Health: Gabriel Attal displays a series of measures to promote access to city care


Prime Minister Gabriel Attal announced on Saturday a series of measures intended to respond to the crisis in municipal healthcare, but some could raise eyebrows, such as the establishment of a five-euro sanction for “rabbits” posed to doctors. In an interview given to the regional daily press on Saturday, the head of government showed his desire to recover 15 to 20 million medical slots. According to Matignon, this is about “responding to the major concerns of the French: access to doctors, the ability to find an appointment within acceptable time frames”.

“Rabbit tax”

A fundamental and long-term measure, the government will continue to push the walls of medical faculties: the number of places in the second year will increase from 10,800 in 2023 to 12,000 in 2025, then 16,000 in 2027, he announced. . But the replacement of the old “numerus clausus” (very limited places) by this “numerus appertus” will only begin to produce its effects from 2035, the time to train these professionals. In the meantime, the government’s strategy therefore aims to “reclaim medical time”.

So patients who do not keep their appointments and cancel less than 24 hours in advance will have to pay: the penalty or “rabbit tax”, already announced in January, will be 5 euros and will go directly into the doctor’s pocket. The amount can be retained via the bank imprint by the appointment booking platforms or by the caregivers themselves if an appointment is made directly. The penalty remains in the hands of the doctor who may decide not to apply it if he considers the patient’s reasons valid. This measure requires a law, which will be quickly examined by Parliament, according to Matignon, who “hopes” for it to come into force in 2025.

The executive also wants to “simplify procedures” to “free up time” for practitioners. Gabriel Attal lists various measures already announced which must quickly come into force, such as the possibility for pharmacists to dispense antibiotics for tonsillitis and cistitis from June.

“Direct access” to specialists

He announces that he will “experiment” in 13 departments with “direct access” to masseurs-physiotherapists, provided for by the Rist law, but also direct access to specialist doctors, without the patient needing to go by a general practitioner, an idea which risks making some unions bristle. “Removing this constraint” would make it possible to “facilitate care pathways” and “avoid unnecessary consultations”, underlines Matignon. Rue de Varenne, we recall that 2,700 practitioners qualified outside the European Union this year passed the competition which allows them to join French hospitals (under more precarious statuses than caregivers qualified in France, editor’s note), including one half who were previously not in the territory.

Another “pillar” of access to care: the permanence of outpatient care, i.e. evening calls (6 p.m. to midnight) and weekends in town practices. Today “5% of territories are not covered and 4 million French people have no solution”, underlines Matignon.

“Bonus” or “financial assistance”

So that “every French person always has a doctor on call less than 30 minutes from home”, the executive wishes in particular to grant a “bonus” or “financial aid” to any doctor who agrees to temporarily leave his area to take a guard in a deprived territory. He also wants to ask other caregivers to participate in these on-calls, such as nurses, who could in particular act as a “first filter”, midwives, capable of “responding to a large number” of problems encountered by women, or even dentists. But the return of “custody obligations” is not immediately on the agenda, indicates Matignon who first wants to appeal to goodwill.

In terms of Mental Health, the executive will also strengthen its “My Psycho Support” system: the reimbursed amount of the consultation is increased and will increase from 30 to 50 euros, with now 12 reimbursed consultations per year with direct access. Should mutual insurance companies be called upon to pay the “30% out-of-pocket cost” that patients pay today? Finally, on the delicate aspect of State Medical Aid (AME), Mr. Attal specified that the reform would be unveiled “by this summer”





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