Home care by private Wales stops approvals for new private Spitex companies

The Wallis has halted the licensing of new private home care companies, effective July 1, 2026, as part of efforts to curb rising costs in the healthcare sector. This decision follows similar measures taken in the canton of Ticino, marking a shift in how public authorities regulate private home care services, known as Spitex in Switzerland. The move aims to prevent excessive cost inflation while ensuring quality patient care. The Wallis government cited growing concerns over the financial burden placed on the healthcare system by private providers. According to officials, private Spitex firms have been charging higher rates for the same services compared to public providers. State Councillor Mathias Reynard, speaking to RTS, stated that some private operators were prioritizing profit over patient welfare, leading to inflated billing practices. He noted that private firms often recorded more hours per case, contributing to higher overall costs. “For the same service, they charge significantly more,” he said, adding that cases of overbilling had already been publicly criticized. Reynard further accused private companies of focusing on lucrative cases and locating primarily in urban areas where travel times are shorter, thus increasing profitability. Public Spitex services, he emphasized, have a mandate to serve all residents, regardless of their location, whether in towns like Sitten or rural areas such as Evolène. The government argues that this disparity undermines equitable access to care and strains public resources. The decision was reached after legal battles with federal authorities. Last year, the Wallis successfully challenged a federal ruling that allowed the canton to reduce payments to private providers who failed to meet minimum wage standards under the collective labor agreement. The court upheld the right of the Wallis to adjust payment structures, reinforcing its authority to control costs. Private Spitex organizations have rejected these allegations, arguing that their operations are essential in supporting public systems. Thomas Birbaum, general secretary of the Wallis Association of Spitex Organizations, stated that some private firms assist public providers by taking on complex cases that require more time and resources. “There are Spitex organizations that ask us to take complete cases because they lack the staff,” he explained. He maintained that longer hours billed by private firms reflect the nature of the work, particularly in handling more complicated medical situations. Birbaum also claimed that private providers offer greater flexibility and efficiency than public ones. “We are more agile and better equipped to handle diverse demands,” he said. He added that patients do not face higher costs once they exceed their insurance deductible, as both health insurance and the canton cover the expenses in the Wallis. Thus, he argued, there is no financial disadvantage for patients using private services. The debate highlights broader tensions between public and private actors in Swiss healthcare. While private Spitex has become a popular model due to its perceived convenience and personalized care, critics argue it risks undermining public funding and creating inequities. The Wallis’s decision reflects a growing willingness among cantons to assert regulatory control over private providers, even amid industry pushback. As discussions continue, the situation remains unresolved. Legal and policy debates will likely persist, with both sides citing evidence to support their positions. For now, the Wallis stands firm in its stance, signaling a potential trend toward stricter oversight of private healthcare services nationwide.