the bill passed at first reading in the National Assembly

The National Assembly adopted at first reading, on the night of Thursday 15 to Friday 16 June, a bill to improve access to care. After four days of debate, the deputies voted by 37 votes to 4, and 25 abstentions, in favor of this text by Frédéric Valletoux (Horizons group, presidential majority), which must now be examined by the Senate.

He has been the subject of a standoff over the freedom of establishment of doctors, a cross-party group of MPs having pushed on Wednesday, but in vain, for more coercion to better provide medical deserts. On the initiative of this group, the socialist Guillaume Garot still deplored Thursday a “missed opportunity” who pushed his group to abstain on the bill as a whole, despite “some progress”.

“We are going to return to the constituency” and having to explain this absence of regulation, whereas “the expectation was so great”, also underlined the ecologist Sébastien Peytavie, who also abstained, like the “rebellious”. The Communists voted against the bill, which “will not make it possible to meet the crying needs” in terms of health, according to Pierre Dharréville.

The right also came out against it, but for different reasons. “Some elements are foils”, explained Yannick Neuder (Les Républicains), citing the automatic attachment of caregivers to territorial professional health communities. The elected National Rally abstained.

“Constructive” discussions

However, all the groups welcomed the exchanges “constructive”and the Minister of Health, François Braun, of ” compromise “. In the home stretch on Thursday, MPs voted a series of additional measures.

Private clinics and their practitioners will have to participate more in the “permanent care” evenings and weekends. All caregivers “participate” to this permanent care, added the deputies on Thursday, some welcoming a “paradigm shift”. But the Minister of Health, François Braun, interpreted this vote as a ” incentive “ to participate in the continuity of care, to which he is in favor, and not as a ” obligation “. These guards are currently provided by a minority of liberal doctors.

The National Assembly also validated an amendment by the transpartisan working group on medical deserts launched by Guillaume Garot (Socialist Party) which opens up, from the second year of study, the possibility for doctors to sign “public service contracts” providing a monthly allowance against a commitment in a medical desert. In addition, to promote internships for general medicine students in under-resourced areas, these internships should be filled first.

A “referral nurse”

In addition, while the working conditions of interns have often been singled out, the rapporteur for the Social Security budget, Stéphanie Rist (Renaissance), added that the entity (doctor or establishment) where the internship is carried out of the student must take “the necessary measures to ensure his safety and protect his physical and mental health”.

MEPs from different sides have also created the function of“referral nurse”, chosen by the patient. He will have a mission of prevention, follow-up, renewal of nursing care prescriptions for chronic patients, in conjunction with the attending physician. The Nursing Order welcomed this vote, which “represents a real step forward”.

To avoid a double penalty for certain patients, the Assembly also unanimously voted for a transpartisan amendment which removes the tariff increase likely to be applied by Medicare during the year following retirement. of their attending physician or when the latter changes department.

The ban on temporary work at the start of a career for certain carers has been extended to the field of child protection and socio-educational support. On the other hand, health students will be able to continue to practice as temporary workers. Finally, in the medical deserts, a health option could be tested in high schools, in order to encourage medical and paramedical vocations.