It was THE central question all weekend, at the congress of rural mayors in Eymet in the Dordogne. That of the medical deserts, the lack of doctors, the months to wait before obtaining an appointment and the kilometers to swallow for a consultation. There is a shortage of more than 6,000 general practitioners in the countryside according to rural mayors. In the Dordogne, there are 67 per 100.00 inhabitants. Throughout the weekend, voices were raised to propose a solution: the selective agreement.
Selective agreement?
The mayors invited Minister Delegate for Health Agnès Firmin Le Bodo Sunday, for the last day of the congress. And it was Roland Caillaud, the mayor of Pouligny-Saint-Pierre in Indre who put the subject on the table: “We are still shocked to see that today we still agree doctors who settle in over-endowed areas, especially since it is in the sun. It is no longer sustainable, tackle the real problem”. In his small village, there are 1,100 inhabitants, zero doctors.
A few days earlier, the president of the department had also mentioned the solution of deconvention, on France Bleu Périgord. “At some point, you have to take more coercive measures. Doctors are funded by communities, social security. You have to have the courage to say no, we are not going to continue to contract you to go to over-supplied areas”he says on France Bleu Périgord.
For the minister, it’s no
For Agnes Firmin Le Bodo, this is not a possible solutionat least not at the moment. “I was taught that zero times zero equals zero. 87% of the territory is a medical desert. Over-supplied areas no longer exist”, assures the minister.
When you look at the maps of France, it’s true that there is no green zone, there are only red or orange zones. But looking closely, there are great disparities between living areas. In the Dordogne for example, nothing to do depending on whether you live in the area of Brantôme sufficiently endowed with doctors, or on the side of Ribérac, where eight additional doctors are needed to reach the national average.
A decree would be enough for some
Gilbert Guérin for example, the mayor of Dausse in Lot-et-Garonne, when he wants to see a dermatologist he has to drive to Bergerac. “Go see if Biarritz is under-endowed, no. The selective agreement would allow in the medium term to distribute the doctors who come out of the faculties of medicine. And the doctor’s salary is made by the reimbursement of the Secu“, he argues. In addition for some, it could be a solution applied right away, a decree would suffice.
Questioned again, Agnès Firmin Le Bodo relies on this same figure, according to which 87% of the territories are under-resourced. Before concluding : “And anyway, you have to go see those who set it up, it doesn’t work.”