A doctor examines one of his patients at home in Fabas, Haute-Garonne, on February 3, 2023 (AFP/Archives/Charly TRIBALLEAU)
Will the National Assembly touch the freedom of installation of doctors? To fight against medical deserts, a transpartisan group hopes to win a showdown this week against the government, headwind against a measure that will “rotten the situation”.
“It’s going to be hot”: the Minister of Health François Braun knows that the week will be tense at the Palais-Bourbon.
“Creating rigidities and constraints” for the installation of health professionals “will be totally counterproductive, and would only divert more from the practice of medicine”, he launched at kick-off. discussions on Monday evening. “These debates offend our doctors”.
The deputies began the examination in first reading of a text of the presidential camp against the medical deserts, carried by Frédéric Valletoux (Horizons group).
With the support of the government and 200 deputies of the majority, he intends in particular to “increase the participation of health establishments in the permanence of care”, by first targeting private clinics, which would be obliged to take part in particular in emergencies.
Its text also plans to prohibit temporary work at the start of their careers for certain caregivers, and to open up, from the third year, the possibility for medical students to sign “Public service engagement contracts” providing for an allowance. monthly against a commitment in a medical desert.
– “Political courage” –
But the eyes of the executive and the profession will be directed towards an amendment to the text, carried by the socialist Guillaume Garot, and a cross-partisan group of elected officials from almost all political groups, including those of the presidential camp. The RN was not associated.
This amendment plans to question the freedom in principle for doctors to settle in areas already well provided with caregivers, by establishing “regulation”.
The deputies began the examination in first reading of a text of the presidential camp against the medical deserts, carried by Frédéric Valletoux (Horizons group) (AFP / Archives / JEFF PACHOUD)
Thus, liberal doctors and dental surgeons could only settle “by right” in areas that lack caregivers. To go to a sector that is already well provided for, they would have to obtain authorization from the Regional Health Agency (ARS), which would be conditional, for example, on the retirement or relocation of a doctor exercising the same type of activity.
“Eight million French people are affected” by difficulties in accessing healthcare, insists the deputy and former socialist minister, for whom it takes “political courage”, in the absence of “magic solution”. A few months ago, he launched a Tour de France of medical deserts, bringing together around his own text a large number of deputies, 207 to date.
In committee at the National Assembly, the transpartisan group notably won a framework for financial aid for installation (only one every ten years) and the principle of six months’ notice to better anticipate unexpected departures, including dentists and midwives.
The real “battle” for regulation has been reserved for the passage in the hemicycle, and should in particular be played out in the number of deputies present for each camp.
– Strike –
Frédéric Valletoux is opposed to immediate “regulation”, believing that the number of doctors will be too low over the next five or 10 years for it to solve the problem: “I will be in favor of it the day we have a large number of caregivers to dispatch on the territory”.
Horizons deputy Frédéric Valletoux at the National Assembly in Paris, November 8, 2022 (AFP/Archives/Thomas SAMSON)
The minister torpedoes the proposal: “The young people will not want to settle, the oldest will say: + it’s good, we move +” [fermeture de cabinet], when others will choose the “deconvention”, he criticizes, calling for the rejection of an amendment which would risk “rotting the situation”. Whatever the vote, the text will still have to pass in the Senate.
Some professionals are already opposed to the “Valletoux” version of the text, in particular because it provides that the liberals are automatically attached, “unless opposed”, to the professional territorial health communities (CPTS), supposed to facilitate coordination at the scale of the territory.
The profession is on a war footing: four of the six representative unions (Avenir Spé, UFML, FMF, SML) announced Monday an indefinite strike from October 13.
In session, the government will also propose measures for “multi-professional health centers (MSP)”, or to insist on the obligation of participation of certain caregivers in the permanence of care.
© 2023 AFP
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