Independent doctors in France have called for more strike action in February, and a protest in front of the Senate, in an open letter to Prime Minister Elisabeth Borne.
The main unions for independent (eg. as opposed to hospital) doctors, including GPs and specialists, have called for surgeries to close on Tuesday February 14 as they demand extra funding for their profession following the reported breakdown of talks with the Assurance Maladie state health reimbursements body.
It comes after they held strike days in early and late December which, at the time, Health Minster François Braun called "particularly unwelcome in this period of extreme difficulty in the health system". Prime Minister Elisabeth Born has also criticised the movement, saying it is "not responsible".
The doctors' letter stated that along with the planned closures on February 14, other action (on unspecified dates) could include strikes in out-of-hours services, services d'accès aux soins (SAS) medical phone helplines, and in administrative paperwork. 'Targeted' closures of surgeries including stoppages of evening and Saturday morning services were also possible, the letter said
The doctors' concerns and demands include:
Fears over obligatory out-of-hours coverage
GPs fear that out-of-hours service in the evenings, weekends, and on bank holidays, could become mandatory.
They say many are currently providing this on a voluntary basis under local cooperation agreements among professionals (called permanence des soins ambulatoires, PDSA). However, they say that if out-of-hours care becomes a mandatory part of the job, this will have an impact on the attractiveness of the profession and so cause more difficulty for people accessing care, not less.
This obligation was scrapped in the 2000s but more recently la Fédération hospitalière has suggested that it could be brought back to avoid A&E departments from becoming overwhelmed.
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Unions are calling for “an extra packet of funding” for the profession to avoid a “failure of negotiations” currently ongoing with the Assurance maladie.
This extra budget would, doctors said, enable them to reach the objectives set by the Health Ministry.
They said: “It is imperative to give doctors resources equal to the challenges.”
At the end of December, GPs already called for the consultation fee per appointment to be doubled from €25 to €50 to make the profession more attractive to new workers.
For patients within the French healthcare system, 70% of the consultation fee is normally reimbursed, with the remainder often covered by a mutuelle (top-up insurance).
Doctors are also calling for better working conditions and more help with administrative tasks.
Read also: Explainer: the CSS, France’s free or low cost top-up health insurance
Count Saturday morning as out-of-hours
Doctors are calling for Saturday mornings to be seen as out-of-hours time, similar to Sundays, so that they can still “take two days off per week, like everyone else”, said the GPs' union MG France.
If this was the case, such work would be better paid and would not be seen as a standard part of the working week.
However, Health Minister François Braun has appeared reluctant to agree to this so far, saying that he is “not sure if it is the best solution”.
Rejection of a bill suggesting ‘direct access’ to nurses
GPs say they are concerned about a proposed law that would give some patients ‘direct access’ to some nurses (ie. without their services having to be prescribed by a GP for them to be reimbursed).
They are also against the idea of giving direct access to physical therapists and speech therapists.
The law is being put forward by MP Stéphanie Rist in a bid to improve access to care in so-called “medical deserts”.
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