VIDEO – With a budget of € 3.4 billion by 2022, the implementation plan for the end of the numerus clausus, the creation of 4,000 places for medical assistants, the sending of 400 doctors in medical deserts and the establishment of territorial health communities open to 20 hours.
Expected in June and postponed in September, the reform of the health system is promised by the government currently unveiled by Emmanuel Macron. "I want the health system to be one of the pillars of our welfare state in the 21st century century … We have to restructure it for the next fifty years," he said in the preamble, citing the "financial tensions" "and the" cost of aging ".
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The head of state then stated that "the health system does not suffer from underfunding, but from an organizational problem". "The hospital is at the end of what it can do," said Emmanuel Macron, citing the congestion of emergency services. "Our health system must be better prevented (…) and built around the patient," said the head of state. The plan of the executive branch called "My Health 2022", with about fifty measures, will go through a law in early 2019. Here are the main announcements made by Emmanuel Macron to remember:
• 3.4 billion euros invested in 2022
The plan "My Health 2022" will have a budget of 3.4 billion euros by 2022, including "almost 1 billion for hospital investments", the Ministry of Health said in a statement. AFP, just before the intervention of Emmanuel Macron.
In detail, € 1.6 billion will be spent on "the structuring of care in the areas", 920 million on hospital investments, 500 million on the "digital transformation" and 420 million on "the evolution of transactions and training," according to this source .
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• The abolition of the numerus clausus from 2020
As expected, the head of state confirmed the abolition of the numerus clausus in the autumn of 2020. From that date, the game will disappear at the end of the first medicine year. "We need to be sure that we train well and have enough doctors," said Emmanuel Macron. Before we continue: "Today it is a mess that affects 25,000 students every year." Emmanuel Macron denounced an absurd system because "our fellow citizens simultaneously face difficulties in accessing care".
• 4,000 medical assistants to help doctors
To free up free care for doctors, the executive will finance 4,000 new places for medical assistants by 2019, especially in low-density areas. "If the need arises, we will finance as much as we need," said Emmanuel Macron. These assistants are "funded by all doctors" who will submit the request as soon as they exercise in a grouped way and commit themselves to objectives and results ", in particular the" care of new patients "," shorter waiting times "and the organization of walk-in consultations.
This measure is intended for all generalists and specialists, but only if they regroup. "With such an organization, doctors can save up to 15% of medical time," said the president of the Republic. In Anglo-Saxon countries, studies show that medical assistants can save 25% to 30% of medical time. The government also wants to save doctors time by making online appointments.
• 400 doctors for medical deserts
Emmanuel Macron also confirmed that the executive would send 400 GPs and hospital staff to the priority areas by 2019. "As of 2019, 400 paid physician positions will be created in the medical deserts to give patients access to a general consultation," he explained. "We need to pay special attention to the poor areas and medical deserts," said the head of state, recalling that the number of retired doctors has doubled in the last 10 years. The president no longer wants an "isolated" city doctor on the horizon of January 2022 & # 39;
• Encourage the creation of territorial communities of health
The president of the republic also announced the formation of territorial health communities to "have a real collaboration between professionals" and "to ensure that the isolated exercise becomes marginal". "We will have to ensure that these communities cover all areas by 1 July 2021," the president said. "We're doing everything we can to help the communities that will be created in the next year and a half," he added.
In addition, to combat the saturation of emergency situations, permanent care will be arranged up to 20 hours without prior costs. However, the President of the Republic has hoped that these offices will last up to 22 hours.
• Gradually lower the price determination to activity
The financing of hospitals will be revised, in line with Emmanuel Macron's campaign promise to reduce the share of activity-based pricing (T2A), the disadvantages of which lead to an increase in the number of operations in hospitals. This funding method, which was established in 2004 as part of the "Hospital 2007" plan, reimburses institutions according to the medical activity they carry out and constitutes about 63% of the resources of public hospitals.
The government hopes that T2A will now be no more than "50% of the financing methods" and that the part of the financing for quality and the care route has a prominent place. Packages "diabetic patient" and "patient chronic renal failure" will be implemented in 2019 for an extension to other pathologies from 2020. "The bonus for quality" for hospitals will be increased by 60 million euros per year to 300 million euros from next year.
• Reorienting local hospitals
Hospitals are now divided into three levels: the hospitals in charge of local health care (general medicine, geriatrics, aftercare), those who provide specialized care such as surgery or maternity services and ultra-specialized care in hospitals. state-of-the-art technical trays. "Every hospital should concentrate on the care it is most relevant to," Emmanuel Macron said, without excluding the closure of certain services and their reuse for other uses. "Some activities will have to be closed in some places when some underused technical platforms become dangerous," he added.