Medical deserts: the Senate and the government agree to regulate the installation of doctors

After the adoption of a first text by the deputies which provoked a wave of protest among doctors , the senators debated a second bill aimed at facilitating access to care, Tuesday May 13. On this occasion, the Senate, with a right-wing majority, and the government agreed to adopt two "complementary" measures: the first aims to supervise the installation of doctors, the second to organize their "solidarity" towards medical deserts, a flagship measure of the "pact" proposed by François Bayrou.

Just days after the Prime Minister presented a plan to strengthen access to practitioners, his proposals are taking shape in Parliament, through a bill from Republican Senator Philippe Mouiller. The bill is expected to be adopted this evening before being sent to the National Assembly. This text competes with a much more coercive bill adopted last week by MPs, at the initiative of Socialist Guillaume Garot, despite government opposition.

The main government measure, which has received a rather cool reception from doctors, aims to establish a "mandatory territorial solidarity mission" , i.e. requiring all doctors in well-served areas to work in priority areas of the territory, up to two days per month . This measure, proposed by the government by way of amendment, was adopted by the Senate on Tuesday.

But many have criticized the vagueness surrounding its implementation: financial penalties, the scope of under-populated areas, replacements in offices, etc. The details must be clarified by decree.

This "emergency mission" must be coordinated with a mechanism of senatorial origin that will target the installation of doctors and which will also be specified by decree. The Senate's idea is to make the installation of general practitioners in well-supplied areas conditional on their practicing part-time in an area with a shortage of caregivers, via a secondary practice for example.

For specialists, setting up in a well-supplied area would be conditional on leaving in the same specialty, with an exemption if the specialist agrees to also practice part-time in an area affected by difficulties in accessing care.

It should be noted that in this scenario, the newly appointed doctor will not be required to participate in the "solidarity mission" proposed by the executive. "Balanced supervision of the facilities will make doctors more responsible and reduce inequalities in access to care," argued Republican Senator Corinne Imbert, rapporteur of the text.