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GPs strike in bid for fixed pay

Payment by consultation is damaging care in rural areas, says union

FRENCH GPs staged a recent one-day strike in a bid to change their payment to a fixed monthly rate instead of being paid per consultation.

France’s leading doctors’ union MG France says fixed pay, like the system used in the UK, would make the job more attractive and help stem shrinking numbers, particularly in rural areas.

The stoppage, supported in some areas by 100% of doctors according to MG France, came as unions began pay negotiations with the state health insurance body Cnam.

The union says it wants to shift from a system in which doctors charge patients a fixed fee (currently €23) per consultation, to one where they receive a fixed income based on patient numbers on their books - the way most UK GPs are paid.

They say this would give them more flexibility, for example, to spend longer with certain patients without counting the cost.

It also wants GPs re-categorised as specialists. The union says few newly-qualified doctors are choosing general practice because pay is low compared to other doctors’.

The drop in numbers is strongest in rural areas and the union says there is a danger some remote areas could end up with none at all.

The regions currently with the fewest doctors include Haute and Basse-Normandie and Poitou-Charentes.

Vincent Rebeillé-Borgella, the secretary general of MG France, said recent figures showed GPs in France earned on average €5,567 a month. Specialists earned on average €9,000 a month.

GPs worked 58 hours a week (including time spent on call) and specialist doctors worked 51 hours a week. As a comparison, in Britain, GPs earn the equivalent of around €10,000 a month, working an average 44.4 hours a week.

The French health insurance deficit amounted to €11 billion in 2010, although for the first time this figure is within government targets to rein in spending.

The annual deficit is to be reduced year on year before the government can tackle a debt estimated by some to be

The Ministry of Health is unlikely to look favourably on GPs’ demands. It says recent reforms to persuade patients to see a GP before they can see a specialist, or lose a large part of their health reimbursements have benefited GPs, who receive more patients as a result.

The Ministry of Health said that in the strike around 18% of doctors’ surgeries were closed, while the unions said that in some areas almost 100% of GPs had gone on strike.

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