The health homes they are the primary solution to fight against the medical deserts?

Agnès Buzyn, minister of Health, and Edouard Philippe, Prime minister, place Beauvau September 6, 2017. — SIPA

  • Emmanuel Macron promised to double the number of multidisciplinary health centres by 2022.
  • But this response is not a miracle solution, and must be accompanied by many other measures.
  • It must be a global reflection to make it more attractive the job of a general practitioner in the medical deserts.

France has never had as much of doctors, but some jurisdictions are facing a shortage of general practitioners. In the Creuse, near Toulouse, but in Paris also… the challenge of an effective fight against the medical deserts, a problem already crying but that is only going to get worse, deserves an ambitious plan. This Friday, the Prime Minister and the minister of Health, will reveal their tracks in Chalus, Haute-Vienne. But we already know that the government,
who undertakes to keep a campaign promise of Emmanuel Macron, is planning to double the number of care homes multi-disciplinary. Effective ?

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Some health homes empty

According to a Senate report, France had 910 care homes in multi-professional and 334 projects in the course of construction in march 2017… compared to 20 in 2008. A boom will continue, therefore.

And yet, many critics say that these health homes are not a panacea. In fact, some are already empty… Or are desperately waiting for a gp as at Avanton near Poitiers. “The foundation of a house of health, it is the medical project carried out by the doctors or else it will not work “, says Jean-Paul Ortiz, president of the
Confederation des syndicats médicaux français (CSMF), who regrets that some elected officials have built walls without asking the upstream to the doctors.

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Alternatives

Another problem : this kind of structure requires a lot of energy and time to succeed. “The collection of doctors, it should be encouraged but not necessarily under the same roof, passing by a common organization or telemedicine,” says he. Jean-Paul Hamon, president of the Fédération des Médecins de France (FMF), speaks of developing “centres doctors” to share their files, their internal.

“The houses of health, this is not the ideal solution “, slice The Olivier Pennetier, president of the Intersyndicat national internal (ISNI). He advocates instead the development of health centres. “The only difference is that the doctors are employees, they are relieved of all administrative procedures, receive a fixed salary, receive social benefits (maternity leave, illness). Which is quite asked by the young people. Good working conditions, it is a lever to be more effective than financial aid. “.

“There is no miracle solution, it is necessarily a puzzle of proposals it is necessary to take, complete, Jean-Paul Ortiz, president of the main union of liberal doctors. A vision that the minister of Health seems to share : “There is no single solution,” she recalled Wednesday before the Meeting.

Encourage students to come into the area under-dense

So that these walls do not remain empty, and, more generally, that all the French could be treated, the CSMF was proposed this summer a series of proposals that it hopes to find in the ad this Friday. “To improve the discovery of the trade for students, it is necessary to facilitate the placements of interns in these medical deserts “, resumed the president of the CSMF. With including assistance in accommodation, transportation.

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This is a track Royère-de-Vassivière, a village of 2,000 souls from the Hollow, was successfully tested. “The interns have been accommodated free of charge, have received a small bonus and now two of them settled in this region,” says Jean-Paul Hamon, president of the FMF. Who sees it as proof that do find this job rewarding is a prerequisite. For him, the financial incentives should go further to enhance the attractiveness of the profession : “It is necessary that the salary of the internal in these regions to under-dense is doubled, it worked in Corsica and at Belle-ile. Similarly, there need to be supervisors of well-trained and well-paid. “

Installation and maintenance

Second step : the installation. Financial aid for the installation have already been put in place by the previous minister of Health. And according to the Senate report, ” their balance sheet is rather modest because the financial leverage is not decisive in the decisions of installation ; but their legitimacy remains “.

“The watchword for the young doctors, this is team work, it is necessary, therefore, to encourage the grouping in all its forms : liberals, with hospital doctors, general practitioners with specialists, doctors with paramedical staff,” says Dr. Ortiz. “It’s easier to announce a figure for the creation of health homes, but it is a horizontal reflection that it is necessary to launch for “reruraliser” and that does not only concern the ministry of Health “, adds Olivier Pennetier. With blows of thumb to limit the number of guards, and the administrative work, assist the spouse in finding work, schooling for children…

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Finally, some advocates of the tracks to keep the retirees active. “A lot of doctors who reach the age of retirement to stop the death in the soul, they would work a few days a week, but it is financially not attractive, assured the chairman of the first union of liberal doctors. To promote the exercise of the accumulated employment-retirement, he would reduce their contributions. “

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