A solution to unclog general practitioners? Parliament is preparing to definitively adopt a bill on Wednesday to give direct access to certain nurses, physiotherapists or speech therapists. Initiated by Macronist MP Stéphanie Rist, this text aims to facilitate access to care. He obtained a final green light from the Senate on Tuesday, before the vote of the Assembly expected at the end of the afternoon on Wednesday.
Under certain conditions, the French will be able, without going through their treating doctors, to consult nurses in advanced practice as well as physiotherapists and speech therapists. But the initial ambition of the bill, which provoked an outcry from doctors, has been partly reduced. To go to IPAs and physiotherapists, direct access will be limited to those working in structures such as multi-professional health centers, in coordination with doctors.
The scope of the text questions
Contrary to what the deputies wanted, caregivers simply registered in the more flexible framework of the Professional Territorial Health Communities (CPTS), which cover around half of the population, will therefore be excluded from the system. A standoff opposed senators and deputies on this point. The discussions were “bitter and long” in a joint joint committee, according to Stéphanie Rist (Renaissance), before the parliamentarians gave up integrating these nurses and physiotherapists practicing independently into this law.
The deputies however snatched an experiment in six departments including two Overseas, she underlines. And for speech therapists in CPTS, direct access will remain possible. In the Senate, the rapporteur LR Corinne Imbert claimed a “balanced”, “reasonable” approach, making it possible to avoid “tensions between health professionals”. And the Minister of Health François Braun in turn praised the “dialogue” for a “sharing of skills”, rather than “coercive measures”.
The text “will only have a cosmetic effect”, judge for his part Sébastien Guérard, the president of the French Federation of masseurs physiotherapists re-educators (FFMKR), who estimates that only 3% of physiotherapists practice in nursing homes. Direct access to these physiotherapists will be possible for eight sessions, instead of the ten in the text voted on at first reading in the Assembly.
Overall, in the eyes of UFC-Que Choisir, even if “we must not have too many illusions about the immediate impact” of this law for patients, “a dike has been broken in terms of sharing of skills between the doctor” and the other caregivers.