After a decade of unsuccessful efforts to improve access to healthcare, the National Assembly has finally dared to challenge doctors' complete freedom to practice. Last night, MPs adopted, by 155 votes to 85, the flagship measure of a cross-party bill introduced by Guillaume Garot, Socialist Party MP for Mayenne. Despite the government's reluctant approval, this decision marks a radical shift in the way healthcare professionals are distributed across the country.
Towards a territorialized approach to healthcare provision
The project, the result of a collective effort bringing together elected officials from the left, the center, and part of the right, aims to regulate the establishment of doctors in areas where healthcare provision is already deemed sufficient. According to the proposal, in 13% of the territory identified as "saturated," any new doctor, whether general practitioner or specialist, will only be able to set up practice if a colleague practicing the same specialty leaves. Initially limited to high-density areas, the text has been revised to now include all doctors, whether self-employed or salaried, contracted or not, in order to guarantee a comprehensive assessment of access to care. For Guillaume Garot, this is about thinking outside the box, similar to the regulations already successfully applied to other healthcare professions such as pharmacists, physiotherapists, and nurses, and more recently to dental surgeons since the beginning of the year.
A marked disagreement between Parliament and the Government
However, the measure is not unanimous within the executive branch. Health Minister Yannick Neuder, echoing the warnings of medical unions, insisted that "coercion does nothing to solve the shortage of doctors" and, on April 1, opened consultations between professionals, users, and elected officials to explore other territorialized solutions. His request to temporarily withdraw the text, aimed at allowing for a more in-depth debate, was met with boos in the chamber. Guillaume Garot, surprised by this attempt at obstruction, retorted that Parliament's role was precisely to vote based on the general interest, even if regulation was not a miracle solution. For the time being, only the first article of the cross-party bill has been adopted, while further debate and the final vote on the text have been postponed until May 5. This vote should, however, serve as an impetus for the ongoing discussions, particularly in the consultations on Avenue de Ségur, and could well open the way to a profound reorganization of access to care in France.
