High workload among GPs, does the Flemish government provide enough support?

In many towns and cities, local general practitioner (GP/family physician) practices have put a freeze on new patients because they cannot cope with any more. To give GPs a boost, the former Impulseo was revamped by the Flemish Department of Care in 2022 and is now the Impulsfonds (incentive fund). With this fund, the Flemish government is trying to encourage recently qualified GPs to start their own practice and existing practices to opt for a telesecretariat. Every little bit helps, but what do these financial incentives entail?

Starting up a practice (Impulseo I)

GPs setting up a new individual practice or settling in to a group practice for the first time can apply for an interest-free loan of up to €35,000. If, in addition to that, they foresee extra space for collaboration with a practice nurse, they can apply for an additional interest-free loan of €10,000.

Conditions for an interest-free loan of maximum €35,000:

• Accredited general practitioners with a practice in the Dutch-speaking area or the bilingual area of Brussels-Capital.
• An application for the loan must be made within 5 years of installation (= date from which the GP participates in the doctors’ on-call system).
• General practitioners in training (GPiTs) can also apply prior to their participation in the medical on-call system with the additional conditions that they will be installed within a year and that proof of purchase of premises can be presented.
• Only beginning and active GPs can apply for this loan (maximum 15 years after their accreditation as a GP).
• GPs must belong to the general practitioners’ association (‘circle’) in their region.

Conditions for an additional interest-free loan of maximum €10,000:

• The same conditions apply as for the interest-free loan of maximum €35,000, except that the application for this loan does not have to be made in the 5 years after installation.
• Collaboration with a salaried practice nurse/general practice assistant (GPA) is required.
• GPs who apply for this must contribute to the cost of renting the extra space.

Loans in the form of Impulseo I are repaid in 5 years at 0% interest with a one-year exemption for the repayment of the capital. If GPs cease their activities or move outside the Dutch language area or bilingual Brussels Capital region before the end of the payment period, they must immediately repay the remaining balance in full.

Fiscal aspect Impulseo I: These loans are tax exempt.

Intervention for wage costs (Impulseo II)

To relieve GPs of some of their care responsibilities, the Flemish government wants to encourage them to hire extra practice nurses. It hopes to support GPs by offering financial help with salary costs. In 2024 the subsidy amounts to a maximum of €7,847.47 per doctor, to be indexed annually.

There are a number of conditions attached to this, as well:

• GPs must belong to the GPs’ association (circle) in their area.
• The employee in question (practice assistant/practice nurse) must be a salaried employee with an employment contract.
• The subsidy can never be higher than 50% of the total salary cost of the extra employee.
• The employment percentage of the practice nurse is important => within a practice, they must be employed at least one third per GP.

The application must be made per doctor, so in a group practice each GP must apply separately (payment is per individual doctor). The amount of the subsidy can be increased if the doctor invests in at least 4 hours extra training per year for the practice nurse.

Fiscal aspect Impulseo II: Each doctor will receive an individual tax slip and will have to include the subsidy in their tax return.

Subsidy for a telesecretariat (Impulseo III)

Besides treating their patients, most doctors are also busy answering telephones and planning their agenda. Here, too, the Flemish government wants to encourage them to outsource these administrative tasks, which can be done, for example, by a medical telesecretariat. This subsidy amounts to €3,400 per year and applications can be made for a period of 5 years.

Conditions attached:

• GPs must belong to the GPs’ association in their area.
• A telesecretariat must at least have an online agenda and answer the GP’s telephone calls.
• A contract must be drawn up between the GPs and the telesecretariat.

This subsidy cannot be combined with the subsidy for salary costs.

Fiscal aspect Impulseo II: GPs will receive a tax slip and must include the subsidy in their tax return.

Studies show that Belgium generally has enough general practitioners available, but they are not adequately spread across the country. The question that may be asked is whether this financial support will effectively reduce the workload.

Our PKF BOFIDI experts will be pleased to give you further advice

Do you have more questions about government support for GPs? Then don’t hesitate to contact us. We are ready to help you.

This article was written by Imane Khammas, an accountant at PKF BOFIDI Medical.