The measure is already irritating doctors. The National Assembly adopted, on the night of Wednesday 18 to Thursday 19 January, the opening of a ” direct access “ from patients to advanced practice nurses (APNs). This is one of the provisions of a bill on access to care.
Section 1er of this text, voted on at first reading by the deputies by 62 votes to 3, also provides for the possibility for these nurses to make certain prescriptions.
Created by the Touraine law of 2016 and a decree in 2018, the status of IPA, which requires a bac + 5 diploma, and not a bac + 3 like state-certified nurses, has expanded the skills of certain nurses on targeted pathologies. The objective was already to reduce the workload of doctors; but the deployment of these “expert nurses” is still limited. In question, in particular, the insufficient number of patients who are sent to them by doctors and an unattractive remuneration.
The article adopted on Wednesday aims to upgrade this status by giving patients the possibility of going directly to these paramedics without going upstream through a doctor, but within the framework of a “coordinated exercise” with the latter.
Support from environmentalists
The deputies also adopted an amendment from the La France insoumise (LFI) group, supported by the government, providing that the decree determining the terms of a “primary prescription” by these IPA must be taken in Council of State after opinion of the High Authority of health.
The bill of Renaissance MP Stéphanie Rist (Loiret), whose examination is to continue on Thursday, also plans to establish a ” direct access “ physiotherapists and speech therapists. “This text meets two objectives: to fight against medical deserts and improve access to care”pleaded Mme Rest.
Socialists and Communists announced that they would abstain on the overall vote for the text, deemed too unambitious to fight against medical desertification. Environmentalists have planned to vote for the proposal, despite reservations.
“We condition our final vote on the attention you give to our proposals”said Farida Amrani, LFI deputy for Essonne, during the general discussion.
“A dangerous and unsuitable text”, according to doctors
The Republicans (LR) group “will be constructive”said MP Justine Gruet (Jura), warning however that a positive final vote on the text would be conditional on the deletion of the article on IPAs.
Doctors’ organizations are alarmed by certain measures in the text, which they believe circumvent the prerogatives of liberal practitioners.
This text is “dangerous and unsuitable”thus estimated on Wednesday the union of general practitioners MG France, warning against “a medicine where health professionals are interchangeable without any consideration of the quality of care”.