Posted Oct 25, 2022, 7:00 PM
MPs will have to wait before debating the issue of medical deserts. After being cut short by the government last week, the debates on the Social Security budget (PLFSS) resumed on Tuesday evening, but focus first on measures related to old age and the family. However, the order of the articles in the bill requires that the issues of prevention and access to care be addressed first.
This agenda modified at the request of the government dampens the hopes of parliamentarians to debate in the hemicycle on the coercive measures which could be imposed on doctors in order to strengthen their presence in medical deserts. While 6 million French people do not have a doctor, the problem of medical deserts is at the top of the concerns of deputies regularly questioned by their constituents on this subject.
Less coercive
The parliamentarians expect the government to draw article 49.3, allowing it to have its text adopted without a majority in the hemicycle. “I’m not sure we’re going very far in the discussions,” said Horizons MP Frédéric Valletoux. The subject of the installation of doctors would then be evaded.
“We can count on the fact that there will be no discussion on the subject [des déserts médicaux] “Explains Thomas Mesnier, another Horizons MP. The government has all the more interest in avoiding a discussion on the “regulation” of doctors since it knows that it could be pushed around on this subject within its majority. The approach of Thomas Mesnier bears witness to this.
The latter tabled an amendment aimed at preventing a doctor from settling in areas that are very well provided with doctors, unless he is replacing a colleague who has ceased his activity or if he agrees to lend himself to “secondary and punctual exercise in under-dense zone”. Knowing that 87% of the territory is considered an area “under dense” in doctors, explains Thomas Mesnier, this amendment is less “coercive” than other measures pushed by elected officials from all sides gathered around the socialist Guillaume Garot.
“There was a place for it to be adopted by the Assembly”, assures Thomas Mesnier, already speaking in the imperfect of his proposal. “A growing number of Renaissance MPs supported him,” he said. This is enough to upset the government, which has already been pushed around on the question of superdividends by its majority during the debates on the finance bill. The government has never ceased to say that it is reluctant to take any measure of coercion against doctors. “No constraint because it does not work and it is counter-productive”, declared the Minister of Health, François Braun, on BFM TV on Sunday.
Free up medical time
To respond to the problem of the French without a doctor, the government promises to free up medical time for doctors by developing medical assistants in town. He also wants to encourage the installation of young people in the territories, in particular by encouraging interns in general medicine to go to medical deserts during the fourth year of internship which is in the process of being created for this specialty.
The creation of this fourth year is already creating a stir among interns. And the possible questioning of the freedom of establishment of doctors bristles all the unions which explain that the coercive measures would only reduce the attractiveness of general medicine and would not solve the problems of availability of doctors since the lack of doctors concerns the whole territory.
Bills
If the subject of medical deserts is not discussed in public session in the context of discussions on the Social Security budget, it could soon return to the hemicycle. The deputies of the transpartisan group brought together by Guillaume Garot have promised to table a bill. The general rapporteur for the budget, Stéphanie Rist, for her part tabled a bill to promote direct access for patients to several health professionals.