INVESTIGATION – The gap between those in power and doctors has widened over the past 4 years. Faced with this anger, Marisol Touraine tries a seduction operation with these white coats who rub shoulders with millions of voters every day. The other presidential contenders are embarking on a recovery business.
The French say the future of the health system should be at the heart of the debates in 2017, according to a recent poll Ipsos (1). With less than a year before the presidential election, the contenders have captured the message. Starting with the power in place. The Minister of Health, Marisol Touraine, has been carrying out a “seduction operation” with doctors for several weeks. A check for 2 billion euros for the hospital, promises to medical interns, a visit by François Hollande to the Congress of emergency physicians, the actions are increasing. But will they be sufficient? Too little, too late, analyzes the right which sets out to reconquer this electoral body.
March 15, 2015, 50,000 practitioners took to the streets against the Health Law. No way, they chant to Marisol Touraine, to accept the generalization of third-party payment. It is even the last straw that broke the camel’s back after several months of heated relations between the minister and the Liberal doctors. The days when medical practices are closed are increasing. And if the city practitioners are exasperated, the hospital workers are on the verge of a nervous breakdown. With savings plans and short-term measures, the government is undermining the morale of the white coats.
Doctors of the left, a rare species
This field of ruins, François Hollande hopes to cultivate it in the coming months. Son and father of a doctor, he knows better than anyone the weight that the doctor’s words represent in the village or in a hospital room. The task is not easy. “For a politician of the left, the hearts of doctors are hard to take,” confirms sociologist Frédéric Pierru. This specialist in the medical profession assures it, “doctors are on the right what teachers are on the left”. And to continue. “It is a conservative and very corporatist social class. Thus, they vote very little on the left and hardly ever at the extremes ”, specifies the researcher from Lille.
In 2012, the candidate who collected the mostvoting intentions with doctors in the first round of the presidential election was therefore Nicolas Sarkozy. He largely led the Liberal vote with 36% of the vote (2). And in the legislative elections that followed, the UMP did even better, by collecting 45% of their voting intentions, against 30% for the PS (3). To these results, Frédéric Pierru brings a nuance. “The lower we are in the medical hierarchy, the more likely we are to vote on the left”.
Political gifts
And politicians know it. At the hospital, a circular recently set at 48 hours per week the maximum working time of emergency physicians, doctors often classified on the left. As they could work up to 60 hours before, the trade unions applauded. Much to the despair of other hospital practitioners.
It must be said that the minister’s gesture looks like a political gift for these “hospital workers who consider themselves to be the proletarians of medicine”, recalls Professor Grimaldi, diabetologist at the Pitié-Salpêtrière Hospital (Paris). Same strategy when Marisol Touraine increases the consultation from 23 to 25 euros for general practitioners. “They are more concerned with the probability of voting on the left than other medical specialties. In fact, there is something about the electoral calculation, ”said the political scientist. But even in her camp, the Minister of Health will find it difficult to convince.
Frédéric Pierru, sociologist / political scientist: ” At the hospital, hospital practitioners are more likely to vote on the left than the Prs of PH universities, the bosses… “
Major voters dreaded from both camps
Often classified on the left, MG France, the main union of general practitioners, refutes the acquaintance. For its president, Claude Leicher, the absence of Marisol Touraine a few days ago at the Union Congress is indisputable proof of this. “General medicine is our only fight,” he annoys. In addition, he no longer hesitates to say that the current five-year term had no ambition for general medicine.
An identical bell resonates in the public hospital where, “Marisol Touraine especially had words”, regrets Professor Grimaldi. But this social Gaullist, as he describes himself, thinks that hospital practitioners will “vote socialist again” in 2017. “These people explain that they will choose the least worst,” he nuances. According to him, “these doctors very attached to the original public hospital service reject right-wing projects, which are too mercantile in their eyes”.
This is not the case with Prof. Philippe Juvin, spokesperson for Europe Les Républicains (LR). The head of Emergency at the Pompidou Hospital (Paris) does not mince his words: “in terms of health, the five-year term is empty. There were a lot of announcement effects at the start, especially with the public hospital service (SPH). But behind, we see that the government has just brushed the hospitals in the direction of the hair, without any action to the key ”, he concludes (see box below).
