A bright red map of France. This is the alarming inventory drawn up by the UFC-Que Choisir, Tuesday, November 8, which highlights the lack of access to care for the population in many regions of the country. While the Social Security financing bill for 2023 has highlighted the extent of the medical deserts in France, the consumer association calls on the government to “allowing equal access to care for all users”.
The interactive map of the health divide lists access by municipality, according to tariffs, for four specialties: general practitioners, ophthalmologists, pediatricians and gynecologists. It highlights that taking into account the medical supply accessible within a forty-five minute drive, 19% of the country’s inhabitants, or 12.3 million people, live in a medical desert for ophthalmology. The proportion rises to 23.6% of women for gynecologists, and 27.5% of children for pediatricians, while pediatric emergencies are currently saturated in several regions of the country.
Access to GPs, which is less critical, nevertheless remains worrying: 23.5% of users experience difficulty in accessing this first player in the care pathway within thirty minutes. A figure much higher than that put forward by the Ministry of Health which estimated in 2018 that between 3.7 million and 7.4 million French people lived in an area under-equipped with general practitioners.
Financial difficulty
The study not only takes into account the geographical distance at which the specialists are located, but also the price list. It includes three criteria which combine direct access to a practitioner, the availability of professionals setting a price not exceeding on average more than 50% the Social Security tariff and geographic and financial access without overruns.
According to these three indicators, the municipalities are classified by color, from bright red for medical deserts to pale blue for an area in which access to a health professional is much higher than the national average.
This map sheds light on the problem of doctors’ fees being exceeded. According to the association, the financial brake is the first explanation for the renunciation of patient care. However, 46.9% of pediatricians, 64.3% of ophthalmologists and 68.6% of gynecologists practice fee overruns according to the UFC.
Engage parliamentarians
Faced with this situation, the government announced, as part of the Social Security financing bill, in October, its intention to impose on future general practitioners a fourth year of internship. “in priority” in an under-resourced area. This proposal aroused the opposition of the first concerned, who deplored a measure of “coercion”. The government also provides for the “sustaining the emergency measures taken this summer to facilitate the recruitment of self-employed regulatory doctors within the Samu and healthcare access services” and the « ssimplification and strengthening of coordination between the State and the municipalities of aid for the installation of private doctors in the most fragile areas ».
Of the “ineffective and very costly measures” according to UFC-Que Choisir, which deplores a “screaming failure” government initiatives. The association calls for the establishment of a territorial agreement for doctors to ensure a better distribution of health professionals. It calls for the closure of access to sector 2 (free fees) and the abolition of public aid to doctors who do not respect the Social Security tariff. She lists these demands as part of an awareness campaign on social networks using the hashtag #MaSanteNattendPas and calls on patients to “contact directly” their parliamentarians according to their situation.
This is not the first time that the UFC-Que Choisir alert on the state of access to care in France. Already in 2012, the association had published a first worrying inventory. Seven years later, a survey brought to light a deteriorated situation in access to general practitioners since nearly one in two general practitioners refused new patients, in most medium-sized towns.