Posted on 13 Feb. 2023 at 06:26 PMUpdated Feb 13. 2023 at 07:47 PM
Doctors are still taking to the streets. The unions of liberals and interns as well as the group Doctors for tomorrow call on their colleagues to close their offices and to demonstrate this Tuesday in Paris against “the dismantling of medicine in France and the destruction of the health system”.
For once, two hospital organizations, the inter-union Action Practitioners Hospital and the Association of Emergency Physicians of France as well as the Order of Physicians, have planned to swell the ranks of the procession. “It’s a historic mobilization,” says the Young Doctors union.
A basic consultation at 26.50 euros?
This initiative comes in the home stretch of negotiations between Health Insurance and representatives of liberal doctors. By the end of the month, the latter must have redefined the agreement which binds them to Social Security and determines their conditions of exercise and remuneration.
The representatives of the doctors, who have called for strikes and demonstrations several times in recent months, are firmly waiting for an increase in the price of their consultations reimbursed by the Health Insurance. Some even went so far as to demand a doubling of the price of the basic consultation to 50 euros.
Having promised to “rebuild” a health system “out of breath”, the government has shown itself ready to increase the price of consultations. Health Insurance has also proposed a first level of revaluation at 26.50 euros for the consultation, far from the 30 euros requested by the first union of general practitioners, MG France.
However, the National Health Insurance Fund (CNAM) has not yet played all its cards and new meetings are planned this week with the unions.
Two-tier medicine
Doctors also oppose the bill brought by Renaissance MP, Stéphanie Rist. In the eyes of the APH and Amuf unions, this “deconstructs the organization of care and establishes a two-speed medicine”.
Already adopted in the Assembly and discussed in the Senate on Tuesday, this text aims to “improve access to care” for the French by allowing them direct access – under certain conditions – to nurses, physiotherapists or speech therapists. Seen with a good eye by the unions of the professions concerned, it bristles the Council of the order of doctors who sees in it “risks of loss of opportunity for patients”. For the unions of liberals, the initiative is synonymous with bypassing the “coordinating function of the attending physician”.
The unions are all the more upset against the bill as it must ratify the concept of “territorial commitment” at the heart of negotiations with the CNAM. At a time when the lack of doctors leaves very many French people suffering from a chronic illness without medical follow-up, the Health Insurance offers much more “significant” revaluations to liberal doctors who would fulfill a certain number of requirements. Doctors, however, are very reluctant to the idea of being more constrained.
“High level of tension”
They also take a very dim view of parliamentary initiatives calling into question their right to open a cabinet wherever they see fit. A sign that the majority wishes to release the pressure, the Horizons group in the Assembly has however withdrawn a bill establishing a new mode of installation of doctors, which was to be discussed in committee on Wednesday at the Palais-Bourbon.
Initially carried by the deputy Thomas Mesnier, beaten during partial legislative elections, it had been taken up by the deputy Frédéric Valletoux and should not finally be approached for a few months. “There is a high level of tension around the medical convention,” admits the latter. A sign that these negotiations are delicate to carry out, unions of physiotherapists did not hesitate in mid-January to reject the increase in their remuneration negotiated with the CNAM for months.