An outstretched hand… Difficult to grasp. This Monday, April 24, liberal doctors learned that they could increase the price of their consultations by 1.50 euros, after months of tension and negotiation with Health Insurance and the government. According to the Ministry of Health, which spoke in the process, the price of the general consultation should therefore increase to 26.50 euros, and climb to 31.50 euros for specialists, from the end of October. . The remaining charge does not change.
Fruit of the “arbitral settlement”, a mediation launched two months ago, this decision is struggling to satisfy the main representatives of the sector: “The government does not compensate for inflation and accepts that the income of general practitioners is falling”, reacts to L ‘Express Agnès Giannotti, president of MG France, the majority union of general practitioners.
In question: this increase is exactly that which had been proposed by the Health Insurance, during the conventional negotiations. The representatives of the general practitioners then refused. They have been asking for months for a revaluation bringing the consultation to a minimum of 30 euros, strikes and demonstrations in support.
“To help patients, let’s help doctors”
At MG France, the pill is therefore struggling to pass: “The government promises to do more for the profession, but on this issue, we have the impression of asking for the moon. So that each patient can have a doctor and to be followed in good conditions, it is necessary to make the profession more attractive”, continues Agnès Giannotti.
A Senate report published in March 2022 shows that 11% of French people aged 17 and over do not have a general practitioner in 2022. Beyond compensating for inflation, the MG union estimates that a greater increase in consultation is necessary to compensate for the lack of doctors.
Even if patients see their out-of-pocket increase beyond the 50 cents provided for in the current agreement: “We are fighting against health inequalities and access to health. If there is no no more attending doctors, only the rich will be able to get treatment. Doctors must be helped to help patients,” says Agnès Giannotti, adding in passing that the less well-off people have additional aid for the support for their consultation.
A sign of the tensions on the subject, some of the liberal doctors went on strike for a week this winter, in the midst of a “triple epidemic”, to call for an increase in consultation prices. The collective behind this mobilization asked at the time for a doubling of the price of the basic consultation to create a “shock of attractiveness” in the face of medical deserts.
No differential increase
The fight against medical deserts is one of the priorities displayed by Emmanuel Macron, who has also set up financial aid for the recruitment of medical assistants, to allow certain general practitioners to settle more easily in the least provided territories. The “arbitration rules” provide for “broadening and softening” this other boost.
Unlike price increases, this measure will apply immediately, as will the creation of a new act at 60 euros for the first consultation of a chronic patient without a doctor. In addition, the annual bonus paid for the follow-up of these patients “in long-term illness” will be raised from 42 to 46 euros, or almost 10%.
On the other hand, to avoid any provocation, “no revaluation subject to a territorial commitment” was retained, although the government pushed a lot in this direction. Two months ago, the unions had indeed braced themselves against the creation of a second level of prices (30 euros for general practitioners). Called “Territorial commitment contract”, it was reserved for practitioners accepting certain counterparties: taking on more patients, doing night shifts, practicing in a medical desert, working on Saturday mornings…