This is a first since his arrival at the Elysée. Despite the repeated crises, Emmanuel Macron had never yet presented his wishes to health professionals. Omission which will be repaired this Friday, January 6 since he must address the caregivers in the morning from the Corbeil-Essonne hospital. The opportunity for him to make announcements, eagerly awaited, on his program to rebuild our healthcare system.
But this time, he will need more than words to convince. Access to care is becoming more and more difficult for many of our fellow citizens, there are fewer and fewer GPs and the hospital is cracking up from every angle. Caregivers, on the other hand, have in mind the major announcements of the president or his ministers, too rarely followed by effects that meet the needs and expectations. “During her first interview as minister, Agnès Buzyn said that we had to put an end to the corporate hospital. But the following year, budgets were again placed under the sign of savings, and activity-based pricing weighs almost always as heavily in the financing of establishments”, deplores Professor André Grimaldi, who has long led the sling in defense of the public hospital.
Health personnel also remember, of course, the great speeches of the Covid (“The welfare state is not a burden but an opportunity”, “superior goods must escape the laws of the market”…). Followed by the great disappointment of Ségur, with a Prime Minister who recalls that “the course followed until then was good”, and certainly substantial means, but which are not enough to catch up with several decades of underinvestment.
On the city medicine side, the balance sheet drawn by the liberal doctors is hardly better. Of course, the doctors’ unions are delighted to have succeeded, once again, in convincing the executive to reject any idea of constraint and supervision of their freedom of installation, despite pressure from local elected officials. “The government understood that it was necessary to invest in primary care. We were heard within the framework of the My health 2022 plan, but since then we have been wasting time”, regrets Dr Jacques Battistoni, former president of the union. MG-France. The investments announced for the city come up against budgets that are still constrained, and the National Council for Refoundation is first seen by many as a delaying tactic to push back the deadlines.
Against medical deserts, one of the major measures has been to remove the numerus clausus. But the “numerus apertus” could not push back the walls in the faculties of medicine, and the number of riflemen progressed only slightly. In any case, this will not solve the difficulties which promise to be immense over the next ten years. And already, the Liberals are worried about the legislative projects of the majority, which aim, with the bill of the deputy Renaissance Stéphanie Rist, to “give the possibility to advanced practice nurses and physiotherapists, to work without coordination with the doctor”. One more contradiction between rhetoric and reality…
