The National Assembly adopted at first reading, on the night of Thursday 15 to Friday 16 June, a bill to improve access to care. After four days of debate, the deputies voted by 37 votes against 4, and 25 abstentions, in favor of this text by Frédéric Valletoux (Horizons group, presidential majority), which must now be examined by the Senate.
He has been the subject of a standoff over freedom of establishment for doctors, a cross-partisan group of MPs pushing on Wednesday, but to no avail, for more coercion to better supply medical deserts. At the initiative of this group, the socialist Guillaume Garot again deplored Thursday a “missed opportunity”, which pushed his group to abstain on the whole of the bill, despite “some progress”.
“We are going to return to the constituency” and have to explain this lack of regulation, when “the expectation was so great”, also underlined the ecologist Sébastien Peytavie, who also abstained, like the “rebellious”. The Communists voted against the bill, which “will not meet the glaring needs” in terms of health, according to Pierre Dharréville.
The right also came out against it, but for different reasons. “Certain elements are foils,” explained Yannick Neuder (Les Républicains), citing the automatic attachment of caregivers to territorial professional health communities. The elected National Rally abstained.
“Constructive” exchanges
All the groups, however, welcomed “constructive” exchanges, and the Minister of Health, François Braun, “compromises”. In the home stretch on Thursday, the deputies voted for a series of additional measures.
Private clinics and their practitioners will have to participate more in the “permanence of care” in the evenings and on weekends. All caregivers “participate” in this permanence of care, added Thursday the deputies, some welcoming a “change of paradigm”. But the Minister of Health, François Braun, interpreted this vote as an “incitement” to participate in the permanence of care, which he supports, and not as an “obligation”. These guards are currently provided by a minority of liberal doctors.
The National Assembly also validated an amendment by the transpartisan working group on medical deserts launched by Guillaume Garot (Socialist Party) which opens, from the second year of study, the possibility for doctors to sign “commitment contracts of public service” providing for a monthly allowance against a commitment in a medical desert. In addition, to promote internships for general medicine students in under-resourced areas, these internships should be filled first.
“A real step forward” for the Order of Nursing
In addition, while the working conditions of interns have often been singled out, the rapporteur for the Social Security budget, Stéphanie Rist (Renaissance), added that the entity (doctor or establishment) where the internship is carried out the student must take “the necessary measures to ensure his safety and to protect his physical and mental health”.
MPs from different sides have also created the function of “referent nurse”, chosen by the patient. He will have a mission of prevention, follow-up, renewal of nursing care prescriptions for chronic patients, in conjunction with the attending physician. The Nursing Order welcomed this vote, which “constitutes a real step forward”.
To avoid a double penalty for certain patients, the Assembly also unanimously voted for a transpartisan amendment which removes the tariff increase likely to be applied by Medicare during the year following retirement. of their attending physician or when the latter changes departments.
The ban on temporary work at the start of a career for certain caregivers has been extended to the field of child protection and socio-educational support. On the other hand, health students will be able to continue to practice as temporary workers. Finally, in medical deserts, a health option could be tested in high schools, in order to encourage medical and paramedical vocations.