Health Minister François Braun ended his closing speech on the health component of the National Council for Refoundation on Wednesday May 3 by quoting Winston Churchill: “There is no point in saying ‘we have done our best’, we must do what is necessary”. However, listening to the measures detailed by the former emergency doctor and his deputy minister Agnès Firmin-Le Bodo, we rather have the impression that the two officials have “done their best”. But not really ‘what is needed’.
The objective of the CNR health was “to allow citizens and health professionals to meet and build solutions to change their daily lives”, says one in the entourage of the minister. In other words, to succeed in doing more (care), with fewer (doctors). For this, 250 territorial meetings were held in seven months, which brought together 10,000 participants.
What has come out, to date, of this great brainstorming? The presentation of a hundred inspiring and replicable local initiatives – to attract young doctors or better organize access to unscheduled care, among other examples. The commitment to perpetuate the “territorial CNRs”, bodies for dialogue at the local level, in order to facilitate exchanges between the various professionals. The provision of 30 million euros to support the projects resulting from these local meetings. The generalization of the right for the ARS to adapt national policies to local realities. And that’s about it.
Missions galore
For the rest, Minister François Braun has mainly announced or confirmed the launch of new missions. The development of health mediation to “reach” the people furthest from care? A mission. Improving the care of pregnant women and births? One more mission. A better distribution of the permanence of care between all the actors? Another mission, of course. And the list could go on: the deployment of one-stop shops in the territories for health professionals, and the generalization of access to care services will also be the subject of missions.
The main principles of the reforms desired by the President of the Republic were also of course recalled. Starting with the desire to unclog emergency rooms, or the need for health professionals to cooperate better. However, this laudable objective can only be achieved by changing the method of payment for caregivers. A question that the Minister raised by mentioning the capitation payment for city doctors. However, he was careful not to go into detail, as the subject is one of the red rags for these liberals who remain in the majority fiercely opposed. The objective of doubling the number of multi-professional healthcare centers (2,000 today) has been confirmed, as has the desire to complete coverage of France with territorial professional healthcare communities.
But the major measures eagerly awaited by caregivers, starting with the revaluation of night work in the hospital, and better remuneration for the Liberals, have been postponed – to the social security financing bill at l autumn for the first, and a hypothetical resumption of negotiations with the Health Insurance for the second. The sequence was an opportunity for François Braun to try to regain control after difficult weeks. Between the failure of the discussions around the new agreement between doctors and Social Security, the Rist bill on direct access to paramedics which had aroused the anger of the liberals and the difficulties in hospitals due to the supervision of the remuneration of interim doctors, the minister appeared to be in a weak position, jostled from all sides. It is not certain that the announcements of the day are enough to improve relations with his former colleagues.