Why GPs in France are threatening to strike in December

Thousands of independent GPs (médecins généralistes libéraux) across France are threatening to strike and close their surgeries on December 1 and 2 in protest at the lack of doctors, increased time pressures and what they are calling a general “lack of resources”.

A statement from the union Confédération des syndicats médicaux français (CSMF) reads: “No health without doctors, no doctors without resources.”

Dr Luc Duquesnel, president of the CSMF GP section, and a GP in Mayenne with more than 30 years of experience, told Capital that the “movement will be massive”, although no official figures have been released on the number of GPs expecting to join the strike. It is thought that in some areas, all GP practices could be closed on the strike days.

If your GP surgery is affected and in the case of an emergency, you are advised to call 15, where you will be directed towards alternatives.

The idea for the strike developed from the creation of a Facebook group called Médecins pour demain, which now has nearly 14,000 members.

GP demands

The GPs’ demands include:

• A €30 payment per consultation, rather than the €25 paid today

• A €60 payment for older people, or those who are suffering from a long-term condition

• More doctors and resources to avoid time pressures and too many patients per doctor

• Greater acknowledgement of the rising number of chronic illnesses due to the ageing population, which take longer to assess and treat

• Combined retirement and employment benefits, and an old-age allowance (supplémentaire vieillesse (ASV) calculated according to inflation

Dr Duquesnel said: “When I first started in 1988, I was doing six appointments per hour. Now, I run late even when I have three consultations per hour.”

He said that his ability to see patients had halved because of the complexity in patient cases, including those who suffer from asthma, diabetes, or other chronic illnesses “often at the same time”, he said.

Doctors and nurses

Doctors are also protesting against proposed government plans to transfer certain responsibilities to other health professionals.

For example, the social security finance bill (projet de loi de financement de la Sécurité sociale (PLFSS)) for 2023, is planning to give senior nurses (infirmiers en pratique avancée (IPA)) the ability to offer prescriptions for ongoing issues.

Doctors say they fear that this will cause a decline in healthcare quality.

Dr Duquesnel is instead calling for better coordination of doctors and nurses, and used his own medical surgery as an example.

He said: “We no longer have a doctor just working alone. We have a salaried IPA who takes care of 600 patients and that's great. I have 170 chronically ill-but-stable patients under her care, but we chat five to six times a day on their cases.”

The GP also sees these patients when they make appointments about issues that are not connected to their chronic conditions. For example, even if an asthmatic who usually receives care from the IPA makes an appointment about gastroenteritis, the GP (not the IPA) will see them.

The doctor is also sceptical about the government’s plans to offer “direct access” to speech therapists and physiotherapists. He called the proposal a “grandstanding solution” and said that waiting times for an appointment with these professionals were already too long.

He said: “In my area, you have to wait six months to get an appointment with a speech therapist. We have almost no physiotherapists.” This is true even for people who have suffered serious conditions such as a stroke, he said.

It comes as some GPs have also been taking part in medical student strikes against the proposed fourth year of placements during medical school training.

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