The issue of access to doctors in areas of ‘medical deserts’ is emerging as a major factor in upcoming local elections in small communes across France.
It comes after the government launched its ‘Un médecin près de chez vous (A doctor near you)’ initiative in September, and several plans to bring more GPs to rural areas, including a new map unveiled in June.
A ‘medical desert’ in France is defined as an area in which patients have access to fewer than 2.5 consultations with a local GP per year on average.
The term can also be used to describe areas in which there are not enough GPs so patient time is very stretched. In this case, even patients who do get an appointment may find they do not have enough time to properly explain their problem, and the GP does not have enough time to offer them a good level of care.
The problem has affected rural and isolated areas of France for years, prompting numerous government efforts designed to improve access to GPs and healthcare facilities – with limited effect.
Now, with local elections set to take place from March 15-22, the issue has once again moved to the forefront of political debates and resident priorities.
‘Health is primary demand’
Health has emerged as the main concern for residents when it comes to what they expect from their local representatives, shows a November 2025 poll by CSA for patient federation France Assos Santé, as reported by Le Monde.
The representative poll of 1,638 people showed the following as areas of main concern highlighted by participants, ranked by percentage:
Some local mayors are also reporting anecdotally that the issue is becoming more of a concern to residents.
“In 2020, the issue was already present, of course, but it is even more so now,” said Christophe Bouillon, an independent left-wing mayor running for re-election in Barentin (Seine-Maritime) and president of the small towns of France group l’Association de Petites Villes de France (towns with fewer than 10,000 residents), to Le Monde.
Gil Avérous, mayor of Châteauroux and president of the towns of France group Villes de France (towns of 10,000-100,000 residents), has seen the same trend. He said: “Health has become the priority issue for all my colleagues.Today, it is the primary demand I hear from my constituents.”
He estimates that 30% of residents in his town do not have regular access to a GP.
“Residents aren’t going to knock on the door of regional health agencies. They’re going to come to us,” he said.
‘Health bigger priority than education’
Health is becoming even more important than local schools and education due to the aging population, added Mr Bouillon.
“Before, mayors were obsessed with schools, to attract young couples,” he said. “That remains partly true, but today, the first question is about doctors. We've gone from ‘Is there a good school?’ to ‘Are there any doctors?’"
Multifaceted solution
He has found that “there is no miracle solution” to the crisis.
Instead, the issue requires a multifaceted approach that goes beyond building GP surgeries, he said. It must also include the setting up of grants for housing for medical interns, support for GPs and their families when setting up, and increased medical and paramedical training for support staff. All of this is intended to attract doctors.
However, “we have to let go of certain images, such as that of the country doctor who settles down with his family in a community to spend his entire career there”, added Mr Avérous. The main priority should be to avoid gaps in coverage, irrespective of whether the GP is located at a hospital, or comes to town a few days a week, he said.
Local mayors say that their role is becoming more important, because “it makes little sense to want to define regional health plans without involving us,” said Mr Bouillon.
However, another mayor, Frédéric Chéreau, in Douai (Nord), has argued that the state should still take responsibility for “ensuring equal access to healthcare”, and not expect local mayors to work miracles.
“We reject a ‘give-and-take’ approach, where state action would be conditional on that of the mayor,” he said.
Village desert
In the Hauts-de-France region, the village of Brunehamel (Aisne), shows how ‘medical desertification’ can happen. In a report by news website BFM, one pharmacist explains how the doctor’s surgery he had built six years ago is empty, after the last GP relocated to be in a larger surgery elsewhere.
Residents can now access telemedicine via video call, but this is not always a satisfactory solution, one woman, Astrid, explained.
“The doctor who was here, he had been following my case for several years, and had my entire medical history,” she said. “He knew everything that had been happening with me. Here [with teleconsultation], I’ve got someone who is just going to renew my prescription.”
Another resident, Jacques, who is diabetic, explained that in case of a medical emergency, his only option now is to be taken to hospital, or visit a doctor 10km away. In hospital, the waiting times can be up to two or three hours, he said.
“The residents of Brunehamel have been forgotten,” he said. “GPs aren’t interested here.”
Now, the local pharmacist is worried about the resultant effects of having up to 500 people without access to a GP, in terms of excess demand at the pharmacy, and deteriorating health overall.
Radical solutions
Some ‘desert’ areas have been successfully implementing radical solutions to the lack of doctors.
For example, in the Bourgogne-Franche-Comté region, the mayor of Nevers (Nièvre) Denis Thuriot has celebrated his town’s introduction of ‘flying doctors’ in 2023, whereby specialists are flown in by chartered planes to the town’s hospital centre. The flight takes 30 minutes, compared to a 2.5-3 hour drive or train ride.
Since the scheme was implemented, there have been 345 return trips.
“We're isolated, in the middle of France, so we have to compensate in other ways,” he said, hailing the scheme as a “great success”. Mr Thuriot has been mayor since 2014, and is running for re-election again.
The town has also set up two teleconsultation booths with nurses, as well as a student campus that is ‘connected’ to the town, and the introduction of ‘discovery weekends’ for interns.
“We are trying to find different, original solutions,” he said. He is also calling for more state-wide, national solutions, to bolster the powers of local mayors.
“When they finish their studies, interns should be offered six or seven areas like ours, where they would have to practise during their first few years,” he said.
Currently, there are no rules in France that require newly qualified doctors to practise in a specific area. Some professions have this system (e.g. nurses, physiotherapists, midwives, and dentists), but doctors’ unions have always protested against the implementation of the initiative for GPs and specialists.
