Proposition 53K3260

Projet de loi portant des dispositions diverses en matière d'accessibilité aux soins de santé.

General information ¶

Submitted by

PS | SP the Di Rupo government

Submission date

Dec. 18, 2013

Official page

Visit

Status

Adopted

Requirement

Simple

Subjects

medicinal product organ transplant organisation of health care right to health social facilities medical institution health insurance

Voting ¶

Voted to adopt

Groen CD&V Vooruit Ecolo LE PS | SP ∉ Open Vld N-VA LDD MR VB

Contact form ¶

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Discussion ¶

Jan. 23, 2014 | Plenary session (Chamber of representatives)

Full source

I am referring to my written report which leads to the rejection of the proposal.

I refer to the written report.

On 15 January, the Public Health Commission unanimously approved the draft law on accessibility of health care. There were few discussions as the measures presented represent real advancements for patients. I will be brief.

I think it is important to take, for example, the program "Unmet medical needs". Allowing groups of patients suffering from a serious or rare disease that put their lives at risk to have much faster access to new innovative treatments, while no effective treatment exists on the market, is nothing! This is truly a new hope given to these people. This, without jeopardizing the balance of our healthcare system, since these new interventions will be financed by a closed envelope and unmet medical needs will be determined in advance.

And it is important to take this into account too, especially when it is known that at present, thanks to the rigorous management of the budget of medicines for example, we can already finance oncological and orphan medicines up to 350,000 euros per patient.

With the adoption of this text, the deadlines for reimbursement of new medicines or new indications will be significantly reduced, while allowing insurance organisations to ensure that reimbursement and distribution circuits to set up. This is important for patients who sometimes have been waiting for a long time for the refund of sometimes expensive treatments.

Finally, in this desire for increasing financial transparency of health care, the patient will now know directly whether the doctor he plans to consult is convened or not, simply by consulting the INAMI website.

Mr. Speaker, first of all, I would like to thank our French-speaking colleague for wanting to be a reporter, which is not so often the case with a proposal from the Flemish Interest.

It can happen that a court case is completely misrepresented or that a court case is assessed on the basis of incorrect data. The Judicial Code provides for a solution to this, in particular the revocation of the judgment in civil matters. I am not talking about the revision of the sacred in criminal matters, but merely about the abolition of the sacred in civil matters.

When mistakes are committed, in very strict and very limited cases can be passed to a revocation of the case. This can be done in six cases, under six conditions, which are listed in Article 1133 of the Judicial Code. I have laid them here in front of me, but I will not read them, so as not to delay the meeting too long.

However, the legislation shows a deficiency. When can such a case be reviewed on the basis of the cases set out in Article 1133 of the Judicial Code? This can only be done up to six months after the discovery of the fact that may give rise to a revocation. Thus, if a citizen discovers a mistake or a defect in a particular court case, if a case would have been misjudged, he or she must be able to report that mistake to the court within six months, of course through a procedure or by bringing it to court as described in the Judicial Code. This procedure is therefore very limited, not only the grounds, but also the procedural antecedents and the procedural remedies that may give rise to it.

So far, the ordinary judicial course of matters as it normally occurs.

My proposal aims at allowing the applicant, while the limitation period has not entered in a particular court proceedings, yet to have the case withdrawn. This was rejected in the committee. However, this would not give rise to a proliferation of legal proceedings; it would only benefit the legal certainty in those cases that were misjudged on a certain basis and it would, of course, be able to provide a right seeking soil as long as the limitation period has not entered for those cases which gave rise to the judicial dispute.

An important procedural measure in this case is the fact that one must find two lawyers with at least twenty years of experience at the bar – they must therefore have been registered on the bar of the Bar Association for at least twenty years – and another third lawyer to whom no requirement is made.

If a party believes that it has found a basis for the revision of a case, it appears that the applicant is not immediately alert or unable to see whether this is really a new fact. Of course, the proverb “nemo censetur ignorare legem” is true, or nobody is considered to not know the law, or everyone is considered to know the law, but it is known that in practice this can create difficulties and may be at the disadvantage of a party that is a lay in the matter and therefore has no knowledge of the law.

If, therefore, a party falls on a certain ground that may lead to the cancellation of a proceedings, it is not immediately certain that that party also thinks so and will also actually go to court or to a lawyer.

