Regulating the establishment of doctors: resumption of debates in the Assembly on an inflammable text

Debates are resuming in the Assembly on a proposed law against "medical deserts" , supported by local elected officials and patient associations, but opposed by doctors opposed to its flagship measure: the regulation of their establishment on the territory.

The deputies will resume their work on the first reading this Tuesday or Wednesday on this largely cross-party text - more than 250 co-signatories ranging from LFI to nearly a third of the LR group - but inflammatory.

Launched in 2022 by socialist Guillaume Garot, the cross-party group succeeded in early April in having the key article regulating the establishment of doctors in the territory adopted.

This broad vote (155 against 85), but with a limited number of MPs, makes it difficult to predict the final vote, probably on Wednesday. It will depend a lot on the mobilization approaching a long weekend.

Before setting up, private or salaried doctors would have to seek approval from the Regional Health Agency. This would be a legal requirement in an area lacking healthcare professionals, but in more well-supplied areas, doctors would only be able to set up when another doctor leaves.

A "territorial indicator" taking into account "medical time available per patient" and "the demographic, health and socio-economic situation of the territory" would be used to target regulation, which would potentially only concern "13% of the territory" according to its supporters.

A "cornerstone of any truly effective policy," insists the cross-party group. But a casus belli for many doctors, particularly medical students and interns, who demonstrated at the end of April .

"It is not the freedom of establishment that jeopardizes access to care" but "the structural shortage of doctors (and the) lack of attractiveness of the private sector," according to a press release from the Young Doctors union on Monday.

On the contrary, more than 1,500 local elected officials called on Sunday in La Tribune to vote for the text in view of the "strong expectations" of their constituents.

The cross-party group argues that regulation and increasing the number of doctors must go hand in hand. This is true of the other articles they will be defending this week: notably, those that eliminate the increase in co-payments in the absence of a primary care physician and reinstate the obligation to participate in on-call care.

If adopted by the Assembly, the text will have to continue its journey to the Senate, finding space in the calendar, probably starting in the autumn.

And without the support of the executive, which is hostile to regulation, he is putting forward his own plan, including the flagship measure announced by Prime Minister François Bayrou, which would require practitioners to hold up to two days of consultations per month in priority areas.