Faced with medical deserts, these elected officers make the guess to pay the caregivers | EUROtoday

On Apr 10, 2025

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“C‘is really a comfort and safety to be able to come and see your doctor here, especially at my age! Cécile, retired, patiently awaits her turn in the waiting room of the Saint-Hilaire-de-Brethmas health center, a town of 4,700 inhabitants at the gates of the Cévennes, in the Gard. Cécile was, until recently, consult her doctor in the neighboring town of Alès. “But he retired. »»

From now on, she will go immediately, very near her home, within the previous city corridor of the city, whose floor flooring has been reworked right into a well being heart. Three medical doctors and a midwife, one full-time, the others part-time, have obtained, for the reason that opening, in June 2023, practically 3,000 sufferers.

“In 2018, we had only one doctor in the town,” says the mayor, Jean-Michel Perret. “We wanted to create a dispensary. And then the Occitanie region launched its plan to recruit doctors. So I said: we’re going, we go for it! »»

“We only work 35 hours per week”

The town paid to the pot: “It comes back to 85,000 euros per year, which is not trivial. But once the subsidies of the Regional Health Agency and the payments of the Société are deducted, the region takes three -quarters of the rest. The doctors met are delighted. “I have been replacing for ten years,” smiles Adrien Lamidieu, a forty -something man who lives in a neighboring village.

Being an employee doctor suits him: “We only work 35 hours a week, we are in a team, and there is no administrative heaviness. All for a monthly salary of 4,700 to 6,400 € net. His colleague Charlie Nogrel, 71, a long time a city doctor in liberal, also appreciates combining his retirement with one day of work per week in the structure. “We can follow patients, and we are free to choose our working time. »»

“When the state does not do so, the regions stick to it”

Health centers in under-to-do areas, such as that of Saint-Hilaire-de-Brethmas, the Occitanie region has opened no less than 23 since 2023, from Hautes-Pyrénées to Gard, passing by the Lot and the Tarn. One hundred doctors have already received more than 30,000 patients there, and they will be 200 salaried practitioners by the end of the mandate in 2028.

The community also finances health homes, where doctors exercise in liberal, and posts of clinical leaders in hospitals far from metropolitan areas. “Health is not a jurisdiction of the region,” said the PS president of the Occitanie region, Carole Delga.

“But when the state does not do so, the regions stick to it. Other regional communities, such as Auvergne-Rhône-Alpes or Center-Val de Loire, have also embarked on the hiring of salaried doctors to combat medical desertification.

Read too Do you have to force doctors to settle in medical deserts? They take advantage of a “legal vagueness, which allows us to recruit doctors, via a public interest group”, explains the president of the regions of France. In Occitanie, the Region acts in concert with the Regional Health Agency, three departments and 32 municipalities and inter -municipalities members of the GIP “Ma Health, Ma Région”. Fourteen million euros will be mobilized in 2025, including three in the region.

“What costs the most expensive is the opening of the center,” explains Vincent Bounes, vice-president delegated to health and the fight against medical deserts. Most of the operating costs are then provided by health insurance. Doctors hired, like those met in Saint-Hilaire, seem to find their account.

But the region acknowledges that encouraging practitioners to settle in rural areas is not always for self -evidence. “Many have urban origins,” admits the president of the Occitanie region. “So you have to boast their living environment for them, the fact that there is access to culture, that there is the possibility of quickly reaching the big city, that there is a quality high school, a work for the spouse …” On the region site, more than twenty job offers are still waiting to be provided.

A law to regulate the installation of doctors

Do we then have to force doctors to settle in the most remote areas? This is the meaning of a transpartisan bill carried by 255 deputies, led by the elected PS of Mayenne Guillaume Garot, whose article 1^erthe most sensitive, was adopted on April 2 by the National Assembly.

Its principle is simple: today, the doctors settle in wherever they see. Tomorrow, they will need an installation authorization, issued by the Regional Health Agency. In the under-to-do area, it will be automatic. But in areas where doctors are in excess, it will be delivered only if the installation follows the cessation of activity of a practitioner practicing the same specialty on the territory.

“For dozens of years, we have deployed in our country incentive policies to the installation,” notes Guillaume Garot. “We have multiplied tax, real estate aid, multidisciplinary health homes. “Undeading:” In ten years, between 2013 and 2023, according to the National Council of the Order of Doctors, the best -equipped territories have won new practitioners. The least endowed territories have lost it. »»

“Dangerous and ineffective”

The bill naturally makes unions of liberal doctors jump. “Dangerous and ineffective”, strangles the MG France union, after the vote, by the assembly of the article providing for the regulation of their installation last Wednesday. For the union, the measure “exposes our system to a deterioration in access to patient care throughout the territory. Its only effect will be to prohibit installations in the communes not classified as under-cuts, however far from being overdoted, even though the demand for care increases, that new inhabitants settle there ”. For Guillaume Garot, this constraint would solely concern “13 % of the territory”.

To uncover

The kangaroo of the day

Answer

He admits: regulation “is not the magic solution that will resolve the entire problem of medical desertification overnight. But we consider that it is the essential lever for all other policies, and in particular incentive actions, work ”.

After all, he recalls, this regulation of the installation “exists for all different well being professions”, pharmacists, physiotherapists, nurses, midwives, and recently dentists. But his bill is still far from being definitively adopted.

https://www.lepoint.fr/sante/face-aux-deserts-medicaux-ces-elus-font-le-pari-de-salarier-les-soignants-10-04-2025-2587050_40.php