An exceptional situation, an exceptional response? The question is asked by health actors, faced with a systemic crisis in the sector: shortage of hospital staff, bloodless emergencies, lack of attending physicians, medical deserts… While they are struggling with a system that has come “to out of breath”, according to their supervising minister, François Braun, they see three decisive deadlines taking shape.
There is, first, about to be inaugurated, the major conference on the healthcare system, a variation of the National Council for Refoundation (CNR) wanted by President Macron. It will be called “CNR health”, and will be launched on October 3 at Le Mans, says Rue de Ségur.
There will also very soon be the budget for the 2023 financial year, which will be presented to the Council of Ministers at the end of September, before the parliamentary debate scheduled for the end of October. Will come, almost at the same time, the negotiations of the medical convention, eagerly awaited by the liberal doctors, and which will have to be completed in March. A busy autumn, after a complicated summer.
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These meetings are not based on the same logic. The first must embody a “change of method”in the words of Emmanuel Macron, and inspire the structural measures promised by the Elysée, which has made health a “priority project”. The other two are classic regulatory tools that come back on the agenda – the review of the Social Security financing bill (PLFSS), every year; that of the medical convention, every five years.
But their sequence – even their entanglement – suggests that there will perhaps be an additional margin of negotiation to wait for, in this return to school. On the side of the liberal doctors who claim “their” Ségur (that of the summer of 2020, at the end of the first wave of Covid-19, had focused on the hospital). On the side of the hospital workers who, after having “hold on” all summer, and avoided the ” disaster ” in the emergencies, however saturated, are waiting for a response to be made to the closing of beds and the bleeding of caregivers. On the side, too, of the health authorities who, to meet the challenge of access to care and medical deserts, intend to move forward ” without taboo ” and (re)raise the question of the relationship between city medicine and hospital.
“I want to be clear, it will be rights and duties”said Minister François Braun in an interview given to the Doctor’s Daily, at the end of August, when he was asked about the additional means to be released, for city medicine in particular. The boss of Health Insurance, Thomas Fatôme, who is preparing to conduct negotiations for the new medical agreement with the unions of liberal doctors, does not exclude “counterparties” to a possible revaluation of the consultation fees.
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