2023-12-19 02:43:22
Fight against medical deserts and make practitioners more responsible without irritating the sector: a sensitive bill on access to care was definitively adopted in Parliament on Monday despite the disappointment of the left, which considers the measures insufficient. A final vote in the Senate, a few days after that of the National Assembly, put an end to lively debates that began in June on this bill aimed at improving access to care in the territories.
The text of the Horizons deputy (presidential majority) Frédéric Valletoux was adopted by 241 votes to 81. The crest line was tenuous for this future law, supported by the government: the discussions took place in a tense period for the doctors’ unions. , who are trying to negotiate an increase in consultations with Health Insurance. They maintained great vigilance over the examination of the text, fearing coercive measures which would have reinforced their distrust of the executive.
To meet health needs, “it would be appropriate to give us means rather than obligations”, reacted the Regional Union of Health Professions – Liberal Doctors of Île-de-France, referring to some “vexatious articles”. Several demands from practitioners were nevertheless heard: no measure regulating the establishment of doctors was retained in the version submitted to the vote, to the great dismay of part of the left who wanted to force professionals to establish themselves in medical deserts.
Parliament chose “trust rather than constraint”, summarized Les Républicains senator Corinne Imbert, responsible for the bill in the Senate, on Monday. “It is certainly a partial text which does not respond to all the ills of the health system”, but it is “pragmatic and concrete” and will make it possible to “decompartmentalize, territorialize” the system “and give more oxygen to those who take care of our fellow citizens,” underlined Frédéric Valletoux after the adoption in the Assembly.
Decompartmentalization
Under the watchful eye of practitioners, Parliament has nevertheless taken up a tense issue, that of the distribution of permanent care: the workload of night and weekend guards will be rebalanced between the healthcare sector. public hospital and private clinics. The mechanism provides for great freedom of organization between establishments, but in the event of a deficiency, the Regional Health Agency (ARS) will have greater power to designate certain ones as a last resort.
The profession will be vigilant about the implementing decrees on this point: “What could make us angry is if we reestablish a certain form of obligation,” explains Patrick Gasser, president of the main specialists’ union Avenir spé. “This would throw conventional negotiations into disarray.”
This text “goes in the right direction” but it remains “in the middle of the ford”, for his part explained Lamine Gharbi, president of the Federation of Private Hospitalization (FHP). “To promote full cooperation between health stakeholders, and move from a culture of supply to a culture of demand, we must renovate the current public hospital service,” he added.
Another hot point, the automatic membership of doctors in professional territorial health communities (CPTS) supposed to facilitate coordination at the territorial level was not retained in the final version. The text also broadens the skills of nurses with the creation of the status of “referent nurse” who will carry out a mission of monitoring and renewing prescriptions for chronic patients.
The Minister of Health Aurélien Rousseau welcomed “an ambition, that of accelerating the decompartmentalization of our health system with concrete solutions to improve access to care”. A formula which did not convince part of the left: the socialists and communists voted against it in the Senate. “We are condemned to patches”, without “the shadow of measures to regulate the installation of practitioners”, denounced the communist Céline Brulin.
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