Sweeping health reforms revealed

Ending GP fees, targeting binge drinking and giving children their own GPs in move to cut care costs

15 October 2014

PATIENTS will no longer have to pay GPs directly in part of a package of around 50 healthcare reforms that also introduce heavy fines or jail for promoting binge drinking, a dedicated GP for under-16s to combat obesity and learning disorders plus measures to reduce smoking.

Health Minister Marisol Touraine said she was making “structural” and “durable” reforms to ease access to healthcare and protect young people.

Saying “it is not acceptable that people refuse to look after their health for financial reasons” the introduction of “tiers payant” in 2017 was a “simple” and “just” measure to allow patients to see doctors and get quicker treatment to cut costs.

The system, which is already used by people with a “carte vitale” in pharmacies, will be opened to patients on the Aide à la Complémentaire Santé benefit from next year and across the board in 2017.

It means the doctor is paid the €23 fee directly by the Assurance Maladie improving efficiency and will allow better monitoring of GPs charging higher fees.

GPs say this will make patients less responsible and have voted 95% against the move but a poll showed it was welcomed by 66% of people.

Binge drinking by adolescents is targeted directly with anyone encouraging heavy drinking being liable to a €15,000 fine and a year’s jail. It will also ban the sale of T-shirts and other products promoting drunkenness to under-18s.

Under-16s will get their own GP (médecin traitant) who will follow them through their early lives, to better control obesity, learning disorders and possible addictive behaviour. Leading GP union MG-France has welcomed this move. At present the system is just for older teens and adults.

Although measures to reduce smoking were not directly mentioned in the proposals, they will be part of amendments that will be inserted during parliamentary debate.

They include the introduction of neutral logo-free cigarette packets, the banning of smoking in cars transporting under-12s and the banning of e-cigarettes in public areas.

Patients will also get their own digital medical records in a move that dates back 10 years but has been widely ignored by practitioners. The dossier médical personnel will be controlled by the Assurance Maladie and used to avoid duplicating tests and procedures.

A previous health minister said it could save “billions of euros”.

An experiment with drug shooting galleries, where users can inject with clean needles with supervision from health workers, will be run for six years to check if it can help cut drug use and prevent infections.

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