The question of medical deserts on the menu of Emmanuel Macron’s trip to Limousin at the start of the week. The government estimated in 2017 that more than five million inhabitants lived in a medical desert, in around 9,000 municipalities. Areas where the average health needs are not covered within a radius of 20 minutes, either because there is no doctor or because there are not enough of them. The number of trained doctors is increasing, but it takes time and local elected officials are trying to find solutions.
Example in Thaon-les-Vosges near Epinal: “ten years ago, we had eleven general practitioners for a pool of 12,000 inhabitants and today we are six doctors for the same population, that poses a problem” according to the mayor of Thaon Cédric Haxaire. Evelyne lives in Thaon, she has her general practitioner there, for specialists, it is in Epinal or Strasbourg. Evelyne who has adopted a strategy of her own so as not to find herself destitute: “me, I try to find doctors not too old like that, I have for a little while“. A medical center is due to open next October. Two general practitioners should set up there, perhaps a third.
To go further, the town hall has decided to finance part of the training of a nurse who wants to change paths and become a doctor. In exchange, she agrees to ten years of service in the municipality. A risk that must be taken for Mayor Cédric Haxaire: “it’s 12,000 euros per year over three years, it’s not trivial. It is only at this price that we will perhaps be able to compensate for our difficulties“.
– Cedric Lieto
A question often comes up: that of the obligation of installation for doctors in under-resourced areas. This is what defends on Franceinfo Michel Fournier, the mayor of Voivres (Vosges) and president of the association of rural mayors of France: “this government did not dare to take the coercive measures that would be necessary so that there would be a much more developed settlement in our territories“. Forcing doctors to work in rural areas would not be a good idea, says Marc Braun, dean of the Faculty of Medicine of Nancy: “force someone to go to a place for three years, he will go backwards and then after three years, he will go away. These are short-sighted measures from the point of view of the future doctor who will have to fit into a canton, a communal fabric“. Marc Braun who recognizes that he is “logic“that the State and the taxpayers have”requests regarding these students“.
300 health professionals supported by the Vosges Department”
In the Vosges, the departmental council launched a health plan in 2017 after a year of work and reflection. It was calculated at the time that more than a hundred GPs were going to retire over the period 2016-2026. The departmental council chaired by François Vannson has therefore decided to set up incentives for the installation of health professionals. A device that is bearing fruit according to François Vannson: “we provide advice on the creation of medical houses, for example, or financial support to encourage health professionals to come to the department […] It works because we have 300 health professionals who have been supported by the Department for their installation“. François Vannson who wants to go further by supporting certain investments in hospitals.
Training capacities for doctors that remain limited
One question remains, that of the number of doctors trained in France. The numerus clausus, the number of students accepted in the second year of medicine was abolished in 2021. This does not mean that the number of doctors trained will explode. The Faculty of Medicine of Nancy was limited to 304 students per promotion, it increases to 350 explains Marc Braun, the dean: “the quantity depends on our training capacities, reception on the courses, support by the course supervisors, we do not produce course supervisors with the snap of a finger, but I understand the politicians’ frustration because it’s late and it’s not dense enough in the territories“.