2023-05-14 12:00:00
Difficult to miss with its bright red color. In the multi-professional health center Simone Veil, in Mazamet (Tarn), the logo of the regional council of Occitanie is everywhere. At the entrance to the very recent establishment, a plaque indicates that this nursing home is part of the “My Health, My Region” scheme. Like this one, a dozen other health centers are currently completing the system in the region, in Ariège, Haute-Garonne, in the Hautes-Pyrénées, the Lot or even the Pyrénées-Orientales. “We have created a public primary care service. It is a political choice because our community has no competence in health and this action has the main aim of fighting once morest medical deserts “, presents Vincent Bounes, vice-president of the regional council in charge of health and director of Samu in Toulouse. An initiative led by the Public Interest Group (GIP) “My Health, My Region”, which brings together the community, the councils of the order, faculties, unions, etc. This consortium aims to install at least 200 general practitioners and nurses in Occitania, by the end of the mandate in 2027, as employees of the regional community. A first that the Center-Val de Loire Region is also trying to implement. Almost two years following the last regional elections, there are already around thirty of them in office, like Saïd Tamar in Mazamet, a town which saw its hospital shut down a few years back. “For 30 years, I worked as an emergency doctor at Castres and Mazamet hospitals. I was tired of the guards and the difficult working conditions in the hospitals. I even considered taking early retirement. Then the mayor of the city, who was looking for general practitioners to replace those who had retired, suggested that I join the system and become a salaried doctor. It’s much easier to work here and now I also want to have free time for myself”comments the 62-year-old practitioner.
An offer all inclusive
To understand, you have to know that through the GIP the regional council offers doctors ideal working conditions in their eyes: a medical secretariat to discharge administrative tasks, fixed hours with a 39-hour contract per week, the provision of a room equipped with the necessary equipment and a fixed monthly remuneration. And despite this tempting offer, according to the community, finding candidate doctors to settle in the medical deserts is not easy. “The fact that it is an offer all inclusive and working in a team is something that all the same appeals to candidates for employment. Their only constraints are to commit to home visits and take part in on-call duty, all in an organized manner. But today, the new generations of doctors no longer want to spend all their time at work. As proof, in number of acts, when a general practitioner retires, it takes two young doctors to carry out the same workload. analyzes the regional elected official, who is currently living his first experience as a politician. In the case of Saïd Tamar, he receives approximately three to four patients per hour, over eight-hour consultation days, off-call and home visits. “I really appreciate the contact and the closeness that I can have with the patients. In the hospital, you see a patient once and you never see him once more, unless he is hospitalized and it all depends on which department. Here, the doctor and the patients form a family. We support them throughout a chronic illness, for example. We are there above all to help people and not to make numbers. I like it “, he comments. While a general practitioner, who is currently completing his thesis, must also settle next May in this medical office financed by the public authorities, the former emergency doctor believes that four doctors would be ideal for Mazamet in order to respond to the the entire demand of the basin, without competing with its independent counterparts. “Ideally, there should be six salaried doctors in the health center in order to offer weekend hotlines without exhausting themselves”even projects Olivier Fabre, the mayor of Mazamet. “Today, we have a dozen general practitioners, liberal and salaried alike, so we are rather well off. But before the area facility opened, we had red flags with aging medical demographics,” he adds. For him, enough general practitioners in a municipality also makes it possible, by ricochet effect, to unclog emergencies and detect major diseases more quickly.
100 candidate territories
In the past, Olivier Fabre even tried to hire doctors from the municipality to satisfy his ambitions, “but the legislation to get there is a gas plant”, he acknowledges. This will of the mayor and his municipal team is partly linked to a significant demographic attractiveness since the first confinement, with many new arrivals from the Paris region and the South-East. “The new residents might not find a referring doctor because the doctors in the city who had settled there were saturated”, remembers the mayor who therefore seized the opportunity offered by the regional council through its GIP. To have the chance to host a nursing home through the latter, in addition to medical demography, interested municipalities must demonstrate a certain voluntarism by applying through calls for expressions of interest (AMI). “A hundred territories responded to the first AMI. We have enough records for the next three years without a problem,” comments Vincent Bounes, who is aiming for an average of ten nursing home openings each year in Occitania. Another condition, each center must bring together at least two general practitioners to establish this concept of teamwork and above all, the regional council leaves three years to each center to find its financial balance. In the event of a persistent financial hole, it is the communities that will have to make up for the operating losses. “A third will be supported by the Occitanie region, another third by the departmental council and a final third by the municipality”, says Olivier Fabre. A financial risk that is of interest. In 2023, the “Ma Santé, Ma Région” GIP should already pass the milestone of 100,000 consultations provided by its practitioners, compared to 25,000 at the start of the year. But this rise in power has a cost: 8 million euros of budget, once morest 1 million in 2022, at the expense of the regional council. “We should quickly reach several tens of millions of euros per year”, projects Vincent Bounes. According to the boss of Samu 31, a third of general practitioners in Occitania are over 60 and will therefore retire in the coming years. Symbol that this budget is necessary and that its release becomes an emergency.
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