The Minister of Health and Prevention, François Braun, came yesterday to meet liberal medicine, gathered in the Summer University of the Confederation of French Medical Unions (CSMF) which was held at the Palais des Congrès in Antibes Juan-les -Pins. Maintenance.
You’ve put prevention on your roadmap, announcing several measures, including free morning-after pills for all. However, prevention is not limited to this type of targeted action, it is a huge project, involving a large number of actors. Where are you?
The department I lead will be the health prevention orchestra conductor; but it is obvious that we cannot act in this area alone. Other ministries, local authorities, elected officials, associations, etc. play a leading role.
Furthermore, this important concept of “a health” (“a health” in French), which emphasizes the interactions between human and animal health and their various environments, implies that all ministries concerned: housing, transport, ecology, etc. invest in prevention in a coordinated way. It is a global project with great challenges. But also my role is to take concrete, practical decisions with immediate effects, like the measure you mentioned.
Far be it from me to want to nationalize liberal medicine!
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The “flash mission” on emergencies and extraordinary care started at the beginning of the summer is about to end. Does it intend to continue it, knowing that the crisis affecting emergencies persists?
Some professionals want different sizes to be extended and I feel them. I had asked for a systematic evaluation of these measures and their effects, and I await the conclusions of the two reports to be drawn up by the Inspectorate General of Social Affairs (IGAS) in the coming days in order to make a decision.
Regional Health Agencies (ARSs) have been widely criticized for managing the health crisis. Local elected officials and health workers are calling for their removal. Your location?
ARS are essential and the health crisis has shown their central role; they are there to implement health and prevention policies at the local level. The conductor must be as close as possible to the musicians; an orchestra is not directed by video.
Regarding crisis management, it is true that ARS came under severe pressure during the pandemic. Now we must learn all the lessons from this unprecedented crisis and, probably, improve the methods of managing this crisis at the level of the entire Ministry of Health. More generally, I would like to put on the table the question of the management of our health system, its financing, its future in ten, twenty, thirty years, involving the elected representatives, our fellow citizens and health professionals in this reflection.
You have been invited to meet the Confederation of French Medical Unions (CSMF) in Antibes, as part of its summer university on the subject: is this your project?
What I would like to mention first of all is the excellence of our social security system, which allows all French citizens to be treated, regardless of their social situation. In many other countries, getting treatment is very, very expensive, leading to a significant foregoing treatment and even a huge impact on the lives of individuals and their families.
On your question: far be it from me to want to nationalize liberal medicine! However, there are health needs, they must be covered and we must all find solutions to meet them together. Franck Devulder, whom I met immediately after his election as president of the CSMF, told me very clearly that doctors have rights AND duties. And on that, we are totally in phase.
It is necessary to be affected by 4 to 6% where this permanence does not work
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Speaking of tasks: in 2003, Jean-François Mattei, then Minister of Health, made the obligation to stay in the city obsolete. Now it relies solely on volunteers. Could the difficulties in accessing a doctor and the impact on emergency services lead you to restore the duty to care for private doctors, for the benefit of citizens?
What our citizens are asking for is to be able to access a doctor when they need it without having been able to anticipate it, especially in the evenings and on weekends. And this goes, in large part, through the commitment of liberal doctors, as they did this summer. In fact, and according to the latest report of the Council of the Order of Doctors on the permanence of care in 2021, this is expected in 94% or even in 96% of the territory. That’s very good, but you actually have to look at the 4-6% where this permanence doesn’t work and wonder how you can move the lines.
My responsibility, and that of the government as a whole, is to meet the health needs of all French people and to adapt our health system to put an end to situations that are unacceptable today, starting with those of medical deserts. In these territories, and in all the others, we will put on the table, within the National Council for Refoundation (CNR) dedicated to health, four important issues: that of access to general practitioners for all frail people, that of attractiveness of the health professions, that of prevention and finally that of continuity of care.
To discuss regularly with my colleagues in general medicine and with the representatives of medical unions, they all say they are ready to work differently to ensure this continuity of care in all territories from next year. If, together, on a territory, we do not succeed, I will take my responsibilities and do not rule out imposing solutions so that our fellow citizens get answers.
Doesn’t this situation require, more than a revision, a real thorough reform, in particular through a redefinition of the hospital’s missions?
You preach a believer. Everyone must be in his place in our healthcare system: the place where he brings the greatest added value. Today our healthcare system is organized exclusively around supply; we prepare health offers without real regulation and with little attention to needs, convinced for decades that these are covered as soon as we put the offer almost everywhere.
It is necessary to refocus on health needs on a territorial scale and to put the adapted offer in the foreground in a spirit of partnership – as prevailed during Covid – and not in a competitive spirit. This is really the goal of the policy I want to conduct; and this policy must be extended to a territory, knowing that the problems in Nice are certainly not the same as in the east of the Moselle! It is on this condition that we can move forward and rebuild our health system.
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