Belgium’s decision to tap medical scanning rates faces criticism

Belgium’s parliament recently approved the health minister’s bill for the exclusive provision of MRI and CT scans at official rates. without extra charges, but the Belgian doctors’ syndicate has called for constructive consultations, fearing the measure will have a counter-effect.

Belgium recently introduced legislation aimed at enhancing access to healthcare services and curbing the overutilisation of CT scans.

The legislation, approved by the federal parliament, mandates that all hospitals across the country must provide MRI and CT scans at official rates, effectively eliminating the prevalent practice of charging extra supplements.

An MRI scan, or Magnetic Resonance Imaging, is a medical imaging technique that produces detailed images of the human body (including organs, bones, tissue etc).

A CT scan, or Computer Tomography, is also a diagnostic imaging procedure, a combination of X-rays and computer technology, that produces images of the inside of the body.

This move aims to ensure that every individual, regardless of their financial standing, can undergo essential medical imaging without the burden of additional fees.

Frank Vandenbroucke, the minister of health and social affairs, underscored the need to reduce financial barriers to healthcare, stating that “everyone should be able to undergo an MRI or CT scan in any hospital in this country without having to pay extra supplements”.

Doctors syndicate: A more nuanced approach is needed

However, the reform has not been well received by those in the medical field. The Belgian Association of Medical Syndicates (BVAS) has expressed dissatisfaction with Vandenbroucke’s decision. They argued that the implementation of the legislation is complex and requires more nuanced approaches, advocating for a more consultative process.

A spokesperson for the BVAS said: “We cannot approve this solution [..] Several measures have already been taken in hospitals for people in difficulty.”

As part of the Médicomut agreement (2022-34), it was agreed that affordable care must be available for all. They stated that in many hospitals, the most vulnerable patients “are already protected, particularly oncology patients, patients with chronic illness status and patients benefiting from an increased allowance.”

Many hospitals already offer time slots to patients who wish to have an examination at the contract rate, regardless of the doctor’s contract status.

The association, however, said that “imposing convention prices calls into question the national Médicomut agreement”.

Overutilisation of CT scans: health risks and cost burden

One key concern raised by the minister is the over-utilisation of CT scans in Belgium, which are linked to health risks.

“Too much radiation is not healthy [..] compared to the rest of Europe; we see that many people in Belgium undergo a CT scan, even when this is not actually necessary.”

The concerns of overutilisation come at a time when a recently published European-funded EPI-CT study led by the Barcelona Institute for Global Health (ISGlobal), reveals a strong link between exposure to radiation from CT scans in young people and an increased risk of blood cancers.

Research institutes from nine countries, including Belgium, came together to conduct the study coordinated by the International Agency for Research on Cancer (IARC).

The findings stress the need for rigorous radiological protection measures, particularly in paediatric populations.

The BVAS agreed that “any unindicated CT examination should be avoided” but said Belgium was not  “an exception in terms of radiological consumption compared to other Western European countries. Belgian figures are lower than in neighbouring countries” such as Germany, Austria, and France.

The association said that “carrying out examinations without first asking clinical and diagnostic questions is not included in our medical training”.

Even if a medical professional believes a test is unnecessary or might not provide useful information for treatment, they may face problems, including legal issues. This is not taken into account when considering the higher utilisation of CT scans in the country.

Providing better access and affordability of care

The legislation states that hospitals are now required to guarantee sufficient capacity for scans at official rates within scientifically determined timeframes, based on the pathology, ultimately improving access and providing more affordable care.

However, the BVAS say the “minister’s comments call into question the accessibility of our health system”.

The association worries that the new legislation could increase waiting times for medical exams, creating a risk that people might have to wait longer for necessary tests and potentially affecting their health outcomes.

While the legislation aims to improve healthcare access and address financial disparities, the BVAS spokesperson asked Minister Vandenbroucke on behalf of patients, hospitals, and doctors that the government work towards “short- and long-term solutions through constructive consultations”.

[By Caoimhe Kelly – Edited by Vasiliki Angrouridi/Zoran Radosavljevic – Euractiv.com]

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