Luxembourg’s reliance on cross-border workers to fulfil staffing levels in its public health system has long been acknowledged. More than two-thirds of the Grand Duchy’s nursing workforce come from outside Luxembourg.

“The Federation of Luxembourg Hospitals has already sounded the alarm, explaining that by 2030, Luxembourg will be short of 3,800 nurses,” according to Marie Friedel, professor of nursing at the University of Luxembourg.

This makes Greater Region cooperation in the health service field essential, and not only for Luxembourg.

A meeting of healthcare professionals and service providers from across the region in Arlon on Wednesday saw the official launch of two cross-border health initiatives funded under the auspices of the EU’s Interreg VI Greater Region programme. The conference announced its ambitious objective to “make the Greater Region a model in the European Union for cross-border health cooperation”.

Two initiatives

The REMOCOSAN (REgion MOdèle en COopération SANitaire) project aims to guarantee access to quality care close to where patients live, by establishing the legal framework for cross-border health cooperation, and to develop the provision of therapeutic patient education and palliative care.

“We have been able to bring together some 39 operators and have secured a substantial budget of €5 million to carry out this project, which will take us through to 2028,” said Benoît Pétré, professor at the University of Liège.

The second project, called WALUXSANTE, will implement a 2023 framework agreement between Belgium and Luxembourg. It will focus primarily on cooperation between Walloon and Luxembourg border municipalities. In the first phase, a detailed health and social profile of the border area will be drawn up.

Strengthen cooperation between hospitals

There are also plans to strengthen cooperation between hospitals in different areas. Henri Lewalle, coordinator of the European Observatory for Cross-Border Health, highlighted the good examples that already exist, such as the cooperation between the Belgian hospital in Arlon and Mont-Saint-Martin in France, where medical first responders can intervene on either side of the border.

“But to put recommendations and solutions in place, we’re going to have to get to know each other better on the Walloon and Luxembourg sides,” Lewalle said.

Despite these examples of existing Greater Region health cooperation, there are still plenty of gaps. There are no framework agreements between Germany and Luxembourg, for example.

A number of projects and ideas that have been on the drawing board for a number of years are still waiting to be put into practice.

Key players in the Greater Region’s healthcare sector met with Walloon health minister Yves Coppieters © Photo credit: Mélodie Mouzon

The conference recognised that the Covid-19 pandemic had been a “laboratory” for putting cross-border health cooperation into practice in the Greater Region.

“It was very effective during the health crisis, particularly in terms of inter-hospital transfers of patients,” confirmed Yves Coppieters, the Walloon health minister and one of Belgium’s Covid experts during the pandemic.

Nursing shortage a cause for concern

The shortage of nurses also needs to be urgently addressed, the conference agreed. This will require making nursing studies more attractive. “We need to invest massively, as the Luxembourg government is doing, in professional academic training, which combines the technical, cognitive and emotional skills that are so necessary today,” Friedel said.

Marie Friedel wants to broaden the scope of nursing skills and improve nurses’ well-being © Photo credit: Uni.lu

She explained that the scope of nursing skills has expanded over the years. “When patients are asked what they remember about their stay in hospital, it is very often the empathy and kindness of the nurses that are cited,” Friedel explained. But she said that the authorities “need to pull out all the stops” to attract future nurses, because the shortages are a real public health issue. “We often talk about the environment and global warming, but this issue must also be a priority,” Friedel said.

Improving the well-being of nursing staff

Priority must also be given to the well-being of nursing staff. This includes improving the working conditions of the profession, 80% of whom are women. But it also means making remuneration more attractive in the countries bordering the Grand Duchy. “Luxembourg is the European country that pays its nurses the best. It should stay that way. We should be delighted that, in Luxembourg, trainees on professional courses now receive compensation when they go on placement,” Friedel said.

Well-being also requires support for professionals starting out in the cross-border area, in the form of mentoring, for example. “When you consider that in Luxembourg, a certain number of nurses leave the profession after just four years, you can understand the need for support,” the professor explained.

One project provides for exchanges between teachers and students of nursing and nursing science at the University of Luxembourg and the Haute Ecole Robert Schuman, in the Belgian province of Luxembourg.

Luxembourg on the sidelines

The project to set up an Interregional Health Observatory for the Greater Region, submitted last week by Wallonia in Belgium and Rhineland-Palatinate in Germany, was also presented Wednesday.

A number of attendees bemoaned the fact that Luxembourg had not responded to this project, despite being sent several reminders. Some said that this somewhat undermined the much-vaunted cooperation of the other projects presented at the Arlon conference.

(This article was first published by Virgule. Translated by AI with editing by Duncan Roberts.)