The deputies examine a text submitted by the deputy Frédéric Valletoux (Horizons), who does not wish to affect the freedom of installation of doctors.
Regulate for better care. The deputies must examine, Monday, June 12, a bill of the deputy Horizons of the Seine-et-Marne, Frédéric Valletoux, “aiming to improve access to care through the territorial commitment of professionals”. The text, supported by the majority and the government, proposes several remedies against medical deserts, including increased use of private clinics, but does not plan to force caregivers to settle in territories poorly endowed with medical personnel.
> > Installation of doctors: demagogic for practitioners, necessary for politicians… We explain to you why regulation is a subject of debate
The examination of the text will however give the PS deputy Guillaume Garot the opportunity to defend the use of this more radical lever, via amendments. The elected representative of Mayenne launched a tour of France of medical deserts several months ago and brought together more than 200 deputies around a transpartisan text.
Franceinfo summarizes for you what the text carried by the majority contains.
An incentive to settle in medical deserts for young doctors
Article 5 of the bill aims to encourage young doctors to settle in under-resourced areas, by opening a “public service contract (CESP) for all students in medicine, odontology, midwifery and pharmacy, at the end of the second year of the first cycle of health studies”. This CESP provides for the possibility of granting medical students “a monthly allowance in return for a commitment to practice for a minimum of two years in a given territory after the end of their training”.
The bill does not mention any obligation to settle in under-resourced territories for doctors. “I will be in favor of it the day we [aura] actually large numbers of caregivers at dispatcher, to be installed on the territory. Distributing the little medical force we have differently will not make any territory rich in doctors.”justified on franceinfo, Monday, Frédéric Valletoux.
During the debate in the Social Affairs Committee, the subject was not directly addressed, but deputies, led by the socialist Guillaume Garot, tabled an amendment to limit the freedom of installation of doctors: in the best provided areas , a doctor could only settle if he replaces a colleague who moves or retires.
Greater involvement of private clinics in the continuity of care
Frédéric Valletoux, former president of the French Hospital Federation (FHF), also wants doctors in private clinics to participate more in night and weekend call duty. In all, “87% of the permanence of care is provided by the hospital, 13% by the private sector. I am not saying that the private sector does nothing, but we must rebalance between public and private”, pleads the elected official on franceinfo. Thus, article 4 of the bill intends “make effective the compulsory participation in the permanence of care for all”. To do this, he “provides the possibility for the Director General of the Regional Health Agency to call on public and private health establishments to contribute to the permanence of hospital care”without giving further details.
Asked about a possible reinstatement of on-duty obligations for city doctors, when only 40% of professionals participate, Frédéric Valletoux believes that it is necessary “raise this figure”, while remaining “on a voluntary basis”. “Anything coercive creates tension. This reform, like all health reforms, will only succeed if we manage to bring professionals with us”explains the MP.
Automatic registration of caregivers to a territorial health community
Section 3 offers to automatically link, “unless opposed”, all health professionals to the professional territorial health communities (CPTS), these administrative structures supposed to facilitate their coordination to organize care. Until now, caregivers have the freedom to join or not.
Facilitating the practice of foreign doctors
While the immigration bill intends to create a specific residence permit for health professionals, article 9 of the bill brought forward by Frédéric Valletoux intends “facilitate the exercise of foreign doctors, called practitioners qualified outside the European Union (Padhue), on national territory”. To do this, the article “creates a temporary authorization to practice in a health establishment, in a medico-social or social establishment, public or private non-profit”. In connection with article 9, article 10 “proposes the creation of a new multi-annual residence permit ‘talent-medical professions and pharmacy’, to meet the need to recruit these qualified personnel in health establishments”.
The ban on temporary medical work at the start of a career
Finally, the text provides for more strictly regulating temporary medical work, whose salaries have been capped since April, by prohibiting it at the start of their career for certain caregivers. A measure dear to the executive, fished out after the censorship of the Constitutional Council, which had deemed it inappropriate in the last Social Security budget.