Despite protests from doctors, the Senate adopted on Tuesday, February 14 at first reading, a text for direct access to certain nurses, physiotherapists and speech therapists. The vote was won by 199 votes in favor and 14 against. Deputies and senators will now try to agree on a common text in a joint committee.
In the long-term fight against medical deserts, Renaissance MP Stéphanie Rist’s bill also aims to expand the missions of advanced practice nurses (IPA), who would now be authorized to prescribe certain care and medications.
Patients could thus go to these caregivers without going through a doctor, but always in the context of a “coordinated exercise” with the latter.
“Structural problem” versus “piecemeal responses”
“The objective is in no way to set aside the general practitioner”, assured the Minister Delegate Agnès Firmin-Le Bodo, while the liberal doctors demonstrated against this text and to demand better rates. This is for the government to “free up medical time and facilitate access to health”.
“Let’s not delude ourselves with chimeras, this text opposes fragmented responses to a structural problem and will not make it possible to resolve the serious difficulties that some of our fellow citizens are facing”, warned for her part the rapporteur Corinne Imbert (LR) .
The senators agreed to these provisions, but by framing them, so as to “guarantee the safety of care” and “maintain the central role of the doctor in the coordination and follow-up of patients”.
“Put the problem on the table”
In addition, they introduced a new article paving the way for compensation for missed appointments with healthcare professionals, and financial penalties for dishonest patients. This initiative has been debated, in particular on the responsibility of dating platforms. The Minister of Health, François Braun, deemed it “premature”, while the left felt that it risked making the most fragile patients more precarious. For Ms. Imbert, “it is not a question of stigmatizing”, but “at least of putting on the table” the problem.
With the consent of the Minister, the Senate removed the possibility for the physiotherapist to prescribe an adapted physical activity (APA).
The left abstained on the entire bill, Bernard Jomier (PS) accusing the government of “crystallizing opposition between health professions where more cooperation is needed”.