Tribune. Emergencies closed at night, territories without doctors: the situation has never been so critical for millions of French people, deprived of a medical presence. And never has it deteriorated so quickly, widening the inequalities of access to care between the departments and, therefore, between the French. Our health system, in the hospital as in the liberal, is cracking on all sides.
The solutions that have been designed for years have not produced the expected effects. And how could it be otherwise, when beds have been removed by the tens of thousands in hospitals – under all governments – when working conditions wear down the best-held vocations and when policies, to guarantee medical presence liberal in the under-endowed territories, were limited to financial incentives that were as ineffective as they were costly for the State and communities?
The presidential election must be the moment to reform the contract between the nation, its doctors and its caregivers.
Let us observe: in the country of Social Security for all, inequalities in access to care are no longer bearable. For the 10% of French people living in the least well-endowed territories, it takes an average of eleven days to get an appointment with the general practitioner, and one hundred and eighty-nine days with an ophthalmologist. On condition that the doctor accepts new patients, when yours has retired without being replaced … This average therefore masks another reality: that of the renunciation of care, and of French people without an attending physician. They are legion.
Not only has France lost nearly 7,000 liberal generalists over the past ten years, but it has also allowed concentrations to form in certain territories, and deserts in others. Faced with an emergency, nothing will be possible without new rules for the installation of doctors, as there are also for other health professionals, such as pharmacists. This is the heart of the matter: doctors who are better present and better distributed, it is a pressure which is relieved on emergencies, and working conditions which improve for all caregivers.
Encourage young people from rural areas and neighborhoods to study medicine
There is no miracle solution, but a set of actions that will have to be articulated between them, in the short term and in the longer term. Let us advance new avenues. First, the “selective agreement”: in the areas with the most extensive medical presence, Medicare will not approve the installation of a new doctor until the departure of another. The aim is to stop the worsening of inequalities.
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