Prof. Philippe Juvin, Chief of Emergency at the Pompidou Hospital (Paris): ” It was during this five-year term that the hospital’s resources were reduced. There was a double talk. “
The end of a parliamentary “lobby”
Faced with these mandarins who sail so much to starboard, what can Marisol Touraine hope for? LR candidates (Juppé, Sarkozy, Fillon, Lemaire, etc.) are eager to unveil their “Health program”.
However, the 281,087 doctors in 2015 seem to weigh little in the face of 44.6 million potential voters. In fact, all fear the power of influence of these “big voters”. The fear of an unofficial election campaign with patients is persistent. President of MG France for 14 years, Dr Richard Bouton recalls that there are 1 million consultations per day in France. “Even if doctors are not proselytes, politicians have always considered them to be opinion makers,” he adds. Another example of this power of influence is the so-called “lobby” of doctors in Parliament. But their number is declining. TO The national assembly, there are currently 23 doctors (and 2 surgeons), against the double twenty years ago. And in the Senate, the medical troops are even more sparse. With only 13 doctors. In short, more than enough to impress the nearly 1,000 parliamentarians in France.
Dr Richard Bouton, ex-president of MG France: ” Doctors are feared by politicians like all professions that are in contact with the public… “
The 1997 legislative elections
This image of Épinal of the practitioner who guides the votes of his patients has its share of captions. Professor Philippe Juvin relates the most famous. That of the early legislative elections of 1997 lost by Jacques Chirac. The mayor of Garenne-Colombes remembers that “at the time, it was said that it was the reform of Social Security which had caused the loss of the right”. “But nothing proves that this is to be attributed to the vote of the doctors opposed to the project”, he corrects.
However, with the exception of MG France, practitioners were widely mobilized against the Juppé plan of 1995. Frédéric Pierru even remembers that liberal doctors’ unions had presented candidates to defeat the Chiraquian camp. From there to tilting the ballot in favor of the left? Not sure, political specialists rather agree that it is the fears of many French people for their retirement that have guided the votes.
At the time, the demonstrations bringing together all the professions were, it is true, gigantic. With more than 2 million demonstrators in the street each time, according to the unions. Unheard of since May 68. In short, even if the result of the ballot was undoubtedly multifactorial, the candidate of the PS, Lionel Jospin, emerged as the clear winner. But since then, politicians fear even more to have to back the electoral body of the doctors.
The presidential bet of abstention?
In the end, like other policies, Marisol Touraine wishes to limit damage with this professional body. “It plays, at least, the card of obtaining the neutrality of the doctors”, judges Frédéric Pierru. And for the secretary general of CISS (4) which represents the users, Christian Saout, this bet is possible. “Today’s doctors are not convinced by anything. No more by Bachelot than by Touraine. Whatever the power in place, and whatever the law envisaged, they are always hostile to any reorganization of the health system, ”he says. According to him, “doctors think that, regardless of the candidate, no one will help them in the current budgetary context.” As always, the president of the National Front, Marine Le Pen, is on the lookout. To try to seduce these professionals, she created last month a new association: the “Collective for Health Users”. And the potential is there. Among the 83,000 members claimed by the FN, more than 1,500 are already from the health sector.
We have understood that the government parties no longer make doctors dream. Juppé, Bachelot, and now Marisol Touraine, all these tenants of avenue Duquesne (Paris) were vilified by the white coats. Their abstention from the next presidential election may be François Hollande’s winning bet… To find out more, we will have to follow the next one Summer school of the CSMF in September. In the program unveiled Thursday, the first liberal doctors’ union announces that Marisol Touraine will be there. Faced with a hostile public, she even had to open the event! A sentence in the conditional because these unionists bitterly remember last year when she canceled her visit at the last minute. A few months before the presidential election, we can imagine that Marisol Touraine will avoid a second misstep. It would be unforgivable for the doctors.
(2) “Doctors and the presidential election”, Ifop study for Le Quotidien du Médecin (February 2012)
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