laws of 16 July 2005 concerning the transfer of certain military personnel to a public employer and of 20 July 2005 concerning various provisions, within the legal framework, were created in order to sensibly reduce and rejuvenate the personnel of the military force by 2015 by transferring certain categories of military personnel to a public employer on their request or allowing them to reorient themselves professionally in the private sector on their request. The KBs designed to implement both of the above-mentioned laws exclude officers from their scope. Also, nurses, clinical biology analysts and kinesiotherapists are not eligible for transfer to the public sector or professional reorientation in the private sector. It should also be noted that personnel who leave the military force in application of the aforementioned laws lose their military status after one year.

The purpose of this bill would, on the one hand, be to address the shortage of medical personnel by allowing a so-called lateral recruitment on diploma of applicants who can justify professional experience in a particular medical field. In order to recruit these candidates, the statute should be made attractive and should open up new perspectives regarding career and motivation of officers of the Medical and Technical Corps, MTK, currently in service. On the other hand, this separate recruitment, coupled with a special statute for this staff, would justify itself on the grounds that the tasks of the medical corps have evolved otherwise increased. This statute would therefore be necessary to provide the necessary medical assistance, both in the field of operational assistance — thus in the case of foreign contracts — as well as in the field of curative and occupational medicine.

I overwhelmed the article in bird flight, a matter of time saving since I understood that a reception was announced. Article 2. In order to keep all reserve personnel in the same status, it would be best that all arrangements of reserve personnel, directly recruited or after their active service being included in this framework, be included only in the Act of 16 May 2001. This law could therefore be amended with a chapter on reserve personnel with a special status. In my view, points 3, 5 and 11 are therefore unnecessary. However, if one wants to make a separate corps from the Medical and Technical Corps, completely alien to the other military components, with extraordinary rights and privileges that are not granted to the staff anywhere else in the public office, then it is explainable why also the reserve personnel MTK is included in this law.

As regards Article 3, I find the wording very poor. It is sufficient to adopt a formula as in the Act of 20 May 1994. In this way, the second member becomes superfluous, so that the reserve staff would be removed from this corps.

Article 4 of 4. The reserve personnel have never been entitled to any military pension under the laws of 11 August 1923. Their services are converted into rights in the pension system to which they belonged or belong. This is an example of why one wants to encapsulate the reserve staff MTK in this law. I can understand that, but I have never heard of a budgetary impact on this, nor have I read about it.

With regard to Article 5, I ask who determines the needs. There are no frame numbers and the subdivision in degrees is almost free.

Article 6 of 6. The minimum training is 6 weeks. Then the maximum yield is 5 to 6 years. In my opinion, this is very short and can be even shorter if the person concerned stipulates a temporary contract.

With regard to Article 7, I say no. By definition, a professional officer shall serve indefinitely up to the age limit. Professional officers with one-year temporary contracts seem very strange to me. What in times of crisis? What about the extension of temporary contracts? Who accepts applicants? Should this be the Minister of Defence? In short, a lot of questions that remain unanswered.

Article 8. The training must be at least one year. If the training is limited to a minimum of six weeks, the rest is an evaluation period. How else can one judge their professional, characteristic, physical and moral suitability? I would like to emphasize that in the public office the internship for recruitment at level A also lasts one year.

Article 9. No one may be appointed to a grade of officer unless he has demonstrated the required language skills. I think this is a circumvention of language laws. I refer in this regard to the law of 30 July 1938. How will this be achieved in the recruitment process? Will they be appointed only after six weeks of training? What happens if the training fails? The language examination, as provided for in Article 5 L 1 of the Statute Act, does not provide for a re-examination. Apparently this is not taken into account. These are some fundamental remarks.

Article 10 of 10. Who determines the duration of the training cycle? Article 8 says nothing about the fact that this would take a year. Is there a possibility to organize the language examinations under Article 5 with any language courses?

