The map of the most marked difficulties in accessing healthcare overlaps almost perfectly with that of the frontist vote. The populist party understood this well, which dedicated in 2022 broad developments in health issues. In its profession of faith with a view to the next legislative elections, the National Rally reaffirms its ambition to “reduce medical deserts, support the public hospital and secure the supply of medicines”. How ? If vagueness reigns over the measures adopted today, it remains possible to refer to the program put forward during the presidential elections by Marine Le Pen.
The main reform proposed to strengthen the attractiveness of under-resourced areas? A differentiated price for consultation in these territories. Unconvincing, for specialists: “We have known since the 2000s that financial incentives have disadvantages (windfall effects, etc.) and do not, on their own, make it possible to strengthen the attractiveness of deficit territories”, underlines the former director of the Institute for Research and Documentation in Health Economics Yann Bourgueil.
Sharing tasks with other caregivers is a complementary response, also proposed by the RN. “But at the same time, we must partially replace fee-for-service payment with fixed-rate remuneration, to encourage cooperation between professionals,” continues the expert. The other proposals – development of telemedicine and health centers, more places in medical courses – are already underway. On this last point, we must especially look for future students in deficit areas, because the chances of them settling there at the end of their training are all the greater. But there is no question of that.
Fewer administrative staff in hospitals
At the hospital, the RN also plans an increase in remuneration, of 10%, to combat the flight of caregivers. “In the same way, we can clearly see that this is not enough: a multifactorial approach is necessary (working conditions, access to housing, etc.),” notes Yann Bourgueil. Especially since this proposal, attractive on paper for the staff concerned, is not funded. The promised increase in the number of places in nursing training is already underway, but the main problem remains the high dropout rate during studies, about which not a word is said.
We also note a step backwards, with the overall allocation for financing the establishments and management placed under the direct authority of the prefects, for whom it is difficult to see how this would contribute to solving the hospital’s problems. Finally, administrative staff would be capped at 10% of the workforce, without clearly measuring the consequences (how many fewer agents, which staff specifically concerned, what impact on operations, etc.).
The RN’s promise to strengthen emergency staff risks coming up against the lack of doctors in our country. Difficulties which could worsen if the migration policies desired by this party led to a flight of foreign caregivers who today contribute largely to the operation of hospitals. This party also proposes to organize collaboration between hospitals and city practices for the reception of unscheduled patients but whose state of health is not a vital emergency. Here too, this reform is already underway, with the access to care service.
In 2022, the National Rally also claimed to “return doctors to their freedom of expression and prescription”. Coming out of Covid, it was undoubtedly a matter of sending winks to all those who had been convinced by the speeches of Professor Raoult and other conspiratorial or anti-vax caregivers, frustrated at not having been able to prescribe hydroxychloroquine or ivermectin, the benefit of which against this infection has never been demonstrated. Fortunately, doctors in our country have complete freedom of expression and prescription – provided, however, that they only advise their patients on treatments validated by scientific studies. Is it against this principle that the National Rally claimed to protest? The sick would have a lot to lose.
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