A visit in the middle of the night by the mayor of Laval (Mayenne), the public support of three deputies, reactions from the Minister of Health, Olivier Véran, and the Prime Minister, Jean Castex: the mobilization of the emergency department of the Laval hospital center revived the public debate on medical deserts.
The Mayenne emergency staff has been on indefinite strike since October 9. On social networks, the doctor Caroline Brémaud, head of the emergency department, disseminates a filmed logbook, entitled “My daily life in the emergency room”, in which some of her colleagues recount the concrete consequences of staffing needs. “On the schedule from 22 to 26 October, there are sixteen twelve-hour slots” without a doctor present, explains a caregiver. “In Laval, there are five full-time equivalents for a goal of between sixteen and eighteen. Barely a third of the target ”, repeat Mme Bremaud, guest on France Inter, October 18.
In another video, the case of a patient with an injured foot is the subject of an emergency exchange. “No trauma program this evening, so you will be meeting here tomorrow morning”, asks the head doctor to her colleague. The injured person will leave with an analgesic and an appointment. “To say nothing is to consent”, hit Mme Brémaud in another message to the attention, this time, of the Minister of Health: “Mr. Véran, at your level, doing nothing is abandoning the population (…). Please have the courage to take up the health challenge. “
Debate on the free installation of liberal doctors
Among the demands of emergency personnel, whose strike is supported in the establishment by the CGT (General Confederation of Labor) and FO (Force Ouvrière) unions, include the opening of beds, the upgrading of the status of hospital practitioner, as well as an audit on the quality of life at work in the hospital “In order to understand why everyone is running away”. “I also ask to come back to free installation”, claims Mme Bremaud.
This last request particularly challenged the socialist Guillaume Garot, deputy for the first district of Mayenne – where the hospital is located. The elected had tabled a bill in October 2019, “Against medical desertification and for prevention” : his article 1 rightly suggested than “The installation of liberal doctors [soit] subject to conditions in areas where the supply of care is already at a particularly high level ”. In 2018, Mayenne had 200 doctors per 100,000 inhabitants, all specialties combined, against 340 per 100,000 inhabitants on average in mainland France.
Forcing liberal doctors to set up a practice in areas where the profession is less present would, in the logic of the parliamentarian, take care of a large number of patients who go by default, today, to the hospital in case of health problem. The subject is not recent: in 2013, a Senate report already recommended influencing the workplace of liberal doctors by opening up the possibility of not agreeing by Social Security to those who would choose a territory where there are already many colleagues. .
“Who thinks there are too many doctors in their constituency? “
During questions to the government in the National Assembly, Tuesday, October 19, Mr. Garot therefore relaunched the subject to Mr. Véran:
“In other departments and cities, it only takes one call in the medical directory to get an appointment within two hours. So, when doctors run out, when emergencies collapse, we launch an SOS: our territories, our hospitals, our emergencies have an absolute need for doctors. “
The response of the Minister of Solidarity and Health, identical to the line held during the five-year term of François Hollande, was a categorical refusal to implement such a regulation:
“The old moon which consists in saying that there would be places where one would be force-fed doctors and that it would be enough to take your phone to see anyone within two hours, this reality is not the reality of France. (…) Who is the parliamentarian here who considers that there are too many doctors in his constituency? I am waiting for a deputy to tell me: “I believe that there are too many doctors, put them in Mayenne because there are too many at home.” “
During the same meeting, Yannick Favennec-Bécot, UDI deputy for the third district of Mayenne, also called on the government on the situation of hospitals in the department and request a “Equal access to healthcare throughout the country”. “The Mayenne people will come and tell you in front of your ministry on November 4”, date announced for a demonstration by caregivers from the department in Paris. The two deputies have requested a meeting with Mr. Véran for the occasion.