Will the National Assembly affect the freedom of establishment of doctors? To fight against medical deserts, a transpartisan group hopes to win a showdown this week against the government, headwind against a measure that will “rotten the situation”.
“It’s going to be hot”: the Minister of Health François Braun knows that the week will be tense at the Palais-Bourbon.
“Creating rigidities and constraints” for the installation of health professionals “will be totally counterproductive, and would only divert more from the practice of medicine”, he launched at kick-off. discussions on Monday evening. “These debates offend our doctors”.
The deputies began the examination in first reading of a text of the presidential camp against the medical deserts, carried by Frédéric Valletoux (Horizons group).
With the support of the government and 200 deputies of the majority, he intends to “increase the participation of health establishments in the permanence of care”, by first targeting private clinics, which would be obliged to take part in particular in emergencies.
His bill also plans to prohibit temporary work at the start of their careers for certain caregivers, and to open up, from the third year, the possibility for medical students to sign “Public service contracts”, with a monthly allowance against a commitment in a medical desert.
But the eyes of the executive and the profession will be directed towards an amendment to the text, carried by the socialist Guillaume Garot, and a cross-partisan group of elected officials from almost all political groups, including those of the presidential camp. The RN was not associated.
This amendment plans to question the freedom in principle for doctors to settle in areas already well provided with caregivers, by establishing “regulation”.
To go to a sector that is already well endowed, private doctors and dental surgeons should obtain authorization from the Regional Health Agency (ARS), conditional, for example, on the retirement or relocation of a doctor practicing the same type. of activity.
“Eight million French people are affected” by difficulties in accessing healthcare, insists the deputy and former socialist minister, for whom it takes “political courage”, in the absence of “magic solution”. He gathered around his initiative a large number of deputies, 207 to date.
In committee at the National Assembly, the cross-partisan group notably won the principle of a six-month notice to better anticipate unexpected departures, including dentists and midwives.
But the real “battle” for regulation has been reserved for the passage in the hemicycle, and should in particular be played out in the number of deputies present for each camp.
Frédéric Valletoux is opposed to immediate “regulation”, believing that the number of doctors will be too low over the next five or ten years for it to solve the problem: “I will be in favor of it the day we have a large number of caregivers to dispatch on the territory”.
The Minister torpedoes the proposed measure, which risks “rotting the situation”: “Young people will not want to settle down, the oldest will say: it’s good, we’re moving” [closing of the cabinet], when others will choose the “déconventionnement”, he criticizes. Whatever the vote, the text will still have to pass in the Senate.
Some professionals are already opposed to the “Valletoux” version of the text, in particular because it provides that the liberals are automatically attached, “unless opposed”, to the professional territorial health communities (CPTS), supposed to facilitate coordination at the scale of the territory.
The profession is on a war footing: four of the six representative unions (Avenir Spé, UFML, FMF, SML) announced Monday an indefinite strike from October 13.
In session, the government will also propose measures for “multi-professional health centers (MSP)”, or to insist on the obligation of participation of certain caregivers in the permanence of care.
And François Braun already praises the additional year planned for interns in general medicine in 2026, with additional compensation if they carry it out in medical deserts. In total, they will be able to reach a “very incentive remuneration”, “up to 4,500 euros net per month”.
06/13/2023 00:19:38 – Paris (AFP) – © 2023 AFP
