Gabriel Attal proposes a sanction of 5 euros against patients who do not honor their appointments

In his general policy speech, the Prime Minister, Gabriel Attal, promised on January 30 to fight against the difficulties of access to healthcare for the French. In an interview given to several titles from the regional press, Saturday April 6, the head of government gave details of the measures he intends to put in place to try to respond to the crisis in the city healthcare system, with the desire to recover 15 to 20 million medical slots. Mr. Attal therefore wants certain medical appointments not honored to be punished in the future with a financial penalty of 5 euros, payable by the offending patient – ​​a sanction known as the “rabbit tax”.

“We can’t afford it anymore” these unfulfilled appointments, declares the Prime Minister, who wants the implementation of a “accountability mechanism” via a legal text. According to the Order of Physicians and certain unions such as the UFML, the cost of these “rabbits” is estimated at 27 million consultations lost each year.

The government wants that from 1^er January 2025, on online appointment platforms such as Doctolib, a financial penalty of 5 euros penalizes the patient who does not show up and who does not notify less than twenty-four hours in advance. This financial penalty will be at the hand but also for the benefit of the doctor, who will have the mission of reporting it. In addition, some 4,000 additional medical assistants will be put in place, who will take care of a certain number of formalities.

The Prime Minister also wants to reconquer certain niches during which the lack of general practitioners becomes even more glaring. This is the case on weekends and evenings from 6 p.m. to midnight. “5% of territories are not covered”underlines Matignon. “These are times when we forego care or we go to the emergency room, which [y] causes an embolism. He says he wants “put it all together” thanks to financial incentives, but warns that if doctors do not play the game the government will consider more restrictive methods.

In thirteen test departments – one per major region – patients will be able to go to the physiotherapist without a prescription, just as it will be possible to consult a specialist doctor again without a prescription.

Failure of the system My psychological support

Other measures, some already known, were described by Gabriel Attal during this interview. The number of places in the second year of medicine will increase from 10,000 in 2023 to 12,000 in 2025, then 16,000 in 2027. But the replacement of the old numerus clausus with very limited places by this “numerus apertus” (from the Latin, “open number”) will only begin to produce its effects from 2035, the time to train these professionals.

Gabriel Attal also intends to experiment in certain departments, from January 2025, with direct access to specialists without going through a general practitioner, contrary to the current rule. The Prime Minister also says “concerned by the deterioration in the state of mental health of our young people and by suicidal thoughts which are increasing very sharply among high school students”. He confirms his wish to review the My Psychological Support system, which, according to him, does not work.

This system, deployed in spring 2022, provides access to eight sessions with the psychologist reimbursed by Health Insurance and complementary health insurance, on the recommendation of the doctor. These sessions, open to people suffering from mental disorders “mild to moderate”did not give “the expected results”said Mr. Attal during his general policy speech.

Freshly welcomed announcements

These announcements caused the unions to react. They “arrive point-blank, at the very moment when we are negotiating with Health Insurance, precisely to improve access to care”, deplores the president of the first union of general practitioners, MG France, Agnès Giannotti. It comes “deconstruct” our work, she affirms, believing that direct access to specialists, “won’t solve anything” since these professionals are lacking everywhere.

Some ads “are amazing, we are very angry”critic Franck Devulder, president of the CSMF union, “shocked” by the idea “direct access to psychologists for 50 euros”while the authorities only propose “30 euros” for basic consultation of general practitioners. He deplores various delegations of tasks to professionals “whose job it is not”. “Under the pretext of simplification, we short-circuit everything, excluding doctors” And “disregarding quality”, he judged. However, he was delighted “that finally”a government suggests that practitioners take a “rabbit tax”.