It always surprises, but Ile-de-France constitutes the first medical desert of the country. Or the region in which the greatest number of inhabitants encounter difficulties in accessing a general practitioner, according to the indicators used by the State to establish the list of territories suffering from this essential level of care.
The situation is not new, but it is getting worse. This is revealed by the proportion of “red” areas affected by a “insufficient supply of care or difficulties in access to care”. These now concern 62.4% of the Ile-de-France population, according to the ministerial decree of 1er October 2021 – more than 7.6 million people, compared to 37% in 2018.
“Difficulties in accessing a general practitioner concern all departments, the phenomenon has become widespread”, points out Pierre Ouanhnon, deputy director of the offer of care at the regional health agency (ARS). The region lost nearly 2% of general practitioners between 2018 and 2020, or 150 practitioners. The precise division of these priority intervention zones (ZIP), an acronym used in administrative jargon and which give the right to installation aid for new doctors (50,000 euros from Medicare in particular, support for ARS, etc.), must be unveiled in the coming days by the regional health agency.
“Vital risk involved”
Despite the worsening situation in Ile-de-France, the deputy director of the ARS wants to see a positive touch: “ Areas that were already classified as red in 2018 lost fewer doctors than elsewhere “, he observes. This leads him to hope that the installation aid has made it possible to “limit breakage “. It should also be remembered that Ile-de-France has a richer network of emergency hospital services than elsewhere, which may somewhat lessen the consequences of the lack of general practitioners.
With so many “red” zones, the ARS is now working to help more strongly those who suffer from lower attractiveness, with little – or no – new doctor facilities. In the first place “rural areas, small towns, and very disadvantaged areas », summarizes Pierre Ouanhnon. Because the system is not immune to a perverse effect in times of shortage: that these territories are even more neglected in the future, doctors now having the embarrassment of the choice to settle in a territory ” aid “.
“One in two liberal doctors is over 60, one in four over 65”, recalls Valérie Briole, president of the URPS-Médecins liberals Ile-de-France
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