A few days before the first round, many French people are still hesitating on their ballot.
Health is one of their main concerns.
It is therefore not surprising that the candidates almost all offer ways to better respond to the problem of medical desertification.
Modify medical studies to force or encourage young doctors to settle in under-dense areas, multiply nursing homes… Here are some leads, which researcher Henri Bergeron analyzes for
20 Minutes.
No more gynecologist, ophthalmologist, dentist or general practitioner for miles around.
The problem of medical deserts is affecting more and more French people, whether they live in rural areas or in large cities.
According to the latest figures from the Research, Studies, Evaluation and Statistics Department (Drees), published in January 2021, 8% of the population lives in a municipality that is under-dense in general practitioners, that is- that is to say that each inhabitant will only be able to carry out 2.5 consultations per year.
An already complicated access to care which is likely to worsen in the coming years with the aging of the population, the lasting lack of general practitioners and the ever more common chronic diseases.
This is why, unsurprisingly, the fight against medical deserts is one of the very prominent health topics in this presidential campaign.
To see more clearly,
20 Minutes
summarizes the candidates' proposals.
And their limits.
A priority for all candidates
"Before, health was the big invisible thing in the campaigns, introduces Henri Bergeron, director of research at the CNRS and Sciences Po. If all the candidates mentioned it, it was clearly not a subject on which the political offer was positioned. and on which the votes were structured.
We got a lot more attention in this campaign.
And one of the entry points is the medical deserts, which refer to the existence of at least two Frances.
However, this local France refers to many very important questions, raised in particular by the "yellow vests".
»
“Health was one of the priorities in the notebooks of grievances of the “yellow vests””, adds Frédéric Pierru, sociologist at the CNRS.
Precisely, to answer this big question, all the candidates have worked on proposals to attract young doctors to these under-dense areas.
For or against freedom of establishment for doctors?
If there is indeed a dividing line, it is the freedom of establishment of doctors.
Until today, young practitioners, after their internship, can choose where they want to practice.
Some candidates think that this possibility should be reconsidered.
Yannick Jadot (EELV) wishes to impose the exercise in areas lacking doctors for three years: during the last year of internship and the first two years of activity.
Moreover, after these years, doctors who would like to settle in territories that are already well provided for could only do so on condition that a liberal does not retire or move to another region.
This last track is taken up by Fabien Roussel (PCF).
Jean-Luc Mélenchon (LFI) goes further.
For him, it is necessary to increase the salary of the interns, so that he reaches the Smic… provided that these medical students work for ten years in the medical deserts.
I want everyone who studies to have an income and be involved in the community.
Example: I am in favor of paying for medical studies but that trained doctors owe the State 10 years to fight against medical deserts.
#FaceaBFM pic.twitter.com/o2uBTqNAX5
— Jean-Luc Melenchon (@JLMelenchon) November 12, 2020
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For her part, Anne Hidalgo (PS) wants to create a new status, that of “assistant doctors”.
The last year of internship would be replaced by a year of professionalization in the medical deserts, paid twice as much as today.
A track similar to that of Valérie Pécresse (LR), who wishes to create an additional year for the boarding school of future general practitioners in a medical desert, in order to create 4,000 "junior doctors of general medicine" by 2025.
Other candidates rely on compensation rather than coercion to attract new health professionals to these areas.
Thus, Nicolas Dupont-Aignan wants to organize advanced consultations of general practitioners and specialists from well-equipped areas to under-medicalized areas, provided that operating and transport costs are covered.
In addition, he plans to create a scholarship for medical students, in exchange for which they will undertake to settle in an under-resourced area during their first five years of practice.
Jean Lassalle proposes a similar idea: the State would pay the studies for the doctors who undertake to remain six years in the medical deserts.
Marine Le Pen (RN) wants to modulate the remuneration of the consultation according to the place of installation.
Which does not convince Frédéric Pierru.
“Today, medical deserts are widely mapped and objectified.
If the financial incentives worked, we wouldn't be here!
»
Eric Zemmour (Reconquest!), He suggests hiring 1,000 doctors urgently by the State, in order to send them as employees in the medical deserts.
Multiply the health centers
Emmanuel Macron has succeeded in doubling the number of nursing homes, to just under 2,000.
But several candidates want to go further….
Marine Le Pen proposes to increase their number and to provide them with the means to treat “minor emergencies”, such as minor fractures, in order to unclog hospitals.
Jean-Luc Mélenchon wants to create networks of public multidisciplinary health centers linked to public hospitals.
Philippe Poutou, for his part, wishes to create “public and free, multi-purpose health centers, financed by the Sécu, which would work in conjunction with liberal doctors, occupational medicine, school and university medicine, social workers, elected officials, associations, unions.
»
For his part, Eric Zemmour speaks of “local hospital services in medical deserts”, so that the French can have access to maternity, chemotherapy services, palliative care, screening and dentists everywhere.
Nathalie Arthaud (Lutte Ouvrière) wishes to impose the reopening of local health establishments (maternities, clinics, health centers, etc.).
Broaden the skills of paramedics
A third part of these proposals proposes to give new skills to paramedics and pharmacists to relieve doctors.
Emmanuel Macron has announced that he wants to create "referent" pharmacists and nurses, who could renew prescriptions.
It also wishes to generalize the deployment of subsidized salaried nurses in the least endowed areas.
Valérie Pécresse wants to strengthen the advanced practices of nurses and the delegation of tasks for midwives, with an increase in their salary as a result.
As for Jean-Luc Mélenchon, he aims to create salaried positions for advanced practice nurses in health centers and to allow midwives to prescribe drugs.
If this question of complementarity between caregivers seems essential, Henri Bergeron underlines that few candidates insist on the links between the actors of prevention, the city medicine, the hospital, the medico-social (disability, Ehpad)... Even if the multidisciplinary health centers and professional territorial health communities (CPTS) are moving in the right direction.
“With the health crisis, we insisted a lot on the question of the hospital.
In other countries, community medicine had an official regulatory role.
The pandemic has shown the difficulty of communication between these different subsystems of our health.
»
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Health
Medical Deserts
Presidential election 2022
Presidential Program 2022
Emmanuel Macron
Valerie Pécresse
Anne Hidalgo
Jean-Luc Melenchon
Eric Zemmour
Marine Le Pen
Elections
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