The freedom of installation of doctors is again debated in the National Assembly
He missed three small voices. On March 26, in an electric atmosphere, the National Assembly Committee of the National Assembly rejected an article aimed at regulating the installation of doctors.
In other words, to ensure that more doctors go to exercise in very poorly endowed areas. Even if the article concerned could return to public session in early April, the episode says a lot. The idea of stinging, in one way or another, the installation of general practitioners and specialists has haunts the hemicycle for fifteen years, and recently still in 2022, 2023, 2024.
An authorization issued by the ARS
Costed by 256 deputies from all the parties, with the exception of the national rally, the article of the law presented by Guillaume Garot, socialist, provides for the establishment of an authorization prior to the installation of doctors, issued by regional health agencies (ARS).
“The authorization would be automatically issued if the doctor was settling in an under-to-do area. And in the case of a sufficiently endowed area, it would be subject to stopping the activity of a doctor practicing the same specialty, “explains Guillaume Garot, who has chaired a transpartisan group of deputies on medical deserts since 2022.
A regulation already applied in Europe
In short, an indirect constraint, but a constraint anyway. Next to the reserve that 87 % of French territory lacks practitioners: in a large majority of cases – with the exception of very coveted places – doctors would therefore see their wishes for satisfied installation.
In addition, this type of regulation already exists in France for other health professions-midwives, physiotherapists, liberal nurses, pharmacists and, since January 1, dentists. For doctors, several European countries are already applying it: Germany, Denmark, Scotland, etc.
Opposition of professional unions
Even though the incentive measures, especially financial, have proven their limits and that the “positive impact” of regulation has been demonstrated by the ministerial statistical service of health (1), the project continues to tense doctors. “He goes against our fundamental right to exercise freely,” pleads Dr. Denis Pezain, generalist in the East.
Professional unions are unanimously standing, denouncing the resulting lack of attractiveness. Health manager at theUFC-Que Choisirmagazine that has been mobilizing for ten years against the health fracture, Théau Brigand points out “a dramatization of doctors on this subject”.
41 deputies are doctors or surgeons
But as practitioners enjoy a certain electoral weight, governments of all sides do not want to dissatisfy them. They have a “sympathy capital and a local anchoring”, adds Professor Emmanuel Vigneron, specialist in health planning.
They are also over -represented in the Assembly, where 41 doctors and surgeons sit … 16 farmers (2). Shortage of professionals obliges, the balance of power is in their favor. For how long?
(1) DREES, Statistics department of the Ministry of Health, file n ° 89, Dec. 2021.
(2) National Assembly, list of deputies by CSP.
