Resolution 1469 (2005)
Language problems in access to public health
care in the Brussels-Capital region in Belgium
1. Language being an important
factor in the quality of health care, it is indispensable that there is
satisfactory understanding between the patient and medical and nursing
staff to avoid compromising the efficacy of medical care, which absolutely
must remain a priority. Leaving medical and humanist considerations aside,
effective communication between patient and doctor in Belgium is presupposed
in the current legislation and case law in the law on patients rights
which entered into force on 6 October 2002.
2. At the same time, access
to health care and language problems in the Brussels-Capital region must
be considered in the general context of Belgiums constitutional development
and its complex language situation, which is the result of historical events
and compromises reached through lengthy negotiations.
3. After several successive
legislative and constitutional reforms, starting in the early 1960s, Belgium
has changed from a decentralised unitary structure into a federal state
composed of three communities, three regions and four language regions
(three monolingual and one bilingual).
4. The Brussels public hospitals
operate under local authority supervision and are subject to fairly strict
rules on bilingualism. Numerous administrative, political and judicial
controls are carried out to ensure that these rules are effectively applied.
In practice, however, strict application of these rules is not always easy
to guarantee, for the following reasons in particular:
4.1. the general level of bilingualism
unfortunately remains rather low in the Brussels region;
4.2. there is strong competition
to recruit qualified staff due to the attraction exerted by the hospitals
located in Flemish Brabant.
5. The solution to the problem
evidently lies not in a reform of the language legislation, but rather
in enforcement of the provisions of the legislation on language use in
6. The Parliamentary Assembly
considers that language problems in access to health care in the Brussels-Capital
region can only be solved if all the efforts currently being made to create
all the conditions for a strengthening of bilingualism in Brussels hospitals
are continued in the same spirit of goodwill, openness, tolerance, pragmatism
and flexibility so as to foster peaceful cohabitation of the different
7. Accordingly, the Assembly
recommends to the political representatives of the language communities
in the Brussels-Capital region to:
7.1. increase the administrative
and judicial means of guaranteeing bilingualism in Brussels hospital services
while respecting the fundamental principle of continuity of public services;
7.2. evaluate and streamline
the supervisory mechanisms for guaranteeing bilingualism and enforcing
the language legislation in order to increase their effectiveness;
7.3. avail themselves of the
necessary means to develop the supply of bilingual staff in the Brussels
7.4. ensure that bilingual
staff are in place in reception services and make efforts to provide a
better welcome for Dutch-speaking patients;
pay urgent attention to the need to ensure effective bilingualism in
emergency services, in order to avoid potentially life-threatening consequences
of possible misunderstandings;
investigate the reasons for the lack of enthusiasm of Dutch-speaking
health-care professionals for practising in Brussels, to promote traineeships
for Dutch-speaking students in Brussels hospitals, to spread information
about vacancies to bilingual professionals who may be interested in working
in Brussels, to promote networking between bilingual general
practitioners and bilingual specialists working in hospitals and to improve
language training possibilities in Brussels hospitals;
7.7. set up a network of bilingual
7.8. implement a language training
programme in the medical schools of the region;
7.9. strengthen and better
define the responsibility of hospitals as a public service.
8. The Assembly further invites
the Belgian Government to:
8.1. encourage cultural communication
and co-operation across the language barriers in Belgium;
8.2. ratify the Framework Convention
on the Protection of National Minorities (ETS No. 157), in keeping with
Assembly Resolution 1301 (2002) on the protection of minorities in Belgium,
and to withdraw the reservations expressed at its signature, in such a way as to complement the existing language arrangements with
the application of relevant provisions of the Framework Convention in order
to ensure the best possible quality of health care for all inhabitants
of the greater Brussels region.
debate on 7 October 2005 (32nd Sitting) (see Doc.
10648, report of the Social, Health and Family Affairs Committee,
rapporteur: Mrs Cliveti) and Doc.
10680, opinion of the Committee on Legal Affairs and Human Rights,
rapporteur: Mr Cilevics).
Text adopted by the Assembly on 7 October 2005 (32nd Sitting).