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Has the explosion in the number of health centers been sufficiently regulated? Two former Ministers of Health sketch the beginnings of “mea culpa” in “Additional investigation”
Has the explosion in the number of health centers been sufficiently regulated? Two former Ministers of Health sketch the beginnings of “mea culpa” in “Additional investigation”
(ADDITIONAL INVESTIGATION / FRANCE 2)
From 2009 to 2023, no prior authorization was required to open a health center. The objective: to fight against medical deserts by increasing the provision of care. In front of the “Complement d’investigation” camera, the two former ministers behind the liberalization of the sector explain their choices.
On March 14, “Complement of investigation” focuses on a system whose some drifts can cost dear to Social Security… and to patients: that of health centers, the number of which has exploded in France. Was their installation sufficiently supervised? ?
According to Abdel Aouacheria, head of a patient association, victim of a dental center, which is fighting for better regulation of the sector, the Bachelot law of 2009 would bring “a major responsibility” in the deviation of the system. To fight against medical deserts, it has in fact relaxed the legal framework, and allowed the opening of a health center without having to getpreliminary authorisation health authorities.
2009: removal of compulsory approval
Fifteen years later, what view does the Minister of Health at the time have on this decision? In front of the camera of “Complément d’investigation”, Roselyne Bachelot highlights the need to create new health centers, following a “very strong and shared demand” emanating from “all political personnel”. But the former minister admits that“it would undoubtedly have been wise if the creation of new health centers in a major way had been better supported.”
2018: opening of the sector to private for-profit players
While relaxing the legal framework, the minister still set a condition: health centers must remain non-profit associations. In 2018, Agnès Buzyn will go alland further: it opens the sector to the lucrative private sector… and this, always without having to obtain authorization before opening a health center. She says she very quickly felt “potential drifts”, but Could these not have been anticipated, nine years after the Bachelot law? Why not reintroduce the obligation to obtain approval?
At the time, explains Agnès Buzyn, “I have an entire ecosystem against me who does not want this authorization process.” The cause, according to her, are procedures deemed too long and too complex by the profession. Faced with the emergency, and “the anxiety that medical deserts create in the population and among local elected officials”, the order of 2018 will therefore not reinstate the obligation of an authorization to open a health center… “It is clear that we should have, but I did not imagine that there would be such deviations in terms of quality,” the former minister justifies herself, admitting not having anticipated “that some who are not even doctors are proposing the opening of health centers”…
2023: return of approval (for dental and ophthalmological centers)
Result: following these successive relaxations, the number of health centers in France has jumped to reach 2,830 in 2022. This is almost 50% more in four years… Faced with numerous abuses and fraud, in 2023, the legislator has reestablished the obligation of approval for dental and ophthalmological care centers.
Extract from “Health centers: profits on prescription”, a document to see in “Additional investigation” on the 14th March 2024.
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