Now GPs want €31 per consultation

Two doctors unions demand higher fees after health minister rejects proposals to raise them from €23 to €25

THE dispute over proposed health reforms in France shows no sign of easing, with two GP unions now demanding an increase in the consultation fee from €23 to €31 after health minister Marisol Touraine again rejected proposals to raise it to €25.

The call came after Monday’s round-table meeting with the minister, at which Ms Touraine reportedly reminded doctors’ unions that they receive more than €23 per consultation.

Taking into account various packages and incentives offered to doctors, including an additional €5 for monitoring the health of patients aged over 80, the minister has calculated that GPs are paid an average of €31.40 per consultation.

Luc Duquesnel, President of UNOF, one of the unions demanding the higher consultation fee, said he wanted to take "the minister at her word”, adding that increasing upfront fees to €31 and removing all the so-called ‘packages’ would ease the financial and administrative burden on health services.

"You have to stop taking doctors for fools," he said.

A 2012 agreement placing limits on doctors’ rights to charge fees higher than the basic state tariffs was “an administrative burden” and that allows the health ministry to "monitor our practices," he said.

The current doctors’ dispute began at Christmas, when they walked out in protest over health reforms. Many have since launched a boycott of the carte vitale.

Their other grievances include:

• The planned roll-out of le tiers payant - a system in which patients have nothing to pay upfront and doctors are refunded by local health bodies and by one of several hundred different top-up mutuelles. Unof-CSMY said the change of payment system, “will cost the State nothing but will mean an unavoidable extra time spent on administration, and will put surgeries at risk due to the inevitable payment delays”.

• A proposal that pharmacists could give vaccines. Mr Duquesnel has previously called this a move towards “low-cost” medicine which was “pulling our profession apart”. Vaccinations should be doctor-prescribed so they can check on any incompatibility with the patient’s conditions and medications, he said.

Photo: Ludovic Lepeltier