Medical deserts: the small towns require the intervention of the State

The Association of small towns of France (VFPA) published Tuesday, February 9, a report pointing embrittlement of providing care in small towns. The Association, which represents the common 2 500 25 000 residents, alarmed by the resurgence of "medical deserts" in these territories.

It makes several recommendations for the great meeting "Health Conference ', held at the initiative of Marisol Touraine from Thursday, February 11.

 The difficult renewal of GPs

 
The problem is not new. In a Senate report conducted in 2012 and entitled "Medical Deserts, really act," the intensification of medical deserts, defined as "under-medicalised areas where patients have difficulty accessing care in terms of proximity and adequate time "was already pointed.

More recently, the National Council of the Medical Association (Cnom) listed 192 medical deserts where live nearly 2.5 million people.

But the survey published by the VFPA stresses that the phenomenon was thought mainly affect rural areas, now covers also the small towns on the outskirts of town.

The challenges are manifold. First, aging doctors, who often do not find their young colleagues to take on. "In some living areas, 100% of GPs are over 55 years," says Erwann Calvez, project manager at the VFPA. Seventy percent of surveyed mayors and doctors say their retiring municipality have struggled to find a replacement.

The situation is even more critical for professionals who do not practice extra billing. By sticking to the geographical criterion, the Senate report considered, for instance, that about 9 million people live in a desert for medical gynecology.

The report denounces a "negative spiral" in small towns, also faced with the closure of hospital services in their city or nearby. Emergency services and maternity are the most affected and the phenomenon is likely to increase in a context of recovery of public accounts.

Priority areas recommended health

 
In response, the VFPA request the installation of physicians in the territory is regulated by law or by the agreement governing the relationship of doctors with Medicare, taking into account the living areas.

"Renegotiation of the agreement Medicare in 2016 may give a new framework," hopes Mr. Calvez, citing the example of liberal nurses practicing in areas called "surdotées" and can not therefore , a claim of agreements Medicare in case of cessation of activity of a colleague.

The VFPA also advocates the creation of "priority areas of health," which would benefit from incentives for the installation of doctors and support the financing of certain activities or the establishment of certain structures, such as centers health.

The Association also proposes the establishment of a conventionnement, led by the Regional Health Agency and the territorial health boards, which allow doctors who want to retire can continue to exercise third time. One way to encourage the renewal of practitioners.