2024-11-02 06:00:00
The Minister of Health and Access to Care, Geneviève Darrieussecq, at the National Assembly, in Paris, October 28, 2024. JULIEN MUGUET FOR “LE MONDE”
If there is a widely repeated attack in the ranks of the oppositions during the examination of the Social Security financing bill (PLFSS) for 2025, which continues in the National Assembly until a solemn vote scheduled for November 5 is that of the absence of structural measures in the face of a healthcare system in crisis. “There is a word that never appears: “medical desert”. It is the unthought, the invisible of your PLFSS”declaimed the socialist deputy for Essonne Jérôme Guedj, at the opening of the discussions, Monday October 28.
For several weeks now, several proposals have been re-emerging in the debates, in circles of the medical community and beyond, raising the sensitive question of the constraints on the installation of doctors to fight against medical deserts. This red flag for the profession, defended by a certain number of elected officials in the Chamber, has always been dismissed during the two mandates of President Emmanuel Macron.
On the benches of a very divided Assembly, it was from the right that several amendments to the PLFSS in favor of regulation of the installation of doctors came. Such as the one tabled by the deputy for Côtes-d’Armor, Corentin Le Fur (Les Républicains), defending the creation of an authorization for the installation of doctors in areas deemed sufficiently provided, conditional on the departure of a practitioner. They will not be the subject of a debate since they have been declared inadmissible, because they are considered “social cavalier”, unrelated to the PLFSS.
“This subject deserves a text in its own right”
The proposal echoes that, put forward for a long time, by the socialist deputy Guillaume Garot (Mayenne), with a transpartisan group, rejected during the examination of the Valletoux law on access to care, in winter 2023. This group was reconstituted after the dissolution of the National Assembly in June and now brings together nearly a hundred parliamentarians from all groups – except the National Rally. He has just put the finishing touches on a proposal including this same measure. “This subject deserves a text in its own right to be debated as quickly as possible, rather than an amendment to the PLFSS”defends the left-wing deputy, who is targeting the window of the beginning of 2025, as part of the week of the National Assembly, devoted to proposals from deputies.
On the government side, the tone seemed surprisingly open among the Minister of Health, Geneviève Darrieussecq, on this explosive issue. On France Culture, Saturday October 26, she threw a wrench in the pond, without warning: by referring to dentists, who adopted a regulatory measure a year ago (one arrival for one departure) in areas deemed over-endowed (the application is planned for 2025), the former Landes MP passed the buck to the doctors. “Maybe the Order [des médecins] could bring a point of regulation in over-equipped areas, in any case so that there is no inappropriate installation. »
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**Interview with Dr. Geneviève Darrieussecq, Minister of Health and Access to Care**
**Interviewer:** Thank you for joining us today, Minister Darrieussecq. The issue of “medical deserts” has once again come to the forefront during discussions on the Social Security financing bill. Why do you think this topic has become so prominent at this time?
**Dr. Geneviève Darrieussecq:** Thank you for having me. The issue of medical deserts is critical for ensuring equitable access to healthcare across France. As highlighted by Deputy Jérôme Guedj, the lack of structural measures to address these deserts is concerning. The ongoing debates reflect a growing recognition of the urgent need to tackle this issue.
**Interviewer:** Can you elaborate on the government’s stance regarding the installation of doctors in underserved areas?
**Dr. Geneviève Darrieussecq:** The government acknowledges the challenges faced by regions classified as medical deserts. While there have been proposals regarding the regulation of doctor installations, our policy has focused on encouraging voluntary practice in these areas through incentives, rather than imposing restrictions. We believe in fostering collaboration and creating an attractive environment for healthcare professionals.
**Interviewer:** Some opposition deputies have called for specific regulations, like those proposed by Deputy Corentin Le Fur, to condition the installation of doctors. What is your response to such proposals?
**Dr. Geneviève Darrieussecq:** While I understand the concerns driving those proposals, we must be careful not to create barriers that could ultimately discourage doctors from practicing in any area, including those already underserved. We believe that incentives and support strategies are a better approach. However, I do agree that a more comprehensive legislative framework is needed to address these issues systematically.
**Interviewer:** With the PLFSS vote approaching, what do you hope to see emerge from these discussions about healthcare accessibility?
**Dr. Geneviève Darrieussecq:** My hope is that we can foster a constructive dialogue that leads to innovative solutions for healthcare access. It’s clear that the issue of medical deserts needs to be addressed head-on, and I am committed to finding relevant measures that will ensure all regions in France have access to quality healthcare.
**Interviewer:** Thank you, Minister Darrieussecq, for sharing your insights on this important issue.
**Dr. Geneviève Darrieussecq:** Thank you for having me. Let’s continue working towards a healthcare system that serves all citizens effectively.