Journalist, mayor, president of the French Hospital Federation (FHF)… Frédéric Valletoux had several careers before joining the Horizons benches in the National Assembly. The former mayor of Fontainebleau, former member of the Republicans (LR), inherits the portfolio of Minister for Health in a sector in crisis.
The new minister had time to discover the health ecosystem, serving for eleven years as president of the French Hospital Federation (2011-2022), which brings together the majority of public health establishments. During the health crisis, Frédéric Valletoux has repeatedly sounded the alarm on the situation of hospitals overwhelmed by Covid-19.
The elected representative from Seine-et-Marne will team up with Catherine Vautrin, appointed last January at the head of a large Ministry of Labor, Health and Solidarity. The duo will notably have to rescue hospitals from a crisis that has become chronic and facilitate French people’s access to city doctors.
The reform of the AME
One of Frédéric Valletoux’s sensitive issues as delegate minister should be the reform by decree of the AME, medical aid for undocumented foreigners, announced by Prime Minister Gabriel Attal in his general policy declaration on 30 January.
In December, the former head of government, Elisabeth Borne, had nevertheless promised reform “by regulatory or legislative means”, ensuring that parliamentarians would be “fully involved in this work”. “It is an ethical and health necessity to treat migrants,” insisted Frédéric Valletoux nearby Figaro on February 6, a few days before his appointment, specifying on the social network that this “useful” device “can always be adapted”.
Regularization of foreign doctors
The new Minister for Health will also have to work on the lack of doctors. Gabriel Attal raised the idea of recruiting foreign doctors to compensate for the lack of qualified doctors in France, while waiting for the end of the numerus clausus decided during the first five-year term to bear fruit. Against medical deserts, the Prime Minister announced on January 30 the appointment of an “emissary, responsible for seeking doctors abroad”.
The installation of doctors
Frédéric Valletoux, then a deputy, introduced a bill aimed at improving access to care in the territories, adopted in Parliament on December 18. This text, aimed in particular at better organizing the permanence of care in the territory, was criticized by liberal doctors. They feared that the majority would bend to the will of a large number of elected officials wishing to call into question the freedom of doctors to establish themselves.
The main unions protested and even called a strike last fall against this proposed law supposed to fight against medical deserts. They denounced several measures, some of which were ultimately not adopted in the final version of the text, remember The Parisian, notably the automatic membership of doctors in territorial health communities and the strengthening of the missions of the Territorial Health Council. This strike was called against a backdrop of standoff to revalue the price of the consultation.
Last fall, Frédéric Valletoux won a standoff with the socialist Guillaume Garot, leader of a transpartisan group. The latter had seen the hemicycle reject their request for regulation in the installation of doctors in the territory in order to fight against these medical deserts. Not completely closed to the idea, recalls AFP, Frédéric Valletoux believes that it can only be implemented after having trained enough doctors.
Prices for consultations with general practitioners
The appointment of the new Minister for Health occurs in the context of conventional negotiations. On Thursday, Health Insurance opened the way to an increase in the prices of consultations with general practitioners for the next five years.
For the first time in the negotiations started in mid-November, after the failure of a first round last year, Health Insurance took a step towards an increase to 30 euros for consultations with general practitioners. Enough to satisfy the MG France union, the first union of general practitioners, which presented this increase as a “prerequisite” while the general practitioner consultation is today at 26.50 euros. Health Insurance also offers increases for consultations and procedures by specialist doctors, focusing on the least remunerative, such as pediatrics and psychiatry.
The financial situation of CHUs
The financial situation of the CHUs, which called for “emergency measures” at the end of January, is also another file at the top of the pile. The 32 French university hospital centers (CHU) reached a cumulative deficit of 1.2 billion euros at the end of 2023, or three times more than in 2022, the representative bodies of directors, deans and doctors alerted on January 29. These latest figures show how “the deterioration was deep and rapid”, after the deficit of 402 million euros at the end of 2022. “The self-financing capacity of CHUs, and therefore investment, fell by 86%. ” explained the presidents of the conferences of general directors of CHU, deans of medical faculties and presidents of establishment medical commissions.
Catherine Vautrin and Frédéric Valletoux will also have to quickly resolve the question of the resources allocated to public hospitals. These, all establishments combined – from university hospitals to small local hospitals – are asking the government for 1.8 billion euros in additional funding for 2023, including 1.1 billion for inflation, according to figures released by the FHF on January 29.
End of life
Another issue on the table: end of life, regarding which final decisions are expected in February. Emmanuel Macron brought together representatives of the main religions in France, doctors and other personalities on Thursday evening at the Elysée for a dinner dedicated to this sensitive issue.
Gabriel Attal assured on January 30 that the bill on active assistance in dying would be examined “before the summer”, while promising to “considerably” strengthen palliative care units. On this text, as anticipated as it is sensitive, the executive has pushed back the deadline several times, to the great dismay of supporters of a change in legislation. After the citizens’ convention on the end of life, mostly in favor of active assistance in dying, Emmanuel Macron had in fact initially asked his ministers for a bill “before the end of summer” 2023.