This law allows even anyone with a basic degree in the medical sector of a doctor, dentist, veterinarian or pharmacist and who has five years of experience to be appointed to major. Moreover, this law will allow to recruit this type of staff with an equivalent diploma or certificate. My question is who will judge that equivalence.

The degree of major corresponds, in the public office — although officially, but it is still frequently used — to a grade of grade 13 in level A, which only exceptionally occurs as a recruitment degree and is awarded to certain highly qualified specialists recruited after comparative examinations in a flat career, such as at the Inspectorate of Finance, the public office advisors, and so on. Here, a degree of chief officer is awarded to recruits without any useful military experience and without requiring a higher specialization than a basic diploma. To the extent that the normal recruitment of medical personnel would still be ⁇ ined, it is almost certain that no more candidates will be found for candidate-professional officer, further abbreviated as KBO, in the current framework that not not be lifted. Furthermore, how can one plan to ensure the continuity of the concerns if one can ever condition a la carte services of a certain duration and one can resign if one wants, after just a few years of return, or can leave in service.

With regard to Article 11, the conditions of admission, the program and the conditions for success shall be determined by the King, according to the analogy of Article 26bis of 1 March 1958. This is also not so clear.

With regard to Article 12, what is the degree of recruitment? What is the rhythm of the appointment, especially if for some the formation would only take six weeks or a total formation of one year?

I am referring to Article 13. Paragraph 1 should be supplemented by the words "for the application of this Act" between the words "belongs" and the word "only" and it shall be "only for the appointment" instead of "only for the appointment". Paragraph 1 thus allows candidates-MPK to appoint during their training in the rank of officer without having to prove their bilinguality. This is, in my view, an unacceptable violation of the principle of bilinguality of officers, as established by the Act of 1938.

Article 14, a degree of Chief Officer is a degree granted to persons with high specialization and years of experience, thus not to someone with a basic degree or even twenty years of ordinary practice as a general physician, dentist, pharmacist, and so on. Also in the public office, no doctor is recruited in grade 13. I referred to it. It is not officially, but officially in use. Such recruitment in grade 13 exists for highly specialized personnel with a flat career after heavy, comparative recruitment exams and years of internship, for example, the corps of the inspectors of Finance and that of the advisors in the public office, but not for a doctor who, after 20 years of private practice, decides to work, for example, as inspector Food Inspection or at the Health Service of the Ministry of Public Health. Article 14 is therefore, in itself, superfluous, since in this particular statute, major is a basic degree for which, by definition, no seniority can be held at the first appointment.

Article 15 is incomprehensible.

Primo, the promotion in that special status does not depend on an earlier antiquity. One is appointed in the basic degree of major and only then must ancientity be built up to promote to lieutenant-colonel. To become a major, one does not have to first take courses of further education. I thought that was the habit before, but apparently it is also put on the road. For example, who determines what ancientity one needs to become Lieutenant Colonel?

The advances of officers are carried out by corps. We do not see how some provisions applicable to lower officers in other corpses should or may have an impact on the advances to seniority for Chief Officer MTK, moreover since they are all outside the framework. A language exam is a prerequisite for appointment. I suspect that is not superfluous. Does the meaning mean that one can be appointed in the degree of major without having succeeded in Article 5L1? The combination of Articles 10 and 13 with the Article does not, in my opinion, exclude that. I think it would be an allegation of all the principles of the language law.

There is no problem with Article 16.

I am referring to Article 17, paragraph 2. What is a patent of equal value? This has never really been clarified.

Articles 19 and 20 do not belong here. I would rather have seen the reserve in a separate law.

I disagree with Article 21, because a new Medical Technical Corps is being created that will almost completely absorb the existing Medical Technical Corps. Now there are 12 Colonels, 36 Lieutenant Colonels and 43 Major. Together, it represents 91 chief officers and 117 lower officers. In total there are 208 doctors, pharmacists, dentists, veterinarians and so on. This includes both professional officers and supplementary officers, regardless of their form of recruitment. Almost everyone now becomes vocational officer and almost everyone will also be included in the special statute. Nothing says how many officers MTK will still remain in the numbers as determined in the framework decision. Since not all officers in the Special Statute are included in the numbers as set out in the Framework Decision, it is clear that the existing framework becomes an empty framework, while there is no specification of how many units in the Special Statute may or may be recruited.

