Two months after the failure of their negotiations with Health Insurance, the unions of liberal doctors learned on Monday that their consultations will increase by 1.50 euros in the fall, a minimum increase supposed to push for a “rapid recovery” of talks.
The “referee” has ruled. Appointed to settle the dispute between doctors and Secu, the former inspector of social affairs Annick Morel announced her verdict at the end of the morning to the six liberal unions. The same who, at the end of February, had completely refused the offer of Health Insurance, despite an envelope of 1.5 billion euros per year, in the long term.
The senior civil servant has however chosen to take up certain proposals from the administration, starting with the general increase of 1.50 euros in medical consultations, i.e. 26.50 euros for general practitioners and 31.50 euros for specialists, excluding overruns fees.
Once validated by the government, these revaluations will come into force “at the end of a period of six months”, according to the “arbitration rules” drawn up by Annick Morel.
The Minister of Health, François Braun, immediately made it known in a press release that he “will approve in the coming days” this text comprising “significant advances for the improvement of the health of the French people”. The 5% to 6% increase in base rates should therefore take place at the end of October or the beginning of November.
This measure, which the Health Insurance had estimated at 600 million euros in a full year, remains however well below the minimum 30 to 50 euros demanded in vain for months by the unions, strikes and demonstrations in support.
If they want more, they will have to get back to the table, assumes the arbitrator, who wanted to “make a transition towards a rapid resumption of negotiations”, following the precept that “a negotiated agreement is better than an administered settlement “.
In the meantime, to avoid any provocation, “no revaluation subject to a territorial commitment” has been retained, although the government has pushed hard in this direction.
The unions had indeed braced themselves against the creation of a second price level (30 euros for general practitioners) reserved for practitioners accepting certain counterparties: taking on more patients, doing night shifts, practicing in a medical desert , working on Saturday mornings…
Several other provisions dear to the executive have however been drafted, in particular the one aimed at “broadening and easing” financial assistance for the recruitment of medical assistants.
A priority to “free up medical time that has become rare”, but also to achieve the objective set by Emmanuel Macron of 10,000 subsidized positions at the end of 2024, against just over 4,300 to date.
Unlike price increases, this measure will apply immediately, as will the creation of a new act at 60 euros for the first consultation of a chronically ill patient without a treating doctor. And the annual bonus paid for the follow-up of these patients “in long-term illness” will be raised from 42 to 46 euros, or almost 10%.
Means of “meeting the expectations of the population, in particular of fragile people”, explains the referee. Concern also shared by the Head of State, who promised that the 700,000 people in this situation would be “offered a treating doctor before the end of the year”.
No new remedy, however, for “urgent and unscheduled care”. Annick Morel has chosen to “perpetuate” the incentives intended for liberals who participate in the telephone “regulation” of Samu (100 euros per hour) and to receive patients within 48 hours (surcharge of 15 euros).
Two key points of the “flash mission” that François Braun had carried out and then implemented upon his arrival in the summer of 2022. And on which he still intends to rely to “relieve all emergency services” within 18 months , as the President of the Republic wished last week.
