Budget, emergencies, shortage of doctors: the pending files at Health

2024-09-22 07:38:11

Financing of social security, drained emergency services, medical desertification, caregivers who are giving up their scrubs: the new Minister of Health Geneviève Darrieussecq has immense challenges ahead of her and an ever-tightening budget.

– EMERGENCIES

Partially eclipsed this summer by the Olympic Games, the chronic asphyxia of emergency services continues.

Staff shortages, lack of downstream beds in the departments to absorb the incoming flow, appointments impossible to find in the city: patients are piling up on stretchers and caregivers are exhausted. By the summer of 2023, one in two departments had had to close at least once during the summer, according to Samu urgences de France.

According to a barometer from the French Hospital Federation (FHF), 46% of establishments believe that the emergency situation has not improved in 2024, and 39% that it has deteriorated.

Various methods have been put on the table: strict filtering of patients via 15, implementation of the SAS, improved Samu associating city medicine, revaluation of night and weekend shifts. Without managing to stop the hemorrhage.

– Medical deserts

Another hot topic: medical desertification and inequalities in access to care, which are the cause of a feeling of abandonment among many French people.

The previous executive branch engaged in a movement of delegating medical tasks to other caregivers (nurses, midwives, pharmacists, etc.) to regain medical time. Two laws have been passed but some implementing decrees are missing.

The dissolution also put a stop to expected reforms, such as the overhaul of the nursing profession (AFP/Archives – PATRICK BERNARD)

The dissolution also put a stop to expected reforms, such as the overhaul of the nursing profession.

Experimenting with direct access to specialist doctors, sanctions for patients who do not honor their medical appointments, increasing the number of medical students: Matignon has made many promises, many of which have yet to be fulfilled.

Other ideas are potentially flammable, such as the one defended by the left, to regulate the installation of doctors on the territory, a red rag for those concerned.

– Deficit

The cost of healthcare is increasing, particularly due to the ageing of the population, but it is not being financed. The deficit in the health branch of Social Security is expected to widen to 11.4 billion euros in 2024, with no prospect of improvement.

The pressure of inflation in health spending is not only being exerted on Social Security, but also on supplementary health insurance, which continues to sound the alarm… and increase their contributions (+8.1% in 2024, according to Mutualité française).

Between belt tightening and growing needs, the Social Security budget for 2025, the preparation of which has already been delayed due to the political crisis, will be a squaring of the circle.

– Foreigners

The new minister must also decide on the sensitive issue of State Medical Aid (AME), a system that has covered the health expenses of foreigners who have been in an irregular situation in France for three months. Widely defended on the left, AME is castigated by the RN and the right, which has already tried to eliminate it via the immigration law at the end of 2023.

Before being appointed Prime Minister, Michel Barnier himself advocated for its abolition.

The outgoing government had also planned to revamp the hiring procedure for doctors with foreign qualifications (Padhue), who work in hospitals under precarious conditions.

– End of life

Introducing assisted dying into law was one of the major societal issues supported by Emmanuel Macron (AFP/Archives – Pascal POCHARD-CASABIANCA)

Introducing aid to die into law was one of the major societal issues supported by the President of the Republic Emmanuel Macron. The executive will have to take charge of the bill, presented to the Council of Ministers in April but left pending since then. The RN deputies are mostly hostile to it.

– Psychiatry

Emmanuel Macron’s promise to treat the dilapidated psychiatric sector, a CNR (National Refoundation Council) on mental health was to be organized this summer, while two million French people are treated in psychiatry each year and the prevalence of anxiety disorders is exploding. It was finally canceled by the dissolution.

– Drugs

In a context of drug shortages and efforts to defend health sovereignty, the future executive will have to manage a sensitive issue: the split of Sanofi’s non-prescription drugs division, which includes the very popular Doliprane.

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