In the memorandum of explanation, one speaks vaguely of a deficit in securing foreign contracts. The provision allows everything, and given the flexibility with which these officers can manage their own career — temporary contracts, dismissal, cumulative, making available to third parties — it is clear that there is intentionally no framework of maximum numbers per degree or group being established or can be established. Such a provision allows for abuse. How can this be reconciled with the annual law on the military contingent? Quid the budgetary aspect of course.

Then I come to the article.

Mr. Sevenhans, you are ⁇ short today, but if you were even shorter...

I will also discuss the articles immediately, because otherwise I will have to do it later. Therefore, I will immediately also make an article-based discussion.

Article 22 is also unnecessary. Article 19 of the Disciplinary Law is sufficient to allow cumul. Is the opinion of the medical government binding for the Minister of National Defence? This must be determined in the law itself. If that is the case, then the law gives a delegated power to a military authority without political responsibility.

Is this in accordance with the Constitution and the jurisprudence of the Arbitration Court? I think it is not.

Many medical practitioners are employees-managers in a company of which they are shareholders. For them, as a military, any cumul is excluded under Article 18 of the Disciplinary Law.

Article 23 relates to training activities. I understand and accept the reasons for this provision. However, I hope that the government realizes that it is not welcomed at all banks.

Article 24 establishes a special statute to attract more candidates through re-evaluation of the career. There is a deficit. However, once they have become military cadres officers, it is immediately provided that they can be made available to almost everyone: a FOD, regions and communities and institutions, except apparently the municipalities. The government may have forgotten.

Paragraph 2 of Article 24 specifies which articles of the law apply to the occupation outside the military force. In this regard, I refer to the Act of 20 May 1994 for officers with a special status. Therefore, the other articles of the same law are not applicable. In fact, the officer of the MTK can still, by agreement, suspend the articles of the Y5 — a law — which are applicable to him.

Article 25 provides that a candidate professional officer of the special recruitment shall receive a recruitment premium. De facto, all officers of the MTK will now belong to the special status. De facto, all returns currently applicable to medical personnel will be discontinued. I refer to the law of 16 May 2001, table AY30. Then everyone has a return period of maximum five years.

There is no problem with Article 26.

With regard to Articles 27 and 28, I have the same comments regarding the reserve.

The provision of Article 29 is permitted by the pecuniary law. What is the ratio legis? The members of the MTK already have a betting scale that is higher than the scale of other, similar specialists, such as pilots, engineers and lawyers. They would also receive a competence allowance, which does not exist in a flat career. There is only transition to higher betting scales within the rank according to a certain subdivision in the betting scales of the same degree. The normalizations, performance and the 38-hour week are not applicable to officers. A full-time performance can only mean a normal 38-hour working week. It would be better to refer to the pecuniary law: "38 hours a week is applicable to ...", and so on.

Such an introduction to the Medical Technical Corps is another advantage over other senior officers, who for the most part perform silently much more than the 38 hours a week. An inequality is created. This must be dared to admit.

According to Article 30, there will be almost no lower officers in the framework decision. Everyone has a major or higher rank.

I say no to Article 31. After all, what are the potential and yield in the higher degree of a promotion, one year before the retirement age? Or is it necessary to raise the pension?

With Article 32 I come to the defense of my amendment.

Mr Sevenhans, that is good. Have you submitted only one amendment?

That’s why I defend it now.

I have submitted an amendment to Article 32. I tried to explain it to the specialists in the committee. Some have admitted that they have not read it. Others, who had read it, did not understand it, because they apparently could not consult the persons who held their pen.

