L’Entente Des Hôpitaux Luxembourgeois

L'Entente des Hôpitaux Luxembourgeois (EHL) groups together the hospital institutions of the Grand-Duché of Luxembourg. According to the clauses of article two of the statutes, the association has the objective of grouping together the hospital institutions of Luxembourg, the defence of their professional interests and the realisation of all forms of progress within the hospital sector, especially those concerning the well-being of the patient. These roles are performed in a spirit of political and denominational independence, the association equipping itself with the necessary structures to fulfil its missions. EHL has been a non-profit organisation for 45 years but has existed as an association since 1948. 

EHL has been a member of EAHM since 2001. As hospital management is one of our priorities we wish to actively participate in initiatives within this context at a European level.

EHL is made up of 16 members including four regional hospitals, three national centres (radiotherapy, cardiac surgery and interventional cardiology, rehabilitiation) and four specialist institutions (gynaecology and obstetrics, psychiatry, medium stay). This is a total of 2621 critical care and medium stay beds for a country of 2.586 km2 with a population of around 500,000 inhabitants with another 150,000 travelling across the border to work.

The current President of EHL is Mr. Paul Junck. Educated in law, Mr. Junck has a sound knowledge of the hospital and healthcare sector through his previous experience as a member of the Board of Directors of the health insurance fund and numerous hospitals. The current Vice-President is Dr. Raymond Lies, Director General of Kirchberg Hospital in Luxembourg.

The different services of EHL are arranged around the General Secretariat, which benefits from a central position around which are arranged different departments and services: legal, economic, quality, statistics, IT, medical physics and SIST-EHL.

The Role of EHL

EHL represents the interests of Luxembourg hospitals at their respective managerial levels. We are to some extent, the Luxembourg hospital federation, that is to say the association whose mission is realise the common objectives of hospitals.

In this sense, our actions are two-fold. We act first and foremost as an employer's association. For example through the negotiation of the collective work agreement of 8,000 salaried hospital employees, or more generally, to make our point of view heard each time it is needed. We maintain good relations with other political and financial associations (notably the Minister for Health, Minister for Social Security, National Health Fund) and we equally wish to develop our lobbying activity. We must also inform all relevant actors in the healthcare sector and the general public of our actions. We want to achieve a political communication that illustrates, in an appropriate and efficient way, our objectives and strong points. 

Main Activities

We want to work on the continuity of quality hospital services in the interest of patients and all other actors involved. We need to collaborate on joint projects which allow us to remain efficient and competitive. We need to manage this approach daily. The General Secretariat and the permanent office are in daily contact with actors from different sectors, notably in the form of numerous meetings on themes which vary from benchmarking quality management, security, financing, investment, standardisation, human resources, purchasing, continuous education, IT, new technologies, etc.

It is unfortunately not possible to list all the activities of EHL over the years but there is no doubt that this activity is increasing and will continue with new projects in the future. Joined together by a solid pact, hospitals possess, through EHL, an indispensible instrument to make their views heard and to define new joint projects. 

In order to realise all of these objectives, EHL is financed by membership fees, that is to say hospitals. Hospitals are in turn financed by the National Health Fund (Caisse Nationale de Sante, CNS). EHL is therefore indirectly dependent on the CNS as its budget is negotiated directly with them. This is why we have created, together with the CNS, a collective approach to manage a certain number of essential activities regarding projects on quality, regulations, investments or statistics. Similar collaborations exist with the Ministry of Health and Social Security. Our means therefore depend directly on the good nature of our members and our financial partners. We must demonstrate the efficacy of our actions, on an association as well as member level. All of these issues are implicit in the decisions we make. 

We must also act responsibly with our actors in face of the rising costs of health services. We must be able to make the right choices, even with more restrictive budgets. Decisions are to be made with a spirit of solidarity and of confidence as in this situation of budget constraints the importance of optimal management in all institutions is indispensible. The healthcare sector must combine an economic and technological approach with an ethical and social component, which is easier said than done. As financial resources are limited it is necessary to define a framework for managing health costs and services deemed acceptable in the national sociopolitical environment. 

Recent Developments

The crisis affected the entire economy and our activities were not spared. The hospital sector is confronted with a question for the public health sector on an international level: how to optimise the functioning and quality of the management of a healthcare institution within the context of financial deficit?

Throughout the years of EHL's existence, it has lived through numerous transformations in the hospital and healthcare landscape. Strategies have been elaborated and readapted. With the health insurance budget in deficit, hospitals are called to contribute to a national effort and EHL must also react with its own propostions. It is in favour of reaching a national strategy to re-stabilise the financial situation of the hospital sector in general.

EHL will continue its efforts and create new projects to optimise hospital services. Particular attention will be placed on using existing resources to make the hospital sector as efficient as possible and prepared for the future. All actors in the hospital sector, on every level, will be implicated in achieving our number one priority: quality care in the interest of the patient.

Some recent developments include central purchasing for goods and services in hospitals, standardisation of IT, new legal framework. EHL wants to introduce codification systems, which will allow, in the future, the generation of qualitative data of hospital activity. This will in turn allow increased transparency of quality of care and the better internal management of the hospital. EHL is also focused on implementing quality indicators, which would allow the comparison of Luxembourg data to other countries.

EHL needs to refocus its activities in light of recent developments and rethink its governance together with the representatives of its member establishments. Statutory changes are very probable in order to facilitate these actions and to guarantee we make the right decisions on a national level.

Training

For several years now EHL has provided several specific training programmes for hospital management. These programmes are provided together with IUIL (L'Institut Universitaire International Luxembourg).

The management training programme is designed to help managers achieve their objectives. It provides:

• Information on management, legislation, financing; and 
• Introduction into applied research.

Through the course hospital managers can benefit from new competences and feel ready to face the problems of the future. The programme will have a positive impact on the professionalisation of the role of the manager in the hospital sector and a better management of services at the heart of health institutions.

Communication and Trade Journal, EHL-Info

EHL-Info is the association's trade journal in circulation for several years now. Since 2009, it is published three times per year. We decided to produce the journal because Luxembourg did not have such a journal, unlike its bordering countries. We wanted an appealing communication tool allowing us to consolidate important information and reach more people in our sector, other sectors and the general public.

So far the journal has been a great success and we receive requests to publish articles. EHL-Info has become the association's business card, an important marketing tool for our activities. Thanks to the journal we can make people aware of our activities and the quality of hospital services in Luxembourg, increase transparency, reinforce inter-hospital collaboration, federalise certain hospital activities, create competence centres and improve relations with patients.

We also wanted to create a website to reflect our activities. Unfortunately we have neglected this tool. This however will change, a new site will be up and running in the next few months. The site will play an integral role in the changes within our organisation. Members will have the opportunity to access information and new services.

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