This is a new proposal that tenses general practitioners, after they took to the streets on February 14 to demand a revaluation of consultations, with a doubling of the price from 25 to 50 euros. The National Health Insurance Fund (Cnam) announced on Wednesday February 22 that the consultation with the general practitioner could increase to 30 euros if the practitioners accepted additional commitments against medical desertification, within the framework of a “contract of territorial commitment (CET)”.
Concretely, these commitments would relate to three points, namely “increasing the medical offer (size and evolution of the patient population), financial access to care, as well as participation in the care needs of the territory (via the permanence of care and unscheduled care, for example)”. “This proposal confirms the will of Health Insurance to respond to the problem of access to care for all, by strongly supporting the liberal doctors who are committed to this same approach, in the logic of give and take”, said specified the Cnam. In the event that the doctors refuse, the price of the consultation will only be increased by 1.50 euros, including with specialists (paediatricians, cardiologists, gynecologists, etc.).
The anger of the unions
If an agreement must be reached before the deadline of February 28, the six representative unions of the profession (CSMF, MG France, Avenir Spé, UFML, FMF and SML) refuse these proposals for the moment. “It’s a cold shower, reacts Sophie Bauer, head of the SML. The amounts advanced do not even catch up with inflation. At this stage, our pen, we keep it at the bottom of the bag!”, Expresses does she in an article from World. “With this CET, we are creating something artificial, which leads to paying more than the basic rates of doctors who agree to overload themselves with work,” said Dr. Raphaël Dachicourt, general secretary of ReAGJIR, a union young doctors observing in the negotiations.
For his part, the Minister of Health, François Braun, defends the logic: “My objective is to meet the health needs of the population”, he insists to AFP, saying he hears “the anger” of the practitioners, “but also that of the French who cannot find a doctor”. The negotiations, which take place at the headquarters of the Cnam in Paris, were still in progress Wednesday in the middle of the evening. They should resume this Thursday afternoon. The Cnam and the doctors’ unions must have signed the new medical agreement by February 28 at the latest, otherwise the new agreement will be drafted by an arbitrator, Annick Morel, a former general inspector of social affairs.