I would like to replace Article 32 with the following provision: "The provisions of Article 17, paragraph 1, shall not apply to the professional officer who has passed the professional examinations for chief officer and the professional officer appointed in the rank of major and lieutenant-colonel on the date of entry into force of this provision". Colleagues, I have asked it again, and no one has a problem with it. On the contrary, it would be a very good supplement to the law. Unfortunately, nobody wants to get involved. I don’t know if that’s personal to me, or because I’m a member of the opposition. Probably the law is so complex and already so blunt, because so much has already been encrypted, that my amendment might make the matter a little more unclear. But I find it regrettable.

After all, in my accountability I have clearly pointed out the purpose of my amendment. Now inequality is created. The current system allows a lieutenant-colonel to simply become a colonel because he would initially have already passed professional examinations. However, this also applies to a major or a captain-commandant who has passed his professional examinations. Why should a lieutenant-colonel be preferred over a major? This may be explained to me. I have not yet found anyone who can explain it to me. I hope that article does not apply to a particular lieutenant-colonel, because that could be another explanation. But why a lieutenant-colonel should suddenly not do a number of things, which are expected from someone else, I do not understand.

My decision is the following. The design opens the doors to abuse in terms of recruitment, formations, cumulations and the disclosure of third parties. There is no balance between the rights and duties of government and staff.

It is a problem or could be a problem that the military members of MTK receive a higher salary than their similar counterparts in public office. I understand that one must do something and want to do something, but I have already mentioned it in the introduction: money does not make everything good. The problem is not just money. A doctor is not for sale, I thought. That would be easy: if there was a shortage, they simply bought them on the labour market. However, this is not how it works. Additional charges and obligations could be covered by an allowance scheme, and that would still partially address the problem. Their

In my opinion, it is not possible for those who provide temporary services of less than 10 years to be entitled to a public pension, though mixed, as this would create a precedent. I would like to offer everyone the maximum, but then one must still calculate the financial impact in advance. I have not read or heard it anywhere. This arrangement is quite unique — we are a unique country, I know that — but I do not know any similar arrangement in any other foreign army. With us, first-line medicine and occupational medicine can be practiced by a generalist with at least the degree of major. In other armies this is just a lower officer. I have the impression that we also want to create a Mexican army in this area: everyone Colonel! I once read the book "Everyone Mayor", but here everyone becomes Colonel. Their

I have already pointed out the question: what is the predictable budgetary impact of this bill. never heard of. Is this quantifiable, since one is not bound by numbers per degree in a framework that cannot be established? I think it will be a bit of nutting work. I have not heard of the impact of the legislation on the mixed career concept on the staff. Their

Colleagues, the original proposal as it was written by the military may have been well intended, but it has now become technically very weak. It can ⁇ no longer be substantially accepted for many drafted provisions. The bill represents a significant revaluation of the pecuniary status of current military doctors. I have never really made a problem of it, but it is not the real, only solution. Will this be a solution to the recruitment problems? I dare to doubt that. Even if one could ever ⁇ equal pay, why would a young doctor add to the disadvantages of military life in operations? The professional must also play. I would regret that if a professional practice has little success, one still enters the army as a kind of second chance. That would not be a good thing. A military doctor is an important figure in the entire military aspect. A military worker on training or on a crisis management mission abroad has the right to the best health care. I doubt if this will contribute to this.

Mr. Sevenhans, you have not exhausted your half hour, but the Room may be.

Mr. Speaker, the MR group will support this bill but I would like to remind in a few words the reasons why the conflict that we have experienced in Neder-over-Heembeek was born and how we can, in my opinion, prevent the recurrence of situations like the one we have known.

The conflict arose because there are, in the army, doctors who only practice military medicine and others who cumulate with private activities, and above all because some doctors who cumulate dedicate most of their time to their non-military activities.

