In France, in the National Assembly, a new health law is under discussion. the purpose of the new law is to better address the aging of the population, the increase in chronic diseases and the persistence of inequalities in health. The law aims to dembed the principle of public consultation on the objectives and priorities of the national health strategy. To bring health care closer to the needs of citizens yes rthe representation of users in the governance bodies of national health agencies will become mandatory and user representatives will be created.
One of the most critical points of French healthcare is the lack of doctors. The measures envisaged by the new law provide for new skills for the non-medical health professions to deal with the problem.
Development of hiking trails
Support local medicine across the country with primary care teams and fight the shortage of doctors
To support the initiatives of health professionals, the law provides:
– the establishment of primary care teams (PSCs), organized around primary care general practitioners;
– the creation of territorial communities for occupational health (CPTS), which brings together general practitioners and specialists, medical auxiliaries, operators 
medico-social and social aspects around a territorial health project.
This enhanced coordination between professionals aims to improve, first of all, the health pathway of chronic patients, people in situations of social insecurity, disability and loss of autonomy.
They also aim to better structure local assistance, encouraging, recognizing and evaluating the initiatives of the actors in the field, ultimately adapting the organization of the health system closer to the territories taking into account their specificities. These devices also strengthen the coverage of the territories.
They are in line with the measures set out in the territorial pact 2, the government plan to combat the lack of doctors.
Expand the skills of some health professions
The law creates an advanced practice exercise for paramedical healthcare professionals. regulatory declination will recognize nurses in advanced practice: if he participates in a primary care team coordinated by a doctor, he can for example follow up a patient with a chronic disease, prescribe further checks or adopt prescriptions.
In addition, the law expands the powers of some health professionals to facilitate public access to vaccination: midwives can vaccinate women and newborns, pharmacists can also vaccinate. Occupational doctors, midwives, dentists, massage therapists, physiotherapists and nurses can prescribe nicotine replacement.
Finally, the scope of intervention of several health professions is redefined (physiotherapists, podiatrists, speech therapists and opticians, medical electroradiology manipulators) and new occupations are created (medical physicist and dental assistant).
During the examination of the health law, the National Assembly authorized pharmacists to issue, without a prescription and under certain conditions, medicines subject to compulsory medical prescription for benign conditions, such as acute cystitis or tonsillitis. This proposal was approved despite the mobilization of the opposition, which denounced the opening of a "prescription right" to medicinal products.
Left deputy Jean -Paul Lecoq (Seine-Maritime) stated that the shift of certain tasks from doctors to pharmacists implies the risk of a two-tier, low-cost medicine! “The doctor has the prerogative of diagnosis and medical prescription: he has been trained for this during a decade of long and difficult studies. The pharmacist has the prerogative of prescription analysis, drug delivery and patient support [...] but is not trained to make a diagnosis,” he specified.
"No problem to give the prescription to pharmacists", defended Thomas Mesnier (in the photo above), author of the proposal. “The objective is to allow, within the framework of an exercise coordinated with other health professionals, to supply medicines, according to a protocol established by the High Health Authority, after ad hoc training in these protocols, and an obligation relating to link with the referring doctors and their information”, explained the speaker, once again citing cystitis as an example, “this simple urinary infection that can be treated with antibiotics”.
The embarrassed Health Minister tried to calm things down by reassuring that he was "reaching a consensus" on this issue among pharmacists and doctors. “Work with the actors is still needed. I will work to ensure that what has been […] adopted is well framed, so that everyone feels comfortable with the new arrangement,” said Minister Agnès Buzyn. An argument that has not had much support, several deputies blame her for considering a consultation … having already decided on the law.
The deputy and former cardiologist Jean-Pierre Porta (Loiret, RS) also recalled the risks of such a provision. “Cystitis: it can be anything, including a pathology that hides something serious. The pharmacist knows nothing about it. It's not just about giving the patient the product that can ease the symptoms, but about what it is. “
The vote on this amendment did not appease liberal medical representatives. The CSFM had warned of the risk of a "serious conflict of interest" if several amendments were not canceled in the open session (including this one). “This is a very bad signal sent to general practitioners who are in survival mode. We trust local authorities rather than impose legal measures, criticizes Dr. Luc Duquesnel, President of GPS-CSMF. There are health risks for patients. Take ibuprofen without a prescription: If you don't ask older adults about kidney function, it can get worse”
MG France, who boycotted the last negotiation session in inter-professional coordination mainly because of this initiative, denounces "interference" in the conventional dialogue. “GPS claims that there is no need for this, but to improve the attractiveness of the profession, its president, Dr. Jacques Battistoni told the” Daily “. We will be attentive to what protocols are applicable, because it is an open violation is being opened, the first step towards widening medical inequities”.
Source: Ministère des Slidarités et de la Santé
The consultation promoted by the Minister
Related news:
