The doctors will not have succeeded in bending the Senate. The upper house adopted on Tuesday in first reading a text for direct access to certain nurses, physiotherapists and speech therapists, after having integrated the principle of a controversial penalization of medical appointments not honored. The vote was acquired by 199 votes for and 14 against.
At the call of the unions, thousands of doctors had nevertheless demonstrated a little earlier in Paris to try to block this reform which facilitates access to other caregivers. A procession of between 4,500 participants, according to the police headquarters, and more than 10,000, according to the organizers. The doctors’ unions were delighted to do better than their January 5 parade, which brought together between 2,300 and 4,000 practitioners.
The executive does not want to “set aside” the generalist
In rare unanimity, these unions accuse the text of “endangering the health” of the population “by circumventing the coordination function of the attending physician”. These arguments are however defeated by the government. “The objective is in no way to put aside the general practitioner”, affirmed the Minister Delegate for Health Professions, Agnès Firmin Le Bodo, who came to defend the text before the senators.
The bill is also supported by nurses, including 50 unions and associations on Tuesday denounced “systematic opposition by doctors to any development in (other) health professions”. The Association of Mayors of France also said it was “favorable” to the text, as did the federation of patient associations, France Assos Santé.
Deputies and senators will now try to agree on a common text in a joint committee. In the long-term fight against medical deserts, the bill by Renaissance MP Stéphanie Rist aims in particular to broaden the missions of nurses in advanced practice (IPA) who would now be authorized to make certain prescriptions for care and medication.
Towards compensation for appointments not honored
Patients could go to these caregivers without going through a doctor, but always as part of a “coordinated exercise” with the latter. The bill also allows “direct access” to physiotherapists and speech therapists working in health establishments.
The senators gave the green light to these provisions, but by framing them, so as to “guarantee the safety of care” and “maintain the central role of the doctor in the coordination and follow-up of patients”. In addition, they introduced a new article paving the way for compensation for missed appointments with healthcare professionals, and financial penalties for dishonest patients. Finally, with the consent of the government, the Senate removed the possibility for the physiotherapist to prescribe an adapted physical activity (APA).