On Thursday 5 March 2026, Luxembourg’s Chamber of Employees (Chambre des Salariés - CSL) unanimously adopted its opinion on the draft law establishing companies and associations formed by doctors, dentists, psychotherapists or veterinarians.
In a press release, the CSL said that it welcomes the withdrawal of draft law No. 8013, which it said did not correspond to the objectives of a public health system based on the general interest and universal access to care.
The CSL highlighted that the text allowed third-party investors who do not practise the relevant medical professions to intervene. The new draft seeks to address this criticism by providing that the shares representing the capital of such companies must be held exclusively by doctors. However, the CSL considered that this provision does not exclude all external influence. Investors other than doctors could intervene indirectly, for example, through the provision of buildings, equipment or services by separate companies. Under these conditions, nothing guarantees that the interests of patients remain at the centre of the priorities of medical structures organised in corporate form.
The CSL recalled that it supported the objective of making the medical profession more attractive in Luxembourg and recognised the benefit of allowing doctors to work together in order to share infrastructure or equipment. It considers that the structure of a company, whether civil or commercial, is not suited to preserving a healthcare system founded on and financed by public solidarity. By nature, a company is oriented towards generating profit. This logic appears difficult to reconcile with the organisation of a healthcare system whose primary purpose must remain the treatment of patients in the general interest.
The CSL said it fears that organising doctors within corporate structures could deepen the divide between the individual interests of doctors and the sound management of hospitals. Such a development could further strengthen the position of self-employed doctors and increase the dependence of hospitals on them, particularly for the organisation of emergency services and on-call duties. In a context of the growing shift of certain technical and medical procedures from hospitals to the outpatient sector, there is a real risk that the logic of profitability will gradually take precedence over the interests of patients.
The CSL also expressed serious doubts about the compatibility between profit, which is inherent to a company, and the essential principles of medical ethics. Medical ethics are based in particular on the impartiality of the doctor, who must detach themselves from personal interests in order to place the patient’s health at the centre of their decisions. Even though the draft law specifies that the companies concerned would retain a civil nature and would not have the status of traders, the logic of profitability inherent in any corporate structure remains. Consequently, there is a risk that the services provided will gradually be assessed in terms of profitability rather than the health needs of patients.
The CSL stressed that the medical professions cannot be equated with other liberal professions. While certain characteristics may be shared, medicine differs in its purpose and in the specific responsibilities that arise from it. Medicine is a service and the patient is not a customer. In certain situations, the care relationship may be a matter of life or death and the patient has very limited room for decision in the face of the prescriptions of their doctor. The care contract that underpins medical responsibility is not a commercial contract and does not fall within a market logic.
It said: “The activities of doctors and healthcare professionals constitute non-economic services of general interest. They are based on principles of solidarity and redistribution and do not fall under the rules of competition and the market. The tariffs for medical acts are not set according to supply and demand but determined through agreements with the National Health Fund in order to guarantee universal access to care for all insured persons.”
In this context, the CSL observed with “serious concern” the recent questioning of the contractual agreement system by the Association of Doctors and Dentists (AMMD). The withdrawal from the agreement system initiated by the AMMD risks sounding the death knell of the public health system and opening the way to a multi-tier healthcare system. Such a development would encourage the emergence of healthcare provision driven purely by profit considerations and primarily accessible to patients with the necessary financial means.
The CSL noted that it also sees in certain recent initiatives, notably the outsourcing of medical services outside the hospital framework, the early signs of an attempt to privatise medicine. Such a vision of the healthcare system risks undermining universal access to care and leading to a situation in which the wealthiest patients benefit from privileged infrastructure while others face more limited access to healthcare.
The CSL said that it considers that the corporate structure is not suited to the practice of the medical professions. It advocates a specific framework for professional cooperation enabling doctors and healthcare professionals to pool resources and develop synergies for the benefit of patients, while preserving the essential principles of medical ethics and the solidarity-based foundations of the healthcare system.
In light of these elements, the CSL said it disapproves the present draft law.