Therefore, consider the fact that a party going to a particular lawyer will have to try to persuade that lawyer. Of course, a lawyer does not like to question his good name and reputation: he must be prepared to see a certain ground as a possibility for revocation. This is, of course, very difficult for one party, but in addition, a second and a third lawyer must be found. The six-month period permitted solely by law when one believes to have discovered a reason for revocation does not guarantee that one can proceed to a revocation of the sacred within a six-month period.

You need to consult with lawyers and they must then make their advice valid. Lawyers with twenty years of billing experience are often lawyers with a lot of affairs and a very large office. The case must still flow through the office before it ends up with one of the titulators, but that is not evident.

Once the entire procedural mallmole has passed, one must therefore again get done within a period of six months what needs to be done. That is fucking impossible. I think that this procedure, as it is now included in the Judicial Code, can lead to nothing and does not provide the soil that parties can be offered in the event of an error in a particular procedure. Therefore, my proposal aims to simply extend the period until the end of the limitation period in the original case. This does not mean so much in practice, one should be aware of this.

Before being admitted to a hospital, and therefore in a serene context, thanks to a simple visit to the hospital’s website, the patient will be able to get acquainted with a series of general information and will know whom to contact if he wants personalized information.

Despite regulatory advances, it is not uncommon for patients to give up or postpone care for fear of the price that will remain to them. This measure will therefore ⁇ enable patients to further measure the financial implications of their admission.

I will conclude by repeating the importance of the three pillars that underpin this bill: accessibility of health care, protection of patients and the safeguards indispensable to preserving the balance of our solidarity-based health care system.

No surprise, my group will therefore vote in favour of this text.

Mr. Speaker, Mrs. Deputy Prime Minister, dear colleagues, just a few words to indicate our support for this project. We find a number of elements interesting, both in terms of information and transparency towards the patient and some advances in the availability of quality care.

I would just like to emphasize the points concerning medicines. It seems to me quite important that access to innovative medicines can be facilitated and advanced even before the full registration process is completed. Of course, this concerns only a certain type of pathology: chronic diseases, very serious diseases against which there is currently no active and effective treatment.

Therefore, I ask to extend the revocation of the sacred until the obsolescence of the case, rather than six months after the discovery of the ground of revocation. If this is not done, this procedure remains ineffective. A minimum number of applicants would benefit from that adjustment and would still be able to find some soil in that scheme if it is approved. That all sounds legal-technical, but to the lawyers in our hemisphere I address the question of approving that proposal, because it is not against any practical or legal logic, nor against the legal certainty. It will only benefit the prosecutors who have a little more time to have their case withdrawn.

Contrary to what could already be achieved through the Special Solidarity Fund, this will be about determining a kind of patient cohort that can collectively benefit, in some way, from this advance.

The temporary authorization for use in France was already known. You know, I am always attentive to what is happening in this country. I am happy that a similar system can be adopted.

We, of course, support this initiative that will meet the needs of patients who are in the impasse, lack of access to innovative medicines, even before registration.

Furthermore, another positive element is the shortening of the deadlines for the refund of pharmaceutical specialties, even though the State Council has been a bit critical about this. Politics must take responsibility.

We therefore also support this measure that allows to accelerate the refund of certain medicines, and thus improve the accessibility of care for patients who need these medicines.

This is a very important project for the accessibility of patients, as has been said.

There are three types of patients. First of all, there are people who suffer from a very serious disease or a rare disease for which there is no effective treatment, who wait for a medicine that exists but is not yet recognized. Two years, for them, is too long because it is a question of life or death.

With the agreement of the pharmaceutical industry, we have planned to reduce this period to a maximum of six months. I would also like to emphasize, Mr. Speaker, dear colleagues, that during these six months, the pharmaceutical firm will have to give these medicines free of charge to those who need them.

This is a shared effort.

In addition, it is effectively addressed to the most precarious patients by allowing associations that do a formidable job, such as street nurses or Doctors of the World, to receive support and financial means to assist them in their daily tasks.

Finally, the project is addressed to Mr. and Mrs. All the World. When we have to make a passage through the hospital, unfortunately too often, we cannot estimate the overall cost of the invoice that comes to us. We are making arrangements to ensure that hospitals apply much more transparency and that real work is done to inform the patient of all the costs of his stay at the hospital.

Finally, I would like to thank the President and the members of the Public Health Committee. As you know, there was no opposition to this project. So there is a very strong membership, which I am delighted!