2024-02-01 07:00:06
What will the French remember from the Prime Minister’s statements? The regularization of foreign doctors, the on-call obligation for all self-employed doctors, access gateways for paramedical professions and the creation of a “rabbit tax”. Announcements in the form of patches while we wait for a new policy for “rearm our health system”.
Medical deserts and the emergency crisis in fact signify the failure of the “funnel” policy: fifty years of numerus clausus, and now the closure of thousands of hospital beds, threaten to explode emergency departments and dry up a little more medical deserts.
By deciding, in 1971, to limit the number of doctors, decision-makers wanted to reduce the number of “expense prescribers”: the doctors trained each year thus fell from 9,170 (in 1977) to 3,500 (in 1993). But as savings were slow to come, in 1987 doctors were encouraged to retire as early as possible, from the age of 57: this was the “mechanism to encourage cessation of activity”, a “stripping-off bonus” like called by some. Faced with the manifest error of this decision, there was a 180-degree change of course and encouragement to continue their exercise with “combination of employment and retirement”.
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Beyond its ineffectiveness in containing costs, at the cost of a collapse in access to care and the creation of medical deserts, the numerus clausus has had considerable consequences. There are tens of thousands of students excluded from the medical profession through an “educational butchery”, filmed by Thomas Lilti in First year (2018). Let us count the families who had to pay thousands of euros for parallel preparation at the university, or even for studies abroad. There are thousands of foreign-qualified doctors, both within and outside the European Union, recruited to fill vacant positions. The recent Rist law, limiting the price claims of replacement doctors, has dried up this pool of “mercenaries” who allowed hospitals to fill the shortage of doctors.
Misleading numbers
The abolition of the numerus clausus with a return to the numbers prior to its creation is seen as a victory; yet the current demand for care is not comparable to that of 1971. The French population has increased by around 15%, or several million people. It has aged, leading to an explosion in the number of people with chronic and multiple illnesses, these “hospital-requiring” patients. Other requests have exploded, such as the use of state medical aid, always discussed in a controversial and financial manner but never in terms of care, number of surgical interventions, consultations or acts performed – this that is to say regarding the number of health professionals mobilized to carry out these new procedures.
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