Inequalities in access to general practitioners have increased in recent years, despite the aid paid to encourage practitioners to settle in medical deserts, according to a report established in early July by Health Insurance and consulted Monday by AFP . The carrot policy did not bear fruit. Negotiated in 2016 with the unions of liberal doctors, four types of “demographic contracts” were supposed to stop the progression of medical deserts. But at the end of 2021, only 4,685 were “in progress”, according to the report presented on July 8 to an internal health insurance commission.
Installation assistance for 2,085 doctors
Less than 5,000 in five years, including a large half (2,396) of “coordination” contracts for practitioners already in place. The installation aid itself (up to 50,000 euros) was granted to 2,085 doctors, mainly general practitioners, or just over 400 per year. All of these systems show an increasing cost: more than 94 million euros over the period 2017-2020, including nearly 32 million in 2020 alone.
A cost compared to an “efficiency” that is not very obvious, since “inequality of access” to general practitioners “was accentuated” between the end of 2016 and the end of 2019, according to Health Insurance, which notes to the reverses a “disparity reduction” for liberal nurses and midwives. Two professions which, unlike doctors, benefit from continuously increasing numbers but have also accepted a “regulation” of facilities: an arrival for a departure in “over-endowed” areas.
An “extremely disappointing result” according to Unsa
This contrast gives arguments to the partisans of the policy of the stick. Thus, Unsa judges in a press release that the “extremely disappointing result” of the incentives demonstrate that they “do not work” and that “it is therefore necessary to put an end to the freedom of installation of liberal doctors”. The Health Insurance recognizes for its part, in a report published at the beginning of July, that its “demographic contracts” have not “enough to erase the imbalances of territorial distribution which persist” and proposes to “merge them into a single contract” to simplify the device.
The subject will quickly come back to the table of the “big conference” on access to care promised by Emmanuel Macron, especially since the executive will have to define its roadmap before the negotiation of a new medical convention from autumn.