The debate is back on the table, for the umpteenth time. Should the installation of doctors be conditioned to deal with the lack of caregivers in a territory? There Law proposition of the deputy of the majority group Frédéric Valletoux (Horizons), former president of the Hospital Federation of France, which aims to fight against medical deserts is examined from this Monday, June 12 at the National Assembly. The question of the regulation of installations had been dismissed during its passage in committee, but the tabling of a transpartisan amendment on the subject promises new heated debates.
Imposing a more radical “lever”
Co-signed by some 200 deputies of the majority and supported by the government, the bill intends to “increase the participation of health establishments in the permanence of care”. Thus private clinics will be used more to ensure emergencies, explains the deputy of Seine-et-Marne. The bill also intends to prohibit temporary work at the start of their careers for certain caregivers, and to open up the possibility for doctors from the third year of study to sign “Public Service Engagement Contracts” providing for a monthly allowance against a engagement in a medical desert. Nevertheless, the majority has so far rejected the idea of regulating the installation of doctors. What this famous transpartisan amendment advocates, on the other hand, tabled by the Socialist deputy of Mayenne, Guillaume Garot (PS).
If Guillaume Garot supports the spirit of the text, he intends to take advantage of the public session to introduce this much more radical “lever” of the “regulation” of the installation by the Regional Health Agencies (ARS). “Health can no longer depend on our postal code,” insisted the elected official of Mayenne to AFP. Several months ago he launched a tour of France of medical deserts, bringing together around his own text a transpartisan group of 207 deputies from almost all groups, excluding the RN. But not having obtained the inclusion of his text on the agenda of the National Assembly, he wants to take advantage of the window of opportunity offered by the “Valletoux” proposal to pass his measures by way of amendment.
The liberal doctors and dental surgeons targeted
Calling for “political courage”, Guillaume Garot intends to ensure that liberal doctors and dental surgeons can only settle “by right” in areas suffering from a shortage of caregivers. To settle in an area that is already well provided for, they would have to obtain authorization from the ARS, which could accept it, for example if another professional leaves the territory.
In committee last week, the deputies of the transpartisan group have already adopted measures to regulate financial aid for installation (only one every ten years) and unexpected departures, including of dentists and midwives (with six months notice).
“Coercive measures” according to doctors’ unions
Asked about franceinfo this Monday, June 12, Luc Duquesnel, installed in Mayenne and president of the union “Les Généralistes CSMF”, denounces a blow to the independence and attractiveness of his profession. “Beyond the original text, the 700 amendments are liberticidal for these young doctors. They are forced to practice in deserts where there is no high school, no colleges, there are no more restaurants… More nothing! And we want to put doctors there?” As of Friday, some doctors announced they were going on strike to protest against the proportion of the law as well as the amendments.
“General practitioners are among the specialists who work the most hours and among those who are paid the least. If in addition they are forced to settle where they do not want to go, they will choose another exercise”, regrets in the columns of Figaro Agnès Giannotti, president of the MG France union. The socialist deputy Guillaume Garot, defends him, these coercive measures. “It’s the only way to really put an end to medical deserts, he assures. And I intend to present an amendment during the debate on Frédéric Valletoux’s law to submit the idea to the votes of my colleagues”.