Government orders freeze on private practices

Switzerland's younger doctors will now have to wait three years before opening a private practice Keystone

The Swiss government has decided to impose a controversial moratorium on new doctors' practices in a bid to reduce health costs.

The interior minister, Ruth Dreifuss, who is also in charge of health matters, said the restriction would be put in place immediately and be valid for a maximum period of three years.

Announcing the measure on Wednesday, Dreifuss said the steep rise in the number of applications by medical doctors and therapists to open private practices had made such a step necessary.

She said the freeze was in line with a decision by parliament two years ago to limit the number of practices to prevent overcapacity. She also pointed out that it was up to Switzerland’s 26 cantons to enforce the measure and make any exceptions.

Switzerland, which has a population of more than seven million people, has a high density of doctors. There are around 14,000 doctors in practice and each year about 300 newcomers join their ranks.

Influx from EU

Fritz Britt of the Federal Office for Social Security told swissinfo that the moratorium was inevitable following the implementation in June of a bilateral treaty with the European Union on the free movement of people. This means medical personnel from the EU have the opportunity to practice their profession in Switzerland.

“We needed to limit access to health insurance coverage,” Britt said.

Up to 3,500 doctors from EU countries already live in Switzerland and the Swiss authorities expect some immigration, mainly of medical personnel based in southern Germany near the Swiss border.

He added that the authorities would now try to find long-term solutions to replace the three-year freeze. These could include lifting an obligation for health insurance companies to cooperate with all certified doctors.

Angry reactions

Wednesday’s decision prompted angry reactions from the Swiss Medical Association and from the Junior Doctors’ Association.

The Swiss Medical Association, the umbrella organisation for Swiss doctors, described the government’s decision as “arrogant” and accused the cabinet of ignoring the medical profession’s concerns.

He warned that the association would take all legal means available to challenge the government’s decision.

Protests

For its part, the Junior Doctor Association said it was considering further protests, including a temporary refusal carry out administrative work in hospitals.

Over the past few days the association has staged several demonstrations and a one-day strike in an effort to force the government to reconsider the three-year freeze.

Both bodies say an increase in healthcare costs cannot be blamed on the number of medical practices. They argue that higher costs are the result of continuing advances in medicine and growing demands from the general public who expect the latest treatment.

They also point out that a similar moratorium on private practices in neighbouring Germany and in the United States has not reduced on healthcare costs.

However, federal authorities say every new doctor on the market costs social insurance about SFr500,000 ($335,300).

by Urs Geiser and Jonathan Summerton