In order to prevent such conflicts from occurring again, it will be necessary to amend the law that we will vote on by providing in the future three categories of military doctors. There will be first the contractors, those who are in charge of a mandate for which they will be remunerated and who, outside that mandate, will do what they want. Then there will be the officials among whom it will be necessary to distinguish two categories: those who do not cumulate because they want to do a complete military career, and whose army will be the only concern at the professional level; then, those who cumulate and who, as a result, will be limited in their possibilities of advancement and who will stop, for example, in the rank of commander or major. by

Mr. Minister, I think that it will be at the cost of such provisions, aimed at rewarding those who take full responsibility for their military career, that the system will be able to function efficiently in the future.

I do not want to weigh on the length of the conversations. How would I dare? But we have another extraordinary session during this afternoon, if you understand me.

First and foremost, I would like to thank the rapporteur for the comprehensive, complete and correct report.

Mr. Speaker, Mr. Minister, I will delight you; I will make a very short political presentation without going into the technical details. The structure of my argument is quite simple and is determined by the following questions. Why, what, how and what consequences will all this have?

Let me start with the why. As you all know, the Belgian Armed Forces is an organization in full transformation. That is logical. After all, the world has changed, and as a result, the tasks of the Belgian army are also changing. The bipolar model is gone. Troops are deployed today in countries that ten years ago no one had thought Belgian troops would be deployed there. The external changes have resulted in the structural plan reforming the various components.

The medical component must therefore also be reformed. The why is simple. On the one hand, there has been a sharp reduction in the number of men, a decrease in the number of patients and therefore also in the number of healthcare providers. On the other hand, there are more operational assignments and humanitarian missions. For both tasks, it is necessary to have well-trained and healthy personnel who are entitled to good medical support.

However, we have found that there are deficiencies in the functioning of the medical component. A number of records have, unfortunately, proved this enough. You can be very cynical about this, but patients and healthcare providers have nothing about it.

We must therefore look further. How will we raise the number of healthcare providers again and how will we organize the medical component so that it works effectively? This is the starting point in all of this.

Instead of cancelling about what is failing, the majority should take an initiative that provides a perspective to the medical component. As I have already cited in the committee, we do not want a patch on a wooden leg, but a patient who will find his second breath.

The current bill itself sets specific provisions for the officers of the Medical and Technical Corps in such a way that it is sufficiently attractive to potential candidates and that it offers new career prospects.

In globo, the proposal is structured around the four stages of the career, respectively the recruitment, the formation, the promotion in degree and the assignment.

I will briefly highlight some elements that are new in the proposal. New instruments, such as the medical government, are being created. The action of these will be decisive for the operation of the medical component. The lateral recruitment on diploma is also new. Doctors who have already gained professional experience can be more easily engaged to meet the current needs of the department. Recruitment should therefore be simplified and applied to the medical qualities. One should not have taken a ballistic course to be able to distinguish a cold from the SARS virus.

Mr. Speaker, I said I would be short. I will soon add two other elements, namely the cumul, which Mr Denis has already cited, and the conditions of promotion.

As regards the cumul, I have listened carefully to what Mr Denis said in the committee, and also here in the plenary session. I fully share his concerns. We shouldn’t call each other “Lizebet” and face the truth. Some of the problems are related to the fulfillment of the cumulative conditions. I want to make it clear that I am not an opponent of cumul, because a doctor must treat a certain number of patients and a certain number of pathologies in order to reach a minimum of critical mass. I have expressed this in the Commission in a plastic way. An ophthalmologist who does not see a patient, I have questions. However, when one is paid by Defence, there must also be services provided for this department.

The cumulative conditions should be drawn up with the medical authority and subsequently executed through a KB. However, I urge, Mr. Minister, that we discuss this issue further in the committee.

Finally, I would like to discuss the conditions of promotion. I know that there is criticism of the fact that some people can very quickly acquire a certain rank, that of major. Also, the flow to the rank of Lieutenant Colonel and Colonel was not free of criticism. In my opinion, these provisions should be read together with the mixed career concept, which introduces the notion of military experts. We will return to this later.

