De old moons on burning news: this is how we could sum up the recurring controversy over “medical deserts”. This summer, with its share of surgeries and emergency services closed, we have seen the difficulties of access to care increase further, affecting in particular territories already in shortage. Far from being simply cyclical and summery, this situation revives positions that are often too caricatural in the debate on medical deserts.
On the one hand, supporters of brutal coercion, who believe that it would be enough to move doctors to solve the problems of access to care.
On the other hand, organizations that limit themselves to advocating incentive measures for settling in, whereas these are already largely in place and, to be honest, not very effective. However, it is a global, precise, geographical and political analysis that will allow us to get out of this sterile duality.
Indeed, the problem of medical deserts is not new in the public debate: since the beginning of the 2000s, the ministries follow one another, and the situation remains. More and more French men and women simply no longer have access to medicine, whether general or other specialties. Thus, 6 million of our compatriots are currently without a doctor.
A real social issue
The appearance of the numerus clausus at the end of the 1960s under the cross pressure of a conservatism which feared an influx of students in the sixty-eight wave and a liberal ideology which considered that reducing the supply of care would reduce the public expenditure, is obviously a central element in our difficulties. Its political management at the end of the XXe century is even more so, in a context of population growth and aging.
The problem of medical deserts is not the only one of its kind in the field of regional planning policies. The “deserts” are, in fact, not only sanitary, but concern all activities, whether public service, economic or even cultural.
If the geographer Jean-François Gravier (1915-2005), in 1947, evoked “Paris and the French Desert”, we could today speak of the great metropolises and the French desert. The old rural exodus and public policies which have knowingly concentrated activities in the cities and in particular the largest of them are today the main determinants of a problem which is a real question of society.
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