The National Assembly is examining from Tuesday evening a text, much criticized by doctors, establishing “
direct access
” for patients to certain nurses, who would be authorized to make prescriptions, but also to physiotherapists and speech therapists.
The bill (PPL) of Stéphanie Rist (Renaissance) supposed to fight against “
medical deserts
” arrives in the Social Affairs Committee on Tuesday then in the hemicycle next week.
The MEP, a doctor, writes in her explanatory memorandum that "
the supply of care being insufficient in relation to the needs of the population, it is essential to find solutions in the very short term
".
In the crosshairs of the unions and the Order of Physicians, Article 1 opens "
direct access
" for patients to nurses in advanced practice (IPA), a status created via the Touraine law of 2016 and a decree in 2018 , with a bac+5 diploma, a better salary and a little more autonomy.
Read alsoThe Macron plan satisfies the hospital but disappoints city doctors
Patients could go directly to these paramedics without going upstream through a doctor, even if it would be in the context of a “
coordinated exercise
” with the latter.
APNs would also be authorized to prescribe certain care and medications.
The PPL also covers “
direct access
” to physiotherapists and speech therapists, who are already authorized to prescribe certain medical devices.
Doctors' organizations are alarmed by these prospects, which they believe bypass the prerogatives of liberal practitioners, while they are renegotiating until the end of February the agreement binding them to Health Insurance for the next five years.
"
Discussing this PPL before the Social Affairs Committee in the midst of conventional negotiations is a provocation for us
", wrote in mid-December the CSMF, one of the main organizations of the profession, which "
requests not to invent a two-speed health system
", between the patients who will be able to see a doctor and the others.
On strike, even in the street in recent weeks against "
the abandonment of city medicine
", general practitioners are again ready to mobilize, according to their first union, MG France.
"
If the Rist bill passed, the movement of anger would increase
," warned its president, Agnès Giannotti.