inequalities have “increased” despite incentives for the installation of general practitioners, according to Health Insurance

Was the carrot too small? Or do we have to pull out the stick ? Despite the aid paid to encourage practitioners to settle in medical deserts, inequalities in access to general practitioners have increased in recent years in France, according to a report established in early July by Health Insurance and consulted Monday, July 18 by AFP.

Four types of “demographic contracts” were negotiated in 2016 with liberal doctors’ unions, with the aim of stemming the progression of medical deserts. Health Insurance recognizes that these new features have not “not enough to erase the imbalances of territorial distribution that persist”. “Inequal Access” to general practitioners has even “accented” between the end of 2016 and the end of 2019, according to Health Insurance.

At the end of 2021, only 4 685 contracts were “In progress”, including a large half under a “coordination” contract for practitioners already established in a medical desert, according to the report presented to an internal health insurance commission. The installation aid itself (up to 50,000 euros) was granted to 2,085 doctors, mainly general practitioners, ie a little over 400 per year.

On the other hand, the Health Insurance notes a “disparity reduction” for liberal nurses and midwives. Two professions which, unlike doctors, benefit from a steadily rising workforce, but have also accepted a “regulation” of facilities: an arrival for a departure in “over-endowed” areas.

This contrast gives arguments to the partisans of the policy of the stick. Thus, the Unsa union judges, on Monday, that the “extremely disappointing result” incentives demonstrates that they “do not work” and that he “we must therefore put an end to the freedom of installation of liberal doctors”. Health insurance, for its part, is content to offer “merge into a single contract” existing contracts, to simplify the system.