Grandstand. Emergencies closed at night, territories without doctors: never has the situation been so critical for millions of French people, deprived of medical presence. And never has it deteriorated so quickly, widening the inequalities of access to care between the departments and, therefore, between the French. Our health system, in the hospital as in liberal, cracks on all sides.
The solutions that have been designed for years have not produced the expected effects. And how could it be otherwise, when beds have been removed by the tens of thousands in hospitals – under all governments – when working conditions wear down the best-held vocations and when policies, to guarantee medical presence liberal in the under-endowed territories, were limited to financial incentives that were as ineffective as they were costly for the State and communities?
The presidential election must be the time to reshape the contract between the nation, its doctors and its caregivers.
Let us state the observation: in the country of Social Security for all, inequalities in access to care are no longer bearable. For the 10% of French people living in the least well-endowed territories, it takes an average of eleven days to obtain an appointment with a general practitioner, and one hundred and eighty-nine days with an ophthalmologist. On the condition that the doctor accepts new patients, when yours has retired without being replaced… This average therefore masks another reality: that of the renunciation of care, and of the French without a doctor. They are legion.
Not only has France lost nearly 7,000 liberal generalists over the past ten years, but it has also allowed concentrations to form in certain territories, and deserts in others. Faced with the emergency, nothing will be possible without new rules for the installation of doctors, as there are for other health professionals, such as pharmacists. This is the heart of the matter: doctors better present and better distributed, it is a pressure that eases on emergencies, and working conditions that improve for all caregivers.
Encourage rural and neighborhood youth to pursue medicine
There is no miracle solution, but a set of actions that will have to be linked together, in the short and longer term. Let’s take new avenues. First, the “selective convention”: in the areas with the most medical presence, the Health Insurance will only approve the installation of a new doctor when another one leaves. The objective is to stop the worsening of inequalities.
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