On the one hand, local elected officials facing severe problems from medical desertification are demanding restrictions on the place of residence of doctors. On the other hand, most presidential candidates refuse to do so.
At the initiative of the Lot-et-Garonne County Council, the Association of Village Mayors, the Association of Mayors and all psy This section issued in February a “solemn appeal” to candidates urging them to commit to a series of “strong and bold” measures to combat medical desertification.
The majority relate to incentives to settle in low-resource areas, support for community initiatives, commitment to internships for trainees in low-resource areas, skill development for allied health professionals or links between regions and medical schools, etc.
But the proposed first measure is laid out on the basis of constraint. It is a matter of preparing a provisional selective agreement, i.e. temporarily retaining the consent of liberal physicians, general practitioners or specialists, for non-grant areas.
For François Dalidouze, mayor of the city of Codecoast (southeast) (Lotes-et-Garonne, 1,000 people), these measures respond to “the priority of life, one of the main points of proximity”, which is not sufficiently taken into account by public authorities and by candidates. He also considers it necessary to condition his support for a candidate on his proactive commitment on the matter.
The single presidential candidate is willing to take action binding on physicians like that suggested in the appeal of these local elected officials: Environmental scientist Yannick Gadot. In fact, he suggests hiring a doctor who doesn’t settle in an area unless he “replaces” another practitioner who has retired. This would amount to banning fixtures in areas where medical deficits are not increasing.
Measuring that “not working”
We asked other candidates among the best in the polls why they wouldn’t propose a binding procedure on the appointment of doctors. Few of them answered(1).
program Republic on the move It does not offer any binding action at the national level. François Brown, a doctor and health adviser to candidate Emmanuel Macron, justifies this choice: “We’ve seen what’s been done elsewhere, especially in Canada, and we’ve found that the restriction doesn’t work.” According to him, setting the terms for the inauguration of liberal doctors “creates” mercenaries, “which are doctors who settle in one place for three or four years and then leave. We can already see it quite a bit. At worst, some might move away from general medicine or go somewhere else as employees.”
However, the “toolbox” that will be given to the regions as part of the “great consultation on health” promised by Emmanuel Macron if he is re-elected, contains a wide range of measures, including restrictions on the installation by financial means. “We are not prohibited from organizing the appointment of doctors but it is a tool among others,” explains his health advisor.
Ineffective and unfair
on the side rebellious Francewhere we also bet on the ‘participatory foundations of medicine’ by department, we consider that restricting the current situation would not make sense because imposing stabilization in one area would be a weakening of another.
However, Jean-Luc Melenchon is not opposed to some form of restriction, but in exchange for helping to fund medical studies: he suggests that in return, he suggests, he helped young medical graduates settle for 10 years in an under-resourced area. Nicholas Dupont Aignan (defender of France) He proposes a roughly similar measure, but for a period of five years.
For his part, the senator, doctor and health advisor said: Socialist Anne HidalgoBernard Gommer also explains that a selective agreement would be “ineffective because there are many potential loopholes, such as wage labour.” He adds that restrictions on installation “will affect installation in liberal, that’s all”.
The spokesperson for the Socialist candidate justifies the fact that she does not rely on installation restrictions either for a second reason: “It would be unfair to young doctors, who are not responsible for this situation”, to force them – indirectly – to settle in areas where they do not wish to live.
Incentive measures, notably financial and regional consultations, familiarization of medical students with life and practice in under-resourced areas, development of a multi-professional practice, or, depending on the candidates, the number of salaried physicians in health centers remains preferred by most applicants.
The Official Gazette contacted the teams of 12 candidates, only 3 responded: La République en Marche, the Socialist Party and La France Insoumise. Back to text