The six representative doctors’ unions have until Tuesday to say whether or not they accept the new price list for consultations and aid and other packages offered by Social Security for five years.
They are unanimous in criticizing the largely conditional increase proposed by the “Secu” to increase the supply of care.
The proposal made by the director general of the Cnam (National Health Insurance Fund), Thomas Fatôme, provides that all medical consultations would be upgraded by 1,50 euro.
For general practitioners, this unconditional revaluation would bring the basic consultation to 26.50 euros, against 25 euros since 2017.
Practitioners agreeing to take “territorial commitments” would obtain a higher consultation rate, 30 euros for example for generalists.
Ces “territorial commitments” plan to reach a minimum level of patients or hire a medical assistant, as well as a mixture of criteria, including participation in guards, openings on Saturday mornings or exercise in medical deserts.
Key role of MG France
“I believe” that the government and the Cnam “have crossed out the signature” of an agreement by the doctors, declares Jérôme Marty, the fiery president of the UFMLS union, who is calling for an unconditional increase and a consultation at 50 euros for all GPs.
Doctor Marty is now waving the threat of a deconvention many doctors, wishing to regain their tariff freedom.
The draft agreement “despise doctors” while“we can’t take it anymore” because of too high a pace of work, fumes for her part Agnès Giannotti, the president of MG France, the largest union of general practitioners.
“When the government says that we do not “commit” to deal with the lack of practitioners, “this makes general practitioners furious”, which “on average 55 hours per week“she adds.
MG France plays a key role in the outcome of the negotiations: with 36.58% of the votes in the last professional elections, the union alone has the power to validate the agreement on behalf of the general practitioners.
Two other doctors’ unions, together, could make it possible to win the decision among GPs, but this hypothesis is very unlikely, as the opposition is often even stronger among them than among GPs.
“Until the end”
The latter will consult his authorities during the weekend, but “there is little chance” that there is a vote favorableadvances Agnès Giannotti.
If the draft agreement is not approved on Tuesday evening, it will be up to an “arbitrator” to prepare the new price list.
Former inspector general of social affairs, Annick Morel will not be required to rely on the current state of negotiations to prepare her copy, at the risk therefore for the doctors of having dropped the prey for the shadows by refusing to sign the Cnam proposal.
In 2010, a medical agreement drafted by an arbitrator had applied for a year, before a new agreement was successfully negotiated with the unions.
In a last effort to convince, Thomas Fatôme recalled on Friday that the draft agreement meant 1.5 billion euros of additional expenditure for the Social Security budget, including 600 million for non-conditional measures and 900 million for measures linked to commitments on the care offer.
“What we offer must meet the expectations of both sides of the table”to know “the socially insured who have concerns about access to care, and the doctors who need to be accompanied” in their efforts, he told reporters on Friday.
“That’s why we will try to push to the end to try to convince our partners to sign”.