Mr. Speaker, I will come to my final point on how and its consequences. Here and there I have been criticized that we, as members of parliament, have cooperated with the defence services. That is true, but I consider this method as an example of the interdependence that can exist between the different state powers. Even Montesquieu’s trias politica teaching allows this. I believe that the discussions in the committee, the questions raised there by both the majority and the opposition, as well as my written question of 13 July 2005, gave rise to this initiative. During the summer months, we worked hard on the reform of the medical component and a number of related files.

I am well aware that the bill is only a first step, but one cannot reach the finish of a running race without also walking the first meters.

Mr. Speaker, Mr. Minister, colleagues, such as colleague Bacquelaine and colleague Geerts have already cited in the discussion of this bill, it saves on the reform of the Medical Service. Many will wonder why we need this bill now. Well, we identified two problems. In 1994 the military service was suspended but in fact there has since little changed in the structure of the Medical Service. Colleague Maggie De Block just said that she remembers the time that many doctors during their military service performed many tasks for the military force. I think that because of its suspension that part has already disappeared.

We have two concrete problems. First, the vacancies that are now open for doctors within the military force have not been filled. Last year 17 vacancies were declared open, of which only 8 were filled. That is the first problem.

Secondly, due to the numerous cumuls that the military doctors fill, we actually have a shortage of doctors to send on mission. Currently, there are 661 soldiers of us abroad, 29 of whom come from the Medical Service, but only 5 doctors. We have to look at the rotation. So, there is indeed a problem there.

Hence this bill, which aims to address the problems, on the one hand, concerning the recruitment, and on the other hand, concerning the motivation of military doctors to remain at work within the military force.

To encourage applicants, a number of decisions have been made. First, students may receive a financial incentive during their medical course at the university to subsequently exercise their profession in the military for a number of years.

Second, one can still join the army until the age of 50. I think this is a very important change. It can be recruited until the age of 50. Because there is now a specific problem: we now have a shortage in a number of specialisations. I think, for example, of emergency medicine, where especially the hospitals create a lot of competition by calling those specialists. Those adjustments can be an incentive.

With the bill, we try to motivate the military. We want to motivate doctors to remain in the military force. We do this by allowing a faster promotion. Colleague Geerts has already emphasized this. That was a good decision. Colleague Sevenhans said that doctors cannot be bought. That is true, but if one earns so much less in the military force than in the private, then the choice is naturally made very quickly to continue to exercise the profession in the private. Therefore, this is one element that definitely plays. Their

I would like to tell you a small anecdote. I have visited our military forces abroad several times. I must tell you that when one tells friends that one goes to the military as a doctor, people ask why one goes to the military as a doctor, who is going to war, who is going to injure. I can assure you that the doctors we master on shipping do numerous good activities. They are not only on the ground to take care of our military, but they also take care of the civilian population on the ground. In Benin, for example, I saw a military doctor at work. There were people from Benin. They had to walk about 30 to 40 kilometers and then wait a whole day before finally being treated by our doctor. Their

Mr. Minister Flahaut, this is a challenge for you in the promotion campaigns to the youth. We must indeed carry out that good humanitarian work that our doctors carry out on those missions. For me, that is a very important challenge, which you will need to take care of in the promotional campaigns. Their

One last point that I am very pleased with is that with this bill we finally make the creation of the medical government. That did not exist until now. That medical government will have to judge whether someone can fulfill a cumul or not within the military force. This is a very important step forward. Their

Colleagues, Mr. Speaker, I am going to finish, because I feel the tension for the other activities this afternoon. The VLD fully supports this bill. It is for us a first step, an important step towards finally also the concept of mixed careers. That we can engage citizens closer to the military force, that we can engage private doctors with their specialties, is for us an important step forward. That is why this bill has our support.

As I have been able to say in the committee, this proposal comes at the right time.

Furthermore, I welcome the good cooperation between the executive and the legislative and the fact that, through this good understanding and dialogue, we can quickly advance projects whose beneficiaries are members of the staff of the Department of Defense, in particular medical staff.